Dr. John Day, Cardiologist

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How Much Calcium Do You Really Need?

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

My Calcium Story

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

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

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

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

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

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

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

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

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

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

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

How Much Calcium Do You Really Need?

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

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

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

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

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

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

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

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

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

What Are the Best Non-Dairy Sources of Calcium?

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

1. Mineral water

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

3. Sardines and canned salmon

4. Sesame seeds

5. Almonds

6. Legumes

7. Oranges

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

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

6 Ways to Prevent Osteoporosis

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

1. Stay Physically Active

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

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

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

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

2. Get Enough Vitamin D

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

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

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

3. Get Enough Vitamin K2

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

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

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

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

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

4. Get Enough Calcium

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

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

5. Avoid Very High Protein Diets

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

6. Avoid Soda Pop

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

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

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

Disclaimer

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

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How to End Loneliness with These 7 Strategies

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

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

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

Social Isolation

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

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

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

Why Do Asians Live Longer?

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

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

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

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

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

Friends and Family Are the #1 Longevity Factor

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

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

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

2. Social isolation is more dangerous than becoming an alcoholic

3. Social isolation is twice as dangerous as obesity

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

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

A Behind the Scene Look at the Loneliness and Longevity Study

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

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

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

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

Is it Social Isolation or Perceived Loneliness that Increases Risk?

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

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

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

2. Socially isolated people had a 29% increased mortality

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

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

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

How to End Loneliness with These 7 Strategies

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

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

1. Reach Out to Others

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

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

2. Focus on the Needs and Feelings of Others

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

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

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

If they feel you care they will love you back.

3. Reconnect with Old Friends

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

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

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

4. Volunteer

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

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

5. Get a Dog

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

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

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

6. Find People Like You

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

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

7. Don’t Forget Your Family

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

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

What have you found that works to prevent feeling lonely?

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How to Maintain a Healthy Weight

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

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

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

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

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

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

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

Intentional Versus Unintentional Weight Loss

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

The Number 1 Factor in Maintaining a Healthy Weight

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

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

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

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

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

Exercise: Weight Loss Versus Weight Maintenance

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

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

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

Mary

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

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

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

The 5 Strategies of People Who Can Keep the Weight Off

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

1. Exercise

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

2. Diet Changes

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

3. Breakfast

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

4. Weigh Yourself Regularly

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

5. Limit Your TV Time

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

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

Disclaimer

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

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

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

Should Jennifer take the iron supplements her doctor prescribed?

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

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

Why are women protected against heart disease prior to menopause?

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

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

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

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

Why Do We Need Iron?

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

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

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

Who is at risk for iron deficiency?

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

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

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

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

Which foods are highest in iron?

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

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

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

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

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

3 Reasons Why Iron May Be Dangerous for the Heart

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

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

1. The Iron Overload State

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

2. Heme vs. Non-Heme Iron

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

3. Iron May Damage Endothelial Cells

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

Can too much iron cause Alzheimer’s Disease?

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

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

What should Jennifer do?

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

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

How to Optimize Dietary Iron and Cardiac Blood Flow

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

1. Get Your Iron and Blood Levels Tested

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

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

2. Minimize Heme Iron

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

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

3. Donate Blood

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

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

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

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

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10 Ways to Boost Brain Function with BDNF

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

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

What is BDNF?

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

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

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

Clearly we want more BDNF!

Airplane Pilots and BDNF

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

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

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

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

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

Turn Old Brains Into Young Brains with BDNF

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

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

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

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

Exercise Boosts BDNF and Cognitive Function in the Young as Well

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

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

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

BDNF is Critical for a Healthy Heart

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

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

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

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

BDNF May Control Our Lifespan

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

10 Ways to Boost Brain Function with BDNF

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

1. Exercise

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

2. Avoid Sugar, Processed Foods, and HFCS

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

3. Intermittent Fasting

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

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

4. Mental Stimulation

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

5. Eat Oily Fish

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

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

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

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

6. Be with Family and Friends

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

7. Get Some Sun

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

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

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

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

9. Do Something to Reduce Stress

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

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

10. Get At Least 7 Hours of Sleep

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

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

Disclaimer

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

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Can You Live 7 Years Longer by Smiling?

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

Baseball Cards, Smiling, and Longevity Study

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

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

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

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

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

1. No Smile: Average lifespan of 72.9 years

2. Partial Smile: Average lifespan of 75.0 years

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

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

Can we believe the results of this baseball card study?

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

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

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

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

How do explain the results of smiling?

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

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

Can you fake a smile?

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

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

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

Thin Slicing

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

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

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

I Didn’t Smile in My Senior Yearbook Photo

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

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

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

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

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

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

Fake It Until You Make It

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

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

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

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

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

Take Home Message

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

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

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

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Squat Toilets, Hemorrhoid Prevention, and Longevity

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

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

My First Experience with a Squat Toilet

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

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

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

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

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

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

Is the key to longevity a squat toilet?

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

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

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

The Dangers of Falling

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

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

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

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

Hemorrhoids Are Completely Preventable

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

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

What Causes Hemorrhoids?

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

1. Sitting and straining on the toilet

2. Not enough dietary fiber and water (constipation)

3. Not enough physical activity

4. Obesity

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

The 3 Benefits of Using a Squat Toilet

1. We Were Not Meant to Sit

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

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

2. Saves Time

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

3. A Daily Work-Out

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

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

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

My Confession

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

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

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

Action Items

1. Daily Squats

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

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

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

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

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

3. Increase Your Fiber, Water, and Physical Activity

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

4. Convert Your Western Toilet to a Squat Toilet

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

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

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

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

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

Disclaimer

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

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The Easiest Diet to Lose Weight: Focus on Fiber

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

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

“Eat More Fiber” versus AHA Diet

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

“Eat More Fiber” Study Group

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

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

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

AHA Diet Study Group

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

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

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

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

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

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

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

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

8. Drink alcohol in moderation.

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

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

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

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

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

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

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

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

Medical Benefits of a High Fiber Diet

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

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

The Traditional High Fiber Diet of China’s Longevity Village

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

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

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

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

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

How to Increase Fiber in 6 Simple Steps

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

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

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

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

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

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

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

Disclaimer

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

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Do You See Everything? Inattentional Blindness

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

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

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

How Can the Obvious Be Missed?

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

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

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

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

Inattentional Blindness

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

Test Yourself to See if You Also Suffer from Inattentional Blindness

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

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Does Cholesterol Still Matter? The New Nutrition Guidelines

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

The New Nutrition Guidelines

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

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

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

Is it OK to eat cholesterol again?

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

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

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

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

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

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

People Sensitive to Dietary Cholesterol

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

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

Why is my cholesterol high?

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

1. Trans fats.

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

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

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

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

2. Saturated fats

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

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

3. You are not getting enough exercise

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

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

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

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

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

6. Bad genes

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

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

1. Salt Guidelines May Loosen

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

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

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

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

3. We may have our first sugar guidelines

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

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

4. “My Plate” Probably Won’t Change

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

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

My Views of the New Nutritional Guidelines

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

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

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

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

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

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

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

Disclaimer

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

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Can Wine and Grape Juice Really Burn Fat?

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

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

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

Red Grapes

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

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

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

What is Ellagic Acid?

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

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

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

What did this latest study actually show?

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

The key findings of this mouse study are as follows:

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

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

3. Ellagic acid lowered the triglyceride levels of mice.

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

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

What dose of ellagic acid do I need?

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

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

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

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

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

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

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

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

The 6 Best Food Sources of Ellagic Acid

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

1. Red grapes

2. Berries including blackberries, raspberries, and strawberries

3. Nuts such as pecans and walnuts

4. Peaches

5. Cranberries

6. Pomegranates

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

How do you get your ellagic acid?

Disclaimer

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

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What Dogs Teach Us About Health and Nutrition

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

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

Our Dog Andi

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What are the lessons of this story?

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

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

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

Dogs Are Not Immune from the Obesity Epidemic

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

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

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

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

The same is true for us.

Most Dogs Are Now Sedentary

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

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

Why do diets and exercise programs fail?

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

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

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

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

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

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

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

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

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

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

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

China’s Longevity Village

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

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

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

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

Change Your Environment, Change Your Life in 8 Easy Steps

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

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

1. Junk Food Free Home

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

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

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

2. Find an Accountability Partner

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

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

3. Avoid the “Bar”

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

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

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

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

4. Change the Furniture in Your Home

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

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

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

5. Pick the Right Friends

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

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

If you spend time with people who eat junk food and sit most of the day you cannot help but to do the same.  Studies show that your friends and family members will subconsciously determine how healthy and vibrant you are.

Spend time with people that you want to become more like and you will naturally adopt their healthy habits.  Become friends with someone healthy today!

6. Make it Easy to Eat Right

To succeed with a healthy lifestyle you need to make it the path of least resistance.  Always have healthy snacks with you.  Put fruits and veggies on the top shelf of your refrigerator where you will see it easily.  Have the right cooking tools and ingredients on hand to quickly prepare a healthy meal.

7. Have a Clutter Free Bedroom

Sleep is critical to a healthy lifestyle.  Keep your bedroom clutter free.  Never bring electronic devices into the bedroom.  Keep it simple, clean, cool, and dark at night for sleeping.  If you are well rested then it will aid you in your quest for health.

8. Have a Daily Stress Plan

Stress is a given in our modern life.  Stress is everywhere.  The key is to have a plan to manage stress every day.  If you don’t manage stress it will manage you.

Stress management could take on many different forms.  It could be yoga, meditation, a walk in nature, or even spending time with family or friends.  Identify what works for you and make it part of your daily stress management plan.

Closing Thoughts

At the end of the day, dogs are just like us.  They will eat whatever they have access to.  Likewise, they’ll go outside and exercise whenever someone takes them out.

Do you have the right supportive environment for health?  If you have enjoyed this article please share it with a friend!

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5 Ways to Heal Yourself with the Power of Your Mind

Did you see the recent worldwide headlines which boldly proclaimed that an “expensive placebo” could reverse the neurologically crippling Parkinson’s Disease?  This was not just an isolated medical study.  Indeed, countless other studies have shown that up to 62% of people can be cured of whatever medical condition they have from just a “dummy pill” or a placebo.

What do these studies teach us?  Namely, that if we can tap into the power of the mind we can literally cure our physical bodies.  In this article we will explore the science behind the power of the mind to cure the body.  I will also share with you five ways to heal yourself with the power of your mind.  These are approaches that I have personally seen transform the lives of my patients in my cardiology practice.

What is the Placebo Effect?

A placebo is a dummy pill or a sham procedure intended to convince the patient that they are receiving treatment for their condition.  The placebo effect occurs when the patient miraculously gets better even though they are not actually receiving any “real” treatment.

This is used all the time in clinical studies.  For example, whenever you test a new medication or medical procedure you must test it against a placebo or a sham procedure.  The reason for this is so that you can know the true healing effects of a medication or a procedure.  As a large percentage of patients “get better” on a dummy pill or by a sham procedure you really have to know what the true effect of the medication or procedure is.

The Nocebo Effect

I recently saw John in my cardiology clinic.  He was experiencing severe headaches, fatigue, and nausea after starting a “new medicine” in a clinical study.  The side effects were so bad that he had to stop the medication.  As soon as he stopped the “new medicine” his side effects immediately went away.

Interestingly, at the end of the study we discovered that John had been randomized to a “dummy pill” in this study.  His headaches, fatigue, and nausea from the “new medicine” were in reality created by the power of his mind.

This is the nocebo effect in action.  The nocebo effect describes a condition where patients have a bad reaction to a dummy pill or a sham procedure.  The nocebo effect can be just as powerful as the placebo effect but just in the opposite direction.

John’s case is not unique.  I have seen many patients who experience severe side effects from a dummy pill while participating in a clinical study.  Fortunately, in clinical studies we see the placebo effect much more commonly than the nocebo effect.  Our mind can really change our reality for the better or for the worse.

If you stop for a moment and think about it, the placebo and nocebo effects are really quite remarkable.  The only explanation is that the mind really can heal or hurt our physical conditions.

Reverse Parkinson’s Disease with an Expensive Placebo

Does the cost of a “placebo” determine just how well the placebo will work?

In this study, researchers told 12 patients with Parkinson’s Disease that they were testing two “new medications.”  The first was a “cheap” new medicine (placebo) and the second was an “expensive” new medicine (the same placebo).

These patients were told that the cheaper new medicine cost $100 per dose and that the expensive new medicine cost $1,500 a dose.  What the patients did not know was that the placebo was in reality the exact same injection of saline or salt water into their veins which really costs just a few pennies.

Parkinson’s Disease is characterized by severe tremors, slow movement, shaking, and ultimately dementia.  Remarkably, these symptoms just seemed to vanish when they were given a placebo (plain saline injection).  Even more astounding is that their functional MRI brain scans also remarkably improved as well.  What set this study apart was that the “expensive placebo” had much more of a healing effect than the “cheap placebo.”

In what seems almost as an act of cruelty, at the end of the study all 12 patients with Parkinson’s Disease were told that they really just received a placebo.  As you can imagine, the patients could not believe this was true.  I suspect that as soon as they were told this news their Parkinson’s Disease likely degenerated and that they lost any clinical benefit from participating in this study.

Redefine What is Possible

I used to get depressed on the long days of being the cardiologist on call at my hospital.  I don’t mind the hard work the problem is that on these days I am generally unable to “exercise” in the traditional sense of the word.  These days are long and as soon as I finish my last surgery and see my last patient I want to hurry home to see my family.

Even though I am not “exercising” on these days, my job as a cardiologist is very physically demanding.  I am on my feet all day long in surgery wearing a 20-30 pound lead suit to shield me from x-ray radiation.  I often walk miles on these days going up and down stairs consulting on patients with cardiac problems throughout the hospital.

Could the reason why I am not getting any of the health benefits from all of this physical activity be because of my definition of what the word exercise means?

The Hotel Maid Study: Placebo Effect in Action

In an equally fascinating study, how we define our lives in our mind can determine our health.  In 2007 the brilliant Harvard psychologist, Ellen Langer, also known as the “Mother of Mindfulness” based on her bestselling book Mindfulness (affiliate link), asked this same question to 84 hotel maids.  The results of this landmark study have had profound effects on our understanding of the mind to heal us.

Langer started the study by asking these hotel maids if they “exercised.”  Most of these hotel maids (67%) reported that they did not exercise.  This response really surprised her as she could see just how physically demanding their jobs really were.

Even though these hotel maids had very physically demanding jobs and clearly exceeded the recommended guidelines for “exercise” you would never know it by looking at them.  These women were not getting any of the health benefits of “exercising” all day long at work every day.  She wondered if the reason why they did not gain any benefit from exercise was because of their perception of what exercise was.

To explore this question, she then took these 84 maids and divided them into two groups.  In the first group she told them how much “exercising” they were doing each day and how many calories they were burning each hour.  For the second group of hotel maids she did not give them any of this information.

Quite unbelievably, for the first group that was told how many calories they were burning and just how much exercising they were doing their health immediately improved.  Even without changing their daily routine or how many calories they ate at all, in just four short weeks their blood pressure dropped and they lost a significant amount of weight.  The second group that was not given any of this information did not experience any beneficial changes.

This study shows us that just having the hotel maids imagine that they were “exercising” during their work day caused their health to dramatically improve.  The same can be true for us.

I personally have tried this approach on my long call days at the hospital with equal success.  By imagining that I am exercising all day long on these grueling physical days has helped me tremendously.  Our mind can really change our reality and our health.

The Mind Cannot Always Heal

Unfortunately, the mind cannot always heal us of everything.  This was certainly the case with the legendary Steve Jobs.

In October of 2003 at the peak of the iPod craze that was sweeping the world, the Apple icon was quite unexpectedly diagnosed with a rare form of pancreatic cancer. His doctors urged him to have this cancer surgically removed immediately.  For 9 months Jobs rejected this advice instead focussing on diet, alternative therapies, and spiritual healers to rid him of this tumor.

Unfortunately, his cancer surgery was delayed 9 months.  This was a decision that he would regret to his death.  By giving his tumor 9 more months to grow many medical experts publicly stated that this delay caused his early death.

Jobs undoubtedly believed he could be healed.  Unfortunately, the tumor proved to be too powerful for his mind alone.

5 Ways to Heal Yourself with the Power of Your Mind

How can we tap into the healing powers of our minds without having to be tricked from a clinical study?  This is something that each of us can do.  I know these 5 strategies work as I have seen them in action many times in my cardiology practice.

1. Believe that You Can Be Healed

Believing that you will get better is probably the most important step.  You need to be able to visualize a life without the medical conditions you are currently battling.  Tell yourself that you are getting healthier every day.

If you are not full of optimism your future health will suffer and it will be difficult for you to overcome your current physical condition.  Every study I have reviewed has showed the same thing.  Optimists enjoy far better health than the pessimists.  To learn how to become and optimist and live up to 8 years longer according to medical studies, please read my article on the topic.

2. Have a Purpose to Your Life

Do you have a reason that gets you out of bed energized and excited each morning?  Do you know what your mission is in this life?

I have seen in my cardiology practice that those patients who have a mission to their lives rarely seem to be held back by their heart conditions.  They seem to just bounce right back up.

Studies have shown that those people with a strong purpose to their life can avoid heart disease, Alzheimer’s Disease, and many other conditions.  To learn how you can develop a purpose or “why” to your life, please read this article I wrote on having a purpose to your life.

3. Trust Your Care Team

If you are going to tap into your mind’s healing powers it is critical that you trust your care team.  Find a doctor or healthcare provider that you can fully trust.  This may require getting a second opinion.

One of the critical reasons why the Parkinson’s Disease patients got better is because they trusted their physicians “expensive” new treatment even though it was in reality just a saline injection or a placebo.

4. Keep a 5 Minute Gratitude Journal

Why is gratitude on this list?  I have seen time and time again that patients who are grateful for what they do have are more likely to recover from their heart condition.

We all have blessings in our lives that we can be thankful for.  Take just 5 minutes at the first of each morning to quickly record your gratitude thoughts in a notebook or even electronically on your phone.

Gratitude can also allow us to redefine the meaning we attach to life’s events.  For example, redefining what “exercise” means is what allowed the hotel maids to suddenly start enjoying all of the benefits of exercise.

5. Understand Your Body Through Meditation

It is too easy to become frazzled and stressed out with our fast-paced modern life.  Indeed, studies have shown that stress plays a role in more than 70% of doctor visits.

If we truly desire better health we need to be in tune with our bodies.  We need to calm our minds and our anxieties.  I have reviewed countless medical studies which show that meditation in various forms can help to heal us.

Meditation can take on a variety of different forms.  It can be yoga, a walk in nature, prayer, or whatever allows you to calm your mind and listen to your body.

Do you believe in the power of the mind to cure?

Disclaimer

While the mind can help to heal us, we cannot rely entirely on our mind alone.  We must trust our care team, including our physicians and other care providers.  This is likely what caused Steve Jobs to die at such a young age from pancreatic cancer.

Of course, physicians and other care providers are not always correct in their diagnosis or treatment plans.  It is always best to get a second opinion for more serious medical conditions.  Find a physician or care provider that you can trust and stick with them.

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Do You Really Need 8 Glasses of Water Daily?

Your mother probably told you to drink 8 glasses of water each day. Many health “experts” also recommend getting at least 8 glasses (64 ounces or about 2 liters) of water each day.

Are you wondering if there’s actually any science backing up this advice?  Just how much water should we be drinking to lose weight and maintain optimal brain and heart function?

What the Science Tells Us about 8 Glasses of Water

You might be surprised to learn that there are actually no medical studies backing up the practice of drinking 8 glasses of water each day.  While there have been studies done on this subject, none of these studies to date have shown any significant benefit.

If there are no data supporting the medical need to drink 8 glasses of water each day then the question naturally arises, how much water should you drink?  The simple answer is, it depends.  In this article we will explore possible reasons why you may want to increase your water intake depending on your weight, brain, and heart goals.

How much water should you drink to stay hydrated?

It appears that the amount really depends on the individual person, where they live, and how active they are. Adults who live in an average climate and are moderately active can likely maintain their health drinking less than 8 glasses per day.  This doesn’t mean that you want to skimp on drinking your water however.

In contrast, those people who exercise frequently or live in very hot climates can lose up to 4 liters of fluid in just one hour of intense exercise on a hot day.  For these people, staying hydrated during a work out is critical for their health and to prevent a heat stroke.  These people could easily drink far more than 2 liters of water in a day.

Why is water so healthy?

Did you know that water makes up about 70% of your body?  Water helps to flush toxins from your bloodstream and cells, allowing your body to experience a daily “detox.”

Staying hydrated is also important for maintaining your energy, getting a good night’s sleep, and keeping your mood up.  If you want to appear young, water can also play an important role.  For example, if you are not drinking enough water, you may appear aged and can suffer from rough or cracked skin, bloating, or puffiness.

Can you really tell the difference between hunger and thirst?

Strangely, medical studies have shown us that we often cannot tell the difference between hunger and thirst. Unfortunately, most of us end up eating something when we really may just be thirsty.

Water helps us to feel full because it takes up a lot of volume in our stomachs.  Sometimes we may think we are hungry, and may even experience hunger pains, but in fact it may be that we are just experiencing mild dehydration.

When we don’t stay hydrated, we don’t feel the best that we could.  We tire easily, feel moody, get headaches, and we don’t function well overall. These uncomfortable feelings make us crave food because we are looking to food for more energy when all we really need is more water.

Water can help us to eat less at meal times as well. Try drinking 2 glasses of water right before you eat a meal and you may find you eat less since your stomach will feel partially full and you won’t be confusing thirst for hunger at all.

Why do water drinkers stay thin?

Have you ever noticed that people who carry a water bottle around with them seem to appear healthier and slimmer than most people?  What is the science behind water drinking and maintaining a healthy weight?

Besides not confusing hunger for thirst, the obvious answer is that if you are drinking a lot of water you probably are not drinking soda pop, fruit juice, or other sugary drinks.  This alone could cause significant weight loss.  I commonly see patients lose more than 20 pounds just by giving up all soda, fruit juice, sports drinks, and other sugary drinks.

Even diet soda may cause significant weight gain in many studies!  Studies show that even though you are not getting any “calories” from diet sodas, the aspartame in diet sodas is feeding your bad gut bacteria which, in turn, may cause weight gain.

Water also causes a significant calorie burn through the process of cold thermogenesis.  If you want to learn more about how to boost your metabolism through cold thermogenesis, I recently wrote an article on this subject (blog #68).

Studies have shown that by drinking 8 glasses (2 liters) of cold water, your body can be forced to burn an extra 400 calories!  Researchers report that most of this 400 calorie weight loss was due to the energy required by the body to heat the cold water up to body temperature.  If you do the math, drinking 2 liters per day of cold water, without increasing your food intake, would burn 42 extra pounds per year.

Since there is no risk in drinking more water for most people (see disclaimer at the bottom of this article), and you might even feel more energetic thereby increasing your work out routine, why not start drinking more water today?

Boost Cognition and Memory with Water

Could helping your child score well on the SAT or ACT college entrance tests be as simple as drinking more water?  Studies have consistently shown that children do better on tests when they are hydrated.  Even adults, based on medical studies, do better on cognition tests when they are well hydrated with water.

Other studies have shown that dehydration, or even relative mild dehydration like not drinking enough water during the day, can impair brain function.  Studies have even shown that fighter pilots don’t fly their planes as well if they are not drinking enough water.  Thus, if you want optimal brain and memory function learn to love water.

How much water should you drink to prevent heart disease?

If your goal is to prevent heart disease and never see a cardiologist, like me, then there are actually some data supporting how much water you should drink.

The Seventh Day Adventists are one of the healthiest groups of people in the world.  The Adventists have been extensively studied and have even been featured in the best selling health book, Blue Zones (affiliate link).

In this study, researchers closely followed 20,297 California Adventists for 6 years.  Interestingly, they found that those Adventists drinking 5 or more glasses of water each day were 54% less likely to die from heart disease!

Just how does water protect against a heart attack?  Could the benefit from water be because they drank water rather than soda pop, fruit juice, or other sugary drinks?  Likewise, could a high water intake be a manifestation of someone who is generally more health conscientious or someone who exercises a lot?

There are some studies that suggest that relative dehydration can cause you to have “thicker blood” or a higher blood viscosity.  If you are not drinking enough water then your blood particles are more likely to clump together and form clots.  These clots could lead to a heart attack or a stroke.  Regardless of how you can prevent a heart attack by drinking more water, it seems to me that drinking at least 5 glasses of water each day is a very healthy habit which we should adopt.

Dr. Day’s 6 Water Rules

To help you maintain a healthy weight and allow your brain and heart to function at its best, let my give you my six rules when it comes to drinking water.

1. Drink water instead of soda, fruit juice, or other sugary drinks

If you want to torpedo your health and your waist line, then drinking soda in either the high fructose corn syrup or diet varieties, juice, or other sugary drinks like sports drinks is a great strategy.  On the other hand, if you want to feel energized and maintain a healthy weight learn to love water.  If water isn’t yet your thing, try adding some fresh lemon or lime to your water.

2. If you are hungry between meals drink water first

Learn to notice the difference between your body’s true hunger signals, versus thirst signals. If you feel hungry between meals, try drinking something first. Wait 30 minutes. If you still feel hungry after 30 minutes, you probably are hungry and should eat something.

3. Drink water to boost your metabolism

To keep your body’s metabolism high, stay hydrated.  As discussed in this article, you can burn a significantly high amount of calories each day by drinking 2 liters of water.

4. Stay hydrated for optimal brain performance

Our brains require plenty of water to function optimally.  Stay hydrated to boost your cognition and memory.

5. Drink at least 5 glasses of water daily for your your heart

While 8 glasses of water (2 liters) has not been shown to make you “healthier,” there are data that drinking at least 5 glasses of water each day may protect your heart.  This may keep your blood viscosity low and prevent clots from forming.

6. Keep water with you throughout the day

As it is so easy for us to become dehydrated through the day, learn to carry a glass or stainless steel water bottle.  Having the water bottle with you is a great reminder to drink more.

How much water do you drink each day?  Do you carry a water bottle with you?

Disclaimer

Please remember that if you suffer from heart failure, kidney failure, or other medical conditions you should discuss your optimal daily water intake first with your physician.

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Could Using This Word on Twitter Cause a Heart Attack?

What you say on Facebook and Twitter better predicts your heart attack risk than smoking, diabetes, obesity, or high blood pressure based on the findings of this new study from the University of Pennsylvania.  Researchers also found that using just one word in a Tweet can predict with great accuracy who will die from a heart attack.  Just what is the most dangerous word to use in a Tweet?

Tweets and Heart Attacks

As soon as this medical study was published it instantly hit news media outlets across the world.  Many news reports, like this one, reported on the findings of this study.

In this study, researchers analyzed 140 million Tweets across the U.S. What they found is really quite alarming. In those U.S. counties where people Tweet their anger or frustrations are the same counties where people have heart attacks.  In other words, people that Tweeted negative emotions died from heart attacks.

And just what is the most dangerous word to use in a Tweet when it comes to your risk of a heart attack? Would it surprise you that the most dangerous word to Tweet, according to this study, is the word “hate?”

Other dangerous emotions to Tweet about are fatigue and anger. In contrast, places in the U.S. that Tweeted about their optimism on life and positive relationships with family and friends tended not to have heart attacks.

Dr. Day’s Take on this Study

1. Facebook or Twitter could give us a “big picture” look at the general health of a person.

We know from many studies that optimistic and grateful people can avoid heart problems. Likewise, people who dwell on the negative tend to die young and sick.  Social media posts could literally be a “window to the soul” of a person.

2. Should cardiologists now start reviewing what patients say on Facebook and Twitter?

In addition to reviewing the blood pressure logs of my patients, should I also start reviewing all of their Facebook posts and Tweets?  Would this be more helpful to me than ordering a stress test for my patients? Perhaps some clever young entrepreneur will create an iPhone or Android app that could quickly calculate a heart attack risk score by analyzing every Facebook post and Tweet from their social media accounts.

3. We should take a look at our own Facebook posts and Tweets.

This study should really be a wake up call for each of us.  I know it was for me.

What do we write about in our own Facebook posts and Tweets?  Also, the findings of this study apply not just to social media but also to what we talk about at work, home, or even on the telephone.  If we can learn to focus on the positive when interacting with others our health and our hearts will get better.

4. Interpret this study with caution.

While the findings of this study are very interesting and certainly grab media headlines, we need to be careful when interpreting the data. For example, in my cardiology practice, the people who are Tweeting are generally not the people having heart attacks.

5. This is a classic chicken vs. the egg type study.

The question I have when I read studies like this is do sick people Tweet negative emotions or do people who dwell on negative emotions in their Tweets get sick? I suspect both are probably true.

Do you keep your conversations, Facebook posts, and Tweets positive???

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Recent Medical Studies Podcast

In this podcast, I discuss four recent medical studies.  As I discuss each of these studies, I provide simple strategies we can all implement to enjoy the health benefits from these studies.

You can listen to these podcasts directly from the website or you can subscribe through iTunes or Stitcher by clicking these links to make sure you never miss an episode!

1. Is Cognitive Function Determined by Occupation? (Links below)

News report:

Actual study:

2. Three Secrets of Getting Kids to Eat Veggies (Links below)

News report:

Actual study:

3. Fitness is More Important than Fatness (Links below)

News report:

4. Lose Weight by Exercising Fasted (Links below)

Actual study:

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In this podcast episode I discuss these four recent studies and what they mean for us.   Here are the links to these four studies:

1. Does Bad Luck Cause Cancer?

News report

Actual study

2. Volunteer to Prevent Depression

Study

3. Weights Beat Cardio for Fat Loss

News report

Actual study

4. BPA Free Plastics May Cause Brain Damage

News report

Actual study

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7 Ways to Extend Life and Prevent Cancer with IGF-1

NFL football players typically die in their 50s from heart disease or cancer.  In contrast, Laron Dwarfs from Ecuador live incredibly long lives without ever getting heart disease or cancer.  Could too much or too little IGF-1 be the reason?  In this article I will teach you how to optimize your IGF-1 levels to maintain muscle mass, extend life, and prevent cancer.

1986 Superbowl

On January 26, 1986 all of America was glued to the TV screen as they watched the Super Bowl XX match up between the Chicago Bears and the New England Patriots.  Favorite among Americans was the massive rookie defensive tackle of the Chicago Bears, William “The Refrigerator” Perry.

Perry seemed to have it all.  He was one of the biggest and fastest players to ever play the game.  He started the season at 380 pounds.  Not only was he formidable on defense but he was also a powerful secret weapon on offense as well in the role of a running back.  Perry represented the modern NFL player built much bigger and stronger than previous generations of NFL players.

In the third quarter of the Superbowl game with the ball on the 1-yard line the call was made to give the ball to “The Refrigerator” Perry.  On one of the most famous NFL plays of all time, “The Refrigerator” Perry scored the touchdown run as scene in this video of the event helping the Chicago Bears to go on to win their first Super Bowl.

What is IGF-1?

Insulin-like growth factor 1 (IGF-1) is a hormone similar in structure to insulin.  IGF-1 is one of the most potent hormones stimulating growth.  IGF-1 levels are highest during the childhood growth periods and continue to play a role in growth and muscle development even in adults.

NFL football players and body builders likely have the highest circulating levels of natural IGF-1 due to their lifestyles.  For some NFL players they still wanted even higher levels of IGF-1 through performance enhancing drugs.  For example, IGF-1 was suddenly thrust into the spotlight during the 2013 Superbowl game when it was revealed that Baltimore Ravens star Ray Lewis was doping with IGF-1 from deer-antler pills.  Deer-antlers contain high levels of IGF-1 as IGF-1 is what causes the antlers to grow so fast each year in the life of a deer.

On first blush it seems like IGF-1 is something all of us want.  Who wouldn’t want to possess super human size and strength?  Is it any wonder New York Yankees baseball legend, A-Rod or Alex Rodriguez lied under oath that he did not use performance enhancing IGF-1 despite evidence to the contrary?

The Laron Dwarfs: People with Genetically Low Levels of IGF-1

At the same time “The Refrigerator” Perry was dominating the NFL, far away to the South, Dr. Guevara-Aguirre discovered the Laron Dwarfs in Ecuador in 1987.   Dr. Guevara-Aguirre was interested in these three to four foot dwarfs as legend had it that they lived very long lives free from cancer or diabetes.

At the time no one believed Dr. Dr. Guevara-Aguirre’s findings.  It was impossible that there were no reported cases of cancer or diabetes in any group of people.

Currently, there are about 300 known people in the world with the Laron-type Dwarfism.  Of these 300 people, most reside in Ecuador.  Researchers have reported that most of these dwarfs could probably live much longer if it were not for their high rates of alcoholism and accidents likely from their short stature.

The reason why Laron Dwarfs don’t develop cancer is really quite simple.  IGF-1 stimulates growth.  If growth is not stimulated then cancerous cells do not grow and multiply.  Likewise, with low levels of IGF-1 their blood glucose levels remain low even if they become obese.

Aside from their short stature, the other challenge Laron Dwarfs face is that of a decreased intelligence.  In addition to growth and muscles, IGF-1 also enhances cognitive performance.

Interestingly, if you inject IGF-1 into these Laron Dwarfs, like A-Rod, during their adolescent growth periods they will grow to a normal size.  However, if IGF-1 is given after puberty then they will remain as dwarfs.  Clearly, IGF-1 administration has to be critically timed to reverse their dwarfism.

Acromegaly and Excessive IGF-1

On the other end of the spectrum from the Laron Dwarfs is acromegaly.  Acromegaly is a condition where people continue to grow due to a pituitary gland abnormality.  As opposed to the Laron Dwarfs, these people are giants and have very high levels of IGF-1.  Unfortunately, these giants tend to die very young.

One of my favorite Hollywood movie stars growing up was André the Giant who reportedly stood at 7 feet 4 inches (224 cm) and starred in the classic movie The Princess Bride (affiliate link).  Unfortunately, André the Giant suffered from acromegaly and died at the young age of 46 due to complications from this condition.

Dog Size, IGF-1, and Longevity

We love our dog Andi.  We rescued this golden lab at the age of 7.  Currently, she is 11 years old.

Even though her health is excellent, we all know that, in general, bigger dogs don’t live as long as smaller dogs.  Given how attached our children are to Andi, we know they will be devastated when this happens.

Why is this the case?  Could the same IGF-1 link hold true in dogs as well?

Recent studies in dogs have shown a similar outcome when it comes to IGF-1 levels and survival.  Larger dog breeds tend to have higher levels of IGF-1.  Consequently, they don’t live as long as the smaller breeds with lower levels of IGF-1.

Unfortunately for me (my height is 6′ 2″ or 189 cm), taller humans have also been shown to not live as long based on IGF-1 levels.  It seems that at least in some studies there is a trade off based on height versus longevity.

Centenarians, Genetics, Cognition, and IGF-1 Levels

Interestingly, studies of centenarians and their offspring have consistently shown lower levels of IGF-1 in those who live the longest.  This link is not just confined to certain ethnic groups.  As we have been very fascinated with the long-term health and longevity of people living in China’s Longevity Village, the same finding holds true with the Chinese.  Chinese living into their ninth or tenth decades of life consistently show lower levels of IGF-1.  These studies seem to suggest that at least in long lived families, there may be a genetic component to IGF-1 and longevity.

While in the extreme cases, like Laron Dwarfs, extremely low levels of IGF-1 are associated with cognitive impairment.  However, in healthy adults like the centenarians mentioned above, IGF-1 levels are not associated with cognitive performance.

7 Ways to Optimize Our IGF-1 levels?

Is there some middle ground between the muscle bound hulking NFL lineman and the diminutive Ecuadorian dwarf?  What is the goal IGF-1 level for optimal muscle strength, cognitive function, longevity, and freedom from cancer and diabetes?

From this article it could appear that there is a trade off when it comes to IGF-1.  On one end of the spectrum you have muscles and strength with high levels of IGF-1 (growth) while on the end you have longevity with freedom from cancer or diabetes with low levels of IGF-1 (repair).  Is there a way to have the best of both worlds?  Can we have both growth and repair going on simultaneously?

Like with most things, there is a healthy range.  For example, when it comes to the heart there is definitely an IGF-1 sweet spot.  Studies have shown that when IGF-1 levels are too high or too low the risk of heart disease is increased.

While in clinical studies or specialized clinics you can test your IGF-1 levels, for most people these lab tests are not available.  However, there are things we can do to keep our IGF-1 levels in the optimal range.

1. Maintain a Normal Vitamin D Level

IGF-1 and vitamin D levels often go hand in hand.  People who have low levels of vitamin D tend to have low levels of IGF-1 as well.  Vitamin D supplementation for people who are low in this hormone tends to normalize IGF-1 levels.

2. Avoid Excessive Animal Meat and Cow Milk

Excessive animal meat and dairy may raise your IGF-1 levels too high.  In contrast, vegans who eat plant-based proteins tend to have low levels of IGF-1.  Could this be one reason why vegans may have a lower risk of cancer and may also live longer?

3. Minimize Simple Carbs

A diet high in the simple carbs has also been shown to raise IGF-1 levels.  Could this explain the reason why a diet high in the simple carbs also leads to an increased risk of cancer and diabetes?

4. Avoid Isolated Soy Protein

Isolated soy protein significantly raises IGF-1 levels.  If you enjoy soy then it should be eaten how it has traditionally been eaten in Asia where they eat a non-GMO variety in the whole bean form.

5. Exercise Regularly

There have been many studies done on the effect of exercise to IGF-1 levels.  The results seem to be mixed.  My research on this topic suggests that regular moderate levels of exercise seems to optimize IGF-1 levels.

In contrast, extreme levels of exercise or excessive weight lifting can significantly raise IGF-1 levels.  Could the excessive animal meat and simple carbs in conjunction with extreme levels of exercise and weight lifting result in very high IGF-1 levels for NFL football players?

6. Maintain a Healthy Weight

Diabetes, obesity, cancer, and premature death all seem to run together.  Researchers feel that there may be a link with IGF-1.  If we want to maintain healthy levels of IGF-1 we also need to maintain a healthy weight.

7. Intermittent Fasting

Studies have shown that intermittent fasting can help to normalize levels of IGF-1.  Could this explain why intermittently fasting may increase longevity? Certainly, excessive fasting or extreme caloric restriction can be dangerous and could drive IGF-1 levels too low for optimal health.

Epilogue: “The Refrigerator” Perry Today

You may be wondering what happened to “The Refrigerator” Perry.  Unfortunately, his post-NFL football career has not turned out well.  Contrary to internet and Twitter rumors, he is still alive at age 52 but his health is extremely poor.  According to this report, he can barely walk, he weighs 450 lbs (205 kg), and he has spent considerable time in the hospital over the last few years.

What are you doing to optimize your IGF-1 levels?

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Is Resveratrol the Fountain of Youth?

At the age of 122, the French woman, Jeanne Calment was still as mentally sharp as ever.  A woman who had met Vincent Van Gogh when he still had two ears while she was a young woman in Arles, Jeanne had become an international celebrity for being the oldest documented person to have ever lived.

At the age of 90, the woman who would one day go on to be the oldest person to have ever lived according to documented records, Jeanne Calment, found herself without any direct heirs and dangerously running out of money.  In such a dire situation, a French lawyer made a deal with Jeanne to pay her the equivalent of $500 USD a month if she would sign over her home to him upon her death.

It probably seemed like a good deal for the lawyer.   The only catch was that he had to wait until she passed away.  Perhaps given her advanced age, he thought it would just be a short period before he would have the home free and clear.

As fate would have it, this woman ended up outliving the lawyer.  Not only that, the lawyer ended up paying her more than twice the value of her home.  This stroke of fate allowed Jeanne to live the rest of her life without any further money worries.

Perhaps this deal is what allowed Jeanne to support her 2.2 pounds of chocolate that she ate each week and her red wine.  When she was later asked how the lawyer must have felt about this deal, Jeanne simply replied, “it happens in life that we make bad deals.”

When asked about her secret to a long life during an interview in 1997 just before her death, she credited her longevity to red wine and chocolate, among other things.

For decades, researchers have been intrigued by the potential link between the ingredient found in both red wine and chocolate–resveratrol–and longevity.

Discovery of Resveratrol

In 1939 an obscure Japanese researcher, Michio Takaoka and his students, were doing experiments on veratrum grandiflorum, a plant found on the northern most island of Japan, Hokkaido.  By chance, they isolated resveratrol crystals and shared their findings in a Japanese medical journal unknown to the rest of the world.

His finding had faded away into obscurity until modern scientists once again discovered resveratrol, this time when red grapes made the compound when infected by a fungus.  Further research concluded that resveratrol was a protective effect of red grapes to environmental stressors like weather, bacteria, or fungus.

Now large pharmaceutical and supplement companies have jumped into the resveratrol quest.  Consequently, many studies have been published on the potential benefits of this anti-oxidant, anti-aging, and anti-cancer compound.

Could Resveratrol Explain the French Paradox?

The French Paradox has baffled scientists for generations.  How could the French eat the “wrong” foods and not exercise more than anyone else, yet consistently have the lowest rates of heart disease in the world?  Indeed, based on World Health Organization data, the risk of a heart attack in France is nearly 3 times lower than in the U.S.!

One of the possible theories for the French Paradox is that while enjoying their red wine, the French benefit from the resveratrol in the red wine which can help protect against heart disease.

Possible Health Benefits of Resveratrol

You may be wondering what the science says about resveratrol.  Can you really live to 122 on a diet that includes red wine and chocolate?

1. Resveratrol Slows the Aging Process

Amazingly, when resveratrol is given to worms, fruit flies, bees, and mice they can live up to 38% longer.  Researchers feel that the life extending benefits of resveratrol may come from activation of the SIRT1 gene.  This gene has the same effect to the body as caloric restriction in extending life.

Unfortunately, as we age our DNA slowly degrades with time.  When this happens it can lead to disease, suffering, and ultimately death.  Fortunately, the SIRT1 gene has also been shown to enhance DNA repair which can also lengthen lifespans.  Other research has shown that the life extending benefits of resveratrol may come from activation of mTOR proteins.

Regardless of which mechanism of longevity may be at play, the French remain one of the longest lived people.  In fact, the French live, on average, several years longer than we do in the U.S.

2. Resveratrol Prevents Cancer

In the laboratory setting, resveratrol has been shown to be highly effective in killing many different types of cancer cells.  However, what happens in a test tube and what happens in real life are often two different things.

In living animals and humans these cancer preventing effects of resveratrol have not been as pronounced.  Currently, there are many ongoing studies looking at the effect of resveratrol in both preventing and reversing cancer.

3. Resveratrol Prevents Heart Disease

With regards to the heart, there are many possible explanations as to why resveratrol may prevent heart disease.  In addition to being an anti-oxidant and anti-inflammatory agent, resveratrol has also been shown to have many heart protective effects including the following:

-Prevention of cholesterol from being oxidized in our arteries

-Prevention of blood clots from platelet aggregation

-Improved blood flow within the heart

Whether or not it is the red wine, the French have the lowest rate of heart disease in the world where there are reliable data.  Is it the resveratrol or something else that seems to protect the French hearts?

4. Improves Cognitive Function

Jeanne Calment was mentally sharp right up until her last day of life at age 122.  With humor, when asked about her remarkable longevity, she was quoted as saying “I’ve been forgotten by God.”

Was this due to good genes or the brain protective effects of resveratrol?

In studies done with fish, resveratrol has been shown to protect against age-related cognitive decline.  Additionally, studies in mice and rats have shown that resveratrol can improve brain function by reversing traumatic brain injury, Parkinson’s Disease, and Alzheimer’s Disease.

While most of the research on resveratrol and cognitive function has occurred in animals, there are studies in humans showing that resveratrol may improve memory.  In other words, not only may resveratrol increase lifespan but many studies have shown that it can also help to protect the brain with this increased lifespan.

5. Reduces Appetite

As researchers have been busy trying to increase the lifespan of mice with resveratrol, they noticed a very strange thing.  Not only did the mice live longer but they also stayed very lean and would not always eat all of their food.

Over time, this finding has been seen in other animals as well.  Resveratrol seems to cause decreased food intake.  This decreased appetite effect of resveratrol was not anticipated at all.  This effect is now also felt due to activation of the SIRT1 gene which has the same effect on the body as caloric restriction.

Could the resveratrol in the French diet possibly explain their much lower obesity levels than what we see here in the U.S.?  Specifically, Americans are nearly three times more likely to be obese than the French.

This too is also part of the French Paradox.  How can they stay slim on the French diet which would cause many to gain weight?  Indeed, the low rates of obesity in France has prompted a number of popular books like French Women Don’t Get Fat (affiliate link).

Natural Sources of Resveratrol

By now you are probably wondering how can you naturally increase your resveratrol intake.  The primary sources of resveratrol come from red wine or red grapes as resveratrol is most highly concentrated in the skins of red grapes.  There are also other natural sources of resveratrol which include blueberries, cranberries, peanuts, and dark chocolate.  Fortunately for me, these are all some of my favorite foods.

Should I Take a Resveratrol Supplement?

If you believe the the French Paradox then it can’t be from resveratrol supplements as most French do not take these supplements.  Jeanne Calmen never took resveratrol supplements as she got all of her resveratrol naturally from her beloved red wine and chocolate.

Perhaps the biggest challenge with resveratrol supplements is that the bioavailability of resveratrol is extremely low. Even worse, what little resveratrol that it usable by the body may have detrimental effects.  For example, one recent study suggested that resveratrol appeared to negate the benefits from exercise.

My Approach to Resveratrol

At the young age of 100, Jeanne Calment was still riding her bicycle.  I, too, love riding my bicycle and do so in some form on most days year round.  While I don’t drink red wine, my favorite fruit, which I eat in large quantities, is red grapes.  Also, my only sugar vice, dark chocolate covered almonds, also has resveratrol.

While there has been a lot of hype in the media about the many anti-aging and other properties of resveratrol, there still are no convincing studies that it is beneficial yet in humans.  Thus, until further scientific data emerge I don’t think resveratrol is our fountain of youth.

Given this lack of data on resveratrol, I cannot recommend resveratrol supplements.  Likewise, if you don’t drink alcohol I cannot recommend that you start drinking red wine just for the potential health benefits of resveratrol.

However, if you love resveratrol rich foods, like me, then at least you can feel good about eating red grapes, blueberries, cranberries, peanuts, and dark chocolate.  As with Jeanne Calment, perhaps these foods will allow you to stay young, smart, and thin while protecting you from heart disease and cancer.

Do you try to get resveratrol in your diet?

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Children and Fast Food, Zen of Yoga, and Dangers of Diet Pills

In this podcast I cover the following medical articles and studies:

1. Children and Fast Food

News report: http://www.medicalnewstoday.com/articles/287414.php

Actual study: http://cpj.sagepub.com/content/early/2014/12/04/0009922814561742.abstract

2. Zen of Yoga

News report: http://www.bbc.com/news/health-30475999

Actual study: http://cpr.sagepub.com/content/early/2014/12/02/2047487314562741.abstract

3. Dangers of Diet Pills

News report: http://www.consumerreports.org/cro/news/2014/12/taking-diet-pills-don-t-waste-your-money/index.htm

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Benefits of Almonds, Turning Medical Challenges into Blessings, Avocados Lower Cholesterol, Longevity with Real Whole Grains, and Best and Worst Diets

In this podcast I cover the following recent medical studies and articles:

1. Benefits of Almonds

News report

Actual study

2. Turning Medical Challenges into Blessings

News report

3. Avocados Lower Cholesterol

News report

Actual study

4. Longevity and Real Whole Grains

News report

Actual study

5. Best and Worst Diets

News report

To make sure you never miss a podcast from me, please subscribe through iTunes or Stitcher by clicking the links.

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How to Bulletproof Your Heart: The Roseto Effect

More than four in 10 Americans will die from a heart attack or other heart problems.  Not only is heart disease still the number one killer for both men and women but the same people who suffer from heart problems are also the ones more likely to suffer from Alzheimer’s Disease, strokes, and poor brain function later in life.

Is it possible to bulletproof your heart so that regardless of your diet or how much you exercise you won’t suffer from heart or brain problems later in life?

What I Was Taught at Johns Hopkins Medical School

When I was a medical student at Johns Hopkins in the early 1990s we were all taught the risk factors for heart disease.  Namely, if you don’t smoke, you don’t have diabetes, your cholesterol and blood pressure are in check, and there is no family history of heart disease then it would be very unlikely for you to have a heart attack.

As I have progressed further in my career and research I have come to learn that there are far more factors at play.  Indeed, these “other factors” may be just as important as the big five I was taught in medical school.   Let’s explore this concept further.  Welcome to a small mysterious town in Pennsylvania where people seemed to magically be protected from heart problems despite a poor diet, high rates of smoking, high cholesterol, and a lack of exercise.

Roseto, Pennsylvania: The Village of “Bulletproof Hearts”

In 1961, at the height of the heart disease epidemic in the U.S., a local Roseto doctor happened to mention to Dr. Stewart Wolf from the University of Oklahoma  that heart disease was virtually nonexistent in Roseto.  From this chance conversation, outside researchers quickly converged on this small town.

With the blessing of the mayor of Roseto, everyone in the village was studied.  They collected blood samples, monitored what they ate, and basically how they lived their lives.  Researchers poured over every death certificate and interviewed everyone.  After spending several years in this small town they had their answer.

As reported in the prestigious Journal of the American Medical Association in 1964, and later by Malcolm Gladwell in his bestselling book Outliers (affiliate link), Roseto was a small community where people ate all of the wrong foods and had high rates of obesity and smoking, had high cholesterol, breathed toxic fumes from working in the slate quarries, and yet somehow were protected against heart disease.  Indeed, the risk of a heart attack in this small Italian village in Pennsylvania was just half as much as the five surrounding towns.

How can this be?  How can you do everything apparently “wrong” for your heart and yet be protected from a heart attack?  There had to be an explanation for this paradox.

At the time, Roseto was a small tightly knit community of Italian immigrants living about 75 miles west of New York City.  This village was settled in 1882 by Italian immigrants from Roseto Valfortore in Italy.  When they immigrated to the New World they kept their exact same social structure as they did in Italy.

This was a socially isolated village.  They only married within the community, kept to themselves, spoke Italian, worshiped God, only shopped at their own local small stores, and lived as three generational families under the same roof.  The worked at the numerous local slate quarries and lived the “old” Italian way even though the rest of the country had already gone through rapid changes in the years following World War II.

The Roseto Mystery Explained

You may be wondering, how can you eat all of the wrong foods, gain weight, smoke, and have a high cholesterol but yet not develop any heart problems?  Let me outline the key factors as to why a heart attack was an incredibly rare event in Roseto.  If we can maintain a healthy lifestyle, unlike the Rosetans, and incorporate these additional four factors then we can truly “bulletproof” our hearts.

1. Family Centered Life

For the Rosetans, family was everything.  Families were close and multiple generations all lived within the same home. Families were self sufficient and took care of their own.

Indeed, there have been countless studies in the medical literature supporting the fact that strong marriage and family relationships can protect us from heart attacks.  As the quality of our family relationships has such a profound effect on our heart health the question is what can we do to strengthen these relationships?

For me, what has helped the most is to put the needs of my family ahead of my own.  As I give of myself it always seems that in the end my needs are met as well.

Also, given my busy lifestyle, I have found that what gets scheduled gets done.  In other words, the calendar on my iPhone is also filled with many family events including scheduled one on one time with family members.

2. Spirituality and Religious Ties

On Sundays, everyone in Roseto went to church.  It was a God fearing community.  They had strong Christian values and were very spiritual people.  They cared for their neighbors and looked after each other.

As with strong family relationships, many studies have shown that religion and spirituality can protect us not only from heart disease but many other chronic medical conditions as well.  Even if you are not religious, taking time to care for your spiritual needs can be very therapeutic.

In our family, we worship together at church each Sunday.  Even if it is a boring sermon at least you can tell yourself that, based on medical studies, you are getting healthier each time you go to church.

3. Strong Community

From a socioeconomic standpoint, you did not know in Roseto who was rich or poor.  There was no keeping up with your neighbors.  Even if you were wealthy it was socially taboo to display your wealth.

The community cared for everyone.  If a neighbor was in need, everyone came to help.  They were all “brothers” and “sisters” in the community.

Once again, there is a vast body of scientific data that socioeconomic disparities or even perceived disparities can lead to heart attacks.  Trying to keep up with your neighbors or peer group will drive you crazy and cause undo stress on your heart.  At the end of the day, all we really need to be happy is a safe home with enough food and loving relationships.

4. Low Stress

Despite difficult working environments at the slate quarries, Rosetans perceived very low levels of stress.  They put their worries into God’s hands and knew that whatever happened in life their family and community would always be there to help.  Crime was nonexistent in this village.

Based on all of the studies published to date, it goes without question that perceived stress is a powerful predictor of who will get a heart attack.  Much has been said about stress and I have published many blog articles on the subject as well.

For me, the three most important things in keeping my stress levels in check are to live as healthy as possible, always plan to arrive or be ready 15 minutes early, and to always look for ways to simplify my life.  As we can eliminate the “clutter” in our lives and focus on that which is truly essential we can minimize our perceived stress.

Roseto Today

By now you are probably considering moving to Roseto, PA and living a utopian life free of heart disease, stress, and worries.  Indeed, this is where Malcolm Gladwell left off in his book Outliers (affiliate link).

I wish this is where the story ended but unfortunately there was an unravelling of the Roseto Effect.  Today, Rosetans no longer have “bulletproof” hearts.  Let me now share with you what happened in the late 1960s.

By the time the late 196os rolled around, the American way of life had infiltrated the village.  They still ate poorly, smoked, and failed to exercise.  However, now they began intermarrying, families started to split up, religion was no longer the glue to the community, and the pursuit of wealth and materialism was in full swing.

Indeed, by the 1970s Roseto was no different than the neighboring towns and their heart attack risk became the same as everyone else as well.  They were no longer bulletproof.

What is the lesson of the Roseto Effect?

In medical circles, the term “Roseto Effect” has come to describe how a close-knit community can escape the risks of heart attacks.  When Rosetans lost the Roseto Effect they then fell victim to the consequences of their unhealthy lifestyles.

While the Roseto Effect is NOT an excuse to live an unhealthy lifestyle, it does show that by having close family relationships, living a spiritual life, caring for neighbors, and minimizing the effect of stress in our lives, we can escape many of the unnecessary chronic medical conditions like heart disease.

Do you have the Roseto Effect working in your life?  Is your heart bulletproof?

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7 Surprising Reasons Why You Need Capsaicin

Are you gaining weight because your metabolism is too slow?  Perhaps you suffer from chronic pain or just have high cholesterol?

Could one solution to these medical problems be as simple as chili peppers?  Indeed, capsaicin, one of the key natural ingredients in chili peppers, has been shown to have many health benefits.

My Experience with Chili Peppers

Growing up, I steered clear of spicy foods.  As a child I even believed the old wives tales I heard that a spicy food, like chili peppers, could cause stomach ulcers.

As my food tastes became more mature as I grew older I started liking spicy foods.  While living among the Chinese in Taiwan during college I fell in love with spicy Szechuan Chinese food.  Later, I learned to love spicy Indian, Mexican, and Thai food as well.  I now enjoy the intense spice and health benefits that come from capsaicin.

What if you don’t like chili peppers?

While our two older children love spicy chili peppers, our youngest child will not eat anything “spicy.”  Fortunately, capsaicin is not just found in chili peppers, it is even present in sweet peppers.  Fortunately, all of our children love eating sweet peppers.  We often cut up sweet peppers as snacks at home or to eat while driving in the car.

7 Surprising Reasons Why You Need Capsaicin

Let me now share with you seven surprising reasons why you need capsaicin.  Of course, like everything I share on this website, always discuss any general information I share with your doctor or healthcare provider first before considering any changes you might make in your own diet or lifestyle.

1. Capsaicin Boosts Your Metabolism

When we think of “burning calories” we usually think of exercise.  However, a much bigger source of “calorie burning” comes from our basal metabolic rate or the energy required to keep our body warm and the millions of chemical reactions happening every minute in our body working properly.  If this metabolic rate, or our metabolism, could be turned up a notch or two then we could burn a tremendous number of calories.

Fortunately, our metabolism can get a significant boost from capsaicin.  For example, in just a few minutes after eating capsaicin your metabolism is quickly boosted by 20% for as long as 30 minutes according to this study.

Not only does capsaicin boost your metabolism but other studies have shown that it can also enhance fat burning and decrease your appetite.  If you like to eat chili or sweet peppers throughout the day then this could be a great way to help you lose or maintain a healthy weight.

2. Capsaicin is a Potent Pain Reliever

Do you suffer from arthritis or neuropathy pain?  If so, topical capsaicin could be a great natural pain reliever to help avoid the disabling and addictive effects of opiates.

Many studies have shown that capsaicin, through the skin, can offer tremendous relief for people who suffer from arthritis.  Nerve pain, or neuropathic pain, can be one of the most difficult forms of pain to treat.  Fortunately, capsaicin has also shown great benefit in clinical studies for this condition as well.

3.  Capsaicin Protects You from Oxidized Cholesterol

Cholesterol, in and of itself, is not dangerous to our cardiovascular system.  The risk comes from when bad cholesterol, or LDL cholesterol, is oxidized or reacts with free radicals inside our arteries.

Fortunately, capsaicin has been shown in this study to help stabilize our bad cholesterol so that it does not cause damage to our arteries.  If the bad cholesterol is not oxidized then it does not cause atherosclerosis or inflammation within our arteries.

4. Capsaicin May Help to Prevent Cancer

Given the many effects of capsaicin, researchers have long looked at the potential anti-cancer role of capsaicin.  Some early small studies with impure forms of capsaicin suggested that capsaicin could increase the cancer risk.  More recent larger studies, using a more purified form of capsaicin, have shown that it can prevent cancer.  The data for prostate cancer prevention with capsaicin appears to be the strongest.

5. Capsaicin Can Prevent Stomach Ulcers

Contrary to what we may have heard when we were young, capsaicin or chili peppers can actually help to prevent stomach ulcers.  Capsaicin protects the gastric mucosa or the cells lining the stomach.  Indeed, capsaicin can be very effective in treating peptic ulcer disease.

6. Capsaicin Can Prevent Diabetes

Nearly half of all Americans have diabetes or pre-diabetes.  The scary thing is that most people with pre-diabetes are completely unaware that they even have this condition.

To help combat diabetes, capsaicin has shown tremendous benefits.  For example, in this study capsaicin significantly improved blood sugar and insulin release following a meal.

 7. Chili Peppers Have Many Key Nutrients

In addition to the myriad of benefits already covered in this article, chili peppers are also a very low calorie food packed with many vitamins including vitamins E, K, A, and the B vitamins.  To see the many vitamins and minerals contained in chili peppers, here is an excellent resource.

Do you like spicy foods?  Do you prefer to get your capsaicin from chili or sweet peppers?

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Dear Podcast Listeners,

Here are the topics and links to the articles and studies discussed on my latest podcast.  If you are not yet a subscriber, please subscribe to my podcast by clicking this link to iTunes.

1. Lemon Juice and Vinegar can help to lower the glycemic effect of foods which could help in weight loss.

2. What does 2,000 calories look like?  Here is the link to the New York Times article.

3. Hugs can prevent the common cold.  Here is the PBS news story on this study.  Here is a link to the abstract of this published study.

4. eBooks at night can harm our sleep and our health.  Here is the link to the news report of this study.  Here is a link to the actual study.

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How to End Insomnia and Weight Gain

Do you suffer from fatigue, stress, depression, anxiety, brain fog, high cholesterol, or a raging appetite?  If so, there is a good chance you are one of 70 million Americans who also have difficulties sleeping.

Could the dramatically rising rates of sleep deprivation over the last 50 years be responsible for why most people are gaining weight?

The Dangers of Sleep Deprivation

A recently published study showed that sleeping an average of just 5.7 hours a night for one week changed the expression of 711 genes in the body!  Many of these genes are the very same genes that cause obesity, heart disease, and dementia.  Is it any wonder that insomniacs are 55% more likely to die from heart disease.

Even as little as one night of severe sleep deprivation can cause the same injury to the brain as a concussion. If you are part of the 10% of Americans who even occasionally take a sleeping pill like Benadryl or an antihistamine, your risk of premature death is 3 times higher!

My Struggles

I have battled with insomnia for most of my adult life.  It started in college and has been with me ever since.  I suspect much of my battles with insomnia are due to stress, travel, and disrupted sleep from being on call for the hospital at night.

I have found that when I am sleep deprived from stress, travel, or being on call for my hospital that I tend to have a ravenous appetite.  In a previous blog post, I shared my 10 strategies to better sleep.

The topic of this article is how can we channel our increased appetite from sleep deprivation into better sleep?  In other words, how can we eat our way to better sleep and weight loss?

How a Lack of Sleep Changes Our Hormones and Metabolism

1. It Increases the Stress Hormones (Cortisol and Adrenalin)

When we are sleep deprived it increases our stress hormones cortisol and adrenalin.  With regards to weight gain, cortisol is particularly troublesome.  As anyone who has ever taken cortisol, in the form of Prednisone or a short course of steroids, will tell you that while they took this drug their appetite was intense and they gained weight.

2. It Increases the Hunger Hormones (Low Leptin and High Ghrelin)

Have you ever felt yourself craving sugar after a bad night of sleep?  Why is this the case?

When we are sleep deprived our leptin levels are low and our ghrelin levels are high.  Leptin is the hunger hormone that tells our brain we are full.  Ghrelin is the hunger hormone that tells us it is time to eat.

When these hormones are particularly out of sync, we tend to crave the high sugar and fatty foods.  Unfortunately, the fatty foods we tend to crave in this hormonally disrupted state are the unhealthy fats like those found in french fries or processed foods.

With low levels of leptin our brains never get the signal we are full.  Likewise, with surging levels of ghrelin we feel compelled to eat even when we have already eaten.

3. It Raises Our Blood Sugar

Our blood sugar levels tend to be high when we are sleep deprived.  There are many reasons why this happens.  Some of these include the decreased use of glucose by the brain, insulin resistance, and from the high levels of cortisol.

When our blood sugars run high, the body compensates by releasing more insulin.  Insulin not only can stimulate hunger, as any diabetic quickly finds out when they start taking insulin shots, but it also drops blood glucose.  When our blood sugar levels bottom out from insulin it triggers the hunger hormones which again tell us we are hungry and it is time to eat.

How to End Insomnia and Weight Gain in 7 Steps

As we have now covered how sleep deprivation changes our hormones and metabolism to eat more, I now want to discuss how we can reverse this process.  Yes, it is very possible to channel our increased appetite from sleep deprivation into eating our way to better sleep and weight loss.  Here are my best 7 strategies to end insomnia and weight gain.

1. Shut the Kitchen Down at 7 pm

Eating late at night not only leads to weight gain but compromised sleep as well.  Indeed, in this study researchers found that late night eaters had worse sleep quality.

Late night eating is an important cause of acid reflux.  Acid reflux is a well-known cause of poor sleep at night.  Even if you don’t get the typical chest pain that often comes from acid reflux it can still disrupt your sleep.

In addition, there is a growing body of evidence that intermittent fasting or time restricted feeding can reverse obesity.  In this recently published study in mice, researchers found that just by timing when mice ate determined whether they were lean or obese even though they ate the same number of calories.

The best way to make intermittent fasting or time restricted feeding work for you is to stop eating early in the evening.  By the time breakfast arrives, at least 12 hours will have passed and you will have accomplished intermittent fasting or time restricted feeding without even trying!

2. Have “Tryptophan Nuts and Seeds” for Dinner

Have you ever felt tired after a big turkey dinner at Thanksgiving?  Odds are that the sleepiness was due to high levels of tryptophan from the turkey.  Tryptophan is a sleep promoting amino acid that helps your body to produce melatonin.

Nuts and seeds are the perfect dinner time food for sleep and weight loss.  They are packed full of protein, healthy fats, and fiber which means they will keep you full until morning so you won’t be tempted for a bedtime snack.

In addition to the perfect trifecta to staying full (protein, fat, fiber), the tryptophan nuts and seeds will help to put you to sleep.  The nuts and seeds high in tryptophan include walnuts, cashews, and sesame seeds.

3. Eat a High Magnesium Dinner

Magnesium is a mineral that 60% of Americans are deficient in.  Magnesium relaxes muscles and our nervous system.  Magnesium has even been shown in clinical trials to improve sleep.

Some excellent choices to increase your magnesium levels would be pumpkin seeds, spinach, sesame seeds, sunflower seeds, almonds, or pecans.  Not only will more magnesium help to improve your sleep but  it can also help with anxiety.  Anxiety robs many of my patients from blissful sleep.  To learn more about the many health benefits of magnesium, here is a link to an article I wrote on magnesium.

4. Have “Lettuce Opium” for Dinner

From as far back as the ancient Egyptians, the milky fluid part of lettuce has long been known to produce opium like effects.  Not only does lettuce taste great in a salad but it can also reduce pain and promote sleep.  This is especially helpful as I have found that so many of my patients are kept up at night from chronic pain.

Studies have now been done to prove what humans have known for thousands of years, namely that lettuce has sleep inducing qualities.

5. Eat a High Calcium Dinner

Like magnesium, calcium also relaxes muscles and the nervous system.  Although the data are somewhat limited, there is some evidence that calcium with magnesium may help to promote sleep.  In addition, calcium can help the brain to better utilize tryptophan in the production of melatonin.

While dairy is certainly a good choice for obtaining calcium, often overlooked options for calcium include tofu, sardines, sesame seeds, spinach, or kale.  To learn more about what foods contain calcium here is a good link.

6. Eat Vitamin B6 Foods for Dinner

Vitamin B6 plays many different roles in the body.  One of these include regulation of tryptophan and serotonin which are important for healthy sleep.

Some excellent foods that are high in vitamin B6 include tuna, salmon, sweet potatoes, sunflower seeds, spinach, or a banana.  It is best to get vitamin B6 at night from foods rather than supplements as vitamin B6 supplements taken at night may cause vivid dreams.  When you are sleep deprived state the last thing in the world you want is to be awakened from an intense dream.

7. Eat Cherries to Boost Melatonin

In one study, cherry juice was shown to boost natural melatonin levels and improve sleep quality.  While drinking your calories is not a good option for weight loss, the same sleep promoting benefit could be obtained by eating whole cherries.

Putting it All Together: The Perfect Dinner for Sleep

I realize that I just shared many different strategies to eat your way to better sleep and weight loss.  How do we put it all together?

Let me share with you my perfect dinner for when I need a good night of sleep.  Have the following before 7 pm at night for best results.  This simple dinner will cover all 7 strategies discussed in this article.

Eat a lettuce and spinach salad loaded with sunflower seeds, pumpkin seeds, walnuts, and almonds.  By loading your salad with nuts and seeds it will keep you very full until morning.  For a sleep enhancing dressing try a healthy cherry vinaigrette dressing made with dried tart cherries or a tart cherry juice instead of orange juice in this recipe. Although this recipe does not call for a blender I would suggest using one for the optimal consistency of this dressing.

What do you eat for dinner when you need a good night of sleep?

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Should I Take Vitamins and Supplements?

With recent articles like “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements” appearing in prestigious medical journals, many people are now reconsidering their daily vitamins and other supplements.  Yet, half of all Americans still take vitamins and supplements.

When you look at who is taking supplements in the U.S., it is generally women, older Americans, and those who are more educated and better off financially.  Should you still take your vitamins and supplements?

My Vitamin and Supplement Disclosure

Before we get too far into this article, I should disclose that I do take vitamins and supplements.  In the past, I used to take a multivitamin and fish oil.  However, given the potential risks of each individual component in the multivitamin, I try to get all of the nutrients I need from real food and I now only take the following:

1. I take a vitamin D supplement from November 1 through March 31 as I live in Salt Lake City which is too far north (above the 37th latitude) for natural vitamin D from the sun during the winter months.  While I do get some vitamin D from fish and eggs, I have tested my levels in the winter and they are low from fish and eggs alone.

2. I take iodine, in the form of whole kelp, several days a week as I rarely eat dairy, my salt is not iodized, and I cannot get enough iodine in my diet from eating wild salmon and strawberries several times a week.

3. I take a biologically active sublingual form of vitamin B12 weekly to ensure that I am getting enough of this vitamin as I generally only eat meat on the weekends (wild salmon) and may only have eggs once a week.  It is very possible that I am getting enough vitamin B12 from the fish and eggs alone.  At some point in the near future I will test myself to see if this is indeed the case.

The Concern with Vitamins and Supplements

Why are prestigious medical journals attacking the powerful 30 billion dollar supplement industry?  It is because most vitamins and supplements have not been shown to prevent chronic disease or premature death.  Moreover, vitamins and supplements may potentially even increase your risk of certain diseases, cancer, or premature death.

Clearly, there is a role for vitamins and supplements when people have known deficiencies.  Also, while people may be eating all of the right foods they may not be fully absorbing key nutrients in their gut.

Potential Risks of Specific Vitamins and Supplements

It seems like each year there is a new study documenting the potential dangerous effects of certain vitamins and supplements.  Here is a review of the life-threatening potential risks of the most popular vitamins and supplements.

1. Vitamin A and Beta-Carotene Supplements

It seems like a paradox, and one that will play out over and over in this article, a diet high in vitamin A and beta-carotene from real foods (fruits and vegetables) decreases the risk of cancer.  However, in well designed clinical trials, vitamin A/beta-carotene supplements had the opposite effect.  When taken as a supplement the risk of cancer was increased!

Fortunately, it is very easy to get all the vitamin A we need from a diet high in fruits and vegetables (here is a list of the vitamin A containing foods).  Clearly we do not understand the myriad of effects of the thousands of different molecules in real food versus an isolated single molecule in a supplement.  Thus far, scientists have not been able to replicate the health benefits of real food in a supplement form.

2. Vitamin E Supplements

Unfortunately, there is an increasing body of data that vitamin E supplements may increase the risk of cancer.  Other studies have shown that vitamin E supplements may cause premature death.  We don’t yet know what dose of vitamin E increases our risk of cancer or premature death.  As vitamin E is in most multivitamins, this does cause me some concern.

Vitamin E is an important antioxidant and can prevent many chronic diseases when eaten in the form of real food. Fortunately, for those eating a healthy diet with plenty of nuts, seeds, fruits, and vegetables it should be easy to get all of the vitamin E your body needs from real food.  To learn which foods contain vitamin E, here is an excellent reference.

3. Selenium Supplements

Once again, while selenium is a powerful antioxidant and can help to decrease your risk of heart disease and cancer, taking too much of this through supplements may increase the risk of cancer.  Selenium is an easy nutrient to get from real foods.  Just one Brazil nut each day is all you need to get enough of this important mineral in a real food form.

4. Folic Acid Supplements

In an effort to reduce the risk of neural tube defects and other folate deficiencies, folic acid is now regularly supplemented in refined grains and processed foods.  If you eat processed foods and also take a multivitamin you are probably getting too much folic acid.

While high dietary intake of folic acid has been consistently associated with lower cardiovascular disease and cancer, taking it in the supplement form has shown no benefit in preventing heart disease or cancer. Even worse, research is emerging that folic acid supplementation may increase the risk of cancer and cause premature death.

Once again, it is easy to get enough folate in your diet particularly if you eat your greens and legumes each day.  To see which foods contain folate, here is an excellent reference.

5. Magnesium, Zinc, Copper, and Iron Supplements

Magnesium, zinc, copper, and iron are considered a “must have” in most multivitamins.  However, some data have linked these minerals, when taken as a supplement, to an increased risk of premature death.

The data implicating these minerals as potentially dangerous is tenuous at best.  Correlation does not mean causation.  It is possible that “sicker” people gravitated to supplements as a way to start feeling better.

Regardless, it does cause some pause for concern.  Especially that in most cases, these minerals can be easily obtained as part of a healthy balanced diet of real foods.  Follow these links to find out what foods contain magnesium, zinc, copper, and iron.

6. Calcium Supplements

While calcium supplements are commonly taken by older women as a means to prevent osteoporosis, could it be possible that calcium is actually causing harm?  Yes, according to this study.  Calcium supplements increase the risk of a heart attack by 31% in this study.

There are certainly other ways to ensure healthy bones.  For example, daily exercise, including strength training, and plenty of vitamins K and D as well as calcium through a healthy diet and lifestyle can do wonders for our bone health.  For a list of foods high in vitamins K, D, and calcium click on these links.

7. Fish Oil Supplements

A few years ago cardiologists were enthusiastic about giving fish oil supplements to most cardiac patients.  I even took fish oil supplements for a period of time.  As fish has long been known to be very heart healthy, it was just typical human thinking to think that we could get all of the benefits of fish in a simple little fish oil pill.  Indeed, early studies even supported the health benefit of a fish oil pill.

Now, there are more and more studies coming out about the potential cancer risk of fish oil supplements.  Once again, we can get all of the cardiovascular benefits from fish by eating real fish at least twice weekly as recommended by the American Heart Association.  For me, I generally have wild salmon each Saturday and Sunday.

Should I Take a Vitamin D Supplement in the Winter?

Low vitamin D levels have been linked to most chronic diseases and even premature death.  Certainly, the best way to get vitamin D is in a sun-smart way so that your risk of skin cancer is not increased.

Unfortunately, if you live above the 37th latitude in the Northern Hemisphere (north of Los Angeles) or below the 37th latitude in the Southern Hemisphere, much of the year it will be difficult for you to get the vitamin D your body needs from the sun.  Here is a map to see where the 37th latitude runs in the U.S.

Fortunately, there are now great apps for smart phones that can even calculate your daily vitamin D intake from the sun and food.  Here is the free iPhone app that I have started using.  For a list of foods high in vitamin D you can click on this link.

Who is Regulating the 30 Billion Dollar Vitamin and Supplement Industry?

Would it surprise you to hear that the answer is no one?  While prescription medications are highly regulated by the FDA, no one is making sure our supplements are free of contaminants or even contain the amount of the supplement listed on the label.  To make sure you are even taking what you think you are taking, make sure that any vitamins or supplements you take are USP or GMP certified.

Vitamin and Supplement Use in China’s Longevity Village

From our research of the centenarians in China’s Longevity Village (links to a video and news report) it was readily apparent that none of them took any vitamins or supplements.  They obtained all of their needed nutrients from their food, water, and sunlight.  The same can be true for us.

Should I Take Vitamins and Supplements?

Returning back now to our original question, should I take vitamins and supplements.  The simple answer is, it depends.  If you have a documented nutritional deficiency, that cannot be corrected with real foods, then you would be a good candidate for vitamins or supplements.

Here are my four thoughts on vitamins and supplements.

1. Vitamins and supplements are very helpful if you have a documented deficiency.

If you have been tested and are low in certain vitamins or minerals, that cannot be corrected by eating real foods, then vitamins and supplements can be very beneficial.  Work with your physician and get tested to make sure you do not have any vitamin or mineral deficiencies.

2. Vitamins and supplements are like pharmaceutical medications.

They have potential benefits and possible risks.  Make sure you discuss the risks and benefits of any vitamins or supplements with your physician before you start taking them.

3. Vitamins and supplements may be contaminated or not even contain what they claim to contain.

There are many reports of people harmed by tainted vitamins or supplements.  Make sure that if you do choose to take vitamins or supplements that they are USP or GMP certified.

4. Supplements cannot replace the nutrients that we can get from real foods.

With a healthy diet it is possible for most people to get all the nutrients that they need from real food sources.  The World’s Healthiest Foods website is a reference that I frequently check to make sure I am getting all of my key nutrients from food.

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7 Warning Signs You May Have BPA Toxicity

While the FDA continues to assert that BPA is safe, millions of Americans continue to suffer from more and more chronic medical conditions.   Fully 93% of all Americans have BPA in their body according to one study.  France has now banned BPA.  Could BPA be one reason why so many of us are developing chronic medical conditions?

 What is BPA?

BPA, or Bisphenol A, is a chemical often used to make plastic, food and beverage cans, the thermal paper used with cash register receipts, and sometimes the liner in water pipes.  BPA has been used since 1957 which, interestingly, seems to coincide with the timeframe of the obesity epidemic in the U.S.

BPA leaches into our food and water from BPA lined cans and plastic bottles.  When plastic is heated or cleaned, like in a microwave or a dishwasher, even more BPA leaches into our food.  BPA is also absorbed from our skin whenever we handle the thermal paper from cash register receipts.

While the FDA did ban BPA in baby bottles in 2012, they did nothing to protect babies from BPA in cans and jars of baby formula or other drinks and foods.

Seven Warning Signs You May Have BPA Toxicity

Aside from having your urine tested for BPA levels, how can you know if you may be suffering from BPA toxicity?  If you have any of the following seven medical conditions you may be exposed to excessive levels of BPA.

1. You Are Overweight

Historically, the concept of obesity was one of “calories in, calories out.”  Now, based on a myriad of new data, whether or not someone is overweight is more of a function of hormonal and metabolic changes rather than just “calories in, calories out.”

Based on this new paradigm of obesity, powerful hormonal disrupters, like BPA, have been implicated as a possible cause in the obesity epidemic.  Many studies, like this one, have shown that BPA is associated with weight gain.

To date, the data are not yet conclusive that BPA causes weight gain.  However, given the increasing data of a link between weight gain and BPA, as well as for the others reasons that follow, we try to avoid BPA in our home.

2. Early Puberty

BPA disrupts our hormones.  It has an estrogen-like effect that can alter many hormonal pathways.  For example, it has been well described in the medical literature that BPA exposure can cause early puberty in both animals and humans.  Could BPA be one of the reasons why most girls in the U.S. are now entering puberty now before age 10? 15% of girls enter puberty at age seven in the U.S. About 100 years ago, the average age of puberty for girls was 14 years.

3. Erectile Dysfunction

How does this estrogen-like effect impact men?  In this study, researchers identified 230 factory workers in China who were exposed to high levels of BPA at work and then compared them to a similar number of men of the same age and other characteristics in the same city who were not exposed to BPA at work.  Interestingly, men exposed to BPA at work were four times more likely to have erectile dysfunction.

4. Your Blood Pressure is Too High

In a study published last week in the prestigious medical journal, Hypertension, researchers concluded that even small amounts of BPA from a canned beverage can shoot our blood pressure up for a few hours. In this well designed study, researchers enrolled 60 people and had them drink the same beverage from either a glass container or the standard BPA lined container and then measured their blood pressure and BPA levels in their urine two hours later.

Not surprisingly, the BPA levels in the urine two hours after the drink were more than 16 times higher from the usual BPA-lined container versus the glass container.  Interestingly, the systolic blood pressure was 5 mmHg higher following the drink in the standard BPA-lined container.  Even just 1 mmHg rise in blood pressure is enough to increase your risk of a heart attack over time.

While your doctor has probably told you to cut back on your salt if you have high blood pressure, one of the causes might be BPA.  For my own health, I would much rather reduce my exposure to BPA than eat bland food or take a drug for high blood pressure.

5. You Have ADHD

Unfortunately, the hormonal effects of BPA seem to go well beyond our reproductive health.  Researchers are increasingly identifying that BPA may affect the brain to cause anxiety and hyperactivity disorders in both animals and humans.  In this study of 292 children, researchers found that BPA levels in moms during pregnancy and then later in the child at age five seemed to predict whether or not they developed ADHD.

6. You Have Heart Disease

Many studies have now linked BPA to heart disease.  Studies show that BPA may be a cause of plaque build up in the arteries of the heart, arrhythmias, and even heart attacks.  One large study showed that people with the highest BPA exposure had a three-fold increased risk of heart disease.

7. You Have Breast or Prostate Cancer

It seems possible, then, that if you are exposed to high amounts of the estrogen disruptor BPA in your food and water, that cancer cells could arise in the breast or prostate.  Indeed, many studies have now linked BPA to breast cancer and prostate cancer.

BPA in China’s Longevity Village

As most of you are aware, my wife and I have been studying the factors involved in the longevity and health of China’s centenarians residing in the remote Bapan Village of Southwest China.  In this village where people are often still working in the fields until their 80s, 90s, or even 100s free from medications and the chronic medical conditions we see in the West, historically there was no exposure to BPA.

In this village, the people eat the produce on the day it is picked.  Produce is not stored in any plastic containers.  For millennia they have drunk from the clean mountain springs around their village, once again, free from plastic water containers.  Any fish they catch from the river running through the village is eaten on the day it is caught and never comes into contact with plastic.

Certainly there is a lesson we can learn from these people.  The less our food and water comes in contact with plastics and other chemicals the better.  There is a lot we can do to ensure that what we eat and drink does not touch plastic or other potentially toxic chemicals.

What Can We Do to Protect Our Families from BPA?

Fortunately, for the most part we have a lot of control how much BPA we are exposed to.  With careful attention, we can be part of the 7% of Americans who do not have any detectable levels of BPA in our urine.  Here are my four strategies to rid our bodies of BPA and other potentially toxic chemicals.

1. Only drink from high grade glass or stainless steel containers.

Even if your plastic water bottle states that it is BPA free, I wonder about what other chemicals they use in the plastic to replace the BPA.  Will these chemicals be found to cause problems for our health in the future?

2. Only Use BPA Free Cans

If you like your soda pop then you are probably going to also get a big dose of BPA unless you can find it in an old-fashioned glass container.  Some canned foods, like beans, can be very healthy.  When selecting canned foods make sure you only use BPA free cans.

3. Do Not Touch Receipts

Unfortunately, a large percentage of receipts are printed on BPA lined paper.  Also, you can absorb a significant amount of BPA through the skin.

What should you do?  This may sound a little extreme, but you could say no, thank you to the receipt, or wash your hands if you handled the receipt.  If you need the receipt for business purposes, you could bring an envelope for it.  If you work as a cashier, you could work with your employer to switch to BPA free receipt paper.

4. Avoid Letting Your Food Touch Any Plastic Product

There is so much we can do to avoid letting our food touch plastic.  For example, we use glass containers in our house.  We don’t overfill the glass containers so that the plastic lid does not touch the food.

The same goes for plastic utensils. We should be very wary of heating TV dinners in the microwave as they often come in plastic containers.

Also, at the grocery store, we avoid most packaged or prepared foods in favor of fresh produce.  When we select our fresh produce at the grocery store we generally do not use the free plastic bags they provide.  We just put the produce directly into paper bags and then wash the produce thoroughly before using.

What can you do in your home to minimize your exposure to BPA and other potentially toxic chemicals?

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Sugar, Indoor Plants, Winter Blues and High Fructose Corn Syrup

In this podcast episode I discuss the following four recent studies:

1. Is Sugar the Cause of My High Blood Pressure?

2. Will Indoor Plants Purify My Air and Reverse Asthma?

3. Am I Suffering from Seasonal Affective Disorder (Winter Blues)?

4. Does High Fructose Corn Syrup (HFCS) Just Make Me Hungrier?

To make sure you never miss another podcast, subscribe to my podcast on iTunes.  Please click on this link here to subscribe.

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Air Pollution, Turmeric, Supercentenarians, Stress, and Organic Produce

In this podcast I discuss five recent studies I posted on Facebook this past week.  This podcast is a more in-depth discussion than what I shared on Facebook.  If you would like to receive my daily health inspirational message be sure to “like” my Facebook Page.

Below are the five studies discussed on this podcast and links to the actual studies for further reading.  If you would like to subscribe to my podcast please click here to subscribe on iTunes.  Also, please be sure to leave me a review on iTunes so that we can help others with their health struggles.

1. Dark Chocolate and Blueberries Protect Our DNA from the Damaging Effects of Air Pollution.

2. Turmeric is as Strong as Ibuprofen in Relieving Pain

3. Your Lifestyle, Not Your Genes, Predict Whether or Not You Can Live to 110

4. Psychological Stress Puts Younger Women at Increased Risk for Heart Attacks

5. Three Compelling Scientifically Proven Reasons to Eat Organic Produce

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Intermittent Fasting, Weight Loss, and Longevity

Could the secret to maintaining a normal weight, avoiding chronic medical diseases, and living a long life be as simple as intermittent fasting? Recent research suggests this is true.  Just what is intermittent fasting as is it something you should do?

Caloric Restriction and Longevity

Restricting calories while still getting the right nutrients for health has been shown to dramatically increase the lifespan of everything from the mouse to the monkey.  For example, caloric restriction, without malnutrition, in mice and rats has been shown to not only increase their lifespan by 30-40% but to also allow them to maintain a youthful appearance.

Caloric restriction appears to slow down the aging process through reduced oxidative stress while at the same time protect the heart and help to prevent cancer. Many repair mechanisms in the body are triggered during periods of reduced caloric intake.

Most of us would love to slow down the “sands of time” and maintain our youth and vitality until very late in life.  For me, I would love to be able to ski until well into my 100s.  However, like most of you, I love to eat and could never willingly practice caloric restriction.

These same life extending benefits of intermittent fasting have not yet been proven to occur in humans.  Also, caloric restriction in humans can be potentially dangerous as you have to ensure that you are getting the right nutrients for health or you could quickly undo any potential health benefits of caloric restriction.

The question naturally arises, is there a better way to achieve the same benefits of caloric restriction without all of the “pain” and potential risks? Fortunately, recent data suggest that intermittent fasting may offer the same benefits as caloric restriction.

Intermittent Fasting

Many different forms of intermittent fasting have been proposed and studied over the years.  These have ranged from reducing calories two days each week, popularized in the Fast Diet, to going without food for 12 to 24 hours.

Many different religions have also promoted fasting for spiritual reasons.  Christians, Jews, and Muslims have practiced intermittent fasting for millennia to gain greater spiritual awareness.

For me, growing up in a religious home I was taught from a young age to fast for 24 hours once each month as a means to gain greater spiritual awareness.  Unfortunately, the hunger pain of fasting for 24 hours was usually too intense for me to obtain much spiritual benefit.

Fortunately, recent data has suggested that fasting for shorting periods of time, such as even just 12 hours, could offer the same health benefits as a 24 hour fast.  A twelve hour fast is something that is relatively easy for most people to do and something you may already be doing without realizing it.

As part of my health turn around several years ago, I started intermittent fasting for 12 hours on most days.  This was not something that I specifically set out to do.

Rather, in efforts to lose weight, I told myself that I had to stop eating by 7 pm each night.  By shutting down the kitchen for me at 7 pm, I naturally fasted for about 12 hours each day.  This is now something that I recommend for my patients who are trying to lose weight and live a long and healthy life.

Intermittent Fasting in China’s Longevity Village

Over the last several years, my wife and I have led a research team studying the centenarians in China’s Longevity Village located in Southwest China near the Vietnam border.  Remarkably, this group of people have been able to avoid the chronic medical conditions that plague us in Western countries.  It was common in this rural Chinese village to see people still working full-time in the fields until well into their 80s, 90s, or even 100s free of disease and the need to take medications.

Of the many principles we learned from these people, which will be described in an upcoming book (here is a link to watch our book trailer), one important factor is that they practiced intermittent fasting every day of their lives.  These centenarians all ate an early and light dinner and then went 12+ hours before their next meal.  This was part of their culture and tradition.

Seven Reasons to Become an Intermittent Faster

1. Weight Loss

There have now been several well designed studies demonstrating that intermittent fasting can be a very effective weight loss strategy.  For example, in this study, women randomized to “relative” intermittent fasting two days a week as they were still permitted to eat on these “fast days,” were still able to lose just as much weight as those who cut their caloric intake every day.

From research performed at my hospital in 448 patients, we found that people who practiced intermittent fasting weighed much less than those who do not.  Even more interesting is that these intermittent fasters were not even trying to lose weight!

Personally, reducing calories for just two days a week sounds a lot better, and possibly even more effective, than trying to cut calories every day.  I suspect that the reason for this is that if you reduce calories every day your metabolism slows down so it is hard to gain any ground.  In contrast, with intermittent fasting you can keep your metabolism high while shedding the pounds.

2. Improved Brain Function

When we go without food for as little as 12 hours our body runs out of stored glucose to burn and starts burning fat.  This fat burning process is called ketosis.

By reducing our dependence on glucose for fuel we can protect our brains from the damaging effects of sugar.  Indeed, intermittent fasting has been shown to improve cognitive function and protect against age related degeneration of the neurons in our brains.  Other studies have shown that intermittent fasting boosts brain derived neurotrophic factor (BDNF) which allows us to create new brain connections, repair failing brain cells, and protect healthy brain cells from damage.

Perhaps this is why religious people for millennia have found spiritual enlightenment with intermittent fasting?

3. Prevent or Reverse Cancer

Intermittent fasting is well known to reduce the tumor inducing insulin-like growth factor 1 (IGF-1).  IGF-1 not only increases the risk of cancer but also allows children to grow big and adults to develop increased muscle mass.

Lower levels of IGF-1, from intermittent fasting, have been shown to prevent or even reverse cancer.  A study published this year showed that a drug which blocks IGF-1 can suppress cancer.

Interestingly, there is a rare genetic condition called Laron Syndrome.  People with Laron Syndrome cannot make IGF-1.  As a result, they tend to be dwarfs but yet live exceptionally long lives free of cancer.  Amazingly, if you give Laron Syndrome people IGF-1 during puberty they will grow to a normal height but yet will still be protected against cancer.

There may be other factors also at play which prevent against cancer with intermittent fasting.  One study even reported that intermittent fasting may be as effective as chemotherapy in fighting cancer.  Please note that I am not recommending intermittent fasting as a treatment for cancer.  If you are battling cancer right now or are just interested in trying intermittent fasting, be sure to talk with your physician first before considering intermittent fasting.

4. Prevent Diabetes

The most commonly reported benefit of intermittent fasting in the medical literature is the prevention or reversal of diabetes.  As mentioned above, going without food for 12 or more hours puts our bodies in a ketotic state.  During this period of ketosis, abnormalities in our glucose/insulin metabolism (insulin resistance) can be corrected so that when we resume eating again our body’s will respond appropriately to glucose and insulin.

An interesting study was published on the effect of Ramadan in people with diabetes.  During the month of Ramadan, Muslims fast from dawn to sunset every day.  An added benefit is that for many Muslims, during the month of Ramadan their diabetes may even go into remission.

5. Prevent Heart Disease

Dr. Ben Horne from my hospital has led a number of research studies looking at the role of intermittent fasting to prevent or reverse heart disease.  His studies have uniformly shown that plaque build up, or coronary artery disease, is less common in intermittent fasters.

In listening to my colleague, there are many potential reasons why intermittent fasting may protect the heart.  Foremost is the effect of intermittent fasting on protecting against diabetes and elevated triglycerides.  However, the most recent research from Ben suggests that other factors might also be involved like the reduction of TMAO which has been associated with coronary artery disease.

6. Restore a Healthy Gut Flora

Increasingly more research is emerging about the importance of maintaining a healthy gut flora and preventing leaky gut syndrome in disease prevention.  Intermittent fasting has been shown to promote a healthy gut flora and may be one additional reason why intermittent fasters enjoy better health.

7. Live a Long and Healthy Life

Many studies in animals show that intermittent fasting may confer the same life preserving effects as caloric restriction.  In addition to the above mentioned mechanisms, it is possible that one additional reason why intermittent fasting may allow for longevity is that intermittent fasting helps to put our bodies into the proper circadian rhythm.

This is certainly one factor we observed during our time in China’s Longevity Village.  These centenarians all had a healthy sleep-wake and feeding natural rhythm.  There is a natural rhythm to life that we need to honor to achieve health and longevity.

Do you intermittently fast?  Intermittent fasting may be as easy as just eliminated that before bed snack.

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Is it a Panic Attack or a Heart Attack?

On a Saturday night many years ago, Mary suddenly felt a pain in her chest and her heart was racing.  She immediately thought, this is it I must be having a heart attack. Am I going to die?  She was naturally very anxious while this was happening.

Her husband immediately dialed 911.  Just as the paramedics arrived to her house her symptoms started to ease up.  The paramedics hooked her up to an EKG machine and her heart rhythm was back to normal.  For precaution, they took her by ambulance to the ER.

As they could find nothing wrong with her she was given the diagnosis of panic attacks.  For many years she was given many anti-anxiety medications but nothing seemed to work.  Despite a normal stress test her intermittent symptoms of chest pain and rapid heart beat just kept getting worse.

She thought she was losing her mind and none of her doctors could figure out what was going on.  That was until last Saturday night.  This time it was different.  The pain was much worse and this time her heart did not stop beating fast.

Once again her husband called 911 and this time when they hooked her up to an EKG they saw that her heart was in an abnormal rhythm called supraventricular tachycardia (SVT) and it was beating at 240 beats per minute.

The paramedics immediately gave her an intravenous medication, adenosine, to stop her heart and get it back to normal rhythm.  For many years she had been prescribed anti-anxiety medications for these very same symptoms when in reality the problem was that she had an intermittent heart arrhythmia.

Is it any wonder she panicked during these episodes?  I would panic too if my heart was beating at 240 beats per minute!  Fortunately, once the diagnosis was made, I was able to perform a simple procedure, called an SVT catheter ablation, which allowed her to be cured of this heart condition.  Best of all she no longer needs drugs for anxiety!

This is not an isolated experience.  Rather this is something that I see every week in my cardiology practice.  Generally, it is a younger woman with a cardiac arrhythmia who is misdiagnosed as having panic attacks.

Three Steps to Answer Is it a Panic Attack or a Heart Attack

Since the symptoms of a panic attack and a heart attack are often the same, how can you tell the difference?  Let me give you three things to consider when trying to determine if the intermittent chest pain, rapid heart beat, and anxiety are coming from the heart or not.

1. Don’t ignore your symptoms.

If it really is a heart attack then any delay in getting to the hospital could mean the difference between life and death.  Don’t delay in getting to the hospital, dial 911 if you think you might be having a heart attack.

2. Get a stress test

A simple stress test can help to determine whether or not you have a significant blockage in the arteries of your heart or a different heart condition.  My favorite stress test to perform is a stress echocardiogram or “stress echo”.  I like a stress echo because there is no radiation, no IV in your arm, and it gives you so much more information like heart chamber sizes, heart valve function, etc.

While a normal stress test can make the likelihood of a heart attack very low, it does not rule out an abnormal heart rhythm or arrhythmia problem.  One thing to remember is that in women life stressors can trigger heart attacks.  Mental stress is not fully evaluated with the standard stress test.  If you are under a lot of mental stress this is something that you will need to discuss with your physician.  To rule out an arrhythmia issue you will need an EKG while your heart is beating fast and while you are having symptoms.

3. Get an EKG During the Attack

As heart arrhythmias like SVT or atrial fibrillation are often misdiagnosed as panic attacks in women, it is critical that you get an EKG while you are having symptoms.  Unfortunately, “Murphy’s Law” dictates that your heart rhythm will probably return back to normal before you can rush in to the ER fast enough for an EKG.

As arrhythmias are often episodic, the best way to diagnose this is to have your doctor prescribe a Holter monitor or an event monitor.  A Holter monitor is a monitor that is attached to your chest for 24 to 48 hours.  If your rapid heart beats happen during this period of time then you can easily make the diagnosis.

For people whose symptoms may only happen once or twice a month, the event monitor is usually the better test to order.  Generally speaking, the event monitor is prescribed to you for one month.  You take it off when you shower or go swimming.  The rest of the time your heart is being continuously monitored.

Even with a month long event monitor many people will not have any attacks during this month.  Fortunately, we now have newer options.  For example, the company Alivecor makes an FDA-approved EKG machine for the iPhone and the Android smart phone (I have no financial relationship with this company).

For $199 and a doctor’s prescription you can have your own EKG machine on your smart phone.  As most people always keep their phones with them at all times now you won’t miss this diagnosis.  Currently, I have about 30 patients using this device and all of them have recorded high quality EKG rhythm strips for me to review.

There you have it, my three simple steps to determine is it a panic attack or a heart attack.  Do you suffer from chest pain, rapid heart beat, and anxiety?

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The Top 10 Benefits of Broccoli

George H.W. Bush was quoted as saying, “I’m president of the United States and I’m not going to eat any more broccoli.”

President Obama shared, “Me and broccoli…we’ve got a thing going.”

When it comes to broccoli, I’m with President Obama. I too have a thing going with this superfood.  Broccoli is my favorite food and something I eat every day.

My Relationship with Broccoli

I generally resisted eating vegetables as a child.  In general, the only vegetables I ate were the ones my parents forced me to eat at the dinner table.

All of that changed at the age of 19 when I first fell in love with broccoli.  While living amongst the Chinese immigrant community in New York City, I tasted broccoli in a stir-fry dish at a Chinese restaurant for the first time and it was literally love at first taste.  I never knew broccoli could taste so good.  It was so crisp and packed full of flavor.

Over the years, my love of broccoli has grown and now I don’t let a day go by that I don’t eat broccoli.  My friends who are in the know, tease me and sometimes even make sure that broccoli is offered at their social gatherings, kid’s birthday parties, etc..

My Broccoli Recommendations to My Patients

When I encourage my patients to eat broccoli they often tell me that they don’t like the taste.  My guess is that the only broccoli they, or George H.W. Bush, have tried is the soggy over-cooked forms of broccoli.  Not only does soggy broccoli not taste good, but most of the nutrients have been cooked out of it.

How to Eat Broccoli

I love raw broccoli with homemade hummus.  Lightly steamed broccoli can unlock other health promoting nutrients.  Broccoli is also the perfect addition to any stir-fry dish.

As the nutrients in broccoli degrade quickly with time, we generally purchase a fresh head or two of organic broccoli every couple of  days.  We love it fresh and use it in so many of the foods we make.

The Top 10 Benefits of Broccoli

In addition to the great taste of broccoli, let me give you 10 additional benefits of broccoli.

1. Broccoli Helps Prevent Cancer

It really does not take much broccoli to help prevent cancer.  For example, eating broccoli just three times a month can decrease your risk of bladder cancer by 40%.

It is not just bladder cancer prevention either.  For example, when the glucoraphanin in broccoli is converted to sulforaphane it has been shown to help prevent breast cancer.  Broccoli may also protect against prostate cancer, colon cancer, and other cancers.

2. Broccoli Reverses Heart Disease

It has often been said in the cardiology community that you are only “as old as your arteries.”  If you want to stay young, vibrant, and mentally sharp you have to keep your arteries from developing plaque build up.

Unfortunately, over time, plaque often builds up.  Arterial wall plaque has even been shown to occur in children eating the Standard American Diet (SAD).  Fortunately, the sulforaphane that comes from broccoli has been shown to help scrub the plaque out of our arteries and prevent heart attacks.  Broccoli can also help to undo the damage of diabetes to our arteries.

3. Broccoli Lowers Cholesterol

Is your cholesterol too high?  Did you know that broccoli binds with bile acid in the gastrointestinal track to help lower cholesterol?  Personally, I would much rather take a daily dose of broccoli, in conjunction with other healthy lifestyle habits, than a statin drug for high cholesterol.

4. Broccoli Helps Combat Vitamin D Deficiency

While broccoli does not have vitamin D, it contains vitamins A and K.  In fact, one serving of broccoli provides 245% of the daily recommended amount of vitamin K.

Vitamin K is important because it helps with blood clotting.  Also, the vitamin K and A in broccoli help to keep vitamin D in balance for optimal health. An exciting new area of research is how vitamin K1 can be converted to vitamin K2 in the body.  Vitamin K2 is critical for health as it has been shown to decrease heart disease by 57%!

5. Broccoli Detoxifies Our Body

Every day we are exposed to toxins in our food, water, and air.  Eating broccoli helps our bodies to detoxify these harmful substances.  For example, the molecules in broccoli have been shown to protect against the toxicities of air pollution in the big cities of China.  Broccoli also contains the powerful antioxidant glutathione that helps us to detoxify our bodies.

6. Broccoli Helps Prevent Diabetes

Chromium is an important mineral that regulates blood sugar.  Of all the foods, broccoli is by far the food with the most chromium.  Just two cups of broccoli provides us with 106% of the chromium we need each day.

7. Broccoli Helps Prevent Arthritis

Do your joints hurt?  Broccoli may help to reduce the inflammation in your joints and elsewhere throughout your body.  Indeed, studies now show that broccoli is a great anti-inflammatory for people suffering from arthritis.

8. Broccoli Prevents Colds

When most people think of vitamin C foods they think of oranges or orange juice.  Did you know that broccoli contains far more vitamin C than oranges?  In fact, just one serving of broccoli provides you with 135% of the vitamin C you need for the day.  The next time your coworker is coughing or sniffling just remember to bring a small bag of broccoli with you to work.

9. Broccoli May Prevent Alzheimer’s Disease

Eating broccoli helps your brain to function optimally now and may even help to prevent cognitive decline with aging.  Even the National Institute of Aging now recommends broccoli to help prevent Alzheimer’s Disease.

10. Broccoli Gives Us Great Looking Skin

Broccoli has long been know to help our skin look young.  Once again, the antioxidants and the glucoraphanin to sulforaphane conversion with broccoli is felt to protect our skin against aging.  More recently, broccoli has even been shown to be effective in preventing skin cancer.

In the presidential debate on broccoli where do you stand?  Do you find yourself siding with Bush or Obama on broccoli?

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Should I Take an Aspirin Every Day?

For many years, physicians have asked people with risk factors for heart disease or stroke to take an aspirin every day.  The idea was that an aspirin every day might prevent a heart attack, stroke, or even premature death.  Millions have followed their doctor’s advice and have faithfully taken their aspirin every day.

This past week at the annual American Heart Association meetings in Chicago this philosophy was turned completely upside down.  The results of this study hit the worldwide press and, as I can attest, created quite a buzz after the results were presented.  In addition to being presented in Chicago this past week this study was also simultaneously published in the prestigious Journal of the American Medical Association.

The Daily Aspirin Study

In this study, 14,646 Japanese were evenly randomized to either 100 mg of aspirin or no aspirin and were following for an average of about 5 years.  None of these people had heart problems or a stroke prior to entering into this study.  All of these people were definitely at risk for a heart attack or stroke as they were all at least 60 years old and had high blood pressure, high cholesterol, or diabetes.

At the end of 5 years they found that 2.77% of the people taking aspirin had a heart attack, stroke, or died.  Similarly, they found that 2.96% of the people not taking an aspirin suffered a heart attack, stroke, or died.  Statistically, there was no difference between these numbers.

While aspirin did not prevent heart attacks, strokes, or premature death it did put the people taking an aspirin at much higher risk of a bleeding complication.  The most serious bleeding complication, bleeding inside the brain or skull, was seen in 31 people in the aspirin group compared to just 14 people in the no aspirin group.  Major bleeding elsewhere in the body was also about twice higher in the aspirin group.

The bottom line from this study of more than 14,000 people was that in people with no prior history of cardiovascular problems, an aspirin a day does not offer any benefit.  Moreover, an aspirin every day puts people at a much higher risk of major bleeding.

Should I Take an Aspirin Every Day?

The question now is should I take an aspirin every day?  The answer is it depends.  Here is my take on this study and how I will advise my patients.

1. If you already have cardiovascular disease then this study does not apply to you.

If you are on an aspirin, please continue to take your aspirin under the direction of your physician.  Aspirin has been shown to be protective in people who already have cardiovascular disease.

2. If you take an aspirin each day just to “prevent” a heart attack, stroke, or premature death then the results of this study would argue that aspirin does not offer any benefit and may even put you at risk of a catastrophic bleed.

If your physician has prescribed an aspirin for “preventative” reasons, please discuss with your physician whether or not you should continue this medication based on the results of this study.  I have a link to this study above if you want to share it with your physician.

3. Medications, including relatively “benign” over-the-counter medications like aspirin, can have serious life-threatening complications.

This also applies to supplements which are unregulated and can also have life-threatening side effects.  Medications or supplements should only be taken under the careful supervision of a healthcare provider.

4. The best way to prevent a heart attack, stroke, or premature death is through a healthy lifestyle.

Eating plenty of fruits, vegetables, nuts, seeds, legumes, oily fish in combination with daily physical activity, stress management, restorative sleep, and close relationships is far more effective than any pill at preventing a heart attack, stroke, or premature death.

Have you or a loved one been prescribed an aspirin to prevent cardiovascular disease?  Did the results of this study surprise you?

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Do Processed Foods Cause Memory Loss?

Can what we eat actually affect our memory?  Yes, according to a study just recently presented at the American Heart Association’s annual scientific sessions in Chicago.  This study showed that trans fat, which is common in processed and fast foods, can cause memory loss in even younger adults.

Can You Believe Trans Fat Food Labels?

You may be thinking, “I always read the labels and make sure that I do not buy any food with trans fat.” But sometimes the labels are not clear.

For example, a Fig Newton bar, which is even made with “real fruit” and is freely given to patients at my hospital, lists 0 grams of trans fat.  However, upon closer inspection of the ingredient list you will notice that it contains partially hydrogenated cottonseed oil.

Whenever you see “partially hydrogenated” or “shortening” listed on the ingredient list it is a trans fat.  This is a man made “Franken Fat” that improves the shelf life of the food like substance but decreases our own shelf life.

The problem is with our labeling laws in the U.S.  Many other countries have much stricter labeling laws.  As long as you have less than 0.5 grams of trans fat per serving in the U.S., you can legally advertise “0 trans fat”.  Although technically legal in the U.S., this is deceptive food labeling and many “food” companies participate in this practice.

How Much Trans Fat Do Americans Still Eat?

Another problem is that most serving sizes are not realistic.  Many people eat much more than one measly little serving as defined on the food label.  Also, trans fat is still in so many of our foods such as fast food, pizza, french fries, biscuits, bakery items, and a large percentage of packaged foods.  At the end of the day, the average American has eaten 5.8 grams of trans fat from all of these food like products.

The Dangers of Trans Fat

No amount of trans fat is safe.  Even the FDA realizes this and is working to ban this man-made trans fat from the American diet.  Trans fat dramatically increases both the bad cholesterol numbers and the risk of heart disease.  Trans fat has also been linked to obesity, cancer, diabetes, and depression.  Clearly, our goal is to completely avoid this very dangerous man-made fat.

Memory Loss from Trans Fat Study

This study, recently presented at the American Heart Association annual meeting  in Chicago, was interesting in that even younger adults (ages 20-45) showed significant memory loss after eating trans fat (here is a link to the news report of this study).  Specifically, they looked at 1,018 people and found that for every one gram of trans fat they ate each day resulted in a memory loss of 0.76 words on their memory test.

The biggest offenders of trans fat younger adults remembered 11 less words that those who tried to avoid these man made fat-like chemicals.  As the memory test only involved 104 words, this becomes even more remarkable.  A “healthy” young adult lost 10% of their memory just from eating junk food.

One could not help but ask, how is this memory loss from junk food affecting them in their schooling or with their jobs?  If these young and middle aged adults were showing memory loss from processed foods is it any wonder that Alzheimer’s Disease has also been linked to a diet high in trans fat?

We Are Making Improvements in the War Against Trans Fat

Fortunately, with recent labelling laws and other regulations, we are eating much less trans fat now than we did a generation ago.  Our average cholesterol numbers in the U.S. have been dropping and most feel the major driver has been less trans fat in our diets.  The recent decline we have seen in heart disease nationwide is also felt to be due to lower amounts of trans fat in our diets.  However, if one eats out a lot or purchases processed foods you are still exposed to this dangerous man-made fat.

How to Avoid Trans Fat

To answer the question, do processed foods cause memory loss the answer is clearly yes according to this most recent study.  As the goal is really zero trans fat in our diet, not the deceptive “0 grams of trans fat” that you see on so many food labels, here are my six rules to completely eliminate this toxic trans fat from your diet.

1. Do not eat anything with “partially hydrogenated” or “shortening” listed on the ingredient list.

2. Assume french fries contain trans fat unless proven otherwise.

3. Assume all pastries, cookies, cakes, pies, and other bakery items contain trans fat unless you are shown proof that they do not.

4. Assume anything fried or battered is trans fat until they can prove to you otherwise.

5. Assume anything that tastes like butter has trans fat unless you can see the ingredient list.

6. Assume any popcorn has trans fat unless you air pop your own corn yourself.

Has your memory or brain fog lifted with elimination of processed and fast foods?  What rules do you follow to keep trans fat out of your diet?

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Don’t Drink Your Calories

Do you ever drink fruit juice, sports drinks, energy drinks, or soda pop? If so, you are not alone.

Fully 50% of all Americans consume sugary soda pop, sports drinks, or energy drinks each day. An additional 20% of Americans drink diet drinks each day.

The problem is that our brains don’t register that we are full when we drink our calories. It is almost as if whatever calories we take in with liquids “don’t count” to the brain. Unfortunately, these liquid calories do count toward our waistlines.  Moreover, the effect of all of this sugar to our hunger hormones and metabolism may paradoxically cause us to eat even more.

Do Diet Drinks Help?

Switching to diet drinks does not correct this problem. Study after study has shown that the more diet drinks we take in the more weight we gain.  Even though these diet drinks don’t have any calories, it affects our hunger hormones, metabolism, and gut flora.

NutraSweet and Our Gut Flora

While we don’t get any calories from NutraSweet, disease causing gut bacteria thrive on NutraSweet. These same NutraSweet loving gut bacteria are also the same ones affecting our hormones and metabolism to make us gain weight.

My Former Love of Sugary Drinks

It was hard for me to give up drinking my calories. From a young age I grew up drinking vast quantities of fruit juice. I loved them all; apple juice, orange juice, or grape juice.

Before we knew about all of the dangers of sugar, we thought fruit juice was healthy. We really did not know what were the healthiest drinks.  If fruit juice wasn’t available then we were drinking milk.

Our favorite drink was sugary soda pop. As a child, my parents limited me to just two 12-ounce cans of soda pop each week. However, once I had my driver’s license, I regularly drove to the 7-11 near my high school with my friends to buy the 32-ounce Big Gulp.  In those days the 32-ounce size was the biggest size they offered.

When I became a physician things did not get any better.  For some strange reason, nearly every hospital I have every worked in has offered unlimited free soda pop to physicians and other staff members.

High Fructose Corn Syrup and Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease is projected to be the number one cause of liver failure in the U.S. by 2020.  Approximately one in five Americans now suffers from a fatty liver.

Sugary soft drinks, loaded with high fructose corn syrup, have been strongly linked to fatty liver.  High concentrations of fructose result in excessive fat deposition in our abdomens and can be toxic to the liver.

When I Gave Up Sugary Drinks

By the time I hit my 40s I knew I had to lose weight. At 6’2” and 200 pounds I was overweight with a body mass index of 26. Knowing that sugary soda pop and fruit juice were not helping my weight loss goal, I thought that I would give them up and switch to Diet Coke for “health reasons”.

No Weight Loss with Diet Coke

To my surprise switching from sugary Coke to Diet Coke did not result in any weight loss. I just could not figure it out why I was not losing weight.

Other than changing from sugary Coke to Diet Coke my overall diet had not changed. Why wasn’t I losing weight by cutting out these 384 calories of sugary soda pop each day?

What I did not realize at the time is that my disease and obesity causing gut bacteria were literally feasting on all of the NutraSweet.  By favoring the growth of the wrong gut bacteria, my hunger hormones and metabolism had now been changed for the worse.

Eventually, I came to the realization that I needed to completely cut soda pop out of my life not just to lose weight but to reclaim my health and my energy.  Amazingly, even my near daily headaches went away when I gave up my daily soda pop.

I Still Crave Diet Coke

Although I have, for the most part, given up Diet Coke, I still crave this substance. I, like so many others, had developed a Diet Coke addiction.  Even though I see free Diet Coke all around me at the hospital, knowing how it harms my health helps me to be strong and resist the temptation.

Is Fruit Juice Healthy?

Even though many of us were taught as children that fruit juice is healthy, fruit juice has nearly as much sugar as a Coke and cannot be considered a health drink. The sugar rush we get with fruit juice leads to a corresponding spike in insulin. Insulin then turns all of this sugar into body fat. Even worse, the insulin spike causes our blood sugar to drop and we are just as hungry as ever.

Fruit, on the other hand, is very healthy. The fiber in fruit slows the absorption so we don’t get the same sugar high that we do with fruit juice.  If you love the taste of fruit juice, like me, then blend up the entire fruit and drink it that way.

Learn to Love Water

Clean water is the best drink for our health.  Drinking five glasses of water each day has been shown to decrease your risk of heart disease by 50%.

Even if you don’t like water, like me until recently, you can learn to love the taste.  Indeed, studies show that we can train our brains to love healthy foods including water.

If all you have ever tried is tap or bottled water, branch out and try natural mountain spring water.  You may find that what you don’t like about water is the chlorine or plastic after taste of tap or bottled water.

My Top 10 Healthiest Drinks

If we really want to maintain a healthy weight, we cannot drink our calories. We need to learn to love water and other healthy drinks that do not alter our hormones and metabolism for the worse.

To help you in this process, let me share with you my top 10 healthiest drinks.

1. Water

2. Spruced up water (lemon, lime, cucumber, ginger, mint)

3. Smoothies (fruit, vegetables, nuts, seeds, etc.)

4. Vegetable juice

5. Unsweetened almond milk

6. Unsweetened organic whole bean soy milk

7. Unsweetened coconut milk

8. Unsweetened teas (especially herbal teas)

9. Sparkling water

10. Raw cacao powder to almond, soy, and coconut milk or smoothies

What are your favorite healthy drinks?

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Is Salad Dressing Healthy?

Eating salads are always your healthiest option, right?  Not so fast.  The 20+ chemicals in your typical highly processed ranch salad dressing could harm your health.

It seems like such a shame to take a healthy food, like a salad, and then smother it in chemicals which may hurt our health.  Can we both make the salad taste great and do our body good?

Unfortunately, most people use commercial salad dressings like the one shown in this photo.  I always worry when any product has more than a few ingredients.  In this article I will answer the question is salad dressing healthy, carefully analyze the 21 ingredients in this popular ranch dressing, provide my personal opinion on these 21 ingredients, and offer much healthier and better tasting alternatives.

The 21 Ingredients in a Typical Processed Food Ranch Salad Dressing

Here are the 21 ingredients, listed in order, of the popular ranch salad dressing shown in the photo. Do you really want to put all of these chemicals into your body?

1. Vegetable Oil

In the past, vegetable oils were felt to be better than saturated fats.  New data suggests that vegetable oils may actually increase our risk of heart disease.

I worry about vegetable oils because they are highly processed and contain high amounts of omega 6 fatty acids which have been shown to cause inflammation leading to conditions such as arthritis, asthma, or even cancer.

Also, vegetable oils may be hydrogenated or partially hydrogenated which means they contain the deadly trans fat.  Fortunately, this one is not listed as being hydrogenated or partially hydrogenated.  However, as it is not organic, we can assume that it is genetically modified (GMO) which may cause long-term health effects that we are not aware of yet.

2. Water

3. Egg Yolk

As it does not state “pasture raised” or “organic” these may not be the healthiest eggs.  These eggs likely came from chickens fed processed foods (GMO grains), antibiotics, and hormones.  These eggs are also likely to be much higher in the inflammation producing omega 6 fats.

4. Sugar

Why does a ranch salad dressing need to have added sugar?  This is just one of many hidden sources of added sugars in our diet.

5. Salt

There actually is a lot more salt in commercial salad dressings than you might imagine.  The label indicates there is 260 mg for a two tablespoon serving.  The trouble is that for most people two tablespoons is an unrealistic serving size.  If you assume a four tablespoon serving that equates to 520 mg of sodium!

6. Cultured Non-Fat Buttermilk

7. Natural Flavors

This one always scares me.  “Natural flavors” are not natural at all.  It could be MSG or some other man-made chemical.

8. Spices

Once again, we don’t know what spices these are.  Let’s hope they are healthy spices.

9. Dried Garlic

10. Dried Onion

11. Vinegar

12. Phosphoric Acid

Phosphoric acid is the same thing that is in Coke!  This is a corrosive acid that is also used in fertilizers.  It gives food a tangy taste and helps to prevent the growth of molds and bacteria in sugary substances.

Phosphoric acid may be a cause of osteoporosis and tooth decay.  Phosphoric acid may also be a cause of kidney stones.  This is definitely a chemical that our bodies do not need!

13. Xanthan Gum

While xanthan gum is probably safe, there are reports that it can cause life-threatening necrotizing enterocolitis in children.  Here is a link to this report from the New York Times.  Also, in some people xanthan gum can cause digestive problems.

14. Modified Food Starch

Once again this is a bit of a mystery.  Modified food starch could be wheat, rice, corn, potato, or tapioca. If you are gluten sensitive this could be a problem.

The “modified” here could mean many different things.  It could have been heated or treated with a number of different chemicals, emulsifiers, or acids.

15. MSG

MSG is certainly very controversial. It can cause headaches.  Some research suggests it may cause us to gain weight or develop neurological problems such as Parkinson’s or Alzheimer’s Disease, multiple sclerosis, or ADHD.

16. Artificial Flavors

Once again this is another mystery ingredient.  These are basically chemicals designed to mimic real flavors.

17. Disodium Phosphate

This is a chemical used in processed foods to stabilize the pH of the product.

18. Sorbic Acid

This is a chemical to keep food from spoiling.  It is a preservative with anti-microbial properties.  This food additive, like so many others in this ranch dressing, is on the list of unacceptable chemicals to be included in food by Whole Foods.

19. Calcium Disodium EDTA

This chemical has been shown to be toxic to animals in high doses.  Once again, it is yet another chemical deemed as an unacceptable ingredient to be included in food by Whole Foods.

20. Disodium Inosinate

This is a flavor enhancer chemical typically used with MSG.  In susceptible people this could contribute to kidney or gall stones.

21. Disodium Guanylate

This is yet another flavor enhancer chemical and is often used in combination with MSG.  Once again, this chemical can cause kidney or gall stones in some people.

Healthier Options for Salad Dressings

When it comes to salad dressings it is best to avoid most commercial salad dressings and make your own.  If you are eating out see if they have olive oil and balsamic vinegar that you can put on your salad.

A better option is to make a large batch of salad dressing at home one or two times a week.  Most can be made in under five minutes and stay fresh anywhere from a few days to a week or two in the fridge.

I especially like the French vinaigrette and lemon olive oil dressings on this page.  If you like a more fruity dressing try one of these dressings on this page.  For an Asian salad dressing try one of these on this page.  Other options could be a Tahini lemon dressing or a roasted tomato maple dressing here.  There are so many different healthy and quick options.

Hopefully the answer to “is salad dressing healthy” rather obvious.  It depends.  If you make your own it could be incredibly healthy and tasty!

Do you make your own salad dressing?  What is your favorite?

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How to Be an Optimist

As a cardiologist I have treated thousands and thousands of patients with heart failure, heart attacks, and life-threatening arrhythmias.  I am always amazed at how my most positive or optimistic patients somehow seem to get better, whereas those who are negative or pessimistic seem to get worse.

How can you adopt a more positive outlook to enjoy being healthier and living longer?

In this article, I’ll share with you the important relationship between mindset and health and give you six steps on how to be an optimist.

My Struggle with Negativity and Pessimism

In general, I have always been a positive person.  However, as one medical condition after the next cropped up around age 40, I started losing hope.

I felt great despair at age 44, as I could no longer exercise due to chronic fatigue and severe joint, back, and neck pain.   When I lost my ability to exercise, especially out in nature, a sense of gloom and doom settled in.

In this mindset, things just seemed to be getting worse day by day.  I had lost all hope and felt that my health would just continue to decline until I died.

Optimism in China’s Longevity Village

Fortunately I was shown another possibility when I met the China Longevity Village centenarians.

Every centenarian we interviewed told us that they were living the best years of their lives.  Those that were not yet 100 longed to live in such a way as to achieve this milestone.  Despite the health challenges that come with age, they were grateful, happy, and optimistic people.

Inspired by these people, I returned home and began making changes.  As I did so, I felt better, turning my despair about the years ahead into optimism. And, now this optimism continues to fuel the pivotal lifestyle decisions I make each day.

The Nun Study

Recent studies, such as the “Nun Study,” shed light on the connection between mindset, health and longevity.

In this study, researchers evaluated the diaries of 180 Catholic Nuns born before 1917, written at about age 22.  At age 22, most of these nuns were likely in good health and had their whole lives ahead of them.

When researchers evaluated these diaries they found that those who recorded positive or optimistic thoughts in their diaries lived 2.5 times longer than those who recorded negative or pessimistic thoughts.

How we think at even a very young age can determine our health and longevity over the rest of our lives!

Optimists Are Protected from the Common Cold

Other benefits to optimists include protection from common illnesses such as the cold.

In a study from Carnegie Mellon University, researchers took 193 healthy volunteers and exposed them to two different viruses.

After participants were exposed to these viruses they were then quarantined and watched to see who would get sick. This definitely does not sound like the kind of study that I would sign up for!

Interestingly, those volunteers who did not feel good about themselves or their prospects were more than twice as likely to get sick when they were exposed to the common cold or flu virus.  Not only were the positive people less likely to get sick but they also had much less mucous production as well.

Embrace the Aging Process and Live Eight Years Longer

In a study of 660 people, researchers from Yale and Miami University looked at how people viewed the aging process.  Interestingly, those people who embraced the aging process and were confident that life would get better with time lived 8 years longer than those who were pessimistic about their own future.

Even though health challenges may arise in the future, it is possible, even necessary, to embrace the aging process and find meaning in everything, including the challenges.

I encourage my patients, telling them that I am going to help keep them alive to age 100.  Nine times out of ten, they respond with something like “I hope I die before I get to 100.”  They see increasingly poor health and disabilities in their future. They have more power than they realize to turn things around, both in mindset and in lifestyle.

My goal is to teach my patients and others how to turn it around  from “growing old is no fun” and “the golden years aren’t so golden,” to “this is the best time in my life and it just keeps getting better.”

How to Be an Optimist in Six Steps

How can you experience the proven health and happiness benefits that come with optimism?  Let me give you my six suggestions on how to be an optimist.

1. Be grateful.

Focus on what you have rather than on what you think you lack.  If you can make it a habit to write down or say out loud what you are grateful for each day it can completely change your perspective. For two years now, my wife, Jane, has kept a daily gratitude journal.  She lists each member of her family and writes a specific reason that she is grateful for that person on that day.

2. Minimize time with negative people.

It has often been said that you are the product of the five people you spend the most time with.  If you spend time with negative, complaining people you will become negative or pessimistic yourself.  Find positive and uplifting people and spend more time with them. Seek out and collaborate with people who are striving to reach goals similar to your own.

3. Spend at least 20-30 minutes outside each day

Feeling the sun and spending time outside or in nature changes our whole perspective on life.  Spending time in nature increases your “feel good” hormones which, in turn, increases your positive outlook on life. For me, being outside daily is critical not only for my physical health, but also my mental well-being.

4. Daily Physical Activity

As with spending time outside every day, daily physical activity also increases our feel good hormones.  Exercise also allows our bodies to feel better and when we feel better we tend to have a more positive outlook on life. I find some way to get physical activity daily.  If my work schedule is loaded, I always find a way to do something, whether it’s working at my treadmill desk, taking the stairs, walking in between commitments, etc.

5. Get at least seven hours of blissful sleep

Have you ever noticed how bleak the world looks when you are sleep deprived?  A good night of sleep lifts our spirits and makes the whole world look a lot brighter.  Strive to get at least seven hours of restorative sleep each night. My secret to improved sleep is to commit to an early, consistent bedtime.

6. Meditate, pray, or do yoga daily

Daily meditation, prayer, or yoga brings about a mindfulness that quiets our fears and anxieties.  When we can let go of our fears and anxieties our sense of optimism increases.  Stress and anxiety are often the enemies of optimism. My best stress relievers include physical activity and nature.

What works for you? How are you developing a more optimistic outlook on life?

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Lose 18 Pounds a Year with a 10-inch Plate

Do you clean your plate at each meal? If so, then you and I both are part of the 92% of Americans that have this same habit.

Our brains seem to be programmed to clear our plates.  Don’t fight it. Rather embrace it, and turn what you have to your advantage.  Use a small plate.

My Grandpa Black

Where did this habit of cleaning our plates come from? Perhaps it originated from our parents or grandparents who grew up in times of scarcity and let nothing go to waste.

I remember many conversations as a child with my maternal grandfather who we affectionately called “Grandpa Black.” My Grandpa Black lost his parents and lived on the streets of New York City during the Great Depression.  There, as a homeless child, in the worst of the Great Depression he foraged and begged for food to feed himself and his younger sister for whom he was caring.

Grandpa Black lived this nomadic life never knowing where his next meal was coming from for many years. Fortunately, when President Roosevelt introduced the Civilian Conservation Corps program during the depths of the Great Depression, my grandfather enrolled and was assigned to work in Nevada. This got him off the streets of NYC and into a structured environment. There he met my grandmother and they eventually had my mother.

Having endured hunger and starvation through the Great Depression, my mother was raised to never leave a crumb on her plate. That same philosophy carried over to our home growing up.

When we visited Granda Black, he sternly counseled us to never waste our food.  Everything that went on our plate should be eaten.

Cleaning My Plate as a Child

As a child I remember sitting at the dinner table, sometimes for hours it seemed, until I cleaned my plate. Usually, it was a vegetable or a fish that kept me there.  We were taught to never waste our food.

If 92% of all Americans have the habit of clearing their plates, then I can imagine that most of us were probably raised the same way. Don’t waste your food and clear your plate.

For many of us, our modern life is now filled with an over-abundance rather than scarcity of food.

The 10-inch Plate Turned into the 12-inch Plate

This habit of clearing your plate worked well when we used 10-inch plates in the 1950s. Now 12-inch plates are the norm. Just how we got to a 12-inch plate I am not quite sure.

Unfortunately, along with our plate sizes, our waistlines have also increased dramatically since the 1950s.

According to the Centers for Disease Control, over this period of time, burgers and fries tripled in size!  Sodas are now six times bigger than they were in the 1950s.

Overall, we are now eating, on average, 500 more calories than we did a generation or two ago.

How to Lose 18 Pounds with a 10-inch Plate

Just how much more food will you eat with a 12-inch plate? According to the Mindless Eating organization we will eat 22% more.  While hormones definitely play a role to whether we feel full or not, surprisingly, psychology has as much to feeling full as hormones do. The psychology here is that our brain registers that we have “cleaned off our plate” so we must be full.

So, how much weight could we lose simply by switching plate sizes?

Let’s calculate this together. Assuming that the typical dinner is 800 calories, this switch from a 12” to 10” plate size could translate into 176 fewer calories per meal, or 64,240 fewer calories over a year. As each pound of fat is worth 3500 calories, that could mean an 18-pound weight loss each year–just by reducing the size of your plate for one meal! If you did this consistently throughout the day for all meals, your weight loss could be much more. Best of all, this 18-pound weight loss comes without hunger as your brain thinks you are full because you cleared your 10-inch plate.

This psychology works not only with plates but with bowls, glasses, spoons, or whatever else we put food in. If it looks “full” our brains are more likely to register that we are full.

The Portion and Plate Size Challenge

To help you lose 18 pounds or more without feeling hungry, the key is to take advantage of how your brain has been conditioned.  Since your brain is more likely to think you are full when your plate is cleared off, then keep clearing it off, just with a slight twist.

Give it a try! Here are some tips:

1. Replace your 12-inch plate with a 10-inch plate.

2. Downsize your bowls. The size of a bowl could mean the difference between getting a serving of cereal, or say, 5 servings of cereal without even realizing it.

3. Look for a bowl that has measurement lines.  You may be surprised by how much you are actually getting. Many of us have lost track of what a portion size is, or even the ability to tell when we’ve had enough.

4.Use smaller utensils. Smaller utensils are shown to slow down our eating.  Slowing down allows us to discern our satiety when it happens, not 500 calories later past the point.

5. Use a smaller glass if you drink anything but water. A tall thin glass makes you feel you are getting more while delivering less.  If you drink water, the bigger the glass, the better.  More on this in a future blog.

6. When you eat at a restaurant split your meal with a friend or have them plate half of it on a smaller plate and take the other half in a to-go box.

They key is to keep your smaller plate, bowl, or glass “very full” without overeating.  Take advantage of they way your brain has been conditioned and lose 18 pounds each year without ever feeling hungry or deprived!

What size plates and bowls do you use in your home?  Has the smaller plate movement helped you keep portion sizes in check?

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Should I Eat Fish?

Do you like fish?  Based on its profound health benefits, you may decide to become a fish lover, if not one already.

If you eat at least two servings per week, studies suggest that you can extend your life by 2.2 years!  Not only will you live longer but fish will also decrease your risk of heart disease by 36%, help to prevent dementia, lower your triglycerides, and lower your blood pressure.

In this article I will discuss the health effects of eating fish and answer the question, should I eat fish?

My Fish Story

I did not always like fish.  In fact, I hated fish until this past year.  I hated the smell, texture, and taste.  Now, at the age of 47, I can say for the first time publicly that I like fish.

I am not really sure how I finally came to like the taste of fish.  It was something that happened very gradually.  As I became increasingly convinced of the health benefits of fish, I forced myself to start eating it.  Slowly, over time, I began to enjoy the taste.  Now I love my wild Alaskan salmon!

Indeed, it has been scientifically proven that people can learn to like foods they previously hated.  This was certainly the case with me.

Live 2.2 Years Longer by Eating Fish Study

Can eating oily fish really allow you to live longer?  Yes, according to a recent study by my friend, Dr. Dariush Mozaffarian, at Harvard University.  I should mention that Dariush and I did our residency training together many years ago at Stanford University in the 1990s.

In Dariush’s study of 2,692 people followed for 16 years, he found that the highest oily fish eaters not only lived 2.2 years longer but also had 40% lower risk of dying from heart disease, 47% lower risk of dying from a stroke, and a 45% lower risk of dying from an arrhythmia.

Dariush concluded in an interview that the minimum amount of oily fish needed to get these benefits seen in this study works out to be about two servings per week.  If a life long fish hater, like me, can learn to like fish at the age of 47 then this is something that we can all learn to like.

American Heart Association’s Fish Recommendations

Based on the very strong scientific data supporting fish in our diets, the American Heart Association recommends that we eat at least two servings of fish each week, preferably an oily fish high in the omega 3 fatty acids.  Despite these recommendations, less than 1 in 5 Americans follow these guidelines.  Even scarier is that about half of us really don’t eat fish at all.

Can I get all of my omega 3s from nuts and seeds?

Not all omega 3 fatty acids are created equal.  The omega 3 fatty acids in walnuts, chia seeds, hemp seeds, or flax seeds are the short chain omega 3s (ALA).  The omega 3s in fish are the long chain omega 3 fatty acids or EPA and DHA.  EPA and DHA have the best track record for long-term health benefits.

While the body can convert some of the shorter chain omega 3s from walnuts, chia seeds, hemp seeds, and flax seeds to EPA and DHA, most of us will be lacking in these critical omega 3s unless we eat fish.  For vegetarians, you can get your DHA and EPA from where the fish do, namely marine algae.

Why do so many people avoid fish?

I suspect that the media’s hyped fear of mercury, dioxins, and PCBs in fish has frightened so many people from eating this incredibly heart healthy food.  Fish is healing food for the heart and brain.

Unfortunately, these industrial pollutants have made their way into our food supply, including fish.  However, as long as you are eating the right fish in the right amounts you don’t need to worry about mercury, PCBs, or dioxins.  Let me explain.

Mercury and Fish

Unfortunately, the fish available to us today is not the same fish that was available to our ancestors.  Today, we have to worry about mercury toxicity with fish.

While the media would have us to believe that any fish will poison us with mercury that it absolutely not the case.  Many of my patients are afraid to eat fish based on all of these media reports.

Yes, it is true that some fish are high in mercury.  However, many healthy oily fish, which are high in the protective omega 3s, are also very low in mercury.  In general, the smaller the fish the lower the mercury content.  Some of the fish which are very high in omega 3s and yet very low in mercury include the following:

   -Wild Alaskan salmon

   -Atlantic mackerel

   -Sardines

   -Anchovies

   -Trout

   -Oyster

   -Herring

Selenium Prevents Mercury Toxicity

While the media has done a good job of scaring us away from fish due to mercury risks, what they don’t tell us is that selenium binds mercury and gets it out of our body.  Fortunately, many fish are also very high in selenium so any potential mercury risks in these fish is extremely low.

Previous studies showing harm from mercury in fish were done with shark or pilot whale meat which are very low in selenium. For example, just one serving of salmon, sardines, tuna, or shrimp nearly give you all of the selenium you need for the day.

As the right amount of selenium in your diet has been shown to help protect against cancer and heart disease, to make sure you are getting enough just one Brazil nut will give you all the selenium you need for the day.  Work closely with your doctor if you are taking a selenium supplement as selenium supplements have been shown to cause harm.

PCBs and Dioxins in Fish

Once again, the media would scare us from eating fish due to the risks of PCBs and dioxins.  While we should be frightened of PCBs and dioxins from industrial pollution, fish is not where we get most of these carcinogens.

For example, according to a Harvard University report, more than 90% of the PCBs and dioxins we are exposed to come primarily from animal meat, dairy, eggs, and to a much lesser degree from vegetables.  Thus, if you are really frightened of PCBs and dioxins then you should also limit your intake of animal meat, dairy, and eggs.

This Harvard University report also states that if 100,000 people ate farmed salmon, which has 16 times the amount of PCBs and dioxins as wild salmon, for 70 years that it would cause 24 deaths from cancer.  However, eating farmed salmon over this same period of time would also prevent 7,000 people from dying of heart disease!

For me, I want the best of both worlds.  I want all of the protection salmon has to offer without the risk of cancer.  This is why I choose wild Alaskan salmon which is 16 times lower in these contaminants according the the Environmental Working Group and I eat one Brazil nut each day.

Can I just take fish oil instead of eating fish?

Perhaps it is because you don’t like the taste of fish or that it just is easier to take a pill.  Unfortunately, when it comes to health it doesn’t work that way.  Many vitamins and supplements, including vitamins C and E, beta-carotene, folic acid, estrogen, and testosterone, have all been linked to heart disease or cancer.

Fish oil is no exception.  Even fish oil, with its healthy halo effect, has been linked to prostate cancer.

It is a combination of everything in healthy fish that provides us with the health benefits not just a concentrated form of the omega 3s.  Nutrition is so much more than just isolated and concentrated compounds.  If you don’t like the taste of fish it has been scientifically shown that you can retrain your brain to like healthy foods.  I know this was definitely the case with me.

Nutritional Benefits of My Favorite Fish

It was probably knowing all of the good things I was feeding my body that allowed me to start liking wild Alaskan salmon.  Here are some of the amazing health benefits you get from just one four ounce serving of this salmon according to WHFoods website.  Even better, all of these nutrients come with only 158 calories!

   -Vitamin B12: 236%

   -Vitamin D: 128%

   -Selenium: 78%

   -Vitamin B3: 56%

   -Omega 3: 55%

   -Protein: 53%

Dr. Day’s Personal Fish Rules

While my diet is primarily plant based, I do eat healthy fish at least twice weekly because of the compelling health benefits and also now because I like the taste.  It did take two years of forcing myself to eat fish every week before I finally started liking the taste.  Here are my personal guidelines to eating fish:

1. Eat fish twice a week.

2. Focus on oily fish with the omega 3s.

3. Avoid the fish high in mercury, dioxins, and PCBs.

4. Get the right amount of dietary selenium to bind mercury.

5. I avoid fish oil supplements due to the link to prostate cancer.

To get back to our original question, should I eat fish?  My answer would be yes given the many health benefits of fish.

Have you always liked fish or did you learn to like it like me?  Do you have a favorite fish? Please leave me a comment and let me know!

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Lose Belly Fat with a High Healthy Fat Diet

Could consuming a liter of olive oil weekly actually help you lose belly fat? According to the latest study, it does.

Indeed, numerous recent studies are showing that replacing simple carbs with healthy fats can help to shrink belly fat.

This goes against everything the American Heart Association and our government taught us for years about eating a low fat diet to lose weight and avoid heart disease. Even the most recent dietary recommendations from our government recommend eating up to a half pound of carbohydrate loaded grains each day.

What would happen if we replaced some of these grains with healthy fats? The key take away from this article is that eating healthy fats will not make you fat but rather could help you to lose the belly fat. It may seem counter intuitive but please read on…

My Transition to a High Healthy Fat Diet

I was no different that the typical American kid growing up in the 1980s. In the 1980s my diet was about 15% protein, 15% fat, and 70% carbohydrates. I dutifully followed the dietary guidelines at that time and drank skim milk, used low or non-fat items, and ate my recommended 6-11 servings of grain each day.

During this period of time, and into the 1990s, I was extremely active physically.  I regularly ran marathons and even started training for an ultra marathon.  Despite these extreme levels of exercise I was still gaining weight on my high simple carb diet (lots of breads, pastas, and pastries).

Things only got worse in the 2000s when high blood pressure, high cholesterol, eosinophilic esophagitis, and an autoimmune disease, among other conditions, also developed. As part of my health turn around a few years ago, I dramatically changed my diet by increasing vegetables 4x and fully embraced a diet full of healthy fats.

Today, my diet is still about 15% protein but now my carbs have dropped from 70% to 40-45%, and my fat has gone from 15% to 40-45% of my diet. The simple carbs have mostly been eliminated  and my nuts and seeds consumption have increased about 10x. Eventually, our government will be forced to acknowledge the ever growing body of scientific data that a diet higher in healthy fats can reverse heart disease, allow us to lose weight, and feel better.

A Balanced Diet

You can’t exclude one of the three macronutirents (fat, protein, carbs) from your diet and expect a healthy outcome. A healthy diet is a healthy balance among the three macronutirents.  My 40-45% fat diet is much higher than the 20-35% currently recommended by our government.

At the same time, my 40-45% fat diet is much lower than the ketogenic diet followers who often target somewhere around 70% fat intake. For me, it is important to keep everything in balance and avoid the extremes until the scientific literature, based on long-term studies, can support these approaches.

From a historical perspective, it is interesting to note that in the late 1800s/early 1900s protein was considered unhealthy. In the late 1900s it was fat that was demonized.  Now in the 2000s it is the carbs.

We absolutely need the right carbs for optimal health, nutrition, and energy. For example, from a scientific stand point, the data supporting fruits and vegetable carbs for long-term health, including cancer and heart disease prevention, are irrefutable.

The Most Recent Study on a High Healthy Fat Diet

In one of the most scientifically rigorous diet studies ever done, researchers have shown that once again people are healthier with a high healthy fat diet. In this study, researchers analyzed 5,801 people randomized to one of three diets.  The three diets evaluated in this study were as follows:

1. Mediterranean Diet with one liter of olive oil each week
2. Mediterranean Diet with one serving of nuts daily (walnuts, almonds, and hazel nuts)
3. Standard low fat diet

The Mediterranean Diet is one also high in fruits, vegetables, fish, nuts, and seeds.  There was no exercise or weight loss goals with this study.  It was purely a diet study for 5 years.

After 5 years, researchers found that those who ate the Mediterranean Diet, supplemented with either a liter of olive oil each week or a handful of nuts each day, had less belly fat and lower triglycerides.  Not only this, the people eating the high healthy fat diet were also 35% (olive oil) and 28% (nuts) more likely to reverse the deadly metabolic syndrome.

Metabolic syndrome is a dangerous condition when at least three of the following are present in a person: excessive belly fat, high blood pressure, high blood sugar, high triglycerides, or low good cholesterol (HDL).

While I do love olive oil, I am still amazed that the people randomized to the olive oil group in this study could eat a liter of olive oil each week and yet not gain weight!

Why are fats healthy?

Don’t be fooled by the fat free label you see in the grocery store! Healthy fats are part of a healthy diet.

Fats are healthy as there are essential fats that our bodies cannot make and that we must get from our diet. Healthy fats are also filling and don’t mess up our hunger hormones and metabolism like a high carbohydrate diet can. The right fats can even reverse heart disease and keep us healthy, vibrant, and strong.

Keep the Right Carbohydrates

In this article I do not want to demonize all carbs.  The simple carbs, like sugar, wheat flour, white rice, processed foods, etc. should be minimized. The complex carbs, like fruits and especially vegetables, should be encouraged at all meals.

I fully support the current 9 daily servings of fruits and vegetables recommended by the American Heart Association. Of these nine daily servings, I would recommend that at least six be vegetables.

What are the healthy fats?

You may be wondering, what are some other healthy fats other than the olive oil and nuts mentioned in this article. Seeds are also loaded with healthy fats. Coconut, avocado, and olives are other great fats. Also, be sure to include the omega 3 fatty fish like Wild Alaskan Salmon, Atlantic Mackerel, sardines, or anchovies.

Dr. Day’s Personal Fat and Carb Rules

Here are my rules as to how I approach fats and carbs in my own diet.

1. I minimize simple carbs

2. I eat at least 9 servings of fruits and vegetables daily (healthy carbs)

3. I eat at least 1 serving of beans or lentils daily (healthy carbs)

4. I eat a variety of nuts and seeds every day (healthy fats)

5. I use organic extra virgin olive oil or coconut oil (healthy fats)

6. I eat Wild Alaskan Salmon at least twice weekly (healthy omega 3 fats)

7. I eat some form of omega 3 fats every day (salmon, walnuts, flax seeds, hemp seeds, chia seeds)

8. I do all I can to avoid hydrogenated/partially hydrogenated oils, vegetable oils, and other “Franken oils” found in processed foods

Do you still find yourself afraid to eat fats, even healthy ones? Why is this? Have you found better health by liberally eating healthy fats? Tell us about it!