Stress is inevitable in our lives. It is something that causes us to react with a fight or flight response. This response is something that has protected us through the ages. When confronted with a perceived dangerous situation, a chemical reaction in the body takes place that can improve alertness and our ability to move quickly. This allows us to flee the danger. If stress continues without relief, it can have a negative, wearing effect long term.

The acute symptoms of stress are a rapid heart rate, dry mouth, clenched jaw, muscle tension; possible upset stomach and loss of appetite. Long-term symptoms include depression, eating disorders, skin and hair problems, and chronic fatigue.

In the US, forty-three percent of all adults suffer from adverse health effects. Three quarters of all doctor visits are for stress-related complaints. Stress can contribute to heart disease, high blood pressure, chronic headaches, arthritis, asthma and anxiety. If left unchecked, there is a 50% chance that it will evolve into a chronic emotional disorder.

Occasional stress can be dealt with, but when stress is continuous an interesting phenomenon sets in. At its most extreme, it is something that occurs in those who are living in abusive situations. At a lesser extreme it can occur with chronic job stress. In both examples, individuals become used to a continuous level of stress and the health effects can be substantial.

An alarming possibility is that stress can cause or spread cancer. It can do this in a couple of ways. In reaction to stress people may adopt behaviors such as smoking, drinking and overeating all of which increase the risk of developing certain cancers. In addition, psychological studies have found in animal studies that stress can affect the ability of a tumor to grow.

A study of women with triple-negative breast cancer treated with chemotherapy that used beta-blockers, medications that interfere with stress hormones, before and after their treatments had a better chance of surviving than those who did not use the beta-blocker. There is also data to suggest that those who feel helpless or hopeless during treatment have higher death rates.

For all of the above reasons, it is important to find ways to cope with stress. Exercise, talk therapy, meditation, yoga, relaxation techniques and finding support from friends and family can be helpful. Sometimes, medication is necessary.

There will always be stress. That is how life works. The key is to recognize what is going on in your body and find constructive ways of dealing with it.
“Its not stress that kills us, it is our reaction to it.”
– Hans Selye

Listening to the Sunday news pundits, angry hateful words from some of the presidential candidates, and watching recent breaking news has caused me to look at what might make a difference to us individually and as a nation. There is one thing. That thing is love. The power of it is amazing.

For starters, half of people who exercise alone 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.

After 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 when they get married.

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.

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 it 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

Spring is approaching and stress is in the air. There are worries over the economy, the upcoming election, and the state of healthcare (among other things). There are ways that each of us deals with stress -both consciously and unconsciously. Some people get sick (not a great solution);others overeat; still others drink too much alcohol. But many people have learned to work it out in a healthy way using exercise, meditation, yoga, and talk therapy such as cognitive behavioral therapy (CBT).

CBT is a process that looks at a person’s beliefs, and helps to change negative thought patterns. It is like teaching people to look at the cup as half full, rather than half empty. A recent study has found that ten sessions of CBT significantly improved worry in older individuals with generalized anxiety disorder. CBT has also recently been shown to have an impact on depression and health outcomes in those who have undergone cardiac bypass surgery.

If you are stressed out, you are not alone. I suggest that you look to healthy ways to deal with stress and worry. If you feel you need help and would benefit from talking to someone, you might want to find a therapist who does CBT. And of course, you can eat a healthy whole food diet and exercise too!

In 1968 a very brave teacher named Jane Elliott embarked on a social experiment with her classroom of third graders. She wanted to teach them about prejudice. In my opinion, she taught them and us a whole lot more. She divided the class into blue-eyed children and brown and green-eyed children. She said that the brown-eyed children were superior to those with blue eyes. That day, the brown-eyed children berated those with blue eyes and became bullies.

The next day, the blue-eyed kids were told that they were better than the shifty, lazy brown-eyed kids. The reverse happened but not to the same degree as the day before. Perhaps, having suffered berating, the blue-eyed children were more empathetic. Just by being told they were better, the children were emboldened, became bullies and lost most of their compassion for their fellow students of different eye color.

Looking at what is going on in the Republican primaries, I am wondering if the same phenomenon is occurring. The candidates are saying essentially that we as American citizens are better then those trying to immigrate here to the US. That white Americans are better than those of color. The behavior that is ensuing as a result is embarrassing, frightening, and downright un-American. The rhetoric coming from Donald Trump in particular is mean-spirited and devoid of compassion. It is bullying behavior that would be very dangerous if he were to become the leader of the free world.

The fact that so many are following him makes sense when we look at the children in Jane Elliott’s classroom experiment. He is tapping into insecurities and fears and preying on those who would like to feel better about themselves. Unfortunately, to stop bullying behavior it doesn’t help to distinguish between them and us. What will work is to give people a hand and hope that their lives can be changed for the better. Stomping on someone to get a leg up will only hurt all of us.

When people are so mean and nasty, it makes me wonder what type of pain and lack of love they must have in their life. What is the answer? I am hoping that if each and every one of us can find a way to be kinder to others and pay it forward, that will help. I know it sounds trite, but love is the answer.

The experiment that Jane Elliott did with her students was and remains controversial. But, many of her students have returned and thanked her for changing their lives in a very positive way and helping them to find compassion and empathy for others. Perhaps it is time for the Republican candidates to have a go at a remedial class with Ms. Elliot!

February is Heart Disease Awareness Month. I could write the usual article blog about what behaviors increase the chance of having a heart attack, or I could describe the signs and symptoms of the disease. However, everyone else is writing about that. I thought that I would take a more positive tack. It turns out that having a positive attitude and having hope and curiosity can keep your heart healthy.

A study of over 6000 men and women from age 25 to 74 who were studied for 20 years found a sense of enthusiasm and hope, emotional balance, engagement in life and the ability to deal with stress reduced the risk of coronary artery disease. Not only did these individuals cut their risk of heart disease in half, they also had a reduced incidence of other chronic diseases.

The researchers of the study suggest that 40 to 50% of our optimism is inherited. Looking at the upside, the other half or 60% is under our control. In other words, to insure a healthy heart it is important to find ways to help you and your family to develop a positive attitude.

Another study of 1000 patients tracked those with coronary artery disease over 5 years. Higher levels of positivity were associated with less smoking, more exercise, improved sleep quality and adherence to medications. That may account for why a positive attitude can improve heart health, but there is probably something else as well.

A recent study of 1500 people with a strong family history of heart disease found that those with a positive attitude had improved heart health. In this group, a sense of wellbeing was associated with a 33% reduction in cardiac events. Those at highest risk (with multiple siblings or parents with heart disease) had a 48% reduction despite having other cardiac risk factors such as smoking.

It is clear that our mind is incredibly powerful. With a positive attitude, hope and enthusiasm your heart can remain healthy as well as the rest of your body. Optimism is contagious. This will extend to those around you as well. If you can find your positive, happy self it can change you, your heart and the world.

“A healthy attitude is contagious but don’t wait to catch it from others. Be a carrier. “

Tom Stoppard

The New Year is upon us. Many of us resolve to eat a healthier diet. Here are some tips.
It is essential for healthy eating that we make good food choices. Here are some suggestions:

1. Do you plan your menus ahead of time? So many of us are busy. If we can plan our meals ahead of time, we can better make healthy choices. If you do shop, don’t go hungry. You are more apt to make impulsive choices for junk food and end up eating it in the store!
2. Research has found that when water is mixed in with food, it is more filing and you eat less. Foods such as stews and fortified soups filled with goodies such as vegetables and broth can help you to eat less, eat healthy and lose weight.
3. It is important to have at least 4 servings of fruits and vegetables daily. They can be very filling. You can eat them as part of your meal or as a snack. If you eat raw veggies as a snack, it is fun to take them and dip them in low fat, low cal dressing. If you get gas from the vegetables, try beano, it works!
4. If you have a sweet tooth, satisfy it with fruit. Apples are a great choice. They contain pectin that helps you to feel full longer as well as provide great fiber.
5. If you start your meals with a healthy appetizer or soup, you can decrease your meal portion size. This will help you to feel full and allow you to decrease your overall calorie intake throughout the day.
6. Eat the majority of your calories early in the day. A study of Israeli women divided a group of almost 100 women into two groups. One group ate their largest meal at breakfast. The other group ate the majority of calories at dinner. Both groups ate the same number of calories (1400). After 12 weeks, the breakfast group lost 9 pounds and the dinner group lost 4 pounds.
7. Finally, eat mindfully and slowly. It takes about ten minutes for your brain to catch up with your stomach.

Follow these simple tips and you will be able to have a healthy year!

I recently returned from a conference where I heard an amazing presentation. Dr. Stanley Hazen of the Cleveland Clinic presented data that showed a correlation between the consumption of L-carnitine and choline and levels of a substance in the gut that has been correlated with the risk of heart disease and stroke.

Large amounts of L-carnitine are present in red meat. Choline is present in foods such as egg yolks and farm raised fish that are fed choline. What happens is that when these foods are consumed, the bacteria in the gut metabolize them and trimethylamine-N-oxide or TMAO is formed. It is the presence of this compound that has been correlated with cardiovascular risk.

TMAO makes it easier for cholesterol to attach to blood vessels and harder for the liver to discard it. In a study recently reported, Dr. Hazen and colleagues followed 4000 patients over three years. Those with the highest levels of TMAO had 2.5 times the risk of stroke and heart attack compared to those with the lowest levels.

Vegans have the lowest amount of TMAO levels. Those who are red meat eaters have the highest. Foods that reduce TMAO levels include cold pressed extra virgin olive oil, grape seed oil and Guinness stout (believe it or not!). Low dose aspirin also decreases TMAO levels.

Clearly, more research needs to be done. However, this study is another example of the power of the gut and gut bacteria. Having the healthiest gut possible requires eating foods considered to be prebiotics. Prebiotics are foods that contain fiber that arrive to the colon undigested. These include fermented foods such as kefir and sauerkraut, vegetables, legumes, and fruits that include garlic, onions, asparagus, chicory, beans and bananas. They are considered fertilizer for healthy gut bacteria. Probiotics are live bacteria that can be ingested. However, if you eat unhealthy foods, the bacteria will be relatively ineffective.

In this day and age we have so many high tech solutions to problems. For a heart attack, you can be on clot thinners and have a bypass or a stent placement. For strokes, if you get to the hospital in time, it can be reversed. How interesting it is that the ultimate solution to these health problems and their prevention can be found in something basic.

How you choose to eat has the greatest impact on your health.

There are many people with serious illnesses who cannot (at this point) conceive of changing their high fat, processed food diets. For those of you who see the mounting evidence for why a healthy, whole food diet can improve your health, I have to ask, isn’t it worth a try?

Global warming with crazy weather happenings, ISIS and domestic terrorism, the upcoming elections and the ranting of politicians, trying to help patients get well when they cannot afford the medications that will heal them, these are just a few things that have led me to write once again about ….STRESS!

Stress is one of those things that is a natural part of life, and one of those things that can show up physically with new, or worsening, symptoms. Some of us handle it better than others. There are various types of stress. There is acute stress that you feel when you are in danger and that provokes a “fight or flight” response, otherwise known as an adrenaline rush. There is intermittent acute stress that is a hallmark of those with the type A personality. These are people who are stress junkies and thrive on deadlines and rushing around. Finally, there is continuous or chronic stress. This can be seen in people who are oppressed either by a job, relationship or a government.

The most dangerous form is chronic stress. After time, those with this type of stress get so used to it they don’t even notice it. The continuous outpouring of stress hormones can lead to obesity, diabetes, heart disease, stroke and even cancer.

It is important that you recognize stress in your life and that you do something about it, especially since there are so many ways to relieve stress. I advise starting with a healthy diet (avoid the urge to devour carbs), exercise is key, and then find ways to relax: read a lighthearted book; watch a funny movie; listen to soothing music; lay on the sofa holding your dog, and pet her nonstop. Turn off the news. Find ways to help so you can make a difference in improving the lives of others.

There are also complementary medical therapies (CAM) such as massage and acupuncture that can help. Meditation and yoga are great ways to relax and manage the stress response. Some may need the help of a therapist.

Regardless of which route you choose, it is important to pay attention to your body and if you are chronically or even intermittently stressed get help and stay healthy.

Every year there are blogs about how to avoid weight during the holidays. So, here we go again. I have some quick tips that I think will help:

• Make sure to eat a good breakfast on Thanksgiving Day so you aren’t ready to eat the turkey all by yourself.

• Go for a walk and relax before your dinner.

• Choose a small plate and take small amounts of food. Talking can distract you and cause you to eat faster. Fast music and being surrounding by fast eaters can do it as well. . So, chew slowly and enjoy every bite.

• Fill yourself up with veggies.

• Dessert is OK but take small amounts and bites.

• Watch the alcohol. Many drinks are loaded with calories and those who drink tend to eat more.

• Fill up by drinking plenty of water and staying hydrated.

• Finally, move around and socialize rather than hang out on the couch after dinner.

Thanksgiving means different things to different people. For most it is a time to express gratitude for our freedom, and to enjoy family and friends. It is important not to get so involved in the food and festivities that we forget the true meaning.

As a physician with conventional medical training, I often used to look at home remedies with skepticism. I have had several patients who have sworn that apple cider vinegar was good for whatever ailed them. Apple cider vinegar has been around for ages. Hippocrates used it to treat wounds; soldiers in the civil war used it for digestive problems and to prevent pneumonia and scurvy. Apparently Cleopatra used it to dissolve her pearls to make a love potion for Mark Antony.

Studies Showing Benefit

There have been recent studies done at the University of Arizona that have caused me to take a second look at apple cider vinegar. One study looked at 29 patients with either insulin resistance (prediabetes) or type 2 diabetes. They were given either a drink of vinegar, water and saccharine or placebo followed by a meal with 87 grams of carbohydrate. Compared to placebo, blood sugar decreased by 64% in the prediabetes group and 19% in the diabetes group.

Another study looked at weight loss in healthy women. The women were given a morning drink of vinegar or placebo followed by a bagel breakfast. Not only did the vinegar group have a 54% lower blood sugar one hour later, but they also consumed 11-16% fewer calories throughout the day.

Yet, another study found that taking a drink containing two tablespoons of apple cider vinegar along with eating one ounce of cheese before bedtime significantly lowered fasting blood sugars in the morning.

Some Cautions

There are potential safety and side effect issues. Obviously those allergic to apples need to avoid apple cider vinegar. Raw apple cider vinegar can contain bacteria, so it would be better to use the pasteurized form. Apple cider vinegar capsules can cause burning in the esophagus if they get lodged there. Apple cider vinegar can also irritate the stomach. There are potential drug interactions if a patient is taking digoxin, insulin or diuretics. Vinegar can lower potassium levels.

And…..

Of course, as with everything, moderation is the key. Taking a mixture of apple cider vinegar in juice or water in the morning may help with both blood sugar and weight control. It is important to discuss this with your doctor before you do it.