Simple Things You Can Do
Eat a Healthy Breakfast
As we work with patients to improve their diet, we continue to be amazed at how few people eat breakfast. Most either skip it entirely, or drink coffee and eat sugary pastries instead.
A healthy breakfast is the cornerstone of a good diet. It is a meal that provides the opportunity to eat a serving of whole grains, a digestible protein, and have a serving or two of fruit. The energy from a healthy breakfast can carry you through your morning in a more stable way than by eating stimulating foods such as sweets and coffee.
Studies have shown, for example, that people can lower their cholesterol by eating breakfast. This is due to several factors. Breakfasts tend to be high in fiber (fruit, oatmeal, whole grain cereals) which absorb cholesterol in the intestines for removal from the body. More importantly, however, when we skip breakfast, our bodies go for 10-16 hours with no outside source of energy. Our chemistry begins to shift to a mode of starvation, which increases appetite and changes how our bodies regulate blood sugar. We then tend to crave high fat and high carbohydrate foods and binge later in the day, resulting in taking in more calories than we need just as our bodies are primed to store energy in the form of fat.
If you are trying to improve your diet and nutrition and stay healthy as you age, eat a good breakfast every day. Vary your foods and try to get some protein if you have problems regulating your blood sugar.
To get you started, here's a recipe for the Immune Support Breakfast which is very popular with students at the naturopathic medical colleges. We eat this a few mornings a week at our house.
Recipe:
4 cups rolled oats
2 cups oat bran
1 cup lecithin granules
1 cup flax seeds, finely ground
1 cup milk thistle seeds, finely ground
1-2 cups sunflower seeds
1-2 cups almond slivers (toasted or untoasted)
1-2 cups raw cashew pieces
Optional: raisins or other dried fruit to taste
Mix ingredients and store in an airtight container, such as Tupperware. In the morning, soak 3/4 to 1 cup of the mixture in soy milk, rice dream or juice for 30 minutes. Before eating, stir in 1-2 tablespoons of flax seed oil. Add fresh fruit if desired.
Drink Water
Drink at least eight 8oz. glasses of water a day.
Thoreau said that water is the drink of the wise man. Water is fundamental to all life on earth. Our bodies are made up of 60% water. It is involved in every function in the body, including circulation, digestion, absorption of nutrients and the transmission of electrical currents in the body which control our nerves, muscles and hormones. Due to its importance in proper elimination and detoxification, I'm fond of saying "The solution to pollution is dilution," as water facilitates the elimination of waste products through urination, sweating, defecation, tears and mucus which line our respiratory and digestive tracts.
While we get water in many foods we eat and beverages we drink, pure water is often the best form to ingest. A recent study surveyed peoples' various aches and pains, energy levels and sense of well-being. When they were instructed to drink 8 glasses of water a day and their symptoms were reevaluated, notable improvements were seen in improved energy levels, fewer aches and pains, and generally improved sense of health. Adequate water is an extremely inexpensive and efficacious health practice.
Water quality is very important. In many areas of the country, tap water may contain lead, radon, nitrates and other potentially toxic chemicals. Additionally chlorine and chloramines are placed in municipal water to decontaminate it. Recently, San Francisco changed from using chlorine to using chloramine. Flouride in water supplies is a controversial topic with some studies suggesting health risks associated with fluoridation.
For these reasons, I recommend using clean sources of water and the use of solid carbon filters, such as Multi-Pure, or reverse osmosis filters. Avoid water that is in soft plastic containers, particularly in hot climates, as these can leach plastics into the water. Nalgene bottles are a good type for storing and transporting filtered water.
Take a Good Quality Multivitamin/Mineral Supplement
Eating a health-promoting diet is an essential component of good health. While it seems to be common sense that eating a healthy diet provides all of the vitamins and minerals we need to enjoy good health and reduce the risk of chronic disease, numerous scientific studies have shown that using good quality nutritional supplements can go beyond addressing nutrient deficiencies and help you achieve optimal health.
A recent study commissioned by Wyeth Consumer Health found that daily use of a multivitamin by older adults is a relatively inexpensive yet potentially powerful way to stay healthy. The group studied the effects of taking multivitamins on five diseases: coronary artery disease, diabetes, osteoporosis, prostate cancer and colorectal cancer.
These researchers estimated that providing a daily multivitamin to the elderly would result in a five-year potential health care cost savings of approximately $1.6 billion, and avoidable hospitalization for heart attacks of approximately $2.4 billion because of improved immune functioning and a reduction in the relative risk of coronary artery disease.
There is evidence that both clinical and subclinical nutrient deficiencies are common in the US. In recent years, the US government has commissioned a number of comprehensive studies (HANES I and II, Ten State Nutrition Survey, etc) to determine the nutritional status of the US population.
These studies in general reveal that marginal nutritional deficiencies exist in approximately 50% of the US population, and that for some selected nutrients and selected age groups, more than 80% of people consumed less than the RDA (recommended daily allowance). While it is theoretically possible for us to get all of the vitamins and minerals we need from our diets, the evidence suggests the reality is many of us do not. Taking a multiple vitamin and mineral formula can in many ways be viewed as cheap health insurance.
While most Americans are deficient in some vitamins and minerals, the level of deficiency is not often obvious. Severe vitamin C deficiency as seen in scurvy is rare, though evidence suggests that marginal, or subclinical, vitamin C deficiency is quite common.
So, what do I mean by a good quality nutritional supplement? First of all, it is not a one-a-day RDA vitamin/mineral combination. RDA guidelines were originally developed to reduce the rates of severe deficiency diseases such as scurvy and pellagra. There is much scientific evidence that the optimal levels for many nutrients, especially the antioxidant vitamins such as vitamins C and E, are significantly higher than the RDAs for these vitamins. RDAs also do not take into account environmental and lifestyle factors, such as smoking, alcohol consumption and exposure to toxins that affect how we absorb and utilize vitamins and minerals.
A good quality supplement, in my opinion, contains higher levels of antioxidant vitamins and minerals. It also balances the minerals and vitamins in proper ratios for absorption and utilization by the body and contains few if any binders, excipients and other additives. While not necessary for many people, I often use ones with hypoallergenic ingredients to avoid reactions in sensitive people. Finally, vitamins and minerals should be in safe amounts and chemical forms that absorb well and are easily utilized by the body.
What this means is most good quality vitamin and mineral supplements are in the range of four to six tablets or capsules per day. I can recommend a specific formula to address your needs and advise taking two or three with both breakfast and dinner. This simple step can go a long way to insure you are not deficient in important nutrients, and is often a core part of one's treatment plan. Typical monthly costs are approximately $1 per day for most formulas, and I prefer the Pure Encapsulations products as well as NF's Women's Formula.
Connect with Other People
By our very nature, humans are social animals. We nurture our young, form families and identify ourselves as part of larger social groups such as circles of friends, neighborhood ties, and memberships in clubs and organizations. Connecting with other people and forming bonds of communication and intimacy nourish our emotional and spiritual health as much as a healthy diet nourishes our bodies.
In this day and age, people can become increasingly cut off from others, leading to an increase in the prevalence of depression and feelings of isolation. Many go through their day-to-day lives surrounded by other people without making meaningful connections. The increasing use of the internet is a mixed blessing, allowing us to connect with other people via email and chat groups while remaining in the isolation of our homes. While the internet makes us feel connected, these communications lack the physical components of touch, body language and face to face communication.
We know that physical touch is extremely important to good health. Studies done in the 1930's in orphanages have shown that infants who are touched and picked up thrive and grow faster than those who are left alone in their cribs. Being touched in our early lives has been shown to help our brains and nervous systems develop in healthy ways.
As Dean Ornish, MD, states in his book Love & Survival, the healing power of love and relationships has been documented in an increasing number of well-designed scientific studies. In one study involving almost ten thousand married men, those who answered "yes" to the simple question, "Does your wife show you her love?" had significantly less angina (heart pain) even when they had high levels of risk factors such as elevated cholesterol, high blood pressure, diabetes and EKG abnormalities.
In other words, no matter how well people manage the physical risk factors in heart disease, the major killer of US citizens, our perceptions of love and connections to others is a major risk factor that is often overlooked by ourselves and our doctors.
In another study, researchers at Johns Hopkins tested and followed male medical students in the 1940's in order to determine if the quality of human relationships might be a factor in the development of cancer. Those who subsequently developed cancer were more likely to have described a lack of closeness with their parents than their healthy classmates, even 50 years later. Father-son relationships were particularly important to these male medical students.
Dr. David Spiegel, in a landmark study of women with metastatic breast cancer, found that women who regularly met for 90 minutes weekly for one year to express their feelings about their illness in a supportive environment lived on average twice as long as did other women who were not part of a support group.
The list of studies supporting the notion that intimacy, love and connections with others play an important role in our physical, mental, emotional and spiritual well-being is growing everyday.How can we stay connected with others in an increasingly disconnected world? There are many ways to do this. Keeping in regular communication with our families and friends, even if separated by distance, can maintain a level of intimacy and connection.
Expressing our love and affection to our partners and loved ones on a regular basis promotes intimacy and opens our hearts. Becoming involved in neighborhood organizations and groups that share our common interests increases our connections with our neighbors and creates bonds with those in our community, growing our circle of friends. Learning the names of people we interact with in little ways on a regular basis and greeting them personally grows our sense of connectedness with others.
I would be remiss if I didn't include the role our pets play in fostering good health and connections with others. Pets have been shown to play hugely important roles in our mental and physical well-being, especially in the elderly, people dealing with chronic diseases, and people who live alone and feel isolated. Fortunately, San Francisco, recognizing this as an important public health issue, recently passed a law allowing people with specific needs such as the above can obtain a waiver to have pets in rental units that traditionally do not allow pets.
Our connection with others is an important part of what makes us healthy, and creating positive relationships provides a healing influence on our society at large. Make an effort to connect with others on a daily basis and I guarantee your happiness and sense of wellness will increase.
Express Your Emotions Appropriately
Traditional Chinese Medicine (TCM) has always recognized that emotional factors play an important role in health and illness and notes seven emotions that particularly affect the body: joy, anger, sadness, grief, pensiveness, fear and fright. These emotions are not by themselves thought to be pathological and all constitute emotional aspects of healthy people. However, if any of these emotions are excessive over a long period of time or arises suddenly with great force, it can generate imbalances and illness.
Many theories of disease causation in TCM are based on inappropriate expression of emotions which leads to physical and mental symptoms. For example, inappropriate expression of anger is thought to affect the Liver. People who feel frustrated or irritable are often not expressing their underlying anger appropriately by talking about it or by creating change in their lives to relieve their frustration. This affects the function of the liver which helps promote the smooth flow of qi, or life energy, in the body. Consequently, this can lead to depression, achiness in the body, constipation, and inappropriate outbursts of anger. If the imbalance persists long enough, western diagnoses such as hypertension or tension headaches may result.
If holding in emotions or expressing them in inappropriate ways can lead to health imbalances which may lead to illness, endeavoring to express our positive and negative emotions in appropriate ways can be as preventive as exercising or eating a balanced diet. In our society, this takes awareness and careful choices of words as the expression of "negative" emotions such as anger or sadness is often discouraged socially. Nonetheless, it is important to be in touch with our feelings and to express them in an authentic way.
One way to appropriately express anger is through the use of "I" messages. Instead of saying "You make me so angry when you...," try instead saying "When you ...., I feel......" This takes ownership for feelings and provokes less defensiveness in the other person.
Learning to be in touch with emotions, expressing ourselves appropriately, and letting things go-it is not easy but produces rewards in enriching our emotional lives and our relationships and connections with others.
Eat Fruits and Vegetables
If you've heard it once, you've heard it a thousand times: Eat your fruits and vegetables! You probably already know that you are supposed to eat plenty of fresh produce every day. Here are some compelling nutritional facts that tell you why, as well as information about just how to go about getting enough into your diet.
Fruits and vegetables supply many nutrients that are important for your health. For example, dark-colored berries contain proanthocyanidins which are potent antioxidants. These, in turn, scavenge free-radicals (which cause cell damage), slow aging, and fight cancer. The orange color of carrots and sweet potatoes indicate their high levels of beta-carotene which the body converts into vitamin A. This vitamin is important for healthy skin and eyes. Popeye's favorite, spinach, is a good source of vitamin A, vitamin C, iron and calcium. All fruits and vegetables supply the body with fiber needed for cholesterol regulation and proper bowel function.
Ok, so now you know why, but how? Whether you eat them raw or cooked, steamed or stir-fried, whole, chopped or mashed, it is best to start with fresh organic produce. Frozen is also good because the nutrients are fairly well preserved by freezing. Rather than getting too caught up in how many servings to eat, what constitutes a serving, or how many cups to eat for your caloric needs, I suggest you use the following helpful tips:
• Emphasize vegetables in your meals, and choose fruits for snacks or dessert.
• Include dark green leafy vegetables every day.
• The brightest and deepest colors indicate the highest levels of nutrients.
• Eat a variety of plant parts: leaves, stems, roots, flowers and fruit.
• At lunch and dinner, aim for half of your plate being vegetables. (And I don't mean french fries!)
One great way to be sure to have a fresh supply of organic and locally-grown produce is to join a Community Supported Agriculture (CSA) program. Here in California, we are lucky to have so many wonderful farms nearby. Many of them offer CSA programs that provide consumers with direct access to economical farm-fresh produce. By paying a membership fee of $15-25 per week, you will receive a box of produce as well as a newsletter with recipes and information about the farm. Typically, you would pay quite a bit more than this at the store for the same amount of food. This system provides the farmers with another way to reach consumers and helps them with the investments necessary to grow quality fruits and vegetables.
Each CSA is unique in their offerings. For example, there may be different sized boxes, weekly or biweekly delivery, home delivery or neighborhood pick up locations; some items like fruit or eggs may or may not be included; and the membership may be monthly or all season long. Whatever your needs, you can find a CSA that will work for you. Because CSAs provide a variety of in-season produce, you may be introduced to vegetables that you don't usually buy at the store. This is a great way to get in touch with nature's cycles, try new foods, build a relationship with your farmer, teach your children about where food comes from, support sustainable agriculture, and be sure that you eat your fruits and vegetables.
Spend at Least 30 Minutes Outdoors
Sunlight is every bit as central to our health and well-being as proper nutrition,clean water, and exercise. Naturopathic Doctors often recommend that we spend at least 30 minutes a day outdoors. Here are a few reasons why:
Our bodies make Vitamin D when our skin is exposed to sunlight. 4-10 minutes in the noon day sun in the southern US, for example, produces the equivalent of 10,000 to 25,000 IU of oral Vitamin D. (MIlk, for example, contains 400 IU Vitamin D per quart.) There is strong evidence for a protective effect of Vitamin D on healthy bone density, muscle weakness, more than a dozen types of internal cancers, multiple sclerosis and Type 1 Diabetes. You do not need to get a sunburn to get adequate vitamin D and suncreens that block UVB diminish our bodies ability to make Vitamin D.
Sunlight affects moods positively and is a natural antidepressant.
Exposure to sunlight stimulates the pineal gland to produce melatonin which plays a role in proper sleep and has been shown to fight cancer.
When we are outdoors we tend to be more active by walking, hiking, and enjoying other physical activities. Also, being outdoors puts us in touch with nature and allows us to see and experience the rhythms and cycles of the natural world, reducing stress and increasing our sense of connectedness.
If you live in a new house or work in a modern office building, you may be exposed to high levels of indoor air pollution. New buildings are well insulated, trapping gases from carpets, pesticide and cleaner residues, smoke, dust and other respiratory irritants. Being outdoors part of the day allows us to get fresh oxygen and reduces our exposure to indoor irritants.
Finally, by doing a brisk walk for 30 minutes outdoors every day you can accomplish several simple healthy tips at once!
Do something physically active.
We've all heard about the importance of maintaining fitness and regular cardiovascular exercise. However, many of us don't get nearly enough activity to stay fit, due to sedentary jobs and lifestyles, busy schedules, etc. Many join gyms only to find a few months later that they are paying their monthly dues and not showing up for their "workouts".
Regular moderate daily physical activity goes a long way to help us maintain and improve our fitness. as well as our sense of well-being. Below are a few ideas to help you find ways to stay active every day:
Play: Have you ever noticed that adults workout and children play? Find an activity you really enjoy and you are more likely to do it more often. Go out dancing. Join a sports team like ultimate frisbee or softball. Go rollerblading or bicycling. Play more often.
Walk 15 minutes away from your house and then return: Walking is one of the best forms of exercise and almost anyone can do it. A recent study found that people who walked their dog 20 minutes daily 5 days a week lost 14 lbs in one year and improved their flexibility and balance. They also felt more positive and energetic. If you have a dog, walk it every day; if you don't, walk it anyway.
Integrate little walks and activities into your daily routines: Run small errands without your car – bike, walk, and ride public transit. Park in the far corner of the parking lot and walk to the front door. Walk two flights up and three flights down in multi-story buildings.
Take a hike: Hiking not only gives us a chance to get in a long walk, it also can take us into the beauty of nature. We are blessed in the Bay Area to have many urban parks, scenic waterfronts, and accessible wilderness areas to hike in. Hikes vary greatly in length and intensity, so choose one that is right for you. If you have trouble being active on a daily basis, try to plan a weekend hike for an hour or so.
Be more active with your household chores: Many local gyms, in addition to weights and treadmills, offer classes such as step aerobics, pilates, and stretching. San Francisco abounds with yoga studios, tai chi classes, pilates studios, and Curves franchises. If scheduling your activity works better for you, consider which activity speaks to you and go for it. SOMA Acupuncture can help you find a neighborhood activity that suits you.
Keep regular sleep hours.
Insomnia and sleep problems are major complaints from people these days. According to the National Institutes of Health, approximately 70 million people in the USA may be affected by sleep problems with approximately 60% of the US population suffering from some type of chronic sleep disorder.
The use of medications to help people sleep is one of the fastest growing segments of the pharmaceutical industry. Between 2000 and 2004, the use of sleep medications doubled among adults 20-44 years old, and the use of these medications in children aged 10-19 increased by 85%. Every night we see ads on TV for Ambien, Lunesta and other sleep aids. Clearly, the promotion of sleep aids is a profitable endeavor for the pharmaceutical industry.
This trend is alarming. We know that extended use of sleep medications often makes insomnia worse over the long term, and many prescription sleep meds can be habit-forming. These drugs often don't treat the cause of sleep problems, thus becoming a crutch instead of a cure, and have a plethora of side-effects. While we know that the use of sleep medications should be restricted to brief periods of time and used intermittently, it is very common to see people at our clinic who have used sleep aids for months or even years at a time.
Fortunately, there are many natural solutions that address the causes of insomnia and other sleep problems which have few if any side effects, are cost effective (or free), and can help improve overall health. One of the most effective behavioral remedies we've found is keeping a regular bed and wake time schedule.
Our sleep-wake cycle is regulated by our brain as part of our circadian, or daily, rhythm. Nervous system chemicals such as melatonin and cortisol tell our minds and bodies when it's time to sleep and when it's time to wake up. By keeping regular sleep hours, we strengthen our natural circadian rhythms which helps us fall asleep more easily. This is especially true if you have different schedules on different days of the week. If you're used to getting up at 6 am on weekdays to go to work but sleep in until 10 am on weekends, your circadian rhythms change as if you flew to the east coast every weekend. No wonder you're tired on Monday morning!
Try it; it works well. I haven't used an alarm clock in years unless there was a special circumstance and find that my body and mind fall in to natural cycles of the seasons. I get sleepy around 10 pm nightly and naturally wake up around 6-7 am in the morning, and have good daytime energy levels. These times vary slightly from winter to summer with changes in daylight. Make sure you allow 7 to 9 hours in bed nightly to get sufficient sleep and rest. If events come along that change this rhythm, that's to be expected; just be sure that the sleep bed and wake times are generally consistent over the long term.
Establish a relationship with a doctor you can trust.
By following a healthy lifestyle, you can greatly reduce the risk of many acute and chronic diseases; however, no matter how well we take care of ourselves, we occasionally need health and medical care. Accidents and injuries happen, acute infections arise, and chronic health issues require ongoing management. Just as important, preventive and wellness care such as periodic physical examinations, gynecological check-ups, dental care, and screening lab tests are tools to look ahead and improve your chances of preventing or delaying the effects of aging and chronic disease.
There are significant advantages to establishing ongoing relationships with health care providers who you know and trust. Early on, your doctor gets to know your relevant medical and family history, assesses your current health status, and can advise ways to lead a healthy and balanced lifestyle. Subsequent care insures that someone is working with you to make sure you are achieving your health goals, adjusting your plan as necessary and avoiding any potential harm. In the long run, when health issues arise, there is a partner you can turn to, to help treat and guide you.
On the other hand, if you don't have a health care provider, you may be unaware of underlying health issues such as high blood pressure, high cholesterol and other predictors of health risk, and seek expensive care at emergency rooms or with doctors who don't know your health history and treatment preferences.
Naturopathic doctors, or NDs, are general health practitioners who specialize in natural medicine. Trained much like medical doctors in physical examination and diagnosis, NDs provide preventive health care including review of health history, physical exam, and screening for disease risk as well as treating common health conditions. NDs are well trained in nutrition, herbal medicine, lifestyle factors and other natural therapies to maintain good health as well as address specific health conditions. An ND on your health care team can help you live a healthy lifestyle as well as treat many health conditions in ways that support your innate healing ability.
Having an MD on your team is also important. Modern medicine is particularly effective in treating injuries and emergency health conditions, and MDs have access to strong medicines which can be life-saving. Further, MDs are well trained in diagnosis and have access to current technology and procedures such as surgery that can be essential in the proper treatment of many injuries and diseases. Medical specialists such as orthopedists and ophthalmologists provide highly qualified treatment for specific health problems.
Rounding out your health care team may involve working with an acupuncturist, physical therapist, chiropractor, or other health care provider either on a preventive basis or to address specific health issues.
Whoever you choose to be a member of your health care team, it is important that they know your goals and your desire to manage your health with an integrative approach. They should be open to your active involvement in your health and be willing to coordinate care as needed with other team members.
In the San Francisco Bay area, we are fortunate to be a member of a group of health care providers who have joined together in a collaborative network called Starfish Health Partners. Starfish partners come together to learn of each other’s practices and ways to work together in the best interests of their patients. Providers partner with one another to make referrals where appropriate and are committed to an integrated approach to health care.
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