Happy Healthy Long Life

Oops! Take It From Me - Half Dietary Measures to Lower Your Cholesterol Will Result in Half Measure Improvements

"The first thing I do when people tell me that they can't reduce their cholesterol to 150 ml/dL or less is press them on precisely what they eat on Friday or Saturday nights, or what they might have consumed at that seemingly endless weekday meeting where there was "nothing else to eat."

Often, under my questioning, they reveal tiny deviations from the nutrition program--lapses so small that they didn't even take them into account.

--Dr. Caldwell B. Esselstyn, Jr., Prevent and Reverse Heart Disease--

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Let this be a cautionary tale!

I thought I was doing everything right with my diet. I'm eating loads of vegetables, fruits, beans, and whole grains.  I feel wonderful.  I've accrued countless benefits.  But I didn't cut out oil or nuts or avocados.

• Two years ago I "mostly" cut out all dairy, eggs, and meat.  And yes, that includes, cheese, yogurt, chicken, my beloved turkey sandwiches, and fish.
• About one year ago I "mostly" cut out sugar--ditching desserts that deliciously combine butter, oil, flour, and sugar.  But, I didn't cut out super dark chocolate every once-in-awhile.
• I limited my cooking oils to just canola or olive oil, and cut down the amounts considerably.
• I still ate nuts, including almond butter, and my fave Larabars--and I ate them in moderation.
• I still ate avocados. 
• Occasionally, I'd eat humus or baba ganoush that were store-bought or restaurant-ordered & of course they're made with fat-heavy tahini.
• I ordered vegan dishes whenever I ate out--but didn't think too much about the oil used back in the kitchen.  Deep-fried falafel?  Fried onions on top of the Mujadara?  Indian vegetable curries?  You get the picture.  And I never asked the chef for "special orders" made without oil
• Maybe every other month I might eat fish at a friend's house, or at a restaurant. 

I figured I was healthy.  No diagnosed heart disease.  I've exercised for over 35 years.  My weight's fine, even though I'd love to drop a few pounds.  I figured I could successfully follow the Esselstyn/Engine 2/McDougall/Fuhrman plant-based diet-thing "my way"--not exactly "their way"!   Unknowingly, I chose to eat plant-based with moderate fat intake--which isn't exactly what they're prescribing.  Oops on me!

Boy was I in for a surprise!

The Cholesterol Test - Did I Ace It?

My last cholesterol test was 2 1/2 years ago, taken five months before I started eating plant-based.  And because I had squeaked in as "healthy" after my last cholesterol test--I still didn't need any statins--and my health plan wouldn't "authorize" a new cholesterol test for me for 2 1/2 years!  I certainly was curious to see how eating plant-based was affecting my cholesterol--but I was going to have to wait 2 more years to find out.

But, when a new "Employee Wellness/Shape Up" initiative began this year at the medical center where I work--all that changed.  Now--all of sudden I was required to retake the cholesterol test, and all the other tests needed to qualify for a health insurance discount.

Here's the deal:  If you want to "Lock Into" 2009 health insurance rates for 2010 & 2011 you have to prove:

• Your weight is healthy--a BMI below 27 (which is actually overweight). 
• Your blood pressure is normal at 120/80 or below
• You are diabetes-free
• Your cholesterol levels are in the normal range.
• If you flunk any of these tests--you have to "enroll" in a "special help" program to lose the weight, lower the cholesterol, control the diabetes, and lower the blood pressure--before you can get an insurance rebate. 

I was sure I would Ace the cholesterol test that I took on May 6th.  The blood pressure test was the one I was a bit worried about.  I knew I'd pass the weight test.

So, imagine my disappointment when I got back my cholesterol test.  I thought for sure the total would be between 150-170.   Boy, was I mistaken.  Yes, my tests were good enough to be in the so-called "normal range".  I passed the test and I'll get my health insurance discount--but now I know I need to kick it up a notch if I want to beat the family "stroke and heart disease curse".

The results were good enough to still keep me "statin-free".   But, now that I'm eating plant-based, ingesting nary a speck of dietary cholesterol I was expecting a STRAIGHT-A LIPID TEST.  Nope, didn't happen. 

Here are my 2007 & 2010 scores--the bad, and the better.  According to my doctor, I'm one of those people whose cholesterol is affected to a large degree by what they eat. 

The Cholesterol Report Card

                        9/28/07        11/08/07        5/6/10

Total CHO          269                198                209

LDL CHO            157                 117               111

HDL CHO             96                   72                77

Triglycerides       84                   44               103

LDL:HDL Ratio    1:64                                    1:44

**Please note:  Total Cholesterol = LDL + HDL + triglycerides divided by 5.  That why a high HDL will falsely inflate the total.

Half-Measures Bring Half the Expected Results.  Oops!

So I was good enough to get my discount, and stay off of statins--but I wanted to know why my scores hadn't dropped more.  What was I doing wrong?  What was I missing?

The next day I decided to email Dr. Caldwell Esselstyn to get his opinion.  Sending this email felt totally presumptuous, an imposition, and nervy on my part--but I hit the send button before I could talk myself out of it.

• I told him I ate dark chocolate the night before the test
• I let him know I had eaten out the previous weekend
• I told him that I use spray oils, some canola & olive oil
• I let him know I ate nuts, and nut butters
• I asked him why he thought my triglycerides had increased so much.  I was only eating  whole grains & hardly any sugar.

But of course the night before my test I ate an Indian chutney made with sugar.  And a piece of chocolate. And I drank a glass of red wine.  No one had told me that it would also be a good idea to avoid alcohol for 24 hours before the test.  Only later did I find out that alcohol can significantly increase triglyceride levels.  I don't drink often--who knows why I decided to have a glass of wine that night?

The next day was Saturday and I headed out of the house early because I had to work.  As I'm driving to the hospital my cellphone rings at 8:00 am.  I figured it was either my husband trying to find something--or my sister, who was visiting from out-of-town.

Turns out it was Dr. Esselstyn, calling in reply to my email.  As he says, a few people can get away with eating foods like avocados, nuts, and some oil and it won't affect their cholesterol at all.  But, for most people, the least little addition of one of these offenders can keep the cholesterol up, and arteries inflamed.  I'm one of those people.

Dr. E:  I don't know what kind of restaurants you go to, or what you order.  What did you order the last time you went out to eat?

Me:  It was a Turkish restaurant.  I had a salad, without cheese, topped with 4 fried falafels--a bit of salad dressing--and a couple pieces of pita bread with baba ganoush.   White flour, tahini, salad oil, fried foods.  Duh?  What was I thinking?  Funny how easy it is to ignore what is going into your mouth when you're eating out--and thinking, "This is vegan. It will be OK."

Me:  And what about those triglycerides?  Why would they be so much higher than before?  I'm only eating whole grains  (except when I'm not--like the restaurant pita bread)

Dr. E:  For one thing, you can't keep eating chocolate, avocados, and nuts--and cooking with olive oil--and expect stellar cholesterol scores.  And what about dried fruits.  Are you eating those?

Me: Uh, yeah.  My morning steel cut oats are loaded with dates, and raisins, and dried cherries.  Dr. E informed me that these are the most concentrated sugars--I should avoid them--or eat smaller quantities.

I went on to express my concerns about eating too little oil, and asked him if a cholesterol under 150 could ever have negative effects.  Not if you're doing it naturally, through your diet, he told me--like many disease-free native communities have done for years.  And don't worry getting enough fat to absorb vitamins--there's fat in almost all vegetables, beans, and grains.

But, the best part...  Dr. Esselstyn generously invited me to join his next small group 5 1/2 hour appointment that would be meeting in mid-June, where I would get a first-hand understanding of how I could kick up my "healthy eating" a notch, and learn why it's in my best interest to do so.  Like ditching those added oils at home--and lurking in restaurant meals.  And I'll get the chance to have all my questions answered.

I thought I would be able to skip the "no-added-oil-no-nuts-no-avocado" requirement of the Esselstyn diet  But I guess My Way wasn't enough.  Click here to read:  I'm Going to Miss My Olive Oil.  Who Knew It Wasn't So Healthy After All?  Drs. Esselstyn, Ornish, Vogel, and Rudel Did.

Dr. Esselstyn's Heard This All Before

"The first thing I do when people tell me that they can't reduce their cholesterol to 150 mn/dL or less is press them on precisely what they eat on Friday or Saturday nights, or what they might have consumed at that seemingly endless weekday meeting where there was "nothing else to eat."

Often, under my questioning, they reveal tiny deviations from the nutrition program--lapses so small that they didn't even take them into account.

One example: by the time you hold down the nozzle on a popular cooking spray long enough to coat a wok or pan, you'll build up about a tablespoon of oil.

Such transgressions can easily be enough to injure the endothelium's capacity for producing nitric oxide, which in borderline cases can mean the difference between success and failure.  It is the kind of attention to tiny details that makes my program work.

It is true that there are some people without heart disease who strictly adhere to a plant-based diet--no lapses at all--and even so, cannot reduce their cholesterol below 165-170 mg/dL.  (Some researchers have suggested that years of eating fat and cholesterol may compromise the body's natural capacity to reduce cholesterol levels.)

For these people, a modest dose of a cholesterol-lowering medication under physician supervision should take care of the problem.  It is worth noting, however, that anyone who achieves a cholesterol level of 165-170 mg/dL by eating a strictly no-fat, plant-based diet is already doing wonders for his or her health, even without reaching the optimal level.

That person is, by definition consuming large quantities of natural antioxidants, which prevents the body from oxidizing LDL cholesterol into its most dangerous, artery-clogging form."

--from Esselstyn, Dr. Caldwell B.  Prevent and Reverse Heart Disease.  New York: Penguin Group, 2007--

Reconsidering the So-Called Healthy Oils

Drs. Matt Lederman and Alona Pulde appear in the upcoming documentary, Forks Over Knives--they're the physicians who were responsible for turning around the health of writer/director Lee Fulkerson and Joey A. of Tampa.  On their web site they provide an excellent explanation of why oils need to go:

Question: Do you prohibit the use of vegetable oils?  Does this include Olive Oil?

Answer: Thank you for your question and your interest. Our feeling about oils is that they are processed forms of foods high in calories and low in nutrients.  The more a food is processed the less healthy it is! 

Furthermore, vegetable oils including olive oil are NOT health foods! These oils suppress the immune system (increasing risks of infections and cancer), promote atherosclerosis (clogging of the arteries), increase bleeding, cause insulin resistance, and lead to obesity.

With regards to olive oil, we have been misinformed of its “benefit” from observations that people on the Mediterranean diet are healthier than people on the American diet. This is so because their diet consists largely of fruits, vegetables, and grains with little animal products...not because of the olive oil. In fact, they are healthier DESPITE the olive oil in their diet and not because of it! 

That being said, although we highly recommend against the use of vegetable oils, we don’t like to use the word prohibited. So if you feel you have to use a little bit of olive oil or else you will go back to cheeseburgers, milkshakes, and fries...then by all means, use that bit of olive oil. 

However, it might be helpful to know that there are many healthier forms of fat to use out there.  Ground up, unsalted olives are much healthier than the extracted olive oil and still add the wanted olive flavor. 

When you are frying something you can use a fat substitute like juice or vegetable broth to cook with rather than oil. Then you can add a healthier unprocessed form of fat if you want that particular flavor...such as ground up cashews, seeds, or avocado. 

The benefit of using a ground up whole food is that you then also get things like fiber, vitamins, and minerals that are discarded when you extract the oil from the whole food. These nutrients are not only important for your health but also help shut off your hunger signals, ultimately preventing you from overeating.

Finally, we don’t like to use the term “okay” like you are doing something wrong if you don’t follow these rules. Certain oils/fats (olive, canola, peanut, avocado) are less saturated and better for your heart than others (palm kernel, coconut, butter) but we would never say olive oil is a health food.

Also, remember that the most important thing is that we do our best. Meaning, if you are out and wind up eating some oil because there is no alternative and you didn't prepare for the situation...it's not the end of the world or your health.  Rather, just be better prepared for next time. Any move closer towards a low fat plant based diet is not only healthier for you, but will prevent more disease and give you more energy.  So in the end, please don't be too hard on yourself as you do the best that you can!

Cleaning up my kitchen act:  I've already started sauteing with vegetable broth, or other flavored liquids instead of with oil or oil sprays.  It wasn't such a big deal. I'm using parchment paper or a Silpat to roast vegetables, or for "stick-free" baking.  Just yesterday I found a delicious tahini & oil-free red pepper humus.  I've also discovered a fat-free whole grain pizza crust made by Kabuli.  I can do this!

I'd really appreciate any tips, advice, or experiences that you can offer to help me with this new adventure in going oil-free--or almost-oil-free.

A New Role for Omega-3? Lengthening Our Telomeres--A Key Marker for Aging, Longer Life, and Health. From JAMA & UCSF.

  

 

"The main result of our study is that patients with high levels of Omega-3 fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length. It's also the first study that shows that a dietary factor may be able to slow down telomere shortening."   

-Ramin Farzaneh-Far, M.D., of the University of California at San Francisco, lead author of "Association of Marine Omega-3 Fatty Acid Levels with Telomeric Aging in Patients with Coronary Heart Disease"  JAMA 2010;303(3):250-257.

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This week's big medical news story appeared in JAMA and it is one more reason why you want to be sure to get your Omega-3s everyday--while lowering your intake of the Omega-6s.

We already knew that the Omega-3s were amazing.

• They're anti-inflammatory and anti-clotting
• They prevent age-related cognitive decline
• They lower triglycerides
• They lower blood pressure
• They slow age-related macular degeneration
• They keep blood vessels flexible
• They lower depression
• They decrease joint stiffness in rheumatoid and osteo-arthritis
• They're necessary for fetal and infant brain development

So What Did The JAMA Heart And Soul Study Tell Us That We Didn't Already Know?

The UCSF researchers followed 608 outpatients with stable coronary artery disease for 5-8 years.  At the start of the study they measured everyone's levels of Omega-3's and the length of their leukocyte telomeres--which is a marker of aging.  Remember though--this was an observational study, not a gold-standard double-blind randomized controlled study.

Here's how the lead researcher Dr. Ramin Farzaneh-Far explains the results:

"The main result from our study is that patients with high levels of Omega-3's fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length."

"Patients with the highest levels of Omega-3 fish oils were found to display the slowest decrease in telomere length, whereas those with the lowest levels of Omega-3 fish oils in the blood had the fastest rate of telomere shortening, suggesting that these patients were aging faster than those with the higher fish oil levels in their blood."

"By measuring telomere length at two different times we are able to see the speed at which the telomeres are shortening and that gives us some indication of how rapidly the biological aging process is taking place in these patients."

What Are Telomeres And How Exactly Do They Affect The Aging Process?

 

 

PLASTIC TIPS ON SHOELACES—that’s the analogy often used to describe telomeres. They are the red caps sitting on the ends of these blue chromosomes. 

Just like plastic shoelace tips that keep the laces from fraying--the telomeres protect valuable genetic material needed for our cells to divide properly, and to repair worn-out cells.

They are also strong markers for aging (see the graph below and get depressed).  Not only do they shorten as we age, over time the telomeres can become damaged and shorten because of inflammation, smoking, obesity, or lack of exercise. 

Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,

"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."

This week's JAMA study is just one more bit of evidence that shows how our lifestyle choices can affect telomere length--and promote healthy aging.

• A 2008 twin study published in the Archives of Internal Medicine compared the telomere length of exercising twins versus couch-potato twins.  After only 12 months, the telomere's of the exercising  showed the equivalent of being 10 years younger than their couch-potato siblings.  Click here to read about the study.
• A 2008 study led by Dr. Dean Ornish followed a group of men with early prostate cancer who made these lifestyle changes:  increased their fruit & vegetable consumption; limited their fat consumption to 10%; lowered their consumption of refined sugar; took vitamin supplements & fish oil; exercised for 30 minutes a day; and either meditated or did yoga for stress relief.  After only 3 months, 24 out of 30 men showed significant increases in their telomerase levels.  Click here to read about the study.
• A number of studies have also shown how stress can accelerate telomere shrinking, especially in caregivers of chronically ill children and the spouses of Alzheimer's patients.  One study even suggested that you can accelerate your biological age by as much as 17 years if you're exposed to what you perceive as high psychological stress!

All About Omega-3's.  Does It Really Have To Be Fish Oil?

Yes, the JAMA study used Omega-3 fish oil, but Omega-3s really originate in green leafy plants--not in fish.

Susan Allport is a medical researcher who is an expert in "all things Omega-3".  She has written a brilliant article in the September 2009 issue of Prevention, "The Vanishing Youth Nutrient" that does an excellent job of explaining why we need Omega-3s in our diet, why so many physicians equate Omega-3 with fish, and why Omega-3 is sorely lacking in our diets.  Click here for the article.

• We can only obtain the Omega-3s through our diet. 
• They are essential to the healthy development of our brains--and they are found in the highest concentrations in our most active tissues: brains, eyes, hearts, the tails of sperm.
• The metabolism of every species on the planet is a function of the amount of Omega-3s in its tissues, according the Dr. Tony Hulbert of the University of Wollongong in Australia.  Think: Omega-3=growth, activity, energy.  Omega-6=hibernation, fat storage, belly fat.   Athletes take note:  high concentrations of omega-3s in muscle cells lead to improved athletic performance.
  
• Research from the 1980s showed fish-eating populations of Greenland and Japan had the lowest rates of heart disease.  That's why the Omega-3s became associated with fish--instead of with green plants.  And that's why the American Heart Association recommends fish or fish oil as our main source of Omega-3s.  Big Problem:  Fish are not a sustainable source of Omega-3s--there are simply not enough fish in the world's oceans.
• Big Point:  "Omega-3s are found in the green leaves of plants.  Fish are full of omega-3s because they eat phytoplankton (the microscopic green plants of the ocean) and seaweed.  They are what turn sunlight into sugars, the basis of life on Earth."
• You can get all your Omega-3s from green leafy vegetables, legumes, flax seeds, chia seeds (they have the highest level of any plant-click here to read more), or walnuts, grass-fed animals and their milk, or eggs, wild cold-water fish like salmon, highly purified fish oil supplements, or algae-sourced Omega-3 supplements.
• Big Point:  If you cut back on vegetable oils, processed foods, trans-fats, corn-fed meat, chicken and milk you will actually lower the amount of Omega-3s you need in your diet to balance the negative effects of the inflammatory, fat-promoting Omega-6s we are getting in our Western Diet.
• The ratio of Omega 6's to 3's should be 2:1, or ideally 1:1.  Currently, for most Americans, the ratio is 17:1 in favor of heart-disease-causing Omega 6's.

Why Is Our Diet So High in Omega-6s, And So Low In Healthy Omega 3's?

• Omega-6 fats come from the seeds of plants.  We need them--but we need far less of them than we are consuming--and we need them in just the right ratio to Omega-3s.  They promote blood clotting, inflammation, and cause us to "pack on the pounds".  Just like corn-fed beef.  Grass-fed or plant-fed animals and humans are naturally lower in fat!
• Big Point:  Omega-6s and Omega-3s are in constant competition to enter our cells.  Eat too many Omega-6s in the form of meat, oil, or processed food--and you'll be seriously deficient in Omega-3s.  Eat less Omega-6s, and your body won't need as many Omega-3s to function properly.
• Omega-3s began to disappear from our food supply when previously grass-fed animals began eating corn and soybeans, which are high in Omega-6s.  The factory-farm and feedlots replaced the family farm, and grass-fed meat, milk, and eggs became history.  Click here to read about King Corn's effect on our health.
• With farm subsidies for corn and soybeans, companies like Archer Daniels Midland figured out how to extract oil from these and other seed plants--giving us even more Omega-6s in our diet.
• The AHA and other health agencies encouraged us to use oil and margarine because they assumed these cholesterol-free oils were good for the heart.  Wrong!
• "Food chemists discovered that rancidity in packaged food was caused by the oxidation of some minor but pesky  fats: the Omega-3s."  So they removed them and extended the shelf-life of packaged food.
• Fewer and fewer of us are eating enough green leafy vegetables, fish, or flax to even put a dent into the "out-of-whack" Omega-6 to Omega 3 ratio.

I highly recommend you read Susan Allport's article in Prevention, as well as her book, The Queen of Fats.  She does an excellent job of explaining the good, the bad, and the ugly of the fat world.

If you need any more convincing on the wonders of Omega-3, watch Allport's brief video, The Rat Race, comparing rats fed on diets rich in Omega-3s with those fed on diets deficient in Omega-3s.

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The Longevity/Vigor Quest. It's Centenarian Joe Rollino Matched Against the Anti-Aging Medicine of Cenegenics Medical Institute. Lifestyle Modification vs Pharmaceuticals

The Great Joe Rollino at 103

The Great Joe Rollino as a young man.

 

 

 

 

 

 

Joe Rollino, was 104, just 2 months shy of turning 105, when he was fatally injured by a minivan in Brooklyn on January 11, 2010.  He was on his daily early morning walk to pick up coffee, a tabloid, and a lottery ticket.  Until the end he was strong, healthy, and a picture of health!

If not for the New York Times, I would never have heard of Joe Rollino.  He was man from a different time. Growing up near the turn of the century, quitting school at 10 years old to join the carnival.  He led a career as a Coney Island strongman, a boxer, and a trainer, who billed himself as "The Strongest Man in the World".  

At 5-feet-4-inches 122 pounds, in his prime he once lifted 475 pounds with his teeth, 675 pounds with just one finger, and moved 3200 pounds with his back.  He bent quarters with his teeth and fingers and continued to demonstrate his coin-bending skills into his 100's.

"Pound for pound, in the feats that he practiced, he was one of the greatest performing strongmen we've ever had, if the lifts he's credited with are accurate.   For his size, Joe was apparently one of the strongest men who ever lived."

-Terry Todd, co-director of the Stark Center for Physical Culture and Sports at the University of Texas, who knew Joe for 40 years-

 

What Can We Learn From New York City's Oldest & Strongest Man?

• He was a lifelong vegetarian, as was his mother--which at the time was unusual.
• He never drank, smoked, or indulged in sweets.  At his 104th birthday party he blew out all the candles on his cake, but passed on eating a piece.  He said if he never would have made it to 104 if he ate that kind of stuff.
• He ate oatmeal every morning.
• "He was the picture of health until he died.  He had no glasses, no hearing aid.  He had no assistive walking device and didn't take any prescription drugs of any kind,"  according to his close friend Arthur Dreschler, president of Joe's club, "The Association of Oldtime Barbell and Strongmen".
• Rain or shine he still walked 5 miles every morning (albeit a little slowly), and exercised daily--which sometimes included swimming laps in the Atlantic ocean.  He continued to lift weights five days a week--even exercising before his 104th birthday party luncheon.
• He was a devotee of the "Iron Game", a body-building philosophy that supports weight-lifting as an enjoyable lifelong hobby but strongly eschews steroid use.
• He was a longtime member of the Coney Island Polar Bear Athletic Club--a group who swims in the icy Atlantic ocean 3 to 4 times a week.   They call it "winter bathing" and attribute their good health to the practice.  They believe "if they stay in for 5 to 10 minutes, the cold water kills germs that fester inside one's body."  All the Polar Bear members claim that once they started "winter bathing" they haven't been sick.  Same for Joe, who at 103 said he couldn't remember the last time he was sick.  His friend, fellow Polar Bear buddy, and former Brooklyn homicide detective,  Louis Scarcella, said Joe held the Club's record, swimming every day, no matter the weather for eight years, never missing a day.
• "Muscle strapped to bone" is how Louis Scarcella described Joe.  Until the day he died, people described him as physically active, agile, and loose.  Mentally lucid and sound.  "His memory was nothing short of astounding, especially when you consider he fought at about 122 pounds, often against boxers weighing 50 pounds more than he.  To say he was a physical marvel, would be a gross understatement." 
• "If he told me he was 75, I would have said he looked great for his age, and here he was 104 years old," said extremely-fit 61 year old  retired NYPD detective, Arthur Perry.
• Friends said he lived life to the fullest, and looked forward to every day with enthusiasm.  He was never skeptical, cynical, angry or resentful. 

To read more about Joe click here.

 
 

The Other Side of The Vigor Quest--$10,000 a Year for H.C.G., Growth Hormones, and Testosterone

Contrast Joe Rollino's simple healthy low-tech lifestyle with the kind of big buck pharmaceutical techniques featured in the fascinating January 17th, New York Times Magazine article by Tom Dunkel, "Vigor Quest".  Click here for the full article.

It's the kind of anti-aging medicine that costs lots of out-of-pocket-cash, and follows controversial skimpy medical evidence. It might bring vigor for now, but serious adverse effects down the road.  The jury is still out.  It's part good common sense, like a low glycemic-diet, weight-training, aerobic exercise, omega-3 supplements--and part human lab rat experimentation.

But its devotees say, "Lifestyle alone isn't enough." 

To combat the corrosive effects of aging, every three months the followers of Cenegenics Medical Institute's  brand of anti-aging medicine--and they now number around 10,000--get 10 vials of blood drawn, in order to measure all sorts of hormone and blood chemistry levels--checking to see what sort of pharmaceutical tweaking is in order. 

A little more testosterone?  A bit more human growth hormone?  Perhaps some H.C.G.--human chorionic gondatropin, a commonly used fertility drug that is distilled from the urine of pregnant women, and can stimulate the testes to secrete more testosterone.

Author Dunkel interviewed John Bellizzi,  a 51 year-old amateur soccer player and businessman from Rye, NY, who got fed up with using Advil, hot tubs, and surgery to keep him in the game. 

Two years ago Bellizzi consulted with Manhattan endocrinologist Dr. Florence Comite, who is affiliated with Cenegentics.  Comite calls her work, "...aggressive prevention, the basis of which is metabolism modulation.  Twenty years from now, this will be the standard of care."  She's like an "ace mechanic who keeps Bellizzi running in spite of worn parts."

Turns out, Comite has impeccable credentials--she's Yale-trained, with former stints at the N.I.H., and as a part-time faculty member at Yale.

Now, two years after working with Comite, Bellizzi is a believer.  He no longer collapses on the couch after soccer games, he can play an hour longer than before, he feels mentally sharper, and he is 15 pounds lighter.  It might be the changes in his diet, eliminating the junk food, adding some mainstream supplements, and having a more well-rounded exercise regimen. 

Bellizzi credits his turnaround to the controversial H.C.G. he injects--which also happens to have a list of scary side effects.
 

The Cenegenics' Poster Child Dr. Jeffrey Life

Who hasn't seen this picture of Dr. Life in every airline's complimentary magazine?  He's the 71 year old doctor, who was once fat and unfit, until he re-invented himself with diet, exercise, and the Cenegenics brand of pharmaceuticals.

For Life this means:

• 1,000 milligrams of calcium a day
• Co-Q10 twice a day
• 5,000 IU of vitamin D a day
• 4 grams of fish oil a day
• 10 mg of melatonin at bedtime
• A testosterone injection once a week
• A human growth hormone injection once a day

Read the article.  Interesting provocative reading, but no thank you!  I'm sticking with my simple lifestyle modification plan of diet and exercise!  It's the Start of the New Year, the Start of the New Decade, and the Start of My Sixties. Some Simple Strategies for Staying Healthy and Happy. At Least I Can Hope!

So, what do you think?  Joe Rollino or Dr. Jeffrey Life?  

Eat, Sleep, Exercise. The Rules. Michael Pollan, Dr. Mark Hyman, and Dr. Oz.

 

If I want to be on top of my game, energetic, happy, nice, patient, healthy, and clear-headed, I need to EAT HEALTHY FOOD, GET A GOOD NIGHT'S SLEEP, AND EXERCISE.  It's that simple.

I'm also a sucker for lists.  So, when I came across these three "Rules Lists" I wanted to "capture them" for future reference.

• Food Rules: Your Dietary Do's and Don'ts, by Michael Pollan, New York Times Magazine Food Issue, October 11, 2009.  Earlier in the year Michael posted a request for readers' rules on Tara Parker-Pope's Well blog.  He received 2,500 responses, and offered his favorite 20 in this issue.  Click here for Pollan's full list.  He has recently published a short-useful-funny paperback--with 64 short simple rules--Food Rules.  An Eater's Manual based on his now famous saying, "Eat food.  Not too much.  Mostly Plants."  For a short interview about the book, click here.  I've provided a "mash-up" of my favorites. Some from NYT's readers and some from Michael's book.

• Sleep Tips:  How to Sleep Better, Lose Weight, and Live Longer, by Mark Hyman, MD, practicing physician and pioneer in functional medicine.  Huffington Post, Jan. 9, 2010.  Click here for the full list.

• Realistic Resolutions From Dr. Oz, by Tara Parker-Pope, Well Blog, New York Times Dec. 29, 2009.  Click here for the full list.

Eat.  Michael Pollan's Food Rules

 1.  Avoid food products containing ingredients that no ordinary human being would keep in the pantry.

2.  If it came from a plant, eat it; if it was made in a plant, don't.

3.  Eat mostly plants, especially leaves.  Aim for a pound or more of fruits and vegetables a day.

4.  Treat meat as a flavoring or special occasion food.  And when & if you do--Eat animals that have themselves eaten well.

5.  Eat your colors.

6.  Eat well-grown food from healthy soil.

7.  Eat some foods that have been predigested by bacteria or fungi.  Many cultures swear by the health benefits of fermented foods: yogurt, sauerkraut, kimchi, kefir, natto, and tempeh.

8.  Pay more, eat less.  

9.  Eat less.  Eat slowly.  Stop before you're full.

10.  Limit your snacks to unprocessed plant foods.

11.  Try not to eat alone.

12.  Cook.  

13.  Don't leave the table until you've finished your fruit.  "My parents are both from Italy & one of our family rules was that you could not leave the table until you had finished your fruit.  'Non si puo lasciare la tavolo fino che hai finito la frutta.' It was a great way to incorporate fruit into our diets and also helped satiate our sweet tooths, keeping us away from less healthful sweets."  Marta C. Larusso

14.  "Don't eat anything that took more energy to ship than to grow."  Carrie Cizauskas

15.  "Never eat anything that is pretending to be something else; e.g. 'textured vegetable protein' or veggie burgers (fake meat), no artificial sweeteners, no margarine (fake butter), no 'low fat' sour cream no turkey bacon, no 'chocolate-flavor sauce' that doesn't contain chocolate, no 'quorn'.  If I want something that tastes like meat or butter, I would rather have the real thing than some chemical concoction pretending to be more healthful."  Sonya Legg  (I'm still sticking with my Field Roast sausages and Gardein.  See rule #22)

16.  "Make and take your own lunch to work.  My father has always done this, and so have I.  It saves money, and you know what you are eating."  Hope Donovan Rider  (love this one!)

17.  "If you are not hungry enough to eat an apple then you are not hungry."  Emma Fogt  (needless to say--this one is my favorite!)

18.  "The Chinese have a saying, 'Eat until you are seven-tenths full and save the other three-tenths for hunger'.  That way, food always tastes good, and you don't eat too much."  Nancy Ni

19.  "One of my top rules for eating comes from economics.  The Law of Diminishing Marginal Utility reminds me that each additional bite is generally less satisfying than the previous bite.  This helps me slow down, savor the first bites, stop eating sooner."  Laura Kelley

20.  "No second helpings, no matter how scrumptious."  Karen Harmin

21.  "It's better to pay the grocer than the doctor' was the saying that my Italian grandmother would frequently use to remind us of the love and attention to detail that went into her cooking."  John Forti.

22.  Break the rules once in awhile!

 

Sleep.  Dr. Mark Hyman's Sleep Rules

Dr. Hyman recommends these "rules" to get us back to our natural sleep rhythms.  "It may take weeks or months, but using these tools in a coordinated way will eventually reset our biological rhythms."  Hyman learned the hard way that even doctors can't compromise on sleep.

1.  Prioritize sleep, or suffer the consequences.

2.  Wind down, dim the lights, reduce mental stimuli, get off the computer two hours before sleep!  Do something more mentally relaxing. Take a little "holiday" before getting to bed in order to get your system physically and psychologically ready for sleep.  I've found this practice makes a major difference in my sleep quality.

3.  Practice the regular rhythms of sleep--go to bed and wake up at the same time each day.  Every single time I have to change my regular wake-up schedule in order to start work at 7:00 am, I have a terrible night's sleep!

4.  Use your bed for sleep and romance only--not reading or television.

5.  Create total darkness and quiet--consider using eye shades, earplugs, or a white noise machine.

6.  Avoid caffeine--it may seem to help you stay awake but it actually makes your sleep worse.

7.  Avoid alcohol--it helps you get to sleep but causes interruptions in sleep and poor-quality sleep.

8.  Get regular exposure to daylight for at least 20 minutes daily--the light from the sun enters your eyes and triggers your brain to release specific chemicals and hormones like melatonin that are vital to healthy sleep, mood, and aging.  Consider using a special light in the morning, like the Philips goLite BLU in the winter.

9.  Eat no later than three hours before bed--eating a heavy meal prior to bed will lead to a bad night's sleep.

10.  Don't exercise vigorously after dinner--it excites the body and makes it more difficult to get to sleep.

11.  Write your worries down--one hour before bed, write down the things that are causing you anxiety and make plans for what you might have to do the next day to reduce your worry.  It will free up your mind and energy to move into deep and restful sleep.

12.  Take a hot salt/soda/aromatherapy bath--raising your body temperature before bed helps to induce sleep. A hot bath also relaxes your muscles and reduces tension physically and psychologically. By adding one-and-a-half to one cup of Epsom salt (magnesium sulfate) and one-and-a-half to one cup of baking soda (sodium bicarbonate) to your bath, you will gain the benefits of magnesium absorbed through your skin and the alkaline-balancing effects of the baking soda, both of which help with sleep.  This was something I remember both my parents used to do, and neither had sleeping problems.

13.  Get a massage or stretch before bed--this helps relax the body making it easier to fall asleep.

14.  Warm your middle--this raises your core temperature and helps trigger the proper chemistry for sleep. Either a hot water bottle, heating pad, or warm body can do the trick.  My heated mattress pad works well for pre-heating my bed in the winter.

15.  Avoid medications that interfere with sleep--these include sedatives (these are used to treat insomnia, but ultimately lead to dependence and disruption of normal sleep rhythms and architecture), antihistamines, stimulants, cold medication, steroids, and headache medication that contains caffeine (such as Fioricet).

16.  Use herbal therapies--try passionflower, or 320 mg to 480 mg of valerian (valeriana officinalis) root extract standardized to 0.2 percent valerenic acid one hour before bed.  On occasion I've tried the valerian/hops combo and lemon balm recommended by herbal expert Dr. Tieraona Low Dog and they worked well.  Click here to read more. 

17.  Take 200 to 400 mg of magnesium citrate or glycinate before bed--this relaxes the nervous system and muscles. If you already take a magnesium supplement, just take it before bed, instead of in the morning.

18.  Other supplements and herbs can be helpful in getting some shuteye--try calcium, theanine (an amino acid from green tea), GABA, 5-HTP, and magnolia.

19.  Try one to three mg of melatonin at night--melatonin helps stabilize your sleep rhythms. I've taken melatonin on occasion, and it definitely helped me.

20.  Get a relaxation, meditation or guided imagery CD--any of these may help you get to sleep.

 

Exercise.  (and Eat and Sleep) Realistic Rules From Dr. Oz

Dr. Oz needs no introduction  This short list of 7 rules covers all the basics.

1.  Commit to family night.  Resolve to eat as a family at least once a week.  My kids are all grown-up, but this rule still works for empty-nesters.  For kids, its benefit is in healthier eating, home-cooking, and conversation. Research also shows it lowers the risk of behaviors like drug abuse and alcohol use.  Oz recommends cooking with your kids.  Works for empty-nesters, too--and when the "kids" are visiting!

2.  Do seven minutes of yoga a day.  We  can all spare seven minutes a day.  Dr. Timothy McCall, the medical editor of Yoga Journal, says 15 minutes of yoga done daily at home trumps going to one or less classes a week.  Oz advises if you haven't tried yoga, try one class to understand what it's all about.  "It centers me and allows me to loosen my limbs up so I don't have nagging small injuries."  I think yoga is one of the best things you can do for yourself.

3.  Go to bed earlier.  To figure out what time you need to go to bed--choose a wake-up time, and count back seven and a half hours.  No compromises.  Oz strongly advises turning off all electronics one half hour before bedtime.  He never sacrifices this rule-ever. 

4.  Always keep nuts or a healthful snack in your purse or pocket.  It's the key to prevent overeating.

5.  Make a space in front of your television.  Since very few of us are ready to give up TV, Oz recommends that we "use it" to improve our health.  Do stretches, use your treadmill or exercise bike, lift weights or do core exercise while you watch TV.  That's where I do my core exercises.  It's where my husband lifts weights.

6.  Floss.  It reduces the risk for heart attack, inflammation, and periodontal disease.  Just do it!

7.  Give it two weeks.

 

 

It's the Start of the New Year, the Start of the New Decade, and the Start of My Sixties. Some Simple Strategies for Staying Healthy and Happy. At Least I Can Hope!

Author Dan Buettner has scoured the Earth — not for the fabled Fountain of Youth — but for the key to a happy old age. He spent five years visiting areas of the world where people tend to live longer, healthier lives, areas he calls "Blue Zones."

Buettner says he has identified four things people can do that can potentially increase life expectancy:

• Create an environment that encourages physical activity
  
• Set up your kitchen in such a way that you're not overeating
  
• Cultivate a sense of purpose 
  
• Surround yourself with the right people.

"These are long-term fixes that have been shown over and over to add not only more years of life, but better years of life."

-NPR story, "Can 'Blue Zones' Help Turn Back the Biological Clock?", June 8, 2008-

If you're reading this through via email, click here to get to the more readable web-version.

 

It's the start of the New Year. 

It's the start of a new decade.

It's the day I turn sixty.

Look, I'm not a big-birthday-celebration-kind-of-person.  They come and go and I don't even think about the years.  But turning 60 is different.  It's the last quarter of life, with no guarantees on what that quarter is going to look like.

Judging by my parents--that last quarter of life doesn't look so promising.  Which is exactly why I've been paying attention to exercise and eating right since I turned 30. 

That's when my dad had one of those massive debilitating strokes that left him unable to communicate, unable to read or fully understand speech, and eventually unable to walk or do anything.  He was 69 at the time--just when he was getting ready to kick back a little, work a little less, travel, and just enjoy life.  He spent 16 years living in this kind of post-stroke-limbo-state, spiraling downward.

My mom was 62 at the time, and my dad's stroke changed her life in an instant.  One minute she was planning all the trips they'd finally have a chance to take--and enjoying their new role as grandparents--and in the next she was jockeying the world of wheelchairs and therapists.

With the stress of full-time care-giving, and years of no exercise or attention to diet, by 72 she had developed severe coronary artery blockages, hypertension, kidney stones, and painful spinal fractures.  Then came the mini-strokes that finally added up to vascular dementia in her eighties.

And unfortunately, this scenario is all too common.  "[M]ost elderly Americans – more than two-thirds of current 65-year-olds, according to a detailed 2005 projection by a team of health policy analysts — at some point will need assistance to cope with daily living, either paid help or unpaid, at home or in a facility."

So, sixty seems kind of scary to me.

Which is exactly why I'm ready for a more "Conscious Aging" plan.  We already have all the evidence we need to stay healthy.  It's not about adding more years to our lives.  It's all about adding more life to our years!

Just a sampling of the evidence.

• The 52 country INTERHEART study was very clear.  There are 9 easy-to-modify risk factors that are associated with 90% of heart disease.  This was a huge study--30,000 people from every inhabited country--and the results were the same for all races, all sexes, all countries.  All 9 of these risk factors are within our control--and would eliminate 90% of heart disease, regardless of one's genetics. 1. Keep lipids (cholesterol & triglycerides) down; 2. Stop smoking; 3. Prevent or control hypertension; 4. Prevent or control diabetes; 5.  Reduce belly fat; 6.  Find ways to control psychological and social stressors; 7. Increase fruit and vegetable consumption; 8.  Moderate alcohol consumption is protective; 9. Get regular physical exercise   Lancet 364:937-952, Sept. 11, 2004.
• The Nurses' Health Study and Health Professionals Follow-up Study.  "The largest and longest study to date, done as part of the Harvard-based Nurses' Health Study and Health Professionals Follow-up Study, included almost 110,000 men and women whose dietary habits were followed for 14 years.  The higher the average daily intake of fruits and vegetables, the lower the chances of developing cardiovascular disease...[F]or every extra serving of fruits and vegetables that participants added to their diets, their risk of heart disease dropped by 4%." Harvard School of Public Health

• The China Study.  This is Dr. T. Colin Campbell's mammoth 2006 study on the effects of a plant-based diet on health--citing over 750 studies.  The conclusion: People who ate the most-animal-based foods got the most chronic disease.  People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.  According to Campbell, "Good nutrition supported by exercise, clean water, and sunshine is greater than the sum of its parts.  It's a biological symphony.  My introduction to Dr. T. Colin Campbell

• The Longevity Personality.  From the Journal of the American Geriatrics Society, April 2009 comes this conclusion: Those who live the longest are more outgoing, more active, more easy-going, more empathetic, and more agreeable than those who live a normal life span. The Blue Zones calls it, "likeability".

Here's My Strategy for Staying Out-of-Trouble After Sixty

Some of these are long-time habits, and they're easy for me to follow.  Some of these I don't do as regularly as I should.  Some of these are new goals.  But this much I do know:  If I don't have a plan, if I don't do these consciously, and if I don't carve out time to make them happen--they won't.

1.  Stick with 7-9 servings of fruits and vegetables a day.  The Green Smoothies make it easy.  I get 6 servings in a 27 ounce Klean Kanteen that I divide over breakfast and an afternoon snack.  I calculated the nutritional info on my daily 27 ounce serving that includes, 2 1/2 cups kale, 8 mini-carrots, 1/2 cup pomegranate juice, 1/2 apple, 1/2 orange, 1/2 kiwi, and 3/4 cup frozen black raspberries.  Check out the nutrient content for 27 ounces:

Nutrition Facts The Healthy Librarian's Green Smoothie-kale,blackberries,carrots,orange,kiwi,pom juice,apple
Serving Size: 1 serving
Amount Per Serving
Calories	342
Total Fat	2.2g
Saturated Fat	0.2g
Trans Fat	0g
Cholesterol	0mg
Sodium	140mg
Carbohydrate	82.1g
Dietary Fiber	13.8g
Sugars	49.1g
Protein	8.9g
Vitamin A 729% Vitamin C 485% Calcium    35% Iron 28%

 

Then throw in some veggie-based soup, a salad, a veggie-based dinner entree, some fruit for dessert, and I'm good to go. 

This eating plan is the same as the DASH Diet (Dietary Approaches to Stop Hypertension)--guaranteed to stop hypertension.  The Cache County (Utah) Study on Memory shows it also prevents cognitive decline.   Dr. Amy Lanou and Michael Castleman, authors of Building Bone Vitality claim it will build and strengthen bones--because the 17 nutrients necessary to build strong bones are all found in a diet high in fruits and vegetables.

2.  A balanced exercise plan.  It's not just about cardio--there are 4 areas that need attention: Cardio (spinning-my fave), Weight-training, Flexibility & Balance (yoga-my fave), and Core Strength.  No, you can't just walk and think you're in good shape.  I'm super regular with my cardio, and not as regular with the weight training and yoga.  Click here to see what my workout looks like. As for core strength--that's pretty much non-existent.  And when it comes to weight-training, according to Randy Raugh, the Canyon Ranch physical therapist, and author of the excellent Prime for Life--Functional Fitness for Ageless Living--to get the maximum benefits you need to do it for 3 non-consecutive days a week--2 at the minimum.  Unfortunately, I often weight train only 1 day a week.  If you want to build strong bones and prevent osteoporosis, and maintain your muscle strength as you age--weight-bearing exercise for the lower body, and weight-training for the upper body is a must-do!  Yoga, helps with balance, preventing future falls, and building strength.  As for core strength, I'm upping my game with Dr. Stuart McGill's routine, and my birthday-present to myself is the physical therapist-designed Pelvicore exercise ball.

3.  A plant-based diet with minimal added fat.  I'm nearing the 2 year mark on eating plant-based, so this is the easy part. I've got this down pat. I still use a little olive oil for cooking and in salads, and very occasionally eat some seafood or dairy when eating with friends.  I'm convinced.  If you want to lower your cholesterol, reduce your risk for type-2 diabetes, lower your blood pressure, reduce your risk of heart disease & stroke, and reduce your belly fat--this is the way to go.  Dr. David J. Jenkins of St. Michael's Hospital in Toronto is one of the pre-eminent researchers on the benefits of a plant-based, low-glycemic diet (like beans, nuts, oats,& quinoa) for improving diabetes control, lowering cholesterol, and preventing cardiovascular disease.  Click here for Jenkins research.  And that's not all--keeping your blood sugar stable with low glycemic plant-based foods and exercise will preserve your brain.  Click here.  And as for too much fat--not only is it bad for your belly--it's bad for your brain--so just ditch it Click here.

4. No time urgency.  This is what keeps the Okinawans calm, relaxed, and living longer.  I'm really working on this one--which goes hand-in-hand with flexibility.  Things don't always go as planned--you either go-with-the-flow or get stressed and anxious.  My favorite 2 words, "Oh well."  Life goes better when you stay in the moment, chill, and don't worry about getting there fast.  When our Christmas Day trip to New York City was aborted because of an ice storm, we checked into a hotel at noon, and enjoyed a dinner of cranberry nut mix, Larabars, Cliff Bars, and clementines.  All the restaurants were closed in this Pennsylvanian town.  Oh well.  We had a good time, and made it to New York safe and sound the next day.

5. More Dancing, Singing, Laughing, Playing, Schmoozing, and Mahjing.  What's the point of staying healthy without having fun?  That's the reason we work at staying healthy. Cool fact: There's a little organ deep in the ear, called the sacculus--and it gives us a great sense of pleasure and well-being when it's stimulated.  But, it can only be stimulated through singing!  So, bring on the Singstar Karaoke!  Click here.

6.  The Supplements.  I'm really bad at regularly taking supplements.  I'm good at counting them out, taking them to work, and bringing them back home with me.  Truth is, there are some supplements worth taking because there's no easy way to get enough of them through diet alone.  Here are my favorites:  Omega-3s (I use Omega-Brite), DHA, (an omega-3 for brain health), Magnesium, Citracal, Vitamin D (I'm up to 3000 IUs), Curcumin (also known as turmeric, the yellow color in curry), and Juvenon (the combo of acetyl l-carnitine & alpha lipoic acid) developed by Dr. Bruce Ames.  Click here to read more about what I take, and what some prominent physicians take.  

7.  Eliminate the time-wasters from my day.  Except for watching "The Middle" or "Glee", TV watching always leaves me bored and unsatisfied.  So, why bother wasting the precious time?  The same goes for my mindless internet cruising, checking in more than necessary with email, the NYT, and other favorite sites.  Enough already!

8.  Maximize my peak energy times of the day.  Over a year ago I blogged about getting in sync with our natural energy ebb and flow throughout the day.  It works--and I intend to start planning my day around them, when possible.  For instance, 9-11 is the peak time for brain work-creativity-and analytical work.  On days when I don't work I would usually use this time for exercise & errands.  Poor use of brain time.  Better to exercise between 3-6.  To read more, click here:  Maximize Your Energy-Match Your Tasks to Your daily Energy Levels.

9.  Give a gift a day for 29 days a month.  When 36 year old Cami Walker of LA learned she had multiple sclerosis, her spirits flagged.  She was tired, in pain, and had the prospect of a debilitating disease ahead of her.  When a holistic health educator gave her the prescription of giving 29 gifts a day for a month she thought it sounded it crazy.  Nothing big (and that's the point)--something like making a supportive phone call or saving a piece of yummy cake for her husband.  Of course the prescription didn't cure her,  but it had a startling effect of helping her cope with her illness and gave her a more positive outlook on life.  I love this idea.  It's a planned regular way to just think about kindness.  No big acts, just something little-done everyday.  To read more, click here.

10. Cultivate my garden of friends and family.  Regular phone calls, visits, dinners, outings, and celebrations.  At 60 there's no time to delay any of these.  It's the glue that keeps us together and makes life worth living.

11.  Once You're Through Learning--You're Through.  This is the philosophy of John Wooden, the 97-year-old retired UCLA basketball coach.  No doubt about it, learning and sharing what I learn is my purpose in life.  I'm lucky to have a job that gives me access to learning about health and medicine, and a hobby that gives me a chance to share what I learn.

12.  Start Eating Less.  OK, I'm ready to shed a few pounds, and I know from past experience that writing down exactly what I eat, and how much I've exercised, really works.  I use something called MyFoodDiary.com and it's set up with all my favorite recipes.  Unfortunately, I haven't used it in quite some time.  The new year is a great time to start!  To read more about this tool, click here.

For some good reasons to eat less, read:  CALERIE: The NIH Calorie-Restriction Experiment. Lessons for Health, Slowing Down the Aging Process, Longevity, and Disease Prevention 

 

 

Time to end this list.  I've already maximized my 9-11 brain time and written this post.  It's now time to make my smoothie, do some core exercises, take those supplements, answer birthday phone calls, enjoy a birthday lunch, followed by an evening out with friends who all share the same wedding anniversary--if we can just make it through our foot of snow!

I'd love to hear from anyone who is 60 or over with advice, tips, and wisdom about maximizing life in the sixties, seventies, and more.

 

 

CALERIE: The NIH Calorie-Restriction Experiment. Lessons for Health, Slowing Down the Aging Process, Longevity, and Disease Prevention

Photo credit: Reinhard Hunger NYT 10/11/09

"In terms of cardiovascular diseases - the No. 1 cause of death; 4 out of 10 people die of it in the U.S. and Europe - we know that they (Calorie Restriction Society members) will not die of cardiovascular death."

"... subjects have cholesterol around 160, blood pressure around 100 over 60, high HDL, low triglycerides and very low levels of inflammation."

"...every day doctors are publishing  hundreds of papers on circulation research  and medications that are lowering blood pressure or cholesterol by a small bit.  And here we have such a powerful intervention that is basically cleaning out the arteries."

"I don't know why anyone would take drugs when they could do something like this." 

Dr. Luigi Fontana & Dr. Susan Roberts, Washington University & Tufts University investigators for the NIH- funded CALERIE Study,   NYT 10/11/09

If you had the chance to stay healthy and lean as you aged--free from the diseases of aging, like diabetes, cancer, and cardiovascular diseases--and all you had to do was cut out 25% of your daily calorie intake--would you do it?  Oh--and if you could also fit into cool clothes, drop to your high school weight,  & enjoy super energy?  Would you be willing to do it?

We know that careful calorie restriction--eating a nutrient-dense-low-calorie diet--works in rodents and those University of Wisconsin rhesus monkeys--but will it work for humans who are constantly tempted by cheeseburgers, pizzas, office parties, and dinners out with friends?  (Read about the Rhesus Monkey 20 year follow-up here)

According Dr. Susan Roberts, one of the principal CALERIE investigators, when it comes to animals,  "They don't just live longer, they are healthier.  They actually aged biologically slower.  Their hair has gone gray less quickly.  Their hormones have stayed at their youthful profile and their immune function has stayed good."

I'd heard for years about too-skinny "calorie-restriction groupies" who were out to beat death with a miserably low-cal boring diet.  It held no appeal for me.  I love food too much!

But, I've got to tell you, after reading about the National Institute of Aging's ongoing calorie-restriction  experiment known as CALERIE  (Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy)--I'm rethinking this whole calorie-restriction scene!  This is not excruciating or boring at all!  And since I started on my "veganish" adventure in March of 2008--I'm not that far away from the CALERIE model already!

Take a look at Jon Gertner's fascinating story, "The Calorie-Restriction Experiment" in the October 11, 2009 New York Times Magazine, here. 

Honestly, I'd describe it as Weight Watcher's on steroids--with help from physicians, dietitians and counselors.  There's even room for an occasional Uno's pizza, Haagen Dazs ice cream bar, bratwurst, or beer.

The first participants are finishing up their 2-year trial and the results are promising.

What is the CALERIE Study?

• Since it's virtually impossible to follow people over a lifetime to find out if restricting calories by 25% would slow aging, drastically reduce diabetes, cardiovascular diseases, and cancer--CALERIE aims to follow a select group (right now there are 132 enrolled) for two years to find out if the biomarkers for aging can be modified when calories are restricted.
• The study will measure if inflammation, insulin levels, blood pressure, core body temperature, and body weight can be lowered simply by reducing calories by 25%.
• Where are the sites?  Tufts University in Boston; Washington University in St. Louis; Pennington Biomedical Research Center in Baton Rouge.
• Who is eligible?  20-50 year olds who are healthy and not too fat or too thin--having a BMI of 22-27.9.  Participants also have to be motivated, organized (they have to measure & record every morsel they eat for 24 months), have stable jobs with little travel, and a supportive family.

What's the Diet Like?

• So, do you think you know how many calories you eat every day?  Think again.  Most participants guessed wrong.  Using a high-tech lab technique that involves swallowing water with rare isotopes, the researchers are able to figure out precisely how many calories each participant is typically consuming.  Then they cut it down by 25%.  
• Liz Ewen, a molecular biologist, was eating 2,226 before CALERIE--now she's at 1,670.  Dr. Jeff Peipert, an OB-Gyn, was consuming a whopping 3,300 a day pre-CALERIE--now he's at just under 2,500. 
• For the first 28 days participants get all their meals & snacks cooked for them and at no cost--based on their individual calorie counts.  This gets them accustomed to portion sizes and adjusted to eating the kind of foods that will keep them filled and satisfied.  And this food isn't spartan:  Mediterranean-style fish with Greek-style potatoes, or Farfalle with Pesto & Diced Chicken, for example.  After 28 days--they buy and prepare their own food--with regular help and guidance from dietitians and a support group.
• The Key to eating 25% less:  eat foods that are nutrient rich and high in fiber, like vegetables, fruit, high fiber cereals, and soups.  Aim for foods that weigh as much as what you were eating before the diet--but lower in calories--to keep you full and satisfied.  Favorite food for keeping hunger at bay:  apples.   Everyone in CALERIE has become a big fan of apples. 
• The 4 Rules for Eating Less:  Eat Foods That Are Filling, Appealing, Low in Calories, Nutrient Rich!
• Dr. Susan Roberts of Tufts says, "If you don't change your diet to a high-satiety diet you will be hungry, and you will fail."  Fiber One, the breakfast cereal, or Nature's Path Organic Smart Bran--both with soluble & insoluble fiber, "have a unique  effect in helping calorie-restriction subjects feel fuller, probably because they activate certain receptors in the lower intestine."

To see some of Dr. Roberts' satiating snack recipes in my previous post click here: "The Instinct Diet Helps Us Combat Our Hard-Wired Food Cravings - And Satisfy Our Cravings for Something Spicy, Salty, Crunchy, & Chocolate"

• CALERIE tip: Save up calories if you have a special occasion or celebration coming up.  Want a bratwurst or Haagen-Dazs?  Save up those calories.  Decide what's more satisfying--170 calories for a gin & tonic, or a  190 calories for a  Haagen Dasz ice cream bar.

What Is the Hardest Part of the CALERIE Diet?

• Surprisingly, no one complains of raging hunger.  Bu most everyone felt hungry for the first few weeks.  When I joined Weight Watchers years ago to lose pregnancy weight I felt exactly the same way.  But then you just get used to less calories and learn to eat more filling foods.
• The hardest (& most annoying) part is getting used to measuring the food, preparing the food, and keeping track of the calories.

Why is CALERIE Working For Most of Its Participants?

• There's accountability. 
• You have to submit a weekly food diary.
• Attend weekly weigh-ins
• Once or twice a week you must attend individual counseling sessions
• Group counseling sessions give participants an opportunity to swap strategies and get support from fellow dieters.
• There's a battery of medical tests every 6 months.  Cognitive tests.  Blood tests.  Bone-mineral density tests.  Measurements of resting metabolism, respiratory output, and internal core temperature.

What About Weight Loss?  What About Health Improvements?  What About Energy? 

• Most participants met their weight loss goals.  They were told to expect to lose about 15% of their weight during the first year.  After that initial drop they would plateau to "weight stability".
• Doug Hansen started out at 198 pounds and dropped to 168--near his plateau--after 6 months.  Jeff Peipert began at 174 pounds--dropped to 151 after 52 weeks--and was projected to plateau at 147 pounds.
• Benefits.  For example: Peipert's blood pressure started out at 130 over 80.  Now almost a year into CALERIE, he's at 110 or 115 over 54. At age 49 his weight is what he weighed in high school.  Same for Brad Beggs. He is down to wearing a size medium shirt--a size he hasn't worn since high school.  And Beggs adds, "I've never gotten so much pleasure in my life."

Dr. Jeff Peipert, a Washington University CALERIE participant

• Wondering about energy?  Check out how Dr. Jeff Peipert spent a recent day off:

1.   18 holes of golf

2.   Biking 8 miles back & forth to his office just to pick something up

3.   Cutting his 1 acre lawn

4.   Pulling out tree roots with his son for over an hour

5.   40 minute after-dinner walk with his wife.

6.   This "calorie-incinerating machine"  was wondering why he felt particularly hungry the next day,  resulting in his eating a bowl of cereal in the middle-of-the-night.  Both my husband & I have definitely noticed the huge uptick in our appetites the day after long work-outs.  It makes sense to us.

Is Calorie-Restriction Possible for the Average American?

• The Naysayers:  Dr. John Holloszy, a Washington University lead investigator thinks 99% of Americans can't stick with it.  Other doctors think calorie-restriction requires too much individual effort--too much in medical resources--too much in counseling.   Dr. Robert Krikorian, a neuropsychologist who happens to be a long-time follower of a calorie-restriction diet himself-- thinks that most people won't pay attention to how much they eat--and they would refuse to keep up the organizational requirements necessary for such a diet.
• The Boosters:  Many doctors involved in CALERIE are surprised & encouraged at the high level of compliance with the diet.
• The Participants:  All of the subjects that Times writer Jon Gertner spoke with intended to continue with calorie-restriction when the trial ended.  Liz Ewen likened it to Weight Watchers (& I agree).  Given the right online tools, some sort of infrastructure, group meetings, and dietitians available for support, Ewen thinks it's suitable for many people.  "It's really not much more than embarking on a diet that teaches you how to eat normal foods but make better choices!"
• Some of the  first of the group to finish:  Most of "first finishers" plan to keep up the diet--but switch to estimating the calories, rather than counting them precisely.  Josh McMichael finished up with CALERIE in September.  In the few weeks since ending the program he gained eight pounds--but it's now mostly gone.  "I tried the new massive burgers at Burger King,"  he said.  "Twice.  Wasn't worth the side effects.  I think I've gotten over things like that.  For the most part."

Words of Encouragement from the Lead Investigators

• Dr. Luigi Fontana of Washington University in St. Louis.  "My perception right now is the effects of calorie restriction are multiple, so I think it is highly difficult to find one, or two, or three drugs that will mimic such a complex effect."  And although he isn't optimistic that calorie restriction will gain traction in the general public, he does believe an important common sense lesson will be learned from the experiment:

"Eating less is better than eating more, especially if it's a nutritious mix of whole grains, fruits, vegetables and the like.  The evidence is overwhelming now that it will improve your health and will improve your chances of living healthier and probably longer."

• Dr. Susan Roberts of Tufts University in Boston:  Roberts thinks the study will have greater effects than the average clinical trial.  "I don't know why anyone would take drugs when they could do something like this--calorie-restriction,"  said Roberts.

The Healthy Librarian Weighs in on Calorie Restriction

For my money, the folks in the CALERIE study are following a plan that seems very similar to:

• Dr. Joel Fuhrman's Eat for Health: Lose Weight, Keep It Off, Look Younger, and Liver Longer
  
• Dr. Susan Roberts'  (a CALERIE lead investigator) Instinct Diet
• Dr. Caldwell Essestyn's Prevent and Reverse Heart Disease
• The Weight Watcher's diet plan

Easiest way to cut calories:  ditch added fats, like butter, margarine, mayo, cooking oils, salad dressings, desserts, high-fat dairy like cheese & ice cream, and the after-dinner snacking.

Foods highest in nutrient density:

*Dr.Fuhrman’s  Aggregate Nutrient Density Index
Top 30 Super Foods Score

1. Collard, mustard, & turnip greens 1000
2. Kale 1000
3. Watercress 1000
4. Bok choy 824
5. Spinach 739
6. Brussels sprouts 672
7. Swiss chard 670
8. Arugula 559
9. Radish 554
10. Cabbage 481
11. Bean sprouts 444
12. Red peppers 420
13. Romaine lettuce 389
14. Broccoli 376
15. Carrot juice 344
16. Tomatoes & tomato products 190-300
17. Cauliflower 295
18. Strawberries 212
19. Pomegranate juice 193
20. Blackberries 178
21. Plums 157
22. Raspberries 145
23. Blueberries 130
24. Papaya 118
25. Brazil nuts 116
26. Oranges 109
27. Tofu 86
28. Beans (all varieties) 55-70
29. Seeds: flaxseed, sunflower, sesame 45
30. Walnuts 29

Drugs or Diet?  I find it interesting that the only cure for celiac disease (the inability to digest gluten) is to follow a gluten-free diet.  There are no pharmaceutical or surgical cures.  People with celiac who want to get better just follow a gluten-free diet.

Yet, when it comes to the diseases of aging, like Type 2 diabetes, some cancers, and cardiovascular diseases--most physicians find that the majority of people are unwilling to follow a diet even if it promises to free them from these diseases.  Oh well!

Do you think such a diet is ready for Prime Time?  Would you be willing to give it a try?

"A WSJ-Style" What's Your Workout? A Medical Librarian's Fitness (Re) Search: Spinning, Weight Training, Yoga, & A Good Walk

1965 Junior High Girl's All-Star Basketball Team (find me in top row left)

2009 Weight Machines at the JCC

I got to thinking.  With the way I'm always writing about food and cooking, you might get the idea that eating is the extent of my health & fitness routine.  So...in the spirit of the Wall Street Journal's series, "What's Your Workout", here's what I've been doing to stay in shape.

First off.  I'm not a jock, a gym-rat, or a competitive athlete by any stretch of the imagination.  What I do 5 days a week is something anyone can do.  Believe me, this exercise plan is all about fun. 

It's a cross between dancing up a storm at a wedding (my spinning class), chilling out at a spa retreat (my yoga class), learning from fascinating experts (listening to podcasts while lifting weights), and having a gab fest with friends (taking a long walk with a buddy).

I graduated from college before Title IX existed--which means women's sports teams didn't exist--except for the one Exhibition Game my Girl's All-Star Basketball team played in 1965.  But back in those days we had daily gym class and we walked to school--and that meant walking home for lunch in elementary school.  No school buses, no parent's driving us to school, and hardly a kid with a car in high school.

When Did I Start Exercising? 

I start running in 1976 when I worked as a paralegal for a huge law firm.  It was boring & stressful----and it left me with insomnia for the first time in my life, as well as a twitch in my left eye.

One day, I felt so exhausted & frustrated from lack of a good night's sleep that I decided to start running to burn off some nervous energy.  Bingo!  I found the magic sleep elixir. That night I had my best night's sleep in months.  And the left eye twitch magically disappeared.

I also came to my senses--deciding that the best part of the paralegal job was doing library research--and took the plunge in 1977 & started a program to get a Master's degree in Library Science, with a medical library specialty.

I kept running regularly, competing in a couple of races, but frankly, running wasn't for me.  It was solitary, and I hated running when it was freezing cold outside.

I moved on to Jackie Sorensen's Aerobic Dancing, anyone remember that?   Loved the music, the dancing & the camaraderie. Over the years I've kept up the exercising--right on through to the end of 2 pregnancies.  I've done it all over the years-- high and low aerobic classes, step aerobics (a former favorite), power walking, power weight classes, power yoga, boot camp, bosu, and plain old free weights.

The Present Workout

My routine covers all the important fitness basics: aerobic conditioning--strength--flexibility--and balance.  And my particular mix exercises my body, mind, and spirit.

I'm a card-carrying JCC member since 1976.  And I'm a huge advocate for group exercise classes--no treadmills or ellipticals for me.  Group classes are motivating and provide variety--and at the J there are over 60 classes a week to choose from.  They keep me moving for 60 minutes--long after I'd quit if I were on my own.  They are a lot more fun than going it alone--and at my community center gym I get to meet twenty-somethings to ninety-somethings.  Where else does that happen?

For at least 10 years now I've been sticking to these four activities--but I'm always ready to try something new!  Pilates & Zumba may be next on the agenda.

Spinning - A Dance Party, Boot Camp or Travelogue rolled into one. This is stationary biking in a group--my class usually numbers around 30--men, women, twenty-somethings to an occasional 60-something.  This is my all-time favorite exercise. 60 minutes of heart-pumping sweat-producing interval training.  You're climbing hills and doing wind sprints. 

A guaranteed high calorie burn that's always a challenge, because you can kick up the bike's tension as you get stronger.  Beginner & super athlete alike can exercise together at their own fitness levels. 

When I'm spinning to high-energy motivating music--that changes to each instructor's taste--I get a huge endorphin smile on my face and I feel like I'm dancing while I'm madly pedaling to Beyonce's "Single Ladies".

Every instructor brings a different style to the table.  With Laurie it's definitely a dance party.  With Kate, I'm at a serious athlete's boot camp.  With Rich, it's a training run on the Boston Marathon course, or a history lesson/travelogue through the Antarctic or on the Tour de France.

Yoga -The Spa Retreat.  I'm so "over" power (Ashtanga) yoga, but my slower-moving yoga classes are still challenging.  Yoga is what I do for flexibility, strength, balance, and relaxation.  Chaturanga (a yogic push-up) and up-dog are definitely arm strength builders. 

Moving through sun salutations, down-dogs, the bridge, boat pose,the wheel, pigeon pose, half moon pose, and more, I strengthen my back, open up my too-tight hips, stay flexible, learn to breathe slowly and to concentrate.  The relaxing shavasana (corpse pose) meditation that comes at the end of class is my sweet reward.  I finish up relaxed, mellow, and chilled out--just like a trip to the spa.

Weight Training - My Visiting Scholar Lecture. OK, I'm in a rut with weight training--basically doing what I shouldn't--sticking to the same weight machines at the same number of reps & weights for about 3 years now.  I've been in maintenance mode way too long.  It's time to mix it up, change the routine, and up the ante. 

But this is my automatic pilot time.  My IPOD Nano is loaded with NPR's Health Podcasts, Science Friday, Diane Rehm, Joe Graedon's People's Pharmacy, & various Internal Medicine and Ob-Gyn Audio-Digests.  When I run through my pecs, chest, biceps, triceps, back, pull-overs, lats & more I'm listening to an hour of knowledge.   Nothing boring about this 2-for-one brain & body exercise routine.

The Long Walk - The Gab Fest or the Silent Meditation.  What could be better?  A 3-5 mile walk with my husband or a friend, walking and talking--it's a chance to catch up, exercise, and enjoy nature.  If I go it alone, it's a chance to just let my mind wander & enjoy the changing seasons--and get ideas for what to plant in my garden.  It could be a walk on country roads, a hike in the nearby park or a hike through our world-class arboretum.

The Gear -  Nothing fancy here.  What you see me wearing in the photo above works for spinning, yoga, and walking outside.  I've worn the same work-out clothes for years now.  They just don't wear out.  2 pair of black yoga pants, 2 pair of black bike shorts, assorted sports bras, assorted Target t-shirts, and about 8 multi-colored sleeve-less tops that I got years ago for $5.00 each at BJ's.  I like the sleeveless because it motivates me to do arm exercises.   I've got one pair of running shoes that I use for cycling, walking, or weight training.

My Must-Have All-Time Favorite Equipment - I wouldn't want to exercise without my F6 Polar Heart Rate Monitor.  It's set up for my fitness level, my minimum &  maximum aerobic heart rates, my age, and weight.  It records how long I'm working out in the aerobic range, my highest, lowest, & average heart rates, and how many calories I'm burning.  I know when I need to kick it up a notch, and when I'm working too hard. And all my exercise sessions are saved so I can see what I've done for the past week.  It's motivating & keeps my honest.  For a great guide to exercising with a heart rate monitor, click here.

Cost:  I got mine for about $100 online. 

IPOD Nano.  Love my Nano.  No music on mine.  Just podcasts.   It's a learning machine.  6 months ago I  added a nifty FM receiver that plugs into the Nano & allows me to listen to the radio--in my case that's NPR. I hear the new 2009 model comes already equipped with an FM receiver. 

Cost:  about $140.00 at Costco

The Routine 

Monday:  1 hour yoga class before work or 1 hour weight work-out after work

Tuesday:  1 hour spinning class (+ weight workout if I don't lift on Monday)

Wednesday:  rest day or one hour walk outside

Thursday:  1 hour spinning class (+ occasional yoga class)

Friday:  1 hour weight workout before work

Saturday:  rest day, or leisurely walk or hike outside

Sunday:  1 hour spinning class & 1 hour yoga class

The Diet 

Mostly plant-based--I "try hard" to avoid sugar and baked goods--but I have my lapses.  I load up on whole grains, vegetables, fruit, a daily salad, soups, and one-dish meals.

Breakfast is a Green Smoothie and a mid-morning Larabar or a bowl of fruited oatmeal with a mid-morning Green Smoothie.

Lunch is leftovers from the night before, or a salad topped with teriyaki seitan, or an Amy's frozen vegan meal, or a vegan lentil dal burger on a bun.  Fruit and a few nuts mid-afternoon.  Finishing up any leftover Green Smoothie.

Dinner is usually a one dish meal with a green salad.  One-dish meals could be Veganomicon's Black Bean Mango Quinoa Salad, Spicy Sweet Roasted Butternut Squash with Black Beans, or Obama's African Peanut Vegetable Soup.  For lots of recipes click here.

I love to cook and experiment with new recipes, and I try to prepare enough so I don't have to cook dinner every night.

The Playlist

It Wasn't Me, Strength of a Woman, Come On Get Higher, Here Comes the Sun, Single Ladies, Super Man (2) to name a few, NPR Podcasts Galore

Fitness Tip

Exercise with other people.  You combine socializing with fitness.   Mix it up.  Do something aerobic for your heart, something to improve your flexibility & balance, and some kind of weight training for strength & to kick up your metabolism. Once you start exercising, whatever you do--DO NOT STOP!!!

Most Memorable Fitness Vacation

Hiking with my husband for two weeks across northern England on the Coast-to-Coast trail--which runs from the Irish Sea to the North Sea.  Click here to learn more.

The Dalai Lama, Denmark, the Unclutterer, & JAMA. All the Advice and Wisdom You Will Ever Need for a Happy Healthy Long Life and It All Appeared This Week

 

"We can’t change the world except insofar as we change the way we look at the world — and, in fact, any one of us can make that change, in any direction, at any moment."

Pico Iyer, writer-journalist who has covered the Dalai Lama for 35 years

It's been a busy week, and I probably won't have much time to write over the coming week. 

Thinking about all that I have read this week, it dawned on me that all the advice anyone could ever need for a Happy Healthy Long Life appeared in 2 newspaper articles, 1 blog post, and 2 medical journal articles just this week!

The only advice you'll ever need (I always exaggerate):

1.  You make your own happiness.  It's not about money.  Stop blaming others, let go of your illusions & expectations and work on yourself.

2.  Lower your expectations for happiness & you won't be disappointed.

3.  Unclutter your life--in terms of stuff, people & activities--determine what and who  matters most.

4.  Eat those fruits, vegetables, & whole grains.  Exercise vigorously, keep your weight down, drink only moderately, don't smoke, limit the non-narcotic pain meds, and take folic acid.

Two must read blogs, from which I lifted 3 of the 4 bits of advice are:

The Unclutterer:  A blog about getting and staying organized. A place for everything, and everything in its place is its gospel.

Happy Days:  The Pursuit of What Matters In Troubled Times.  Produced by The New York Times.

The Expert on Practical Happiness:  The Dalai Lama

From Happy Days:  The Doctor is Within, by Pico Iyer. The New York Times,  July 22, 2009

(My edited Cliff Notes version.  Just read the article!)

“We can’t change the world except insofar as we change the way we look at the world — and, in fact, any one of us can make that change, in any direction, at any moment. The point of life, in the view of the Dalai Lama, is happiness, and that lies within our grasp, our untapped potential, with every breath.”

“Easy for him to say, you might scoff. He’s a monk, he meditates for four hours as soon as he wakes up and he’s believed by his flock to be an incarnation of a god.”

But, don't be so quick to judge.  Believe me, his life has been filled with challenges & responsibilities that would send most of us running & screaming for cover.

“Yet in 35 years of talking to the Dalai Lama, and covering him everywhere from Zurich to Hiroshima, as a non-Buddhist, skeptical journalist, I’ve found him to be as deeply confident, and therefore sunny, as anyone I’ve met.”

He’s a realist and he’s practical, with optimism & a sunny nature.  Which is exactly  why people all over the world want to know---How can I be like that?

What the Dalai Lama would advise: 

 1.  If an arrow is sticking out of your side don’t argue about where it came from or who made it; just pull it out. You make your way to happiness not by fretting about it or trafficking in New Age affirmations, but simply by finding the cause of your suffering, and then attending to it, as any doctor (of mind or body) might do.

 2.  Think in terms of enemies, he suggests, and the only loser is yourself.

 3.  Concentrate on external wealth and at some point you realize it has limits — and you’re still feeling discontented.

 4.  Learn how to be delighted by the smallest birthday cake.

 5.  Happiness is not pleasure,  and unhappiness, is not the same as suffering. Suffering — in the sense of old age, sickness and death — is the law of life; unhappiness is just the position we choose — or can not choose — to bring to it.

 6.  How can you always remain so happy and smiling?”  That kind of happiness is within the reach of almost anyone.

 7.  We can work on happiness as we work on our backhands, our soufflés or our muscles in the gym.

True happiness, in that sense, doesn’t mean trying to acquire things, so much as letting go of things (our illusions and attachments). It’s only the clouds of short-sightedness or ignorance,  that prevent us from seeing that our essential nature, is blue sky. 

Why Is Denmark the Happiest Country in the World?  Lowered Expectations!

From Happy Days:  Lowered Expectations, by Eric Weiner.  The New York Times, July 19, 2009.

(My edited Cliff Notes version.  Just read the article!)

Denmark is the happiest nation in the world.

Why?  Low expectations.  And that’s one of the big secrets of happiness.

“We’re the happiest lige nu.”  Lige nu is a Danish phrase that means literally “just now” but strongly connotes a sense of “for the time being but probably not for long.”

Danes, in other words, harbor low expectations about everything, including their own happiness.

Danes seem to know instinctively that expectations kill happiness, leaving the rest of us unhappy un-Danes to sweat it out on the “hedonic treadmill.”

That’s what researchers call the tendency to constantly ratchet up our expectations, a sort of emotional inflation that devalues today’s accomplishments and robs us of all but the most fleeting contentment.

If a B-plus grade made us happy last semester, it’ll take an A-minus to register the same satisfaction this semester, and so on until eventually, inevitably, we fail to reach the next bar and slip into despair.

Yes, happiness is a function of our expectations — or, as it has been said: “Happiness equals reality minus expectations.”

Given that neat formulation, there are two ways to attack the problem: boost our reality or lower our expectations. Most of us choose the former.

We’d rather stew in our misery than trim our expectations. Lowering our sights smacks us as a cop out, un-American. Better a nation of morose overachievers, we reason, than a land of happy slackers.

Erin Doland, The Unclutterer, Shares Her Advice on "Having It All" and Remaining Sane

From Ask Unclutterer:  Having It All

(Read the full post & visit Erin's site often)

The Secret to “Having It All”

How do you have time for all of this - running a blog, writing a book, all of these musical activities & all the other stuff you seem to do?

   1.  Purge clutter, downsize, and minimize. The less stuff you own, the less you have to clean, store, maintain, manage, protect, worry about, stress about, waste money on, forget, and pick up. Have the minimum amount of stuff for you to be comfortable. (This level is different for everyone and you’ll have to figure it out for yourself.)

   2.  Organize what you choose to own and use. Your home and office don’t need to be pristine museums, but you and the people who access the same space/items need to be able to easily find things when they’re needed. Order is better than chaos, and order saves you time and energy.

   3.  Commit to a streamlined routine for the mundane tasks in your life and be disciplined enough to maintain that routine. If you do 30 minutes of housework a day, your home is never chaotic. But, you have to be committed to these daily activities (dishes, laundry as needed, things put back in place when finished, kitty litter scooped, etc.) and not put them off for another day. The same is true for work; you have to stay on top of the necessary tasks or they will haunt you. I also think of this item as taking responsibility for the things you choose to own.

   4.  Determine what matters most to you. Make a list of the people, activities, and things in your life that mean the most to you and then spend the vast majority of your time focusing on these items. Be honest with yourself, though, and put on your list what really matters to you, not what you think should matter to you.

   5.  Remind yourself that even if you live to be 100, life is short. There is no better time to live your life than right now. My life’s motto is carpe vitam, Latin for seize life. It’s morbid to think about, but someday might not ever come. Stop putting things off until tomorrow.

   6.  Say “no” to what doesn’t matter. If an activity or responsibility isn’t on your list of what matters most to you, say “no” to it. Learn to say “no” in such a way as to not be a jerk, but say “no” when you need to. This is where I greatly differ from most people because I don’t feel guilty about protecting my time. And, as far as I know, most people don’t think I’m a jerk because I’m clear about why I’m declining offers and invitations. (”Taking a yoga class with you would be fun, but Wednesday nights are date night with my husband. Is there a similar class we can take together on another night?”)

   7.  Enjoy being industrious. Working provides us with the resources to take care of the things that matter most. Whatever you do for a career, make sure it is something that you enjoy (even if just minimally).

   8.  Get rid of everything that is toxic in your life because toxic things are clutter. Toxic people and habits suck up resources and energy. I was an avid smoker until I calculated how much of my money, time, and energy were going into my smoking addiction. No matter how gifted and talented, I avoid employing, working with, and spending time with people who are toxic. A toxic person can waste your time and mental energy faster than any other form of clutter.

   9.  Live within your means and save money for retirement, rainy days, and adventures. Get rid of your credit cards and only use cash or your debit card. Live on a budget even if you don’t need to be mindful of your spending habits. Have a retirement account, and two savings accounts — one for emergencies (refrigerator died, fender bender) and one for splurging on what matters most to you (vacation, rock climbing lessons, a camera to capture your child’s first steps). Buy quality instead of quantity. Be a smart consumer.

  10. Take risks and be brazen.  A second motto in my life is ad astra per aspera, which is loosely translated as to the stars through difficulty. (It’s also the Kansas state motto.) Great things might fall in your lap from time to time, but for the most part you have to get outside your comfort zone and initiate something new. Have you always wanted to learn to play the flute? Get your hands on a flute and start taking lessons. You’ll be really awful those first six months (or year or five), but you’ll never learn to play the flute if you don’t take the chance and try.

  11.  Get adequate sleep. Keep a sleep journal and find out how much sleep you need to function at your best. Then, make sure you get that amount of sleep every night. When you’re well rested, it’s easier to stay calm, be productive, and focus on what you need and want to do.

From JAMA: The Physicians' & Nurses' Health Study: The Six Behaviors for a Long Healthy Life


 

The Six Healthy Behaviors:

1.  Control your weight.  Stay trim.  A BMI under 25
2.  Exercise vigorously for 30 minutes a day.
3.  No smoking
4.  Eat a diet in line with the DASH Diet--lots of vegetables, fruit, and whole grains (especially for breakfast)--and be sure to get 400 mcg of folic acid/a day.
5.  Moderate to low alcohol consumption
6.  Keep non-narcotic pain relievers down to less than once a week. 

Read the Science Daily summary of the two JAMA articles + editorial.  Click Here.

 
All that heart-healthy advice about eating the right foods, exercising and losing weight pay off in real life for both men and women, two new studies show.

The reports, both originating at Brigham and Women's Hospital in Boston and published in the July 22/29 issue of the Journal of the American Medical Association, focused on different aspects of cardiovascular risk in two large groups: the 83,882 women in the second Nurses' Health Study, and the 20,900 men in the Physicians' Health Study I.

Both arrived at the same conclusion: Do the right things, and you get measurable benefits.

Simultaneous appearance of the two reports was more or less a coincidence, said Dr. Luc Djousse, an associate epidemiologist at Brigham and Women's at Harvard Medical School, who led the men's study.

While the clear message of both studies is that "a healthy lifestyle prevents a number of illnesses," what is often overlooked is that the choice of a healthy lifestyle is not a purely individual decision, said Dr. Veronique L. Roger, a professor of medicine and epidemiology at the Mayo Clinic, who wrote an accompanying editorial.

"There is a shared responsibility between the individual and the community," said Roger, who read off a dictionary definition of lifestyle as "a typical way of life of an individual, group or culture."

"The reality is that society has engineered physical activity out of our lives," Roger said. "

"Diet & Lifestyle Risk Factors Associated With Incident Hypertension in Women."  JAMA 302(4):401-411, 2009.

"Relation Between Modifiable Lifestyle Factors & Lifetime Risk of Heart Failure."  JAMA  302(4):394-400, 2009.

Do I Really Want to Give Up Cheeseburgers & Fries? Hear What Three "Real Men" Have to Say About Food Addiction, Calorie Restriction & the Joy of Rich Food

                                                                      Jeff Miller/Univ. of Wisconsin-Madison                                      

Canto, left, a 27-year-old rhesus monkey, is on a restricted diet, while Owen, 29, is not. The two monkeys are part of a study of the links between diet and aging.

After 20 years, the long awaited results of the rhesus monkey calorie restriction study are finally in.
 
The controversial conclusion:  The researchers say that now, 20 years after the experiment began, the monkeys are showing many beneficial signs of caloric restriction, including significantly less diabetes, cancer, heart and brain disease.  In principle, people could fend off the usual diseases of old age and considerably extend their life span by following a special diet.

What is "Real Man" #1 Roger Cohen of the New York Times Saying about Cheeseburgers?

Roger: "Why would anyone want to extend his life if it meant giving up cheeseburgers & fries?  Why inflict needless misery on yourself?"  Read his opinion piece here.  (I say, "Why would anyone want to risk an old age filled with disability just for the sake of eating cheeseburgers & fries?)

"Which brings me to low-cal Canto and high-cal Owen: Canto looks drawn, weary, ashen and miserable in his thinness, mouth slightly agape, features pinched, eyes blank, his expression screaming, “Please, no, not another plateful of seeds!”

Well-fed Owen, by contrast, is a happy camper with a wry smile, every inch the laid-back simian, plump, eyes twinkling, full mouth relaxed, skin glowing, exuding wisdom as if he’s just read Kierkegaard and concluded that “Life must be lived forward, but can only be understood backward.”

It’s the difference between the guy who got the marbleized rib-eye and the guy who got the oh-so-lean filet. Or between the guy who got a Château Grand Pontet St. Emilion with his brie and the guy who got water.

Maybe Roger doesn't know anyone who suffered a massive stroke because of atherosclerosis, and endured 16 years without being able to walk or talk.  Maybe he hasn't seen someone whose life is cut short or severely restricted because of diabetes, heart disease, or vascular dementia.  The list goes on.

Eating plant-based, vegan, nutritarian, or whatever you want to call it, isn't caloric restriction (eating 30% less calories a day) but it still is restriction of sorts--and it's definitely a change.  No meat, no dairy, no chicken, no processed foods.  But it certainly isn't deprivation.  My eating repertoire has mushroomed way beyond cheeseburgers & fries.

Two Emails - Two Completely Different Points of View

Roger Cohen's flippant opinion piece made me think about the two emails I received recently. 

One came from Michael F., who decided he was tired of being overweight and unhealthy and decided to do something about it. 

The other came from Leonard J.,  who after having major heart surgery, thought about changing his diet, and decided, "Nope, don't think so! Life without cheeseburgers and fries just isn't worth it."

"Real Man" #2 Michael F. - Why I'm Giving Up the Cheeseburgers

Who is Dr. David Kessler?  Click here.
What's The China Study?  Click here.
Who is Dr. Joel Fuhrman? Click here.

The following came from an email I received from one of my readers, Michael F. (*I added the headers)

 

 

Dear Healthy Librarian,

 

I'd like to share with you my own success story following a plant-based diet.  I think Dr. David Kessler's new book, The End of Overeating is absolutely right on the money.             

•  "The China Study" & Dr. Fuhrman's "Eat to Live" Principles.  Since the beginning of last November I've lost 107 lbs through following essentially the spirit of The China Study and really to the letter of Dr Fuhrman's writings.

1. Emphasize the most nutrient-dense foods: vegetables, especially greens, beans, nuts, seeds & fruit
2. Limit salt, sugar, processed foods, dairy, red meat, caffeine, saturated fat, added oils, white flour
3. Exercise, and understand the difference between real hunger & the addiction to fat, salt, and sugar--you really can change your palate.

• The addictive power of fat, sugar, & salt. I was and will continue to be successful this time because I approached it as an addiction.  Explicitly, I knew I would have to eat to accelerate withdrawal, break addictions, and re-boot my mental and physical chemistry.  It took around 4 to 6 weeks.

•  Keep Junk Food Out of the House. To be safe and get through as quickly as possible, my wife and I agreed to a few specifics.  First, we purged the house of anything not allowed; if it had been there, I would have found it and eaten it.  Second, we agreed to not eat out at restaurants until I was ready.

• Curb the Restaurant Habit First. I didn't eat out at a restaurant for two and half months.  The first time I actually "ate out" was when we were driving to a concert and stopped at roadside fruit stand and we bought a banana, an apple and some citrus.  I hadn't had a banana for months, even though they are fruit, merely because of the sugar content.  I couldn't believe my reaction when I took my first bite.  It was like eating a piece of massively overly rich cake some crazy aunt had foisted upon you during a holiday family gathering.  I was stunned.  It was so rich tasting it was sickening.  Thinking I had got a bad banana I had my wife try it and she said, "Nope.  It's just a normal banana."  It was surreal.  I couldn't believe what they books had said would happen had really happened.

• Changing Your Food Tastes & Cravings. After this I had re-trained my tastes to desire the healthy things I was eating.  It took a little more than two months until I noticed one day I no longer had to grab the remote and change the station away from pizza commercials in fear of the stimulus-response.

• Avoiding Usual Food Traps & Falling Back Into Bad Habits. During the first few months it was exactly like quitting smoking.  To break the late night habit of drive through at In & Out Burger, I changed into sleeping clothes early and read or watched TV in bed.  I made up an extensive menu of meals I enjoyed where I could eat all I wanted (of vegetables, beans, and fruits) to attain a sense of fullness.  I shopped daily at Trader Joe's for freshness.

• Cutting Caffeine, Sugar, Salt, Fat, and White Flour.  I cut green tea which stopped the caffeine from spiking hunger.  I have no sugar, salt, flour, wheat, or oil.  I don't count calories.  I eat when hungry but try to make time to eat three well spaced meals.  I work out once if not twice a day.

• Easing Back Into the Restaurant Scene. Eventually, my wife and I began going to restaurants again (lots of time I would eat before-hand or afterward).  Up until then, I had spent 39 years wherein when I saw or smelled delicious food I immediately wanted to eat it.  Now, it was again bizarre.  It was as if someone had severed the nerve connection between smell and aesthetic looks and the need to taste.  I couldn't believe it.  It looked good but I didn't want to eat it.

• Going Through Food Rehab. When my wife and I were watching a recent Oprah she had on a few celebs and others who had lost and then regained tremendous weight.  They all seemed to frame it as a battle of mental will and discipline.  It was perfectly clear to me why they and all others who regain lost weight do so: they haven't gone through what Terry Gross calls "Food Rehab" in her interview with David Kessler.

GROSS: So what are some of your suggestions for effective food rehab?

Dr. KESSLER: There are things I can do just to decrease the amount of stimulation. So don't cue me. You know, take that bread away. I don't want to see that because that's only going to increase the stimulation. Or don't deprive me because if - deprivation's only going to increase the reward value. So taking away the cues, not being primed, decreasing feelings of deprivation, all those can decrease being stimulated. But how realistic is that in our current environment? So, you know, the ultimate goal is to cool down the stimulus. And the way to do that is to want something more. So I can set rules for myself. I can eat in not a chaotic way and say boy, I don't want this now, I'm going to want something better later. So rules work. Structured eating, eating in - in meals. But ultimately is to have what psychologists call a critical perceptual shift. If you look at a huge plate of fries and say wow, that's great. But if you can get to the point of looking at those - that food, that plate of nachos and say boy, what is that? That's just fat on fat on sugar and fat. If you can change what, you know, what scientists call the reward value of the stimulus, then when you are cued by that stimulus, your brain doesn't get stimulated, you don't get activated.

• It's Not About Discipline or Willpower--Surround Yourself with Healthy Options--Taste Preferences Can Change.  I am convinced that the "key" (if there is one, sorry to be dramatically reductionistic) is to change the physical to control the mental.  Friends and loved ones cannot believe I happily survive on either steamed/raw vegetables, beans, fruit, nuts/seeds.  They say "you are so disciplined, I could never do that."  Actually, at this point there is no discipline.  The only remaining challenge is to be tolerant of the waiting for the rest of the weight to melt.

• Conquer Food Addiction First.  Mental discipline is no match for physical craving.  I am convinced that someone ought to write a book addressing purely the "how to" of weight loss around the thesis of addiction.  Change the body and the mind will follow.

Best regards,

Michael F.

"Real Man"  #3 Leonard J. - Why I'm Sticking With Cheeseburgers & Fries

The following came from an email I received from a reader, Leonard J.

Dear Healthy Librarian,

I just read your post on the Legacy of a Father's Heart Disease - Can Prevention Overcome Genetics - Steve McKee's Memoir.  I found it quite interesting.

I had the good fortune to have my heart attack while in the cafeteria at Tripler Army Hospital for another appointment.  My wife quickly found a Doctor in the dining room and I was taken in a wheelchair to have tests done. The test results indicated I needed surgery. They did 5 bypasses and the surgery had some bad problems with bleeding and I was in there for 13 hours.

I remember seeing a Colonel later on. He told me, "I can't believe you're alive." His people did a great job.
 
Prior to the surgery, I had received an email from the son of a classmate. He told me that his mom had died after refusing to do a surgical procedure on her heart.  For some reason it was the first thing I thought of when I regained consciousness in recovery.  I immediately thought, "Beverly was right."  After a few weeks at home I no longer felt that way, of course.

What I am writing about is the approach people take after surgery. Initially I was going to change my diet and do all the "right things." 

Eventually I realized I won't be around forever and was already 70, so I decided to enjoy my bacon and eggs and all those things I was denying myself.  I won't gain a few months of life through boring behavior, but I will enjoy every waking minute I have left.

Now 73, the only thing that keeps me from doing more, is the lack of energy I once had. I am leaving in another hour or so for a cold beer and great cheeseburger by the ocean in Waikiki.   

Aloha, Leonard

In A Later Email, Leonard Wrote Back To Explain Further:

Dear Healthy Librarian,

I am aware of all the possible risks to having heart disease, having been a Type 1 diabetic since 1967 (at age 31).  Didn't ever think I would still be around now. 

I'm not worried about having a stoke and dealing with that sort of long-term disability.  I take three different meds for blood pressure which work well.  It was 94 over 46 a few minutes ago.  It  makes one a little dizzy, but I really prefer it this way. No one has ever had a stroke in our family, but heart attacks are the norm.  I hope I can die in my sleep as my mom did.

Good luck with your health. I find it hard to believe that it is 2009 and we can't come up with a pill that dissolves plaque. Oh well, I have been fortunate to say the least...

Me Ke Aloha...Leonard.

Me:  I still stand by my comment at the end of "Legacy of a Father's Heart Disease" -- the post that prompted Leonard to write to me:

Steve McKee's story strikes so close to home for me.  My dad suffered a massive stroke at age 69 that left him alive, but unable to talk, read or communicate for 16 years. What saddens me the most is that he never had the chance to really know his grandchildren.

My dad never went to a doctor until after it was too late.  He never knew he had high blood pressure or high cholesterol, or that he was considered obese by today's standards.  He's the reason I started exercising and eating right over 30 years ago.  Steve's story makes me glad I did!

Yes, I loved cheeseburgers & fries.  But I'd prefer to stay healthy for as long as I can.  Besides, I've really grown fond of Boca & Dr. Praeger's Burgers.

A Nutritarian? Not!
Real Life Adventures-Gary Wise & Lance Aldrich

 

Is It Time to Reconsider Hormone Replacement Therapy? Winnifred Cutler's "Hormones and Your Health: The Smart Woman's Guide to Hormonal and Alternative Therapies for Menopause"

"Unfortunately....one large study (the Woman's Health Initiative - WHI) sent us back into the Middle Ages, because its data were misunderstood, misinterpreted, and misreported...But keep in mind that the majority of postmenopausal women who do not use hormonal-replacement therapy will not merely experience unpleasant symptoms; they will risk diseases brought about by loss of bone, loss of blood vessel elasticity, and decreased protection from cardiovascular disease."

Winnifred Cutler, PhD.

"Most experts say women should take hormones for only a few years after menopause, and only if their symptoms are severe. Now, in a new book, biologist Winnifred Cutler claims that Hormone Therapy is safe for long-term use and highly beneficial -- as long as you do it right. Here, she makes her case."

Stephanie Young, "The Other SIde of the Hormone Controversy. A New Argument for Hormones"

Oh Boy.  This book is sure to be controversial.  Ever since the WHI was halted in 2002 the "standard recommendation" has been:  Only go on hormones if your menopausal symptoms are intolerable, and then go on the lowest possible dose for the shortest possible time! 

Dr. Cutler believes  this is not only unwise, it's an incorrect assumption.  "Panic trumped good science."

I happen to have a very savvy physician who is a national expert on menopause and women's health.  We've discussed at length the whole hormone issue and how the results of the WHI (the Women's Health Initiative) were misinterpreted, which basically brought the use of hormone replacement therapy to a screeching halt.

I read the results and the interpretations of the WHI study in the medical journals for myself, and together with my doctor's advice I made the completely radical & unorthodox decision to start hormone replacement therapy even though I didn't have any "intolerable" menopausal symptoms--which post-WHI, is the only reason to start HRT.

Full Disclosure Here:  I decided to take HRT for prevention--and because I knew from the literature, and the WHI, that if one wanted to receive any of the benefits of hormone replacement--like prevention of osteoporosis, urogenital health, possible brain health & flexible blood vessels--there is just a small window of opportunity when you can begin HRT.  If you wait too long after menopause to start, once blood vessels start to stiffen, you could put yourself at risk for adverse cardiovascular effects.

But I wasn't about to take Premarin, the equine-derived estrogen or a synthetic progestin like Provero or the combination of the two, called Prempro.  Let's just say, these are the synthetic hormones that were probably responsible for some of the adverse results of the WHI.

Together, we decided upon a regimen that closely duplicates a woman's natural cycle; the daily use of a bio-identical topical estrogen (estradiol-17 beta) cream called Estrasorb; and for 12 days a month--a bio-identical pill form of progesterone, called Prometrium.  As time went by--the doses of both of these have been cut in half.

Books and articles cross my desk constantly, but last week when I spotted Hormones and Your Health: The Smart Woman's Guide to Hormonal and Alternative Therapies for Menopause by Winnifred Cutler, I scooped it up and couldn't put it down.

What a find!  Finally, a book written in plain language by a biologist who has studied and written extensively about hormones and has reviewed many of the studies on the subject. Cutler studied over 3,000 peer-reviewed articles--and she cites 880 of them in her book.  

I've reserved a copy at my local library and I can't wait to read the entire book.  Dr. Cutler certainly has the credentials and background to write such a book, and she has no vested interest in selling hormones, no pharmaceutical research funding, or hidden agenda.

Be sure to read Stephanie Young's interview with Dr. Winnifred Cutler, "The Other Side of the Hormone Controver--A New Argument for Hormones" in More magazine, April, 2009.   Click here.

A Study You Should Know About But May Not:  KEEPS is an ongoing study--"Kronos Early Estrogen Prevention Study"--which aims to study what the WHI did not.  Can HRT prevent  cardiovascular disease (atherosclerosis in particular) in women, if it's given early--immediately after menopause.  Unlike the WHI, it's comparing a bio-identical estrogen/progesterone combo with the synthetic Premarin.  Many researchers feel that bio-identical hormones given transdermally & right after menopause will make all the difference. For more click here.

In other words--it's the study that's answering the questions that the WHI did not.

Here are a few highlights from "Hormones for Your Health":

1.  How hormones got a bad name from the WHI study

• One result cannot be applied to all.  Dr. Fred Naftolin, an eminent biomedical scholar at Yale has said the "WHI has been inappropriately used to create guidelines (for physicians) that are incorrect for any group other than the overweight, average-seventeen-years-postmenopausal population on which the particular regimen (synthetic Premarin, Provera or Prempro) was tested."
• The study participants weren't particularly "healthy".  "The WHI participants ranged in weight from simply overweight to frankly obese, with an unusually high incidence of arterial hypertension and a high prescription drug use to control other conditions.  Nearly 50% of the study population started out with several serious cardiovascular risk factors."
• The WHI was not a preventive study.  The WHI, contrary to its claims, wasn't designed to study "primary prevention"--which is preventing disease in an already healthy population.  You can't study "primary prevention" in healthy women when the majority of the women  enrolled either already have cardiovascular disease or are at a high risk for getting cardiovascular disease, because they were overweight, well past menopause, & hypertensive.
• Not all progestins and estrogens are alike.  Synthetic progestins (medroxyprogesterone acetate-generic Provero) affect the body differently than bio-identical progesterone.  Research has long shown adverse cardiovascular effects from the synthetic form. The bio-identical variety is also dosed in a cycle that is similar to a woman's natural cycle--taken only 12 days a month.  Transdermal (topical) estrogen has a more favorable and safer effect than oral forms.

2.   Postmenopausal hormone deficiencies can lead to:

• Decline in bone quality
• Diminished cardiovascular health
• Urogenital atrophy--atrophy of the urogenital tissues in up to 47% of women.
• Wrinkled skin
• Blood vessel thickening and atherosclerosis
• Cognitive decline
• Increase in fat, decrease in muscle.

3.   Benefits of Hormonal Therapies--The Well-Known & Lesser-Known

• Skin benefits with increased thickness, greater blood flow, faster wound healthing, greater water-holding capacity, less wrinkling
• Healthier vaginal tissues.  Responsible for higher acidity which prevents infections; less dryness, less atrophy, less thinning, less urinary tract infections
• Less hot flashes & night sweats
• The nose benefits from estrogen & progesterone.  Without hormones the nose is drier, feels stuffier, produces less mucus.  Since the nose is the first line of defense against airborne infections, hormone therapy helps the body to fend off colds & flu.
• Estrogen and your voice.  There are estrogen receptors in the voice box--women taking HRT had fewer voice complaints, hoarseness, vocal cord dystrophy.
• Estrogen and your teeth.  More estrogen--less tooth loss.
• Estrogen and progesterone and your eyes.  Hormone users had better vision and fewer eye conditions.
• Estrogen and progesterone and sleep quality.  Hormone users had superior sleep quality compared to non-users.
• Estrogen as an antioxidant--lessening the damage of oxygen free radicals that attack the cell membranes of blood vessels.
• Estrogen and gut/intestinal function.  Helps the absorption of key minerals, like calcium,  and helps to maintain the healthy functioning of the gut
• Estrogen, more positive profile for maintaining stable blood sugar, and preventing type II diabetes.

4.  The Big Scare: The Hormone Breast Cancer Question

• Cutler devotes an entire chapter to explaining the entire controversy--how to understand in real numbers the actual risks; why the type of hormones; the kind of dosing & regimen (mimicking a natural cycle); and the method of delivery (oral vs. transdermal) are important to understanding this controversy.
• Breast cancer rates with statin therapy are comparable to breast cancer rates with HRT.
• "Even in the WHI study, the risk of breast cancer on an individual basis was low. In the WHI, of the 8,506 women taking Prempro, 166 cases of invasive breast cancer occurred; in the 8,102 assigned to placebo, 124 cases were detected, that is, 1.95 percent versus 1.53 percent, or a difference of 0.42 percent. So 99 percent of women will not be at increased risk of breast cancer regardless of which hormones they take."

  "And remarkably, most studies show that postmenopausal women who develop breast cancer when they are on hormones are less likely to die from it than postmenopausal women who have breast cancer and are not on hormone therapy. This points to the complexity of the relationship between hormones and breast health."

5.  Choose Hormones Wisely - What Should You Take?

• Estradiol-17 beta taken transdermally (patch, cream, gel).  This mode will not increase triglycerides, and it will enhance heart rate variability.
• Bio-identical progesterone like Prometrium taken on a natural cycle of 12 days a month.  A sequential regimen lowers the risk of breast cancer, builds better bones, better mental function and a healthier cardiovascular system.
• For urogenital health, consider the ESTring which delivers a very low dose of estrogen  (estradiol) at a steady rate locally, not systemically.  It's a small flexible ring inserted vaginally.  It's an option for women who aren't able to take hormones.

6.  Hormones and the Brain

• Estrogen increases the electrical activity of the regions of the brain responsible for verbal and spatial working memory.
• Hormone users perform better in tests of executive function, except when using the synthetic form of progestin (medroxyprogesterone acetate, Provera)
• The brain is receptive to estradiol-17 beta--accept no substitutes.
• Conjugated equine estrogens like Premarin, Prempro or their generic equivalents do not produce the same benefits as the bioidentical estrogen and Cutler believes they may be actually detrimental.  Steer clear of synthetic progestins, like Provera or the generic medroxyprogesterone acetate.

7.  Hormones and the Heart

• Women who start hormone therapy before age 60 have a significantly better likelihood of enjoying good cardiovascular health.
• The best scores of heart health in the Nurses Health Study were in women using hormones, and who had their uteruses & ovaries intact.
• Once women stopped taking hormones they lost their advantage over "never-users".
• A Swedish study found hormone users had lower triglycerides, lower LDL cholesterol, less obesity, less type-II diabetes, less carotid atherosclerosis and lower risk of developing calcium deposits in the coronary artery.

Click here for an excerpt, the Table of Contents & the Index.

Obviously, hormone replacement therapy isn't for everyone.  It's a decision for both you & your doctor.   We're all different, with different risk factors and family histories.  Cutler's book advises us to not get so easily scared by the WHI--to not dismiss the hormone option out-of-hand.  Read the book--and then make a decision.  But remember, there's only a small window of opportunity to start--should you choose to take the HRT route.

Good health isn't found in isolation--with just a pill, a patch or a cream--it must include exercise, a healthy diet, stress reduction, and a healthy lifestyle.