If Food is Medicine, “What should I eat?”

Keep it simple.

INCLUDE  What Your Body NEEDS:

  1. Water
  2. Protein
  3. Colorful or non-starchy Vegetables
  4. Fats

Whole grains and whole fruit may be beneficial in specific doses depending on your weight, exercise routine and other health conditions.

AVOID  What May HARM Your Body:

  1. Sugars of any kind including high fructose corn syrup, agave, natural sugar, etc.
  2. Processed foods including enriched wheat flour, white flour, corn meal, etc.
  3. Sweet beverages & Juice including 100% fruit juice.

 

 

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Healthier Together Series: Cycle 5B. Exercise and Fitness and Sedentary Jobs

Recently, after presenting at Grand Rounds about exercise, it became clear that there are many physicians who appreciate the value of exercise and recommend it to their patients. It is impressive- the number of very busy physicians who are fitting exercise into their own lives, on a daily basis. We see what many people don’t see, the variety of ways we can get older and the consequences of our lifestyle choices. It is with this wisdom that they are living what they preach- “Exercise- however you can fit it in.” Physicians who regularly see patients aging, prioritize exercise.

Exercise and physical fitness is one thing that has the greatest impact on all areas of health and cannot be replaced by pills or medical procedures. Yet, according to CDC, only 20 % of adults get “enough” aerobic and muscle strengthening exercise. This amounts to 150 total minutes of moderate intensity activity (or 75 minutes of vigorous activity) divided throughout the week plus 2 days per week of muscle-strengthening activities per week.

Many people state that they have no time (such as “small children and childcare concerns” or “long work day” or “care-taking/traveling sports duties” or “homework”) and/or that they have a “very sedentary job.” They sit for much of the day and it’s hard to find the chunk of time to prepare for exercise (clothing, determine appropriate and effective exercise plan for the day), work out, and then deal with the sweat (shower, change clothes, makeup/hair), never mind the time to get to and from the gym if that’s the exercise zone. It is easy to get discouraged.

However, the great news is that 15 minutes a day of walking UNIVERSALLY improved health in a study of over 400,000 male and female adults of all ages despite other lifestyle choices. The study demonstrated that a minimum of 15 minutes of walking a day, decreased all cause deaths by 14% and extended lifespan by 3 years compared to people who were sedentary. Every additional 15 minutes daily decreased death from any cause another 4% and from cancer another 1%. In fact, the researchers noted that 1 in 9 cancer deaths may be avoided with that 15 minute walk. Maybe 15 minutes of walking daily is possible for an added 3 years of life or a chance to avoid a death from cancer.

And about that sedentary job, many people would choose to be more active at their otherwise sedentary job if given a choice. Sometimes, we might not recognize some of the options. See if you can get up from your chair at regular intervals or consider moving the printer or trash farther from your desk so you have to get up for access. Take the long way to the restroom or the stairs. Many people appreciate the reminders and step tracking from various fitness trackers.

What helps me? It is the stand up desk that I am a fan of. My stand up desk keeps me moving more throughout the day. Treadmill desks (cons: higher risk of serious injury and difficult to use a keyboard or write due to the movement) and cycling desks (cons: non-weight-bearing) are also available but are more expensive, take up more space and often go unused. It is the stand up desk that I am a fan of. And when colleagues see my at my stand up desk, they often end up getting one and using it too.

Find ways to incorporate that 15 minute walk every day. See if you can set up your sedentary job to be less sedentary. Please share your methods of increasing your physical fitness even when you have a sedentary job.

Healthier Together Series: Cycle 5A. How To Manage Your Hunger

Hunger can be a natural physiologic signal from the body requesting more fluids or nutrients or it can be cravings (learned habitual behaviors) and pathologic symptoms of a mismanaged metabolism. We sometimes forget to check in and determine why we might be hungry.

NATURAL & HEALTHY HUNGER SIGNS:
1. Dehydration. In most cases, this can be managed by drinking water.

2. Need to replenish nutrient supply. For most people, eating a variety of colors of vegetables and supplementing with protein, will meet all the body’s nutritional needs. Make a list of easy naturally nutrient rich snacks that you can have readily available – then you can make healthy choices when you are hungry and need to replenish.

HUNGER SIGNS TO BEWARE OF:
1. Insulin resistance. If your waist line has grown since after highschool and you are not pregnant, you are developing or have developed insulin resistance. As we age, we also naturally become more insulin resistant. This means that our body over-reacts to sugars and carbohydrates in the diet which leads to a roller coaster ride of high and low blood sugar levels which lead to fatigue, mental fog & “the munchies.” Solution: Drink water, Eat protein or leafy vegetables when hungry and avoid sweetened or carbohydrate heavy foods.

2. Poor food choices earlier (ie. starting your day with sugar or processed carbs). Eating sugar will cause you to crave more sugar later in the day. Sugar can trigger the same area in the brain as heroin. It IS addictive. Solution: Avoiding it is the best way to manage being losing control. Make smart food choices. Start your day with protein instead of sugars or starchy processed carbohydrates. Choose whole foods.

3. Some medication and illicit substances (ie. marijuana). Some medications and illicit substances make people hungry and eat more, usually poor quality foods like most fast food. Solution: If your meds are making you want more broccoli, that’s great, but if it makes you get “the munchies” or you notice weight gain, have that important discussion with your doctor to see if you can find a way to manage it. Also, when you get “the munchies” or are hungry, drink water, eat veggies, nuts, or a cheese stick or have a light soup.

4. Boredom. Solution: Find something to do that is NOT related to food. Do something physical – take a walk, stretch, dance, move. Connect with family or a friend. Journal, garden, read, play solitaire, play a musical instrument, work on a hobby or create something artistic, etc.

5. Emotional unrest. Solution: If you are an emotional eater, it will be important to find new ways to soothe yourself. Consider finding a counsellor to help you process and learn better ways to cope. Find other healthy outlets – take a walk, spend time in nature, contact a friend or family member who nourishes you, spend time with you pet, listen to soothing music, learn meditation, go to a religious/spiritual place.

6. Habit (ie. before bedtime or while watching TV/movie). If you link certain activities or times of the day with eating/drinking, this is a habit and can be challenging. Solution: The best way to change that habit, it to create a NEW (more desirable) habit to replace the old, undesirable habit. For example, instead of having hot cocoa after being out in the cold or at bedtime, have some hot rooibos tea which is caffeine free and deliciously different. Instead of buttered popcorn with a movie at home, try berries or baby carrots. Keep healthy snack options easily available for “break time” at work- have salty, crunchy and “creamy” options available.

7. Seeing or thinking about food/drink you like. Having a variety of options to eat actually has been shown to increase the amount of food we eat. The larger the plate, the more options of different foods at any time, we eat more and sample more. Solution: Use a smaller plate. If you are sampling, think of the size of your stomach when not-too-full (the size of your fist), and look at the total volume of food you have on your (smaller) plate. STOP adding to your plate when it exceeds the size of your stomach. If you have more foods to sample, take less of each item so that you are not OVER-stuffing your stomach as it would not feel good anyways. Really, if you look at your plate and wonder how that would fit in your body, it’s too much. It’s ok to leave food on your plate. Note: Raw leafy greens shrink dramatically when chewed up, so you can be liberal with raw leafy greens!

8. Worry that later you won’t have time/opportunity to eat (ie. busy schedule). How many of you are “go-go-go” all day long and time for eating is a luxury? As a physician who may be running behind because of an earlier unexpected patient emergency, I hear you. Solution: Keep that stash of quick, healthy food/drink readily available, ALWAYS. Nuts, cheese stick, baby carrots and hummus, celery sticks and almond butter, whatever. Remember, IF you are unable to eat, as long as you are drinking, you are going to be fine for several hours. In fact, if you do not eat, but you maintain proper hydration, worse case, you will have to eat later than desired. However, your body starts to draw energy from your personal fat stores. Unless you are medically underweight, you should be ok to be burning extra fat on your body until you can eat later in the day.

Do you have other times you “hunger” triggers? How do you manage your hunger? What are some of your snacks you keep on hand?

Healthier Together Series: Cycle 4D. Winter Well-Being

Winter in the Midwest – ice cold this year, but we don’t have the 7+ feet of snow as in Boston. The cold and darkness of winter are often used as excuses as to why someone is not exercising or eating as healthy. It’s used to explain “loss of motivation” to continue to make healthy choices. This “motivation” and “effort” may resume for a short time after the NEW year, but often dwindles away again until the days get much longer and warmer.

Here’s another option. Have “seasonal” wellness plans! Figure out what you need to include to maintain a healthy lifestyle: nutrition, physical activity and relaxation & sleep. There are many ways to incorporate those into each season. They don’t all have to be the same. In fact, the body will be optimized if you change it up periodically, so why not with the seasons? So change up your healthy lifestyle routines for the different seasons.

Here are some suggestions to get your creative juices flowing…Find what works for you.

If you workout in the mornings in the spring and summer, maybe in the winters, you meditate in the morning for a shorter duration than what your workout would have been? Maybe your workout is on the drive home from work or school or running errands- when you already are out of the house. Just DON’T go home first without the workout (as it can be hard to motivate to go out into the cold). Or maybe your workout is at home instead of at the gym. Maybe you use home workout DVD’s or smartphone exercise apps? The workout routine might be different – you may work more on strength or core training or take a different exercise class this season. If you have snow, you may choose to incorporate winter sports into you life – ice skating, skiing, snowboarding, snow shoeing, etc. A good friend introduced me to snow shoe-ing last year, and it’s wonderful! What a treat to be out in nature and having the brightness of the snow recharge me!

You may choose to rely on the crockpot more (especially if you are going to be working out after work and have less time to cook in the evening). You may get more of your veggies in a soup or stew. These also make great lunches the next day! You may cook more winter root vegetables- they last longer after purchase (less frequent grocery shopping trips).

The winter seems to have more quiet times of the day when it might be easy to stop and meditate, even if only for a brief time. There are many smartphone apps that help facilitate and time meditation sessions. You may even find incorporating meditative activities with physical activity is the answer for winter – Tai Chi and Yoga are popular ways to get both the relaxation and physical activity in one.

Sleep changes with the seasons and with stressors. Allow yourself to have a day once a week, when you can sleep in as much as you need. It will help you bring it all together and help keep your mind young and keep you upbeat throughout winter.

Please share what works for you!

Capsule Nutrition

I love the idea of capsule wardrobes. So I thought, why not capsule nutrition? How about the essentials same shopping list (change out seasonal fruit & veggies) & change up the meals? So easy! Also, make recipes/prep short or able to be done ahead of time when you have more time or motivation. Consider once weekly grocery shopping- so foods that don’t last as long, would be used earlier in the week after grocery shopping…AWESOME. That’s the dream. So, I came up with the capsule nutrition plan’s grocery list.

Capsule Nutrition: What you need – Create your own list of the basics to have on hand for healthier nutrition. Here’s my list: 

Produce for the week (Varies with season & preference):

  • Green leaves – 2+ cups per day per person. Eat the flimsier green leaves earlier in the week as the heartier leaves last longer.
    • Lettuces – various kinds, Romaine hearts last longer
    • Kale, Spinach, Swiss chard, Collard, turnip or mustard greens
    • Parsley, cilantro
    • Salad packs – check the expiration date
  • Avocados, lemons
  • Additional veggies that looks good to you – 2 cups per day per person. Consider: cucumber, broccoli, cabbage, brussel sprouts, zucchini, summer squash, eggplant, mushrooms, celery, tomatoes, etc. etc.
  • Fruit – approx. 1 handful per day. Berries are extra nutritious.

Enough for 2 meals daily, some combination of (Varies with availability & mood & season):

  • Fish (Fatty, wild) – 2 days of week
  • Poultry (chicken, turkey, etc.)
  • Meats (beef –grassfed, lamb, pork, bison, etc.)

Dairy for 1+ week (if you are including dairy in your diet):

  • Cheeses – individually wrapped are easy for packing and for quick snack
  • Whipping cream – organic
  • Butter – organic
  • Greek yogurt – plain – enough for 1 week. Individual packed are easy for portion control & for packing
  • Eggs – pasture raised – 2 dozen. Older eggs are easier to peel (remember to boil with 1tsp baking soda or if steamed in an egg steamer!).

Keep stocked:

  • Salad dressing (No sugars or high fructose syrup. Avoid diet dressings)
  • Olive oil, coconut oil
  • Mustards, vinegars, capers
  • Seasonings: pick your favorites. Some of mine: Greek seasoning, garlic salt with parsley flakes, Malden sea salt, black pepper, red pepper flakes, dried parsley flakes, soy sauce, thyme, ground ginger, cinnamon.
  • Nut butters – like almond butter, peanut butter, cashew butter. Make sure they are without additional ingredients other than salt. This usually means the oil separates and you will have to stir it when you first open the bottle.
  • Various nuts (almonds, walnuts, cashews, pecans, hazelnuts, peanuts, etc.)
  • Old fashioned rolled oats
  • Unsweetened coconut flakes
  • Bittersweet chocolate chips
  • Flaxseed
  • Chia seeds
  • Almond flour
  • Coffee
  • Tea – various

Frozen- keep stocked:

  • Veggies (chopped onions, peppers,  & greens such as spinach, green beans, peas, edamame, etc.)
  • 1 bag Berries
  • Ezekiel bread
  • Low carb tortilla

Healthier Together Series: Cycle 4C. Relaxation & Sleep — Meditation

The act of quieting the mind…Meditation.

Meditation comes in various forms and is easily misunderstood. It does not require one to empty the mind. How many times have I heard, “I can’t think of nothing!”?  In fact, you can let the thoughts pass by in your mind and observe them.

There are many ways to meditate, but the focus is on practicing to quiet your mind. You might learn to quiet your reactions to thoughts and events in the past and future. You may work on focusing on the present and practice bringing your mind to the present and experiencing the present (Mindfulness Meditation). You may train your mind to be quiet by distracting it, such as with a mantra (Transcendental Meditation) or deep breathing exercises or by incorporating specific physical activity (Tai Chi or Yoga).

It does not require too much time. In fact, you can choose and you can meditate for various amounts of time based on time you have available or stress level in your life. Also, as you practice, like any sport or activity, it gets easier and you are more effective and efficient with the time. There has been evidence that as little as 12 minutes a day can make so much of a difference that it structurally changes your brain (for the better) and improves your overall function. It reduces stress, improves depression, anxiety, reduces pain, improves chronic disease management, improves quality of life, trains our minds to be more adaptable and flexible and it works for children too!

Meditation can be done anywhere, but it is easiest in a quiet place. There are apps on the phone/computer/tablet and there are books, classes, meetings and audio files. It can be learned on your own or with a guide or teacher. It’s pretty cool because it’s about you and it’s good for you and you can notice positive changes in other areas of your life pretty quickly. Your neurons in your brain start to work together and coordinate. Your body has a chance to check in with itself and reconnect.

Find a way to incorporate some practice of meditation on most days of the week. Work to find a time when you can disconnect from the electronics and focus on you, in the present moment. Give yourself a time out and allow yourself to be You. Just right. Right now. Exactly as you are.

 

Incorporating Morning Exercise & Healthy Nutrition – How To Guide

Prioritize your health. Learn to plan and to follow a plan successfully. Make “Success” your habit.

1. Every 2 weeks: Plan exercise in 2 week chunks. Make your exercise plan every 2 weeks.

  • Sit down with notebook and calendar.
  • Write how many continuous weeks you have been exercising as planned.
  • Review how the last 2 weeks went & determine how you change your workout or advance it for the next 2 weeks.
  • Write down what you learn from your review.
    • I total the calories I burned in the last 2 weeks and the total minutes exercising.
    • I make notes of what I want to do differently or if I will try a different exercise or weight.
    • I note if certain music correlated with more enthusiasm or a better workout.
  • Then write what you will change for the next 2 weeks, such as increasing the weights you were benching or the incline on the treadmill or the lower body exercises you are going to do in the upcoming 2 weeks.
    • I write my plans for improvement
  • Look on the calendar and note any significant scheduling challenges in the next 2 weeks (such as travel).
    • I might move a harder workout to a better day fo th
  • Look at the next 2 weeks and pick 5 days each week that you CAN workout in the morning. PUT IT ON THE CALENDAR exactly when you will work out. Include time for your shower, blow dry, etc. and your commute if applicable.
    • For example, I am least motivated to workout on Monday mornings and Friday mornings- so those are my “flex” days when I don’t plan to work out. The rest of the days of the week, I will plan a workout. I figure out when I have to be on the road to work & I schedule my workout 2 hours before I go off to work. 2 hours gives me time for my planned workout & shower & getting ready for work & eating breakfast. If I will be travelling or have a particularly EARLY morning, I may move one of my workout days to Monday and/or Friday– my “flex” days.
  • Make sure there is NEVER 2 days in a row without a work out.
    • For example, I have been following my plan and working out Sat, Sun, (Mondays are off),Tues, Wed, & due to a family emergency, I miss Thursday (which is my usual workout day), I will make it up on Friday (instead of taking that off as would have been my usual). So, Mondays & Fridays act as my make up days, my “flex” days.

2. Every Workout Day: Log every workout in the notebook on the day you work out.

  • Log at a minimum: date, time, what you did.
    • I log my weight & my heart rate (HR) monitor data: average HR, maximum HR, calories burned. I also take a minute to rate how motivated I was prior to my workout (scale 1-3) and how much effort I put in (scale of 1-3).
  • Jot down any notes on the past 24 hours including today’s workout .
    • I might reflect on how much I was yawning during my workout & recognize that it is because I ate so many starchy carbohydrates yesterday. Basically, by reflecting, I am learning to read my body and understand how I am feeling and how to optimize my daily function and happiness. It is kind of like mindfulness meditation.
  • Review what you will do tomorrow & make adjustments as necessary based on your reflection of the past 24 hours and how you are doing today.

Again, prioritize your health. Learn to plan and to follow a plan successfully. Make “Success” your habit.

  • KEY POINT: Once it is planned, you do not deviate from the plan unless you “plan” to deviate from it at least 1 day prior to the event. Here is an example using your workout plan: you planned to work out Upper Body on Tuesday, Lower Body on Wednesday, Upper Body on Thursday. Tuesday goes great. On Wednesday, after your Lower Body workout, you realize your Upper Body is not going to be ready to do the workout that was planned on Thursday. On WEDNESDAY, you can ADJUST your original Thursday workout plan, while you are reviewing the next day’s workout. You should change the workout plan for Thursday on that Wednesday- maybe you decide you will just walk on the treadmill. Now, when you wake up on Thursday and get ready to workout, your notebook tells you the plan is to walk for 20 minutes at a brisk pace. Fine. You are still ON PLAN and being SUCCESSFUL. You know the adjustment was thoughtful and deliberate instead of because of your “mood.” You are training yourself to be healthy and successful and feel good about what you are doing.

3. ALWAYS makeup any missed workout.

  • If possible, even if the workout will be missed, consider doing at least 5 minutes of some physical activity that will boost your heart rate.
  • From the example above, that upper body workout that I planned not to do on Thursday, I will plan to make it up on the Friday morning. I put it on the calendar. I will also note that when planning my next 2 week workout schedule, I will need to reconsider if I need to change my workout pattern, the weights or the exercise(s) I am doing.

4. Keep meal planning simple. Have a plan for your basics (as back up in case you don’t have more exciting meal plan available) & modify as necessary. Here is an example of mine using Panera which is on way to work and a drive thru :

  • 4 Breakfast options – availability and convenience are key, I don’t have to think about it.
    1. At home: Eggs & Ezekiel bread toasted (or low carb tortilla) with avocado &/or tomato slices or other veggies.
    2. Home or easily transportable: Plain greek yogurt with 2 Tbsp Old Fashioned Oats, 1 Tbsp unsweetened coconut flakes, 6 bittersweet chocolate chips and 2 Tbsp almond butter. Sometimes I include chopped pecans or ground flax seeds or Chia seeds too. Occasionally, add 1/4 c. fresh berries.
    3. On Road/No Kitchen/No Time: Panera’s Power Breakfast sandwich with 2 eggs on it – key when I am not able to eat breakfast before leaving the house and the boys ate the last of my yogurt
    4. Home or On Road: Large iced or hot coffee with cream with plan for midmorning “snack” or  late brunch out or just plan “not hungry.”
  • 3 At-Work QUICK Lunch Options:
    1. Time crunch day- no time to prepare or plan or grab a salad: In my work refrigerator: plain Greek yogurt, almond butter. Have Old Fashioned Oatmeal avail. if want to add. Will mix up for protein power lunch.
    2. Bring from home: salad or prepared salad pack & leftover protein from dinner night before or salmon or tuna pack. Sometimes, I will add some cheese crumbles to the salad prior to bringing to work. Salad dressing at work.
    3. In a Rush/Out of Groceries at home: Drive thru Panera’s Chicken Cobb with Avocado Salad with apple (instead of bread) as side. Yum.
  • Dinners Vary. Always have protein & veggies that grow above the ground. If I didn’t have a salad earlier in the day, I will have one with dinner on most days.
  • Drinks: Drinks are water, black coffee & unsweetened teas.
  • Desserts: Dark chocolate and berries and unsweetened fresh whipped cream,  individually or in various combinations, are my desserts of choice.
  • The Day OF my plans to go out for dinner: If I am going out for dinner, ie. on Friday, I eat breakfast later and then nibble some cheese, handful of nuts or celery with peanut butter in the afternoon if I get hungry before dinner.
  • Eating out: Majority of the time– keep it simple with protein & veggies. Replace the bread/fries/potato with side of veggies or salad. If I had a great workout and did not eat any sweets or starchy carbs earlier in the day, I may share a dessert.

Keep your nutrition plan simple and easy to keep track of. Eat lots of veggies and eat your protein and stay hydrated. You don’t need to spend energy thinking up new ideas or figure out what you need to eat when you are in a panic or have limited choices. Plan ahead and be prepared. Follow your plan.

Prioritize your health. Learn to plan and to follow a plan successfully. Make “Success” your habit.

This post is in honor of my mom.