The Doctor is Human By Dr. Robin Miller

Healthcare has become a maze of insurance companies, regulations and lack of access to providers. Part of what makes it so complicated is all the charting and coding doctors must do. All of this takes away from patient care. Doctors spend more time on their computers than with patients. In my opinion, it has caused medicine to become dehumanized.

I read a wonderful article by a physician who trains interns, Dr.Suzanne Koven (http://www.nejm.org/doi/full/10.1056/NEJMp1702010). She had her students write letters to themselves at the beginning of their internships. At six months they read their letters.

She and I have been in medicine for about the same amount of time. When we started training, our individual feelings and hopes and dreams were not a concern to those who we trained under. We just dove in and kept going. Inspired by her students, Dr. Koven decided to write a letter to her younger self. I was so moved I decided to write one as well.

When you see your doctor, you probably are not privy to his or her more personal side. The road many of us have traveled in medicine has not been easy, but for me it sure has been exciting. I hope in sharing my experience it will help patients to understand where we have been and how far we as physicians we still have to go. Read and enjoy this letter I wrote to my younger self.

Dear Robin,

Right now you are energized, excited to launch your medical career and full of idealism. You will be able to maintain some of that energy and excitement throughout your career. However, there will be times when things get tough. You will work so hard, get so tired and become so discouraged that you will feel you can’t keep going.

One day, during your internship, when you feel unqualified, overworked and underpaid, you will consider walking away from it all. Something will stop you. Your love of patients and the fun you have figuring out what is wrong with them will keep you in the game.

The other thing that will inspire you and keep you going is the women you will meet along the way. They are an amazing group of residents who are brilliant, compassionate, and the most incredible role models you will find. As you keep moving through your career, you will remember them and continue to be inspired by them.

Eventually, when you do your fellowship you will be absorbed in research and when that happens, you will lose your way with patient care. But, eventually you will realize that your passion is caring for people. You will get back to direct patient care and find your true path. You will be witness to your patients’ most profound and poignant moments. You will help their babies to be born, and sit with them when they die. You will help people to become well and some you will not.

Your creativity will allow you to step out of the box and help people to help themselves. You will design a career that will shape the medicine around you and you will find yourself. In doing so, you will make a difference.

You will never be entirely comfortable when you cannot find the answers to patient’s problems. However, what you will learn is that your true value as a physician is to listen to their stories, to provide comfort and solace and you will realize that getting them to laugh and giving them a hug is the best form of medical therapy you can provide.

I hope this has given you a bit of insight into how my career has progressed which may mirror the career of others as well. Most of the physicians I work with care deeply for their patients. Unfortunately that is something their patients may not realize due to lack of time and all the hoops we have to jump through.

“The role of a clown and a physician are the same – it’s to elevate the possible and to relieve suffering”

~ Patch Adams

Don’t Quit Your “Wine-ing” By Robin Miller, MD and Dave Kahn, MS


“To take wine into our mouths is to savor a droplet of the river of human history.”
New York Times, 1967

Let’s Start With A Little History

Wine has captivated the interest and the palate of humanity for thousands of years. There is evidence the first winery was started as far back as 4100 B.C. Unlike other libations that were intentionally man-made (or woman-made in the case of beer), wine was most likely discovered by accident. An ancient Persian story tells of a Princess who lost favor with the King. Distraught, she tries to kill herself by eating table grapes that had spoiled in a jar. Instead of dying, she gets drunk and giddy and falls asleep. The next day, she wakes up free from the stress of her life. The King is so impressed he lets her back into his good graces and shares her discovery with his court. Thus started the production of “spoiled” grapes.

Wine was initially used for medicinal purposes, then ceremonially, and then finally for enjoyment, especially when accompanied by food. As with most things, what is old is new and what is new is old. Wine has circled back from its prominent position in the food world back to the medicinal world. Lately there have been many articles and studies touting its health benefits. Are they significant? Maybe.

Heart Health

A study in 2000 found light wine drinkers as compared to teetotalers cut their risk of premature death due to heart disease by almost a third1. This may be due to the increase in blood flow that occurs with wine drinking. The fruit in the brew boosts good cholesterol (HDL) and prevents the bad cholesterol (LDL) from causing damage to the blood vessels. Research in Amsterdam studied 275 men and women. Those who drank one to two glasses of wine daily had significantly higher HDL cholesterol levels2.

Brain Health

A research group from Loyola University Medical Center has found moderate red wine consumption reduces the risk of developing dementia. They analyzed data from 19 nations and found a decreased risk in moderate red wine drinkers from 14 of them. The risk was 23% lower in red wine drinkers compared to people who rarely or never drank wine3. They attribute the beneficial results to resveratrol, a powerful antioxidant that is present in red wine.

Cancer

While it is doubtful that wine decreases the risk of cancer, there are studies showing the growth of oral, liver and breast cancer cells decrease when exposed to red wine. However, studies of alcohol use in people have revealed those who drink have a slightly increased risk of throat, esophageal, liver, and pancreatic cancers. Epidemiologic studies have found the consumption of one small glass of wine daily increases the risk of premenopausal breast cancer by 5% and postmenopausal breast cancer by 9%4.

Osteoporosis

A study published in the American Journal of Epidemiology in 2000 showed women who drank the equivalent of one to three glasses of wine a day had greater bone density than nondrinkers or heavy drinkers5. Another study tested 500 elderly women and found their bone density was 12 to 16% higher among moderate drinkers compared to nondrinkers6. A comparable study of men found similar results7.

Words of Caution

The above benefits are only found in those who drink moderately. In fact, a study of heavy drinkers found those who drink to excess die on average two years earlier than moderate drinkers. Interestingly, moderate drinkers outlived nondrinkers by the same amount8.

Wine drinking may be beneficial, but those with a drinking problem should avoid alcohol in any form. There are many other ways to improve heart, brain and bone health. Exercise, healthy eating, and living a life with less stress and more sleep is a good place to start.

“Wine has been a part of civilized life for some seven thousand years. It is the only beverage that feeds the body, soul and spirit of man and at the same time stimulates the mind.”
Robert Mondavi

1. http://annals.org/aim/article/713862/type-alcohol-consumed-mortality-from-all-causes-coronary-heart-disease

2. https://www.ncbi.nlm.nih.gov/pubmed/10837856

3. https://www.sciencedaily.com/releases/2011/08/110816112134.htm

4. https://www.sciencedaily.com/releases/2017/05/170523084758.htm

5. https://academic.oup.com/aje/article/151/8/773/116791

6. http://ajcn.nutrition.org/content/72/5/1073.full

7. https://link.springer.com/article/10.1007/BF01626602

8. https://academic.oup.com/ije/article/29/4/667/765546/Alcohol-and-survival-in-the-Italian-rural-cohorts

Your Technicolor Fat: Help with Weight Loss? By Robin Miller, MD & David Kahn, MS

Believe it or not, fat comes in multiple colors. We have yellow, also known as white fat, and we have brown fat. Brown fat is found in high levels in newborns and hibernating mammals. Brown fat cells contain high levels of iron-containing mitochondria, the turbocharged power-packets of cells. That is how brown fat it gets its color. It also contains lots of capillaries, which increase its utilization of oxygen. White fat is found around the waist and thighs, while brown fat is in the front and back of the neck. Brown fat burns calories to generate heat and white fat stores calories. The big question, is there a way to increase our brown fat and increase our metabolism as a result? Perhaps.

Be Cool

A very small research study of six normal to overweight men had them wear cooling suits. Their skin temperature was lowered by 3.8 degrees Celsius over a three-hour period. The men exercised when they felt cold and started to shiver, which researchers discovered activated their brown fat cells. They burned 250 extra calories when these brown fat cells were active. They increased calories burned by 1.8 times compared to the men with normal temperatures who went walking.1

Embrace Stress

Another way to increase brown fat? We know it sounds strange, but a little stress will do it. A study of mild psychological stress was done in five healthy, lean women who were given a short math test. It was followed by a relaxation video. The researchers measured stress responses by testing cortisol levels. They used infrared thermography to follow the brown fat activity. The anticipation of the test is what triggered stress, not the test itself. The higher cortisol levels measured were linked to brown fat activity and increased heat production, all of which increased calories burned.2

Reprogramming

Researchers in Denmark have found a way to program white fat cells to become more like brown fat cells. In other words, the reprogrammed white fat cells burned calories as heat instead of storing calories. These converted cells are known as “brite” cells. By finding the right areas on the gene program of the “brite” cells, they can be turned into energy burners, which (in the future) could help you to…brite-n-up!3

Do it the Easy Way: Exercise

A study of mice and men! Researchers found that mice training on wheels for 11 days and men training on exercise bikes for 12 weeks developed new brown fat that was more metabolically active. The animal researchers took it further and transplanted the brown fat of the mice on wheels into sedentary fat mice. The fat mice then had improved glucose tolerance and improved insulin sensitivity. They became more fit. Human fat transplants are not imminent, but they could be utilized in the future. In the meantime, exercise will help build more brown fat.4

Watch the Medicines You Take

A study in the journal Science showed in genetically-engineered mice, a specific enzyme, known as cyclooxygenase-2 (COX-2), has an important role in making more brown fat cells in the body.5 The mice were bred especially have more of COX-2 in their bodies, and thus more brown fat cells. They were 20% lighter in body weight than ordinary mice. Since the bone and muscle mass of each group of mice were the same, this difference in body weight was completely accounted for by the fact that the mice with more brown fat had less overall body fat. And since both groups of mice had the exact same amount of food intake, the lesser amount of body fat was due to the fact that the mice with more brown fat were burning more calories than the others.

Even more interesting is the fact that the mice with more brown fat seemed to be protected against gaining weight. When these same mice were fed a diet with a substance that inhibits the COX-2 enzyme, and thus caused them to have less brown fat, they gained weight. If you’re wondering where you’ve heard of a substance that inhibits COX-2, remember that many of the anti-inflammatory drugs known as NSAIDS that are used for joint and muscle pain are COX-2 inhibitors, such as Celebrex.5

So, what does that mean for us humans? The new knowledge that the enzyme COX-2 can stimulate the formation of more brown fat will hopefully lead to new medications that will do the same thing, and thus help us to control weight gain. And what about the thought that those anti-inflammatory drugs may be causing us to make less brown fat, and thus gain weight? That needs to be studied in humans, especially the doses that may do this. So don’t stop your NSAID pain reliever if it is helping you, but stay tuned for more information in the future.

So YES, your Technicolor fat, especially the brown, can help!

In our search to come up with an answer on how to stop the obesity epidemic, making more brown fat may be a possible solution. Exercise, staying cool with a little bit of stress in your life, and avoiding anti-inflammatory medications when possible may be a good start by helping to increase your fat—that’s your healthy brown fat, of course—the natural way.

1. https://www.scientificamerican.com/article/supercharging-brown-fat-to-battle-obesity/

2. Lindsay J Robinson, James M Law, Michael E Symonds, Helen Budge. Brown adipose tissue activation as measured by infrared thermography by mild anticipatory psychological stress in lean healthy females. Experimental Physiology, 2016; DOI: 10.1113/EP085642

3. A. Loft, I. Forss, M. S. Siersbaek, S. F. Schmidt, A.-S. B. Larsen, J. G. S. Madsen, D. F. Pisani, R. Nielsen, M. M. Aagaard, A. Mathison, M. J. Neville, R. Urrutia, F. Karpe, E.-Z. Amri, S. Mandrup. Browning of human adipocytes requires KLF11 and reprogramming of PPAR superenhancers. Genes & Development, 2014; DOI: 10.1101/gad.250829.114

4. Yuan Zhang, Chao Xie, Hai Wang, Robin M. Foss, Morgan Clare, Eva Vertes George, Shiwu Li, Adam Katz, Henrique Cheng, Yousong Ding, Dongqi Tang, Westley H. Reeves, Li-Jun Yang. Irisin exerts dual effects on browning and adipogenesis of human white adipocytes. American Journal of Physiology – Endocrinology And Metabolism, 2016; 311 (2): E530 DOI: 10.1152/ajpendo.00094.2016

5. Vegiopoulos A et al. Cyclooxygenase-2 controls energy homeostasis in mice by de novo recruitment of brown adipocytes. Science 2010 May 28; 328:1158.

Healthy Eating? Time for Something Different, Something Better By Robin Miller, MD and Dave Kahn, MS

One of the most common topics of conversation at any restaurant or cocktail party is dieting! It is estimated that as many as 45 million Americans go on a diet each year. Approximately half of women and 90% of teenagers are on a diet. No wonder every time you turn around there is a new diet book on the market—the irony?

Diets don’t work! Researchers at UCLA analyzed 31 long-term diet studies and found abysmal results. “Several studies indicate that dieting is consistent predictor of future weight gain,” the researchers note. You have probably seen the same thing, either from your own dieting failures or from watching your friends and family fail.

We suggest you throw the whole idea of a diet out the window! Here are some ideas:

• Choose whole foods and get back to the basics. That means eating fresh fruit and vegetables, fresh fish and lean meats. Avoid processed foods, such as chips and cookies.
• Functional foods that heal would be a welcome addition to your diet. What you eat has an impact on how you feel and how you heal. There are certain foods that have anti-inflammatory effects. Fish oil, flax seeds, pumpkin seeds, and olive oil all have anti-inflammatory properties. Fresh fruits, berries, nuts such as almonds and walnuts, fresh fish and beans are also part of an anti-inflammatory diet.
• Avoiding trans fats and saturated fats that can cause inflammation is important. Most fast food can be pro-inflammatory. It is best to avoid it.
• Set an example for your children. If you make healthy food choices they will as well. You may not think they are watching but they are.
• If you are someone who frequents restaurants, you can still be healthy. You can almost always find healthy choices on the menu.

Once again, diets do not work. Healthy food and lifestyle choices do. It is crucial for us to turn the tide of obesity around.

We Americans are now fatter than ever: more than two thirds of are overweight or obese, and 35.7% of adults are obese. Almost 3 in 4 men are considered to be overweight or obese. Childhood obesity is rising precipitously. Healthy eating is important for our overall health, both individually and as a nation.

Love Heals By Robin Miller, MD and Dave Kahn, MS

Listening to the Sunday news pundits and watching recent breaking news has caused us to look at what might make a difference—individually and as a nation. There is one thing: love. Its power is amazing.

We’ve all heard the stories of people losing their will to live after a partner dies. They say that often a long-time love will follow a sweetheart into death, passing in less than six months, or often much sooner, of their spouse. The occurrence even has a name: the Widowhood Effect. At first glance, this may seem the stuff of fairy tales (or perhaps nightmares), but a study published in the American Journal of Public Health verifies the facts.

The Widowhood Effect “is one of the best documented examples of the effect of social relations on health. The Widowhood Effect has been found among men and women of all ages throughout the world.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636447/

This phenomenon may seem scary at first, but there’s also many quite positive sides to the Widowhood Effect—love makes people not only want to keep living, love makes people live better, healthier lives.

For starters, it’s true that half of the people who exercise solo quit their programs after one year. However, two-thirds of those who work out with a loved one stick to it. In addition, men and women alike workout 12 to 15 percent harder when they are with a romantic partner.
(http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091401)

After a heart attack, men and women who are married recover more quickly and have a lower mortality rate than those individuals who are single. Those in committed, healthy relationships experience less stress, and men are more likely to give up risky behaviors such as smoking and driving too fast when they get married. (http://www.health.harvard.edu/newsletter_article/marriage-and-mens-health)

Happily married and/or committed people have fewer doctor visits, less depression, substance abuse and less anxiety. They have lower blood pressure. Those who are unhappily married have the highest. An added benefit to marriage is that in a study done by the Centers for Disease Control of over 127,000 adults, married people were less likely to complain of headaches and back pain. Those in a happy marriage heal more quickly, have fewer colds and are able to manage stress better. (https://www.cdc.gov/nchs/data/series/sr_10/sr10_185.pdf)

The National Longitudinal Mortality Study, following more than a million subjects since 1979, has shown that married people live longer. The study confirmed they have fewer heart attacks and lower cancer rates and even get pneumonia less frequently than those who are single. (http://link.springer.com/article/10.1007/s13524-011-0032-5)

The benefits of a loving, committed relationship are innumerable. If we love, we are happier, and if we are happier, there will be less anger and hate. Life isn’t always easy, but love makes life better.

Promoting loving and healthy relationships will help us all to thrive and survive. So, that brings me to what can make the world a better place, back to a simple, one-word answer: love.

“Where there is love there is life.” Mahatma Gandhi

Hug It Out By Robin Miller, MD and David Kahn, MS

You may not be a hugger, but maybe you should be. It turns out hugging is actually a
very good thing, and can be beneficial on many levels for both hugger and hugee. (We
just verified this is an actual word—in the Urban Dictionary).

The Healing Power of Hugs on the Body

The Skin
Hugs create a galvanic response, changing the electrical resistance of the skin. This
creates a more balanced state in the parasympathetic (or involuntary) nervous system.
The skin sensation activates receptors which then send signals to the vagus nerve, the
area of the brain responsible for relaxation and creating memories. (https://www.ncbi.nlm.nih.gov/pubmed/11251731)

Touch and hugging affect the brain the same way chocolate does, by lighting the orbital frontal cortex causing a surge of oxytocin allowing a feeling of trust and
connection. The electrical impulses result in lowering blood pressure and heart rate. ( https://www.ncbi.nlm.nih.gov/pubmed/15740822)

A study of married women who were exposed to experimental pain had their brains
scanned while their husbands touched their hands. There was an instant drop in activity in the areas of the brain involved in danger, fear and threat.
The women were calmer and less stressed. A similar but smaller effect occurred with the touch of a stranger.
(https://news.virginia.edu/content/uva-researcher-finds-high-quality-marriages-help-calm-nerves)
Hormones
Hugs stimulate the release of oxytocin, the feel-good hormone that helps with bonding in relationships and promoting empathy.
Stress raises cortisol levels responsible for our
fight or flight response. Hugs lower those levels. (https://www.ncbi.nlm.nih.gov/pubmed/15740822)

Hugging’s Healing Effects for the Soul

Hugging helps to boost self-esteem. For babies, hugging is incredibly important for nerve development.
The experience of touch is imprinted on us at a cellular level, and when we are hugged as adults,
we remember that. It helps us to feel secure and confident.

There is something about a hug that makes everything better. It helps boost confidence
before a test, it soothes the hurt of a failed romance, and it makes parting from friends
easier. Physiologically, hugs soothe our nervous system, and psychologically they are
calming and also boost our confidence.

If you want to help your friends, family and yourself embrace them. Give hugs freely and
be grateful for the ones you receive.

“Hugs should be available at the medical stores 24/7. Sometimes, they are the best
healers for almost everything.”

― Minhal Mehdi

Kindness: Good for your Health and Good for the World By Robin Miller, MD and David Kahn, MS

If you listen to the news, it’s easy to see our country and our world is rife with conflict and divisiveness. It can be hard to remain positive and hopeful. One thing we can do in response to this sometimes-overwhelming feeling is to simply turn off the news for a while. This strategy is officially called a news fast. The other thing we can do is to actively work to make our own personal world a better place; this can have far-reaching effects—
particularly on our own health.

The Health Benefits of Kindness

There have been a large number of studies conducted by The Institute for Research on Unlimited Love. (Yes, this is an actual institution. Learn more at: http://unlimitedloveinstitute.org.) Headed by Stephen G. Post, PhD, bioethics professor at Case Western Reserve University School of Medicine, the studies have shown that when people are on the giving and/or receiving end of generosity and compassion, their health is improved.

As an example, studies of older adults found those who volunteered lived longer than nonvolunteers. In fact, volunteers had a 44% reduction in early death compared to those who did not volunteer; the effect was greater than exercising four times a week!

Good deeds reduce our stress and boost endorphins, those feel good chemicals we hear about in runners and other athletes. MRI brain studies have actually found what they call the compassion-altruisim axis. The scans show joy and happiness that comes from giving to others. It is something totally different from the emtoion of romantic love, even located in a different part of the brain. It comes from interacting with others, giving a hug, a smile or speaking in a certain tone.

The Bottom Line

Happy, joyful people have both a better quality and quantity of life. They also spread happiness around them. Practice kindness with good deeds. Volunteer, smile at strangers, say a kind word, and/or give lots and lots of hugs for a start.

This new year we suggest you try a news fast to begin with, and encourage you to strive to perpetuate kindness and break the chains of negativity. It is something we all can do for our health and the health of our world.

“It would be easy to become a victim of our circumstances and continue feeling sad, scared or angry; or instead, we could choose to deal with injustice humanely and break the chains of negative thoughts and energies, and not let ourselves sink into it.” –Erin Grunwell, The Freedom Writers Diary

Burr! Time to Try on Your Winter Boost By Robin Miller, MD and David Kahn, MS

We really do mean winter boost—as in immune boost, although we also recommend you put on your boots as well. Winter: ‘tis the season for colds and flu, but you can stay healthy. There are some simple ways to improve your immune system and ward off colds and viruses. It can be as simple as eating the right foods and exercising!

Foods that Boost your Immunity

Omega 3 fatty acids that are found in fish, flaxseed, and walnuts, reduce inflammation and help strengthen the immune system. Step up to at least two servings a week.

Protein

Zinc is important for white blood cells to function properly. The white blood cells are the cells that fight infection. Zinc is found in protein such as lean meats, chicken, eggs, and tofu. It is also found in fortified foods. It is important to eat adequate amounts of these zinc-containing proteins.

Fruits and Vegetables

Brightly colored fruits and vegetables are loaded with phytonutrients. Phytonutrients improve the immune system and can help to fight cancers as well. Not to mention, they are just plain good for you. And they look good.

Citrus

Citrus fruits contain vitamin C. This vitamin can help ward off colds. Although you can find it in supplements, it is probably more effective if you can get it in food such as oranges and grapefruit.

Nuts

Nuts contain vitamin E. Vitamin E is an antioxidant vitamin that helps to fight colds and upper respiratory infections. The best nuts for vitamin E are sunflower seeds (1/4 cup per day), almonds (1/4 cup per day) and 2-3 Brazil nuts per day (they also contain selenium, which plays a key role in metabolism and contains antioxidants).

Garlic

Garlic has immune boosting properties that fight bacteria and viruses. If you have a cold, the best way to use garlic is to chop it up and swallow it. You can use it as a paste on bread or mixed in applesauce. Don’t chew it if you don’t want your breath to smell!

Chicken Soup

The hot liquid of chicken soup clears the nasal passages. However, something else about most chicken soup helps boost the immune system and helps to fight colds. Whether it is the soup or the love with which it is cooked, chicken soup works!

Mushrooms

Maitake, shitake, and reishi mushrooms are among the mushrooms that help boost the immune system. You can stir fry them or get them in capsules (fungi.com). Better yet, put them in your chicken soup.

Exercise

Regular, moderate exercise allows the cells that fight viruses and bacteria to circulate more quickly throughout the body. While they are getting an energy boost, they give your immunity a big boost. The more you exercise, the longer lasting the immune effect. That is another reason why exercise is so important. Again, consider wearing your boots while boosting your immunity when exercising outside.

In Summary

By eating well and exercising, you can increase your odds of having a healthy, cold-free winter despite the cold!

When It Comes To Weight Loss, Timing is Everything By Robin Miller, MD & David Kahn, MS

There is an age-old argument about whether eating breakfast is important. I have so many patients who tell me how hard it is for them to think about eating anything in the morning. Unfortunately, the majority of these people are overweight; they crave sugar and are totally pooped out by the end of the day. The connection between their lack of sustenance in the morning, their carbohydrate cravings, their low energy level throughout the day and overall weight problem has not dawned on them.

There’s a proverb that advises, “Eat your breakfast alone, share your lunch with a friend, and give your dinner to your enemy.” In other words, eat a big breakfast, a middle-sized lunch, and a light dinner.

It turns out this proverb is right on the money. There are multiple studies that have shown why my non-breakfast patients and anyone else who wants to get thinner might want to reconsider their eating patterns. The most impressive study was one done in Israel. Researchers took 93 obese women and divided them into two groups. They were given the same number of calories and in fact the same food daily for 12 weeks. Their meals totaled 1400 calories a day. The only difference was when they ate them.

The breakfast group ate 700 calories in the morning, 500 calories at lunchtime and 200 calories at dinnertime. The dinner group ate 200 calories for breakfast, 500 calories for lunch and 700 calories for dinner. Both groups ate exactly the same foods, just at different times.

Those who ate the high-calorie breakfast lost an average of 17.8 pounds each and three inches off their waistline, while those in the high-calorie dinner group lost only 7.3 pounds and 1.4 inches off their waistline. That’s more than twice as much weight lost! In addition, the breakfast group significantly lowered their triglyceride levels and sugar spikes throughout the day as compared to the dinner group. This improves energy levels as well as reduces the risk for cardiovascular disease. They also had less of a desire to snack during the day and felt satiated.

Interestingly, the meals did contain forbidden foods such as cakes and cookies. But this did not seem to impact the large weight loss in the big breakfast group. Another study found that having some forbidden foods early in the day is probably a good thing. See what we mean and read on.

A study of 193 obese adults was done in which participants were assigned to two groups. Men were given 1600 calories a day and women 1400. One group was given a low carbohydrate diet including a 300-calorie breakfast and the other (lucky) group was given a 600-calorie breakfast high in protein and carbohydrates which always included a tasty dessert. Halfway through the study, both groups had lost on average 33 pounds a person. However, in the second half, the low-carbohydrate group started gaining their weight back due to the difficulty of resisting temptation. They regained 22 pounds a person on average by the end of the study that lasted 32 weeks. The 600-calorie, yummy breakfast people lost on average 40 pounds a person!

Both of these studies show the significance of eating a nice-sized breakfast and tapering off your calorie intake as it gets later in the day. They also illustrate why it is important to find ways to eat so you are making healthy choices most of the time and that you don’t feel deprived. For those patients who I have been able to convince to eat either dinner for breakfast or to make it their biggest meal of the day, the results have been nothing short of a miracle. They have energy, feel great all day and have been able to lose weight and maintain it.

If you are struggling, think about changing the timing of your calorie intake. If commit to this approach, you will be delighted with the results.

A New Group of Super Heroes: Soaring Super Agers By Robin Miller, MD & David Kahn, MS

Super Agers are people who are over 80 and perform cognitively as well as those much younger. A study was done looking at 40 adults between the ages of 70 and 80. It compared these older adults with a group of 41 younger adults between the ages of 18 and 35. Twenty-three of the older adults performed normally as regards to memory and cognition for their age group. However, 17 of the older adults performed equally as well compared to the younger adults who were 4 or even 5 decades their juniors! MRI studies showed the brains of these “super agers” revealed no shrinkage of the prefrontal cortex and the hippocampus, areas that typically shrink with age.

Researchers are not sure what makes a Super Ager, but there are some clues: Most are socially connected and have a positive attitude. My mother is a member of this club. She will not let me reveal her exact age, so I can’t tell you how long she has been a part of this esteemed group. However, she is athletic, witty, smart and articulate. She plays doubles tennis, bridge and golf. She hikes and bikes. She goes to lectures and classes as often as she can and is an avid reader of books and newspapers. She volunteers as a court appointed special advocate (CASA) for children.

She looks at least 20 years younger than her actual age. She eats a healthy diet much like the one that is described below, and it is something she has done for over half of her life.

Are you wondering how you too can achieve Super Ager status?

Eat Like a Greek

Multiple studies have found the Mediterranean diet is good for brain and heart health. It improves mood, cholesterol and prevents coronary artery disease and diabetes. Those who follow the diet eat plenty of vegetables, whole grains, fruit, lean protein, and drink an occasional glass of red wine. [For more information on the specifics of this diet, check out: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801]

Exercise your Body and your Brain

Several other studies have found that reading, doing crossword puzzles and exercising the body and the brain in general is good for maintaining cognitive function. This is something that my mother has done for decades. She has always been physically active. If you have not been physically active yourself, it is never too late to start; fitness can be achieved at any age.

Dance!

One way to improve brain function and increase neural connections is by doing ballroom dancing. In fact, a study of seniors who were followed over 20 years found those who did ballroom dancing 2 to 3 times a week reduced their risk of developing Alzheimer’s disease by a whopping seventy-six percent. It’s good cardio, too! Time to find a local dance studio and get started.

Healthy aging is something that we all hope for. Clearly it takes work, but you don’t need super powers or even tights and a cape. No matter how old you are, it is never too late to take flight toward achieving and maintaining physical health, and to keep your brain vital and fit. My mother is having the time of her life, and she is over 80 years old.

When you get there you can too!

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