Dr. John Day, Cardiologist

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How to Eat Your Favorite Foods and Lose Weight

Can you really eat your favorite foods and still lose weight?

Maybe it’s the meatloaf that your grandmother used to make. Maybe it’s the apple pie á la mode you shared with your spouse on your first date.  Regardless of what it might be, in this article I’ll show you how you can eat your favorite foods and lose weight.

We All Have Favorite Foods

We’ve all had favorite foods. And sometimes, it’s true, those things aren’t the healthiest of choices.

But the psychological impact of these foods cannot be ignored or dismissed. And when you deprive yourself of these foods, the impact feels greater than it actually is — which means the counteractions you’ll take as a result are likely to be greater, too.

Sally’s Experience

Let’s say, for instance, your favorite food of choice is the same as it is for Sally, a patient who has been working with me for the past year. Her comfort food is a warm, gooey, chocolate chip cookie and so-cold-it-hurts glass of milk.

Normally, Sally went to the grocery store with a shopping list and a full stomach.  This way her willpower muscle was not fatigued and the chocolate chips stayed out of the shopping cart.  One recent instance, though, was different.  It was her daughter’s birthday party and she wanted chocolate chip cookies for the party.

At first, Sally didn’t think about it.  The chocolate chips and other ingredients went into the cart without much thought.  However, later in the day when she got hungry she remembered the grocery store purchase.

“All day long today, for some reason, I’d been thinking about having a cookie,” she wrote to me in an email. “I thought about going home, making the cookies, and sharing a few with my family before the birthday party, but I kept battling back that thought.”

That night, after Sally’s three children went to bed, something completely predictable happened. She went ahead and made the cookies, then ate them all before she went to bed.

“Ugh!” she wrote. “I felt like a total failure. Worst of all, the house smelled like cookies, and my daughter woke up and came down to the kitchen as I was polishing off the last one. It was humiliating.”

Tip: Eat Your Favorite Foods

When it comes to the way we eat, perfection simply isn’t possible. In fact, studies even show that your food choices don’t have to be perfect to be healthy.  The recommendation to eat your favorite foods doesn’t mean, of course, that you shouldn’t strive to get better and better about the way you eat.

Time and again, my patients have demonstrated that people who take small but consistent steps toward big health goals are almost always more effective in their pursuits than people who try to do everything at once. What it does mean, though, is that we should acknowledge that our connection to food is far deeper than what’s on the nutrition label.

3 Ways to Eat Your Favorite Foods

When it comes to favorite foods, I ask my patients to do three things.

1. Be mindful about when you eat your favorite foods.

2. Discover new favorite foods.

3. Upgrade old favorite foods.

This takes time. We simply cannot do this overnight. It took a long time to develop the psychological connections that make these foods meaningful to us, and it will take a long time to untangle those connections and build new ones.

Identify Your Favorite Foods

So, first things first: You need to know what these favorite foods are — and that can start by building a simple list of the sorts of foods that you understand aren’t particularly healthy but you reckon might be harder to give up than other things. For Sally (and me too, by the way) that list would have included chocolate chip cookies.

After that, it’s time to find some new comfort foods — and that means it’s time to do some epicurean exploration. Sift through cookbooks. Consult friends and family members. Spend plenty of time perusing social media sites dedicated to healthy recipes.

When you find something you really love and find yourself craving, cross something else off the list.  For Sally it was “superfood salad” with broccoli, edamame beans, avocados, quinoa, spinach, pomegranate seeds, pumpkin seeds and a citrus-olive oil dressing.

The Chocolate Chip Cookie Upgrade

Sally has been engaging in this exercise for more than a year, and she still hasn’t been able to cross chocolate chip cookies off the list. That’s OK, too, because at this point more than 95 percent of the foods on her evolving comfort list are really quite healthy.

And the cookies she makes for her friends and family on a regular basis are getting healthier, too. That’s because she now makes them with blended oats, almond flour, coconut oil and dark chocolate instead of bleached white flour, partially hydrogenated vegetable oil and sugar-packed milk chocolate.

The Mashed Potatoes and Mac and Cheese Upgrade

Two other great examples of relatively unhealthy foods that can easily be turned into something much better for you are mashed potatoes and mac and cheese. By simply substituting in some blended cauliflower to the potatoes or the cheese sauce, you can turn this comfort food into a powerful weight-loss tool — one backed by a Harvard University study that shows that no vegetable comes anywhere close to cauliflower when it comes to losing weight.

The key point to remember is that the ingredients of any favorite food or favorite recipe can be upgraded to make the food comforting and nourishing.

How do you enjoy your favorite foods?  Please leave your comments and questions below.  To make sure you never miss a thing, now is the time to sign up for my free weekly newsletter or podcast.

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5 Proven Secrets to Younger Looking Skin

Studies show that you can have 10 years younger looking skin.  While we all want healthy and younger looking skin, do you really have to use all of the lotions and potions promoted in advertisements?

In this article, I share the five proven secrets to younger looking skin.

1. Daily Skin Care

Studies show that proper skin care can make you look two years younger.  Proper skin care doesn’t mean scrubbing your face until it is squeaky clean.  It also doesn’t mean lots of expensive skin care products.

According to my dermatology colleagues, for most people, a gentle face clean before bed may be enough.  You don’t need to scrub hard or use harsh soaps.  This goal of this gentle face cleaning before bed is to remove dirt, bacteria, oil, pollutants, and makeup.

A daily moisturizer can also help your skin to look young.  Moisturizers protect your skin from weather and from drying up.

2. Get the Healthy Vegetable and Fruit Tan

Most of my patients have no idea they can get a healthy looking skin tan just from eating more vegetables and fruits.  This is because the carotenoids from vegetables and fruits are absorbed into the skin.  Indeed, medical studies show that the carotenoids from vegetables and fruits not only give you a nice looking skin tan but make your skin appear younger and more attractive as well.

How many servings of vegetables and fruits do you need to get this healthy skin tan?  According to studies, the more you eat the better your tan.  For best results, focus on the vegetables and fruits highest in the carotenoids like carrots, green leafy vegetables, sweet potatoes, or tomatoes.

Interestingly, this vegetable and fruit skin tan doesn’t give you any lines.  It is a nice tan even to those areas that never see the light of the sun.

3. Avoid Sunburns, Sunbathing, and Tanning Salons

The two fastest ways to age your skin, get wrinkles, and appear old are to get excessive UV light and smoke.  Indeed, studies show that people who get excessive UV light from the sun or tanning salons appear about three years older than their actual age.  Skin wrinkles the most in sun exposed areas, like your face.

Even just using a tanning bed once a year has been associated with looking two years older than you really are according to studies.  Likewise, if you ever sunbathe or let your skin turn pink or red from the sun you also appear two to three years older.

For those of you who follow my TV news segments, blog, or podcast, you know that I am a big fan of being active outside.  The key is to do it in a sun smart way.

For most people, 15 minutes of direct sun is all you need.  If it is not the summer, or if it is earlier or later in the day, you may need more than 15 minutes to get the vitamin D your body needs.  The most important thing to remember is to never let your skin turn red or pink from the sun.

4. Stop Smoking

Right up there with excessive UV light exposure, smoking is the fastest way to make yourself look old.  I’m sure everyone has seen that 60 year old smoker who really looks like they may be in their 80s.

Smoking is toxic to the skin.  It causes the skin to lose its elasticity.  It also starves the skin of oxygen and causes the loss of collagen.  All of these changes makes the skin look old.

The skin damage from smoking is dose dependent.  In other words, the more people smoke the older their skin looks.  The key is to stop smoking as soon as possible so that the skin can start to repair itself before these changes become permanent.

5. Get a Daily Workout

Not only do people who exercise have less wrinkles and younger looking skin, but exercise, according to medical studies, reverses skin aging.  Indeed, one study showed that regular exercise could make the skin of a 65 year old appear like that of someone in their 20s to 40s.

Based on studies, any exercise helps.  The best exercise is the one you will do.  To maximize your chances of developing a daily exercise habit, the best exercise should be fun, convenient, and with someone else.

Take Home Message

While skin naturally ages, you can reverse or at least dramatically slow down this process.  Studies show that if you can faithfully follow these five tips, you will likely have less wrinkles and appear about 10 years younger than your actual age.

What do you do to enjoy healthy and younger looking skin?  Please leave your comments and questions below.  I will do my best to respond to every question.

Also, if you like what you have read, please be sure to sign up for my free weekly newsletter.  If finding the time to read is a challenge for you, try subscribing to my podcast so that you can listen while working out or driving.

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Should I Avoid Carbs?

Should I avoid carbs is something I am asked all the time.  Indeed, the low-carb craze today differs little from the fat-free craze a generation ago and, for that matter, the low-protein craze a hundred years ago.

Diets are like fads, they go in and out of style because they aren’t based on science. That’s why I hate the word “diet.” It turns something that couldn’t be more natural, food, into something harsh and rigid.

Not All Carbs Are Created Equal

Here’s the thing: Not all carbs are created equal. While it is true that carbs from sugar and processed foods cause weight gain — and lots of it — carbs from vegetables, legumes and fruit have the exact opposite effect.

In general, what determines whether a carb causes weight gain or weight loss is determined by how fast it is converted to sugar in our bodies. The flour in even a slice of whole wheat bread, for example, is converted to sugar faster than a Snickers bar. In contrast, broccoli carbs — yes, there are carbs in broccoli — take hours to digest. Those are good carbs.

The Science on Weight Gain and Carbs

In a study that looked at more than 130,000 people over nearly a quarter century of food consumption, researchers from Harvard and Tufts University found that the more carbs you get from vegetables, fruits and legumes the less you will weigh. Meanwhile, another Harvard study — this one including 120,000 people — showed that the more carbs you get from sugars, sweets and processed foods the more you will pack on the pounds.

Want more proof?  The longest lived people in the world, the people of Okinawa, Japan, who also happen to probably be the healthiest and leanest people as well, eat mostly carbs – the good ones.

Avoiding all carbohydrates because things like processed bread can contribute to weight gain is like avoiding all liquids because soda pop is a scourge to public health. In my experience, the number one factor of weight gain or weight loss is the type of carb you pick.

Tip: Get to know your carbs.

There’s a tremendous difference between filling carbs and hunger carbs. And once you understand the difference, it makes it a lot easier to decide which is which.

The Filling Carbs

Filling carbohydrates are a part of “real food,” which is how I think about food that isn’t highly processed (or processed at all, for that matter.) Sweet potatoes have good carbs. So do vegetables, fruits, beans, lentils, and unprocessed grains. These carbs fill you up and keep you satiated for a long time.

The Hunger Carbs

Hunger carbohydrates are a very big part of “fake food,” which includes just about anything that doesn’t look like the ingredients from which it is made. This includes processed breakfast cereals, potato chips and most breads — especially those that are made from pulverized, very fine flour.

Take Home Message on Carbs

The best way to get to know your carbs is to memorize a very simple mantra from food guru Michael Pollan: “If it came from a plant, eat it. If it was made in a plant, don’t.”

Do you limit carbs?  If so, which carbs?

Please leave your comments and questions below and I’ll do my best to quickly answer every question.  If you liked this article, please sign up for my free weekly newsletter.  If you would rather listen to these topics, please subscribe to my podcast.

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Why is my willpower so weak?

Why is my willpower so weak but yet everyone knows you can do anything you set your mind to.

I’ll bet that’s what people have been telling you all your life. I’ll bet it’s something you’ve told yourself, too. And you know what? It’s simply not true.

What is willpower?

Willpower isn’t something you can simply conjure up when you need it. Studies have repeatedly shown that the ability to control one’s impulses, or to sustain a difficult task over time, works like a muscle. If fact, researchers have demonstrated that using our willpower actually zaps us of physical strength, just like using a muscle.

Secrets of People Who Enjoy Great Health

Surprisingly, I have found that my patients who have been the most successful at transforming their lives haven’t relied on willpower at all. Rather, they have engineered their lives so that for most of the day willpower isn’t needed at all.

For example, if your home is free of junk food then you never need your willpower muscle at home to eat right.  Likewise, studies show that just wearing a pedometer boosts your exercise by 27% with absolutely no willpower required.

When willpower is needed, like when your coworker brings in donuts or leftover Halloween candy, the willpower muscle is strong and ready to spring into action.

The Dangers of Exhausting Your Willpower Muscle

How is this ruining your life? When you rely on willpower to help you achieve one specific health goal you’re robbing your body of the strength it needs for all sorts of other things. So even if you are able to accomplish the thing upon which you’ve focused your willpower (staying away from the pastries when you pick up your morning coffee, for instance,) you’ve made it less likely that you’ll have the strength you need to do something else later on, like using the stairs at work instead of the elevator or focusing on that big work project instead of Facebook.

Tip: Use an Accountability Device

We can’t turn willpower on and off. It’s not innate in any of us. Just like a muscle, it must be exercised to get stronger and needs time to rest and recover. And just as we have many different muscles in our body that do many different things, we have a lot of different kinds of willpower — and need to identify different ways to work out each kind.

We can start with food. Not all food. Not even a type of food, like those high in unhealthy fats or sugars. Just one specific food that you know you probably shouldn’t eat, but do anyway.

Which one? That’s completely up to you, but before you decide, I strongly recommend that you start using a food journal or app to keep track of what you eat over the span of a week or two. Studies show that the mere act of recording what you eat increases your chances of maintaining a healthy weight by up to 500 percent.

This journal or app will also help you better understand what your food choices actually look like. Your food journal or app then becomes your accountability device.  The same thing can be done for exercise or anything else that is a struggle for you.

An accountability device is like putting your willpower muscles on steroids. This accountability device doesn’t even have to be a journal or app but could even be a person like a personal trainer.  Basically it could be anything or anyone that keeps you accountable with yourself.

As long as you use an accountability device, you won’t fatigue your willpower muscle trying to eat right and exercise every day.  Rather, you’ll be able to keep your willpower muscle strong for the other challenges in your life.

How do you keep your willpower muscle strong?  Please leave your thoughts and questions below.

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Why haven’t I lost weight after exercising?

Why haven’t I lost weight after exercising is a question I get all the time from patients.  In fact, the idea that exercise alone causes weight loss is probably the biggest weight loss myth I hear.  In this article, I’ll share the science behind exercise and weight loss.

A Typical Cardiology Clinic Visit

“Now then,” I said, looking down at a recent patient’s chart, which showed she was carrying at least 50 pounds more than even a fuller-bodied healthy person should be, “let’s talk about some ways to get back down to a healthier weight.”

“Oh doctor,” she immediately protested. “My back is in too much pain to exercise!”

I hear this all the time. If it’s not the back then it is a knee.  And it is something I used to believe as well. As soon as I start to talk with my patients about getting back to a healthy weight, they tell me why they can’t exercise.

“That’s fine,” I always say, “because we don’t need to talk about exercise yet. Let’s put first things first.”

Exercise Doesn’t Cause Weight Loss

Truth be told, medical studies show that exercise alone doesn’t cause weight loss. This is the answer to why haven’t I lost weight after exercising?

That’s because, in the overwhelming majority of cases, the more we exercise, the more we eat. The Gatorade, the latte, or the muffin you consume after your workout erases the calories you happened to burn in your gym class.

For most people, weight loss doesn’t come from exercise.  Rather, it comes from food choices. If you really could lose weight by exercising, I suspect you would see a lot of thin people. While studies show that exercise is critically important to maintaining a healthy weight, it really isn’t very good at getting you there.

Tip: Exercise for the right reasons

Exercising to lose weight is like driving your car more to save on gas.  True, your car may become a bit more efficient if you are driving it frequently, however, the more you drive the more gas you need to put in your car. The same is true with us. The more you exercise, the hungrier you get and the more food you need to put in your body.

That doesn’t mean exercise isn’t healthy, of course. It is — particularly when it comes to heart health, but also when it comes to brain, muscle and bone health. But for losing weight? Not so much. And once you know this, it can be exceptionally freeing.

That’s because a lot of people do exercises they don’t particularly enjoy on the notion that they need to be doing those things to lose weight. And because they don’t see weight-loss results, their only reward is frustration.

When you exercise for the right reasons, though, it’s easy to see results. If you exercise for fun — and low and behold you actually have fun — that’s a great result.

If you exercise daily to improve your cardiovascular health, you’re likely to start seeing results in your heart rate, breathing rate and endurance in just a few short weeks. And if you use exercise as an excuse to spend time with family members and friends, you’ll start reaping the benefits right away.

Do you agree with the studies showing that exercise alone causes little to no weight loss?

Please leave your comments and questions below.  As always, I’ll do my best to quickly answer every question.

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4 Best Superfoods for Weight Loss

What are the best superfoods for weight loss?  In this article, I share the four best superfoods for weight loss and disease prevention according to the latest scientific studies.

My Slow Adoption of Superfoods

I didn’t use to eat superfoods.  I guess that deep down I didn’t really believe that these foods had the ability to heal.  I thought superfoods were really just a marketing gimmick to sell grocery store checkout magazines.

However, by the time my mid-40s rolled around, I was overweight, had a long list of medical conditions, and was taking a number of prescription medications.

Clearly, something had to change.  At that time, I definitely needed the best superfoods for weight loss and to reverse medical conditions.

4 Best Superfoods for Weight Loss

After countless hours of research, and many life experiences later, I landed on these four superfoods that I eat regularly to stay healthy and maintain a weight that works for me.

1. Berries

Want to drop your heart attack risk by 34%?  According to a recent Harvard study of 93,600 people, all it takes is three servings of berries each week.

When it comes to vitamin C, and other antioxidants, berries top the list for fruits.  Antioxidants block the day-to-day free radical damage which causes aging, heart disease, and dementia.  To maximize the antioxidants in your produce, studies show that buying organic and as fresh as possible is best

Berries are also very low glycemic.  This means that even though they taste sweet, they don’t spike your blood sugar.  As a low glycemic fruit, it can help to prevent diabetes.

Lastly, when it comes to weight loss, berries are your very best fruit.  They are low in calories and high in fiber.  Indeed, another Harvard study of 133,468 Americans showed that for every daily serving of berries participants averaged during the study, they lost 1.11 pounds.

I am often asked which berries are best.  The best berry is the one you will eat.  So whether it is a blueberry, strawberry, raspberry, etc., enjoy your berries as they are all good for you.  Berries are definitely one of the best superfoods for weight loss.

2. Nuts

It wasn’t long ago that people avoided nuts because of the fat.  Yes, nuts are high in fat, but it is exactly the fat your body needs.  In fact, this fat appears to protect you from a heart attack.

Indeed, based on many studies, nuts decrease your risk of dying from heart disease by 37%.  These studies also show that the more nuts you eat, the lower your risk of heart disease.  Likewise, as I discussed in a previous article, studies show that nuts also prevent autoimmune disease, cancer, high blood pressure, diabetes, and high cholesterol.

But won’t all of this fat cause weight gain?  Not according to a large Harvard study.  In this study, nut eaters, regardless of how many nuts they ate, still lost a pound of fat even though they weren’t even trying to lose weight.

As with berries, it really doesn’t matter which nut you eat.  While there are some differences between nuts, as I described in a popular previous article I wrote on Almonds vs. Walnuts, they are all good for you.

3. Cruciferous Vegetables (Cauliflower/Broccoli/Kale)

Nutritionally, you can’t beat the cruciferous family of vegetables.  This family includes cauliflower, broccoli, kale, cabbage, Brussels sprouts, bok chop, and arugula.  Indeed, you simply can’t find another food group that is so packed with vitamins, minerals, fiber, omega 3 fats, and protein.

While you likely would never consider cauliflower, broccoli, or kale as great sources of omega 3 fat and protein, they actually are.  Calorie for calorie, the cruciferous vegetables have as much omega 3 as salmon and almost as much protein as chicken.

When it comes to disease prevention, cruciferous vegetables top the list.  For example, regularly eating cruciferous vegetables may decrease your heart attack risk by 34%.  Also, regardless of the cancer type, cruciferous vegetables appear to decrease all cancers by about 20%.

For weight loss, cauliflower is very best vegetable.  Indeed, a Harvard study showed that cauliflower eaters lost a total of 1.37 pounds for each daily serving they averaged during the study.  While broccoli wasn’t quite as effective as cauliflower for weight loss, it wasn’t far behind.

I should point out that there is an Internet myth that cruciferous vegetables cause goiters and other thyroid issues.  When examined in a study, cruciferous vegetables do not cause thyroid problems.  In fact, when it comes to thyroid cancer, cruciferous vegetables appear to be very effective in preventing this cancer as well.

4. Fish

When it comes to optimizing brain and heart function, studies show that fish is your best meat.  For example, a recent study of 181,580 people showed that for every one serving of fish you eat each week, you can cut your risk of Alzheimer’s disease by 7%.

For heart disease prevention, it is a similar story.  Even eating just one serving of fish weekly may decrease your risk of heart disease by 15%.

If you are trying to maintain a healthy weight, fish is also your best meat.  While red and processed meats have been associated with intense weight gain in studies, adding fish to your weight loss efforts has been shown to boost weight loss by 14%.

Take Home Message

The main message of this article is that to prevent disease and maintain a healthy weight, shoot for at least one serving of berries, nuts, and cruciferous vegetables each day.  For those who choose to eat meat, fish is your best meat.

Try to eat at least one serving of fish weekly.  Always select a fish low in contaminants.  To learn more about which fish are best, here is a link to an article I wrote.

Of course, for optimal health, you’ll want to include many other fruits and vegetables outside of the berry and cruciferous families.  To make sure you get all the nutrients your body needs, make sure your produce includes all the colors.  Likewise, peanuts and seeds seem to offer the same health benefits as nuts.

What superfoods do you eat everyday?  How do you prepare your superfoods?

Please leave your comments and questions below.  I’ll do my best to quickly respond to each question.  Also, if you have enjoyed this article, please be sure to sign up for my free weekly newsletter so that you never miss a thing.

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Can Over Working Hurt Your Heart?

The average salaried American now works 49 hours a week.  When you add in the average four hours of commuting time, that number increases to 53 hours weekly.  Can over working hurt your heart?

In this article, I discuss the risks of overworking to your cardiovascular system and offer tips for a better work life balance.

John D. Rockefeller’s Experience

While still in his 40s, the richest man in the world was dying.  John D. Rockefeller had developed an autoimmune disease that caused him to lose every hair on his body as well as other medical conditions.  He was so close to a nervous breakdown, that he even slept with a gun next to his bed.

His doctors told him that if he didn’t stop working so hard he was going to die from a heart attack. Heading the advice of his doctors, he gave the reins of his company to another man and stepped back to more of a consultant role.

His health immediately improved.  He then lived by three simple rules:

1. Avoid worry.

2. Exercise outside daily.

3. Get up from the dinner table a little hungry.

By achieving a healthy work life balance, he was able to faithfully follow these three rules and went on to live a healthy life until the age of 97.

Working Hours and Risk of Heart Attack and Stroke

To answer the question, can overworking hurt your heart, let me share with you a recent study.  In this, the largest study ever done on the subject, researchers looked at the risk of a heart attack or stroke in 603,838 workers.

To make sense of the data, researchers divided the people into two groups.  The first group worked the standard 35 to 40 hour work week.  The second group put in more than 55 hours a week on the job.

Researchers then followed these two groups of people for 7.2 years to see what would happen.  After more than seven years, the results were obvious.  Those working more than 55 hours a week were 13% more likely to get heart disease and 33% more likely to suffer a stroke.

Karashi: The Ultimate in No Work Life Balance

The Japanese are known for working long hours.  They have long recognized that working long hours or multiple jobs can cause an early death from a heart attack or a stroke.

The Japanese even have a word for death by over working–karoshi.  The first reported case of karoshi was in 1969 with a fatal stroke in a 29 year-old man suffering from work exhaustion.

Karoshi is a national health problem in Japan.  To help decrease karoshi deaths, the Japanese government now regulates work overtime hours.

Karoshi, World Leaders, and No Work Life Balance

Even if you don’t die a karoshi death, unhealthy stress from a job can take years off your life.  In a fascinating study, researchers looked at the effect of the most stressful job—leading a country.

In this study of 540 heads of state over the last 300 years, researchers found that the person who won the election lived 4.4 years shorter than the losing candidate.  As world political leaders are not known for having a healthy work life balance, could these shorter life spans be a Western manifestation of karoshi?

Main Cause of Work Life Balance Challenges

I have seen many patients at risk for karoshi.  In talking with these patients, over working generally comes down to one of three things.

1. Money concerns.

2. Bad boss, too many emails/meetings, or other non-essential work activities.

3. Personal drive.

Of these, money concerns is clearly the number one cause of work life imbalance.  Generally, the solution is simple.  Want less and spend less.  If you can lower your overhead, downsize your life, and eliminate all the stuff you really don’t need, most of my patients find they can reclaim their work life balance and do what they have always dreamed of doing.

Work life imbalances from a bad boss, too many emails/meetings, or other non-essential work activities generally means that you need to set clear boundaries and priorities in your work life.  If you can’t solve these challenges with your employer, it may mean that you need to look for a new position or find a better organization.

The last, a strong personal drive, may be the most challenging to overcome.  I know this is something I struggle with.  I have found that setting up rules in my life, like John D. Rockefeller, has helped.

I have four rules that I try to follow each day to help maintain a healthy work life balance.  These four daily rules are to connect with each family member, have family dinner, do something spiritually uplifting, and take care of my health.  While I am still guilty of working more than 55 hours each week, if I can accomplish these four things each day then I feel I have achieved a work life balance that works for me.

Final Thoughts

Are you at risk for karoshi?  If so, now is the time to evaluate the causes and come up with a plan to find a work life balance that works for you.

What has helped you to find a healthy work life balance?  Please leave your thoughts and questions below.  Also, if you like what you have read, please join the community and sign up for my free weekly newsletter!

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How Much Water Should You Drink?

Everyone knows the answer to how much water should you drink is eight glasses, right?

In this article, I will answer how much water should you drink and debunk the top 10 hydration myths based on the latest medical science.

The Top 10 Hydration Myths

1. Drink 8 Glasses of Water

The biggest hydration myth is that you must drink eight glasses of water every day.  Even my children have been taught this in school.

Guess what, no medical study has ever shown that you need eight glasses of water.  The best medical studies I could find recommended five and six glasses daily.

The first was a study of 20,297 Seventh Day Adventists which showed that drinking five or more glasses of water each day was associated with a 50% decreased risk of a heart attack.

The second study, recommending six glasses of water, included 47,909 people.  In this study, those drinking six or more cups of water were observed to have a 51% lower risk of bladder cancer compared to people who only drank one cup daily.

Both of these studies should be interpreted with caution as they were just observational studies.  These studies don’t prove that water was the reason why people had less heart attacks or bladder cancer.  An alternative explanation for these findings is that water drinkers tend to be more health conscientious, eat a healthier diet, and are more likely to exercise regularly.

So where did the 8 glasses a day myth originate?  My best guess is that it came from a 1945 publication by the National Research Foundation.  This 1945 report wasn’t based on any medical studies.  Since 1945, the recommendation has become urban legend and the rest is history.

2. Caffeinated Drinks Dehydrate You

The second biggest hydration myth is that caffeinated drinks dehydrate you.  When put to the test in a medical study, this was simply not true.

In fact, there was no significant difference in how well a caffeinated drink, like a carbonated beverage or coffee, hydrated you compared to water.  While I would never recommend that you drink anything other than water, the take home message of this study is that any drink hydrates you.

3. You Can’t Drink Enough Water

With all of the sensationalized media reports every summer of people dying from dehydration, many people now carry huge water jugs and drink water all day long.  Can you get too much of a good thing?  Yes.

There is actually a medical condition called water intoxication.  If you drink too much water it can cause hyponatremia.  Hyponatremia occurs when sodium levels are too low in the blood.  When this happens it can cause confusion, brain swelling, and even death.

Interestingly, one study found that 13% of Boston Marathon runners had hyponatremia.  This is because they over hydrated with water and sports drinks.  Over compensating with fluids, following massive sweat losses, caused dilution of their blood and resulting hyponatremia.

The key point of this study is that drinking fluids in moderation is best for endurance athletes.  You don’t want to over hydrate with endurance events.

4. You Need Sports Drinks When Exercising

Does the risk of hyponatremia with exercise mean that you need to start drinking Gatorade when working out?  Absolutely not.  In fact, studies show that sports drinks don’t protect you from hyponatremia.

Sports drinks are nothing more than sugar water with a few electrolytes.

Fortunately, even if you sweat a lot, you can get all the electrolytes you need from eating real food.  For example, you can get all the magnesium you need from nuts, seeds, and greens.  Table salt or tomato juice will get you your sodium.  Fruits and vegetables pack in the potassium.

5. You Can’t Rely on Your Thirst

Many Internet reports will tell you that you can’t rely on your thirst.  According to these reports, once you are thirsty it is too late.  You are already dehydrated.

However, that is not the opinion of the world’s leading scientists on this issue.  As published in the Clinical Journal of Sports Medicine, the world’s leading scientists came to the conclusion that thirst is the best way to know if you need water or not in an athletic competition.

The take home message here is that if you are thirsty, you are probably low on water but not yet to the point of dehydration.  Indeed, many leading scientists feel that if marathon runners simply let their thirst guide rehydration, hyponatremia could largely be avoided.

6. Drink Until Your Pee is Clear

You’ve heard the recommendation, keep drinking until your pee is clear.  The reality is that if your urine is totally clear then you are probably over hydrated.  Ideally, your urine should be pale or have a slight color to it.

7. Yellow Urine is a Sign of Dehydration

It is true that your urine is yellow when you are dehydrated.  However, it is also true that if you are taking a multivitamin containing riboflavin, or vitamin B2, your urine will also be yellow.  Thus, the only time yellow urine is a sign of dehydration is if you don’t take a multivitamin.

8. Drinking Extra Water Gives You Beautiful Skin

Once again, Internet reports and articles in women’s magazines would have you believe that if you drink water all day long your skin will be beautiful.  Unfortunately, there is no proof.  Indeed, a study looking at skin beauty and water consumption found absolutely no relationship.

9. Drinking Extra Water Flushes Out Toxins

Of course, you need to drink the right amount of water for your kidneys, and the rest of your body, to do its job.  However, there is no scientific proof that drinking more water than what your body needs helps the kidneys to flush out toxins.  The one possible exception is that in those with a history of kidney stones, drinking extra water may help to prevent further stones from forming.

10. Food Doesn’t Count as Water

Studies show that even on the Standard American Diet, which is very low in fruits and vegetables, you can still get 22% of your water needs just from food.  Of course, studies also show that people in Asia and Mediterranean countries, where fruits and vegetables are commonly eaten, can get much more of their water needs from food.

How much water should you really drink?

Feeling confused?  You’re not alone.

The truth is that everyone is different.  Depending on your size, the temperature, how active you are, your food choices, etc. you will need a different amount of water each day.

There is no universal recommendation on how much water you should drink.  Be curious.  Observe your body.  You will learn exactly how much water your body needs.

Rather than focussing in on a specific number of glasses when it comes to hydration, studies show that common sense is best.  Here are my four common sense tips:

1. Have a glass of water soon after awakening in the morning.

2. Drink if you’re thirsty.

3. Quickly rehydrate if your urine is too concentrated.

4. Drink more if you are sweating.

How do you make sure you get the right amount of water your body needs?  Please leave your experiences below for everyone to learn from.  As always, I’ll do my best to answer any question posted.

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How to Eat Pasta Without Gaining Weight

Pasta is a forbidden food for anyone wanting to lose weight, right?  Not necessarily.  In this article, I will teach you how to eat pasta without gaining weight.  I will also show you how you can enjoy rice and potatoes as well without gaining weight.

Susan’s Experience

Susan’s comfort food was pasta.  The problem was that she also weighed 50 pounds more than she should have, she had diabetes, and also suffered from a heart condition, atrial fibrillation, that was not responding to the usual treatment.

“We have to get 50 pounds off you if we want any chance of getting your atrial fibrillation under control,” I said.

“I’ve tried.  The problem is that I can’t give up pasta.  It’s my comfort food,” she said.

“You don’t have to give up your comfort food to lose weight,” I said.

I went on to explain how she could continue to enjoy pasta and still lose the 50 pounds.  Over the course of a year, I helped her find new comfort foods and enjoy her old comfort foods in a healthy way.

Fortunately, the weight came off and her atrial fibrillation went into remission.  The remainder of this article is what I shared with Susan.

The Problem with Pasta, Rice, and Potatoes

The problem with white pasta, white rice, and white potatoes is that they are instantly converted to sugar by the body.  The digestion process is way too fast.  Indeed, white pasta, rice, and potatoes are converted to sugar faster than a Snicker’s Bar.

This sugar spike then leads to an insulin spike, fat deposition, and feeling hungry all over again.  The key for Susan’s pasta addiction was either a healthy substitution or complete modification of her comfort food.

Healthy Pasta, Rice, and Potatoe Substitutions

To lose weight, you never need to give up your comfort foods.  There are always ways to do healthy substitutions.

For example, there are many healthy pastas.  Our favorite is organic edamame spaghetti.  Even our local Costco even carries this pasta.  If your local stores don’t carry this, you can always buy it online from Amazon.

A 200 calorie serving of organic edamame spaghetti has nearly half the fiber and protein you need for the day.  Studies show that protein and fiber make it much easier to lose weight.

Organic edamame spaghetti is also extremely low glycemic so there is no sugar spike.  Every week my wife and I cook up a big batch of this pasta to eat with various dishes during the week.

If edamame spaghetti doesn’t do it for you, you can try other bean pastas, quinoa pasta, or even vegetable pastas.  While you may need to buy other bean pastas on Amazon, your local health food store should carry fresh vegetable pasta. Any of these pastas are extremely heart healthy.

Just as there are healthy pasta substations, the same is also true for rice and potatoes.  For example, brown rice and sweet potatoes are both important parts of a heart healthy diet.

How to Turn Pasta, Rice, and Potatoes into a Resistant Starch

What should you do if you just can’t give up your white pasta, white rice, or white potatoes?  Can you still lose weight?

Fortunately, the answer is yes.  All three of these foods can be modified into a resistant starch to make them healthier.

Resistant starches are a game changer.  By simply putting white pasta, rice, or potatoes in the fridge overnight and then reheating them the next day, you have completely changed the chemical structure of these starches.

You have turned a quickly digested bad carb into a very slowly digested better carb.

This cooking, cooling, and reheating process has now made it difficult for your body to break down the starch.  Thus, you get a nice and slow digestion process with no significant sugar or hunger spike.

Indeed, many studies now show that resistant starches may prevent diabetes, promote a healthy gut, and help you to lose weight.

While we still prefer bean pastas and brown rice in our home, we occasionally like a baked white potato.  While it does require a little advanced planning, we always bake the potato the night before and let it cool in the fridge overnight first before reheating the next day.

Take Home Message

The key message of this article is that you can still enjoy pasta, rice, and potatoes without gaining weight.  The key with these foods, like all other comfort foods, is to either substitute or modify.

If you haven’t tried a bean or vegetable pasta, let me challenge you to give it a try this week.  Likewise, brown rice and sweet potatoes taste just as good as their “white” versions.

If you just can’t give up your white pasta, white rice, or white potatoes, then turn them into a resistant starch in the fridge overnight before eating.  While the Olive Garden pasta is still not heart healthy, eating the left over pasta the next day may not be too bad for you provided you selected a healthier sauce to go with the pasta.

What substitutions have you tried for your comfort foods?  Have you ever tried turning pasta, rice, or potatoes into a resistant starch?

Please leave your experiences below.  Also, if you have any questions about what you have just read, please leave your questions below as well.  I’ll do my best to answer everything.

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How to Protect Yourself from Mosquitos

I hate mosquitos.  You probably do as well.  In this article, I am going to teach you how to protect yourself from mosquitos, especially those carrying the Zika virus.

The Aedes Mosquito and the Zika Virus

The Zika virus is carried by the Aedes mosquito.  The scary thing is that the Aedes mosquito visits a large portion of the United States.  Basically, if you live along the coasts, or in the southern part of the U.S., you are at risk.  Here is a map, to see if your home is at risk from this mosquito.

The Aedes mosquito is an aggressive mosquito.  It hunts human blood and will even enter into your house.

The Aedes mosquito has recently invaded the U.S.  This mosquito can be identified by the black and white markings on their body and legs.  Unlike most mosquitos, the Aedes mosquito bites during the day.

The Zika virus has already caused countless birth defects in South America.  It may even cause permanent paralysis.  Even if you don’t live in an Aedes mosquito infested area and don’t travel, you could still get infected from a loved one who has recently visited the coastal or southern regions of the U.S.

While the media is focussed on the Zika virus, it is important to remember that this is not the only mosquito-borne disease.  For example, the West Nile virus, elephantiasis, dengue fever, yellow fever etc. are all carried by mosquitos.

Why do mosquitos bite?

Actually, not all mosquitos bite.  Only the females do.

This is because they need a protein from your blood to help them reproduce.  Thus, your blood helps even more mosquitos enter into this world.

Are you a mosquito magnet?

Do you always seem to be the one that is munched on by mosquitos?  I know I often feel that way.  Is there any truth that some people are actually mosquito magnets?

According to medical studies, the answer is yes.  The first step in how to protect yourself from mosquitos, is to minimize those things that make you a mosquito magnet.

Here are six proven ways you can become a mosquito magnet.  To see the study supporting each way you can become a mosquito magnet, click on the link.

1. You have type O blood.

According to a controversial study, people with type O blood are twice as likely to be bitten than those with type A blood.  Type B blooded people are somewhere between the Os and As.

2. You exercise outside.

This is probably the main reason why I seem to be a mosquito magnet.  I love exercising outside.

Unfortunately, mosquitos are attracted to movement, heat, carbon dioxide, and lactic acid.  Thus, anyone exercising outside, like me, instantly becomes a mosquito magnet.

3. You are pregnant.

In a study of 72 women in Gambia, pregnant women were twice as likely to attract mosquitos.  As mosquitos are attracted to heat and carbon dioxide, researchers suggest that this is the reason why pregnant women are targets.

4. You have the right skin smell.

The bacteria living on your skin emit a characteristic smell.  Depending on which bacteria live on your skin, you may have the right smell that attracts a mosquito.

5. You wear dark clothes.

Mosquitos prefer dark colors.  Indeed, this is why studies show that black mosquito traps perform the best at attracting mosquitos.

For some people, like me, this is a hard fact to live with.  Black is my favorite clothing color.  Based on my review of the medical literature, I am now trying to wear light colored exercise clothing.

6. You drink alcohol.

Strange as it may seem, drinking alcohol attracted mosquitos in one study.  Unfortunately, the researchers offered no reason for this unexpected finding.

How to Protect Yourself from Mosquitos

The second step in how to protect yourself from mosquitos, is to take specific actions to minimize the risk of a serious bite.  Here are my top three recommendations.

1. Avoid Outbreaks.

Right now, the biggest global outbreak is with the Zika virus.  Pregnant women should avoid Latin America and the Caribbean.

Sexually active men may want to avoid Zika virus outbreak areas as well.  This is because they can pass the virus through sexual contact.  The virus can live for months in your semen.  Pay attention to CDC updates as new outbreaks happen every year.

2. Cover Up.

Unfortunately, spandex exercise clothes probably won’t protect you from mosquito bites.  Mosquitos can bite right through this material.

Baggier or thicker clothes offer more protection.  Long pants and long shirts are best.  Hats provide additional benefit.

Tuck shirts in.  Tuck pants into socks.  The less skin that is exposed the better when it comes to preventing mosquito bites.

3. Use Mosquito Repellant.

When considering the use of a repellant, you always have to balance the risks versus benefits.  For example, if you are pregnant, and live in a Zika virus outbreak area, the benefits of preventing brain damage to your unborn child may far outweigh any potential risk from even the strongest mosquito repellant.

For people at the highest risk of a Zika virus infection, you will want to use a mosquito repellant with DEET, IR3585, or picariden.  Of these, DEET has the best long-term track record. Despite toxicity concerns, studies show that the risk is relatively low.

For those in lower risk areas, like me, lemon eucalyptus is a great option.  Select the repellant form of lemon eucalyptus, as only this form has been tested against mosquitos.

One study even showed that lemon eucalyptus was as effective as DEET.  Lemon eucalyptus is the only natural remedy recommended by the CDC.

The main drawback of lemon eucalyptus is that the effect may not last as long as your bottle advertises.  Plan on only one to two hours of protection from each application.

As mosquito bites in our area of the U.S. are generally benign, our family uses lemon eucalyptus.  While it doesn’t prevent every mosquito bite, I have found that I can significantly reduce the welts on my arms and legs when exercising outside with this essential oil.

Other Natural Mosquito Repellants

Vitamin B1, or thiamine, is widely promoted on the internet as a safe way to prevent mosquito bites.  Unfortunately, recent research has shown that it offers no benefit.  Thus, despite what you may have read on the internet, the only proven natural remedy for preventing mosquito bites is lemon eucalyptus in the repellant form.

We Have the Technology to Destroy All Zika Mosquitos

According to this recent MIT review, we now have the technology to destroy all Zika mosquitos.  This technology is called “gene drive.”

Basically, the Aedes mosquito is genetically modified so that as it reproduces it wipes out the entire Aedes mosquito population.

As there are many different types of mosquitos in the world, and the Aedes mosquito is not even native to the U.S., wiping out the Aedes mosquito population would likely have no significant impact to the U.S.  The impact for the rest of the world will likely be hotly debated over the next few years.

I suspect that if enough children in the world suffer permanent brain damage from this invasive mosquito, public debate may change in favor of eradicating the Aedes mosquito.  Even if the Aedes mosquito is eradicated from this planet, there will still be more than 3,500 other species of mosquitos left.  Fortunately, most species of mosquitos don’t torment humans.

Take Home Message

Until the world has decided that we have had enough of the Aedes mosquito, this invasive mosquito will likely be with us for the foreseeable future.  Depending on where you live, mosquito bites can be a major public health concern.

The most important thing to remember in how to protect yourself from mosquitos, is to not become a magnet and take special precautions so that you don’t get bitten too often this year.

To stay safe, anyone looking to grow their family should steer clear of the Aedes mosquito.  Cover up when  outside and use a repellant.  If you choose a natural repellant, like lemon eucalyptus, remember to apply it every one to two hours.

Are you a mosquito magnet?  What do you do to protect yourself from mosquito bites?

Please leave your experiences below.  As always, I will do my best to answer any questions you leave below.

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Your Diet Doesn’t Have to Be Perfect to Be Healthy

What if you occasionally slip up and eat something you shouldn’t?  Fortunately, a new study shows that your diet doesn’t have to be perfect to be healthy.  In this article, I discuss this latest study and show what it means for you.

Mark’s Experience

Mark appeared defeated at his last clinic visit.

“What’s wrong?” I asked.

“I’m a failure.  I couldn’t do what you asked me to do.  I just can’t completely avoid soda pop and chips.”

“Have you at least cut back?” I asked.

“Heavens yes.  But I’m not perfect,” he said.

Guess what, your diet doesn’t have to be perfect to be healthy.

The Less than Perfect Diet Study

Studies show that the Mediterranean Diet is one of the healthiest diets in the world.  Contrary to popular belief, the Mediterranean Diet is not an all you can eat pasta diet.  Rather, this way of eating is mostly vegetables, fruits, legumes, whole grains, and fish.

In this study, researchers evaluated 15,482 people with preexisting heart disease from 39 countries.  The study design was quite interesting.

Everyone was given a Mediterranean Diet score based on how closely their food choices stacked up to the perfect Mediterranean Diet.  Researchers then looked to see if their Mediterranean Diet score predicted whether or not they would suffer a heart attack, stroke, or premature death over the four years of the study.

To get a high Mediterranean Diet score in this study, participants had to eat a lot of vegetables, fruits, legumes, and fish.  In contrast, the more Western foods they ate, like red or processed meats, sugar, and processed foods, the lower their score.

As expected, those who most closely followed the Mediterranean Diet had the lowest risk of a heart attack, stroke, or premature death.  However, if you read the study closely, their diet didn’t have to be perfect to enjoy this health benefit.  It just had to be mostly healthy.

Indeed, even in those people with preexisting heart disease, your diet doesn’t have to be perfect to be healthy.

Take Home Message

The most important message from this study is that your diet doesn’t have to be perfect to be healthy.  If you do occasionally give in and eat the whole box of Oreos, it is not the end of the world.

Rather than beating yourself up over the box of Oreos, let a bad day be good data.  Learn what went wrong so that you don’t feel compelled to eat the whole box next time.

Be curious.  Learn what your triggers are.  Learn what works for you.

As long as you are mostly eating vegetables, fruits, legumes, whole grains, and fish you are eating a healthy diet.

How do you avoid beating yourself up over occasionally eating things you probably shouldn’t eat?  Please leave your experiences below so that others may benefit.  As always, I will do my best to answer every question.

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3 Critical Things to Know About Sunscreen

While there are many things to know about sunscreen, in this article I’ll stick to the three critical issues.

Unfortunately, if you want to be outside much this summer, sunscreen is a necessary evil.  Studies show that being physically active outside may offer far more benefits to your physical and mental health than exercising in a gym.

As a parent of four children, I know just how challenging sunscreen issues can be.  Read on to find out the the three critical things to know about sunscreen so that you can be sun smart.

1. Sunscreen May Not Prevent Skin Cancer.

Growing up, I thought that sunscreen was protecting me from skin cancer.  Unfortunately, I later learned that there are little data from medical studies backing this up.

While faithful sunscreen use may prevent the less dangerous forms of skin cancer, there is no clear proof that it prevents the more deadly forms, like melanoma.

Even though more people are using sunscreen, studies show that melanoma rates have risen 81% in the last 30 years and are continuing to rise at 3% per year.  This ongoing rise has some researchers now questioning if sunscreen actually increases the risk of melanoma.

There could be many possible explanations for this phenomenon.  For example, sunscreen may give people a false sense of security to stay out in the sun longer than they should.  It could also be that many sunscreens don’t block the UVA form of cancer causing sun rays.  Perhaps people are not applying sunscreen evenly or frequently enough.  Lastly, some researchers have even suggested that the vitamin A (retinyl palmitate) in many sunscreens could theoretically increase the risk of cancer.

The only proven way to decrease your risk of skin cancer is to avoid any prolonged sun exposure.  This means staying indoors during peak exposure times (10 am until 4 pm) or covering up with clothing, hats, sunglasses, etc. when outside.

Interestingly, some studies have observed that safe levels of sun exposure may be protective against melanoma.  Perhaps vitamin D somehow blocks melanomas.  Fifteen minutes of direct sunlight is all that many people need to get their daily dose of vitamin D according to the Vitamin D Council.

It is important to know that if you choose to avoid all sun exposure, you need your vitamin D levels checked regularly.  Research from our hospital has shown that low vitamin D levels are associated with heart disease as well as many other medical problems.

2. Don’t Rely on the SPF Number

If you are like me, I always selected the highest SPF number sunscreen I could find.  I somehow imagined that the higher the number, the more protected I was.  Unfortunately, that is not the case.

The SPF number means how much longer you could theoretically stay out in the sun without burning.  For example, an SPF of 15 means that you could stay out 15 times longer without getting a sun burn.

The problem is that SPF only measures the UVB ray blocking ability.  While UVB rays are the main cause of sunburns, UVA rays can penetrate deeper and also cause skin aging and skin cancer.

In one of many studies, European researchers compared 15 sunscreens which were all marketed with the same SPF number.  Here is what they found:

1. The same SPF number does not predict the UVA blocking ability of sunscreen.

2. The same SPF number is not very accurate when it comes to UVB blocking.

What should you do?  The key is to buy sunscreens which are clearly labelled as broad spectrum.  Seeing broad spectrum on the label increases the likelihood that your sunscreen also blocks UVA rays.

When it comes to the SPF number, you want at least a 15.  Anything above 50 is more about marketing than anything else.

Lastly, remember to apply it evenly and regularly.  Regardless of your SPF number, sunscreen should be applied every two hours.

3. Some Sunscreen Ingredients May Be Dangerous

In my youth I never thought much about what was in the sunscreen I was using.  Somehow I figured that it had to be safe or the government would never let these companies sell their products.  Once again, I was wrong.

As discussed above, many sunscreens contain vitamin A or retinyl palmitate.  Retinyl palmitate could theoretically increase the cancer risk.

The spray on sunscreens may pose additional risks.  Besides uneven application of sunscreen, the spray on versions pose a potential inhalation risk.

As convenient as spray on sunscreens are for our small children, it is because of these inhalation risks that we no longer use spray on sunscreens.  Spray on sunscreens with nanoparticles could even present a possible cancer risk.  For children under 6 months, it is best to avoid sunscreen altogether and just keep them covered up when outside.

While the mineral sunscreens, like zinc oxide and titanium dioxide, may offer the best protection with the least risk, there is still some debate in the medical literature about the safety of nanoparticles.  Until these safety issues can be resolved, it is best to avoid sunscreens wth nanoparticles.

Lastly, there are many chemicals in sunscreens, like oxybenzone, which may have estrogen-like effects on the body.  While it is impossible to remember the names of every potentially bad chemical to look for on the sunscreen ingredient list, there is help.  Before deciding which sunscreen to buy, our family checks the Environmental Working Group’s free app to make sure it is safe and effective.

Take Home Message

There is a very fine line between getting enough sun for your vitamin D needs and not getting too much sun that you prematurely age your skin or get skin cancer. In this article, I focussed on the three most critical things to know about sunscreen.

While the right sunscreen can help you be safer outside during the summer, covering up between 10 am and 4 pm is much safer and more effective than sunscreen.

How do you stay sun smart but yet get your vitamin D?  Please leave your comments below so that all may benefit.  I’ll do my best to answer every question posted.

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60 vs 20 Minute Cardio Workout: Which is Best?

Do you have 60 minutes to spare each day for exercise?  If you are like most of my patients, the answer is “no.”  Can you get all the benefit of exercising for an hour in just 20 minutes?  In the 60 vs 20 minute cardio workout, which is best?

Michael’s Experience

Michael was my typical hard charging CEO patient.  He routinely put in 60-hour workweeks and his health suffered.  For years, I encouraged him to start exercising.  Unfortunately, I always got the same response.

“Doc, I just don’t have time to exercise.”

Our breakthrough finally came when I talked with him about compressing a workout into just a few minutes several times a week.

“Will exercising such a short time even do any good?” he asked.

“All the benefits of a long exercise session in just a fraction of the time,” I said.

“Count me in,” he said.

60 vs 20 Minute Cardio Study

Here is the study I recently shared with Michael.

To answer the 60 vs 20 minute cardio workout question, University of Alabama researchers recruited 28 overweight people who weren’t used to exercising.  For six weeks, these people were randomly assigned to one of two workout groups.

The first group was the usual moderate intensity exercise group.  These people pedaled 60 minutes a day, five days a week, on a stationary bicycle.

In contrast, the second group was the high intensity exercise group.  These people pedaled all out in four, 30-second sprints, mixed with cool down periods, for a total of 20 minutes on three days of the week.  Even though the high intensity group really only exercised six minutes a week (two minutes of sprinting on three days), the total time investment with the warm up and cool down periods was one hour.

Did 60 minutes of cardio beat out 20 minutes?

Basically, the study was a draw.  There was no statistical difference between a 60 vs 20 minute cardio strategy.  After 6 weeks, both groups saw roughly the same benefit with regards to weight loss, lower blood pressure, better cholesterol numbers, and improved insulin sensitivity.

The only benefit of the 60 minutes group, was that they were in slightly better shape at the end of the study.  However, this finding is an outlier, as most other studies have shown no difference.

The key message is that you can get all the benefit of exercising in just a fraction of the time.

How To Do High Intensity Exercise

Here is how you could apply this high intensity exercise protocol in your own life.  First, pick your favorite exercise.  It could be walking, cycling, hiking, or just about anything.

For your 20-minute cardio workout, start by warming up for four minutes.  If walking is your exercise of choice, walk at your normal pace for four minutes.

After warming up, you will do a total of four, 30-second sprints, interspersed with a two to three minute cool down period.  In the walking example, your “sprints” could be walking as fast as you can up a hill for 30 seconds.  Your cool down periods would be walking at your normal pace on a flat surface.

To know that you are going all out with your sprints, your heart rate should hit 85% of your maximally predicted heart rate.  This was the criteria that they used in this study.  To calculate this number, your maximally predicted heart rate is 220 minus your age.

Thus, if you are 40 years old, your maximally predicted heart rate is 180 (220 minus 40).  Eighty-five percent of 180 is a target heart rate of 153 beats per minute.

Share Your Experience

High intensity or interval training sounds simple, right?  Give it a try and let me know how it goes in the comment section below.  If you have a question, I will answer those in the comment section as well.

Of course, if you are not used to exercising or suffer from any medical conditions, please check with your doctor first before exercising.

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Why Believing Stress is Bad May Shorten Your Life

Believing stress is bad may be dangerous to your health.  In fact, believing stress is bad could be considered the thirteenth leading cause of death in the U.S. according to recent research.  Read on to learn how to make stress work for you and extend your life.

I Was Also Convinced Stress Was Bad

Growing up, I thrived on stress.  Later, stress allowed my mind laser-like focus when pouring through medical charts or performing operations.  It even allowed me to stay up all night caring for sick patients without the slightest fatigue.

But that all changed a few years ago.  About the same time my poor diet led to a health crisis, I started examining all aspects of my life.

As part of this evaluation, I read many articles on stress. And, the more I read, the more I began believing stress is bad.

I was so convinced that stress was bad I started looking for ways to eliminate it from my life. Interestingly, the more I tried to avoid stress, the more stressed I became.

Long days in the hospital were no longer effortless for me.  To help battle stress, I even wrote articles like this, “Eliminate Stress in Seven Steps” (blog #14).

However, one study forever changed my life.  I now approach stress in a mindful and positive way.

Stress is not evil nor is it something that should be avoided. Rather, to grow and contribute in this life you have to embrace stress.

Stress once again gives me energy, clarity, and the strength to take on meaningful challenges.  Stress can do the same for you.

The Study That Changed Me

In this provacative study, researchers from the University of Wisconsin asked a fascinating question–is stress bad or is it the perception that stress is bad that cause health problems and an early death.

To answer this question, these researchers dug through survey forms from the 28,753 people who participated in the 1998 National Health Interview Survey.  As part of this survey, people were asked three questions.  Are you under a lot of stress?  Do you believe stress is harming you?  And, are you doing anything to reduce stress?

Researchers then compared the answers to how people rated their health and who was still alive eight years later.

Stress May Shorten or Extend Your Life

As you might have guessed, more than half of the people filling out this survey reported moderate or high levels of stress.  Also, as expected, those reporting high levels of stress were much more likely to suffer health problems and die early.

Fortunately, these University of Wisconsin researchers didn’t stop here.  And this is where things get really interesting.

For those people who reported high stress and also believed stress was hurting them were 43% more likely to die over the eight years of the study.

In contrast, those who reported high stress and also believed that stress was not harming them were 17% more likely to be alive.

Basically, this study showed that believing stress is bad was associated with health problems and an early death.  Based on these findings, these researchers estimated that 20,231 Americans needlessly die each year from believing that stress is bad. This would make believing stress is bad the thirteenth leading cause of death in the U.S.

How do you explain the findings?

How can stress be a good thing?  Fortunately, your body came pre-programmed with a stress response for a reason.  That stress response helped your ancestors fight off predators.   That same stress response can help you with a work or relationship challenge.  It can even help you stay up late helping your child study for a test and still function great the next day.

Exercise is Stress to the Body

A great example of how stress is good for you is exercise.  Exercise stresses the body.  For example, when you lift weights you are literally tearing small muscle fibers.  As the body repairs these small tears, the muscle gets stronger.

In contrast, if you did everything possible to avoid the stress of exercise, it wouldn’t be long before your muscles would weaken and health problems would develop.

What You Believe Becomes Your Reality

Perhaps it is the nocebo/placebo effect that explains the findings of this study.  For example, before a new medication is ever FDA approved, it must be compared to a “dummy pill.”  In these studies, people have no idea if they are taking the real pill or the dummy pill.

You would think that the “dummy pill” would have no effect.  However, quite the opposite is true.

Remarkably, 30% of people get better by taking the dummy pill.  This is the placebo effect.  And, any new medication has to help more than a dummy pill.

In contrast, about 10% of people in studies get deathly ill from the same dummy pill.  This is the nocebo effect.

It is possible that stress works the same way.  Whatever your beliefs are on stress, this then become your reality.

Five Reasons to Embrace Stress

1. More Strength and Energy

Have you ever wondered how people have been reported to lift cars or tractors off of dying loved ones?  While most people don’t need superhuman strength, studies show that viewing stress as a positive thing is associated with more energy during the day.

2. Enhanced Brain Function

Did you ever notice how much better you were able to study the night before a test?  This was the stress response in action.  Medical studies have linked stress to improved brain function.

3. Feel Happier

Studies show that avoiding stress isn’t associated with being happy.  Actually, depression is much more common in people trying to avoid stress.

4. A More Meaningful Life

Life challenges create deeper meaning.  Indeed, studies show that successfully passing through adversity is associated with a more meaningful and happy life.

5. Closer Relationships

When you are stressed, oxytocin hormone levels increase.  Oxytocin is what I like to call the “bonding hormone.”

When oxytocin levels are high, your body is programmed to seek the company of others.  And, as you strengthen these relationships, studies show that even more oxytocin is released.  Surging oxytocin levels can then block the potentially detrimental effects of stress.

Take Home Message

The key take away from the study, is that believing stress is bad may put you at risk for health challenges and an early death.  While no one study is ever definitive, other research has shown that eustress, or positive stress, is a good thing and should be embraced.

My challenge to you is to do the same thing I am now doing.  Every time I am feeling “stressed out,” I now say to myself “embrace the stress” or “stress is making me stronger.”

Have you also learned to mindfully embrace stress?  If so, please leave your experiences below so that others may benefit.  Also, feel free to ask any questions.  I read and respond to every question.

Special thanks to Dr. Kelly McGonigal whose writings introduced me to some of the research discussed in this article.  For a great read, please check out her book, The Upside of Stress.

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Top 10 Proven Natural Home Remedies

Can you treat your medical condition naturally?  In this article, I share my top 10 proven natural home remedies.  Read on to learn how to “hack” your health.

1. Magnesium for Arrhythmias and Palpitations

As magnesium is found in nuts, seeds, and greens, is it any wonder that up to 89% of Americans are magnesium deficient?  The Standard American Diet is very low in magnesium.  Magnesium is critical for everything from DNA repair to keeping your heart beating normally.

Arrhythmias, or abnormal heart rhythms, are very common.  The main symptom of an arrhythmia is heart palpitations.

Studies show that one in four adults will experience the most common arrhythmia, atrial fibrillation.  Even palpitations from skipped beats (PVCs and PACs) are very common and trouble many people.

Besides living as healthy as possible, are there any proven natural home remedies?

Let me introduce you to magnesium.  As a cardiologist, I have seen countless patients benefit from either increasing the magnesium in their diets or from magnesium supplementation.  Unless you suffer from kidney disease, magnesium supplements are generally safe.

In a review of 17 medical studies involving 2,069 patients, magnesium supplementation was shown to decrease nearly all arrhythmias following surgery.  In particular, the risk of atrial fibrillation was decreased by 29% and ventricular arrhythmias by 48%.

In addition to calming the heart rhythm, studies also show that magnesium may help with constipation, headaches, anxiety, diabetes, depression, exercise performance, high cholesterol, and high blood pressure.  As with all of the proven natural home remedies that will be discussed in this article, check with your doctor first as there could be possible side effects and other dangers from any of these home remedies.

2. Cranberries for Bladder Infections

Bladder infections, or urinary tract infections, plague many people.  These infections can even be life-threatening.  Are there any alternatives to antibiotics?

Consider cranberry juice.

While cranberry juice isn’t the perfect treatment, studies show that it helps.  In a review of 10 studies involving 1,049 people, cranberry products were shown to decrease urinary tract infections by 35%.

Unfortunately, we don’t know which form (juice, whole fruit, or extract capsules) or which dose is best.    As with all proven natural home remedies, there can be side effects so check with your doctor first.  For example, cranberry juice may spike blood sugar in diabetics or it could interact with the blood thinner warfarin.

If you suffer from recurrent bladder infections, adding whole cranberries or unsweetened cranberry juice to your diet may be much safer than an antibiotic.

3. Cinnamon for Diabetes

Nearly half of all American adults now suffer from diabetes or pre-diabetes.  In addition to losing weight and exercising, cinnamon has been shown to be very effective for diabetes.

Indeed, medical studies show that cinnamon may reduce blood glucose by 25 mg/dL.  Fortunately, this natural blood sugar reduction generally does not cause hypoglycemia or low blood sugar in people not on diabetes medications.

However, if you are also on diabetes medications, then you could become very hypoglycemic with a big dose of cinnamon.  Thus, if you want to start eating more cinnamon, your doctor may need to reduce the dose of your diabetes medications.

In addition to lowering blood sugar, you can also drop your total cholesterol by 15 mg/dL and your triglycerides by 30 mg/dL with cinnamon.

Unless you suffer from liver failure, you probably can’t eat too much cinnamon from foods.  The main side effect of cinnamon is that most people want to eat it with sweets.

Of course, adding cinnamon to sweets completely negates any possible blood sugar benefit.  Rather, put cinnamon on your steel cut oatmeal, mix it in with your unsweetened almond milk, or drink it as an herbal tea instead.

4. Turmeric for Knee Pain

Do you suffer from chronic knee pain?  If so, turmeric/curcumin has been shown in multiple studies to be just as effective as ibuprofen with far fewer side effects.

Turmeric/curcumin are spices that have been used in Indian and Asian cuisines for millennia.  Most commonly, these spices are used in curry dishes.

Turmeric/curcumin is one of the most potent anti-inflammatory agents known.  Not only can this spice reduce inflammation in your knee but it has also been shown to protect against cancer, Alzheimer’s Disease, and heart disease.

In our home, we like eating this spice in curry dishes or adding it to other recipes like soups, hummus, or vegetable dips.  If you would rather not incorporate this spice into your food, it also comes in a supplement form.  As the potential side effects of turmeric/circumin supplements are too numerous to mention in this article, please check with your doctor first before taking this supplement.

5. A Tennis Ball to Cure Snoring

According to the National Sleep Foundation, 90 million Americans snore.  While most cases of snoring just make it difficult for the sleeping partner, 20% of Americans have the dangerous form of snoring, called sleep apnea.

With sleep apnea, excess tissue in the neck and back of the tongue obstructs the airway while sleeping.  As a result, these people typically snore like a train and then stop breathing for periods of time while their airway is obstructed.  Sleep apnea also causes fatigue, high blood pressure, arrhythmias, and heart failure.

Besides losing weight, there is a real easy solution.  For all but the most serious cases, studies show that simply not sleeping on your back is all that is needed to stop snoring and start breathing at night.  As you can’t control which sleeping position you will be in at 2 A.M., there is a way to ensure that you never sleep on your back.

As snoring and arrhythmias go hand-in-hand, I have successfully treated many of my patients with a tennis ball.  The concept is simple.  Just sew a tennis ball in the back of your sleeping shirt.

With the tennis ball in place, it will only take rolling onto your back a few times before your brain subconsciously learns not to do this.  Given that the alternative to a tennis ball is sleeping with a C-PAP machine, I would choose the tennis ball every time.

If your doctor has already prescribed C-PAP therapy for your sleep apnea, don’t stop this treatment.  Rather, speak with your doctor about getting retested with the tennis ball.  It is possible that retesting will show that your sleep apnea is gone as long as you don’t sleep on your back.

6. Probiotics to Treat Diarrhea from Antibiotics

Yes, antibiotics are overprescribed.  However, there just may come a day when the only thing that can save your life is an antibiotic.

Antibiotics not only kill the bad bacteria but also your friendly bacteria in your gut as well.  It is for this reason that one of the first symptoms from taking an antibiotic is diarrhea.

With the helpful gut flora wiped out, clostridium difficile or “C. diff,” can move in.  A C. diff infection of your colon is a difficult to treat, life-threatening infection.

Probiotics may help.

In a review of 16 published studies, probiotics decreased the risk of antibiotic diarrhea by 39% and C. diff colon infections by 63%.  In addition to probiotics, fiber is also critical.  The beneficial gut flora require fiber as their primary food source.

Probiotics generally come in the form of supplements or fermented foods, like yogurt.  Not all yogurt contains live bacterial cultures so you have to look closely on the ingredient list.  Also, never buy yogurt with added sugar as sugar is detrimental to the friendly gut flora.

Probiotics are not without risk.  There are published reports of life-threatening infections from probiotics, particularly in the young, old, or those with compromised immune systems.

If your doctor ever wants to prescribe an antibiotic, your first question should be, is it absolutely necessary?  If the answer is yes, your second question should be, is it safe to take probiotics and eat more fiber while on the antibiotic?

7. Ginger for Nausea and Vomiting

Nausea and vomiting are especially common with pregnancy and chemotherapy.  While the standard nausea medications come with many side effects, ginger may work just as well with a fraction of the side effects.

For example, in a review of 12 studies involving 1,278 pregnant women, ginger decreased nausea by 20%.  Although not statistically significant, ginger also reduced vomiting in this study by 28%.  In a study of cancer patients on chemotherapy, ginger reduced nausea by about 50%.

Fortunately, even with large doses, ginger side effects are rare.  For example, in the cancer study above, only 1.5% of patients had any side effects from ginger.  These side effects were mostly benign and consisted of gastrointestinal symptoms, acid reflux, bruising, flushing, or rash.

Rather than take a supplement, we like adding ginger to stir-fry dishes.  We also enjoy ginger tea.

8. Vitamin C and Zinc for Colds

The average American adult will likely suffer from at least two colds this year.  These annoying viruses not only make you feel miserable but may even cause up to 14% of all heart attacks.

In addition to washing your hands and getting enough sleep, vitamin C and zinc may be helpful.  For example, getting plenty of vitamin C may reduce your risk of catching a cold by 50%.  If you happen to come down with a cold, high doses of vitamin C may help you to recover one to two days faster.

Fortunately, it is extremely easy to get vitamin C from food.  For example, one bell pepper will get you 157% of the vitamin C you need for the day.  A cup of broccoli is not far behind at 135%.  If you would rather get your vitamin C from fruit, a cup of strawberries gives you 113% and an orange comes in at 93%.

The other home remedy that helps with colds is zinc.  For example, one study showed that zinc lozenges taken as soon as the cold developed, helped people to recover 7 days faster.

I should point out that not every vitamin C or zinc study has been positive.  Some have shown no benefit.  This is important to remember as high doses of zinc can be toxic.  Also, zinc should never be taken through the nose as it may forever damage your ability to smell.

If you feel yourself getting sick, there is little downside to boosting your vitamin C containing vegetables and fruits.  However, with regards to zinc lozenges, you may want to check with your doctor first.

9. Tart Cherries for Insomnia

According to the CDC, 70 million Americans have troubles sleeping.  I am one of them.

While healthy sleep routines, daily exercise, and natural sunlight during the day all help, tart cherries may be the only thing standing between you and a great night of sleep.

Studies show that tart cherries are loaded with melatonin.  In fact, tart cherries have six times more melatonin than other cherries.

In a University of Rochester study, tart cherry juice was shown to decrease the insomnia index 11% more than placebo.  While an 11% improvement was not dramatic, tart cherries appear to be just as effective as valerian or melatonin.

When you consider that even Tylenol PM, or other forms of Benadryl (sedating antihistamines), are highly linked to dementia, taking some tart cherries before bed seems to be very benign.

As I worry about the long-term dangers of sugar in fruit juices, a better approach is always to eat the entire fruit.  In our home, we love tart cherry smoothies or just eating the whole fruit as a frozen treat after dinner.

10. Honey for a Cough

There is nothing worse than being awakened at night with a cough.  As a parent of four children ranging from a newborn to a teenager, we have been awakened many times at night over the years.

In an interesting study, Israeli researchers compared a placebo to honey in in the treatment of 300 children suffering from an upper respiratory tract infection related cough.  The children treated with honey took half of a tablespoon of honey 30 minutes before bed.  This little dose of honey significantly decreased coughing and increased the total sleeping time of both the child and their parents.

If a cough is keeping you up at night, there is little downside risk, other than the sugar, to a spoonful of honey before bed.  As long as you are an adult, and your immune system is strong, you may want to consider raw honey for additional cardiovascular benefits as I discussed in a previous article.

Take Home Message

The take home message of this article is that there are many proven natural home remedies for many of the common conditions.  To learn more about how to prevent and treat various medical conditions naturally, please sign up for my free weekly newsletter.

What natural home remedies have worked for you?  Please leave your experiences and questions below.  I will do my best to answer every question posted.

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Flax vs Chia: Which Seed Should You Eat?

Flaxseeds and chia seeds are both superfoods.  While most health conscientious people now include these seeds in their diet, in the flax vs chia matchup, which seed is best?

Where did flax and chia come from?

Flaxseeds originated from the Middle East.  At one time, flax was considered so holy that ancient Egyptian priests only wore clothes may from flax fibers.

In contrast, chia seeds are the newcomers.  While it seems as if we just discovered chia seeds in the U.S., chia seeds were used anciently by Mayan and Aztec warriors.  It was said that chia seeds could sustain them for days.

Flax vs Chia

Below is a 12-point analysis of which seed is best based on the latest medical studies.

1. Omega 3s

The reason why most people eat flaxseeds and chia seeds is for the omega 3 fatty acids.  Indeed, most of the fat in these seeds are the inflammation fighting omega 3s.

For example, one tablespoon of flaxseeds provides you with 146% of the recommended omega 3s for the day.  Likewise, one tablespoon of chia seeds gives you 132%.

Ounce for ounce, flaxseeds and chia seeds have more omega 3s than salmon.  However, this is the plant form, or ALA form, of omega 3.

In contrast, salmon is packed with the DHA form of omega 3.  When it comes to omega 3s and the prevention of chronic diseases, the DHA form of omega 3 may be more important.

Unfortunately, the body converts little of the ALA form to the DHA form.  Thus, to get all of your omega 3 types, you may need to add in marine algae or fish.

Winner: tie

2. Anti-Inflammatory Effects

Due to the high omega 3 content, flaxseeds and chia seeds have powerful anti-inflammatory effects.  For example, studies show that both flaxseeds and chia seeds reduce C-reactive protein by 25% and 40% respectively.  C-reactive protein, or CRP, is a routine blood test that measures the level of inflammation in your body.  You don’t see this kind of an anti-inflammatory effect from any of the pharmaceutical medications.

Winner: tie

3. Fiber

Fiber is critical to maintaining a healthy weight and a healthy gut.  Fiber may also protect against heart disease and cancer.

Both flaxseeds and chia seeds are loaded with fiber.  For example, one tablespoon of flaxseeds and chia seeds gives you 3 and 5 grams of fiber respectively.  That works out to be 11% of your daily fiber from flaxseeds and 18% from chia seeds.

Calorie for calorie, chia seeds are one of the highest sources of fiber you can find.  Chia seeds also absorb 10 to 12 times their weight in water.

If you are not used to eating much fiber, go slow with chia seeds.  With all of this fiber packed into a tiny seed, there are case reports of where people have obstructed their esophagus or intestines by not drinking enough water.  If you are going to eat these fiber powerhouses, you must also drink copious amounts of water.

Winner: chia seeds

4. Calcium

Both flaxseeds and chia seeds are excellent sources of calcium.  In fact, a tablespoon of flaxseeds gives you 26 mg of calcium (2.6% of your daily needs) and chia seeds 76 mg (7.6% of what you need daily).  For those who can’t tolerate, or wish to avoid dairy, chia seeds are a great option.

Winner: chia seeds

5. Protein

These seeds are high in protein.  By weight, flaxseeds are 18% protein and chia seeds seeds 14% protein.  All nine essential amino acids are found in both seeds.

When it comes to weight loss and satiety, nothing beats protein according to medical studies.

Winner: tie

6. Antioxidants

Antioxidants are substances that protect against oxygen damage or free radicals.  Thus, antioxidants protect against heart disease, cancer, and the aging process.

Studies show that while antioxidant supplements may be harmful, food antioxidants extend life and ward off chronic diseases.  Fortunately, both flaxseeds and chia seeds are extremely high in these protective antioxidants.

Winner: tie

7. Weight Loss

The flaxseed and chia seed should be weight loss champions.  Both are low carb and packed with protein and fiber.  However, in the few weight loss studies done, both seeds have been anything but impressive.

Unfortunately, I could find no study showing convincing weight loss from these seeds.  Two flaxseed studies showed no more weight loss than the control group.  Likewise, two small studies of 90 and 62 people did not show any weight loss from chia seeds.

Winner: neither

8. Cancer Treatment/Prevention

When it comes to cancer prevention and treatment, flaxseeds may be one of the best food sources.  Specifically, one study showed that flaxseeds shrunk tumor size by 48%.  While flaxseeds appear protective against most cancers, the benefit may be the strongest for breast and prostate cancers.

As chia seeds are the newcomer, there are no convincing studies available yet.  However, given the high amount of omega 3 in this seed, studies would predict that chia seeds also fight cancer.

Winner: flaxseeds

9. Cholesterol Reduction

Flaxseeds have long been known to lower cholesterol.  Depending on the study, you can expect a 10-20% reduction in bad cholesterol (LDL) as well as your triglycerides.  While chia seeds reduce cholesterol in animals, those same benefits have not yet been proven in humans.

Winner: flaxseeds

10. Diabetes Treatment/Prevention

When it comes to diabetes, flax seeds may be one of the best treatment options.  Indeed, one study showed that you could lower blood glucose levels by 20% with flaxseeds.

While chia seeds also help with diabetes, the benefit may not be as much.  For example, in a study of diabetics, chia seeds reduced hemoglobin A1C by 4%.

Winner: flaxseeds

11. Blood Pressure Lowering

There have been many studies on the blood pressure lowering effects of flaxseeds.  In a study of Brazilian men at risk for a heart attack, flaxseeds reduced systolic blood pressure by 3 points (mmHg).

Likewise, chia seeds also treat high blood pressure.  In particular, one study showed that chia seeds reduced blood pressure by 6 points (mmHg).   As there are few studies available for chia seeds and blood pressure treatment, it is unclear if the blood pressure lowering effect is better with chia seeds.

Winner: tie

12. Increased Exercise Tolerance

To test the legend that chia seeds allowed ancient Mayans and Aztecs to run for days, scientists put this to the test.  In a fascinating study, researchers compared gatorade to chia seeds in endurance athletes. As expected, the endurance athletes assigned to chia seeds did just as well as the gatorade group.

In contrast, I could find no studies evaluating the exercise effects of flaxseeds.

Winner: chia seeds

Overall Winner

Adding up all 12 categories, flaxseeds came out ahead in three and chia seeds also were better in three categories.  Thus, it is a tie.

Are there any risks of eating flaxseeds or chia seeds?

While both seeds are incredibly healthy, you don’t want to eat too much of them.  For example, flaxseeds contain a potentially dangerous substance, called cyanogenic glycosides.  One study suggested that the maximum amount of flaxseeds you can safely eat in a day is 50 grams or 4.5 tablespoons.

In addition, the phytoestrogen effect of flaxseeds could, theoretically, cause concern with pregnancy.  However, it is this same phytoestrogen effect of flaxseeds which makes them so effective in the treatment of hormonal cancers like breast and prostate cancer.

A side of effect of any omega 3 source is that they also thin the blood.  While this is not a problem in most people, for those taking blood thinners it could increase the risk of bleeding.

As mentioned above, chia seeds rapidly absorb water and can become “glue balls.”  Thus, you must drink enough water when you eat chia seeds.

How do you eat flaxseeds and chia seeds?

Flaxseeds and chia seeds can be worked into almost any recipe.  Put them in smoothies, salad dressings, or on yogurt.

There is now even a Trader Joe’s brand of natural peanut butter that includes both flaxseeds and chia seeds.  This is the main peanut butter we eat in our home.

While flaxseeds may need to be ground first, you don’t have to do this with chia seeds.  Chia seeds also make a great thickener for sauces.

Take Home Message

The key message of this article is that both flaxseeds and chia seeds are incredibly healthy.  Try eating some of these seeds each day to turbo charge the nutritional aspect of your diet.

Are you a flaxseed or chia seed person?  How do you eat these seeds?

Please leave your comments and questions below.  I read and respond to every question.  If you enjoyed this article, please be sure to sign up for my free weekly newsletter and share it with a friend.

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Top 10 Health Foods to Avoid

Conspiring food manufacturers have blurred the lines between what is real and what is processed.  Health foods must be real.  To clear the confusion, here are the top 10 supposed health foods to avoid.

1. Yogurt

Yogurt is part of any healthy breakfast, right?  While yogurt can be healthy, most yogurt options at your local grocery store is anything but healthy.

For example, one small Yoplait original strawberry yogurt has 26 grams of sugar.  That is more than six teaspoons of sugar.

Even worse is that sugar is listed as number two on the ingredient.  To put this in perspective, a Twinkie only has 18 grams of sugar.

If obesity and diabetes weren’t bad enough, studies show that added sugar is a major cause of heart disease.  Fortunately, yogurt can be healthy if there is no added sugar and live bacterial cultures (probiotics) are present.

Look for “plain” yogurt and read the ingredient list carefully.  You don’t want any added sugar.  Likewise, you want live cultures.

Fortunately, there are options that meet this standard at your local Whole Foods or Trader Joe’s.  If you need to sweeten your yogurt, try adding real fruit.

2. Granola

Even in the 1980s, most health conscientious people packed granola.  Yep, peace, love, and granola.

How granola got equated as a “health food” is a bit of a mystery to me.  To find the healthiest granola, I made a recent trip to our local Whole Foods.  There I found, Nature’s Path Organic Pumpkin Flax Granola.  With a name like that, it must healthy.

However, a closer look at the label showed that just one small cup of this granola contained 13 grams of sugar.  Once again, sugar was the second ingredient.  A closer inspection showed that this “healthy granola” was also sweetened by oat syrup and molasses.

To make matters worse, this “healthy granola” also contained soy oil.  Studies show that processed vegetable oils may cause inflammation and heart disease.

When it comes to oils, your best bet is extra virgin olive oil.  Coconut oil would be my second choice.  Even butter, from grass fed cows, is probably a better option than the industrial processed vegetable oils.

Does this mean you should never eat granola?  Absolutely not.  Just recognize granola for what it really is.  A treat that should only occasionally be eaten.

Of course, if you can make your own granola then you can avoid all of the sugars and unhealthy oils.  Alternatively, you can do what I do.  I like to add a little of the “healthiest” granola I can find to a big bowl of frozen blueberries topped with chia seeds and walnuts.

3. Fruit Juice

Fruit juice is just liquid sugar.  Most of the health benefits of fruit have been stripped away leaving only the sugar and a few remaining nutrients behind.

Liquid sugar causes weight gain.  Indeed, a Harvard University study of 120,877 people found that fruit juice was linked to long-term weight gain.

If you like fruit juice there is a healthy alternative.  Rather than “juicing” the fruit, blend it instead.  Drink the whole fruit rather than just the sugar.

4. Gluten Free Foods

You can now buy gluten free Honeycomb, corn flakes, or Rice Krispies.  A good rule of thumb is that if the label says “gluten free,” it probably isn’t real food.

A recent study in the British Journal of Nutrition evaluated 3,213 gluten free products in Australia. The conclusion of this study was that there was no health benefit of gluten free foods.  Indeed, gluten free foods may even be worse than their gluten containing counterparts.

Gluten free products are often loaded with sugar, processed carbohydrates, and processed vegetable oils.  For those with celiac disease, many “gluten free” products have also tested positive for gluten.

Gluten is just a protein found naturally in many grains.  People with celiac disease or gluten allergies definitely want to avoid gluten.  Fortunately, studies show that 86% of people who thought they had a gluten sensitivity didn’t after rigorous testing.

If you have celiac disease or a gluten allergy, buy gluten free ingredients not gluten free food-like products.

5. Salad Dressing and Toppings

Could a Big Mac actually be healthier for you than the McDonald’s salad?  According to a recent CNBC report, the answer is yes.  Indeed, a McDonald’s salad has more calories, salt, and fat than even a double Big Mac!

Salads can be one of the healthiest foods on this planet.  I eat at least one heaping salad every day.

The key is to avoid any prepared salad dressing, the croutons, and all the cheese.  Rather, top your salad with olive oil, balsamic vinegar, a homemade salad dressing, nuts, or seeds.

Commercially prepared salad dressing generally is nothing more than inflammation causing processed vegetable oils, sugar, and salt.

When eating out, I always ask for olive oil and balsamic vinegar to put on my salads.  At home, we love homemade salad dressings.  Recipes for many of these dressings are on our website.  A healthy salad dressing generally only takes a few minutes to make.

6. Smoothies

Everyone concerned about health and nutrition should drink a smoothie, right?

Yes, if you control the ingredients and make it at home.  A smoothie outside of your home should be viewed like an ice cream sundae.

Why is this the case?  Most commercially made smoothies are loaded with sugar, chocolate syrup, or ice cream.

If you choose to drink a smoothie you need to control the ingredients.  Make it at home and include plenty of vegetables, fruits, nuts, and seeds.  If you are looking for a good smoothie recipe, we have several on the recipe page of our website.

7. Veggie Chips

What could be better than getting your vegetables in something that tastes like a potato chip?  The problem is that nutritionally, a veggie chip is really no different than a potato chip.

For those wishing to maintain a healthy weight, a large Harvard University study showed that potato chips were second only to french fries as the main cause of weight gain.  Veggie chips are loaded with inflammation causing processed vegetable oils, salt, and many other food additives and chemicals.

There is a way to enjoy a healthy veggie chip.  Just thinly slice your favorite vegetables, add a little olive oil, herbs, and spices, and then bake at low temperature until crunchy.

8. Protein Bars

A protein bar is a healthy way to eat breakfast on the go, get through your workout, or just as an afternoon snack, right?  Not so fast.

Most protein bars are just highly processed candy bars.  Indeed, many have a long ingredient list and more chemicals than you could ever learn to pronounce.  Even worse, the sugar of many protein bars exceeds that of a candy bar.

While I would never call a protein bar “healthy,” there are “less bad” options.  Our favorites are some of the Kind bars or Trader Joe’s brand of bars.

A protein bar should never have more than 5 grams of added sugar.  The ingredient list should be short and pronounceable.  The protein source should be from real foods, like nuts and seeds.  Avoid bars with the word “isolate,” as an isolated protein is a highly processed chemistry lab protein.

9. Almond, Coconut, or Soy Milk

Almonds, coconuts, and soy beans are all health foods, right?  Yes, if you don’t drench them with sugar, food additives, and other chemicals.

Indeed, a glass of a typical alternative milk has around 7 grams, or two teaspoons, of sugar.  Likewise, you will often find the food additive, carrageenan, or “natural flavors,” on the ingredient list.

Carrageenan is a food additive to make the alternative milk creamy.  The problem is that carrageenan has been associated with cancer in animals.

With natural flavors, you never know what you are getting.  A good rule of thumb is that if you ever see the word “natural flavors,” the food manufacturer is trying to hide something.  That something could be MSG or just about anything.

We often drink healthy alternative milks in our home.  Whole Foods and Trader Joe’s do carry some alternative milks without any added sugars, food additives, or other chemicals.

If you like soy milk, buy organic varieties using the “whole bean.”  While there is some controversy around soy, medical studies from Asia, where they have traditionally used the whole bean, have consistently showed a lower risk of breast cancer and heart disease.

10. Farmed Fish

Studies show that fish prevents heart disease, dementia, and premature death.  Despite these benefits, not all fish are created equal.

For example, some studies show that the contaminants in farmed fish may outweigh any potential health benefits.  However, other studies show that any increased risk of a cancer death is more than offset by a reduction in the risk of dying from heart disease.

Fortunately, you can enjoy all the health benefits of fish while minimizing the risk from mercury, dioxin, and PCBs.  For example, the Environmental Working Group found that farmed salmon has 16 times more dioxins and PCB contaminants than wild salmon.

To minimize your risk, buy wild, smaller, and ocean fish.  To keep costs down, we generally buy frozen Alaskan wild fish from our local Costco.  If you want to learn more about which fish are healthiest, a great reference is the Monterey Bay Aquarium Seafood Watch.

Which Supposed Health Foods to Avoid

The main take home message of this article is that food manufacturers have blurred the lines between real and processed.  Healthy food is real food.  Real foods look like something your ancestors from a hundred years ago would have recognized.

Have you been fooled by any of these supposed “health foods?”  Please leave your questions and comments below.

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8 Things You Need to Know about the Paleo Diet

The Paleo Diet remains one of the most popular diets.  Despite this popularity, the Paleo Diet consistently ranks as one of the worst diets according to the annual U.S. News and World Report rankings.

In this article, I’ll cover the latest medical studies on the Paleo Diet.  I’ll also discuss the benefits and possible risks of the Paleo Diet.

What is the Paleo Diet?

The Paleo Diet is really simple.  If something wasn’t around during caveman times, you shouldn’t eat it.

One unique aspect to the Paleo Diet, compared to other diets, is that the Paleo Diet is considered a lifestyle by most followers.  Indeed, there is an entire culture now built around this “Paleo Lifestyle.”  With a strong paleo culture in place, it makes it much easier to stick with this way of eating long-term.

Specifically, the Paleo Diet avoids sugar, processed foods, legumes, dairy, and grains.  While no one would argue with cutting out sugar and processed foods, the controversy really centers around legumes, dairy, and real whole grains.  This controversy has spawned modified Paleo Diets which may include sprouted legumes, some dairy, and some whole grains like brown rice.

Is the Paleo Diet safe?

If done right, the Paleo Diet can hit on all key nutrients for health.  Animal meats should ideally be wild or lean, organic, and non-processed cuts.  Also, vegetable intake should be dramatically increased.  Probably the biggest benefit from the Paleo Diet comes from just eliminating added sugars and processed foods.

8 Things You Need to Know about the Paleo Diet

Based on the latest medical studies, here are the top 8 things you need to know about the Paleo Diet.

1. It Is Not Any Harder than Any Other Diet

According to the U.S. News and World Report rankings, the Paleo Diet is just too hard for most people to follow.  This is the main reason why the Paleo Diet typically ranks as the worst.

Yes, avoiding grains is hard.  What do you eat at your next social gathering or birthday party?

Despite this perception, the medical science doesn’t support this.  Indeed, medical studies show that a low carb eating style is not any harder than any other diet.

2. You May Lose Weight

Studies show that people lose weight fast when they cut out added sugars and processed carbs.  Studies also show that people tend to feel very full on the Paleo Diet.  Is it any wonder then that studies show that people lose weight fast when following the Paleo Diet?

Of all the Paleo Diet weight loss studies, my favorite is one from Australia.  In this study, researchers took 10 overweight and diabetic aborigines eating a Western diet and put them back in the bush eating only what their hunter gatherer ancestors would have eaten.  After just seven weeks of roaming the bush looking for food, their diabetes resolved and they lost an average of 18 pounds.

3. You Must Eat a Lot of Vegetables

By eliminating legumes, dairy, and whole grains from your diet, you are missing out on many key nutrients.  To make this up, you will have to dramatically increase your vegetable, as well as your fruit intake.

Vegetables are especially important with the Paleo Diet.  Vegetables need to be a part of every meal, including breakfast.

When it comes to nutrition, studies show that the biggest risk of the Paleo Diet is a lack of calcium.  Calcium is critical for bone and other body functions.  Fortunately, there is much more calcium in green leafy vegetables, nuts, and seeds than the dairy industry would like you to believe.

To easily determine if what your diet is nutritionally sound, I highly recommend downloading the free Healthwatch 360 app.  With this app, you enter in the foods and the app will tell you what percentage of 39 key vitamins, minerals, and other nutritional markers you have hit for the day.  If you can’t get enough nutrition, you may need a “modified” Paleo Diet, which includes sprouted legumes, some dairy, or real whole grains, like brown rice, to hit on all key nutritional parameters.

4. Your Saturated Fat Intake Will Go Up

As covered in a previous blog article, there is a lot of confusion about the risk of saturated fat.  Historically, saturated fat was believed to be one of the major causes of high cholesterol and heart attacks.  That thinking is changing.

Based on a recent review in the British Medical Journal of 73 studies and 339,090 people, researchers concluded that saturated fat is neutral when it comes to heart disease.  The real risk is from replacing saturated fat with processed carbs.  In contrast, if saturated fat is replaced with omega 3 fats, cardiovascular risk can be reduced.

While modern day Paleo Diet followers are mostly meat eaters, studies show that the real paleolithic people were primarily vegetarians.  Thus, to be nutritionally safe, and be a true follower of the paleolithic eating style, you will likely need to significantly eat more vegetables and fruits.

5. Your Blood Pressure May Go Down

Studies show that 90% of people will have high blood pressure by age 55.  High blood pressure is one of the main causes of disability and premature death.  Fortunately, as I discussed in a previous blog, high blood pressure can be prevented or reversed.

Fortunately, studies consistently show that blood pressure goes down on the Paleo Diet.  This blood pressure drop is likely due to weight loss, the elimination of added sugar and processed foods, less sodium, and more potassium in the diet.

In every study I reviewed, the blood pressure lowering effect of the Paleo Diet seemed to be 3 to 10 points (mmHg).  If you consider that the typical blood pressure pill only drops blood pressure by about 8 points (mmHg), this really is quite impressive.

6. Your Diabetes May Resolve

Reversing diabetes is probably the main selling point of the Paleo Diet.  Indeed, all low carb diets dramatically improve glucose and hemoglobin A1C.  For example, one small study of 29 people with heart disease showed that the Paleo Diet was even better than the Mediterranean Diet for the treatment of diabetes.

7. Your Cholesterol Numbers Might Improve

Quite surprisingly, in a very small study of only 20 people, the non-grain Paleo Diet was shown to be better than the grain-based American Heart Association (AHA) Diet for cholesterol numbers.  While this study was quite interesting, there was not enough information for me to draw any firm conclusions.

For example, the study did not report vegetable or fruit intake of either group.  Nor did it report which grains and dairy the AHA Diet followers ate.  There also was no mention if legumes were even eaten in the AHA Diet group.

Based on this lack of information, this study could have simply compared the Standard American Diet to a diet comprised of lean meats and lots of vegetables and fruits.

8. Your Cancer Risk May Go Down

In another interesting study, the Paleo Diet was shown to be as good as the Mediterranean Diet for preventing colon cancer.  In a careful read of the study, people had to report eating a lot of vegetables and fruits to be considered followers of the Paleo Diet.  As high consumption of vegetables and fruits are well know to boost fiber intake and lower colon cancer risk, the findings of this study came as no surprise.

Take Home Message

The take home message of this study is that any way of eating that minimizes or avoids added sugars and processed foods can be very healthy.  As long as followers of the Paleo Diet eat large quantities of vegetables, fruits, nuts, and seeds, they should be able to get all the nutrients they need from food, including calcium.

Based on my careful review of the medical literature, the U.S. News and World Report ranking system is flawed when it comes to their assessment of the Paleo Diet.

Have you tried the Paleo Diet?  Did it work for you?

Please leave your experiences, comments, and questions below.  I read and respond to every comment.  If you have enjoyed this article, please sign up for my newsletter and tell a friend.

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The Top 11 Weight Loss Myths

Weight loss myths are everywhere.  Is it any wonder that up to 98% of people can’t get back to a healthy weight?  In this article, I debunk the top 11 weight loss myths with the latest medical science.  You can regain a healthy weight relatively painlessly by following the simple principles discussed in this article.

1. Diets Don’t Work

Studies show that up to 98% of dieters will fail.  Based on these dismal numbers, most have concluded that diets don’t work.

According to medical studies, people really do lose weight on almost every diet studied. The problem is that the results are just temporary.

These people have not put in place healthy lifestyles.  Thus, as soon as their study or diet is over, they immediately regain the weight.

Diet is a “four letter word.”  I never recommend diets.  Many are not healthy.

The key to a healthy weight is a healthy lifestyle.  However, for some people, diets can be helpful to start the process.

I have found that for most of my patients, their weight and chronic medical conditions will melt away by eating more vegetables, tracking their steps, and avoiding sugar and processed carbohydrates.  A healthy lifestyle is really that simple.

2. You Have to Count Calories

For some people, counting calories bring awareness and accountability. I have found that tracking my nutrition helps me to eat more mindfully.

The problem is that counting calories is highly inaccurate.  While 3,500 calories equals a pound of fat in the science lab, 3,500 calories does not equal a pound of fat in the real world.  To make matters worse, studies show that it is human nature to significantly underestimate your food calories and overestimate your burned exercise calories.

Food is information to your body.  For example, 100 calories of a processed breakfast cereal will spike your blood glucose and insulin levels so high that you will feel compelled to snack before lunch.  In contrast, 100 calories of plain almonds doesn’t have this effect.

In addition to messing up your metabolism, processed breakfast cereals may cause food cravings through activation of the dopamine brain reward system.  In my practice as a cardiologist, I have yet to meet a patient with an irresistible urge to eat more plain almonds.

Digestion is also different.  You will likely absorb close to 100% of the processed breakfast cereal calories whereas many of the calories from almonds will pass through to your stool.  Indeed, one study showed that you absorb 32% less cal0ries from plain almonds than what it says on the food label.

If counting calories works for you, then stick with it.  If it isn’t working for you, it is time to stop counting calories.

3. You Need Willpower

Studies show that willpower is like a muscle.  If exercised for short intervals, muscles get stronger.  If overused, muscles tire or become injured.

While you could never lift weights 16 hours a day, you also can’t rely on your willpower muscle for 16 hours each day.  You simply can’t resist junk at home, work, and social events.  Something has to give.

It seems counter intuitive but most of my patients who have successfully maintained their weight loss have done so with minimal willpower.  In other words, they have created an environment where they are rarely tempted.

These people have a support team.  Spouses, friends, and coworkers all help.  For those without this support, they often find help from online groups or fellow gym goers.

These people don’t bring unhealthy foods into their homes.  They avoid the center isles of the grocery store.  They stay away from their temptations.

Just like the alcoholic should never go into a bar, the same holds true with food.  If you don’t want to slip, don’t go where it is slippery.

Don’t use up your precious willpower muscle at home.  Rather, save it for the office or social events where you have less control.

The bottom line is that if losing weight requires willpower then you are probably doing it wrong.

4. Exercise Causes Weight Loss

Often, when I talk with patients about getting back to a healthy weight, they tell me why they can’t exercise.  Truth be told, medical studies show that exercise doesn’t cause weight loss.

The reason is simple.  The more you exercise the more you eat.  Weight loss comes from food choices, not exercise.

While exercise doesn’t cause weight loss, studies show that exercise is critically important to maintaining a healthy weight.  The easiest way to exercise is to track your daily steps.

Studies show that you will subconsciously exercise 27% more by just tracking your steps.  You don’t even need to spend any money on fancy technology or exercise equipment.  Step tracking apps are free with any smartphone.  Absolutely no willpower is required to boost your exercise by 27%!

5. Carbs Cause Weight Gain

Not all carbs are created equal.  While it is true that carbs from sugar and processed foods cause weight gain, carbs from vegetables, legumes, and fruit have the opposite effect.

In general, what determines whether a carb causes weight gain or weight loss is determined by how fast it is converted to sugar by the body.  For example, the flour in whole wheat bread is converted to sugar faster than a Snicker’s bar.  In contrast, broccoli carbs take hours to digest.

In a 24-year study of 133,468 people, researchers from Harvard and Tufts University found that the more carbs you get from vegetables, fruits, and legumes the less you will weigh.  In contrast, another Harvard study of 120,877 people showed that the more carbs you get from sugars, sweets, and processed foods the more you will pack on the pounds.

The main exception to the eat more vegetables rule is the potato.  Studies show that eating potatoes, not sweet potatoes, is associated with weight gain.

In my experience, the number one factor of weight gain or weight loss is the type of carb you pick.

6. Fat Makes You Fat

In the 1980s, most people believed that fat made you fat.  I remember hating the skim milk on my breakfast cereal.  Little did we know then that future studies would show that the fat in milk helps prevent weight gain and diabetes.

Sadly, many people still believe that fat makes them fat.  Remarkably, in a study of 7,447 patients, even eating a liter of olive oil each week did not cause weight gain.

Like carbs, not all fats are equal.  Some, like trans fat, causes intense weight gain and heart disease.

Trans fat is found in processed foods.  Virtually all processed food companies game the system and report “zero trans fat.”

You have to dig deeper.  If anything is listed as “partially hydrogenated” in the ingredient list, this is a trans fat.  As long as processed food manufacturers pack in less than a half gram of trans fat per serving, they don’t have to disclose the trans fat.

Most vegetable oils in processed and prepared foods are also problematic.  The goal is to get as much of your fat naturally, like from nuts and seeds.  Indeed, studies show that nuts are one of the best foods to lose weight.

The bottom line is that when most people cut the fat, they replace it with processed carbohydrates.  Is it any wonder that studies show low fat diets don’t work very well.

7. Metabolism Can Be Boosted by Eating Breakfast, Frequent Small Meals, or Certain Foods

A quick search on the Internet will tell you that if you just eat the right food, breakfast, or frequent small meals that you can boost your metabolism.  Unfortunately, it doesn’t work that way.

While some foods, like chili peppers or green tea, have been shown to boost metabolism, the effect is so small that most people will never see a difference on the scale.  As I have discussed in previous articles, breakfast, snacking, and frequent small meals have not been proven to either boost metabolism or cause weight loss.

If eating breakfast, frequent small meals, or certain foods help you then stick with it.  The take home message is don’t feel compelled to eat breakfast, frequent small meals, or certain foods just because of something you have read on the Internet.

8. Gluten Causes Weight Gain

After reading a popular “health book” a number of years ago, I wondered if gluten could be contributing to me being overweight.  Just like the prominent doctor of this “health book” said, once I eliminated the gluten I lost weight.

It retrospect, this was because I eliminated processed carbs.  It wasn’t long before I found gluten free alternatives for my processed carb fix.  In no time, I had gained the weight back.

Gluten is simply the name of the protein in wheat and other grains.  While some people have digestive or autoimmune problems with this protein, gluten has never been proven to cause weight gain.  In fact, quite the opposite is true.  Studies show that those who eat real whole grains, even those containing gluten, lose weight.

9. You Have to Starve to Lose Weight

Hunger is like gravity, it always wins.  While you can starve yourself to lose weight short term, you will never be able to maintain that weight loss if you are hungry.

Hunger is complex.  While hunger can be your body telling you it is time to eat, often it is not.  Hunger can also be due to a lack of micronutrients in your diet, thirst, or just a psychological need to eat.

A simple way to tell if your hunger is real or not is what I like to call the “broccoli test.”  If you are hungry enough to eat broccoli then you are really hungry.

The key to keeping your belly full while losing weight is simple.  Eat more vegetables, fruits, and legumes while avoiding sugar and processed carbohydrates.

There is no limit to the amount of non-starchy vegetables you eat.  The more the better.  I have yet to meet a patient who gained weight from eating too much broccoli.

10. You Can’t Eat Your Favorite Foods

The psychological impact of “comfort foods” can’t be ignored.  We all have comfort foods.  If you feel deprived of these foods, you will likely gain weight.

The key is to eat your comfort foods while losing weight.  Healthy substitutions are an often overlooked secret to weight loss.  All of your favorite recipes can be very healthy with just a few key substitutions.

For example, it is well known that mashed potatoes cause weight gain.  By simply substituting in enough cauliflower, you can turn this comfort food into a powerful weight loss tool.  Indeed, based on a Harvard University study, no other vegetable comes even close to cauliflower for losing weight.

11. Don’t Weigh Yourself

You’ve heard the advice, don’t weigh yourself.  Weights fluctuate and you will become discouraged.

The reality is that you need real feedback.  You need periodic course correction.  Indeed, studies consistently show that frequently weighing yourself if one of the most important things you can do to maintain your weight loss.

There is Hope

While most people can achieve a healthy weight with a few minor course corrections, for others it is not so simple.  Regardless of how many times you have tried, you can beat your genes and the trappings of modern life.  Based on an eight-year study of 5,145 people, most of the people in this study were able to maintain their weight loss for eight years.

What was their secret?  The key is that they met regularly with other study participants, nutritionists, psychologists, and physical trainers for eight years.  The message is simple, you need a support team.

Fortunately, support groups are free and can be found in most cities.  Many of my patients with compulsive overeating or food addictions have found relief by joining Overeaters Anonymous.

If you have developed a condition related to weight gain, like high blood pressure, diabetes, or a heart condition, many insurance plans now cover nutritionists, psychologists, or a cardiac exercise program.  Check with your doctor and health plan administrator to see what benefits are available.

Take Home Message

The main reason why up to 98% of people can’t lose weight is because they don’t understand the science.  There are simply too many weight loss myths.

Maintaining a healthy weight is really simple.  For most people, a few small changes is all that is standing between you and a life of never having to worry about weight issues again.  A healthy lifestyle really boils down to eating more vegetables, tracking your steps, and avoiding sugar and processed carbohydrates.

What has worked for you?  Have you struggled with any of these weight loss myths?

Please leave your comments and questions below.  Also, if you like what you have read, be sure to share it with a friend and sign up for my free weekly newsletter.  In this newsletter you will find life-changing gems that can’t be found anywhere else on my website.

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Skipping Breakfast is Bad for You, or Is It?

You were always told that skipping breakfast is bad for you.  After all, breakfast is the most important meal of the day, right?

According to the experts, if you skip breakfast you will gain weight, feel horrible, and put yourself at risk for heart disease.  But is that really true?

In this article, I challenge this long held belief that skipping breakfast is bad for you.  Based on the latest scientific findings, I’ll let you decide if skipping breakfast is bad for you or not.

Breakfast for Me

I have always been a breakfast eater.  Even today, as soon as I woke up I ate breakfast.

In my younger years, I ate the standard American breakfast.  Plenty of processed carbs, in the form of breakfast cereal, instant oatmeal, pancakes, and fruit juice.  Somehow, I always found it strange that I was hungry again an hour or two after eating such a large breakfast.

Today, I eat much better and don’t get hungry again until lunchtime.  Every morning I have a big salad without salad dressing, chia and flax seeds mixed with nut butter on Ezekiel Bread, fruit, and a few dark chocolate covered almonds.

I would never dream of skipping breakfast.  For me, I just feel better with breakfast.  I am also much more productive with my morning routine if I eat first.

Just because eating breakfast works for me, does it mean that everyone else should eat breakfast as well?

What is the scientific data for eating breakfast?

Everyone knows that skipping breakfast is bad for you, right?  Eating breakfast is so ingrained in our culture that few would consider it possibly healthy to skip breakfast.  Indeed, many observational studies have shown that eating breakfast protects against weight gain and heart disease.

The problem is that these studies have just been observational studies.  In other words, people who ate breakfast were observed to be leaner and healthier.

These studies don’t prove that eating breakfast made them leaner or healthier.  Perhaps it had nothing to do with eating breakfast at all.  Perhaps the real reason is that breakfast eaters may be more inclined to work out in the morning.  Fortunately, we now have much better studies to answer the question, is skipping breakfast is bad for you?

The Bath Breakfast Study

To challenge the long-held belief that skipping breakfast is bath for you, researchers from Bath England randomized overweight adults to either eating or skipping breakfast. Here are the key findings of their study:

1. Metabolism was not affected by eating or skipping breakfast.

2. Breakfast eaters ate more total calories and had a statistical trend toward weight gain.

3. Measures of heart disease were not affected by eating or skipping breakfast.

4. Breakfast eaters were more physically active in the morning.

5. The longer feeding window of breakfast eaters caused lower insulin spikes.

As you can see, there really were no critical differences between breakfast eaters or skippers.  Indeed, in two other well designed studies, there also was no significant difference in eating or skipping breakfast.

When is eating breakfast critical?

Does the Bath Breakfast Study mean that you should skip breakfast?  Absolutely not.  I certainly will not give up my daily breakfast routine based on the results of this study.

However, it should be noted that the Bath Breakfast Study does not apply to everyone.  This was just a small study of overweight young and middle aged adults.  For children it is a completely different matter.

Studies have consistently shown that breakfast is critical for optimal school performance in children.  This is especially true for impoverished children.  In fact, even children who eat two breakfasts, one at home and then one at school, are less likely to become obese.

When may skipping breakfast be healthy?

If you are a healthy young or middle aged adult, and do not feel hungry in the morning, then forcing yourself to eat breakfast may be the wrong thing to do.  Indeed, depending on what time you last ate the previous day, skipping breakfast may be a form of intermittent fasting.  As I have discussed in a previous article, intermittent fasting may help with weight loss and preventing heart disease.

Another benefit to skipping breakfast is that, for most Americans, breakfast is the unhealthiest meal of the day.  Fruit juice, and at least 99% of all breakfast cereals, bagels, pancakes, waffles, toast, or yogurt, are little more than rapidly absorbed sugar to the body.

Take Home Message

The take home message of this article is that the conventional wisdom that skipping breakfast is bad for you may not be correct.  Based on my research of the scientific data, I could find no compelling reason for adults to eat breakfast as long as you are healthy.

Indeed, my opinion is the same as the researchers in a recent study, breakfast may just be another meal.  For some people, skipping breakfast may be the right thing to do.

As long as you are healthy, try skipping breakfast a few times to see if it helps you with your health goals.  If you are already skipping breakfast, then don’t feel like skipping breakfast is bad for you.  The key message of this article is to find out what works best for you.

As for me, I will continue to eat my same breakfast every morning.  For me, skipping breakfast absolutely doesn’t work at all.  When I skip breakfast I get so hungry and irritable that I am of no use to anyone.  Especially myself.

Are you a breakfast eater or skipper?  Please leave your experiences below.  If you have any questions about what you have read, leave those questions below as well.  I will do my best to answer every question as quickly as possible.

If you have enjoyed what you have read, please sign up for my weekly newsletter and share it with a friend.  In this newsletter you will find information that you can’t find anywhere else on my website.  If you would prefer, I also have a podcast where I cover this and every other article I have published on my website.

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The Number One Food to Live to 100

Have you ever wondered what the secret is to a long life?  Is there a certain food to live to 100?

Even if you have no intention of ever living to 100, those who make it to 100 are often still doing everything they did in their 40s or 50s at age 90.  Read on to find out the number one food to live to 100.

The “Fountain of Youth” Food Study

In 2004, professor Irene Darmadi-Blackberry from La Trobe University in Australia published a study that was completely overlooked by most of the medical community.  As diets and life expectancy vary greatly from one country to another, Dr. Darmadi-Blackberry was convinced that a specific food could confer longevity.

To search for this “Fountain of Youth” food, Dr. Darmadi-Blackberry studied 785 people from four of the longest-lived countries.  These four countries were Japan, Australia, Sweden, and Greece.  All four of these countries have a life expectancy much longer than the U.S.

As you might imagine, what people eat in Japan, Australia, Sweden, and Greece vary dramatically.  After carefully dissecting through the food logs of these 785 people, Dr. Darmadi-Blackberry and her colleagues found that eating legumes was the number one food predictor of longevity in these four countries.

Which legumes people ate also varied by country.  For example, the Japanese ate mostly soy in the form of tofu, natto, or miso whereas the Swedes preferred brown beans and peas.  The Greek preferred lentils, white peans, and garbanzo beans.  Kidney beans, garbanzo beans, lentils, peas, and mung beans were popular in Australia.

Specifically, she found that for every 20 grams of legumes eaten each day, you could live 8% longer.  While legumes came out as the number one food for longevity, fish and olive oil also conferred longevity in this study.

Twenty grams of legumes each day really isn’t that much.  Basically, 20 grams works out to be two tablespoons of beans or lentils every day.  Even the pickiest eater could tolerate just two tablespoons.

I should point out that this was an observational study.  In other words, people in these four countries were “observed” to live longer if they ate legumes.  This study certainly doesn’t prove you will live longer if you start eating legumes.  There could have been other factors that contributed to the longevity of legume eaters.

For example, the average Japanese person in this study ate a mere 1,599 calories each day whereas the typical person in Sweden ate a hearty 2,501 calories daily.  The average Japanese person ate five times more fish than someone living in Australia.  The Swedes consumed the most dairy.  The Greeks and Australians ate much more animal meat than the Japanese.

Meat or no meat?  Dairy or no dairy?  Which is best?

From this study, it may not matter.  The really answer may also be in what they didn’t eat.  People from these four long-lived countries ate much less sugar, processed carbohydrates, and fast foods than what we do in the U.S.

Food doesn’t have to be that complex for optimal health.  The real answer is just to eat real food in the least processed state possible.

Indeed, people from these four long lived countries thrived on very different diets.  Legumes, in addition to vegetables and fruits, were an important part of all these diets.  Legumes may be the number one food to live to 100.  What these diets lacked was a lot of sugar, processed carbohydrates, and fast foods.

What is your take on diet and longevity?  Do you get your two tablespoons of legumes each day?

Please leave your comments below.  Also, if you have any questions about what you have just read, please post your questions below.  I will do my best to answer these questions as quickly as I can.

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Couch to 5K: Fit for Life 4 Easy Steps

Not exercising prematurely ages you 10 years according to studies.  For my patients who have not been active for years, most don’t know where to begin.  In this article, I share a scientifically proven way to go from couch to 5K and become fit for life in four easy steps.

My Couch to 5K Experience

In 1991, I was a couch potato.  I was also 30 pounds heavier than I am now.

At that time, I had just been accepted to Johns Hopkins University Medical School and had not exercised in many years.  As fate would have it, I was assigned two roommates who were both hardcore marathon runners.

Not long after living with them, they had convinced me to run the New York City Marathon with them.  The problem is that I had never run before.  In fact, I hated running.

Never in even my wildest dreams had I ever considered running a marathon.  I had never even walked or run a 5K before.

A marathon seemed so far beyond anything I was ever capable of doing.  Still, I was up for the challenge and I needed to get in shape.

When I shared my plans to run the New York City Marathon with my soon-to-be wife, Jane, she was excited.

“Let’s do it together,” she said.  Even though we were living on opposite ends of the country, she suggested that we train together and share our progress.

“To get ready for the New York City Marathon in the fall, will you run the Salt Lake City Marathon with me this summer?” She asked.

“Sure,” I reluctantly said.  Now, the couch potato had publicly committed to not one but two different marathons both in the same year.  One with Jane and one with my roommates.

While I no longer run marathons, these two marathons kick started a lifelong fitness habit.  I have remained physically fit ever since.

How do you go from couch to 5K?

I should point out that running a marathon, based on the latest research that I described in a previous blog,  may not be a healthy decision. However, at least walking a 5K is something that everyone should be able to do. Even if you are confined to a wheelchair, a 5K is still within reach.

The problem is that most of my patients don’t know where to begin.  Let me take you through a four-step scientifically proven process that will maximize your chances of success and lifelong fitness.

Couch to 5K: Fit for Life 4 Easy Steps

1. Commit to a Two-Month Public Goal

To go from couch to 5K, you have to commit.  For many of my patients, committing to an event, like a 5K, is often all they need to also kick start a lifelong fitness habit.

Fortunately, there are 5K races most weekends.  If you can’t run, then commit to walk a 5K or another event.  Studies show that if you commit publicly to your goal, you are much more likely to succeed.

In my case, I definitely committed publicly to my fitness goal.  My reputation was on the line with my medical school classmates as well as with my future wife.  I couldn’t let them down.

The process of training and running two marathons took me about a year to complete.  As I had not exercised in many years, this year long commitment was probably what I needed to make fitness a habit for life.

However, you don’t need to commit to a year.  Studies show that two months is about all you need to develop a new habit.

Why a two-month goal?

Common wisdom is that it only takes 21 days to form a new habit, right?  Unfortunately, there are no data supporting this.  Interestingly, no one really knows where this belief originated from but it was certainly popularized by Dr. Maxwell Maltz, a plastic surgeon, in his book Psycho-Cybernetics published in 1960.

Dr. Maltz noted that it took his patients about 21 days to get used to looking at their new face in the mirror after plastic surgery.  Now, getting used to how you look in the mirror and training for a 5K are two completely different things.

To challenge this long held belief, Dr. Phillippa Lally and colleagues from University College London conducted a study to see just how long new habits take to form.  In this study, Dr. Lally and colleagues recruited 96 volunteers to track how long it took them to form a new healthy habit around eating, exercising, or drinking.

What they found is what I typically see in my cardiology practice.  There is nothing special about 21 days.  In fact, depending on the person, their situation, and how difficult the new habit was for them, it took anywhere from 18 to 254 days to make their new habit stick.

Fortunately, for most people it did not take 254 days.  Most people were able to achieve their fitness, weight loss, or drinking habits in about 66 days.

It is important to remember that the real goal is not to walk or run a 5K, but rather to use this 5K event to develop a life-long habit of physical activity.

Use a Commitment Device

If you really want to ensure success, use a commitment device to make sure you don’t back out of your 5K.  A commitment device is a means to get you to follow through on your commitment that you wouldn’t normally do.

There are lots of different commitment devices.  My favorite is Stikk.com.  On Stikk, you define your goal and then tap into the power of loss aversion to increase your chance of success by three-fold.

If you don’t achieve your couch to 5K goal, then whatever money you “pledged” will be taken from your credit card and donated to the anti-charity you have selected.  This “anti-charity” could be anything from the NRA Foundation to the Freedom to Marry organization depending on your political beliefs.  The key to the anti-charity commitment device is that you would do almost anything to prevent your hard earned money from going to an organization you detest.

2. Recruit a Partner

If you want to succeed, you need a partner.  The best partner is your spouse or significant other.  Studies show that couples who commit together for health goals are up to 11 times more likely to succeed!

If your spouse or significant other is not willing to go on the couch to 5K journey with you, find a coworker or friend who will.  Even an online “virtual” partner can help you succeed.

In my case, I was doing the marathons with my medical school classmates and Jane.  With most of the important people in my life all training together with me, it made it much easier to succeed.

3. Buy the Right Tools

To help you succeed, you need the right gear.  Buy a new pair of running shoes, shorts, and shirt.  As soon as you wake up each morning, put on your new running shoes and exercise clothes.

Whether or not you choose to exercise that day is entirely up to you.  You just can’t make the decision not to exercise until your entire exercise gear is on your body.

In my case, I kept my new running shoes, shorts, and shirts hanging prominently in my medical school dorm room.  It was always visible and reminded me of my goal.

4. Tracking Device

The right tracking device will not only “gamify” your couch to 5K adventure, but will also be your coach through the process.  It will teach you what you need to do each day to achieve your 5K goal.

My favorite app for patients just starting on the couch to 5K path, is the smartphone app “Couch to 5K.” All this app requires from you to achieve your 5K goal is about 20 minutes, three times a week, for two months.

The app will even tell you what specifically you need to do for your 20 minute workout to stay on course to reach your 5K goal.  It will also track your progress and allow you to share the journey with your friends and family through Facebook and other social media sites.  If you would rather not use an app, a fitness trainer works just as well.

Alternatively, any pedometer will help you achieve your 5K goal. Many of my patients like the Fitbit or the Apple watch to track their progress.  Studies show that just putting a pedometer on your body will cause you to subconsciously take 2,500 extra steps a day.  That is 2K of the 5K, every day, without even having to think about exercising.

As a first year medical student in 1991, there were no apps or pedometers around to help me in my training. Rather, I shared my daily mileage with my roommates and Jane.  Often, we ran together.  The key was that I was 100% accountable.

As I reflect back, somewhere during the training process I experienced the “runners high.”  This is the euphoria that runners experience.  A euphoria or drug-like state that is so strong that they never want to stop running.

Once I experienced this “runners high,” I was hooked for life.  Since 1991, exercise has been something that I just can’t live without.

Final Thoughts

In this article, I discussed how you can use science to maximize your chances of becoming fit for life.  The goal is not really to walk or run a 5K, but rather develop a lifelong habit of physical fitness.

Often times, a “big race” is all you need to jump start a lifelong fitness program.  It certainly worked well for me.

The four steps discussed in this article also work well for weight loss, smoking cessation, or any other health goal.

Did you use a 5K, or another event, to help you become physically fit?  Please share your experiences as to how exercise became a habit for you.  As always, leave your questions and I will do my best to answer every question.

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5 Ways Snacking and Frequent Meals Cause Weight Gain

Many popular “health books” and internet sites claim that snacking and frequent small meals will boost your metabolism and help with weight loss.  Does snacking and frequent meals cause weight gain or weight loss?

Jeff’s Experience

Jeff struggled with weight issues his entire life.  He also wanted to get off his blood pressure and arrhythmia medications.  At the advice of a friend, he got a physical trainer at the gym in January.

His trainer told him that eating six small meals a day would keep his hunger away, boost his metabolism, and allow him to lose weight.  Jeff eagerly tried this new approach.

“How did it go?” I asked.

“I did what he told me to do.  Instead of three big meals I ate six small meals but the weight didn’t come off.  To be honest, I have gained five pounds in the last two months.”

While frequent small meals didn’t work for Jeff, I have seen it help other patients.  Could it work for you?  Let’s review the science.

94% of Americans Snack

Snacking has become part of our culture.  According to the Snacking Motivations and Attitudes U.S. 2015 study, 94% of Americans snack.  I am one of them.

Based on our research of people living in China’s Longevity Village, people did not snack or eat frequent small meals.  In fact, most of the centenarians we interviewed ate two or three meals each day without any snacking.

Their daily “feeding window” was compressed to 10 hours for those eating three meals daily and six hours for those eating two meals daily.  This means that they went the other 14-18 hours each day without anything to eat.  This is what we now call “intermittent fasting.”

5 Ways Snacking and Frequent Meals Cause Weight Gain

Why do so many people gain weight with snacking or frequent small meals?  Below are 5 ways snacking and frequent meals may cause weight gain.

I should point out that some of my patients have lost considerable weight by eating six small meals a day.  With this approach, you have to make sure that the six small meals consist of the right foods and don’t start becoming larger meals.

1. You End Up Eating More

Americans now get one third of all their calories from snacking.  Based on a recent study, Americans are now eating 15 hours a day.  It is one long, continuous meal.

In this study, researchers found that anything eaten after 6:36 pm was simply more calories than their body needed for the day.  Based on the benefits of intermittent fasting, these researchers then allowed study participants to eat anything they wanted, but just limit this daily feeding window to 10 t0 11 hours.

Remarkably, researchers found that even though they could eat anything they wanted, their daily calorie consumption went down by 20% when limited to a 10-11 hour feeding window.  They also found that they lost a lot of weight, had more energy, less hunger, and slept much better at night.

2. Metabolism is Not Increased by Snacking or Frequent Meals

Despite popular belief, metabolism is not increased by snacking or frequent small meals.  When this question has been put to the test in medical studies, it turns out to be yet another weight loss myth.

Indeed, in a review of all medical studies published on snacking, frequent small meals, and metabolism, researchers concluded that there was no change in metabolism.

Of course, I should point out that these studies were “averages” of many people.  I know that there are some people who definitely do better with frequent small meals.  To find out if you are one of these people, closely monitor yourself.

3. Snackers Eat Alone

Not only have we become a nation of snackers, studies show that we also enjoy snacking alone.  Eating with others helps you to eat better.

For example, there are many studies showing that family meals help in maintaining a healthy weight.  Unless your family or friends are encouraging you to eat junk, regular meals with others may help significantly with nutrition and weight loss.

4. Snacks and Frequent Small Meals Are Often Unhealthy

According to the Nielsen Report, below are the top 7 snack choices enjoyed by Americans:

1. Chips

2. Chocolate

3. Cheese

4. Cookies

5. Fruit

6. Bread

7. Crackers

Of the top seven snacks enjoyed by Americans, only fruit has been shown to prevent weight gain.  Indeed, studies show that snackers, and people who eat frequent small meals, often end up eating less nutritious foods.

5. Always Hungry

Despite claims to the opposite, many snackers and frequent small meal eaters never feel satiated.  Medical studies support this finding.

I know that I am this way.  Snacking doesn’t fill me up.  I continue to feel hungry until I enjoy a satisfying meal.

How to Snack Right

For those who need or want to snack, there is hope.  Snacking can be incredibly nutritious and filling if done right.

It starts each day with breakfast.  For many of my patients, once they eliminate added sugars and refined carbohydrates, most no longer need to snack.

For example, when you replace the bagel, fruit juice, breakfast cereal, “energy bar,” granola, or instant oatmeal  with real food, most people feel full until lunch time.  I have found that for me, some nut butter on Ezekiel Bread, a few dark chocolate almonds, fruit, and a salad keeps me full until lunch.

When counseling patients on snacks, here are my three recommendations.

1. If hungry, eat more vegetables.

There is no limit to the number of vegetable snacks you can have each day.  The more the better.

2. Eat a fruit.

Studies show that the most filling fruit are berries and apples.

3. Have a handful of nuts or seeds.

When it comes to nuts and seeds, some moderation is needed.  This is why I recommend just a handful as a single snack.  I have seen many patients gain weight by eating endless quantities of nuts and seeds.

Take Home Message

Eating all day long doesn’t boost metabolism.  When it comes to eating and metabolism, everyone is different.  The key is to find out what works for you and then do it.

I still snack.  I find that my body is ready for dinner somewhere around 5 pm.  The problem is that I am often still in surgery or seeing patients at 5 pm.  I need that healthy snack to keep me going until I can enjoy a family dinner later in the evening.

Does snacking or frequent small meals work for you?  Please share your experiences below.  As always, I will do my best to answer every question posted in the comments section below.

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Top 10 Proven Ways to Feel Happier Now

Have you ever wondered what the secret to a happy life is?  Do you want to feel happier now?  If so, keep reading.

A lack of happiness in your life is a known risk factor for heart attacks, arrhythmias, and dementia.  In this article, I share the top 10 scientifically proven ways to feel happier now.

Broken Heart Syndrome

Mary suddenly had difficulties breathing after her husband of 40 years died.  She was also suffering from a rapid heart beat and chest discomfort.

“I miss him so much,” she said.  “I just keep thinking of him. I can’t sleep and I don’t want to even leave my home.”

“We need to get you into the hospital,” I advised, “to figure out what is going on.”

Mary reluctantly agreed.  After some tests it was obvious what was going on.  Mary was suffering from the broken heart syndrome or Takotsubo cardiomyopathy.

In Japanese, tako-tsubo means an octopus trap.  Indeed, with extreme sadness or stress the heart actually changes shape to look like the Japanese octopus trap.  Fortunately, once the sadness or stress resolves, the heart returns back to its normal shape.

While milder forms of sadness are unlikely to cause Takotsubo cardiomyopathy, it is still a risk to your long-term health.

Do your genes predict your happiness set point?

Many people mistakingly believe that they have no control over their happiness.  While it is true that genes matter, at most, only 50% of your happiness is influenced by your genes.

Based on my own genetic analysis, I found that I carry most of the depression genes.  As I have learned, the daily choices you make have a far greater impact on your overall happiness than the genes you were dealt.

Secrets to a Happy Life

What is the secret to a happy life?  The answer may come from a study that closely followed 268 Harvard students for 75 years.

Little did these 268 Harvard students know, back in 1939 to 1944, what they were in for when they agreed to participate in this study.  Researchers carefully tracked every detail of their lives right up until their deaths.

Interestingly, our former president, John F. Kennedy, was one of the 268 people in this study.  Those few surviving study participants have now been tracked by researchers for 75 years and are now well into their 90s.

Here are the 6 secrets to a happy life based on the Harvard Grant Study.

1. Warm and loving relationships were the main predictors of a happy life.

2. Those who maintained their health were happier.

3. Having a perspective or purpose to life helped with life challenges.

4. Finding satisfaction in your work was more important than money or power.

5. You can learn to be happy over time even if you had a traumatic childhood.

6. Alcohol and tobacco abuse were the main predictors of divorce, poor health, and an unhappy life.

While these six things can help you feel happier at the end of your life, what can you do now to feel happier?  Below are my top 10 proven ways to feel happier now.

Top 10 Proven Ways to Feel Happier Now

1. Daily Gratitudes

Practicing gratitude daily is probably the fastest way to feel happier now.  Indeed, studies show that daily gratitudes quickly increase happiness.  The key is to focus on what you have rather than what you lack in your life.

Practicing daily gratitudes can be quick and simple.  For example, when I have worked with heart patients, I have had them write down three new things they were thankful for each day.  I had them focus on “new things” so that their brains would scan their lives for the positive.

Other patients have kept gratitude journals or have downloaded one of the many electronic gratitude journals for their smartphone.  Still others have used morning prayer as an opportunity to verbally express their gratitudes.

It really doesn’t matter how you do it.  Just start today.

2. Be Nice

As relationships were the key to a happy life in the Harvard Grant Study, the best way to get the most out of your relationships is to be nice.  In a famous study, psychology professor emeritus, John M. Gotten, from  the University of Washington, could predict whether a marriage would ultimately end in divorce or not just by observing the couple for three minutes.

Professor Gotten found that the key to a happy marriage is to be nice.  In other words, happy couples have five positive interactions to every one negative interaction.  This same approach works equally well with children, neighbors, or business partners.  Thus, to feel happier now, be nice to the people in your life.

3. Schedule a Vacation

We all need vacations to recharge our batteries.  The problem is that most Americans don’t use all of their vacation days.

A recent survey showed that Americans only use 51% of their vacation days.  I understand, I used to be the same way.  While vacations boost happiness, anticipating a vacation may have an even bigger effect.

In a study of 1,530 Dutch, researchers found that just scheduling a vacation made people happy.  From this study, it didn’t seem to matter if the vacation was weeks or even months away.

Based on the results of this study, to feel happier now always have a vacation scheduled.  Multiple small vacations may boost happiness more than the one big annual trip.

The saying, money can’t buy happiness, may not be entirely correct.  Studies show that those who spend money on exerpiences, not more stuff, are happier.  So give yourself permission to buy those tickets to that upcoming concert you have dreamed of attending.

4. Exercise

As discussed in my last blog post, when it comes to boosting happiness, exercise is more potent than an antidepressant.  Indeed, many studies have now shown that exercise consistently works better than antidepressants.

Exercise increases the feel good endorphins in your brain.  Exercise also reduces inflammation.  As studies now suggest that depression may be inflammation of the brain, the combination of more endorphins and less inflammation may be the reason why exercise makes you feel happier now.

5. Eat a Mediterranean or Asian Diet

Studies show that what you eat may determine whether you are happy or depressed.  For example, those eating a Mediterranean diet, high in vegetables, fruits, fish, nuts, and olive oil, are 32% less likely to be depressed.

Perhaps this explains why countries like Greece and Spain come in at numbers 190 and 191 respectively, when it comes to countries most likely to be depressed.  By comparison, the U.S. comes in as the most depressed country in the world.

Alternatively, you could eat like the Asians.  The Asian diet is also high in vegetables, fruits, and fish.  This way of eating may be one possible explanation why the Japanese come in last place, at number 192, on the most depressed countries list.

As health determines happiness from the Harvard Grant Study, it may be that eating right allows you to feel better now by keeping you healthier.

6. Hang Out with Happy People

Happiness is contagious.  Who you spend the most time with may determine how happy you are.

In a landmark study of 4,739 individuals followed for over 20 years, researchers Nicholas A. Christakis and James H. Fowler from Harvard and U.C. San Diego concluded that happiness is determined by social connections.  For example, the happiness of your friends, spouse, siblings, or neighbors determines how happy you are.

What should you do if you don’t know any happy people?  While you are seeking out positive friends, you could get a pet.  Animals are loving and positive.  Indeed, studies show that pet ownership can allow you to feel happier now and prevent depression.

7. Smile and Laugh (real or forced)

According to functional MRI studies of the brain, the mere act of smiling makes you happier.  In contrast, frowning makes you unhappy.

In a fascinating study, researchers wanted to see if they could boost happiness levels by paralyzing the frowning muscles.  To test this hypothesis, researchers injected Botox to block negative facial expressions.  As predicted, if you can’t frown you feel happier.

While I certainly am not advocating Botox, there is a lesson from these studies.  Smiling is easy.  Smiling engenders a friendly response from others.  Smiling rewires your brain for happiness and allows you to feel happier now.

Laughter has the same effect.  As with a forced smile, studies show that forced laughter also boosts happiness.

Laughter is where I personally struggle.  While I used to laugh a lot in my youth, I have become too serious as an adult.  Perhaps it is the stress of modern life.  Regardless of the cause, my children are helping me to laugh and play more.

8. Make Sleep a Priority

According to the Centers for Disease Control (CDC), up to 70 million Americans suffer from sleep deprivation.  Sleep deprivation is a known cause of depression.

In a fascinating study, researchers found that getting one extra hour of sleep had the same effect to your happiness as a $60,000 pay raise.  Any parent knows the role that sleep plays in children.  For example, based on how much sleep our children get on any given night, Jane and I can predict whether our children will be happy or struggle the following day.

Sleep has the same effects in adults.  Studies show that even naps help.  If you want to feel happier now, make sleep a priority tonight.

I have found that for most of my patients, the reason why they are sleep deprived is because of screen time at night.  Screen time could take the form of the television, computer, or smartphone.  Whether it is the blue light emitted from the screen, or the fact that people are going to bed too late, the result is the same.  To make sleep a priority, have a screen time curfew in your home.

9. Meditate or Pray

I suspect that right up there with physical inactivity and a poor diet, stress may play a big factor in why the U.S. leads the world in depression.  I know I certainly am not happy when I am being crushed by stress.

Being mindful of everything you do is a great way to combat the stresses of modern life.  Along these lines, meditation may be a great tool to help boost happiness.

A number of small studies report that meditation increases happiness.  Based on these studies, I have tried meditating for the last few years.

While I still struggle with finding time to meditate during the day, I have found that meditating at night has been particularly helpful.  Within just a minute or two of meditating, I am fast asleep. While many meditation gurus may disagree with my approach, at least it has helped me with insomnia.

If meditation is not your thing, studies show that prayer has the same effect on happiness.  It really doesn’t matter if you meditate or pray, the important thing is that being more mindful will help you to feel happier now.

10. Stop Commuting

The automobile is the scourge of modern life.  Princeton University researchers, Daniel Kahneman and Alan B. Krueger, found that commuting, especially the morning commute, was the single activity that caused people the most unhappiness.  The Harvard Grant Study found the same thing, a job you don’t love makes you unhappy.

It is hard to tease out how much unhappiness comes from the job and how much from the commute. Based on the Princeton Study, I suspect commuting may be the bigger cause of unhappiness.  For example, the Princeton Study showed that the evening commute home caused just as much unhappiness as working.

It has often been said that if you find a job you love that you’ll never work a day in your life.  While changing career paths may be difficult for most, eliminating your commute may be a much easier way to happiness.

The goal is to minimize windshield time.  Can you work from home a day or two a week?  Could you work four 10 hour shifts rather than five eight hour shifts?  Could you move closer to your work?

Too often, I have seen my patients buy big homes far from their work, thinking it will make them happier.   This approach rarely works.  In my experience, it is much better to live in a smaller house without a commute than a mansion with a long daily commute.

Final Thoughts

Contrary to popular belief, our daily choices may have the biggest impact on our happiness.  The Harvard Grant Study showed this.  Young Harvard students, even those contemplating suicide from unhappy homes, later learned to be some of the happiest people over time.

What helps you to stay positive and upbeat?  Please share your experiences with our community below.  Also, if you leave your question to this article I will do my best to answer it.

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7 Things Exercise Does To Your Brain

Is it hard to find the time to exercise?  Perhaps if you knew how exercise “re-wires” your brain, it would give you new willpower.  In this article, I share the latest medical research on the 7 things exercise does to your brain.

Becky’s Experience

Becky was a 38 year-old mom who came to see me for heart palpitations.  Since the birth of her third child, she never seemed to “bounce back.”

“I am always feeling palpitations in my chest,” she said.  “To make things worse, I often feel sad for no apparent reason and it is almost as if I have “brain fog,” she said.

“Are you exercising regularly?” I asked.

“That’s the problem,” she said.  “I’m afraid to exercise.  I’m worried that with the palpitations I might have a heart attack.”

To figure out what was going on, I asked Becky to wear a heart monitor for 30 days.  I also scheduled her for a stress test.

Fortunately, all of her tests came back just fine.  All she had were some benign premature heart beats.

I encouraged her to start exercising again and come back to see me again in a month.  Reluctant at first, she agreed to this plan.

One month later she was a changed person.

“How did it go?” I asked.

“At first it was hard,” she said.  “Knowing that the palpitations were benign, they didn’t bother me so much.  I’m much happier now.  The brain fog also went away.  My memory is better and my thinking clearer.”

Is there any scientific explanation for what happened to Becky?  Below are the 7 things exercise does to your brain according to the latest medical studies.

1. Makes You Happier

Have you ever wondered if an antidepressant would make you feel happier?

Four years after graduating from medical school, I came across this landmark study that caused me to rethink everything I had been taught about depression.  The study design was very simple.

Dr. James A. Blumenthal and colleagues from Duke University recruited 156 people suffering from a severe bout of depression.  Half of the patients were given the antidepressant, Zoloft, and half were prescribed an exercise program.  The exercise program wasn’t hard.  Just a total of 145 minutes of exercise each week.

Even though this study was funded by a drug company, to everyone’s surprise the patients prescribed “exercise,” did every bit as well as the group that was given Zoloft.  Not only did the group prescribed exercise also recover from their depression, they also became much more physically fit than the group prescribed Zoloft.

At the time, I wondered if the findings of this study were really true.  So often one study says one thing and then a few months later a new study comes to the opposite conclusion.

Since this study was published in 1999, there have now been many studies done that have all come to the same conclusion.  While the initial study resulted in a “tie” when it came to depression treatment, subsequent studies have shown than exercise beats antidepressants for the treatment of depression.  If you are currently taking an antidepressant, never stop a medication without the approval of your doctor.

While we aren’t 100% sure why exercise makes people feel happier, it likely has something to do with the feel-good endorphins which are released with exercise.  Another possibility is that moderate levels of exercise decrease inflammation.  New research suggests that depression may really just be inflammation of the brain.

2. Boosts Your Memory

Can you remember phone numbers like you once could in high school or college?

Your memories are stored in the part of your brain known as the hippocampus.  To keep memories intact, you need as many healthy nerve connections in the brain as possible.

If you don’t take care of your brain, over time these neurons and nerve connections in your hippocampus may fail.  Fortunately, studies show that exercise boosts nerve growth and new connections in the hippocampus area of the brain.

This memory enhancing effect of exercise is so powerful that it may even be passed on to your children.  For example, studies have shown that exercising during pregnancy increases the memory of your children.

How exercise boosts memory is not completely known.  However, it likely has something to do with increased levels of BDNF, or brain-derived neurotrophic factor.  BDNF can be though of as “brain fertilizer.”  To learn more about how to boost your BDNF levels, please read the article I wrote on BDNF (blog #81).

3. Gives You More Energy

“Why am I always so tired?” patients ask me everyday.  Indeed, this is the number one symptom patients report to me.

“The best energy pill I can give you is to exercise,” I typically respond.

Is fatigue, or a lack of energy, a physical or mental thing?  I suspect it is both.  Regardless, exercise works.

In a review of eight studies involving 1,518 people suffering from chronic fatigue syndrome, exercise was shown to be the most effective treatment for this condition.

4. Reduces Stress

Like Becky in the story above, do you often feel overwhelmed with everything you have to do?  I know this is something that I am always struggling with.

For me, my stress reducing drug is exercise.  This is what got me through medical school and my residency training.  Without a regular dose of exercise, I would never survive my stressful life as a cardiologist and as a father of 4 young children.

Indeed, many studies back up what I have long experienced.  Exercise decreases stress levels.  It even helps people who suffer from anxiety.

Once again, we’re not quite sure how exercise helps with stress.  Two likely candidates include increased endorphins or just better sleep at night from exercising.

5. Increases Your Brain Processing Speed

Have you ever struggled with a slow computer?  The same thing can happen to your brain.

While you can’t yet “buy a faster brain,” you can significantly speed up the processing power of the brain with exercise.

6. Frees You From Addictions

Do you suffer from a sugar addiction?  Based on the results of many studies, exercise may be one of the best tools you have to free yourself from any addiction.

While we aren’t yet sure how exercise helps to break addictions, it likely has something to do with normalizing the dopamine signaling and reward pathways in the brain.  Regardless of your addiction, studies show that exercise will help you break your addiction.  Thus, to take control of your brain, start exercising.

7. Improves Concentration

Are you easily distracted?  Based on the results of medical studies, one possible reason is that you may not be as physically active as you should be.

Being able to focus your mind helps you both at work and when listening to a child.  Many Fortune 500 CEO’s credit their success to their ability to focus and concentrate.  If you want to improve your concentration, exercise is your new best friend.

Final Thoughts

The evidence is clear, if you want a better brain you need to exercise regularly.  If you aren’t exercising now, talk with your doctor to make sure it is safe for you to start.  Exercise doesn’t mean you have to buy a gym membership.

Personally, I hate the gym.  My wife, on the other hand, loves the gym.

The very best exercise is the one you will do.  If you don’t like to exercise, keep exploring new ways to move your body until you can find something that you like.  It could be dancing, carrying your clubs on the golf course, or even taking a nightly walk in your neighborhood.

If you are strapped for time, be creative.  You may need to multitask to stay physically active.  For me, I would not be able to exercise on most days without my treadmill desk.

As my work requires me to spend many hours on the computer each day, I had to find a way to combine computer time with exercise time.  Even as I am writing this article, I am walking on my treadmill desk at 3 mph at a 4% grade.  While this may not seem like much, I have walked more than 10 miles uphill while writing this article.

How has exercise helped your brain?  Please share your experiences below so that others may be inspired to keep exercising.  As always, I will answer any question left below.

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Is Organic Food Really Better for You?

Is organic food really better for you?  What about for your children?

This is a question patients ask me all the time.  It is also a question Jane and I ask ourselves every time we see the high price of organic food.

Organic versus conventional foods can be an emotional issue.  Many people choose organic because they want to do everything possible for their health and the environment.  In this article, I share the latest medical science behind organic versus conventional foods to help you decide if the extra cost is really worth it.

Produce: Organic versus Conventional

Organic blueberries versus conventional blueberries?  Which should you put in your basket at the grocery store?

Fortunately, we now have enough medical studies to help us make a more educated decision.  The widely recognized “definitive study” on organic versus conventional produce was published in the prestigious British Medical Journal.

This study combined the results of the 343 smaller studies comparing organic to non-organic produce.  Here are the three main findings of this study:

1. Organic produce has more antioxidants.

2. Organic produce has 4 times less pesticide residue.

3. Organic produce has less of the toxic metal, cadmium.

Why more antioxidants with organic?

Why are antioxidants so much higher with organic produce?  The answer likely has something to do with plant stress.

Organic produce does not get the same megadose of nitrogen that conventional produce gets from synthetic fertilizer.  As a result, organic produce tends to grow more slowly.

Also, organic produce has to do battle with more insects.  In order to fight off insect attacks, plants have to produce protective compounds like flavonols.  The combination of slower growth and extra flavonols gives you an extra boost of antioxidants.  In many medical studies, more antioxidants from food may decrease your risk of cancer, heart disease, and dementia.

Does pesticide residue matter?

While some experts claim that the pesticides you are exposed to with conventionally grown produce is too little to matter, other experts disagree.  To be honest, we really don’t know how much is too much.  What we do know is that children may be more susceptible to pesticides than adults.

When it comes to pesticides, studies show pesticides are closely linked to Parkinson’s Disease, autism, cancer, and many other conditions.

For the extra dose of cadmium in conventional produce, the risk is clearly cancer.  The unanswered question really comes down to whether there is even enough cadmium in conventional produce to matter.

Dirty Dozen

If funds are tight, then focus your precious food dollars on where the return on investment is highest.  When this comes to produce, buy organic whenever possible for the dirty dozen or those foods highest in pesticides and heavy metals.  The “dirty dozen” includes apples, peaches, nectarines, strawberries, grapes, celery, spinach, sweet bell peppers, cucumbers, cherry tomatoes, imported snap peas, potatoes, hot peppers, and kale.

Clean 15

In contrast, for the clean 15 you are fine saving some money and buying conventional produce.  The clean 15 are avocados, sweet corn, pineapples, cabbage, frozen sweet peas, onions, asparagus, mangos, papayas, kiwi, eggplant, grapefruit, cantaloupe, cauliflower, and sweet potato.

How do you remember the dirty dozen and the clean 15?

Can you name off the dirty dozen and the clean 15?  I can’t.

To help you remember, there are many free apps you can download to your smartphone to help you remember.  Alternatively, you can do what we usually end up doing.

Basically, if you eat the outer portion, like broccoli, strawberries, or grapes, buy organic when possible.  In contrast, if you eat the protected food inside, like with nuts, oranges, or onions, we generally buy conventional.  Of course, this method is not perfect as pesticides can still be taken up by the root system of the plant.

Should you ever eat something on the dirty dozen list?

As I travel frequently, this is a dilemma I face all of the time.  When I am on an airplane, would it be better for me to eat the conventionally grown apple or the organic protein bar?

Even though the conventionally grown apple is number one on the dirty dozen list, the apple is probably a lot better for you than all of the sugar, processed proteins, refined grains, industrial oils, and other chemicals in organic protein bar.

While organic has many advantages, what you choose to eat is far more important than if it is organic or not.  As the average American only eats 1.1 fruits and 1.6 vegetables each day, the real question isn’t organic or conventional.  Rather, the bigger issue is to eat more produce, regardless of how it is grown.

Is locally grown better than organic food from afar?

Should you buy conventionally grown produce from a farmer’s market or the organic variety shipped in from South America?  When it comes to nutrients in food, local trumps organic.  In one study, researchers found that freshly picked local broccoli had twice the nutritional benefit than organic broccoli shipped from afar.

As most Americans are deficient in one or more micronutrients, if there was a clear difference in the farm-to-plate time, like the farmer’s market conventional produce versus organic from South America example, conventional may be better for you.

Meat: Organic versus Conventional

When it comes to meat, should you purchase the cheaper conventional meat or opt for the expensive organic cut?  To help settle this question, a study was just published in the British Journal of Nutrition.  This study, looked at the combined results of 67 studies on this subject.

The main finding of this study was that organic meat had 47% more omega 3 than conventional meat.

Does the extra dose of omega 3 in organic meat matter?

The real question here is why is organic meat so much higher in omega 3?  This is because conventionally raised animals are fed grain and organic animals are allowed to go outside and eat natural grasses.  Omega 3 is much more common in grass than grains.

To put the finding into perspective, a single serving of organic beef is likely to get you about 50 mg of DHA (omega 3).  Thus, you would have to eat about 20 servings of an organic steak to get the same amount of omega 3 as eating a single 3.5 ounce (100 g) serving of salmon.

Don’t get me wrong.  Every little bit of natural omega 3 you can get from food helps.  Omega 3 clearly has a role in preventing heart disease, depression, dementia, cancer, or arthritis as  I discussed in a previous blog.

Dairy: Organic versus Conventional

In a recent study on organic versus conventional milk, researchers came to a similar conclusion.  Once again, this study was just published in the British Journal of Nutrition and was a meta-analysis, or a study averaging the results of 170 previously published studies on the subject.

As with organic meat, the main finding of this study was that there was 56% more omega 3 in organic milk compared to conventional milk.  When they looked at other nutrients, the data were mixed.  For example, they saw more vitamin E and iron in organic milk but less iodine and selenium.

Each glass of organic milk contains 32 mg of DHA (omega 3).  Compare this to the more than 1,000 mg of DHA in a single serving of salmon.  As with eating the organic meat example above, you would have to drink about two gallons (about 8 liters) of organic milk to get the same dose of omega 3 as eating a single 3.5 ounce (100 g) serving of salmon.

What about all of the antibiotics, hormones, and pesticides that conventional cows are exposed to?  Fortunately, by law, every truckload of milk in the U.S. is tested for antibiotics and other drugs.  If drug residue is found, the milk is discarded.

When it comes to pesticides, the United States Department of Agriculture tests dairy.  Fortunately, pesticides in either conventional or organic milk is low.  The main pesticide is a remnant of DDT.  Since DDT was banned many years ago, levels of any DDT byproducts will continue to fade over the next 50 years until this chemical is essentially eliminated from the soil.

One other problem with conventional milk is the bovine growth hormone that they are given.  While this hormone doesn’t survive pasteurization or digestion in your stomach, a byproduct does.  Indeed, IGF-1 is much higher in conventional than organic milk.  As discussed in a previous blog, IGF-1 may increase the risk of cancer.

Take Home Message

Should you buy organic or conventional?  The simple answer is, it depends on what is available, who is eating it, and your food budget.  Here are the five key take home messages of this article.

1. Organic may be more important for children than adults.

2. Organic produce has more antioxidants.

3. Organic produce has less pesticide residue and heavy metals.

4. To save money, only buy organic for the “dirty dozen.”

5. Organic meat and dairy is higher in omega 3.

When do you buy organic?  Have you noticed a difference between organic and conventional?  Please leave your comments below.  Also, I will do my best to answer any questions you have about this article.

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10 Ways to Stop Inflammation from Air Pollution and Other Causes

Breathing bad air is one of the main causes of inflammation, breathing problems, and heart conditions.  A poor diet, too much stress, not enough sleep, and lack of exercise also cause inflammation.

Inflammation is a silent killer that not only causes chronic pain and fatigue now, but also puts you at risk for Alzheimer’s Disease, cancer, or arthritis.  This article will teach you everything you need to know about how to stop inflammation now.

How bad is breathing bad air?

The air this past week in Salt Lake City has been especially dangerous.  Red air days have been common.  For most of this past week, our beloved mountains were hidden by dense smog.  Here is a photo from our local newspaper to show just how bad the air has been.

When our air pollution is bad, my hospital fills up with patients.  We see many patients with respiratory problems and heart attacks on these red air days. It gets so bad that our local schools won’t even let our kids go outside for recess.

Based on data from the Environmental Protection Agency, one organization has calculated that breathing Salt Lake City air for one year is the equivalent of living with a smoker for three months.  For those of you living in North America, you can find out your “cigarette equivalent” air pollution risk by visiting their website.

It isn’t just Salt Lake City that suffers from bad air.  Studies from people living in Los Angeles, New York City, Chicago, St. Paul, and Winston-Salem can lose up to five years of life from air pollution.

Acute versus Chronic Inflammation

Inflammation is like fire.  It can be a good or bad thing depending on the company it keeps.

For example, if you caught a cold or sprained your knee this year, you need your body to rev up the immune system for a couple of weeks to repair the damage.  Once things have healed, the inflammatory response should shut off.

However, with chronic inflammation the inflammation never turns off.  Inflammation that is never settles down causes “rusting” throughout your body, many chronic medical problems, and even a premature death.

How to Measure Your Inflammation

To find out your own inflammation level, there is a simple and reliable blood test your doctor can order for you.  Perhaps you have already had this done.  It is called C-reactive protein or CRP.

Based on your level of chronic inflammation (CRP level), your doctor can predict your risk of a heart attack.  The goal is to get your CRP level as low as possible.  Ideally, your CRP level will be below 1 mg/L.  Levels above 3 mg/L put you at high risk of a heart attack and premature death.  An abnormally high CRP level also puts you at risk for cancer and dementia as well as a myriad of other chronic medical problems.

Of course, you don’t want to get a CRP blood test when you are battling a cold or other infection as it will be quite high.  To truly measure your level of chronic inflammation, this test should be done when your body is not fighting off an infection.

What causes chronic inflammation?

Besides breathing bad air, what causes chronic inflammation?  Inflammation tends to be elevated in people eating the Standard American Diet (SAD) which is high in sugar, refined carbohydrates, red/processed meats, fast foods, and processed foods.

Inflammation, and the CRP blood test, are also elevated in people who don’t regularly exercise, weigh more than they should, have a stressful job or life, have difficulties sleeping, suffer from depression, have arthritis or autoimmune diseases, or suffer from medical conditions like diabetes, high blood pressure, or high cholesterol.

10 Ways to Stop Inflammation

Regardless of what is causing your inflammation, here are my 10 best ways to stop inflammation now.  The more things you can correct, the lower your risk from inflammation.

If air pollution is high where you live, then you may need to work even harder on these things to keep chronic inflammation levels low.  To track yourself, you can have your doctor check your CRP levels before and after you do these 10 things.

1. Breathe Clean Air

Breathing polluted air from tobacco or air pollution activates inflammation and causes lung and heart disease.  One study showed that environmental air pollution can double the level of inflammation in your body.  Fortunately, another study showed that breathing clean air immediately lowers inflammation.

One thing to remember is that indoor air can be two to five times worse than whatever air you are breathing outside of your home.  To breathe cleaner air, consider the following things: Have smokers smoke outside of the home, office, or cars, use HEPA air filters for your home, keep your home well ventilated, use exhaust fans when cooking on the stove, don’t drive when there is traffic congestion, recycle the air in your car on red air days, exercise outside in the mornings when air pollution tends to be lower, etc.

Of course, make sure you are part of the solution rather than the problem.  Minimize your contribution to air pollution and continue to put pressure on your local politicians to make clean air a priority.

2. Maintain a Healthy Weight

Of all of the strategies to reduce inflammation, weight loss consistently lowers inflammation and CRP levels the most.  For example, weight loss can result in up to an 81% decrease in CRP.  Even just losing a few pounds can significantly lower your inflammation and CRP levels.

3. Daily Exercise

Physically fit people have very low levels  of CRP.  However, too much of a good thing, like training for a full Iron Man triathlon or an ultra marathon, may increase inflammation and CRP levels.  Optimal CRP levels tend to occur with moderate levels of daily exercise.

4. Eat More Fiber

As 70% of your immune system resides in your gut, it only makes sense that a healthy gut lowers inflammation and CRP.  In one study, boosting daily fiber intake to more than 30 mg daily cut CRP levels  in half.  To keep gut inflammation low, focus on fiber from vegetables, fruits, and legumes as well as fermented foods.  To learn more about gut heath, please read my blog “How to Heal Your Gut in 5 Simple Steps” from blog #140.

5. Get More Vitamin C from Vegetables and Fruits

The antioxidant, vitamin C, has also been shown to decrease inflammation and CRP.  In a well designed study, vitamin C decreased CRP levels by 25%.

To get more vitamin C, eat more vegetables and fruits.  For example, just one serving of papaya, bell peppers, broccoli, brussels sprouts, strawberries, or pineapples will give you more than enough vitamin C for the entire day.

6. Increase Omega 3s

To stop inflammation, eat more omega 3 fatty acid foods.  For example, in a recent study, omega 3 fatty acids nearly cut CRP levels in half.

Unfortunately, up to 95% of Americans are deficient in omega 3.  To boost your omega 3s, make sure to eat oily fish weekly in addition to a daily dose of the plant form of omega 3.  Plant based foods high in omega 3s include flaxseeds, walnuts, chia seeds, hemp seeds, soy beans, cruciferous vegetables, and berries.

7. Reduce Stress:

Chronic stress and anxiety increases inflammation and CRP levels.  If stress is unavoidable, then focus on doing something daily to manage stress.  This could be yoga, meditation, exercise, prayer, or even a walk in nature.

8. Get Restorative Sleep

Not enough sleep or sleep apnea are additional causes of chronic inflammation and elevated CRP levels.  Make sleep a priority to stop inflammation.

Go to bed earlier so that you don’t need an alarm clock to wake you before your body is ready to get up.  If you are overweight or snore, talk to your doctor about getting tested for sleep apnea.

9. Limit Sugar, Refined Grains, Red/Processed Meats, Fast Foods and Processed Foods

Besides carrying extra weight and smoking, the Standard American Diet (SAD) is probably one of the main causes of excessive inflammation. The sooner you can get off of, or at least significantly limit these foods, the better off your health and inflammation levels will be.

10. Keep Glucose and Hemoglobin A1C Levels Low

Half of all American adults suffer from pre-diabetes or diabetes.  With pre-diabetes or diabetes, blood sugar levels (glucose) tend to be high, especially after eating.

One of the best tests for pre-diabetes and diabetes is hemoglobin A1C.  This is a simple blood test your doctor can order for you.  This test measures how much glucose is stuck to your red blood cells.

Elevated blood sugar levels are highly inflammatory.  Thus, to stop inflammation, keep hemoglobin A1C levels as low as possible to keep inflammation and CRP levels in check.

Take Home Message

Most of the patients I see everyday suffer from high levels of chronic inflammation.  Indeed, most of the chronic diseases Americans suffer from can be traced back to chronic inflammation.

Whether this inflammation comes from breathing bad air, making poor food choices, or not exercising, the effects are the same.  The key to a long, healthy, and happy life is to only have inflammation when it is absolutely needed, like in battling an infection or an acute injury.

What are you doing to keep inflammation levels low?  Please share your experiences with our community below.  Also, if you have any questions about what you have just read, please leave your questions below.  I will do my best to answer every question.

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Foods to Prevent Dementia and Strokes

Most of my patients fear dementia and strokes even more than death.  Fortunately, dementia and strokes can largely be prevented.  In this article, I share the latest research on omega 3 foods to prevent dementia and strokes.

Three Types of Omega 3 Fatty Acids

Before we review this new study, let me first introduce you to the three types of omega 3 fatty acids.  The first is the plant-based omega 3, also known as ALA or alpha linolenic acid.  ALA is found in walnuts, flaxseeds, hemp seeds, chia seeds, soy beans, cruciferous vegetables, and berries.  The other two omega 3 fatty acids, DHA and EPA, come primarily from oily fish.

Foods to Prevent Dementia and Strokes Study

In a recent study of 286 people, Dr. Martha Clare Morris and colleagues from Rush University in Chicago reported their findings on omega 3 foods to prevent dementia and strokes.  When these 286 people signed up to participate in this study, none of them had dementia or a stroke.

Each year, Rush University researchers checked in with these 286 people to see what they were eating.  Then, after they died, researchers got the opportunity to autopsy their brains.

Here are their five main findings:

1. Eating fish weekly prevented Alzheimer plaques and nerve tangles.

2. Fish was most beneficial for those with a family history of Alzheimer’s Disease.

3. Omega 3s from plants prevented strokes.

4. Fish oil did not prevent Alzheimer’s Disease or strokes.

5. Increased mercury levels from fish did not cause dementia or strokes.

Family History of Alzheimer’s Disease and Fish

This study offers tremendous hope for people with a family history of Alzheimer’s Disease.  Indeed, those with the ApoE4 Alzheimer’s gene seemed to benefit the most from oily fish.  To learn more about how to prevent Alzheimer’s Disease, please read my article, “How to Prevent Alzheimer’s Disease” (blog #90).

95% of Americans are Deficient in Omega 3

Odds are that you are deficient in omega 3.  While there are no official government recommendations yet on the daily amount of omega 3 you need, studies suggest that Americans only get 5% to 10% of the omega 3s their brains need each day.  Fortunately, by focussing on omega 3 foods, this nutritional deficiency can easily be corrected.

Is Mercury Still a Concern with Fish?

Unfortunately, media reports of mercury in fish have scared away many people, including pregnant mothers, from this brain food.  In the case of pregnancy, any possible mercury risk should be balanced against new research suggesting that mom’s who eat fish have much smarter kids.

The biggest and longest-lived fish, like tuna, swordfish, king mackerel, and shark, have the highest levels of mercury.  It was reassuring to read in this study that mercury levels in the brain had absolutely no relationship to Alzheimer’s Disease or strokes.

Fish lowest in mercury include salmon, anchovies, sardines, oysters, and scallops.  To see where your favorite fish falls on the mercury scale, there is an excellent table of 67 different fish on this webpage.  Also, eating selenium rich foods may provide an added layer of protection.

Does selenium prevent mercury toxicity?

The antioxidant, selenium, is an antidote to mercury toxicity.  Selenium, in the right amount, may also prevent heart disease, cancer, and thyroid problems. Fortunately, ocean fish are high in selenium so there is already natural protection packed within the fish.

If you are a fish eater, and want to make sure you are fully protected, eat one Brazil nut daily to top off your selenium levels.  This is something I have been doing for years.

When it comes to selenium, nothing is higher than Brazil nuts.  However, you don’t want to go overboard with selenium as too much selenium is also toxic.  Perhaps this explains why researchers observed that those brains with too much selenium in this study had more nerve tangles.

Strategies for Fish Haters and Vegetarians

Not everyone likes fish.  This was me for most of my life.  Even though I still don’t love fish, I have learned to tolerate it at least once weekly.

Also, many people do not eat meat due to religious, moral, or environmental concerns.  If this is you, what should you do to protect your brain from Alzheimer’s Disease?

Unfortunately, fish oil offered no protection in this study.  For those who either don’t like fish or are vegetarians, I have three suggestions.

1. Eat more ALA, the plant-based omega 3 fatty acid, to boost DHA and EPA levels.  Thankfully, about 15% of ALA can be converted by the body to DHA and EPA.

2. Get DHA and EPA omega 3s from the same source that fish do.  Indeed, some studies show that omega 3s from marine algae may help to prevent cardiovascular disease.

3. Focus on other brain foods.  As discussed in blog number 135, there are brain foods other than just the omega 3s.

Seven Benefits of Omega 3s

Why are the omega 3s so important for health?  The omega 3 fatty acids are a critical component to the membranes of every cell in your body.  Also, omega 3s are essential for the hormones controlling blood clotting, arteries, and inflammation.  Below are seven reasons why you need to eat foods high in omega 3 every day.

1. Optimize Brain Function

Omega 3 fatty acids may enhance brain function at any age.  They appear to play an important role in memory, information transfer, and the development of new neuron connections.

2. Prevents Fatal Arrhythmias

Cardiac arrests remain the number one cause of death in the U.S.  Cardiac arrests can even strike young, otherwise healthy people.  Fortunately, studies show that people who eat foods high in omega 3 fatty acids are much less likely to suffer a cardiac arrest.

3. Prevents Cancer

Omega 3s may help to prevent cancer.   We aren’t quite sure why the risk of cancer is reduced with omega 3s but it likely has something to do with lowering inflammation in the body.

4. Prevents Inflammation, Arthritis, and Autoimmune Diseases

Historically, our ancestors ate far more omega 3 foods than we do today.  As omega 3 containing foods are  anti-inflammatory, this is one possible reason why autoimmune diseases are much more common today.  Getting enough omega 3s may also help to reverse arthritis.

5. Lowers Blood Pressure

As there is a 90% chance that you will develop high blood pressure, omega 3s may help to decrease this risk.  Indeed, when researchers looked at 31 studies on omega 3 fatty acids and blood pressure, they found that omega 3s lowered systolic blood pressure by an average of 3 mmHg.  While this may not seem like much, when you consider that the average blood pressure medication only lowers systolic blood pressure by 8 mmHg, this isn’t so bad.

6. Lowers Triglycerides

Omega 3 fatty acids are very effective in reducing triglycerides.  Elevated triglycerides is an important cause of heart attacks.   To learn more about omega 3 fatty acids and triglycerides, please read blog #90 on fish oil.

7. Prevents Depression

Many studies have linked low levels of omega 3 to depression.  While we still aren’t quite sure why people who are deficient in omega 3 are at high risk for depression, it likely has something to do with inflammation.

Does the ratio of omega 6 to omega 3 in the diet matter?

You may have come across health books or internet sites discussing the importance of getting the right ratio of omega 6 to omega 3 fatty acids in your foods.  While earlier studies suggested that this may matter, more recent data refutes these claims.

So what should you do?  As long as you are limiting processed foods and eating something high in the omega 3 fatty acids everyday, there is no need to calculate your omega 6 to omega 3 ratio.

The Main Thing You Need to Know About Omega 3s

The message of this article is really quite simple.  To lower your risk of dementia and stroke, make sure you eat oily fish weekly and get a daily dose of the plant-based omega 3s like walnuts, flaxseeds, hemp seeds, chia seeds, soy beans, cruciferous vegetables, and berries.

How do you get your omega 3s?  Please share your experiences in the comment section below.  Also, if you have any questions about this article, leave your comments below.  I will do my best to answer every question.

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The 6 Best Vegetables and Fruits for Weight Loss

In my work with thousands of patients in preventing heart disease, I have observed that people with the healthiest weights tend to eat the most vegetables and fruits.  In this article, I discuss the latest medical research on the best vegetables and fruits for weight loss.  I also cover which vegetables and fruits to minimize if you are trying to get down to a healthy weight.

How do vegetables and fruits cause weight loss?

For those of you who want to know how vegetables and fruits cause weight loss, here are the five best scientific explanations from medical studies.

1. Low glycemic load.

Most vegetables and many fruits have a low glycemic load.  This means that these foods are converted to sugar by the body very slowly.  Thus, the overall sugar impact from these foods is incredibly low.   An additional benefit of foods with a low glycemic load is that they tend to keep hunger away.

In contrast, foods with a high glycemic load, like most desserts, breads, pasta, cereals, and other processed foods are rapidly converted to sugar by the body.  In fact, even whole wheat bread and most breakfast cereals are converted to sugar by the body even faster than a Snickers bar.

The glucose surge from most breads, pasta, cereals, and other processed foods are then followed by an insulin spike.  In no time at all, you’ll find yourself hungry again.

2. Fiber is filling.

Along with protein, fiber is very filling.  Fiber slows down the digestion process and allows people to feel full longer.

3. High in micronutrients.

Many overweight people suffer from a micronutrient deficiency.  Hunger may really just be the body’s way of signaling to you that it needs a particular micronutrient.  This could explain why I have observed in my patients that as they eat more vegetables and fruit their hunger seems to lessen.

4. Fiber increases metabolism.

One great way to increase your caloric burn, even while you are sleeping, is to eat foods high in fiber like vegetables and fruit.  Fiber requires more energy to move through the digestive system than readily processed foods like most snack foods, breads, or cereals.

5. Healthy gut microbiome.

As I have discussed in a recent blog article, having the right gut microbes in place can effortlessly allow you to maintain a healthy weight.  If you feed these healthy gut microbes the food they need, like fiber, they will reward you with a healthier weight.

Best Vegetables and Fruits for Weight Loss Study

To study the effects of different vegetables and fruits on weight loss, researchers from Harvard and Tufts University recently analyzed food intake and weights over a 24-year period of time from 133,468 people.  With the reams of data collected, researchers gained many key insights from this study.  Below are the six best vegetables and fruits they found for weight loss.

Please note that the expected weight loss from these foods are based on eating one serving daily for an entire year.  Thus, if you ate one vegetable or fruit from each of the six items listed, for an entire year, you could expect to lose an average of 1.9 pounds each year.  While this may not seem like much, over 20 years it could amount to a 37 pound weight loss.

1. Edamame/tofu/soy: 0.62 pound weight loss per year

As most readers know, edamame/tofu/soy is not technically a vegetable but rather a legume.  However, as this study lumped them in with vegetables, I included it here.

The soy bean was clearly the very best food for weight loss in this study.  Perhaps this helps to explains why there is so much less obesity in Japan, China, and Korea.

In some circles, edamame/tofu/soy has a bad reputation in the U.S.  This is likely because most Americans don’t eat real soy beans but rather the highly processed GMO soy isolates.

In Asia, where people eat the natural whole soy bean, the scientific data are pretty clear.  Soy beans appear to be protective against heart disease and cancer, even breast cancer.

We regularly eat the organic whole bean forms of edamame/tofu/soy in our home. We enjoy them dry roasted and lightly salted like nuts.  We also like edamame spaghetti for pasta dishes, tofu in a stir-fry, or even unsweetened soy milk for breakfast.  I also like fermented soy beans in the form of natto.

If you are wondering where to find dry roasted edamame beans, edamame spaghetti, or natto, try your local health food store, Asian store, or online through Amazon.

2. Cauliflower: 0.34 pound weight loss per year

Cauliflower is a cruciferous vegetable.  However, I have separated out cauliflower from its peers due to the especially potent weight loss effects it packs.  In our home, we love cauliflower raw or as part of a stir-fry dish.  It also works great in mashed potatoes or as a substitute for creamy sauces.

3. Apples/Pears: 0.31 pound weight loss per year

I was definitely surprised to see apples and pears so high on this list.  However, when you look at the scientific data, the pectins and other phytonutrients in apples and pears have unique effects that not only help with weight loss but also in the prevention of diabetes and cardiovascular disease as well.

4. Berries: 0.28 pound weight loss per year

I’m sure berries on this list came as no surprise to any readers.  Berries not only have a relatively low glycemic load but they are also off the charts in antioxidants.

5. Cruciferous vegetables: 0.17 pound weight loss per year

Ah, the cruciferous vegetables.  My favorite.  Overall, this group of  vegetables, which includes cauliflower, broccoli, kale, brussels sprouts, bok choy, and cabbage fared quite well when it comes to weight loss.  In addition to their weight loss effects, this special group of vegetables is also very effective in preventing cancer as I discussed in blog #6.

6. Green leafy vegetables: 0.13 pound weight loss per year

I was a bit surprised to see the green leafy vegetables down so far on the weight loss list.  Perhaps this is because of the company it keeps.  In other words, most people eat these vegetables with salad dressing which may undo many of the potential health and weight loss benefits of green leafy vegetables.

Are your wondering where your favorite vegetable or fruit falls on the weight loss list?  In general, this study found that the higher the fiber content and the lower the glycemic load, the better the vegetable or fruit performed for weight loss.

Vegetables Causing Weight Gain

Not all vegetables cause weight loss.  Indeed, the starchy vegetables in this study did not cause weight loss but rather weight gain.  From this study, here are the top three vegetables and legumes causing weight gain in order.

Please note that corn and peas are not officially “vegetables” However, as the authors of thus study have lumped them in with other vegetables, I have done the same as well.

1. Corn

2. Peas

3. Potatoes

Unfortunately, the vegetables causing weight gain are also the main vegetables eaten by most Americans.  Thus, if your goal is weight loss, then minimize corn, peas, and potatoes.

Fruit Causing Weight Gain

As with vegetables, not all fruits cause weight loss.  In general, most fruits, other than melons or fruit juice, cause weight loss.  Once again, if your goal is weight loss, then minimize melons and fruit juice.

Take Home Message of this Study

In the big picture, vegetables and fruits are incredibly nutritious and prevent weight gain, heart disease, and cancer.  While there is a lot of confusion about nutrition in health books and on the internet, the one area where most people can agree is on the need for more vegetables and fruits.

In my opinion, the one saving grace of the new U.S. dietary guidelines is the call for nine servings of vegetables and fruits each day.  If you are a mindful eater who does not like to “count” your food, then just remember to always fill your plate with mostly vegetables and fruits and you will be just fine.

What vegetables and fruits help you the most in minimizing hunger and maintaining a healthy weight?  Please leave your comments below.  Also, if you have any questions about this article, or the study discussed, please leave your questions below and I will try my best to answer every question.

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Is Caffeine Safe for the Heart?

New research reports that caffeine does not cause an irregular heart beat, palpitations, or heart arrhythmias.  Can we really believe the results of this new study?  Read on to see my answer to the question, is caffeine safe for the heart?

Mark’s Experience

Mark was a 46 year old man who came to see me for palpitations and a rapid heart beat.  Mark was tired all of the time.  The only thing that could get him through the long work day was Red Bull and Monster energy drinks.

He typically started off the day with a Red Bull.  In the afternoon, when energy levels were at the lowest, he would switch to Monster.  Sometimes, if he was really tired, he might add in a third energy drink or even a cup of coffee.

To identify the cause of his palpitations and rapid heart beat, I had him wear a heart monitor.  After just a few days it was obvious what was going on.

His palpitations clearly correlated with premature heart beats arising from his ventricles or PVCs.  The rapid heart beat coincided to short episodes of a heart arrhythmia called atrial fibrillation.

Fortunately, Mark’s stress echocardiogram and other tests were completely normal.

Knowing about the reported possible heart dangers of energy drinks, I asked him to stop the energy drinks.  I also encouraged him to eat healthier, exercise every day, and make sleep a priority.

When he came back to see me a month later, he reported that his energy levels were much better.  His symptoms were also completely gone.

Initially, I suspected it was the eliminating the caffeine from the energy drinks that did the trick.  I was surprised to find out that while he no longer drank energy drinks, he was now eating dark chocolate on most days.  With this new information, it became clear to me that perhaps caffeine was not the cause of his heart troubles.

Latest Study on Caffeine and Abnormal Heart Rhythms

This past week, a new study was published by my colleagues at the University of California, San Francisco  (UCSF) on the effects of caffeine to the heart’s rhythm.  As might be expected, as soon as this study was published, headlines around the world reported “Caffeine May Not Cause Palpitations.”

In this study, UCSF cardiologists recruited 1,388 participants in this study.  As part of this study, participants reported their coffee, tea, and chocolate intake.

To measure the effect of coffee, tea, and chocolate on the heart, participants also wore heart monitors to record every heart beat.  When UCSF cardiologists reviewed their heart monitors, they found no correlation between the number of irregular heart beats and caffeine intake.  In other words, regardless of their caffeine intake, it did not seem to affect how many premature atrial contractions (PACs) or premature ventricular contractions (PVCs) study participants had.

Limitations of this Caffeine Arrhythmia Study

Does this study mean that people who suffer from heart arrhythmias can have all the caffeine they want?  Not so fast.  This study leaves many questions unasnwered.  In my opinion, there are three big limitations of this study.

1. This was an observational study.

As an observational study we can’t conclusively say that caffeine from coffee, tea, or chocolate doesn’t cause heart arrhythmias.  All we can say is that, for whatever reason, the amount of caffeine consumed from coffee, tea, and chocolate in this study, did not seem to affect the number of irregular heart beats.

There could be other reasons why these study participants were not affected by caffeine.  Perhaps these people practiced mindfulness techniques, like meditation or yoga, to control stress and keep irregular heart beats at bay with increasing doses of caffeine.

2. This study did not include caffeine from other sources.

Study participants were only asked about coffee, tea, and chocolate consumption.  They were not asked about caffeine from other sources.  For example, researchers had no idea if study participants were also drinking Diet Coke or Red Bull.

3. This study did not compare fast versus slow caffeine metabolizers.

It is possible that most of the study participants were fast caffeine metabolizers.  For fast caffeine metabolizers, caffeine consumption has little affect on the heart.

Fast vs. Slow Caffeine Metabolizers

Does caffeine make it hard for you to sleep at night?  If so, then chances are that you are part of the 50% of people who have a genetic variant to your CYP1A2 gene.

Variations in the CYPA12 gene can cause you to metabolize caffeine more slowly.  Indeed, based on your genetics, there can be up to a 40-fold difference in how fast caffeine is metabolized in your body.

These genetic differences may explain why some studies report that caffeine may be dangerous to your heart and other studies, like the one discussed in this artice, report that caffeine is safe.  Indeed, other studies report that caffeine slow metabolizers can have up to a 64% increased risk of a heart attack depending on their caffeine dose.

Fortunately, less than 100 mg/day appears to be safe, even for caffeine slow metabolizers.  How much is 100 mg of caffeine?  A 100 mg dose of caffeine is approximately the equivalent of one cup of coffee, two cups of tea, three 12-ounce cans of soda pop, or four ounces of dark chocolate.

Why does medical science seem to be “flip flopping” on issues like coffee and caffeine?  This is likely because we have not taken into account genetic differences.  Just as everyone responds differently to medications, everyone responds differently to caffeine.

When it comes to caffeine metabolism, I am a slow metabolizer.  Fortunately, dark chocolate does not cause palpitations or arrhythmias for me.  While I love my dark chocolate, as a slow caffeine metabolizer, I must eat it first thing in the morning or I will have troubles sleeping at night.

The Big Picture

In the big picture of things, if you suffer from palpitations, arrhythmias, or heart problems should you or shouldn’t you consume caffeine?  Fortunately, this study suggests that if your caffeine source is coffee, tea, or chocolate you may be just fine.

One important thing to remember is that this study was just an average of 1,388 people.  I’m sure that of these 1,388 people, there were some whose heart’s were very sensitive to caffeine.  Perhaps these were the caffeine slow metabolizers?

While you could certainly have your genes tested to find out, as I described in a previous blog, perhaps an easier solution would be to just monitor how caffeine affects your body.  If caffeine causes palpitations or heart arrhythmias it would be best to avoid caffeine.  In contrast, if it doesn’t seem to bother you then it is probably OK unless your doctor tells you otherwise.

If you have heart problems or insomnia, try cutting out caffeine, or even setting a caffeine curfew of say 12 pm in the afternoon, to see if it makes a difference.  Perhaps you are like me in that caffeine is fine first thing in the morning.

How does caffeine affect you?  Please leave your comments below.  Also, if you have any questions about this article, please leave your questions below.  I will try to answer every question.

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What Should Your Heart Rate Be?

What should your resting heart rate be?  This is a question I am asked everyday as a cardiologist.  Can your resting heart rate, also known as your pulse, predict just how long you will live?

A fascinating study was just published this past week on resting heart rate and lifespan.  In this article, I will share the latest research on how your resting heart rate may predict how long you will live.

Michelle’s Experience

Michelle was a 42 year old woman who recently came to see me for a slow pulse.  Her resting heart rate was 46 beats per minute (bpm) and her doctor was worried that she might need a pacemaker.

“Have you ever passed out?” I asked.

“Nope.” Michelle said.

“Do you ever get dizzy or lightheaded when your pulse is below 50?

“Nope again.” Michelle said.

In Michelle’s case, her heart rate of 46 bpm was because she was very physically active and healthy.  Contrary to popular belief, if you are healthy and your resting heart rate is below 50 bpm it is generally a good thing.

Pacemakers are only indicated for people with an abnormal heart rhythm (arrhythmia) which causes their heart to beat to abnormally slow.  Michelle’s heart rhythm was totally normal.

What is a normal resting heart rate?

If you consult online with the Mayo Clinic, they will tell you that a normal resting heart rate is 60 to 100 bpm.  While this may be a typical resting heart rate, it is certainly not an optimal resting heart rate.  Read on to find out what your goal resting heart rate should be.

How do you find out what your resting heart rate is?

To check your resting heart rate, simply find your pulse in either your wrist or neck.  Then, count the number of heart beats you have in one minute.  This is your heart rate in beats per minute (bpm).

Alternatively, you can also use a blood pressure machine.  Blood pressure monitors will give you your heart rate in addition to your blood pressure.

Whales vs. Mice

In 1928, Dr. Raymond Pear proposed the “Rate of Living Theory.”  One implication of this theory is that each mammal is given a certain number of heart beats for their life.  If your “rate of living” was faster, he predicted that you would die younger.

For example, the mouse can have a resting heart rate faster than 600 bpm.  However, at this fast of a resting heart rate they typically die after two years.

In contrast, the resting heart rate of a whale is about 10 beats per minute and some whales can live up to 200 years.  In each case, the total number of heart beats is remarkably similar.

In humans, studies suggest that the average person gets 3 billion heart beats.

Heart Rate and Lifespan Study

This past week, media headlines loudly proclaimed, “Slow Heart Rate Doesn’t Mean Early Death Risk.”  As a cardiologist knowing that a slow heart rate is actually protective, I was quite surprised to see these eye catching headlines.

Despite hundreds of studies showing that slower heart rates are associated with longer lifespans, every day I see patients who are worried that their heart rate is too slow.  Let’s take a look at the scientific data from this latest study on heart rate and lifespan.

In this study, researchers enrolled 6,733 mostly middle aged people.  Everyone’s resting heart rate was recorded at the beginning of the study.  These study participants were then followed closely for 10 years to see who died and who was still alive 10 years later.

Here is what they found:

1. If the resting heart rate was naturally slower than 50 bpm, survival was 29% higher.

2. If the resting heart rate was artificially lowered with medications to less than 50 bpm, the risk of death was 2.4 times higher.

3. If the resting heart rate was naturally faster than 80 bpm, there was a 49% higher chance of dying during the study.

4. If the resting heart rate was faster than 80 bpm, despite medications to slow the heart, the risk of death was 3.6 times higher.

Why did people with a naturally slow heart rate live the longest?

While most people would never guess that those with the slowest resting heart rates live the longest, this study is just one of many studies showing that a slow resting heart rate is protective.  Before you get too excited or worried, depending on your own resting heart rate, I need to point out that this was just an observational study.

There is no conclusive proof that a slow resting heart rate will make you live longer.  In fact, a slow resting heart rate may have nothing at all to do with survival.  Any survival advantage from a slow resting heart rate may be do to regular daily exercise or other factors.  In other words, a slow resting heart rate may just be a sign of someone who exercises regularly.

How dangerous is an artificially slow heart rate?

The finding that people with a resting heart rate of less than 50 bpm on heart slowing medications are 2.4 times more likely to die prematurely, is a new finding.  For these people, the slow heart rate may be a sign that they are on too much heart medication.

Common medications that artificially slow the resting heart rate include beta-blockers, calcium channel blockers, digoxin, and anti-arrhythmics.  If your heart rate is artificially slowed to less than 50 bpm, please speak with your physician to see if you should be on less heart medications.

When is a pacemaker needed?

A pacemaker is a small electronic device placed under the skin with wires that connect to the heart.  Pacemakers can speed up a slow heart.

In the study discussed in this article, a slow normal heart rhythm predicts a long life.  In other words, the heart is beating totally normal but just slower than most people.

In contrast, I see patients every day with arrhythmias causing them t0 have an abnormal heart rhythm with a slow heart rate.  Sometimes, their hearts may even stop beating.  For people with abnormal heart rhythms (arrhythmias) causing their heart to beat too slow, a pacemaker may be indicated.

Only your cardiologist can tell you if your slow resting heart rate is from a normal rhythm or an abnormal rhythm (arrhythmia).  To determine if your heart rhythm is normal or not, your cardiologist may have you wear a heart monitor.

In Michelle’s case, she had a slow normal rhythm.  Thus, no pacemaker was needed and the study discussed in this article predicts she will live a long life.

Why is a fast resting heart rate so dangerous?

This study, along with many other studies, have shown that a fast resting heart rate is associated with an increased risk of premature death.  There are many possible reasons why a fast resting heart rate may be dangerous.  Here are some of the many possible reasons:

1. A higher resting heart rate could be from an abnormal heart rhythm (arrhythmia).

2. People who don’t routinely exercise have a high resting heart rate.

3. People under a lot of stress can have a fast resting heart rate.

4. Chronic medical problems can cause a higher heart rate.

5. Being overweight makes the heart beat faster.

What can you do to lower your resting heart rate?

If your heart beats too fast, here are some things you can do to get your heart rate under control.

1. Check with your doctor to see if you have an abnormal heart rhythm (arrhythmia) or another medical problem causing your heart to beat too fast.  Getting these conditions treated can quickly bring your resting heart rate down.

2. Exercise regularly.  Regular aerobic exercise (jogging, swimming, biking, etc.) significantly slows the resting heart rate over time.  Most well trained athletes will have a resting heart rate below 50 bpm.

3. Practice mindfulness techniques.  Mindfulness techniques like meditation, yoga, tai chi, etc. all lower the heart rate and stress levels.

4. Maintain a healthy weight.

Final Thoughts

While there is no conclusive proof that humans are only given a lifespan of 3 billion heart beats, this study certainly suggests that if you can “save your heart beats” with a slower resting heart rate you may live longer.  Certainly, if you feel well and are living a healthy lifestyle, I wouldn’t worry if your normal resting pulse is 49 or 89 bpm.

What are you doing to optimize your resting heart rate?  Please share your experience in the comment section below.

Also, if you have any questions about this article, please leave your questions in the comment section as well.  I will try my best to answer every question.

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How to Heal Your Gut

New research shows that having the wrong gut bacteria may cause weight gain, illnesses, allergies, autoimmune diseases, and problems with your heart.  Indeed, a study this past week showed that within 4 generations on a low fiber “modern diet” your beneficial gut microbes may become forever extinct.  In this article, I will share with you 5 simple things you can do to heal your gut and prevent chronic medical problems.

The Challenge

The number of bacterial cells in your gut out number the rest of the cells in your body by 10 to one.  The modern diet, low in fiber and high in sugar and saturated fat, wipes out healthy gut microbes.  Even worse, modern foods promote unhealthy strains of gut bacteria which may cause chronic medical conditions.

Weight Gain

Regardless of your willpower, you may never lose weight with the wrong gut bacteria in place.  Likewise, pre-diabetes and diabetes may also be caused by these same “bad” bacteria living in your gut.  To better understand the science of gut bacteria and weight gain, please read my previous blog.

Illnesses, Allergies, and Autoimmune Diseases

Do you seem to catch every cold going around?  Do you suffer from allergies?  Are you battling an autoimmune disease?  If so, your immune system challenges may be from the wrong gut bacteria.

Fully 70% of your entire immune system is in your gut.  What is happening to your gut’s immune system may also be affecting the rest of your body.

Cardiovascular Disease

In addition to weight gain and diabetes, new research shows that high cholesterol and heart disease may also be caused by the wrong gut bacteria.  Until recently, researchers were not sure how the bad gut bacteria caused heart attacks.

The link between bad gut bacteria and heart attacks may be due to TMAO.  TMAO, or Trimethylamine N-oxide, is a chemical produced by the wrong strains of gut bacteria.  TMAO in the blood may be a bigger risk for a heart attack than even high cholesterol.

People eating foods high in carnitine and lecithin produce a lot of TMAO.  Carnitine and lecithin are especially high in meat and eggs.  Red meat seems to be the biggest offender of TMAO creation by the gut bacteria.

Interestingly, studies show that people on antibiotics produce little TMAO.  Likewise, a vegan who suddenly eats a big steak also won’t produce much TMAO either.  However, if the vegan starts eating meat daily then their gut bacteria will start making large amounts of TMAO.  The bottom line is that if you eat a lot of meat and eggs on a daily basis, you will grow large amounts of the TMAO producing bacteria in your gut.

One puzzle to the TMAO theory of heart disease is fish.  While fish eaters have long been known to have lower rates of cardiovascular disease, fish eaters also have TMAO in their blood.  One theory to explain this conundrum is that the TMAO produced from fish is eliminated easily by the kidneys.

Are Good Gut Microbes Becoming Extinct?

A very sobering study on the gradual extinction of beneficial gut microbes was just published this past week by Drs. Erica D. Sonnenburg and Justin L. Sonnenburg from Stanford University.  It is well known that beneficial gut microbes thrive on fiber.  Fiber is their fuel source.  If fiber is not available, these healthy microbes die from starvation.

In their place will emerge strains of “bad” gut bacteria causing weight gain, poor immune system function, and heart disease.  These “bad guys” in your gut love the modern diet.  They especially love massive quantities of sugar, artificial sweeteners, refined carbohydrates, and saturated fats from animal products.

Although this Stanford study was done in mice, the findings may apply to you as well.  To study the effects of fiber on the human gut, they bred mice without any bacteria in their guts.  Next, they populated the guts of these germ free mice with healthy gut bacteria taken from humans through a procedure known as a fecal transplant.  In this case, they transplanted healthy “poop” from humans into the guts of these germ free mice.

With healthy human gut microbes in place, the Sonnenburgs then put these mice on a low fiber diet similar to what most Americans eat.  After several generations of mice, here is what they found:

1. A low fiber diet kills off beneficial gut microbes.

2. Healthy gut microbes gradually become extinct on a modern diet.

With each generation of mice on a Western diet, healthy strains of gut microbes became progressively extinct.  By the 4th generation, the mice had forever lost 75% of the beneficial strains of gut microbes.

3. A healthy diet alone can’t bring back healthy gut microbes.

While a high fiber diet allows the surviving beneficial gut microbes to multiply, a healthy diet alone could not bring back healthy gut microbes from extinction.

The finding that healthy strains of gut microbes can become extinct is a new scientific finding.  This finding has serious implications for the health of your children and grandchildren.  On a bigger scale, if healthy strains of gut microbes are forever lost from the human race, chronic medical conditions will afflict even more people.

Of course, it is possible that after thousands or possibly even millions of years your body may learn to adapt to a low fiber diet.  In the meantime, what can you do to prevent the extinction of healthy gut microbes from your family line?

Heal Your Gut in 5 Simple Steps

1. Eat a High Fiber Diet

While our ancestors once ate more than 100 grams of fiber daily, the average American now eats just 15 grams of fiber each day.  Even our government has set the bar very low by recommending just 14 grams of fiber for every 1,000 calories you eat.  Thus, a person eating a 2,000 calorie diet only needs a mere 28 grams of fiber daily according to our government.

Since reading this article, I have tried to significantly increase my fiber intake.  Even while traveling most of last week, I still averaged 81.1 grams of fiber each day.  All of this fiber was from natural whole foods.  No supplements were taken.

To increase your fiber intake, eat more fruit, vegetables, legumes, nuts, and seeds.  If you enjoy grains, make sure they are only whole grains which are high in fiber.

If you currently don’t eat much fiber, talk with your doctor first.  Suddenly switching from a low fiber diet to a high fiber diet could cause abdominal distress and possibly even an intestinal blockage.  You may need to gradually increase your fiber intake.

2. Eat More Fermented Foods

While fiber allows good bacteria to multiply, to introduce new healthy strains of gut bacteria you will need to eat more fermented foods.  Some examples of fermented foods include yogurt, kefir, natto, sauerkraut, kimchi, etc.  One ray of hope from the Stanford mouse study was that if researchers did a fecal transplant and fed the mice a high fiber diet they could restore a healthy gut.

Most of my patients are not willing to sign up for a fecal transplant.  Besides, a fecal transplant is still considered “experimental” and is only indicated to treat the most severe cases of C. diff colitis.

Thus, to introduce more healthy gut bacteria, eat more fermented foods. While I still don’t like fermented foods, I make it a point to eat them on most days.

If you have a weak immune system, talk with your doctor first to make sure it is safe to consume fermented foods.

3. Avoid Unnecessary Antibiotics

While antibiotics can be life-saving, most antibiotics currently used in the United States are unnecessary.  Unnecessary antibiotics in human and animals are breeding superbugs that can no longer be treated.

In addition to killing harmful bacteria, each course of antibiotics also wipes out billions of healthy gut microbes.  These healthy gut microbes may forever be eliminated from your gut and family line.

Work with your doctor to make sure any prescribed antibiotics are absolutely necessary.  Also, if you must take an antibiotic, be sure to quickly replenish your healthy gut microbes with plenty of fiber and fermented foods.

4. Give Your  Children Every Advantage

Many mothers have no choice but to undergo a C-section or feed their baby formula.  The beneficial gut microbes a baby starts this life with is determined, to a large extent, by a normal delivery and drinking mother’s milk.

As children grow older, do everything possible to encourage high fiber and fermented foods.  Work under the direction of your pediatrician as to when these healthy foods can be safely introduced.

Yes, children will fuss about eating healthy foods.  Don’t give up.  Starting off life with a healthy gut can help them to avoid weight gain, allergies, and future heart problems.

5. Don’t Live in Too Sterile of an Environment

Anti-bacterial soaps, toxic cleaners, hand sanitizers, and too much time spent inside may wreck havoc on your immune system and your gut.  Sadly, your contact with the microbial world is shrinking with each new generation.

It has long been recognized that farmers, children from big families, or people with pets suffer less from allergies and asthma.  Indeed, exposure to microbes in the dirt, microbes from a sick sibling, or microbes from a pet may help to fine tune your immune system.

These observations provide the basis for the hygiene hypothesis.  The hygiene hypothesis states that if your hygiene is too sterile then your immune system may not function properly.  If your immune system doesn’t get enough exposure to the microbial world then it could look for the wrong things to attack and cause conditions like allergies and autoimmune diseases.

The Big Picture

More and more studies are pointing to a healthy gut as one of the most important things you can do to maintain an ideal weight and prevent chronic medical problems.  The study by Erica and Justin Sonnenburg is a call to action now to prevent healthy gut microbes from forever becoming extinct in your family.

Please leave your experiences below on how you have healed your gut.  Also, if you have any questions about what you have just read, please leave your questions below.  I will do my best to answer every question.

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Top 10 Changes to New Dietary Guidelines

This past week the U.S. government released their new dietary guidelines.  These dietary guidelines are updated every 5 years and determine what the new “food pyramid/MyPlate”” looks like, what our children eat for school lunch, and how your doctor will advise you to eat.

What has changed?

After spending much of my weekend carefully dissecting this 100 plus page report, there are actually many new changes.  The biggest changes had to do with sugar, fruit and vegetables, as well as cholesterol in the diet.  Read on to see the top 10 changes to the new U.S. dietary guidelines.

Top 10 Changes to New Dietary Guidelines

1. Sugar Limits for the First Time

With Americans now getting 20% of their calories from high fructose corn syrup, something had to be done.  I applaud our government for finally setting sugar limits.

While the World Health Organization had no fear of the junk food industry in their recent recommendations to limit added sugar to just 5% of total calories, our government caved in.  To keep the sugar industry from becoming too enraged, new guidelines call for limiting added sugar to 10% of your total calories.

This is added sugar, not the natural sugar that is in fruit.  To put this in perspective, the average American eats about 2,000 calories daily.  If you limit added sugar to 10%, this means that you can have 50 grams of added sugar or 1.3 cans of sugary Coca-Cola each day and still be within the guidelines.

The problem is that sugar is not just in soda pop.  It is everywhere.  For example, yogurt and ketchup may have even more added sugar than sugary Coca-Cola.

To help my patients navigate the added sugar landmines, I advise them to read the label on everything they eat.  Track your added sugar for a day or two to see where your baseline is.  You may be surprised.  Personally, I support the Word Health Organization’s guidelines of keeping added sugar to less than 5% of your total calories.

2. Nine Servings Daily of Fruit, Vegetables, and Legumes

The new guidelines want you to eat a lot more fruit, vegetables, and legumes.  In fact, I am thrilled that they now call for 9 servings daily.  How did they define a serving?

For vegetables, a serving size is a half of a cup unless it is a salad.  For salads, a serving size is one cup.  When it comes to fruit, a serving size is a whole fruit or a half cup.

As I have been recommending 9 servings daily of fruit and vegetables to my patients for years, I am often asked how much of each you should eat?

Of the 9 servings daily, at least 5 should be vegetables.  To help guide you on vegetable selection, the report states that at least one should be green (like broccoli or kale), one should be yellow or red (like peppers or carrots), one should be a legume (like beans or lentils), and one should be a starch (like corn or green peas).  To keep things simple, make sure you are eating a rainbow of colors each day.

Surprisingly, this report counted fruit juice as a “fruit.” Fruit juice is not a health drink.  Fruit juice is not much different than added sugar.  Indeed, studies show that fruit juice causes weight gain.  My advice is to skip the fruit juice and instead focus on eating real fruit.

To get to 9 servings daily, you have to start out the day right or it is hard to catch up.  This is why I recommend that my patients include vegetables with their breakfast.  Personally, I eat a salad on most mornings as part of my breakfast.

3. No Dietary Cholesterol Limits

In a marked shift from previous guidelines, this new report has no limits on how much cholesterol you can eat.  Thus, eggs, which are loaded in cholesterol, are now in.

While it is true that for most people dietary cholesterol has little impact on blood cholesterol, there are three groups of people who seem to be very sensitive to cholesterol in the diet. For these people, dietary cholesterol can translate into plaque in the arteries of the heart and brain.  This, in turn, can lead to heart attacks, strokes, and dementia.

The three groups of people who should continue to limit dietary cholesterol are the following: those people with a family history of high cholesterol (familial hypercholesterolemia), those with a family history of Alzheimer’s Disease (ApoE4 gene), or those with diabetes.  As cholesterol is only found in meat and dairy, people with these 3 conditions should work with their physicians to minimize unnecessary dietary cholesterol.

4. No Limits on Red and Processed Meats

Not surprisingly, our government clearly caved in to the meat industry with the new guidelines.  As you might have suspected, there were no firm recommendations to limit red and processed meats.  As I discussed in blog #129, red and processed meats are now considered carcinogenic.

Interestingly, the new dietary guidelines did call out young and middle-aged men for eating too much meat and dairy in general.  Also, the document included recommendations to eat more plant-based sources of protein, like legumes and nuts, and to shift more of your meat consumption to fish low in mercury.

5. Coffee and Tea Are In

While soda pop was definitely called out in this report, coffee and tea were both encouraged based on the new science.  While some have concerns about the caffeine in these drinks, the report states that caffeine is generally recognized as safe.

When it comes to caffeine, most people are unaware that, based on your genetics, you are either a fast or slow caffeine metabolizer.  If you are a fast metabolizer, your body can tolerate large doses with minimal risk.

In contrast, if you are a slow metabolizer, like me, then caffeine lingers for a long time in your body.  For slow metabolizers, higher doses of caffeine may be dangerous to your heart.

For example, slow metabolizers have up to a 64% increased risk of a heart attack depending on their caffeine dose.  Fortunately, consuming up to 100 mg of caffeine daily seems to be safe even for slow caffeine metabolizers.

In addition, recent scientific reports have shown that coffee may increase the risk of heart attacks in younger patients with high blood pressure.  To find out if you are a fast or slow caffeine metabolizer, you can take a simple home saliva test from 23andMe.

6. Half of Your Grains Can Be Processed

At one time our government’s dietary guidelines recommended up to 11 servings of grains each day.  Fortunately, the new guidelines no longer recommend a specific number of grains daily.

Interestingly, the report does state that Americans now seem to be eating the “right amount” of grains.  Even more surprising was that the new dietary guidelines say that up to half of your grains can be fully processed and refined.

This was a huge mistake.  If you follow these new grain guidelines, then odds are that you will suffer from weight gain and possibly even diabetes.

When it comes to grains, you need to follow the science.  Processed and refined grains are clearly associated with obesity and diabetes.  In contrast, real whole grains have been linked to less cardiovascular disease without weight gain issues.

7. Keep Restricting Salt

While the latest U.S. dietary guidelines have slightly loosened salt recommendations, they still call for restricting salt to less than 2,300 mg of sodium daily.  To put this in perspective, one teaspoon of salt has 2,300 mg of sodium.

As 80% of the salt the typical American gets is from processed and fast foods, the real answer is to limit processed and fast foods.  In my opinion, as long as processed and fast foods are rarely eaten, then flavoring your real food with some salt is probably fine unless your doctor tells you otherwise.

Indeed, as I discussed in blog #138, recent scientific studies show that salt restriction may be dangerous for the heart.  Of course, people suffering from high blood pressure, and other heart conditions, should not increase their salt intake unless your doctor says it is OK.

8. Keep Limiting Saturated Fats to 10% of Your Calories

While cholesterol limits were dropped, the Atkins Diet and Paleo Community were angered to see ongoing saturated fat limits.  What does the science say?

As I covered in blog #118, saturated fat seems to be neutral when it comes to the risk of cardiovascular disease. The key is that if you limit saturated fat, what are you eating instead?

For example, if you replace saturated fats with refined carbohydrates, like we did in the 1980s and 1990s, heart disease and premature death risks go up.  On the other hand, if you replace saturated fat with omega 3 fats or complex carbohydrates (fruits, vegetables, and legumes), cardiovascular disease and premature death risks go down.

Saturated fats are complicated.  It goes without saying that most physicians agree that the saturated fat in a hamburger or hot dog probably is not good for you.  Where it gets complicated is when it comes to nuts.  Nuts clearly prevent heart disease and increase longevity, yet they are also high in saturated fat.  Should the saturated fat in nuts count toward your daily limit of saturated fat?

My feeling is that if you are eating a mostly plant-based diet, then you don’t need to worry about limiting saturated fat unless your doctor tells you otherwise.

9. Eat More Fat Free and Low Fat Dairy

As with previous guidelines, the U.S. dairy industry exerted their influence on this document as well.  Indeed, according to our government, you are not eating enough non-fat or low-fat dairy.

Why non-fat or low fat dairy?  This is because full fat diary was felt to have too many calories and too much saturated fat.

As I discussed in blog #38 and blog #85, dairy is very controversial.  For example, people living in Japan, Singapore, or Hong Kong, rarely consume dairy but yet have some of the lowest rates of heart disease and bone fractures in the world.  If dairy is so critical to human health, why do these people live so much longer than we do?

10. Eat More Polyunsaturated and Monounsaturated Fats

Coming in at number 10, our government says you need to eat more polyunsaturated and monounsaturated fat.  What exactly does this mean?

The problem is that this guideline was not well defined.  Nor did they distinguish between the omega 3 and the omega 6 polyunsaturated fats.

Here is what the new dietary guidelines should have said:

1. Eat nuts and seeds daily to get monounsaturated fats.

2. Eat something high in the omega 3’s, like salmon, walnuts, or chia seeds, each day.

3. Avoid processed and fast foods which are high in the disease causing fats.

Take Home Message

While our government’s dietary guidelines have improved from previous years, the guidelines are still very much controlled by the sugar, meat, and dairy industry.

Still confused on what you should be eating?

Instead of a 100 page report telling you what you should eat, I can summarize 99% of what you need to know about eating healthy in just one simple sentence.  This sentence was adapted from Michael Pollan’s book, In Defense of Food.

Eat real food, not too much, mostly plants.  

In other words, eat real food not processed or fast foods.  Eat healthy portions and focus on a mostly plant-based diet.

What is your view of these new dietary guidelines?  I look forward to reading your comments below.  Also, please leave your questions and I will do my best to answer every one.

If you enjoy what you are reading, please sign up for my newsletter as there is information in this newsletter that you can’t find anywhere else on my website.  Also, please share this information with a friend so that we can help more people in their quest to eat healthier.

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Restricting Salt May Be Dangerous For Your Heart

Salt is something your doctor has always told you to avoid, right?  In this article, I will share with you the latest medical research showing that, in some cases, restricting salt may be dangerous for your heart.

American Heart Association’s Salt Recommendations

The American Heart Association continues to preach that Americans should reduce their 3,400 mg average of sodium each day to just 1,500 mg.  To put this in perspective, 1,500 mg of sodium is a little more than a half teaspoon of salt.  Is it any wonder that only 1% of Americans can actually follow such strict salt restrictions?

Who wants to eat such a low salt diet?  Our ancestors never ate such bland food. I personally enjoy flavorful food.

Salt Restriction and Heart Failure

Since I started my cardiology training nearly 20 years ago, I was taught that heart failure patients must restrict salt.  When it comes to salt, heart failure patients are like the “canary in the coal mine.”

In other words, if anyone is going to get into trouble from too much salt, it is the heart failure patient.  The thinking was that too much salt led to water retention.  Water retention then caused swollen legs and shortness of breath.

Even today, heart failure patients at my hospital are told to restrict salt.  Are there any medical data to support salt restriction in heart failure?

Salt Restriction Worsens Heart Failure Study

Surprisingly, there are no compelling medical studies supporting the recommendation for heart failure patients to restrict salt.  In fact, a new study showed that salt restriction can actually make heart failure worse.

This past week, cardiologist Dr. Rami Doukky and colleagues from Rush University in Chicago, published a study that has cardiologists around the world questioning everything we have been telling our patients for generations about heart failure.

In this study, Rush University researchers recruited 833 people from 10 different hospitals in the Chicago area.  All patients suffered from severe heart failure.

Some of these heart failure patients restricted their salt to less than 2,500 mg of sodium daily and some did not.  I should point out that the 2,500 mg sodium restriction in this study is far higher than what is allowed with the American Heart Association’s recommended 1,500 mg of sodium each day.

After following these heart failure patients for 36 months, the researchers found that those who restricted salt were 85% more likely to die or be hospitalized during the study!  Wow, the very thing these patients were told to do may have caused them to die prematurely or end up in the hospital.

Of course, I should point out that this was just an observational study.  In other words, just the observation that salt restrictors were more likely to die or be hospitalized doesn’t prove at all that salt restriction was the cause.

There could have been other factors at play to explain these results.  For example, perhaps the salt restrictors were much more sedentary, thus they did not need salt to replace sweat losses from exercising.  That is why my conclusion to this study is that restricting salt may be dangerous for your heart.

Certainly, when it comes to heart failure and salt intake, we need more studies to know what we should be recommending to heart patients.  In the meantime, as long as heart failure patients are not eating a lot of processed and fast foods, they are probably fine flavoring their food with salt unless their doctor tells them otherwise.

Salt and High Blood Pressure

When it comes to salt and high blood pressure, the medical data are pretty clear.  Excessive salt from processed and fast foods raises blood pressure.  Where the medical data aren’t so clear is whether salt, by itself, actually causes heart attacks and strokes.

How much salt should you eat?

This new salt and heart failure study adds further confusion to how much salt you should eat.  This study should not be interpreted that processed and fast food is okay.  Rather, if you rarely eat processed or fast foods then flavoring your “real food” with some salt may be just fine.

To help clarify things, the Institute of Medicine recently reviewed all of the medical studies on salt and came up with the following conclusions:

1. You need at least 1,500 mg of sodium each day to cover sweat losses.

2. Eating up to 2,300 mg of sodium daily is safe.

3. There are not enough quality medical data yet to make any firm salt guidelines.

How do you know how much salt you are eating?

People suffering from high blood pressure should consider tracking their salt intake.  This doesn’t have to be for a long period of time.  Even just a few days would be helpful to at least get an idea of how much salt they are consuming and how sensitive their blood pressure is to salt.  How should this be done?

My Fitness Pal and Lose It are both great free apps to track sodium and nutrition.  Personally, I use the Lose It app.

According to the data compiled by the Health app that comes with all iPhones, I have averaged 1,895 mg of sodium daily for the last year.  This is an underestimation, as I generally don’t take the time to add in the amount of salt I use when cooking or preparing food.  I suspect that if everything was included I would probably end up somewhere near 2,300 mg of sodium or one teaspoon of salt each day.

The Big Picture

Most of the salt in the American diet comes from processed and fast foods.  This is definitely not the way to get salt.  For people who eat minimal processed or fast foods, then you are probably fine flavoring your food with some salt unless your doctor tells you otherwise.

In general, the people who get in trouble from salt are those with high blood pressure on a processed and fast food diet.  For the rest of us, there is no reason to restrict salt unless your doctor has told you to limit salt.

Please leave your comments on this article below.  Also, if you have any questions on this article please leave them below as well and I will answer every question.

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10 Years Younger This Year: One Simple Resolution

This year, 81% of New Year’s resolutions will fail. What is the secret to the 19% that succeed? To show you how it works, I’ll show you how to accomplish something that not one of us wouldn’t love to experience–feeling 10 years younger this year than we did last year.

Sound like a massive overhaul? On the contrary. It really just begins with finding one simple thing that you can do for the rest of your life. That one simple thing is your key domino which will set off a domino effect of naturally occurring behaviors that bring the change you seek.

We’ll look at the four highest leverage areas to becoming biologically 10 years younger this year: stress, extra weight, sitting, and smoking, but you will pick just one to focus on. This will be your key domino.

4 Things That Age You 10 Years

If you are like me, you want to “see the data” before selecting your key domino. Below are links to studies showing that each of these 4 things can individually cause your cells to age prematurely by 10 years or rob you of up to 10 good years of life.

1. Stress

2. Extra Weight

3. Excessive Sitting

 4. Smoking

10 Years Younger This Year: One Simple Resolution

Too often my patients feel like they need to make big life changes to “get healthy.”  In reality, success comes from making one key change permanent.  The key domino.

Indeed, studies show that most people are more successful with one simple resolution.  Studies also show that early success from this one simple resolution is key to long-term success.

Depending on what you are struggling with, here are some examples of one simple resolution you might select in becoming biologically 10 years younger this year:

Stress Less: “I will meditate for 1 minute each morning as soon as I get out of bed.”

Weight Loss: “I will eat a vegetable with my breakfast.”

Exercise More: “The first clothes I put on in the morning will be my exercise clothes.”

Stop Smoking: “I will chew a piece of gum every time I want to smoke.”

You will notice that each of these examples are simple, measurable, and has something to remind you.  While these new habits might not seem like much at first, if done faithfully it could be the “key domino” to feeling 10 years younger this year.

5 Steps to Make the One Simple Resolution Successful

Even with just one simple resolution, change is still hard.  Below are the 5 key steps to success based on my review of over 30 medical studies on healthy lifestyle changes.  Not only have these steps been shown to work in studies, I have also seen them help hundreds of my patients turn their health around.

1. Fun and Convenient

The one simple resolution must be fun and convenient.  If not, too much willpower is required.  Here are some examples:

Stress Less: If yoga is fun and there is a convenient place, then this is the perfect stress less resolution.  However, If you don’t like yoga, or it is a 30 minute drive to your yoga class, it will never work.

Weight Loss: As Americans now get 1/3 of all their calories snacking, if weight issues are where you struggle then snacking may be the only thing standing between you and feeling 10 years younger this year.

The solution? Make your one simple resolution to always have your favorite fruit, vegetable, or nuts with you wherever you go.

Exercise More: If you hate the gym, or the gym is 30 minutes away, then a resolution of going to the gym everyday will fail.  Look for physical activity that is both fun and near your home or work.

If dancing is what you love, and there is a place near your home or work, then go for it.  If golfing is your passion, then carry your clubs on a course near your home or work.  For most of my patients, a simple resolution to take an evening walk with your spouse may be the best activity for both your health and happiness.

Stop Smoking:

Quitting the smoking habit can also be fun and convenient.  Perhaps you don’t like chewing a piece of gum whenever you think about smoking.

One possible solution would be to buy a nice piece of jewelry or an expensive watch.  As long as you have not smoked that day, you can wear your new jewelry or watch.

2. Have the Right Reason

If you don’t have a compelling reason, your willpower will fade.  Studies show that your beliefs can determine success or failure.  Make it real and make it compelling.

Some examples of compelling reasons which have changed the lives of my patients are as follows:

“I can’t die early on my family.”

“I don’t want to feel this way anymore.”

“I want to get off of my medications.”

3. Support

You simply can’t do it alone.  Indeed, studies show that people who try to go it alone generally fail.  You need support from family and friends.

Having a spouse make the same changes can be the most important key to success.  Supportive family members and friends can help you to eliminate temptations.  Without temptations, no willpower is needed.

For people without the support of family or friends, online communities or “gym friends” can be equally helpful. Find support so that healthy living can become the path of least resistance.

4. Accountability Partner or App

The saying, “you can’t manage what you don’t measure,” applies equally in business as well as with one simple resolution.  If no one or no thing holds you accountable, you likely won’t succeed.

Accountability can come in the form of a trainer at the gym.  It could also be a family member or a friend who isn’t afraid to call you out on your short comings.

For me, a hand held app on my iPhone does the trick.  By faithfully tracking my nutrition every day for the last couple of years, I have been able to successfully maintain my 30 pound weight loss.

As long as someone or something holds you 100% accountable, you will succeed.

5. Have a “Slip Up” Plan

At some point you will “fall off the wagon.”  This is human and something that should be expected.  The key is not to let a slip up start a downward spiral that reverses all progress.

You have to have a plan for managing slip ups.  Studies show that people who accept slip ups ahead of time will be more successful.  The goal is to be flexible not fanatical.

As soon as you recognize your slip up, call your accountability partner or record it on your accountability app.  Do this quickly before you completely finish off the entire pie or holiday candy.

Take Home Message

Becoming 10 years younger does not come by making big changes but rather by working on the key domino that makes everything else natural and effortless.  Select one simple resolution in the area you are struggling and then faithfully follow the 5 steps outlined above.  Soon you will be biologically 10 years younger this year.

Please share your success below in making changes.  Also, if you have a question about this article, please leave your question below and I will answer every question.

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The 6 Warning Symptoms Before a Cardiac Arrest

Cardiac arrests are the number one killer in the U.S.  Each year up to 550,000 Americans will suffer a cardiac arrest.  Only 7% will survive and even less will be lucky enough to survive without permanent brain damage.  What are the warning symptoms before a cardiac arrest?

A new study released this week showed that most people who die suddenly had symptoms up to a month prior to their cardiac arrest.  These warning symptoms before a cardiac arrest were generally ignored by either the victim or their doctor.

In this article, I will share with you the 6 warning symptoms before a cardiac arrest so that you can protect yourself and loved ones from tragically having your life cut short.

A Typical Cardiac Arrest Story

“Looking back, there were warning symptoms before the cardiac arrest,” Kristin’s husband said.

“What were these symptoms?” I asked as we spoke at Kristin’s bedside in the intensive care unit.  Kristin was still in a coma and on a breathing machine.

“I remember her telling me that she had a hard time breathing and felt as if she was going to pass out.  The same thing happened with her father before he died suddenly.  I took her to the doctor and he didn’t think much of it.  He thought she was dehydrated and was maybe coming down with the flu.”

“Then what happened?”  I asked.

“Later that night as she was putting our kids to bed she told me that she didn’t feel right.  Just then she fell to the floor unconscious.  Our oldest child called 911 as I started CPR.”

Kristin’s husband had to stop as tears were streaming down his face.  He continued, “I’ll never forget the fear on my 4-year old’s face when she asked, ‘Is mommy going to die?'”

In the end, the paramedics arrived in time and shocked her heart back to normal rhythm.  Fortunately, she survived her cardiac arrest and eventually got out of the ICU.  Before going home, I performed an implantable defibrillator surgery for her so that this would not happen again.  However, despite beating the odds, Kristin was left with life-long short term memory challenges.

What is the difference between a cardiac arrest and a heart attack?

A cardiac arrest is complete electrical failure of the heart.  When this happens, cardiac arrest victims immediately pass out and cannot be aroused.  The heart is not beating at all and, unless the heart can be shocked back into rhythm fast, permanent brain damage or death will happen in minutes.  CPR can keep the victim “alive” a few extra minutes while waiting for the paramedics to arrive with a defibrillator.

Whereas a cardiac arrest is an “electrical problem” of the heart, a heart attack is a “plumbing problem.”  In other words, one of the arteries feeding blood to the heart suddenly plugs up and the heart muscle fed by the artery starves for blood and dies.  As portions of the heart muscle die with a heart attack, this can cause heart failure as the surviving muscle has to work harder to compensate.

Heart attack victims don’t usually lose consciousness.  For these people, time is also critical.  The faster the artery can be opened the less heart muscle dies.

The confusion is that heart attacks can trigger a cardiac arrest.  However, cardiac arrests often occur in people with absolutely no blockages in the arteries of their heart.

The Warning Symptoms Before a Cardiac Arrest Study

This past week a study was published on the warning symptoms before a cardiac arrest.  This study was published by my friend, Dr. Sumeet S. Chugh, from the Cedars-Sinai Medical Center, Heart Institute in Los Angeles, California.

In this study, Dr. Chugh and his colleagues carefully analyzed the medical records of 839 cardiac arrest victims from 16 Oregon hospitals.  Here is what they found:

1. The average age for a cardiac arrest was 52.

2. Warning symptoms before a cardiac arrest were often ignored by the victim or their doctor.

3. The main symptom for men was chest pain.

4. The main symptom for women was shortness of breath.

5. Most victims had a family history of heart problems or a heart condition themselves.

What are the warning symptoms before a cardiac arrest?

Here are the top 6 symptoms, in order, prior to a cardiac arrest from Dr. Chugh’s study.  As victims can have more than one symptom, these numbers add up to more than 100.

1. Chest pain prior to 46% of cardiac arrests.

2. Abdominal symptoms before 20% of cardiac arrests.

3. Shortness of breath at the time of 18% of cardiac arrests.

4. Flu-like symptoms preceding 10% of cardiac arrests.

5. Fainting prior to 5% of cardiac arrests.

6. Palpitations before 5% of cardiac arrests.

Making Sense of the Symptoms

The most difficult part of this study is how do you make sense of these symptoms?  Everyone gets a little chest pain, abdominal pain, shortness of breath, palpitations, or flu-like symptoms from time to time.  Do you dial 911 every time this happens?

In this study, a key thing to remember is that most cardiac arrest victims had a history of heart problems or a close family member with a heart condition.  Thus, if you fit either of these two categories then you need to pay more attention to these symptoms.  Also, other studies show that if you have an unhealthy lifestyle you are far more likely to suffer from a cardiac arrest.

New chest pain, shortness of breath, fainting, or palpitations should always be evaluated.  “Classic” cardiac chest pain is pain that happens with physical activity or mental stress and is relieved with rest.  In this study, the chest pain never went away prior to the cardiac arrest.

For women, the symptoms are more likely to be new shortness of breath, abdominal pain, or flu-like symptoms.  New abdominal discomfort or flu-like symptoms can be much more challenging in deciding whether or not to go into the emergency room.

Why Warning Symptoms Before a Cardiac Arrest Matter

One of the key take away messages of this study is that symptoms matter.  For example, if someone called 911 before the actual cardiac arrest, 32% of these people lived in this study.  However, if 911 was not called until the victim became unconscious, then only 6% of these people survived.

Thus, recognizing the symptoms of a cardiac arrest increased survival more than 5-fold!

81% of Cardiac Arrests are Totally Preventable

No one wants to die suddenly in front of family members.  This trauma could scar them for life.

Rather than watching for the warning symptoms before a cardiac arrest, a much better approach is to make the right lifestyle changes now so that a cardiac arrest never happens.

Fortunately, studies show that at least 81% of cardiac arrests are totally preventable by doing just 4 things.  In a study by my friend, Dr. Christine Albert at Harvard University, of 81,722 women, she identified 4 healthy lifestyles than can prevent 81% of cardiac arrests.

1. Don’t smoke.

2. Maintain a healthy weight.

3. Exercise 30 minutes a day.

4. Eat a diet high in fruit, vegetables, nuts, legumes, whole grains, and fish

Take Home Message

The take home message from this study is that a cardiac arrest can strike anyone, most people had warning symptoms before a cardiac arrest, and those that heeded their symptoms were 5 times more likely to survive.  I was pleased to see that this message was covered by the news reports of this study that I was interviewed for–However, not smoking, maintaining a healthy weight, daily exercise, and a healthy diet can prevent 81% of cardiac arrests!

If you have been diagnosed with a heart condition, have a family history of heart problems, or live an unhealthy lifestyle, you are at significant risk of a cardiac arrest.  For you, knowing what warning symptoms to look out for and changing your lifestyle is critically important.  Regardless of your age, it is never too late to change!

Please leave a comment below if you have had a loved one who has died suddenly or have made changes to decrease your risk of a cardiac arrest.  Also, please feel free to leave your questions about this article and I will do my best to answer every question.

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 7 Foods That Reverse Brain Aging By 8 Years

“Are there any foods that reverse brain aging,” Steve’s wife asked.

“Why do you ask?” I replied.

Just then, Steve said, “What is this lump under my skin?” He had completely forgotten all about the pacemaker surgery I had done for him the week before.

“He has been getting more and more forgetful over the last couple of years” his wife said.

Currently, 1 in 8 U.S. homes now have someone who is struggling with memory issues.  Many of these people are younger adults.

Fortunately, there is something you can do.  Studies show that eating the right foods can make your brain function 8 years younger.  In this article I share the 7 essential foods which have been shown to reverse brain aging by 8 years.

Best Two Anti-Brain Aging Ways of Eating

While many websites, news reports, and popular books claim the latest fad diet will reverse brain aging, there are actually few ways of eating that have been scientifically proven to reverse brain aging.  Here are the two best ways of eating that optimize brain performance.

1. Traditional Mediterranean: Reverses Brain Aging by 8 Years

Contrary to popular belief, the Mediterranean way of eating is not pizza and pasta.  Rather, it is mostly plant-based with some meat, mostly fish.  There are a lot of fruit, vegetables, nuts, legumes, olive oil, and whole grains in this traditional eating style.  This way of eating minimizes or avoids sugar, soda pop, red meat, and pastries.

Studies show that the Mediterranean way of eating can reduce Alzheimer’s Disease by 54%.  This translates into roughly an 8 year younger brain.

2. MIND Diet: Reverses Brain Aging by 8 Years

The MIND Diet is a new, science based diet, created by researchers at Rush University in Chicago.  This way of eating is also mostly plant based with some fish and poultry for meat.  In contrast to the Mediterranean way of eating, the MIND Diet asks for green leafy vegetables every day but less fruit, fish, and potatoes.  Berries are emphasized.  This way of eating minimizes or avoids sugar, red meat, fried foods, cheese, butter, and margarine.

The science behind the MIND Diet shows that it can lower the risk of Alzheimer’s Disease by 53%.  To put this into “real terms,” that is also about an 8 year younger brain.

7 Foods That Reverse Brain Aging By 8 Years

While the Mediterranean and MIND ways of eating both reverse brain aging by eight years, neither eating style corners the market on maximizing brain function.  Based on my careful review of the studies on the Mediterranean and MIND ways of eating, in combination with the latest research on “brain foods,” I have compiled a list of the 7 most critical foods that reverse brain aging.

1. Salad Plus Other Veggies Daily

Every study I reviewed supported the critically important role of vegetables in maintaining a healthy brain.  Of the vegetables, the strongest data are for the green leafy vegetables which include kale, spinach, and lettuce–basically the green leafy vegetables.

The benefit of a daily salad for the brain likely comes from all of the folate, vitamin E, beta-carotene, and flavonoids in salad.  Incorporating a daily salad is something that is easy for most of my patients to do.  Personally, I like a daily salad as part of my breakfast.

The one thing to remember in eating salads is to not undo any potential brain benefit by the toppings or salad dressing.  The best salad dressings are either a little olive oil and balsamic vinegar or a homemade dressing using the healthiest of ingredients.  For ideas on great homemade salad dressings, please take a look at some of my wife’s salad dressing recipes.

2. Berries Plus Other Fruit

When it comes to fruit, the strongest data for optimal cognitive function comes from berries.  While blueberries are often viewed as the best brain fruit, all berries appear beneficial.

Fruit is high in anti-oxidants, vitamins C and E, as well as folate which has been shown to block plaque formation in the brain.  Thus, for optimal brain function, include a serving of berries on most days.

Most of my patients like berries in their smoothies, on their oatmeal, or in their yogurt.  Personally, I like savoring the sweet taste of berries by eating them plain.

3. Olive Oil

In one of the best types of medical studies that can be done, using olive oil as your primary oil was shown to significantly improve memory and cognition.  Indeed, the traditional Mediterranean style of eating consumes a lot of olive oil.

While coconut oil is very popular on the internet right now, there are limited quality studies showing the long-term brain benefit of this oil.  If you are looking for an oil that has been scientifically proven to improve brain performance, make olive oil the primary oil that you use.

4. Fish Weekly

Oily fish, like salmon, has long been associated with a healthy brain.  While the traditional Mediterranean way of eating calls for fish several times a week, other studies show that less fish may be required for optimal cognitive function.

It is for this reason that the new MIND Diet only calls for fish once a week.  If you are not a fish eater, the MIND Diet also encourages poultry.

Fish has been shown to reduce plaque build up and increase nerve connections in the brain.  Thus, for a healthy brain, shoot for at least one serving of an oily fish each week.  Personally, I eat wild salmon at least once weekly.

5. Beans on Most Days

Beans are a staple for traditional cultures which enjoy great health and low rates of dementia.  When it comes to legumes, both the Mediterranean and MIND ways of eating recommend legumes on most days.

If you don’t like beans, you can get the same nutritional benefits from lentils.  Lentils are also nice in that they are less gas producing.  For ideas on new recipes using legumes, please see my wife’s recipes.

6. Walnuts Plus Other Nuts Daily

As with olive oil, a high quality study showed that eating nuts daily significantly improved memory and cognition.  The nuts used in this study were primarily almonds and walnuts.

As discussed in my last blog article, due to the extremely high amount of omega 3 fatty acids in walnuts, these nuts may be the best nut for cognitive function.  Indeed, just one serving of walnuts, which works out to be 14 halves, one handful, or a quarter of a cup, has 100% of the omega 3s you need for the day.

Walnuts can be especially beneficial for people who don’t enjoy fish.  Since writing last week’s blog article, I have heard from many of you that walnuts give you canker sores.  If this is the case, you could eat chia, hemp, or flax seeds to get your daily dose of omega 3s.

7. Whole Grains

Recently there have been many popular books claiming that the source of all medical problems, including dementia, is from all of the carbohydrates in grains.  While refined grains have been shown to hurt brain function, there is no scientific evidence that real whole grains do anything but improve cognitive performance.

The Mediterranean way of eating, of which whole grains are an important component, has consistently shown a decreased risk of dementia.  In addition, studies evaluating the risk of dementia in traditional whole grain eating cultures, have also shown decreased risk.  It is based on these studies, and many others, that the researchers at Rush University also included whole grains in the science based MIND Diet.

With whole grains, look for grains with minimal to no processing.  For those who are gluten sensitive, there are also many options including brown rice, some oats, quinoa, amaranth, etc.

Final Thoughts

For most of my patients, dementia is more frightening than a heart attack or even a cancer diagnosis.  Fortunately, the decisions we make every day play a significant role in determining how well and for how long our brain performs.

What foods have you found that improve brain function?  How do you incorporate these “brain foods” into what you eat?  Please leave a comment below for our community.

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Almonds vs. Walnuts: Which Nut Should You Eat?

Almonds are now more popular than peanuts.  Indeed, almond consumption has increased ten-fold since the 1960s.  In contrast, walnuts have seen little increase.

Are almonds that much better for you than walnuts?

Depending on which medical condition you are trying to prevent or reverse, the answer may vary.  In this article, we will look at which nut is best for weight loss, brain health, heart health, and other medical conditions.

Which Nut is Best for Weight Loss?

As most people struggle with weight issues, I will start off this article by exploring which nut is best for weight loss.  For years, people trying to lose weight avoided nuts because they are so high in fat and calories.  Despite medical studies consistently showing that nut eaters were leaner, it wasn’t until the 1990s that nuts started to catch on as a way to help keep your weight in check.

There are several ways that nuts help with weight loss.  The first is that all of the protein and fiber fills you up.  Second, the body has a hard time using all of the calories in a nut so you get some “free calories.”  Lastly, nuts may increase your metabolism so you burn more calories even at rest.

So which nut is best for weight loss?  When it comes to almonds, a recent study showed that almond eating dieters were able to lose 65% more weight than their non-almond eating dieting counterparts.  Many other studies have also shown significant weight loss with almonds.

Walnuts also do not cause weight gain.  Interestingly, one study showed that even eating large amounts of walnuts for six months did not cause weight gain.  While you don’t gain weight eating walnuts, I could not find any convincing evidence that walnuts helped with weight loss.  Thus, for weight loss I am going to declare almonds the winner.

Winner: Almonds

Which Nut is Best for the Brain?

When it comes to having optimal brain performance, nuts play an important role.  For example, in the famous PREDIMED Study, eating almonds, walnuts, and hazelnuts was shown to improve brain function by up to 60% after 6.5 years.  Interestingly, even people with the Alzheimer’s gene (ApoE4) benefited from nuts in this study.  While nuts improve brain performance and prevent dementia, is there a difference between almonds and walnuts?

At the time I wrote this article, if you search the Pubmed website for “cognitive function almonds” and “cognitive function walnuts,” you will find 6 studies on almonds and 19 on walnuts.  In reviewing all of these studies, the high omega 3 content of walnuts seems to give this nut the advantage.  Walnuts even look like a brain.  Regardless of your age, studies show that younger and older people’s brains function better with walnuts.

Winner: Walnuts

Which Nut is Best for Nutrition?

When it comes to nutrition, nuts are definitely a superfood.  From a nutritional standpoint, most people tend to view all nuts as essentially the same.  However, there are distinct nutritional differences between almonds and walnuts.  Other than the omega 3 fatty acids, for which 70% of people are deficient, almonds come out on top for most other nutritional categories.

Fiber: Fiber is critical for gut and heart heath.  When it comes to fiber, almonds have more than twice the amount of fiber than walnuts.  Indeed, one serving of almonds (1/4 of a cup, a handful or 23 almonds) has 4 grams of fiber which is 14% of the fiber you need for the day. Winner: Almonds

Protein: For protein, almonds again come out on top.  A single serving will get you 6 grams of protein versus the 4 grams of protein in walnuts. Winner: Almonds

Omega 3s: Here is where walnuts really shine.  Indeed, one serving of walnuts (1/4 cup, 14 halves, or one handful) will get you 100% of your omega 3s for the day. Winner: Walnuts

Electrolytes: Electrolytes are important for proper heart function.  In the electrolyte category, almonds again have the advantage.  Each serving of almonds will get you 4% of the potassium, 16% of the magnesium, and 8% of the calcium you need for the day. Winner: Almonds

Vitamin E: Vitamin E is a powerful antioxidant.  When it comes to vitamin E, almonds are again the clear winner.  One serving will get you 40% of the vitamin E you need for the day. Winner: Almonds

Nutritional Winner: Almonds

Which Nut is Best for the Heart?

If you are a woman or man in the U.S., there is a 40% chance you will die from heart problems.  Fortunately, eating nuts every day will decrease your risk by 40%.

While both almonds and walnuts lower bad cholesterol (LDL), triglycerides, blood pressure, blood sugar, and inflammation, I could not find any quality studies specifically looking at one type of nut and the risk of a heart attack.

Some studies do show a specific benefit of omega 3 fatty acids in the treatment of arrhythmias.  Similarly, other studies show that magnesium, which is high in almonds, may also be helpful in preventing arrhythmias.

Certainly, when it comes to the heart, there are specific benefits to each nut.  Almonds are packed with the powerful anti-oxidant, vitamin E, as well as magnesium.  In contrast, walnuts are sky high in the anti-inflammatory omega 3s.

Winner: Tie

Which Nut is Best for Cancer?

Next to heart disease, cancer is the main cause of death in the U.S.  Can nuts prevent or reverse cancer?

While the data are not as strong for nuts in preventing or treating cancer, one large study of 354,933 people showed that nuts can prevent 14% of cancer deaths.  Another study showed that you can cut your breast cancer risk by 2-3 fold with almonds and walnuts.

In my review of the medical literature, there are many studies showing anti-cancer properties of both almonds and walnuts.  While both appear beneficial, I could not find clear evidence that one nut was better than the other.

Winner: Tie

Which Nut is Best for Blood Pressure, Cholesterol, and Diabetes?

Unfortunately, most adults in the U.S. have either high blood pressure, high cholesterol, or diabetes/pre-diabetes.  While these conditions often don’t cause symptoms now, they are “ticking time bombs” for your health.  Do nuts also prevent these problems?

When it comes to high blood pressure, nuts are extremely beneficial.  For example, in the PREDIMED Study, almonds and walnuts decreased systolic blood pressure (top number) by 7 points.  This beneficial effect was reported to be due to the nitric oxide effect of nuts which relaxes arteries and normalizes blood pressure.

For cholesterol it is a similar story.  Studies show that nuts decrease bad cholesterol (LDL), raise good cholesterol (HDL), and lower triglycerides.  The perfect combination.

Nuts also work magic in preventing and reversing diabetes.  Indeed, if everyone ate nuts, diabetes could be reduced by 39%.

In trying to determine which nut is best for high blood pressure, cholesterol, and diabetes, I could not find a clear winner.  Both seemed to be equally effective.

Winner: Tie

Which Nut is Best for Arthritis and Autoimmune Diseases?

The anti-inflammatory omega 3 fatty acids have shown significant promise in treating arthritis, autoimmune diseases, and other inflammatory diseases.  For example, one study showed that omega 3 fatty acids directly stopped the molecules causing inflammation in osteoarthritis.  Another study showed that the omega 3s could even reverse osteoarthritis.

When it comes to autoimmune diseases, early data indicate a potential role for omega 3s in reversing these diseases.  Ongoing studies will help to answer the question of how effective the omega 3s are for these conditions.  Until further data are available, if you are battling arthritis, autoimmune diseases, or other inflammatory conditions, walnuts are your best nut.

Winner: Walnuts

Overall Winner

For optimal health, nuts clearly play an important role.  Thus, trying to answer the question, which nut should you eat is definitely a challenge.

Overall, I am calling it a tie between almonds and walnuts.  If there is a particular medical condition you are battling, you may want to choose one nut over the other.

Personally, I “cover my bases” and eat both nuts.  I eat 1-2 servings of almonds daily and a serving of walnuts on most days.

When I am craving something sweet, I love a little dark chocolate over almonds.  For salads, I like both almonds and walnuts.  If I am looking for a nut butter, I tend to favor walnuts.

Are you an almond or walnut person?  How do you like to eat your nuts?  Please leave your comments below for our community.

If you enjoyed this article, please be sure to sign up for my free weekly newsletter so that you don’t miss a thing.  For those who like to work out or spend time commenting, try listening to my podcast.

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Top 10 Things You Should Do To Avoid Colds

I opened my hospital report, 100% hand washing for the month.  “Not bad,” I thought.  At least I was doing my small part to stop the spread of the common cold.

Even with hand washing, the average adult will still get two to three colds each year.  This translates to 20 million doctor visits and 40 million sick days in the U.S. alone.

Even more worrisome is that during the peak winter virus season, up to 14% of all heart attack deaths are due to upper respiratory tract infections.  I also see viral infections triggering other heart problems like atrial fibrillation.

As my patients depend on me, I can’t afford to get sick.  You also have too much going on in your life to get sick.  To help you not get sick this season, here are my top 10 scientifically proven things you should do to avoid colds.

1. Get Enough Sleep

Most people assume that hand washing is the most important thing in preventing colds.  While hand washing is important, sleep seems to be even more important.

I suspect this is because everywhere you go in the winter you are surrounded by viruses.  Even if your hands are always washed, you can’t stop everyone else from coughing, sniffling, or sneezing on you.  Your immune system must be functioning at 100% to beat off these viral invaders.

For me, it seems like every cold I have caught in the last 10 years has been while sleep deprived.  Indeed, studies show that sleeping less than 7 hours a night triples your risk of a cold.

2. Zinc

Since the first major study on zinc and colds was published in 1984, there has been a lot of excitement about zinc.  While not every study has agreed with the 1984 findings, most studies report that zinc may prevent and shorten the duration of colds.

We aren’t quite sure how zinc helps but it is likely due to strengthening the immune system and blocking viruses from attaching to your nasal or throat passages.

If you do take zinc supplements caution is required as zinc is not without side effects.  More serious side effects include disrupting your zinc/copper balance and the possibility of neurological diseases from either too little or too much zinc.

The best natural sources of zinc are from meat, seeds, or legumes.

Personally, I have occasionally taken zinc lozenges, in lower doses, when everyone around me seems to be sick.  I’m not sure whether this helps or not but it does give me piece of mind that I am doing everything possible to not get sick.

3. Don’t Touch Your Face

Without realizing it, most people touch their nose, mouth, or eyes.  I know I find it challenging not to touch my face unless I have thoroughly washed my hands.  It is also common for me to see patients under anesthesia still reaching for their face.

Perhaps this is why studies show that wearing a surgical mask may be more effective than hand washing in preventing the common cold.  With a mask on it is hard to touch your face.

While surgical masks help prevent the spread of illness in the hospital, it would look strange if you wore one every day to the office.  However, you can help to create a policy where anyone who decides to go to work sick wears a surgical mask.

Likewise, a simple reminder, like a bandaid on your right index finger, can remind you not to touch your face.  The scratching sensation of the bandaid or tape on your face will quickly remind you not to touch your face.

4. Meditate

Stressful life events double your chances of getting a cold.  The more your stress the higher your chances of getting sick.

Stress weakens your immune system.  Fortunately, meditation is one of the best antidotes for stress.  For example, one study showed that meditation reduced sick days by 76%.

Meditation is not just for Buddhist monks.  Even the Bible, in Joshua 1:8, teaches meditation may help you to prosper and have good success.  According to reports, Fortune 500 companies, like Google, Apple, and Aetna, now offer meditation or mindfulness classes to employees.

Recent reports show that doctors are writing more meditation prescriptions to help their patients.  While I am not meditating every day, I do periodically meditate.

If you not yet tried meditation, try sitting in a quite place for 5 minutes.  You don’t even need to get into a yoga pose–a comfortable chair works just as well.

Close your eyes.  Take slow and deep breaths.  Clear your mind.  If you can’t clear your mind, try reflecting on your life’s purpose or happy memories.

5. Exercise

Every day patients tell me they don’t have time to exercise.  I get it.  With family, work, and social responsibilities it can be difficult to carve out even 20 minutes to exercise.

However, if you consider that the average adult has cold symptoms 25 days a year, that means you are sick 600 hours each year.  One study showed that just 2.5 hours a week of exercise reduced sick days by 52%.  Thus, 130 hours a year of exercise (21 minutes daily), can prevent 312 hours of feeling crapy from a cold.

Exercise definitely doesn’t mean you have to start going to the gym.  Walking is one of the best forms of exercise.  Find something you enjoy and do it every day.

If you are not exercising now, start slow.  Of course, if taken to an extreme, excessive exercise could actually increase your chances of getting a cold.  If you have medical problems, talk with your physician first before starting an exercise program.

6. Vitamin C

Right up there with chicken noodle soup, your mother probably told you to get your vitamin C when you were starting to come down with a cold.  While the science doesn’t support the soup, there may be some truth to the vitamin C.

Although medical studies are somewhat conflicting, many studies report that vitamin C may help.  Rather than reaching for vitamin C supplements, natural food sources are best.

For example, one cup of my favorite vegetable, broccoli, provides 135% of the daily vitamin C you need.  If broccoli is not your thing, one large orange will also get you to 100%.

As I used to get sick after plane trips in the winter, I now pack a bag of broccoli.  I’m not sure if it is the vitamin C or a placebo effect, but when I eat my broccoli I don’t get sick.

7. Probiotics, Prebiotics, and a Healthy Diet

Over the last decade there have been many studies evaluating probiotics and colds.  While not every study has shown benefit, most studies show it helps.

This makes sense as 70% of your immune system is in your gut.  To optimize your immune system, you need a healthy gut flora.  Just as important as probiotics for a healthy gut are prebiotics or fiber.

A high fiber diet promotes healthy gut bacteria and the Standard American Diet (SAD), which is high in processed foods, added sugars, and saturated fats from animal sources, promotes disease causing gut bacteria.  In addition to gut flora changes, studies show that an unhealthy diet increases inflammation and weakens the immune system.

To stay healthy this year, make sure you get your recommended 9 servings daily of fruits and vegetables as well as fiber from other sources like legumes and whole grains.  As people with weak immune systems may be at risk from probiotics, please discuss this with your physician first.

8. Wash Your Hands

Cold viruses may survive up to 24 hours on door knobs, faucets, or light switches.  Yikes!

While studies do show that washing your hands can prevent the common cold, the data are not as strong as one might suspect.  The biggest benefit of hand washing may be for those people who are around small children.

At my hospital, doctors are secretly watched to see if they are washing their hands.  Speaking from personal experience, knowing you are being watched improves behavior.  The only draw back is that most people in the healthcare field suffer from skin problems due to washing their hands 50 or more times each day.

As anything you touch may be infected with the cold virus, it is critically important that you regularly wash your hands.  This is especially important if you need to touch your face for any reason.

9. Do the “Elbow Bump”

You never know who may be getting sick.  Every hand shake may be your next cold.

If you don’t want to get sick this year, either don’t shake hands or wash your hands with soap and water after each hand shake.  An even better socially accepted way to greet people is to do the “elbow bump.”

The elbow bump is easy to do.  Just touch elbows with the person you are greeting.  Many of my physician colleagues now only do elbow bumps when greeting people.

10. Breathe Clean Air

For decades it has been known that the quality of the air you breathe is directly related to your chances of getting a cold.  When it comes to air quality and colds, smokers suffer the most.  Indeed, studies confirm that smoking damages the bronchial air ways and weakens the immune system.

Even non-smokers are at risk.  As indoor air pollution is often two to five times worse than outside air, it is important that the air in your home and place of work is clean.

The best way to breathe clean air is to either have a well ventilated area or buy a HEPA air filter.  Perhaps this explains why so many people get sick after air travel as the air on a plane is just recirculated from one sick person to another.

Cold Remedies that Didn’t Make the List

There are many other cold remedies that did not make this list.  While these therapies may have helped you, they have not been shown to help others in medical studies.

One such popular remedy is echinacea.  Unfortunately, medical studies have shown no benefit.  Other popular cold remedies that are also lacking in data are gargling water, garlic, ginseng, nasal irrigation, honey, elderberry, or herbal teas.

Final Thoughts

I hate colds. The purpose of this article was to help you also do everything possible to minimize your risk of another cold this season.

What have you found that helps with colds?  Please share your experience in the comments section below.

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Top 10 Heart Healthy Thanksgiving Tips

Odds are that you will gain 1 to 2 pounds between Thanksgiving and New Year’s Day.  The problem is that most people never lose these 1 to 2 pounds.  Over time, 1-2 more pounds every year takes a toll on your heart.

I was no different.  Every year I started the holiday season by eating myself into a Thanksgiving food coma.  All I could do was park myself on the couch and doze off during the football games.

It all starts with Thanksgiving.  In this article, I share my top 10 heart healthy Thanksgiving tips so that you can start off your holiday season right.

Can you Exercise Off the Thanksgiving Meal?

At my wife’s gym, the Wednesday evening before Thanksgiving and the morning of Thanksgiving tend to be the busiest times of the year.

“Pedal faster if you want some pumpkin pie” or “don’t let the mashed potatoes and gravy turn into fat.”  Yells like these from her instructors motivate gym goers to work even harder.

Unfortunately, medical studies don’t support the commonly held belief that you can burn off everything you eat.  The more you exercise, the more your appetite is increased.

Top 10 Heart Healthy Thanksgiving Tips

As you can’t out train a bad diet, the goal should be healthy holiday eating.  To start you on the right path, here are my top 10 heart healthy Thanksgiving Day strategies.

1. Eliminate Thanksgiving Stress

Preparing for Thanksgiving can be stressful.  Every year you feel like you have to come up with something new.  The ultimate meal.

The real goal of Thanksgiving is to strengthen relationships.  Carefully review your Thanksgiving traditions.  If they don’t strengthen relationships then eliminate them.  Eliminating the non-essential is the key to minimizing stress.

For example, if no one wants to eat turkey then don’t cook the bird.  We learned this the hard way.  As our kids won’t eat turkey we now do a Thanksgiving stir fry instead.

If possible, see what you can prepare the day before.  If most of the work can be done the day before you can better enjoy Thanksgiving.  Definitely don’t stay up late preparing.

Trying to meet the requests of her children, my mom always made three different pies from scratch for Thanksgiving. While we all loved her pies, in retrospect it may not have been fair for us to keep her up most of the night preparing everything.

If the goal of Thanksgiving is to strengthen relationships, then make sure you get at least 7 hours of sleep. With a good night of sleep the little annoying things won’t bother you and your stress levels will be much lower.

Simplify your Thanksgiving traditions.  Focus on relationships not food.  Unnecessary stress will cause you to overeat the comfort foods.  Besides, stress only takes you down the path to dementia, heart attacks, and heart arrhythmias like atrial fibrillation or PVCs.

2. Have a Slow Thanksgiving Meal

Ever year it was the same.  My mom spent all day in the kitchen carefully preparing the Thanksgiving feast.

Then, like sprinters, the meal was devoured in minutes.  We were onto our second and third helpings before the required 20 to 30 minutes passed for our brains to get the message we were full.

Studies show that slowing down can allow us to feel full on less food.  As the first two to three bites taste the best, savor these bites.

My challenge for you this year is to slow down and see if you can make your Thanksgiving meal last one hour.  I am confident this will help you to avoid the Thanksgiving food coma.

3. Eat Heart Healthy Turkey

Turkey can be a lean protein, high in the healthy omega 3 fats, and loaded with most of the essential vitamins and minerals if done right.  It goes without saying that for a heart healthy bird you need to stay away from deep frying.  Here are my heart healthy tips when it comes to eating turkey.

1. Skip the skin.  Unless turkey skin is something you can’t live without, it is best to drop it.  Turkey skin is loaded with calories and saturated fat.  To learn more about the latest research on saturated fats and heart health, please read this article I wrote.

2. Choose white meat.  Once again, for a leaner meat stick with the white rather than the dark meat.  White meat has less saturated fat.

3. Choose organic pasture raised birds.  If you can afford it, an organic turkey can minimize the risk of contaminated feed, hormones, and antibiotics.  Pasture raised birds can enhance the nutritional profile with more heart healthy omega 3 fats.

4. Make Vegetables the Star of the Show

After turkey, the next critical step is to make vegetables the star of your Thanksgiving meal.  A heaping green salad and several other vegetable options are a must for a heart healthy Thanksgiving.

Countless studies have shown that vegetables prevent and reverse heart disease.  For some great salad and salad dressing options, please take a look at what we eat in our home.

Unless vegetables are ruined by sugar, excessive oils, or sauces, the caloric content is next to nothing.  For example, a heaping salad, minus the dressing and toppings, has less than 50 calories.  Better yet is that vegetables can be very filling from all of the fiber.

Make it a goal for your Thanksgiving meal to be at least 50% vegetables.  This simple act can help to prevent the Thanksgiving food coma.

If you have been invited to Thanksgiving dinner, volunteer to bring the salad or vegetables.  This way you will be sure to have healthy options.

5. Opt for Heart Healthy Mashed Potatoes and Gravy

Mashed potatoes and gravy may be the worst part of the meal for your heart.  Mashed potatoes are converted to sugar by your body faster than a Snicker’s bar.  Gravy could cause your coronary arteries to clog up.  Here are some simple tips for guilt free indulgence.

The first is to add pureed cauliflower to your mashed potatoes.  Your guests will never know you just slashed their sugar high while raising the nutritional profile of mashed potatoes.

Next is to use heart protective extra virgin olive oil, instead of butter, in your mashed potatoes. If your family likes sweet potatoes, consider mashed or a baked sweet potato.  Sweet potatoes are very nutritious and are packed with fiber, vitamins, and minerals.

When it comes to making gravy heart healthy, it is a bit trickier but still can be done.  Instead of a white flour or cornstarch thickener, try whole wheat, oat, or spelt flour as the thickener.  Rather than milk or cream in the gravy, substitute part with pureed cauliflower.  Lastly, try adding part vegetable stock, instead of the turkey fat drippings, with extra herbs and spices for flavor.

6. Make Heart Healthy Pumpkin Pie

A great trick that few will notice is to slightly alter your pumpkin pie filling recipe.  Instead of the cream or evaporated milk, try substituting at least half with almond milk.  Almonds lower your cholesterol and are one of the best foods to prevent heart problems.

The second healthy substitution is to use half the sugar and double the cinnamon.   Cinnamon prevents weight gain and blood sugar spikes.

For the pie crust, stick with whole grain options.  If you make your own crust, substitute almond flour for at least one third of the flour.

7. Enjoy Heart Healthy Stuffing

Stuffing is a must for Thanksgiving feasts.  Don’t even think of adding turkey fat drippings, bacon, or sausage to your stuffing.  Rather, here are some heart healthy ways to making this a nutritional powerhouse without sacrificing any taste.

1. Double the vegetables.  Whatever vegetables your stuffing recipe calls for, double them.  Consider new vegetables like kale or butternut squash.

2. Reconsider bread crumbs and croutons.  If you like the bread then whole grain options are best.  Rather than sticking with the bread, you could consider quinoa or brown rice in your stuffing.

3. Go nuts.  Nuts are heart healthy and add a nice mouth feel.  Your family will love the taste of walnuts, pecans, pine nuts, or almond bits in your stuffing.

4. Add fruit.  To sweeten your stuffing, consider adding small pieces of apple, cranberries, or Craisins.

8. Serve Heart Healthy Bread and Rolls

Bread and rolls are a staple at Thanksgiving.  While 99% of breads and rolls are converted to sugar by the body faster than a Snicker’s bar, it doesn’t have to be this way.

Fresh hot bread and rolls taste so good that people will never notice that you used whole grains rather than refined white flour.  We love almond and garbanzo bean flour in our bread.  Here is Jane’s bread recipe that we use in our home.

9. Go For Heart Healthy Drinks

Alcohol is high in calories and may cause overeating.  To increase your chances of eating healthy this year, try replacing the alcohol with a heart healthy drink.

Some great options include adding fresh squeezed lemon or lime juice and stevia to carbonated water.  Lemons and limes are extremely low in calories and lower the glycemic response of your meal.  This helps to prevent overeating and diabetes.

10. Take a Walk After Thanksgiving Dinner

The Chinese have a famous saying, “take 100 steps after dinner and live to 99.”  While 100 steps is probably not enough after a Thanksgiving meal, there is still wisdom in this Chinese saying.

Indeed, studies show that taking a walk after a big meal can help to prevent weight gain.  To learn more about the science of taking a walk after a big meal, please read blog #28 that I wrote on the subject.

My challenge to you is to invite your Thanksgiving guests to join you on a walk after your meal.  My experience is that at least one person will join you and this walk may be the most enjoyable part of your day.

Final Thoughts

Thanksgiving should be about relationships not food.  If certain foods strengthen relationships, then include them.  If not, eliminate.

Perhaps this is why our Thanksgiving traditions have changed over the years.  Our kids look forward to skiing together as a family more than anything else.  As such, we spend part of Thanksgiving on the slopes near our home.

After returning home from skiing, we all chip in and prepare a simple family Thanksgiving meal.  Rather than slip into a Thanksgiving food coma, we remain energetic.  The focus of our meal is for each person to share what they are grateful for.

How do you celebrate Thanksgiving?  What have you found that minimizes the stress and overeating?