A couple of months ago a patient of mine came in wearing a pedometer known as the fitbit. I was intrigued. It calculated her steps; calories burned and could be used at night to see how well she was sleeping. I decided to try it out and experience it for myself.

What I found was something that has taught me quite a bit about my own health habits. First of all, I realize that there are some days when I feel that I have run myself ragged at work, and in reality I have taken half as many steps as I would have guessed.

In addition, I burn far fewer calories than I expect regardless of how many steps I take. I wondered why I was unable to lose weight recently. Now I know why. I am just not burning enough calories in spite of how much I am exercising. I eat a healthy diet but apparently my portion sizes need to be smaller.

As far as sleep goes, I now know that it takes me an average of 7 minutes to fall asleep and I move on average 10 times during the night. My fitbit program gave me a 95% sleep efficiency rating, and I am satisfied with that.

When the people at work saw my fitbit, they all decided to get one and before I knew it they were starting a competition. I have been trying to get them all fired up for fitness for the last couple of years. I have tried nutrition games, biggest loser competitions, and many other programs and finally I found a hook. They have all lost weight and they are looking really healthy.

There are many slick pedometer and sleep monitoring programs out there. In addition to the fitbit there are bracelets. One is Up by Jawbone and the other is the Nike fuel band. They all do the same thing. The bracelets are definitely more stylish. I like the fitbit because it clips to anything and has a firm fit. It is light and inconspicuous and it talks to me in the morning.

When I pick it up off the counter it flashes all kinds of words of encouragement to me. It tells me that I rock. No one recently has told me that! I love it. It encourages me to keep walking and burn calories. I look forward to what it has to tell me every morning.

If you need encouragement to keep walking, and you want to know how much exercise you are doing and what you are burning, I suggest any one of these devices to help you. It is amazing what you might find yourself doing to add to your steps for the day. What is even more wonderful is that these little devices will put a spring in your step and a healthy glow on your face.

Once upon a time, people used to think that hormone replacement therapy after menopause was a risk-free proposition. In fact, way back when, some doctors thought that every woman ought to go on hormones at menopause and stay on them for the rest of her life. Then came the Women’s Health Initiative, raising questions about the safety of these hormones, and women got scared. I have many patients who come to me terrified of taking hormones, and as a result they have suffered with severe hot flashes, insomnia, mood swings, and vaginal dryness.

But the truth is somewhere in the middle: These hormones are too big a risk for some women, but can be a big help for others. So it’s worth noting that a recent consensus statement, published on behalf of seven international menopause and women’s health societies, has deemed hormone replacement therapy (HRT) to be relatively safe in women who are under 60 years of age or within 10 years of menopause. Here are some of the highlights of the statement:

- HRT may prevent osteoporosis-related fractures in women who are at risk of these debilitating bone breaks.

- The use of estrogen-only hormone replacement can help in the prevention of heart disease.

- When these hormones are taken orally (as opposed to being used in skin patches, for instance), they can increase the risk for blood clots and stroke.

- Women who use a combination of estrogen and progesterone may have a slightly higher risk for breast cancer.

I am glad that the relative safety of HRT for women under 60 has been acknowledged. But even this consensus statement makes the therapy seem a little riskier than it is when it’s prescribed with care. Why do I say this? The societies’ statement expresses caution regarding the use of estrogen and progesterone in combination. However, the clinical studies on which they based their opinion actually used progestin, not progesterone—and there is a big difference between the two.

Progestin is a synthetic hormone. This type of hormone is known to increase the risk for blood clots, fluid retention and high blood pressure. Natural progesterone is the “feel good” hormone of pregnancy. It reduces inflammation, acts as a natural diuretic and helps to keep blood vessels dilated so that blood can flow smoothly. Women can get a bioidentical version of progesterone (not progestin) by prescription, and that is what I recommend to my patients who need it. I do not recommend progestin, which is also called Provera.

As for estrogen, I agree that the oral form increases a woman’s risk of blood clots and other problems. Because of that, I recommend using estrogen in a transdermal (through-the-skin) form—in a gel or patch. It can also be used under the tongue. Any of these routes will help to avoid blood clots.

Many women breeze through menopause. The rest of us have symptoms that can be debilitating (in addition to making us hard to live with). The key, if you are in the latter category, is to find a doctor who understands the benefits and risks of HRT and realizes the need for a good quality of life. Then, the two of you can find a treatment that works for you.

Today I was looking at a picture of my mother that she sent me last year when she was traveling in Cambodia. She looked fit and happy. It got me thinking about the fact that as we age we have many choices. The major one is to be or not to be fit. I saw what happens both ways in my family. Let me start with my father.

My dad was brilliant but stubborn. He smoked, ate a fat-filled, high sugar diet, and was totally opposed to exercise. He had to quit smoking when he developed bladder cancer and his urologist told him that if he continued to smoke he would not see him in his practice, because a cancer recurrence would be inevitable.

He started eating healthier when his brother developed type 2 diabetes and he realized that he might end up with the same thing. However, he refused to get regular check-ups until he was in his mid 60’s. He did not realize that for most of his adult life he had high blood pressure, because he did not feel it. But, it took its toll on his kidneys in a big way.

By the time he was being seen on a regular basis he was in renal failure. Despite treatment for his hypertension, his kidneys finally failed completely. He made it to 84. He was alert and with-it till the end. Had he been treated for his high blood pressure early on he would still be here. It was amazing that he made it into his 80’s, but his quality of life suffered, especially the last 10 years.

My mother on the other hand has always been a health nut. She was exercising and eating healthy before it was fashionable. She quit eating red meat when she was in her 40’s. She has been walking and going to exercise classes most of her adult life. She now does Pilates, yoga, and is an avid tennis player. She started playing doubles a couple of years ago because her knee was acting up and she couldn’t run as fast in her singles games. She plays bridge, goes to lectures at the local university, and is now traveling around the world.

I cannot say how old she is because she would kill me, but I am 58 and she was not a teen mom so you can kind of guess her age. To look at her you would think that she was in her 60’s. She is committed to keeping her brain and body healthy and has been for most of her life. Fortunately my siblings and I have followed her example.

We have no control over what goes on in the world, but we can control how we treat our bodies. Life can get crazy, but there are choices we can make. You can choose to ignore your health as my father did (and please say hello to him when you see him) or you can follow the path that my mother is on and be well!

“To resist the frigidity of old age, one must combine the body, the mind, and the heart. And to keep these in parallel vigor one must exercise, study, and love.”
Alan Bleasdale

If I told you there is something that could improve your mood, decrease blood pressure, keep your blood flowing, lower your heart rate, calm you down, boost your immunity, and enhance your ability to learn, would you be interested?

What if I told you that it is free and does not involve medication? Now I have your interest! There is something that will do all of the above and is also quite enjoyable.

It is music!

Studies in England have found that patients who were taught to play music as part of a study for the treatment of depression experienced a reduction in their symptoms by 25%. Research in Italy revealed that listening to Celtic, classical, or Indian (raga) music for 30 minutes a day can significantly lower blood pressure. Researchers in the US found that relaxing music can dilate blood vessels in the body and improve general blood flow. Music that was perceived as stressful (heavy metal as an example) caused the blood vessels to contract and decrease blood flow to the body.

When students were studied by having them listen to six types of music, researchers found their heart rate synced up to the speed of the music regardless of the style and their interest. If the music was lively, their hearts sped up. If the music slowed down, so did their heart rates. It produces an additional calming, immune, and mood boosting effect by lowering cortisol levels, increasing hormones that improve the immune response and raise endorphin levels.

Finally, you have probably heard about the Mozart effect, where listening to Mozart’s music enhances learning. Baroque music, with a 60 beat per minute pattern, particularly activates both the right and left side of the brain. This enables the brain to process information more easily. It also improves recall of information when a particular tune is used during studying and then replayed.

Music is the universal language appealing to all of us while enhancing learning and healing. As medical costs continue to skyrocket, it is nice to know that there is something enjoyable and therapeutic we can do (in addition to your regular preventive evaluation and treatments) to improve our health!

“I think music in itself is healing. It’s an explosive expression of humanity. It’s something we are all touched by. No matter what culture we’re from, everyone loves music.” ~ Billy Joel

What music helps you to feel better and heal?

I thought that sharing this blog from a year ago may help everyone get ready for spring!

At my house next to our front door there is a beautiful bush filled with Daphne flowers. It smells wonderful and makes me smile on my way in and out of the house. That got me thinking. Can flowers make us happy? I did a little research and found several studies that do indeed show that flowers can affect our mood in a positive way.

At Rutgers University a behavioral research study has found that flowers elicit a universal reaction that can help people feel happiness. Those who received flowers felt less depressed and anxious after receiving them, and the flowers led to more frequent contact with friends and family.

A study done at Harvard found that when people had freshly cut flowers around the house, they were less anxious. They were happier at work and also expressed more compassion and kindness towards others.

A study done at Texas A&M found that when both men and women were exposed to cut flowers at work, they both had an increase in ideas and solutions to office problems. Men generated more ideas than women, but women had more innovative and creative solutions to problems when flowers were nearby.

Flowers have certain meanings according to those who specialize in that sort of thing (Taken from The Language of Flowers by Vanessa Diffenbaugh). If you want to say something specific you might try these: Gerber daisies represent cheerfulness, baby’s breath reveal everlasting love, bird of paradise say magnificence, hyacinth communicate beauty, and jonquils represent desire.

It is spring and flowers are blooming everywhere. If you want to brighten your day or someone else’s bring in some flowers or visit your local flower shop. It will help you to be more productive, tell people how much you appreciate them and keep a smile on your face!

Despite the fact that there has been a huge campaign to inform women about the different ways that heart attack can present, we (women) are still waiting too long to call for help. I believe that one of the reasons has to do with our nature. Most of us live in the land of denial. We do not think that something like heart attack can happen to us. In addition we are so busy taking care of others that we often ignore our own symptoms.

Research looking at heart disease in women done by the National Institutes of Health found that 95% of women studied noted symptoms that were unusual for them one month prior to having their heart attack. The most common being unusual fatigue; sleep problems, shortness of breath, indigestion and anxiety.

Despite all the research and push for public awareness, heart disease is still the number one cause of death in men AND women. Risk factors include: family history of heart disease, high blood pressure, high cholesterol, obesity, diabetes, lack of exercise, smoking, stress, and low magnesium.

Regardless of whether you have any of these risk factors or not, if you are a woman and you experience overwhelming fatigue like you do with a bad flu, (but you don’t have the flu), trouble sleeping, anxiety, a sense of dread, shortness of breath, vague chest or jaw discomfort; you may be having a heart attack or you are about to experience one.

If that is the case, do NOT drive yourself to the emergency room. Do NOT wait till a friend or family member can take you to the emergency room. Do NOT ignore the symptoms. Do call 911 and chew an aspirin while you wait (provided you are not allergic to aspirin).

The reason you call 911 is that you want to be cared for as soon as possible. As most cardiologists will tell you, time is muscle. If you take yourself to the emergency room, you may have to wait and that might have tragic consequences. I had a patient many years ago, who had her heart attack while she waited three hours in the waiting room of a hospital emergency room. Do not let that happen to you. The longer you wait the greater the chance you will sustain long-lasting heart damage. The sooner they can help you the better your chances of a full recovery.

Most of us may be self-sacrificing but we have really good gut instincts. Listen to your intuition. If you think that something is wrong with your heart then you are probably right. Take care of your heart so it can take care of you and keep you vital and healthy.

A recent article in the New England Journal of Medicine dispelled certain myths and presumptions about weight loss and it has certainly given me food for thought. When translating the conclusions of this article, I think it is important to take them with a grain of salt so to speak. Sometimes, it is important to inject some common sense, and realize that studies address groups of people and some things may not apply to the individual.

What About Breakfast?

Let’s start with breakfast. As mentioned in the article, there are some studies showing that people who eat breakfast are not more likely to lose weight than those who skip it. However, there are many studies that show those who eat a regular breakfast are less likely to gain weight and are less hungry throughout the day. It is important for maintaining your metabolism. I have patients who have lost a significant amount of weight just by adding a healthy breakfast. Weight loss aside, breakfast is important for general health and daily function.

Is it Really Better to Lose Weight Quickly?

Another myth involves studies showing those who have goals of losing a lot of weight quickly are more successful than those who have more modest goals. That may be the case when you look at shows like the Biggest Loser. However, if you look further, the majority of those on the Biggest Loser do not maintain their weight loss.

Looking at pooled data the researchers found that although those with rapid weight loss vs. slow weight loss were more successful in the short run. There was no difference in their weight loss at the end of a year.

Along those lines, low calorie diets including those with prepackaged meals can be quite successful. Some of these diets can be maintained for over a year, but eventually the calorie restriction becomes too much and many patients gain their weight back.

Fruits and Vegetables Add Calories

According to the myths and presumptions, adding more fruits and veggies to the diet does not result in weight loss and can result in weight gain. Of course if you add them on top of what you are already eating, it will not work. However, if you replace unhealthy food choices with healthy ones such as lots of vegetables and a moderate amount of fruit, weight loss will happen. If you fill up with broccoli vs. foods such as potato chips and cheetos, of course you are going to lose weight.

Yoyo dieting does not cause early mortality

Finally, The article dispelled the presumption that yoyo dieting will cause premature death. It will not do that, but regardless it is unhealthy. It can slow metabolism and contribute to weight gain in the long run.

Knowing about these myths and presumptions is helpful. Clearly we have much to learn. However, it is important to realize that things such as eating vegetables and breakfast are healthy habits whether they aid weight loss or not.

We still do not have the magic pill or solution for successful weight loss. There are probably as many diets out there as people in the United States. The issue is complicated, but I believe that by honoring our uniqueness, we can find what works for the individual.

The connection between low magnesium and heart disease is one of the best-kept secrets in health research.

It was way back in 1957 that a study gave us evidence that low levels might cause cardiovascular problems, and research has percolated ever since. We now know that not having enough of this mineral can cause:

- high cholesterol

- plaque build-up in the arteries

- thickening of artery walls

- type 2 diabetes

- high blood pressure

There’s no dispute about any of this — and any researcher would say that all of the above raise the risk of heart disease. But over the last many years, the focus in heart disease prevention has been on everything but low magnesium. It’s time for that to change.

Last year, the Japanese Collaborative Cohort Study published data collected over the course of almost 15 years on more than 58,000 Japanese between the ages of 40 and 79. The scientists found that people with high levels of magnesium were 50% less likely to have a fatal heart attack than the people in the study whose levels were low. This adds to the data that supports the important connection between magnesium and heart health.

There’s another reason for us to get more magnesium: Our health depends on magnesium and calcium being in balance in our bodies. We should consume these in a 1:1 ratio, but public-health recommendations to get calcium for our bones has generally ignored the need for magnesium. That may be why an increased intake of calcium has been found to increase the risk of heart disease.

Unfortunately, most of us get way too little magnesium in our diets. One reason: Processed foods contain little to none! The recommended daily intake of magnesium is 400 mgs. Good sources include nuts, seeds, beans and organically grown vegetables. (A Mediterranean diet provides plenty of magnesium in heart-healthy whole foods.) It is always best to get it from food, but if you cannot get enough in your diet, you may need to take a magnesium supplement.

The data on the need for adequate magnesium is compelling. But whether you are convinced by the data or not, the key for health is to eat a balanced diet. I suggest that in addition to lean protein, fruit and whole grains, you eat plenty of vegetables (preferably organic), healthy nuts in moderation (almonds are the nuts with the most magnesium) and beans. It just makes sense! You might find that your blood pressure as well as your cholesterol goes down and that you feel better overall.

Magnesium seems like such a small thing, but as basketball coach John Wooden once said, “It’s the little details that are vital. Little things make big things happen.”

Recently, a friend of mine recommended coconut oil for my cracked hands and dry lips. I found a jar at the local health food store for under $10 and thought that I would give it a try. It worked like a charm. My hands are soft and my lips are no longer rough and flaky.

That got me thinking. What types of food preparations are being studied for the treatment of skin problems? Here is what I consider to be the top three: coconut oil, honey and garlic. The following are some simple, effective uses for all three.

Coconut Oil

There are many studies looking at the therapeutic benefit of coconut oil. In patients with atopic dermatitis or eczema, the use of coconut oil improves healing and prevents infection with bacteria, viruses and fungus. Specifically and importantly it prevents infection with staphylococcus aureus.

Studies have found that coconut oil effectively moisturizes the skin and improves the appearance. In studies of coconut oil and wound healing researchers noted that it improves the turnover rate of collagen, which will also help to diminish wrinkles.

As an interesting aside, massage is standard therapy for preterm babies. A recent study found that when babies were massaged with coconut oil their weight and growth improved more quickly than those massaged with mineral oil.

Coconut oil is inexpensive and can be safely used as a moisturizer and lip balm.

Honey

Honey has been used as medicine for thousands of years. Recently there have been multiple studies done to examine its wound healing properties. A specific type known as Manuka honey from New Zealand has powerful anti-inflammatory and antibacterial properties. A special gel called medihoney has been studied in wound healing and found to be very effective over standard therapies.

Please note! If you have a cut or a sore, do not take out your honey bottle and start applying it. Not all honey is made the same when it comes to healing properties. It depends on the kind of honey and when it is harvested. Medihoney is made specifically for medicinal use and cannot be found on the honey shelf at the grocery store.

Garlic

Garlic has antifungal properties and has been found to be a very effective treatment for athlete’s feet. A study done in 2000, compared a garlic solution to the fungus cream Lamisil. They were both applied twice daily for two months and garlic had a 100% cure rate vs. 94% for Lamisil. Garlic can be used as a paste when mixed with olive oil or mashed up and dissolved in a foot bath.

Garlic is cheap and easily available. The down side is that it might be a bit stinky especially when your feet get hot and sweaty.

It is very interesting that in this day and age when we are dealing with antibiotic resistant bacteria and hard to treat infections, that food may be the ultimate healer. As a famous old-time physician once said,

“Let food be thy medicine and medicine be thy food” ― Hippocrates

For a migraine sufferer, there’s nothing better than a medicine that will make the headache go away — nothing, that is, except never having the migraine at all. Because let’s face it: Migraine drugs aren’t perfect. They can be pricey, and they can have side effects. What a lot of migraine sufferers don’t realize, though, is that a few simple steps can often work just as well as the drugs, without as much cost or risk. Here are a few moves that may help you control your headaches without so much as looking at your medicine cabinet:

Step 1

Start a food journal. Migraine experts know that some foods may trigger migraines. The biggest culprits are those that have an increased amount of a substance known as tyramine, which can cause headaches by increasing blood pressure. High-tyramine foods include aged cheeses, alcohol, processed meats and red wine. By keeping track, you can learn your triggers. Avoiding them can decrease the number of headaches you suffer.

Step 2

Exercise. A study done in Sweden found that regular exercise can be just as effective at preventing migraines as the drug Topamax. When study participants rode a stationary bike for 40 minutes three times a week, they had as big a reduction in headaches as participants who took 200 milligrams (mg) of Topamax a day. The only difference was that a third of the Topamax users had side effects, while the exercisers had none (unless you count a boost in fitness). Exercise increases endorphins, which may be the mechanism by which it prevents headaches.

Step 3

Try some healthy supplements. A number of studies have found that a daily dose of 400 mg of the B vitamin riboflavin can prevent migraines. It can’t stop one that’s already in progress, but people who take it for three months see their migraines drop by half.

Another nutrient that wards off migraines: magnesium, a common mineral found in beans, pumpkin seed, and nuts. The amount recommended varies according to which expert you ask, but anywhere from 600 to1000 mg daily is recommended, provided you don’t have kidney problems. A study done in Germany found that when migraine sufferers were given 600 mg magnesium daily for a month, their migraines decreased by more than 40%. Magnesium helps by calming the brain. And there’s a bonus: It’s good for the heart, too.

The herbal extract butterbur has been used for thousands of years for a variety of health issues. Several studies have found that in a dose of 50-75 mgs twice daily, it can reduce the number of migraines by as much as 50%.

I generally recommend starting with magnesium and riboflavin. If your headaches have not decreased then I suggest adding butterbur. In addition, I recommend trying 150 mg daily of coenzyme Q10. In one study, this supplement halved the number of “migraine days,” probably, researchers think, by improving blood flow in the brain.
Studies have also found that 1000 mg daily of omega 3 fatty acids reduce the frequency of migraines by reducing inflammation. Both of these supplements are good for general health.

These supplements are all generally safe (though, as with any supplement, you should discuss them with your doctor before you start). Whichever you choose, you’d need to take it regularly. And, unfortunately, none will help with a migraine that’s already in progress. Still, if you’re a migraine sufferer, it’s worth discussing alternatives like these with your doctor. They’re inexpensive, have fewer side effects than many migraine meds – and just might make your head feel much better.