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Ten Commandments of Good Health


Many years ago a desert dweller climbed a mountain and talked to a bush on fire.  What resulted was a set of laws that was to revolutionize mankind’s behavior.  These were not ten suggestions formulated by a long range planning committee nor were they ten proposals put forth by a strategic consultant, they were commandments from a Holy God.  These laws have become almost universally accepted, even by divergent religions, as wise and worthy of adopting. 

     With all humility and a sincere desire to be unpretentious (I am not even worthy enough to scrape the grasshoppers from Moses’ designer goat skin sandals), I propose the Ten Commandments of good health to serve as a lamppost for your journey down fitness lane.  It seems unfair to hurry through these guidelines, so I will opine in both this month’s and next month’s column to cover them all.

                                                      Commandment One

You Shall Exercise:

Live Longer, Reduce Stress, and Grow Your Brain

     Exercise is the elusive fountain of youth.  If you are heavy, harried or hormonal, moving with purpose is a critical part of the solution. Everyone knows exercise is good for you, but few of us follow through. Exercise begins above the neck with a commitment to self and family.  Part of this motivation lies in the hidden benefits of exercise that are not common knowledge such as the prevention of breast and prostate cancer,  reduction in the onset and progression of Alzheimer’s disease, and as a cure for clinical depression.  Start with a simple walking program and free yourself from the “couch of doom”.

Commandment Two      

You Shall Rest:

A Nap a Day May Keep the Doctor Away

     We live in a hurry-up culture where “Just Do It” supplants “Let It Be”. Busyness has be­come a virtue that is without merit.  Idle hands are the devil’s playthings only in those who haven’t learned the discipline of relaxation.  Certainly there is a place for goal setting and industrious behavior, but there is also a purpose in rest and play. Relaxing on purpose is healthier than just doing something aimlessly. A major area of our lives that is most affected by this culture of chaos is sleep. The average adult requires eight hours of restful sleep a night to function best the next day.  The average adult actually gets around six hours of sleep a night.  This obvious disconnect leads to chronic fatigue and foggy thinking.  40% of Americans (100 million people) are moderately to severely sleep-deprived!

Commandment Three     

You Shall Not Worry:

Make Stress Work For You

     Stress is the little yapping dog biting at the heels of our health.  It is generally an annoyance, but, if it goes on long enough, can become a festering wound.  There are a number of books and counselors that provide a wealth of guidance on effective stress management in a world that oozes anxiety.   Studies indicate that up to 75% of visits to doctors are related to anxiety.  Stress is simply a perception of an internal or external event and thereby can be influenced by our thoughts.  One person’s stress is another person’s opportunity.  You will never be without stress, but you can control and minimize the adverse effects. 

Commandment Four 

You Shall Get Checkups:

                                          Prevention Pays Lifelong Dividends

     A healthy mind and body is dependent on action and education, not passivity and ignorance.  You must be an advocate for you and your family’s well-being by embracing prevention.  Men are especially negligent in this arena, and often decisions regarding family health are delegated (by default) to women in the household.  Seventy percent of health decisions involving the family are made by mom, which includes checkups, vaccines, nutrition, and screening tests.  Most importantly, the woman, by her actions and decisions, sets the tone for current and future health decisions.  A major health care crisis today is not cancer, AIDs, or heart disease, but people not making healthy, proactive lifestyle decisions.  We have to transform a system based on sick care to one that truly embraces well care, and that can only be achieved by practicing individual, responsible prevention.

Commandment Five

You Shall Not Be Gluttonous:

Eat Your Way to Good Health

     

     We are often called a society of consumption.  The talking heads are referring to consumerism; however, the real consumption issue is what we eat.  Our diet has more of an impact on our health and longevity than almost any other activity.  Content and quantity are the evil twins of gluttony.  There are four simple guidelines that, if followed consistently, will provide a foundation of healthy nutrition that will build a legacy of wellness.  Simply stated, eat balanced, low fat, low sugar, and high fiber meals. It is possible to alter the health inheritance of our kids and grandkids by changing how we think about food.  You can spring the family from the prison of poor nutrition and not be held captive by your genetics through a simple and doable eating plan.  We truly are what we eat. 

Next month…what else but six through ten!

Healthy Tips

A celebration is often the result of an accomplishment, a special event , or honoring memories.  These are good things, but do we really need the “special” to warrant a celebration? Wouldn’t it be great to be able to delight in the relatively mundane?  Some of the happiest folks I know are those who relish just being able to get out of bed in the morning.  We can celebrate our health, good or bad, by reflecting on what a true miracle it is that all these billions of cells are working in concert to allow us to walk, run, think, eat, love, write, and even occasionally complain.  In celebration of simply being alive, I have compiled a list of healthy tips (or rambling recommendations) collected over the years to promote, extend, repair and rekindle your health.  Let the celebration begin!

   

People who rarely spend time outside (elderly, housebound) are at a greater risk for osteoporosis due to a lack of vitamin D, which is increased in sun exposure.  400 IU a day in supplement form can help prevent brittle bones.

Taking 400 micrograms of folic acid a day before getting pregnant can reduce the likelihood of neural tube defects in the baby (spina bifida, etc.)

Exercise 30 minutes every day.  The more and bigger the muscles used, the less time needed to achieve fitness (cross country skiing best, walking is good, using the channel changer is bad.)

The more colorful your meals the better. Bright colored fruits and veggies contain greater anti oxidants and other protective substances.

Use herbs (Black Cohosh) and vitamins (E) to control mild menopausal symptoms.  Many are scientifically valid and may work for you.

It’s not brain surgery; to eat healthy go low fat, low sugar, high fiber and balanced.

Eliminate soft drinks.  An extra can of soda a day can add 15 pounds in a year.

Almost half of all doctor visits are stress related.  A great tool for stress management is regular, aerobic exercise.

The solution to permanent weight loss is not dieting, it is getting fit.  Only muscles burn fat, and only muscles that are used!

If you are pressed for time, three ten minute exercise sessions can be as helpful as a single thirty minute segment.

Most women over twenty need to take some extra calcium (500mg) The better the bones before menopause, the better they are afterwards.

Eating habits are formed at an early age.  Teach children as early as two to be aware of good and bad food choices.

Don’t focus on weight.  Your per cent body fat and/or your Body Mass Index (BMI) are better measures of health.  Throw away the traditional scales and get a device that calculates body fat and BMI.  They are reasonably priced and accurate.

A good doctor will always encourage and support getting a second opinion…so in important decisions, do just that.

Don’t limit yourself by thinking that health is strictly physical.  Wellness is a balance of mind, body, and spirit.

Don’t skimp on preventive care.  The Pap test and mammogram have saved millions of lives.

If you have a strong family history of ovarian cancer (in mother or sister) demand a yearly sonogram and CA-125 blood test to check your ovaries.  It is far from a perfect screen, but it is the best available so far.

Young women (ages 9-26) who are not yet sexually active should strongly consider getting vaccinated against the Human Papilloma Virus (HPV). It is the single biggest cause of pre-cancer and cancerous changes in the cervix.

Acupressure has been effective for the nausea associated with early pregnancies. The most common device used is “Sea Bands”, an elastic band that applies pressure to a point on the wrist.

Caffeine consumption is one of the leading causes of bladder problems in women.  Eliminating caffeine from the diet may reverse symptoms of incontinence, frequency, and urgency.

Some women in the menopause need testosterone supplementation along with estrogen and progesterone to help with a lagging sex drive.

Many herbal medicines and treatments can interact with prescription drugs.  When getting your yearly checkup, don’t forget to tell your doctor about any supplements or herbs you take on a regular basis.

Before any surgery, always stop taking Ginkgo, Ginseng, Garlic, or vitamin E.  They can increase bleeding and lead to problems with the surgery.

Always bring two things to every doctor’s visit: a written set of questions and a list of your current medications.

20 percent of cancer deaths are related to obesity.  Maintaining a healthy weight may be your best guard against developing cancer.

Aerobic exercise might be better for your brain than your body.  Early studies show that exercise can cause damaged brain cells to regenerate, possibly thwarting diseases like Alzheimer’s.

The average person makes about 250 decisions about food every day and most people don’t have a clue as to what influences their choices. Consciously think about what you are eating and you will generally eat less.

A massage once a week can not only reduce muscle fatigue and soreness, but it can be just as good for stress management as a session with a counselor.

The quickest way to get fit with exercise is to WALC.  Wind sprints (just periodically increase the intensity of the exercise) Aerobic (this type of exercise burns fat) Lift (lifting weights builds muscle, which in turn increases metabolism) Cross train (vary your exercise regimen and you will get fit faster).

We hope you’ll find these healthy tips useful!

Menopause or Mental Pause?

     Aileen blew into my office like a Summer storm.  “Help me, I’m a poster child for Hormones from Hell!”  After catching my breath, I assured her that there were many ways of dealing with the ravages of hot flashes, dry skin, mood changes and forgetfulness.  I started by reinforcing that menopause is not a disease. Inaccurately and unfortunately there is a pervasive sense that menopause is the “ultimate and inevitable bad experience” for aging women.  I jokingly explained that women were not designed to self-destruct at fifty!   

     Menopause is a normal, natural transition, and it is vital for women to view it with a positive perspective.  That simple understanding is the cornerstone in building a plan to thwart the symptoms of “the change.”  But it is equally important to realize that not everyone has a problem with menopause.

      As a physician, my experience treating menopausal women is that there are some universal similarities in women’s experiences, but because of every person’s unique physiology and life journey, this time in a woman’s life is very individualized.

      I am a “recovering traditionalist”.  I was trained in the old school approach to menopause (which means drugs, and if that didn’t work, more drugs). In almost thirty years of practice I have found that many women are not satisfied with their options and many discover that their “treatments” are worse than their symptoms.  Especially in this age of “estrogen panic” where the media (and many physicians) has touted misleading and confusing advice on hormones, many women are looking towards alternative treatments for their symptoms. One woman put it well.  She said, “Physicians have a duty to give a woman the best care they can provide, especially their options.  However each person is ultimately responsible for his or her own health.  We, the patients, need help, guidance, and a listening ear.” Those were powerful and challenging words.

   The general dissatisfaction among women is amplified by the observation that only 17% of eligible women in the US are taking some type of hormone replacement and up to 80% of women who start on hormones stop them after two years!  The needs of women are not being met!  This problem with compliance is due to poor communication and fear.  After all, treatment of symptoms is not limited to simply taking a drug.  Successfully navigating the potentially turbulent waters of menopause requires a more comprehensive approach.

Herbs, complimentary teachings, diet, and exercise all should be discussed along with hormones.  The main caveat surrounding these modalities is that they must be held to the same standard and scrutiny that safeguards traditional hormone replacement.

The major problem in meshing the traditional and complimentary approaches to health is a mistaken perception of mutual exclusivity.  These treatments can coexist and be complimentary.

  I am saying that choice and personal responsibility are keys to unlock a joyous menopause.

      This is an opportunity to live with passion and fulfill your life mission. This is a time to take stock of the past and choose your path for the future. The choice is yours. It is a choice that is difficult if not impossible to make wisely without sound information and guidance

Brain Food

     “I’m not kidding; it’s Miracle-Gro for the brain!”  The statement reminded me of some ridiculous infomercial infecting late night TV.  In this case however, it was generated from the mouth of a world class neurobiologist, so I took notice.  He was speaking of a substance called Brain Derived Neurotrophic Factor (BDNF).  What immediately intrigued me was he claimed that BDNF was the link between exercise and improved brain function.  For years I had read articles in both the medical and running journals touting the psychological benefits of fitness, yet here was proof that fit folks were happier folks.  Dr.John Ratey, a clinical professor of psychiatry at Harvard, outlined in his amazing book “Spark: The Revolutionary New Science of Exercise and the Brain” how exercise increased the production of BDNF which in turn stimulated nerve cells to grow and connect in the Hippocampus, a tiny area in the brain responsible for a number of high level functions. This growth of new cells actually translated into better memory and quicker learning.  He went on to claim that certain other chemicals were released by exercising muscles that improved functioning in the amygdala, the emotional center of the brain.  The implications of this and other research are monumental. 

     Twenty-five years ago when I was in medical school we were taught that we were born with a set number of neurons (brain cells) and there were no more to be made…period.  I remember joking in college about taking another late night excursion to the disco (yes, I am that old!) to “kill some brain cells” with Singapore Slings and Jack and Coke.  We didn’t fret about the wholesale slaughter of brain cells as we all knew from biology class that we only used 20% of our brain anyway.  In our way of thinking, that gave us a pretty good cushion!  It was the unlucky folks born with fewer brain cells, and we all knew a few of those, who had the most to fear.  We were wrong on all accounts.  Now research is proving that new brain cells can be created, and formed in areas that have a major effect on cognition and emotions.  Don’t take this as permission to guiltlessly get plastered; I don’t need to tell you of the disastrous effects of that, but it does open the door for medical miracles.  The study of such alphabet soup as BDNF, IGF-1, and VGEF and other neuropeptides has given hope to developing successful treatments for senile dementia, Alzheimer’s and Parkinsonism.  Medicine is not there yet, but we can conclude that getting fit by exercising regularly can reduce the incidence of these diseases as well as certain cancers and diabetes. 

     The great news is that you don’t have to train for a marathon to reap the benefits of fitness. The studies indicate that a brisk walk for 45 minutes three to four times a week can elicit these life enhancing outcomes.

    

One of the most exciting applications of this knowledge is illustrated by the Naperville school district.  A middle class suburb south of Chicago, Naperville has been the focus of a real-life experiment documenting the benefits of fitness in kids.  It is no surprise that kids who are active are more physically fit than their sedentary counterparts, but what has been found in Naperville is that these fit kids are also smarter!  Over the past seventeen years the school district, consisting of 11 elementary schools, five junior high schools and two high schools, has made physical education an integral part of the school day (unlike the national average where only 6% of high schools have a daily PE program).  Their gym class is not your typical dodge ball, basketball, softball curriculum (the average student in the typical hour long PE class spends 16 minutes actively moving).  It is a program that promotes and measures fitness, not competition, and grades based on effort, not ability.  They regularly run or ride bikes using donated treadmills and stationary bikes measuring effort by heart rate monitors. And they do it at a lower cost per student than comparable school systems!  The results have been amazing.  In 2002, 97% of entering freshmen were at a healthy body mass index (BMI) as compared to the national average of 65% and most striking was the impact that fitness had in the classroom.  In that same year 96% of the eighth graders took the Trends in International Math and Science Test, an instrument designed to compare student’s knowledge level in different countries around the world.  On the science part of the test the Naperville students scored the highest…in the world!  Through a strict and comprehensive analysis it was shown that regular physical activity and fitness level correlated with the academic success of the Naperville students!

     The message is clear.  For adults and kids alike, regular aerobic exercise is not only good for the body, but it is great for the mind.