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Happy Friday !
Please let me invite you to peruse the entire Nutrition section of our blog, which is the first section of the Health pages to be finished.
I think you will find some novelty here, such as information on how to obtain healthy food on a budget. There also the standard information about nutrients, but also information about the timing of meals and combinations of different foods.
I hope you enjoy the content, including the graphics and photos, most of which I produced myself.
Gina at the summit of the " Dish" run at Stanford, after her 20th reunion. http://web.stanford.edu/group/runningclub/Runs/Dish.htm
There is a great deal one could say about exercise. However, talking or writing about exercise is only useful if it leads to people actually doing it. So, since I am committing the Wednesday column to the topic of exercise, I decided to reach out and ask about your interests and needs on the subject of exercise. I would like to tailor the column to meet these needs. Here is a link to a short survey that will be fun and illuminating to take.
Gina with Zumba Royalty Acea Theroux Zes and Nancy Mehring
I have really decided to give exercise some serious focus because I really feel it is at the center of optimal mental and physical health. If you have mediocre exercise and excellent nutrition you are probably moderately healthy. However if you have mediocre nutrition and excellent exercise you are probably very healthy. Plus, good nutrition seems to follow in the wake of good exercise, but not as much the other way around. And of course, the worst attitude can be fixed better by a good workout than a good meal.
I realize there are serious and challenging obstacles to exercise, from money to peer support to childcare challenges, injury, chronic illness, social culture, motivation, depression and more. But I would like to explore and deconstruct these and look for solutions.
I am hoping this survey and its results will help pin some of these reasons down and help us solve them.
Next Wednesday I will post the results, and add a few thoughts of my own from over twenty years in medical practice and over 40 years exercising regularly.
Many thanks, Dr. Gina
What does vagina steaming and the recent measles outbreak having common ? Need a hint ? OK. What can make people on both sides of the political spectrum mad ? You guessed it ! The anti - science movement.
According to that venerable site rationalwiki.org, anti science
" refers to persons or organizations that promote their ideology over scientifically-verified evidence,[3] usually either by denying said evidence and/or creating their own."
Recall that science is advanced through the scientific method, which involves testing hypotheses with experiments, then revising said hypotheses. Experiments should be on done on that which is measurable, done blinded, controlled, and should be reproducible and peer reviewed by the appropriate scientific institution. Science is always undergoing a process of refinement based on observable facts.
This should be clear. Yet the media and advertising to which we are daily exposed has become a brew of fake science and real science. How is a person to know the difference ? Well you can use your gut feeling of course. ( And I have a bad feeling about vagina steaming.) Or, you can have a look at my section of this site where I try to give some help on this issue. It is called Information and Learning. I try to give you some tools with which to navigate the information stream coming at you every day.
Let's look at some hot news topics where anti-science is in play: climate change, genetic engineering, vaccines, juice cleanses, GMO food, stem cell research, and yes vagina steaming. These topics are especially hot in election years, and when money is involved.
Here is a great article in Scientific American about a science quiz given to presidential candidates 2012.
Click here to either laugh or cry.
Here too, is a fair handed look at anti-vaccine sentiment on both sides of the aisle from Slate.
Here is fantastic compendium of articles from various writers on the anti-science movement from Huffington Post.
I would like everyone to take a charitable look at the nature of our national dialog. Feelings are running high, especially in the wake of the recent measles outbreak. In this climate, where there are many voices clamoring to be heard, let us keep the dialog civil and ahem, scientific, whenever possible.
In that spirit, I will share with you an article about one of my favorite most well intentioned celebrity health gurus, Gwyneth Paltrow. Don't get me wrong, I love Gwyneth. Her site, Goop.com is full of lovely recipes and pretty unaffordable clothes. She has a holistic approach and a lovely positive attitude which really does count for a lot. HOWEVER, I cite this article below to show that sweet well intentioned people can get it wrong. Enjoy, and remember that laughter and affection are the best medicines.
Three Reasons You Definitely Shouldn't Get Your Vagina Steamed , from Women's Health
Bath, England
There is a village in England called Bath. It is called this after the natural heated pools that are found there. There and in similar places around the world people have sought healing waters. Theses waters have alleviated pains in muscles and joints perhaps by virtue of their warmth and enhancement of mobility and circulation. In such places the spa was born.
I have always thought of exercise as a spa treatment from the inside out. Of course it takes more effort than simply slipping into a heated pool, but the benefits are greater. For example, the cardiovascular system is healed and strengthened. The immune system is boosted. Muscle and bone growth is stimulated and fat is burned. Arthritic joints are mobilized and balance is improved. Stress is relieved and mood is enhanced. Moreover, confidence and a sense of accomplishment are created.
All of this sounds appealing and yet exercise is so hard to sell. Once begun, seems hard for many to continue. This is one of the main challenges I face in my practice: How to inspire people to exercise, and even more, how to educate them to be consistent in perpetuity.
I am just starting to build my section of the website which deals with fitness. I have surveyed many authoritative websites having to do with exercise but my favorite so far is the American College of Sports Medicine, or ascm.org. I have looked for their answers to some fundamental questions. In the following link, I will share a few of them with you. I plan to devote the Wednesday Wellness blog post exclusively to exercise. Join me as we learn from the ground up.
If you grew up in the 70s, you will recall the extreme emphasis on the low fat diet. Thank goodness that singular emphasis has gone by the wayside. Back then, the best science of the day indicated that saturated fat and cholesterol was the primary concern. Therefore, we were cautioned to reduce our consumption of things like beef, butter, and heavily marbleized meats from feedlot cows, which are full of saturated fat.
Here is a section from this websites page on Fats.
The Chemistry :
Different fats are different hydrocarbons. They have different levels of saturation, meaning a varying number of hydrogen atoms along their carbon chain structures. Fats can be classified as polyunsaturated, monounsaturated and saturated. More hydrogen atoms makes the chain more saturated, solid and more stable to temperature. Unsaturated fats are more liquid at a given temperature, and clog the arteries less.
Click HERE to learn more.
omega three fatty acids
Back in the seventies, we were encouraged to substitute margarine for butter since it was made of less saturated fat, including some trans fats. Since then we have discovered the dangers of trans fats, which, have been prevalent in margarines. There is also concern that overly unsaturated so called polyunsaturated fats are easily oxidized , and then become unhealthy to consume.
More importantly, we have discovered the benefits of monounsaturates like olive oil, which reduce cardiac risk. Additionally we have come to understand the short chain fatty acids, like omega 3s which actually reduce risk of cardiac disease and also help with inflammatory disorders.
Finally we have come to understand that it is our carbohydrate intake that has contributed greatly to the problem of obesity, which leads to so many other problems including heart disease. In particular, our simple refined carbohydrate ( e.g. white flour products) and plain old sugar intake has been off the biological charts. These are almost always processed foods not found in nature and they enter our bodies very rapidly. We cannot metabolize them quickly enough and they are stored as fat. Additionally they can raise triglycerides, which in women, are more associated with heart disease than cholesterol.
Taking all of this into consideration, what are the current recommendations ? Roughly a quarter of our calories should be each from fat and protein, and half from carbs. But the devil's in the details. The fats should all be healthy ones like olive oil, avocado, and walnuts, and the carbs should be complex, unrefined, and nutritious. You probably think I mean whole wheat seedy bread. Actually I mean carbs even more complex than that: vegetables and fruits. Yes, they provide carbs too.
In summary, our current thinking on consuming fats, and avoiding becoming fat has changed quite a bit in the last 40 years. And quite frankly, we are eating quite a bit better because of it. Diet conscious folks used to run around with a diet coke, and slice of wheat toast and margarine for breakfast. These days, it would be more like an omelette with kale and fresh tomatoes, salsa, fresh fruit, green tea, and a small bowl of oat bran cereal with olive oil and sea salt. Bon appetite.
The Flathead Valley has a problem with narcotics. I am told this is not unique to our Valley. I never thought I would have this much first hand experience with narcotics, even heroin.
Problems with narcotics affect our women of childbearing age. Narcotic use in pregnancy is associated with low birth weight, preterm labor, SIDS and several major birth defects, as well as a lengthy neonatal withdrawal.
Narcotics are a class of drug which acts in our body though our body's own neurotransmitter and receptor system. We have many neurotransmitters, tiny molecular messengers that allow us to feel sensations and even emotions. Neurotransmitters like dopamine bind, lock and key style, to specific receptors in nerve cells and set off a reaction which make perception possible.
Narcotics also fit these nerve cell receptors. While bound at the receptor, narcotics can block pain and simulate pleasure. That is why they work, and that is why they are abused.
If only that were the whole story. You see, when a narcotic binds at the receptor, it stimulates an electrical potential, or pulse, down to the end of the nerve cell, and there another neurotransmitter is secreted, further conveying the signal. If there is constantly narcotic at the receptor, the molecules at the other end get depleted and the system no longer works.
The patient initially experiences relief with use of the narcotic. If too much is used for too long, it begins to no longer work. Worse still, more drug barely produces the feeling of being at baseline. No drug comes to feel worse than bad; hideous, in fact. More and more needs to be used to even feel baseline. This is the basis of addiction.
Patients, caregivers, and bad luck are responsible when things get out of hand. It is always easier to give or take a pill than to treat, cure, or work on things. Physical methods like exercises and therapy take time and are not always perfect. Surgery is expensive, and not always the answer to pain. Other nonnarcotic medications may be partial solutions.
Life can be hard and confusing. Well meaning people can slip unknowingly from using pain meds to treat real pain, to using them to treat other things like withdrawal, anxiety, or their ability to deal with life. Those of us who care about these people need to start from a place of knowledge and compassion. No one really signs up to be miserable.
January and February are big birthday months for our family and I'm glad. After the holidays, and with the weather, these months can seem kind of dismal. Don't let this happen. Research from many fields indicated that we are happier and healthier when we connect with others. And, it is an ancient human tradition to connect over food: To break bread with one another, or in our case, cake.
I generally make most of our gatherings pot luck. This way, everyone can contribute and no one person is overburdened. Plus, you get more variety. Yes, you have to clean and spruce your house and buy a few extra groceries, but it is well worth the fun. You may choose an occasion as a reason to get together, or have none at all. We have done board game nights, movie nights, a mocktail party, and of course gatherings for birthdays and holidays. My friend's son once had a Braveheart party. And about birthdays: don't think anyone is too old for a birthday party. Just do it.
If you would like to learn more about how social connections are associated with longevity and happiness, let me refer you to the book Thrive, by Dan Buettner. It is not to be missed. It is about the lifestyles of those around the globe who are very long lived. You might be surprised at what you learn. This book is listed in my " Retail therapy" section of the website in my Amazon store.
Did you realize the concept of wellness wasn't always around ? According to an article in the November issue of Real Simple, the term did not appear in the English language until the 16th century. Until then we simply thought of the absence of disease.
After World War Two, the World Health Organization ( WHO ) explicitly defined health as not simply the absence of disease, but rather a state of " complete physical mental and social well-being ". The concept of " High Level Wellness" was defined in a book of the same name in 1961. And finally the first " Wellness Center " was opened in northern California in 1975, and was catapulted to both fame and ridicule with its spot on the TV news show 60 minutes in 1979. Today the general public and the medical profession take wellness very seriously. I agree with the WHO definition of what it is. What interests me is how to attain it.
My first comment is this: that wellness is not a one time goal. Rather it is a constant work in progress. It is borne of a repetitive but dynamic rhythm of daily activities that we must consciously put into place. If I have emphasized anything about health maintenance in my practice it is this: that no one thing that will confer wellness. It is a comprehensive approach which says that every thing you do or take into your body must be for a good health promoting purpose. Whether it is a food, an exercise, or even a manner of communication, it should be for the good. If these good things are done so often as to become habits, their cumulative result is wellness. In other words, it is the summation of all the well chosen good small things and actions in the day, experienced repeatedly over time.
In this spirit I would like to introduce the concept of optimal health. Yes there is great satisfaction in curing disease. But there is even more in teaching people how to move toward optimal wellness. And with that in mind I would like to share a terrific website :
Of course it is a play on the word "greatest" and I take it to mean someone who studies and tries to embody that which is great. The site offers tips not only on nutrition and fitness, but also addresses optimal life functioning in general. So check it out, as a part of your quest for wellness.
For more information see:
We are all aware of the new interest in gluten free diets. Should you be concerned ? To answer, I would first say that if you are well and feeling fine, you need simply eat properly and exercise regularly to keep it that way. You need not avoid gluten. However, if you suffer from bloating and cramping, a visit to your doctor is in order. To prepare, keep a simple food and symptom diary. Be prepared to undergo certain lab studies, or even get a referral to the Gastroenterologist. There are many conditions which might cause these symptoms. Sometimes it is challenging finding out what is wrong.
Celiac disease is an autoimmune destruction of the lining of the gut, stimulated by gluten, in those that react to it. Gluten is a protein in various grains. Gluten intolerance is very specific reaction and even a small amount can set it off. It can be diagnosed by blood work and sampling at colonoscopy. Avoidance of gluten allows the lining of the gut to heal.
If celiac disease proceeds unchecked, the lining of the bowel becomes overly permeable, giving rise to the so called " leaky gut. " The leaky gut is associated with various forms of autoimmunity, but it is not known whether it is the cause or the effect. Regardless, a leaky gut means poor digestion and increased inflammation.
People without celiac disease can get a leaky gut. They may suffer from other chronic or autoimmune illnesses, or from high levels of chronic stress which influence the gut directly. They may simply have a very unhealthy diet or take in toxic substances like alcohol and tobacco which damage the lining of the gut, leading to a cascade of additional problems later. Again, it is unclear whether the leaky gut is the cause of the effect.
According to Dr. David Rakel, Assistant Professor and Director of the Integrative Medicine Program, Department of Family Medicine, University of Wisconsin, Madison, treatment for a leaky gut includes the Four R's.
The four R's are:
1. Remove irritants
2. Replace enzyme agents
3. Reinoculate with probiotics
4. Repair the mucosal lining with exercise fiber and fluids.
For more information, please see his excellent handout here.
I hope this reduces concern about this hot topic. Just be aware, it is a relatively new area of study, and we do not yet have all the answers. Beware of any blanket prescriptions or quick fixes out on the market. And by all means, whatever you do, enjoy your meals.
I have been meaning to write a post about how routine is the basis of all health maintenance. It has to do with how small simple tasks repeated over and over in time, create health. Or wealth, for that matter. Everyone knows that small consistent contributions to a savings account make large gains over time. One could also argue that consistent routine is the basis of most work or creative productivity.
But health is our wealth, and what I want to emphasize is the regularity of just a couple things: nutrition in three healthy meals and snacks, and regular 6 days per week of exercise. If these could be done simply, moderately, and consistently, without a lot of stress or fanfare, it would be awesome.
However, it is the holiday season. Holidays can be disruptive, to health, wealth, nutrition, exercise and work. And as you have seen, I am a bit off schedule in certain things. For example, I took some time off from the blog due to sheer merriment and kids being home from college. But I have been thinking about you all, and how you are faring, during this festive and sometimes disruptive season.
Here are my simple suggestions for keeping the happy in the holidays. Try to keep to your exercise above all, especially since you're perhaps eating richer food this season. Even if you eat treats, such as those on this holiday table, don't fret. Sample them in moderation, by all means, but be sure to include healthy holiday food in the menu.
And since it is the holiday season, I feel I can ask for a few more things. Have ice water or plain club soda on every table, and ladies, no more than one 8 ounce glass of beer, wine, or champagne per day. Try to sleep at least 7 hours per night. Finally, develop a holiday month plan, right down to gifts, wrapping, invitations, and meals. I am a big advocate of plotting all this on a calendar, and refining what works bests year after year.
Routines, large and small, will help you keep the holidays merry and bright.
It's November, when rates of upper respiratory infection tends to rise. Everyone is tuned into the idea of getting a flu shot. Most people know that it's especially important for pregnant women. But did you know that the TDAP is now given in the latter part of pregnancy ?
TDAP vaccination has been proven safe and effective for prevention of pertussis. TDAP stands for tetanus diphtheria and PERTUSSIS, otherwise known as whooping cough. A relatively recent recommendation is to give it between 27 and 36 weeks of gestation. We don't wait until the end of pregnancy since we want there to be enough time for mom to create protective antibodies to pass to baby. That way, baby is protected against pertussis from the moment of birth.
In other vaccine related news, the HPV vaccine rates are still lower than they should be. HPV stands for human papilloma virus, and it is cause of genital warts and cervical cancer. HPV vaccination should be given to both boys and girls around age 11-12. It is given in three doses over 6 months, and is very well tolerated. It can be given until 26 years of age. A recent report indicated that states with high vaccination rates have low cervical cancer rates, and visa versa. This is some of the first longer term data emerging from the HPV vaccine experience. Happily it is preventing disease as well as expected. We have just got to do more to promote its adoption.
Source: Medline Plus from the National Library of Medicine.
