Activities for the Whole Family

Have you made the decision that YOU want to start living your best health ever? What about your family? It’s hard to get on track without the support of your loved ones and that’s why it can be necessary to make sure they’re on board for your lifestyle changes as well! It doesn’t have to be a tedious task for them or feel like a burden, it can be fun and a great way to spend more time together. So why not pack in the quality time while getting in a good workout and being active? Here are some perfect examples to get you started as you incorporate your family life into your journey to your best health ever. 


Go Hiking Together


As long as you do your research ahead of time you can find plenty of family friendly hikes where you live. Map out how long it will take you to get there, have some classic car games ready, plenty of water and snacks, and make a day out of it. Pack a healthy picnic to enjoy when you reach the top of your destination and enjoy a beautiful day outdoors while kicking up your heart rate. 


Try Out Fun Sports

You don’t need to be an athlete to play a friendly game of basketball or soccer. Try out a basketball game of HORSE or run around with a soccer ball at your nearest park. Tennis can also be a great game to get the whole family in on. Find your nearest court and grab a couple of rackets and balls. You’ll get some sun and burn off a ton of calories running back and forth on the court. If you’re not feeling so adventurous, just grab a frisbee and head to the beach. Before you know it you’ll be starting your own Ultimate Frisbee team!


Sign up For A 5k Walk Or Run 


See what’s coming up on active.com for the latest 5k Walks and Runs. These events are usually family friendly, a great way to build community and the perfect opportunity to get some steps in. Better yet, find one that is for a cause close to your heart and educate your family on why it means so much to you. You’ll feel the positive impact not just physically, but also get a mental boost for supporting a charity that you feel personally connected to. 


Start a Neighborhood Recreation League


Get your neighbors involved in your health journey by starting a friendly weeknight Kick-Ball league (or Ultimate Frisbee team!) with one side of the street against the other. You’ll create a greater sense of community within your neighborhood, meet new people and maybe even find your next babysitter. You can also do some research to see if your town already has social sports leagues set up and join an existing team with your family and friends. Weeknight games are a great way to break up your weekly routine and add some diversity to your exercise habits. 

Travel With Games

Keep a soccer ball or a frisbee in your trunk. Instead of waiting in the car in between errands or after school activities, get out of the car and throw the ball around. If you’re on your own, try jump roping wherever you are. You can burn as many as 200 calories in just one 10-minute jump-rope session. Or make sure to just get out of the car and walk around, as long as you’re moving you’re one step closer to achieving a healthier life!

Go For A Bike Ride

A great way to burn calories and explore your neighborhood, biking is a perfect outdoor activity. Whether you’re on a beach cruiser or a tandem bike, you’ll be enjoying the ride so much you won’t even mind the burn when you’re going up those hills. Make sure to strap on a helmet, ride with water and plan out a fun pit stop. Check out TrailLink to find safe, family-friendly trails in your city. 

Get Technology Involved 

Add an element of competition between family members and see who can get the most steps in the day. You can use the Health app on your phone or invest in a FitBit to track your steps. Set a goal of 10,000 or 20,000 steps a day and create incentives for whoever hits the goal first. For example, the winner doesn’t have to do dishes that night or gets to choose what movie you’ll see that weekend! 

Make sure your family and friends know about your commitment to your healthier lifestyle so they understand how important it is to you that you have their support. Rallying your community is a pivotal step towards achieving your best health ever and there are endless fun and active ways the whole family can join in on your journey. 

How To Be A Morning Person

There are many benefits to rising early. It boosts your energy and lifts your mood. It amplifies your productivity and sparks your creativity. And it improves your chances of getting to work on time!

Are you looking for ways to become a morning person? Getting more sleep is a great first step. In fact, the National Sleep Foundation recommends that adults get seven to nine hours of shuteye each night. But it’s not just the number of hours you sleep that affects your ability to wake up and seize the day. It’s also the quality of those ZZZs.

Even if you’re a true night owl, you can transform yourself into a morning person by making a few tweaks to your daily routines. So what are you waiting for? Adopt these healthy sleep habits and you’ll soon find yourself waking up refreshed and ready to go

  1. Set bedtime reminders: Sticking to a healthy sleep schedule starts with hitting the sheets around the same time every night. On your smartphone, set an alarm with a soothing sound that reminds you when it’s time to start winding down. (If you have an iPhone, check out the Bedtime tab on your alarm clock for a sleep analysis bonus.)
     
  2. Start slowly: Training your body to get sleepy when it should doesn’t mean you need to convince yourself to hop into bed at 9 p.m. when you’re used to doing so much later. Making too big of a leap will keep you lying awake and restless, plus more likely to rebound into old habits. Instead, try turning in just 15 minutes earlier than usual. When your body adjusts to this new bedtime, turn in another 15 minutes earlier.
     
  3. Stay consistent: Waking up at the same time every day will also help you stick to your new schedule, which you may find easier to commit to on weekdays. If you’re tempted to reward yourself with extra shut-eye on the weekends, resist the urge to lounge in bed. Sleeping in a couple of hours later than normal may feel luxurious now, but it can throw off your body’s internal clock—and land you with “a case of the Mondays.”
     
  4. Reframe your thinking: Do you tend to procrastinate when it’s time to go to bed? How you think about bedtime sends signals to your body, which may trigger or inhibit a sleepytime response. By the time you feel tired, you might find yourself saying, “It’s late, I should go to bed.” A little trick to make bedtime less flexible is to shift the way you think about it. Next time you’re up an hour later than intended, try saying to yourself, “It’s an hour past my bedtime.”
     
  5. Destress your morning routine: How you start your day can set the tone for a positive day—or not. Hectic mornings may seem like the norm, but they don’t have to be. Shorten your morning to-do list by shifting tasks to the night before, like picking out what to wear, preparing a make-ahead breakfast, packing a healthy lunch, setting the coffee timer, and organizing your work bag.
     
  6. Skip the snooze button: Tired of being tired, even after a full night’s sleep? If you tend to hit the snooze button, you may be making yourself more tired than you think. Setting your alarm to go off just eight to 10 minutes into a new REM cycle can lead to sleep inertia or that feeling of heavy morning grogginess that’s hard to shake. Moving your alarm clock away from your bedside will encourage you to get up and start moving right away.
     
  7. Cut back on caffeine: Any coffee lover knows that going cold turkey on the joe can be quite the feat. Gradually scale back on your caffeine intake. Not only will it help you snooze more soundly, you’ll be less likely to spend those extra dollars on a cup of coffee the next morning.
     
  8. Jumpstart your day: You don’t have to leap out of bed and hit the gym for a vigorous workout to reap the benefits of morning exercise (unless, of course, you want to).There are plenty of early-bird workouts you can do from the comfort of home, and all you need is 10 – 30 minutes of moderate physical activity to get your heart pumping and feel more energized for the day ahead.

All it takes to start your journey to becoming a morning person is to make one small change. You’ve got this! Which healthy sleep habit will you try tonight?

 

 

 

 

3 Simple Breathing Techniques You Can Practice Anywhere

It doesn’t always take a vacation to a private island or a lavish spa day to get some relaxation time in. There are simple, quick techniques you can learn and incorporate into your everyday schedule to help ease that nagging tension and anxiety you might feel, and they take only take 5 minutes or less! Any time you might feel overwhelmed by an upcoming deadline at work or stressed out just coping with everyday tasks, you can try out any of these three breathing techniques. Find a quiet space wherever you are (even at work!) and try one of these out to help you feel more relaxed and ready to tackle the rest of your day. 

Belly Breathing 

Also known as diaphragmatic breathing, this technique requires you to focus on expanding your stomach, rather than your chest, as you take in each deep breath. 

1. Preferably lying on your back, place one hand over your stomach and another over your chest. 

2. Breathe in slowly through your nose and through your stomach so that you feel your stomach rise against your hand as your abdomen fills with air. 

3. Exhale completely and as you exhale through your nose, feel your stomach deflate to its neutral position. 

4. Repeat this process for 5-10 minutes, focusing on the sensation of your stomach rising and falling with each breath. 

The 4-7-8 Method

This exercise helps you breathe more deeply while putting your mind into a meditative state as you focus on counting the seconds during each breath in and out. 

1. Sit in a comfortable position and start by slowly inhaling through your nose on a count of 4 seconds.

2. After the fourth second, hold your breath for a count of 7 seconds*

3. After 7 seconds, exhale your breath for a count of 8 seconds. Repeat this exercise 3-4 times. 

*If 7 seconds feels too long, lower the count to a number of seconds that feels more comfortable for you. 

Progressive Relaxation

Your entire body will take a role in this breathing exercise as you coordinate each breath with the tensing and relaxing of your toes and feet all the way up to your shoulders and head. 

1. Lying or sitting, start by tensing the muscles in your feet as you breathe in through your nose. Hold the breath for a moment as you experience what the tension feels like in your feet and toes. 

2. As you relax your feet, release your breath and exhale through your nose. Take another moment to appreciate the feeling of your feet no longer tensing and contracting. 

3. Continue the process throughout your whole body, including your legs, abdomen, arms, hands, shoulders, jaw and eyes. 

4. Finish the exercise by tensing the entire body as you take a final deep breath in, and as you release your breath make sure to focus on the sensation of each muscle returning to a relaxed state. 

Taking the time to breathe deeply not only helps remind your brain to calm down but it can help remind you to be mindful and present in the moment.  Just by taking 5 to 10 minutes out of your day to try any of these breathing techniques you’ll notice a difference in how you cope with your stress, negative thoughts and the tension you’re holding in your body. Give it a try and let us know which one works best for you! 

Looking for Knowledge in All the Wrong Places

I always found it interesting when people talked about feeling their loneliest in the middle of New York City, surrounded by millions of people. It may seem like a leap, but that’s how I feel about finding reliable, reputable, easy to understand information on being healthy.

In today’s media-centric society, we have more information more easily available than ever before. Yet when it comes to healthy lifestyles, we may be at a low point in having accurate information that we can use to live healthier lives.

The popularity of social media has inflated the importance of just that….popularity.  It is more important to be popular than to be correct, accurate, intelligent, reasonable, balanced, and hundreds of other adjectives. Popularity -measured by numbers of clicks, likes and shares- is king.

That may be harmless when we are talking about videos of cats playing the piano and kangaroos jumping in the ocean, but when it comes to advice that directly impacts our health, popularity may be confusing us more than ever.

We have to be 100% vegan or we are killing ourselves. Statins are poison and should be avoided by everyone. Meat has been incorrectly vilified and we should all eat as much meat and bacon as possible. Low-fat is the only healthy diet. Ketogenic is the best diet for everyone. Cardio exercise is worthless and we all need to do heavy lifting. We need to do interval training every day for weight loss. Tumeric will solve all your problems. Vaccines are killing us and giving us autism.

I could go on and on. I’m getting disgusted just typing these.  But you can see how claims such as these from a popular voice, with thousands of shares and likes, could be taken as “truth” and as something that must be part of healthy living.

Fortunately, there are a smattering of popular voices that are also concerned with scientific evidence, reasonable approaches, and practical utility. I hope to be one of those voices. That was the goal behind creating my book, Your Best Health Ever: A Cardiologist’s Surprisingly Simple Guide to What Really Works (available on Amazon here).

My focus is the foundational principles of a healthy lifestyle, made very simple.

I present a balanced, scientifically accurate evaluation of lifestyle as medicine, and help build a sense of self-efficacy and “can do.” It’s meant to be a mix of science and practical tips for incorporating healthy habits into your life.

If my book and my message resonates with you, great. I am happy to be a voice to help. But do not stop there. Below is a list of other individuals with social media and web presence who are valuable sources of health advice. I do my best to summarize them to help you find the right ones for you.

 

The Physicians:

Mark Hyman, MD- @markhymanmd. One of the most well-known functional medicine doctors, head of Cleveland Clinic’s functional medicine program, and multiple times best-selling author. He is a proponent of eating fat as his book Eat Fat to Get Thin suggests. He is one of the more respected and reasonable voices at the intersection of traditional and functional medicine. He tailors posts to the general public with recipes and other concrete health suggestions, and he does an admirable job of combining scientific evidence with clinical experience.

 

John Mandrola, MD- @drjohnm John is an electrophysiologist (a sub-specialty within cardiology focusing on electrical problems of the heart) who is excellent at dissecting data and seeing multiple points of view. His posts can be on advanced topics and are usually geared towards physicians and less so to the general public.  He is still an outstanding example of a reasonable and intelligent voice who challenges the status quo when appropriate yet still acknowledges the benefits of agreeing with the masses.

 

Kevin Pho– @KevinMD. He is a primary care physician who is vocal regarding the challenges doctors face in providing high quality care and remaining engaged as physicians. He is a good resource for physicians to realize they are not the only ones facing these challenges, and he provides actionable advice to help with them. He may also be beneficial for patients to understand what MDs are going through, although most information may too technical for the public.

 

  Frank Lippman MD-@drfranklipman. He is a physician and functional medicine practitioner. He promotes basic, reasonable health and wellness advice. Sometimes his information is too general, but can still be helpful for general reminders about health and wellness. He avoids the extremes and controversial topics. Has a gentler approach to functional medicine than most.

 

Val Jones MD- @DrVal She runs Better Health LLC and provides intelligent and well balanced health information.

 

Tim Caufield- @cuafieldtim He is affectionately known as “The B.S, Detector.” He is very quick to call-out and engage anti-vaccine proponents, chiropractors, naturopaths, holistic practitioners, and of course Gweneth Paltrow for their lack of evidence.  His downfall is that he lumps groups together rather than recognizing a “few bad apples” can ruin the reputation of an entire profession. But if you have doubts about whether something legit, Tim likely has an opinion on the matter.

 

The Vegetarian:

David Katz MD-@drdavidkatz Controversial for his history of self-promotion, but aside from that he provides a reasonable, intelligent, although heavily vegetarian biased, voice on nutrition and health. Frequently gets into twitter battles with Nina Teicholz, which provides an excellent point-counterpoint discussion of nutrition and quality of scientific evidence.

 

The Vegan:

Joel Kahn MD-@drjkahn He is an admirable mix of practicing cardiologist, businessman, author, and passionate individual. He is heavily biased toward Veganism, and practices what he preaches. He even has his own Vegan restaurant in Detroit. He is committed to promoting health and wellness, and it is noteworthy how strongly he believes in his message. He is very active contributing articles on multiple websites, and is always quick to weigh in on current issues. He also frequently engages in twitter debates with Nina Teicholz. Eventhough I don’t personally believe we all need to be vegan, I appreciate Dr. Kahn’s message and his style, and I highly recommend him as a vegan health resource.

 

The Alternative Practitioner:

Chris Kresser-@chriskresser  Of the non-MD functional medicine practitioners and Paleo proponents, he is the most reasonable, and the most detailed regarding science and research. He does not subscribe to the all-or-none approach to Paleo, and his level of thinking is deeper than most others.  If you read an article on fish oil and then read Chris’ article on the same, you will immediately see his added layer of thinking and analysis.

 

Comedic Relief:

@zdoggMD– Likely the most entertaining and humorous physician to follow. He may not be the best resource, but he certainly is the most entertaining.

 

Non-Physician Authors and Writers:

Gary Taubes-@garytaubes He is a journalist and author of The Case Against Sugar and Good Calories Bad Calories. He is not a medical professional, but he is a very good researcher and writer, and a vocal crusader against sugar and refined carbohydrates. The attacks against him would be the strength of evidence behind his claims, but overall he is a wealth of information and a vigilant proponent of health and the crusade against sugar.

 

Nina Teicholz-@bigfatsurprise Author of The Big Fat Surprise. Vocal proponent of saturated fat and one of the initial whistleblowers on the poor-quality science demonizing fat. She embraces controversy and can frequently be seen in twitter debates with Drs. Katz and Kahn listed above. That makes her always entertaining and informative, and a great source to help us see the “other side” of the low-fat trend that has been present for decades.

 

The Nutritional Movement:

The Whole 30: @whole30 Best-selling book promoting whole food nutrition and avoiding processed, refined foods. Great resource with recipes and inspirational links.

 

The Standard Medical Sites:

WebMD

NIH

MayoClinic

Everyday Health

These all seem to have a balanced and reasonable approach to standard medical advice.

 

New Generation:

@Greatist- The health website for millennials and Gen X.

 

Most Popular

 

Joseph Mercola DO-@mercola- He is one of the most popular and most active voices in the health and wellness sector. Many of his posts are reasonable and great resources. However, he also drifts to the extremes and overstates the strength of the evidence to suit his claims such as (Do Drug Companies Secretly Favor a World Flu Pandemic?” “Zinc Can Cure Diarrhea” and “Learn How Homeopathy Cured a Boy of Autism” not to mention calling shampoo, tampons and other daily use items a “poison.”  Of course, he sells healthy versions of them all on his website. There are multiple articles written calling him the most dangerous voice in health and wellness, and the FDA has reprimanded him on a number of occasions. Yet that doesn’t stop him from getting almost 2 million visitors to his site every month.  As far as the public is concerned, he is doing something very right.

 

Mehemet Oz, MD- He wins the award for most popular physician voice on multiple mediums- TV, website, social media etc. He reportedly reaches millions every day in over 100 countries. He has gotten into trouble in the past for episodes such as “Plant based magic weight loss cures,” “miracle appetite suppressants,” communicating with the dead to reduce stress, and others. Doctors have petitioned Columbia University to remove him from his faculty position due to his “egregious lack of integrity” and his promotion of “quack treatments.” Yet it is clear he has won the popularity game and has a voice millions yearn to hear. He could never have done that if he wasn’t helping people to some degree. From that aspect, we can all learn from him.

 

Dr. Oz and Dr. Mercola are two of many popular voices promoting a message of either distrust of modern medicine, or belief that miracle cures exist. This message resonates with millions. They both have credentials as experienced clinicians, and much of their advice is scientifically sound. The challenge comes in knowing when they cross the line and enter the potentially dangerous realm. That is why now more than ever, we need reasonable and responsible voices promoting health, wellness and prevention of chronic diseases.

 

 

Conclusion

 

So where can we turn for reputable, easy to understand information that will help us lead healthier lives? I encourage you to follow those on the above list whose style resonates with you, and I hope my book and website can fill that role as well. Just remember, everyone has a bias. Everyone. Every point has a counter point. Every story has more than one interpretation.

 

Look for balance, look for rational analysis, look for people who ask more question and don’t pretend to have all the answers. And please, remember to question every dramatic claim or headline you read. They rarely are as simple or impressive as authors would like you to believe.

 

Follow these principles, and you will ensure that you get the most accurate and reliable health information available. It may not always be the most popular or have the most likes, but hopefully it will be the most accurate and helpful. That’s more important than cats playing the piano, don’t you think?

 

 

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

 

How Many Pills Do We Need to be Healthy?

How many pills do you need to be healthy? To be healthy we would want to do the following:

  • Lose weight
  • Lower LDL
  • Raise HDL
  • Lower blood sugar
  • Lower insulin levels
  • Reduce inflammation
  • Reduce your risk of heart attack and stroke

 

To do all that you would need five or more prescription drugs. But is that what it means to be healthy?

 

Our traditional medical culture seems to be saying, “Yes!” That type of thinking is why prescription drug use continues to rise, with over 60% of American adults taking prescription drugs, and 15% taking five or more drugs.

 

Guess what. It doesn’t have to be this way. Not even close.

 

Here is the secret you can do that is better than taking 5 or more pills.

 

You can commit to healthy lifestyle habits.

 

Do that and you will lose weight in a healthy manner. You will lower your blood sugar and insulin levels. You will improve your cholesterol profile, reduce your inflammation and lower your risk for heart attack and stroke.

 

And you can do it all without side effects, unless of course you consider being happier, having more energy, and feeling better as side effects!

 

Sounds easy? It can be. It won’t always be easy, and it certainly isn’t easy to be perfect. But being better, and seeing every day as a new opportunity is well within our grasp.

 

The Science Supports Lifestyle First

 

A 2016 study in NEJM investigated four different trials comprising over 55,000 subjects. They concluded that even those with the highest genetic risk of cardiovascular disease can reduce their risk by almost 50% with healthy lifestyle habits, defined as eating healthy, getting regular physical activity, not bring obese, and not smoking.

 

In addition, A 2014 study showed that 80% of all first heart attacks are explained by 5 risk factors (smoking, waist circumference, healthy diet, regular physical activity, moderate alcohol consumption). It turns out, all five of those factors are within our control. We don’t need a pill to control them. We just need to commit ourselves to controlling them.

 

Putting it into practice

 

Despite this encouraging information, A study published in the Mayo Clinic Proceedings concluded that an only 2.7% of the Americans studied led a healthy lifestyle (defined as regular physical activity, healthy eating, not smoking, and having a recommended body fat level).

 

It should be no surprise, therefore, that heart disease remains the leading cause of death in men and women. There are approximately 900,000 heart attacks annually in the U.S., one every 42 seconds, with 365,000 people dying from a heart attack every year. Heart disease costs $207 billion annually in the U.S. alone. And for the first time since 1993, the life expectancy in the U.S. has started to decline.

 

The Health-Drug Disconnect

 

If more and more people are taking prescription drugs, yet our life expectancy is declining, how do we rationalize the disconnect?

 

I propose it is because we have lost sight of what first line medical therapy should be.

 

Statins come with a litany of side effects, and at best reduce your risk of heart attack by 3% over 5 years.

 

Drugs that raise HDL level can worsen your risk of dying (CETP inhibitors).

 

Diabetes drugs can increase insulin levels, increase weight, and create a medication dependency.

 

Weight loss drugs are rarely sustainable over the long run, and come with severe side effects.

 

Do any of those sound like good choices for first-line treatments? Not to me. And I hope not to you either.

 

Change What We Reach For

 

Instead of reaching for our prescription pads, physicians should be reaching for cookbooks, lists of farmer’s markets, different options for activity trackers, stress management apps, and other healthy lifestyle tools.

 

That is where true health begins. That is our best chance of achieving real health. Not health that is dependent on a medication, or health that is defined by a lab value.

 

For more information on how to improve your health with healthy lifestyle habits, read more about our book and instructional video series. They may just change your life.

 

Thanks for reading

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

Take a look at Your Best Health Ever: A Cardiologists’ Surprisingly Simple Guide to what Really Works. You can buy it today on amazon (here is the link). It has all the information you need to prioritize healthy lifestyle practices over prescription drugs. Together, we can promote natural, long-lasting health that feels great.

Is Alzheimer’s Disease Preventable?

Is Alzheimer’s Disease Type III Diabetes? And Can it be Prevented?

By Bret Scher, MD

 

Alzheimer’s disease is one of the most devastating conditions in our country, and you may have the power to prevent it.

 

There is nothing more empowering than knowing you have the ability to prevent a chronic disease. Especially when some view that chronic disease as worse than death. While not all factors that lead to chronic disease is controllable (e.g., genetics), there are some diseases that you can protect yourself against. And one of those might be Alzheimer’s disease.

 

Alzheimer’s disease—which is the sixth leading cause of death in the U.S.—is a devastating condition that impairs your memory and ability to think. It progresses over time, eventually condemning an otherwise functional body to a life completely dependent upon care from others. It changes the lives of not just those affected by the disease, but their loved ones and caregivers as well.

 

In 2015 alone, approximately 15 million caregivers provided an estimated 18 billion hours of unpaid care to the 5 million Americans who suffer from Alzheimer’s disease. But the cost to families and to society as a whole cannot be measured in just dollars and cents. The emotional toll can also be enormous. The negative effects on caregivers can be vast, including:
 

  • Psychological distress
  • Impaired health habits
  • Psychiatric illness
  • Physical illness

 

To make matters worse, the number of people diagnosed with Alzheimer’s dementia is only getting larger and is expected to triple as baby boomers reach the at-risk age of 65 and older.

 

Paradigm Shift in Understanding Alzheimer’s

Modern medicine has struggled to find effective treatments for those who suffer from Alzheimer’s. The most effective medicines may slow the symptoms by a few months, but the inevitable progression always happens in the end.

 

A new paradigm shift, however, offers promise for methods to prevent and treat Alzheimer’s disease. The paradigm shift is that Alzheimer’s may be Type III Diabetes.

 

To understand this relationship, it helps to understand the basics about diabetes, blood sugar, and insulin. Insulin’s job is to signal cells to take sugar out of the blood and convert the sugar into energy. When a person has diabetes, the cells no longer listen to insulin, so the body needs to produce more and more insulin to get the message across.

 

As the efficiency worsens, the body can’t keep up, the blood sugar rises and diabetes develops. This causes two main problems:
 

  • Insulin levels rise sky high. Since insulin is a fat storage and pro-inflammatory hormone, higher levels equate to deterioration of overall health.
     
  • Blood sugar levels increase to dangerous levels. This can eventually lead to heart disease, vascular disease, kidney disease, vision loss, neuropathy, and other serious conditions.

 

It turns out that brain cells can become resistant to insulin as well, thus drawing a connection between diabetes and Alzheimer’s. The theory is that increased insulin and increased sugar in the brain leads to damage of brain cells and eventual dementia.

 

The Connection Between Alzheimer’s and Diabetes

 

Medical science is starting to explore the relationship between diabetes and dementia and is drawing a strong connection. One study, for instance, reviewed previous investigations of diabetes and dementia, accounting for over 2 million subjects. The study concluded that those with diabetes were 60 percent more likely to develop dementia.

 

While an association does not prove causation, it does raise an interesting potential link that deserves further exploration.

 

The next question is whether there is a reasonable explanation for why the two diseases might be related. And it turns out there is.

 

Another study demonstrated that individuals with type II diabetes are more likely to develop the same “brain tangles” that are seen in those affected with Alzheimer’s. It is thought that these tangles are directly responsible for the progressive cognitive decline. And they are present in both the brains of individuals with Alzheimer’s disease, and the brains of those with diabetes even in the absence of dementia.

 

How to Prevent Diabetes, and possibly Alzheimer’s

 

This emerging research could be discouraging news since the incidence of diabetes is on the rise, with an estimated increase from 285 million cases worldwide in 2010 to 439 million in 2030.  The result could be an equal surge in new Alzheimer’s cases.

 

Or it could be encouraging news, since type II diabetes is almost entirely preventable with healthy lifestyle habits. Presumably, these same habits may help prevent Alzheimer’s as well.

 

In fact, a 2001 study in NEJM suggested that 90 percent of type II diabetes cases could be prevented with:
 

  • Proper exercise
  • Healthy eating
  • Not smoking
  • Maintaining a healthy bodyweight

 

 Another study showed that a lifestyle program that included 150 minutes of weekly physical activity and a goal of 7 percent weight loss prevented diabetes better than the popular drug Metformin—an oral diabetes medicine that helps control blood-sugar levels.

 

Finally, a 2012 study followed 2,700 people over three years and found those who ate a diet higher in carbohydrates and sugars and lower in protein and fat were more likely to develop dementia.

 

This information shows that diabetes, and by extension Alzheimer’s disease, may be preventable by following a healthy lifestyle that includes these elements:
 

  • Exercise 150 minutes per week and remain physically active throughout the day
  • Maintain near ideal body weight
  • Eat a real-foods, vegetable-based diet with healthy fats
  • Avoid simple, refined carbohydrates
  • Avoid added sugars in food and drinks

 

A Healthy Lifestyle Is Necessary

 

Unfortunately, this is not hot-off-the-press news. These studies were published over 15 years ago, yet many people are still reluctant to adopt such healthy practices. In fact, one study of American adults found that only 2.7 percent of the subjects followed a truly healthy lifestyle.

 

The public shouldn’t need more inspiration to strive to be healthy, but knowing that Alzheimer’s disease and diabetes are likely preventable will hopefully be enough motivation to spark a revival for healthy lifestyles now and for decades to come.

 

Change doesn’t come easily, so start by making simple steps and find a support system that will help you adopt new ways of living.

 

Those in positions of influence (doctors, nurses, personal trainers, nutritionists, health coaches, chiropractors, and other medical professionals) need to actively educate society about the association between Alzheimer’s and diabetes.

 

If you fall into this category, it’s important to learn how to inspire individuals to adhere to healthy life habits, which may help prevent one of the most devastating conditions that touches the lives of tens of millions Americans every year.

 

Now that’s empowering.

 

Thanks for reading.

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

ACTION ITEM:

Make 1 meal this week a Vegetable Based meal. Don’t have chicken with a side of veggies, or salmon with rice and a couple veggies. Make the basis of the meal veggies and add 4-6 oz. of high quality animal protein.  Notice how it looks different, tastes different, and how you feel differently after you eat it. If you can do this, then you can increase it week after week until most of your meals are veggie-based. You will be amazed at how it improves your health and how you feel!

Breakfast, Fasting and Our Health

“Breakfast is most important meal of day.”- Said in a thick eastern European accent by Colossus in the movie Deadpool. The statement has become so ingrained in our society that even a CGI created super hero quotes it as if it were fact.

 

What if I told you breakfast was the most important meal to skip each day? Would you dismiss the comment since it goes against everything you have heard up until now? Well, it turns out, it may be true. And the science backs it up.

 

Science Quality Matters…A Lot

 

First, where did the concept of breakfast being the most important meal come from? Would you believe cereal companies, and other food companies who have a vested interest in more people eating cereal? Yep. Bias and hidden motives over-rides scientific evidence once again.

 

This article in the Guardian is a good summary of how this came to be. Additionally, according to the book Three Squares: The Invention of the American Meal, Abigail Carroll proposes that breakfast used to be comprised mostly of leftovers. There were no “breakfast foods.” It was simply another meal, nothing unique.  But it did not take long for Kellogg’s to start promoting breakfast cereals, and suddenly it was expected that we eat specific “breakfast foods.”

 

What followed was a collection of media talent and poor science to elevate breakfast from just another meal, to “The Most Important Meal of the Day.” In fact, the claims were clear. If you skip breakfast you will have no energy, your metabolism will grind to a halt, and you will suffer from low blood sugar. You will gain weight and over-eat the rest of the day.

 

Unfortunately, these drastic clams were derived from poorly run observational studies. Obese people skip breakfast. Therefore, skipping breakfast must make you obese, right? Not so fast.

 

Could it have been obese people try to reduce calories and therefore skip breakfast?

 

In an observational trial, we can’t prove which theory is correct. All it tells us is that obese people skip breakfast. It tells us nothing about why, and what effect that may have on their health.

 

But cereal marketing firms will jump on that evidence and claim that skipping breakfast makes you obese. That’s scientific hogwash.

 

Better Quality Science

 

Fortunately, we now have randomized trials to investigate these claims. One study demonstrated that eating breakfast had no impact on resting metabolic rate, and another demonstrated that eating or skipping breakfast had no direct impact on weight loss.

 

Not all the science is faulty. The claim that missing meals can slow your metabolism is true, somewhat. It turns out that prolonged starvation of more than three days triggers a survival reflex resulting in a reduced resting metabolism. But that goes way beyond simply skipping breakfast. In fact, resting metabolic rate INCREASES in the first two days of a fast.  So if we are only skipping breakfast, it is clear that our metabolism is safe.

 

The Case for Intermittent Fasting (IF)

 

Nail in the coffin. We can now put away the baseless claims that we need breakfast. But that still doesn’t mean we should skip it, right?  Why would we want to skip breakfast?

 

I’m glad you asked……

 

One main reason to skip breakfast is that reducing our insulin and glucose levels allows our body to start breaking down fat stores. To make it sound technical, the concept of skipping breakfast is referred to as intermittent fasting, and it comes with numerous potential benefits.

 

In addition, some scientists believe intermittent fasting is the closest thing to the fountain of youth. It turns out that calorie restriction has increased survival in all sorts of animals, and shows promise for humans as well. But who wants to severely restrict their calories every day? In modern day society, that becomes nearly impossible.

 

Enter intermittent fasting. IF allows us to experience the physiological effects of calorie restriction without having a critically negative impact on our social existence.

 

Here is how it works. You set up an “eating window,” noon to 7pm, and a “fasting window,” 7pm to noon the next day. The key is that our bodies don’t enter a true fasting state until more than 10 hours after our last food intake. This is the point where our glucose and insulin levels are low enough to allow for lipolysis (the body breaking down fat stores for energy instead of using glucose circulating in the blood). In the above example, the fasting window is 17 hours, thus giving you 7 hours of fat breakdown. There are other versions of IF, but this is the one that I have seen works best for most people.

 

Food Quality Matters…A Lot

Now that I have made the case for trying intermittent fasting, I should be honest and tell you that intermittent fasting will not work for most of you.

 

Not until you improve the quality of what you eat.

 

If you eat mostly carbohydrates, simple sugars, and processed foods, then you don’t stand a chance. These foods cause rapid spikes and falls in glucose and insulin, throwing you into a cascade of hunger and cravings without a chance at extending the time between meals.

 

So, before you try IF, make sure you are eating nutrient dense, low sugar foods. Focus on lots of veggies, healthy fats (nuts, olive oil, avocados), appropriate proportions of animal fats and proteins, and a small amount of complex carbs. Once you do this, IF will be easily manageable.

 

Tips

 

  • Choose your IF days carefully. Make sure you will have control over the timing and food content of your first meal. You don’t want to get stuck eating “whatever is around” when you are hungry at 1pm after an 18hour fast. For best results, that first meal needs to be a healthy, nutrient dense meal low in simple carbohydrates and sugars.
  • Give it time! The first few times you experiment with IF, you may feel hungry and feel like you can’t survive. That feeling quickly passes with physical and psychological adaptation.
  • The initial psychological barrier to IF seems imposing. In reality, it’s simple to implement and stick to. Once you get over the initial hurdle in your mind, you will see.
  • Embrace the psychological benefits. IF allows you to know that you are in control of your feelings of hunger. You do not have to react to every small pang of hunger or food craving. You are in control, not the food.

 

 

So, Colossus should have said, in his thick Eastern European accent, “Breakfast is most important meal of day to skip. If you want.”

 

Don’t get me wrong.  A few days each week, I look forward to my big plate of leftover veggies, spinach and kale over two eggs and a sprinkle of grass-fed cheese. It’s a great way to start the day. And the other three-to-four days, I look forward to skipping breakfast, knowing that I am burning my fat stores, lowering my insulin and glucose levels, raising my HGH, and possibly taking one step closer to the fountain of youth.

 

Give it a try and see what it can do for you.

 

Thanks for reading.

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

Pick a day this week when you have complete control over the timing of your lunch. Commit to practice IF that day. Stop eating at 7pm the night before, and don’t eat again until noon or 1 pm the next day. Make sure both of those meals are nutrient dense, veggie based meals with high quality fats and proteins. Expect to feel hungry, and remind yourself that you are in control of your hunger, not the other way around. You can do anything for 1-day. Then pick 2-days for the next week to try again. The more you do it, the more you adapt to it and reap the benefits.

Local Farmers- The New Frontier of Health

I’m convinced that to be the best physician possible, to be the ultimate health advocate for my clients, I need to be a coach, a personal trainer, a nutritionist, and a farmer.

 

That’s right. Our health may rely on farmers as much as on doctors. Farmers control how our vegetables are grown and how our animal protein sources are raised. It turns out, that’s a pretty big deal.

 

200 Decisions per day!

 

Every day we make over 200 food and drink related decisions. Decisions to put substances into our bodies that either augment our health, or substances that poison our health.  Considering that over 60% of the average American’s calories come from moderately or heavily processed food, the poison seems to be winning.

 

Instead, we need to focus on a real-foods, plant-based nutrition with a high proportion of healthy fats and, for many, appropriate proportions of high-quality animal protein. With these nutritional choices, we would see the incidence of diabetes, heart disease, strokes, dementia and other chronic diseases plummet.

 

Better Than Good

 

But what if we are already pretty health conscious with how we eat? What if we want to make sure the food we put in our bodies augments our health as much as possible?

 

For that, we need to look beyond the macro-nutrients. We need to look to the farms.

 

We have all heard the buzz words that we should eat local, organic produce. We should eat grass fed beef. Our eggs and chickens should be pasture raised. But does it really make a difference?

 

Yes, Yes and Yes!

 

Studies have shown that grass-fed meat has higher levels of vitamin A, vitamin E, Omega 3 fatty acids, and more beneficial saturated fats (such as CLA and stearic acid) compared to grain fed meat. In addition, wild fish have fewer dioxin contaminants compared to farmed fish, and greater benefit to harm ratios that farmed fish. Pasture-raised chicken produce meat and eggs with higher levels of vitamin E, omega-3 fatty acids, and vitamin A compared to cage-raised poultry.

 

When it comes to animal proteins, quality matters. A lot.  Not to mention the ethical considerations of how these animals are raised.

 

The industrialization of the food industry has done nothing to improve the quality of our food, and in fact, has done the opposite. To be fair, it has allowed some populations to enjoy animal protein at an affordable price, but it has gone too far. I’m not sure of the exact definition of “too far,” but all you need do is see the conditions at a CAFO (Concentrated Animal Feeding Operation) to know we have gone too far.

 

CAFO’s have overcrowded, inhumane conditions that lead to excessive methane production, concentrated waste that destroys the soil and contaminates the water runoff, and the end result is meat that has reduced nutritional value.

 

But it does not have to be this way. Cattle and the environment can have a symbiotic relationship. In fact, they did for generations before humans developed and industrialized the land and forced cattle into confined spaces. 

 

Ranchers have started to recreate the “good ‘ol days” of cattle by setting up migratory grazing, and cycling their cattle, chickens, and crops. The result is more nutrient dense meat, milk, chicken and eggs. It also leaves healthier soil, and results in a sequestration of carbon in the soil (as opposed to unopposed release of carbon in methane).

 

So, what can you do to help this process? First, eat grass-fed, locally sourced meat. Eat pasture raised chicken and eggs. Buy from your local butcher or even mail order meat from sustainable ranches. You will dramatically improve the nutrients you derive from your food and you will benefit the environment.

 

Won’t this be more expensive? That leads me to the second point.

 

Eat less meat.  Remember, the healthiest meals are vegetable-based. That means the main portion of the meal consists of veggies. In contrast, today most meals have vegetables as a small side dish if they are eaten at all. Some sources state that only 41% of all dinners contain a vegetable at all.  

 

What takes their place? Animal proteins and simple carbs/grains.  By refocusing on making our meals veggie-based, we can reduce the unneeded simple grains and sugars, reduce the quantity of animal proteins and INCREASE their quality. Think about it. You can eat less of a more nutrient dense animal protein source, you can get the same satisfaction, better nutrition, and you can manage to keep the cost fairly constant. That’s a win-win by any definition.

 

Eat your Veggies!

 

But what about the veggies? The news isn’t all rosy there either.

 

The National Academy of Sciences issued an alert that our veggies ‘aint what they used to be.

 

It appears that the nutritional value of vegetables has declined compared to the 1970s. For instance, the vitamin C content of sweet peppers declined by 30%, the vitamin A in apples dropped by 40%, and the calcium in broccoli has been cut in half. 

 

The most likely explanation for the nutrient decline is modern farming’s evolution to maximize yields and profits. To this end, the health and diversity of the soil has largely been ignored, resulting in undernourished soil feeding a larger number of crops. 

 

It doesn’t take a mathematician to see that there are fewer nutrients to go around.

 

The recommended daily allowance (RDA) is 5 servings of veggies per day with an optimal intake of 9 servings per day. But those are based on the “old” nutrient values for veggies. Assuming a 30% decline in nutrient value across the board, the optimal number of vegetable servings would go up to 12 per day.

 

Considering 87% of American adults don’t consume the current RDA for vegetables, it would be safe to assume an even lower number are getting adequate nutrition from vegetables. Something must change.

 

Re-Define a Meal

The first step is reframing how we see our meals. We need to make veggies the center of our meals. We need to start seeing veggies as fun, sexy, and enticing. That means exploring new veggies (How about tubers, chard, Romanesco, kohlrabi, or just multi-colored carrots?), and experimenting with new ways to prepare them.

 

By making veggies exciting, we can begin to make them the center of the meal. No longer is the chicken the main dish. Now it is a veggie medley with chicken and avocado on top. No longer is it miso salmon on a bed of white rice. Now it is a spinach salad with grilled salmon and an array of fresh veggies. Now that is a step towards health!

 

Know your Farmer

 

The second step, however, is where we all need to be a farmer, or at least know a farmer.

 

We don’t have to rely on produce that has been stripped of its nutrients by modern farming techniques. We don’t have to rely on mega-food corporations that are far more concerned with their stockholders than public health. Mega-food corporations have lost the public’s trust, and for good reason.  We shouldn’t have to eat carcinogens mixed with our spinach or our berries.

 

Granted, local farmers still need to make a profit, but they are not beholden to stock holders and large corporate greed. They can maintain their beliefs about the proper way to treat soil, the healthiest way to grow vegetables, and the most efficient way to support their community.

 

And don’t forget about the new generation of entrepreneurs. Folks like Kimbal Musk and Tobias Peggs with Square Roots. Not only are they growing fresh organic vegetables in Brooklyn in the middle of the winter, but they are teaching others how to do the same. Their use of hydroponics and vertical farming promises to revolutionize urban farming.

 

And the result? More fresh, healthy vegetables on our plates year-round.

 

So, the next time you want to be proactive about your health, you can go see your physician. Or you can go see your local farmer or rancher. They have as much, if not more to offer you for promoting your health and preventing chronic diseases.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action item:

 

Find the closest farmers market to you and go there! Find out when it is and plan your schedule accordingly. That is your time to go grocery shopping. Notice how the fresh fruit and vegetables looks and smell differently than in the grocery store. Talk to the local farmer. Ask if they use pesticides or other chemicals. Learn more about their farm and farming practices. Feel the sense of community and take pride that you are helping support local farmers and your health.

Statins- What do We Really Know?

45 million Americans “should” take statins. Are you one of them?

 

 It may surprise you to find out that you might be. When your doctor plugs your information into a cardiac risk calculator, he or she may tell you that you should to take a statin.

 

You may not feel bad. You may not have many other cardiovascular risk factors. Yet you may be labelled with the “disease” of elevated cholesterol.

 

“New” Guidelines- Questionable Sources, Questionable Guidelines

 

Why are so many more previously healthy Americans now being treated for high cholesterol? We can thank the 2013 ACC/AHA guidelines, which increased the intensity with which physicians prescribe statins.

 

Interestingly, these were not based on any new data. Instead, they were based on new interpretations of old data, much of which has not been made available for third party reviewers. None the less, it is now recommended that physicians consider prescribing a statin to anyone with a 5% 10-year risk of cardiac disease (increased from a previous 20% risk).

 

To me it seems that a recommendation to dramatically increase the use of these drugs should save lives left and right and have almost no down side.  Unfortunately, that is not the case.

 

Don’t get me wrong. Statins are not useless. They can reduce the incidence of heart attacks and strokes. For someone who has never had a heart attack (referred to as primary prevention) we need to treat between 60 and 104 people for 5 years to prevent one heart attack without any significant difference in the risk of dying.

 

That’s a little underwhelming, is it not? That seems like a “shotgun” approach where you send a hundred bullets out knowing that one will hit the right person (in this case getting hit by a bullet is a good thing). It doesn’t have to be this way.

 

In addition, statins are not perfect drugs. For every 50 people treated over five years there will be one new case of diabetes. There will also be at least 10% risk of muscle aches and pains with potential damage to the mitochondria (the energy producing part of the cell), and may even be linked to onset of dementia and memory dysfunction.

 

A system that potentially harms more people than it helps doesn’t seem like a viable solution to me. We can do better.

 

Better Define Your Risk

 

The problem is that our medical culture emphasizes prescribing drugs more than further defining your risk, and more than exploring alternatives to reducing your risk.

 

The current cardiac risk calculator uses:

  • Age
  • Gender
  • Race
  • Total cholesterol
  • HDL
  • Blood pressure or previous diagnosis of hypertension
  • Diagnosis of diabetes
  • Smoking status

 

Those are all reasonable initial risk factors to evaluate. But doesn’t it make sense that if we are using a drug that will only benefit one in 100, maybe we should try to further define those at high risk? To me that is a no-brainer.

 

For instance, one study showed that by measuring a coronary calcium score on statin eligible individuals, we could reclassify 50% of them so that they no longer “qualify” for statin treatment. We can avoid an enormous number of statin prescriptions with one simple test. A test that is readily available now. A test that has minimal risk (very low radiation dose, and a small chance of incidental findings), and is relatively low cost (about $100).

 

And we don’t have to stop there.

 

The Scripps Research Institute has developed an app to allow people to use their genetic information to better define their risks. This could potentially be used to define those who are not at high genetic risk for heart disease and therefore would likely not benefit from statin therapy.

 

Now we are starting to get somewhere. What if we could better define cardiac risk so that one in 5 people benefit from a statin, as opposed to the current 1 in 100? That is an admirable goal.

 

Even Better Than A Statin

 

Once we better define our risk, let’s not forget all the alternative to statins.

 

One recent study demonstrated that even those at the highest genetic risk for heart disease can cut their risk in half with healthy lifestyle habits (eating healthy, getting regular physical activity, not smoking and not being overweight). And that was the highest risk group! That’s likely just as good as, if not better than, a statin could do.

 

So why don’t we write prescriptions for intensive healthy lifestyle education programs instead of drugs?

 

Lifestyle changes are “harder.” Lifestyle changes take longer to see results. Lifestyle changes require more education, encouragement and follow up.

 

Do you know what else is associated with healthy lifestyle changes? Decreased risk of heart attack, strokes and death. Decreased risk of diabetes, high blood pressure and depression. And the only side effects are feeling better, having more energy, and being in control of your health.

 

That sounds like something that is well worth the extra work, the needed patience, and the more vigorous follow-up. Don’t you agree?

 

Start Asking Questions

 

So, what should you do if your doctor recommends a statin? Start asking questions. Lots of them.

  • How high is your calculated cardiovascular risk?
  • How much will a statin reduce that risk?
  • What else can be done to better define your risk (i.e. coronary calcium score)?
  • What else can be done to lower your risk (i.e. intensive lifestyle modifications)?

 

Ask yourself questions as well.

  • How can I improve my nutrition to focus on a vegetable based, real food, Mediterranean style eating that focuses on healthy fats and appropriate proportions of high quality animal products?
  • How can I improve my daily physical activities in addition to increasing my weekly exercise?
  • How can I improve my stress management and sleep habits?

 

Remember, the benefits of statins are small. Not zero, but small.

 

Also, remember that statins have not been directly compared to healthy lifestyle habits. We don’t know if they add anything to a comprehensive lifestyle modification program. In fact, I would wager that if you have healthy eating habits, you get regular physical activity, you exercise regularly, and you practice regular stress management, then statins will not reduce your cardiovascular risk at all.

 

It may seem like a bold prediction, but to me it seems obvious.

 

Unfortunately we will likely never see a head-to-head study between statins and healthy lifestyle interventions (I discuss the specifics of the study I would like to see in my prior blog post here).

 

We can do better than a drug

 

In the end, remember that we can do better than drugs. We can be in control of our health. We can achieve real health that is not dependent on blood tests or medications.

 

So, don’t blindly accept a prescription for a statin (or any drug for that matter) without further defining your risk, and without further exploring your alternatives. You and your health deserve at least that much.

 

Thanks for reading.

 

Bret Scher, MD FACC

Cardiologist, author, founder of Boundless Health

www.DrBretScher.com

 

Action Item:

If you are on a statin, or any drug for that matter, make sure you ask your doctor why you are on it, exactly what benefit you should expect, and what the potential short- and long-term side effects are. Also, ask what the alternatives are, specifically regarding your lifestyle and healthy habits. If you aren’t getting adequate answers, ask me! info@drbretscher.com. I welcome your emails. 

858-799-0980Dr Bret Scher