Food Friday: Soup Stock

Our evening temperatures are beginning to dip into the 30s and yet, our outdoor activities continue unabated. This weekend I'm sure we will be out either observing the lunar eclipse or the Northern lights. This means we're going to get chilly. This means we will want soup. 

Soup season is here again. While I love summer with its fruit platters and salads, I adore the soups of fall. A beautiful soup makes a great centerpiece for a meal, and if made well, soups are healthy and appeal to everyone.

What does it take to make a delicious soup? It takes a well-made soup base. Some people call this broth and some people call it stock. I think when you see how it is made you will understand why it tastes so good.

The first thing you should do is roast some chicken. I realize this sounds daunting to some, but it is actually one of the simplest things you can do in the kitchen. Moreover, whole chickens are one of the most inexpensive healthy foods you can buy. Around here, we can get them from our local farmers or you can get a good whole organic chicken at Costco. You will need a roasting pan, but it need not be fancy. It should have a roasting rack. You can usually get these at secondhand stores. You will also need a meat thermometer and these are available for just a few dollars at any grocery store. This is a small price to pay for food safety. Before you start to unpack your chicken, adjust the shelf in your oven and preheat it to 425°. Read through all the instructions first, and assemble everything you need before you start. In French, this is called “ Mise en Place”, or to put in place. 

Start by reviewing food safety. Recall that raw chicken and its juices are a culture medium for bacteria. Keep everything confined to the sink or nonporous cutting boards. Open the packages in your area and do not reuse any of the utensils or surfaces for anything else without thoroughly cleaning them in hot soapy water. Once you get your chickens unpackaged, remove the giblets and rinse them. Set your hollow chickens onto the roasting rack in the roasting pan. Then, discard the packaging, wash the utensils and surfaces and finally wash your hands with hot soap and water.

Brush the surface of both chickens thoroughly with olive oil. Sprinkle them liberally with good kosher salt and freshly ground pepper. Encrust them with whatever other herbs you like. Add about an inch of liquid to the bottom of the pan. This can be water or white wine. Cover the birds loosely with foil. Roast at 425°until their internal temperature is 165 degrees deep in the flesh. For the last 10 minutes or so, take off the foil and brown the tops of the chicken until they are nice and crispy but not burned. This will serve about 10 people or a  small family for several days. 

To make broth, take all of the chicken meat of all of the bones and serve or store it. You can use it to make sandwiches, chicken salad, main dishes, and pasta. Keep all of the drippings in the pan unless they are burned black. Compress the carcasses down in the pan and place back in the oven and either bake them at high temperature or broil them until they are golden brown and dried but not burned. Take the roasting pan out and add several ingredients which will flavor the broth. Here are some choices:

• Garlic cloves, and onion with their skin
• Chopped carrots, Chopped celery
• Older apples that are still good
• Any fresh herbs and peppercorns

Cover all the ingredients with water and bring to a boil on the stove top. Boil for 10 minutes, then simmer for at least two hours.. When finished, strain and transfer to a clean cool container or containers, preparing either to use, refrigerate, or freeze. Consider adding salt at this time.

If the weather is cold, I like to cool my broth outside. This way I don't have to put hot containers of broth into a freezer or refrigerator, compromising the temperature of other items. Either hot broth or cold broth is safe, but warm broth spoils quickly, and should be stored or used promptly. 

I freeze our broth in quart containers being careful to leave about three quarters of an inch of head space at the top. Now I have a delicious base for any number of different kinds of soups or sauces. We have used this to make soups with chicken, red meat and all kinds of vegetables.

Mostly we just make soup with what is on hand. The general principle is this: Pick a soup pot of adequate size. Saute your meats, garlic, onions, and hard vegetables one by one in olive oil and spices. Once they are cooked, cover with broth and add the softer vegetables such as tomatoes and greens. Bring to a boil, then simmer until done. Season to taste. To your health ! 

Wellness Wednesday: Survey Results for your Biggest Health Challenges

Don't you like getting survey results? It's like getting the punchline to a joke or solving a puzzle. Basically you get to compare your anticipation of the results with the actual results. It's even more fun when the results you get are unexpected. 

Many thanks to those who took the time to complete the survey. The number is small, but it is more than last survey I ran.

Here are the key results:

• Approximately three quarters of respondents felt that their health was only somewhat where they wanted it to be.
• The biggest health challenges were divided almost equally across nutrition, fitness, weight, and stress.
• Most everyone who took the survey took the time to write a bit about the biggest obstacle to health maintenance. Time was the most common theme expressed in a variety of different ways. Some people referred to the time demands of their job, partner, kids, house and pets. I doubt very much that these things are ever going to go away. In fact, I hope all of us always have jobs, partners, kids,  houses and pets. It sounds to me that concerted improvements in time management would be helpful across the board.
• Respondents were uncertain and vague when asked open ended questions about what would help them the most with there health. However when given a choice of specific set of health related products, they were able to clearly choose what would help them the most. This is where the surprise came. It wasn't a product at all. Far and away the most often chosen product was a "health coach." 

Fairly recently I ran into a physician friend of mine who I thought had retired. It turns out she had actually gotten certified as a health coach. She is loving it and and really feels like she's making a difference in her patients' lives. So after I saw the results of my survey I called her up to find out a little bit more. It turns out that health coaches are probably the next big thing in preventive medical care. 

It turns out that there quite a few health coaches out there and it turns out there are a lot of courses you can take in person and online by a great many certifying organizations to become one. However, only one organization is approved by the American College of Sports Medicine, the Wellcoaches School of Coaching. (wellcoachesschool.com) It is an evidence based program which uses up to date behavioral, exercise and fitness science to help people improve their life and their health. Luckily for us, my friend was certified in this manner. She works at out local fitness center. 

All well and good. But I called her later and grilled her about insurance coverage for such services. It turns out that, yes, many insurances do cover some health coaching, which struck me as a pleasant surprise. So I am going to start utilizing her and her team for my patients. I and many other doctors do a lot of office based health coaching, but in the setting of providing specialized medical care I can only give health coaching a limited focus. 

I wonder about those without insurance, those with high deductibles, and those with insurance that does not cover health coaching. I still would like to know what resources would be helpful to people who wish to, in effect, be their own health coach. What do you think ? 

Medical Monday: Weekly News Update in Obstetrics and Gynecology

It's a mixed week in OB/GYN news, as always.

A Swedish study indicates that women who are overweight or obese at the time of the first pregnancy are more likely to develop diabetes in the next decade or two of their life. The risk of increase is six times baseline.

The eighth circuit court of appeal in St. Louis Missouri has taken the position that forcing employers to cover the cost of contraception through their insurance “ violates the groups religious freedoms".

In other news in the war on contraception, the Congressional Budget Office has estimated that cutting off funds from Planned Parenthood for one year could "reduce healthcare access for about 390,000 people" and at least through the Planned Parenthood budget with sales tax payers about $235 million. They hasten to indicate that defunding the organization could result in"several thousand unplanned births that would drive up government costs elsewhere such as in the Medicaid budget which pays for 45% of all births in this country.

The Census Bureau reports that the percentage of people without health insurance dropped in 2014 to 10.4 % down from 13.3 % the year before.

In the department of general women's health the following finding is rather striking. When comparing the cost of institutional care for male Alzheimer's patients versus women's Alzheimer's patients the following is noted. The cost of caring for women with Alzheimer's is six times greater then for a man with the same diagnosis. This is because when man has Alzheimer’s, female family members put much more time and energy into their care, saving them from expensive institutionalization. The reverse is not true when male family members take care of women with Alzheimer’s.

In other gender gap news, the Journal of the American medical Association reports that the gender gap in academic medicine is alive and well. Despite the fact that half of all medical school graduates are and have been women for sometime, Men are 15 percent more likely to have the rank of full professor. It also shows that women generally do produce less reach her research than men, But that this may be due to lack of mentorship, institutional support, and most importantly research funding through research grants. According to the same study, men received over twice as much research funding from their employers for equipment and labs. Women researchers are also less likely to receive NIH grants than there male colleagues.

For some good news this week we will have to turn to the field of vaccines. The CDC or Centers for Disease Control found that about 90% of children under the age of three were vaccinated against the common disease entities in the years between 1994 and 2013. What did this do for us? The CDC estimates that this will have prevented 732,000 early deaths in United States alone.

Finally, also in the good news department, the flu vaccine may be more effective this year according to the CDC or Centers for Disease Control. It is estimated that it will be nearly 3 times as effective as last year’s preparation. Remember that even if the vaccine doesn't prevent flu entirely, it will decrease the severity of flu which is very important in children and other vulnerable populations.

Stay tuned for more news from the world of OB/GYN next week in Medical Monday.

Wellness Wednesday : Your Wellness Challenges

This Wednesday I am reaching out to understand your health challenges and what could potentially help you meet them. I work with patients nearly every day and give them information about what can improve their health. Sometimes they are able to work successfully with it and sometimes not. I am fascinated with what separates the two groups. 

I have always tried to make the process of becoming healthy accessible to everyone. I am striving to learn the pertinent behavioral science behind health habits that will enable me to help you actually make those positive health changes. 

I myself am motivated by a variety of things: healthy cookbooks, exercise videos, stories of success, and even inspirational cards that sit on my desk. 

I invite you to take my survey and let me know about your challenges and what you think could help. I am most interested in your response. Click on yoga girl below to access the survey. I promise to publish results next week on Wellness Wednesday. 

Best,

Dr. Gina 

Food Friday: The Healthy Junk Food

What is the secret superfood that shows up at every tailgater, and is served alongside beer and junk food ? Salsa of course. 

Salsa simply means sauce in Spanish. It is usually a tomato based sauce which can be flavored with other vegetables, fruits, and spices. Classically, it contains chilis of some kind and garlic, but the variety from there is infinite. 

Most Americans buy their salsa rather than make it. I would venture to guess it is eaten most often in this country with tortilla chips. I am going to suggest you take a walk on the culinary wild side and make your own salsa. Then take it a step further and serve it with something other than chips. 

Consider mixing and matching the following ingredients. 

Base: 

• red tomatoes, raw or cooked, pureed or diced 
• green tomatillos, cooked 
• avocados, creamed or diced ( always include something acidic with these, i.e. lime juice, which prevents browning).

Heat: 

• garlic
• onions 
• chilis- powdered or fresh, with sweet, fiery and smokey variations.
• black pepper

Flavor: 

• fruits like mango, peaches, pineapple, strawberries 
• greens like cilantro, green onion or fresh mint
• olives 
• chocolate ! for mole

Texture: 

• fresh corn 
• chopped sweet peppers, red, green, yellow, orange
• Beans, i.e. red or black
• cucumbers 
• Jicama

Dressing: 

• olive oil
• vinegar or citrus i.e. lemon, lime, or even orange. 

I think you can see from these ingredients that salsa is rich with healthy ingredients. Now try it on meat, fish, chicken, eggs, or really any main or side dish. Salud ! 

Wellness Wednesday: The Benefit of Trying New Things

Nutrition, fitness and good relationships can keep us healthy. But... trying new things ? Yes, being adventurous has physical as well as psychological benefits to our health. (1) 

Adventure is a relative thing. For one person it might mean trying a new cookbook (me) while another may need to paraglide to 5000 feet above sea level (my son). But in all cases it means doing something different than your usual, and, for best results, it means getting out of your comfort zone. Comfort zones vary considerably in size.  

Does adventure have to be dangerous ? Of course not. But it should expose you to a new environment and require you to do things you have not done before. So why does it have to be all that? 

Before I explain, lets take a look at the American vacation. It is an endangered species. We are one of the few developing countries without a national policy of paid leave. Those companies who do provide paid leave do not always encourage its use, even though research shows it greatly improves employee productivity and satisfaction. When the companies do provide leave AND encourage its use, employees are reluctant to take it. Why ? Forty percent are afraid of coming back to " a mountain of work" , a third feel no one can do their work but them, a third feel they cannot afford it, and about a fifth feel guilty.  Forty-three percent of adults do not remember the last time they tried to have an adventure. Reasons for avoiding adventure range from lack of money to embarrassment. (2) Fear of one thing or another plays a role in skipping vacations. Ironically, it should be the opposite, since skipping vacations is associated with a measurable and significantly increased risk of heart disease in men and women, according to the Framingham study. (3)

And yet, we bemoan our lack of time off and we make bucket lists all of the things we don't and won't do. We execute what Tim Ferris calls the " deferred life plan". (4) Moreover, we note how every year seems to pass more quickly. 

Enter adventure. If we do get around to it, here is what happens. First, our narrow view of the world opens back up. We experience different ways of living, and see ourselves and others in a new light. Novelty and some degree of challenge have to be a part of it. This way, our confidence and competence is enhanced. A 2015 Study on newly graduated nurses found that a nontraditional outdoors adventure leadership program increased feeings of competence and confidence. When they returned to work, their transformation was felt to have impacted their entire work culture. (5) 

Adventure may even be an antidote for the accelerated passage of time. Dave Engelmann, a neuroscientist, notes that the more familiar the world becomes, the less we remember, and thus the faster times seems to pass. (3). I deduce that novelty and adventure may help us savor the time we have. 

Check out these fun resources: 

30 New Things to Try by Lifehack.com

The Beginner's Guide to Trying New Things

Staying on Top of Your Game

References: 

1. http://www.huffingtonpost.com/laurie-gerber/are-we-having-fun-yet_b_7948588.html
2. http://www.huffingtonpost.com/2014/08/19/americans-vacation-days_n_5682576.html
3. http://www.newyorker.com/magazine/2011/04/25/the-possibilian
4. http://www.bothsidesofthetable.com/2010/01/10/what-can-you-learn-from-the-4-hour-workweek/
5. http://www.ncbi.nlm.nih.gov/pubmed/25608096

Food Friday: Cooking for One

I have written a lot about the value of meals with others. But what about the single person, student or empty nester who is often cooking for one ? 

In doing some research for this post, I found some unexpected hilarity. One of the best posts came from one of my favorite websites called Greatist.com. They addressed headlong the temptation to have a pity party. They called out tendency to wallow in loneliness and junk food. They described " sad bowls of cereal ". I was laughing and feeling bad at the same time. 

But seriously, loneliness is bad. And if a person finds themselves feeling lonely, they should name it and change it if they wish. I am no expert in this regard since I am most often surrounded by people. But I am a physician and I would encourage any one who suspects they have the corollary of loneliness, i.e. depression,  to reach out to their physician for assistance. 

But let's say you are not depressed. You're just cooking for one. You have several options. 

1. Find someone to eat with. There is a large selection of apps and websites out there to help you find a random stranger to dine with. Seriously ! Check out the HuffPost article below which features several of them. Consider also eatwith.com, mealsharing.com, lunchmeetapp.com, and cookening.com.

2. Go out to a restaurant and at least be around people. This could work if the food was healthy and good choices were made. However one of my sources listed below indicated that, as a general rule, restaurant food is consumed in greater quantities, and contains more saturated fat and sodium compared to home cooked food. 

3. Cook a nice full meal with nice regular sized recipes and have a bunch of leftovers. This is the theme in the Bon Appetite pages cited below. They take the position that you should eat only the best. Tiny little streamlined recipes do not do it for them. 

4. Cook a balanced little meal for one with little mini recipes for one. Most of the links below propose this. 

Notice I did not say have a bowl of cereal or have a TV dinner. I am talking about healthy food here. Here are some tips for literally cooking portions for one. 

Buy food strategically. Here are some examples:

1. Choose individually frozen portions such as cut fish fillets  or chicken tenders.

2. Choose foods that doing not spoil quickly such as broccoli over red lettuce.

3. Choose foods that require very little preparation since let's face it, the time we usually want to spend cooking is directly proportional to the number of people for whom we are cooking. Fresh fruit takes little prep. Sliced tomatoes with fresh mozzarella takes little more. 

4. Accept that you are going to have to add a few different components to your meal to make it nutritionally optimal.   A banana and a glass of milk is not a meal. It is, however, a decent snack. 

5. Buy large quantities of healthy foods an repackage them for easy storage and access. 

This weekend I might, through a series of unfortunate events, be spending some time cooking for one. I'll be all about the can of salmon over the complex giant salad. But you may want to do better. Here are some great recipe collections for one. 

http://greatist.com/health/healthy-single-serving-meals

http://allrecipes.com/recipes/15050/everyday-cooking/cooking-for-one/

http://www.helpguide.org/articles/healthy-eating/cooking-for-one.htm

http://www.bonappetit.com/entertaining-style/trends-news/article/cooking-for-one

http://www.huffingtonpost.com/2013/09/18/dining-app_n_3942874.html

Food Friday: Cold Desserts

It’s hot and fruit is in season. Here’s a little history of your favorite summer desserts and some tips on how to modify them to make them healthier. 

• Frappes- ice, milk of some sort, flavorings, blended as a drink, originated in Greece  in the 1950s, named with the French word for shake or strike. 
• Smoothies-a thick beverage made of  ice, milk of some sort, yogurt, fruit, blended as a drink. Some include vegetables, nut butters or protein powder. Recipes originated in Brasil, and were popularized with the invention of the blender. These became popular in the US in the 1960s. 
• Ice cream - In the US defined as having 10 % butterfat or more, frozen, with lots of air whipped in. Frozen dairy desserts date back many centuries to many countries. The English first published recipes for ice cream in the 1700s. 
• Gelato- Italian ice cream; must be at least 3.5 % butterfat; comes from Sicily since Sicily is near both mountains with ice and orchards with fruit. 
• Sherbet- frozen blend of milk and fruit flavors about 1-2 % butterfat, An lower fat American version of ice cream.
• Frozen yogurt - yogurt with flavoring like fruit, frozen and whipped. Originated in the Us in the 1980s during the fitness revolution. 
• Granita- water, large ice crystals, sugar and flavorings like fruit juice or coffee; also hails from Sicily. 
• Sorbet - dense frozen confection of water, sugar, flavoring, frozen and blended smooth; folklore dates it back to the Roman emperor Nero. 
• Popsicle- originally was frozen flavored ice on a stick. Patented in Oakland California in the 1920s. Modern versions may contain other ingredients like fruit. 

Cuisinart ICE-21 Frozen Yogurt-Ice Cream & Sorbet Maker, White

$53.51

Cuisinart

Buy on Amazon

You can find recipes for these in many places. My favorite sources are :

epicurious.com

Food.com

Foodnetwork.com

 Pinterest

Here are some general principles which will help you create desserts that people will enjoy. 

Ben & Jerry's Homemade Ice Cream & Dessert Book

$7.01

By Ben Cohen, Jerry Greenfield, Nancy Stevens

Buy on Amazon

• Get a good electric ice cream machine. 
• Get a good blender, preferably a Vitamix. 
• Get some popsicle forms and make your own healthy versions. Make icy or dairy versions; consider adding fruit slices. 
• You may use a simple metal pan placed in the freezer, combined with periodic stirring. Granitas work especially well this way. 
• Use sweet ripe fruit if you are omitting or reducing sugar. Consider adding half a banana or a few sweet grapes to certain desserts to sweeten. Those who like stevia may try that, though be sparing. The point is to taste the natural flavors. 
• Choose coconut milk if you are dairy intolerant. 
• Choose dark chocolate flavoring. 
• Choose decaf coffee for flavoring. 

It is a fun summer family activity to make healthy cold desserts. However, you have to have a good attitude if you are going to take conventional recipes and modify them to make them more healthy. You can’t expect them to taste exactly like store brands, and that’s just fine. 

Wellness Wednesday: Dealing with Disappointment

The other day, I inadvertently backed up into my husband's truck, for the second time in one month.  Both times it was parked in an atypical location, but both times I should've seen it. Both times I was going about 1 mile an hour. I have incurred enough damage to pay for two round-trip airfares to Europe. This was a disappointment.

My initial reaction was that I was sad and dismayed. However I was on my way to a delivery, so I knew I had to be sharp. I knew it was nobody's fault really and that there was nothing to be done about it at that moment. The necessity to get out of my funk in short order was actually a really positive exercise. It caused me to think about the best way to deal with disappointment.

All the sources that I consulted on the subject indicated the same basic set of recommendations. Here is my personal redux on the matter. 

• Pause and breathe before reacting. Take a couple of minutes if need be.
• Acknowledge your own feelings of disappointment or anger, but do not act out.
• Accept the present state of affairs.
• Deliberately avoid blame and invoke an attitude of neutrality.
• Take responsibility for what you can.
• Remind yourself that all problems have solutions or at least strategies.
• Deal constructively with what you have to and postpone the rest until the initial shock wears off.
• After the initial shock wears off, reach out to others who you know will be helpful and supportive.
• After any big disappointment, stay in your basic routine. Observe a good sleep schedule and stick to your three meals and three snacks every day as well as your workout.
• Go out of your way to remind yourself about all the good things in your life. 

Keeping this routine will help keep your stress levels down and help you recover from disappointments. 

 

Medical Monday: ACOG weekly news

Headlines proclaim “ Aggressive Treatment for DCIS May Not Save Lives”.This sounds rather dismal. Reading further, what they should have said is “ Aggressive Treatment for DCIS May Not Be Necessary to Save Lives”, which is good news. DCIS is very early microscopic breast cancer, and as such its concerns everyone. Such an alarming headline got my attention. But once I found out the news was actually good, I was a little dismayed.  There must be a chapter in the Journalism textbook where it says bad news gets more attention than good. I don’t know. Read carefully out there ! 

Just to refresh your memory, ACOG stands for the American College of Obstetricians and Gynecologists. They send its Fellows, myself included, news updates throughout week. These are articles of pertinence to women’s health. Each Monday, I pick a small sample and present them to you for your consideration. More such articles can be found at www.acog.org. 

There is such a thing as “ distracted snacking”. The Journal of Health Psychology reported the results of a small study which indicate that distracted snacking results in greater intake even afterwards. I speculate that it has to do with the fact that distracted snacking results in greater intake that say “ mindful snacking “ ( my term)  causing insulin levels to spike more than they would have, and more hunger to be stimulated later. So be mindful about your snacking and remember to always include some protein. 

The venerable diaphragm has gotten an upgrade. A Seattle based nonprofit has developed a new more contoured model. It’s name is Caya. Go to Caya.eu to learn more. It is not yet available. 

Finally, ACOG has released new guidelines regarding the treatment of morning sickness. First line therapy should be in the form of the class A combination of doxylamine and vitamin B6, commercially available over the counter without a prescription in the US as Diclegis. ( Class A is the safest pregnancy category for a drug. ) This is not to say that we are not still going to need Zofran for certain patients. It will still be considered after Diclegis is deemed insufficient. 

When you read medical related articles in the mainstream press, read very carefully. It is tricky to report accurately if you do not have medical background. For more on that please see our section “ Your internet learning toolbox”. 

Stay tuned for more medical news next week on Medical Monday. 

Food Friday: Treats

This is a health oriented blog. And yet, I hope for all my readers to experience a wide range of culinary delights. Food is for celebration and rich sweet treats are served at celebrations. How can you participate without feeling like you’ve eaten poorly ? Here are ten tips to turn nutrition buffs into connoisseurs too. 

1. Eat properly on all regular days. 
2. Get your workout done before attending your party. 
3. Fill up on healthy foods before the dessert treats arrive. Savor them as much as the treats to come. 
4. Fill up on healthy beverages like water, soda water and herb tea before dessert arrives. 
5. Skip dessert if its not really well done. 
6. Skip alcohol if you chose a rich dessert. 
7. Be discriminating. Chose only the best for yourself, e.g. choose chocolate mousse over a cheap candy bar. 
8. Take a small portion. 
9. Savor your portion; Eat slowly and mindfully. 
10. Enjoy ! 

Wellness Wednesday: Physical Methods

Not uncommonly I have patients with pain issues, mood issues or both. Now, I suppose I write as many prescriptions for these conditions as the average doctor, but such a thing is hard to know. And yet, I am an advocate of what I like to call "physical methods" to control these problems.  

Since I practice evidence based medicine, I am committed to sticking to methods that have evidence supporting them. Believe it or not, the following methods are all evidence based. 

Let’s tackle pain first.

It’s pretty simple. If you have pain when stationery, you need to move. If you have pain when moving, you need to reduce movement or get help to find a better way to move. Physical therapy can provide this. 

Use heat and cold. Heat is to increase circulation which helps tight muscles or cramps. Cold is best for anything inflammatory or injury related in the first 24 hours. 

Massage is helpful in many cases of muscle pain. 

Abdominal binders, support hose, and wrist braces can be helpful in certain circumstances like pregnancy related pain. 

For the open-minded, I advise yoga for all sorts of pain: migraines, rheumatologic conditions like lupus, and for back pain pending approval of the back doctor.

Meditation takes a little more commitment, but it too, is evidence based and has been shown to favorably impact pain. 

Of course actual exercise is well known to improve resilience and to make people more resistant to pain. 

I consider music a physical method. Post operative patients have lower pain medication requirements when exposed to music they consider pleasant. The applications go way beyond that. 

Physical Methods for Mood 

All of the above also improve and stabilize mood. But did you know that the smell of natural citrus elevates the mood ? That’s why we have atomizers for natural essential citrus oils in our office. 

Simple adequate sleep is a proven method to improve the mood and increase the pain threshold. 

And if you haven’t heard this term before, you need to: Hangry. It is the combination of angry and hungry, which pretty much makes the connection between mood and blood sugar. Yes, something as simple as three meals and three snacks rich in protein can improve the mood immensely. 

All of these interventions and their effects are quite measurable and act via the nervous system and the circulatory system. Take the time to incorporate them into your life. They work. They’re cheap, and they’re fun. Because we all need to feel better sometime. 

To learn more see our pages: 

Meditation 

Yoga

Music and Health

Medical Monday: ACOG weekly news

What's an Ob/Gyn site without a little OB/Gyn news ? I like reading the Ob/Gyn News and I like translating science information into clear non medical language. So I'm going to give Medical Monday's another go. 

A large Finnish study has show that those who have depression and who are treated for it in pregnancy have lower rates of preterm labor than those who have it and are not treated for it. 

Most everyone has heard of BRCA1 and BRCA2, the genes conferring increased of breast cancer. Unfortunately there are many more gene mutations which are associated with the development of breast cancer. Fortunately, testing for 20 more of these genes may soon become available for select patients with strong family histories of breast cancer. 

Fully one quarter of American women 65 and older have osteoporosis. Thank our marginal diet, heredity, Big Soda, Big Tobacco, alcohol and our sedentary lifestyle. 

One third of ovary cancer patients are living in excess of 10 years. This is a substantial improvement over the last several decades. 

Finally, stats are in through 2013 and infant mortality in the US has dropped to a record low. Wow, finally ! I'm going to try to end on a good note, so with that, stay tuned until next week. 

Food Friday: On the Glories of Summer Fruit

Summer fruit is not just something to eat. It is a family project. It is a creative endeavor, and it is Holiday preparation. Finally it's a great bargain. 

Most people think of boxes of ripe summer fruit as the mere predecessors of pies and cobbler. I love fresh pie and cobbler as much as anyone else, but there is only so much you can eat and stay healthy. 

Consider the price of frozen fruit at the grocery store, even Costco. Frozen fruit is a premium item, and if you have ever tended a tree or picked a bushel of fruit you will know why. But, to go to a produce vendor for a box of ripe fruit in season, you will pay a fair price for an excellent product. But you must buy it by the box or bushel, which might be daunting to some. 

Take courage ! To freeze you need only freezer worthy ziplock bags, some time, and some lemon juice. Freeze by the quart or by the gallon. 

To dry, you need patience, an oven, a very hot day, or a dehydrator. With a little more cleverness and maybe a recipe, you can make fruit leathers, which are a most welcome gift. Now is the time to get some made to give at the holidays. 

Jam has less sugar than jelly and is a suitable treat or gift when home made. Delve into the exotic fruit spiked salsas, and you will have serious trouble keeping it around. 

To be fair, you will need some equipment. First you will need large bowls and pots. You will also  need many hands to help wash and slice. The thrifty among you will want the largest good freezer you can afford. Canning pots and tools are relatively inexpensive, and jars are a common item at garage sales. Just be sure they are in good condition and not chipped. Finally for the connoisseurs, you will want a proper dehydrator. And by all means indulge yourself in one of the many beautiful books about preserving. You may as well get the gold standard, the Ball Blue Book Guide to Canning and Preserving. 

If you do this sort of kitchen magic with the kids, they will be fascinated. Photo document your fun and you will be blog- worthy and an instagram hit ! You will also have a really good spoon to lick. 

Canning for a New Generation: Bold, Fresh Flavors for the Modern Pantry

$16.63

By Liana Krissoff

Buy on Amazon

Ball Complete Book of Home Preserving

$15.30

By Judi Kingry, Lauren Devine

Buy on Amazon

Ball Blue Book Guide to Home Cannin, Freezing & Dehydration (Volume 1)

Alltrista

Buy on Amazon

Wellness Wednesday: My Specific Workouts

Do you understand the power of being specific ? Have you ever tried to give someone instructions and found that it didn't work?  It may have been because you weren't specific. 

Everything from parenting to counseling patients about fitness is easier when you are specific. Case in point: I have recently changed the way I counsel about nutrition. I used to tell people about protein, carbohydrates and fats. I told them about meals and snacks. Then I let them run with it. Not much changed. They would come back in, with no change in weight or inches. They were frustrated and disappointed, since they had made concerted efforts. 

Then I started asking people to do simple food journals over a couple weeks time. Most people used a paper journal. When they would return, I reviewed it page by page, which took surprisingly little time. I took a red pen to each page, and marked it like a paper for a class, with comments. Most particularly, I wrote in the changes I wanted to see. I even gave a grade, which everyone found amusing. After that feedback, they would go home with a very specific idea of the changes needed. This made changing very easy to accomplish. And it got great results every time, in terms of blood sugar, weight and inches. 

So today's Wellness Wednesday is devoted to some very specific fitness strategies. I have suggested cardiovascular exercise to people as long as I have been a doctor, but only a small percent actually keep a consistent workout regimen. But I have found that when I suggest specific workouts, adoption rates are greater. 

A workout is a very personal thing. A workout regimen is even more tailored. But to give you an idea of what one should look like for a healthy adult, I will present my favorite DVD workout which I use on a regular basis. 

As I indicated in a prior post, I think it is important to take one day off per week. Mine is Monday, since Monday is the beginning of my workweek and is generally challenging. Beyond that, I like to alternate harder workouts with moderate workouts. I like each workout to be for the whole body, but I like to vary them through the week, to be well rounded literally and figuratively. Finally all my workouts qualify as high intensity intervals since research shows they yield the best results in the shortest period of time. I go from 20 to 40 minutes a session, depending on the workout. That's not much time out of the day ! 

My current favorite workouts are from Beach Body. And while this series has a somewhat comical name, it is extremely well crafted, arduous, fun and comprehensive. It is, (drum roll please) the Brazilian Butt Lift Workout series. Among those, Sculpt and Rio Extreme are the Hardest, with Cardio Axe being the most fun. Tummy tuck is the most time efficient at 20 minutes. 

Jillian Michaels does a great job at crafting a balanced workout which is hard and fun. She is also very encouraging in a drill sergeant kind of way. I like her workout series Ripped in 30 (days) and the sequences are only 24 minutes long. Her cardio yoga DVDs like Yoga Inferno are very cool but not for the faint of heart. 

Zumba is fantastic if you like a dance type workout. Zumba is generally of lesser intensity, but Rush and Ripped can give you a respectable workout. 

Chalean Extreme is for those who want to increase their resistance part of their workout. Hip Hop Abs is for those who can dance hip hop. 

Cardio Burn Sculpt by Gaiam is one of the best for getting back into exercise. It can be done at any intensity and is very well rounded, with a warm up, a cool down and attention to both upper and lower body. There is even an express version. The teacher Tanja Djelevic, is very soothing and encouraging. 

Finally on those days when yoga is required, the GAIAM DVD Am and Pm Yoga is the best. It is relaxing, thorough and quite brief at 15 minutes per session. For a really creative and moderately hard yoga exercise, try any DVDs by Shiva Rea. I do the Daily Energy and Vinyasa Flow Yoga. 

I pick from these like a smorgasbord. It keeps all kinds of things going well, like my mood, joints, muscle mass, bone density, and energy. If you check with your doctor, and carve out some time 6 days per week, you too will be rewarded when you do appropriate and consistent exercise. 

To learn more, see our sections below : 

Fitness

The Quantified Self 

Structure Sunday:The Structure of Back to School Preparation

I loved school. But I always hated those back to school signs in the stores. I still do. It always made summer seem shorter than it really was. And yet, now that I am a seasoned parent, I think there are real benefits to preparing for back to school. 

Just about now, it’s time to check in with your kids about any summer assignments they might have had. Don’t be that parent who declines to ask since they want their child to “ do it on their own”. Ask and get involved. Yes, it is nice when kids are self starters, but each kid is different, and you should at least know what is going on. 

It’s time to get together with your munchkin and deep clean their room. Give them some advance notice so that it is not a shock and so it does not interfere with their remaining summer plans. Let them know you might be willing to make some improvements if a good job gets done. Great examples would be a new bulletin or marker board, or perhaps a cool shelf.

Make sure that once their room is clean that everything truly has a place. Sometimes kid get blamed for having messy rooms when in fact there really is nowhere to put anything. Make sure there are enough hangers, shelves, baskets, boxes, or whatever it takes to fulfill the maxim “ A place for everything and everything in its place. “ And of course, most importantly, set a good example and keep your house clean, tidy and organized. People, especially kids, get used to whatever they’re in. You do your kids a big favor to model organization to them in this way. Being spatially organized does so much to lower stress in the house. 

Make sure to supply what they need for school. Make sure the basics are there, but also try to show you value education by going the extra mile for them with their school supplies. Make sure they have an excellent backpack to carry it all. Allow them to express their personal style. 

Make sure you know about the lunch and PE situation to come. Consider a well done home made packed lunch if school lunch quality is marginal. You can even teach your child to make her lunch eventually. Food is a great place to show kids values in action. Make sure your child has a chance to choose how they carry their lunch. 

Attend any orientations or registrations with your child, all the way through twelfth grade if you ask me. 

Finally, survey the back to school clothing situation. Assuming the room cleanup went well, ill fitting, damaged, or unwanted clothing has been given, donated, or recycled. Introduce the idea of starting your school shopping at a good thrift store such as Goodwill. Offer to take some of your child’s friends along. It is a truly fun treasure hunt. It is hip, green, and cheap.Then after that, check online for any swaps or sales, then get what you must new. 

You are the parent and you have a lot of influence. You can have this influence better by what you do, compared to what you say. Your day to day choices about how you interact with your kids convey your values. These back to school  tips will help you your convey your interest in their education, life habits, and health. They help you convey that you care about them.