Category Archives: Healthy Living

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Better Than Before: Making the Best of Arthritis

arthritisThe Europeans have it all figured out. At the first sign of any aches they don’t take to bed with a bottle of Aleve. No, they head for the thermae of Italy, the baden of Germany, the baths of England, and station thermales of France The treatments at these detox meccas include water (fresh and sea) and mud therapies that promise freedom from pain — not to mention a cleaner liver. And the concept goes back millennia. After all, Spa is not an acronym for Super Place for Aerobics. Rather, it is named after the town in Belgium favored by Peter the Great. (Yes, that Peter the Great!). They are based, instead, on the restorative and healing powers of thermal and mineral springs and imbibing waters that come directly from those sources.

Alas, we in America may be hard pressed to find these types of cures closer to home as there are only a handful of natural hot springs indigenous to this country. And, truth be told, most people don’t even know they exist. Just ask someone in your office to name a liquid that makes you feel really good. I doubt hot, bubbling water would be the first thing that comes to mind. In fact, make mine a kale and celery smoothie — and a Dirty Margarita for The Lawyer.

Does this mean, though, that we have to suffer such inflammatory ailments as arthritis in silence? After all, about 50 million Americans have been diagnosed with one of the seven common forms of Arthritis. Yes, I am one of them. But limited space will not allow me to regale you with stories about my recent hip replacement! (Call me!) Curative spas aside, it is important, therefore, for patients and care givers to understand the potential impact of the disease and how best to manage it. It can be a critical part of making the decisions to make good on your intent to live a healthier lifestyle that is Better Than Before.

Let’s start with learning a little more about the illness itself. For this I turned to Phyllis Crockett, a specialty-trained pharmacist in the Accredo Rheumatoid Arthritis and Inflammatory Disease TRC.

“Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions,” she says. “Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Also, arthritis affects people of all ethnicities.”

According to Crockett the vast majority of sufferers, about 27 million Americans, have what I have, Osteoarthritis (OA), which is characterized by a breakdown of joint cartridge. A vast majority of OA patients are elderly. (But it could be genetic, and the result of what sets in after you’ve sustained an injury! Hellooo!!)

The rest of arthritis sufferers have the more severe form: Rheumatoid arthritis. “Rheumatoid Arthritis (RA) is characterized by inflammation of the membranes lining the joint. Although it can strike at any age, women are typically diagnosed between the ages of 30 and 60, while male patients are usually older. There are about 1.5 million affected individuals in the United States. Finally, Juvenile Arthritis (JA) is a term used to describe many autoimmune and inflammatory conditions that can affect children ages 16 and younger.”

The disease takes a heavy toll. “Each year, arthritis accounts for 44 million outpatient visits and over 900,000 hospitalizations. In fact, it’s the leading cause of disability in the United States and is a more frequent cause of activity limitations than heart disease, cancer or diabetes. By some estimates, 67 million Americans will have arthritis by 2030.”

So what do we do?

“Managing the disease so that patients can continue to live normal lives is important,” Crockett continues. “Each patient is different and a physician can help determine the best treatment plan, including pain management and managing the symptoms of arthritis.”

She shared with me some tips that she offers her patients, starting with exercise. “It is a valuable tool in the fight against arthritis. OA and RA patients particularly can benefit from both endurance and resistance training.”

Maintaining a healthy weight and protecting against joint injury can help prevent OA. “Every pound of weight lost reduces the pressure on each knee by 4 pounds. Even a small weight loss can be a big help in fighting it.”

Apart from lifestyle modifications, there are also many drug therapies available for arthritis patients—and doctors and specialist pharmacists can help identify the best one for you.

For patients who already are on medication to treat the condition, adherence – taking medications as prescribed – is critical to healthier outcomes.

“But do not self-medicate!” she cautions: “Combining over-the-counter medications with prescription medications can be risky, and can cause side effects such as an increase in GI irritation or a GI bleed. And don’t adjust doses or making changes to the medication regimen without checking with your health care team.”

“Watch for drug interactions: Some common medications like acetaminophen can have a drug-drug interaction with arthritis medications. Limit intake and remember that acetaminophen is often a component in common sinus, cough/cold and pain medications.”

Opt for an anti-inflammatory regimen like the Mediterranean diet – you know the drill, easy on the acidic foods like sugar, white flours, and alcohol, and sticking with leafy greens, whole grains, and lean proteins. “But some foods and beverages can block the effects of arthritis medications,” Crockett concludes. “These include grapefruit, apple and orange juice as well as milk and yogurt. Wait at least four hours after taking medications. Exact times can vary depending on the disease and the treatment. Check with a trained clinician.”

I can assure you from very painful, personal experience that if arthritis does go too far, surgery may be the only option. So if your intent is to help avoid – or at the very least, prolong – this possible outcome, be aware that lifestyle modification and medication may be the answer.

 

Better Than Before: Thinner for (Holiday) Dinner

holiday dinnerNext week brings us Passover and Easter. And just these two holidays alone can spell diet disaster. If you’ve ever eaten matzoh, you know that it stays in your system for all eight days, unable to find a way out! And matzoh balls can sometimes weigh as much as a Mack truck. An Easter brunch menu offers similar regimen wreckers as Thanksgiving fare, plus the obligatory chocolate eggs. And we haven’t even gotten to the rest of the barbecues and feasts found on Mother’s Day, Father’s Day, Memorial weekend, July 4, and at June weddings, to name just a few. So what are we to do if our intent is to still be able to fit into a bathing suit this summer?

Since there doesn’t seem to be any end to opportunities to pile on the pounds, I asked Jacqueline B. Marcus, a Nutrition Consultant and Owner of Jacqueline B. Marcus and Associates Food and Nutrition Consulting in Highland Park, Illinois, if it’s possible to be Better Than Before weight-wise in spite of it all. Happily, Jacqueline devotes an entire chapter to healthy weight management in her new book, Culinary Nutrition: The Science and Practice of Healthy Cooking.

“Yes,” she began, “you can end the nonsense and regain control, if you simply stop, look and listen.” By that she means to stop the negative self-talk about your body and willpower, to take a hard look at yourself in the mirror and the numbers on your scale, and then to listen carefully to her advice to achieve and maintain your “true weight,” no matter what the temptations.

If you are invited to dinner, first up is to call ahead and ask your host: “What’s cooking?” If the answer is a collection of calorically-challenged courses, propose to augment the repast with BYO. Offer to bring a favorite dish to share the cost of a holiday meal. (You don’t have to mention that it is –horrors!—healthy.) If you happen to have a green thumb in cooking rather than gardening, there is no rule against buying something rather than risk poisoning your friends.

Of course, not all (or that many) social occasions will lend themselves to a non-insulting offer to bring your own food to someone else’s dinner party – or even an inoffensive query as to the menu. So Jacqueline suggests that if friendship or propriety trumps your diet concerns, eat a little lean protein or veggies beforehand to lessen your hunger.

Jacqueline also shares some general suggestions for keeping up with your weight management program any time of year. “Think Clean, Lean, Attractive, Simple, Small and Yummy.” In other words C.L.A.S.S.Y! “Choose small servings of simply prepared food without fat or skin and leave sauces on the side. Large, over-dressed portions are always no-no’s.”

Focus on selecting delicious lean proteins, brightly colored vegetables, fiber-rich whole grains, wholesome legumes and flavorful fruit. “Healthy food prepared with care can be enormously satisfying. Nix the extra fats and sugars from fried appetizers, snacks and sweetened drinks. If tempted, make do with just a nibble or sip.”

I always like to make half my plate just salad and vegetables. (It helps, of course, that I actually like salads and vegetables.) On the other hand, the Lawyer’s worst nightmares usually start with a dish filled with Swiss chard. He therefore might disagree with Jacqueline’s prescription for delightful dieting. (But don’t go by him for health advice. He likes Cronuts.) “Nothing beats the color, crunch and aroma of garden-fresh vegetables,” Jacqueline continues. “If steamed or lightly dressed, you can pile non-starchy vegetables like D-L-G’s (deep-leafy greens) pretty high on your plate for lots of vitamins, minerals and fiber. Then add some lean protein and wholesome grains or legumes.” (Check out The Dukan Diet at www.dukandiet.com for great recipes, meals and diet recommendations.)

It is also important to practice what Jacqueline refers to as tradeoffs. “Want that starchy side? Forget the breadbasket. Dreaming of dessert? Skip the appetizer. Love those creamy sauces? Just dribble over protein-rich foods or steamed vegetables. Fried foods your temptation? Save those fat calories for something delicious and nutritious—like velvety nonfat yogurt or ricotta cheese.” (Sounds great to me; but cue the eye rolling by The Lawyer and his ilk.)

Water, not mixed drinks, should be your beverage of choice. “Mixed drinks may add a wallop of calories!” (Boo!) “If you must imbibe, stick with lower calorie and alcohol options, such as light wine or beer. And, of course, always exercise control.”

Speaking of exercise, “try the free track at the mall, park district or gym,” she suggests. “And while you’re there, use the stairs, too. It takes a lot of exercise time to balance any indiscretions. Body fat below the waist is particularly stubborn.” (Sigh!)

Furthermore, it’s important to maintain records. “By doing so, you commit on paper or screen (like on a smartphone) and then confront what you see or do. Record your biggest obstacles and greatest successes. Write positive affirmations and prominently place them where they will motivate you: Your bathroom mirror, the scale, fridge or closet.  Keep a weight loss chart so that you can monitor the way down.”

Practicing positive self-talk is essential. “Ditch the negativism. Dieting is hard, but there are no excuses for “I can’t”, “won’t”, “should have” or “would have.” Also, remove the words “failure”, “cheat” and “loser” from your vocabulary. “No dieter is perfect all of the time. Just focus on your successes one day at a time and get back in charge ASAP.”

It’s also fine to reward yourself along the way or when you reach your “true weight” and maintain it. “Just do it without food. Buy yourself a new pair of all-purpose athletic shoes for your new commitment to walk ‘30 in 30’ –30 minutes of daily walking for 30 days, or a jump rope to burn more calories, or even light weights to tone your muscles. (A new outfit also works, as do Louboutin pumps. Trust me!)

It’s easier if you don’t attempt to do it alone. “Reach out and connect with someone who knows how challenging it is to lose weight and keep it off. They can be your dieting or exercise buddy. “Just make sure that they’re really your pal throughout the ‘thick and thin’ of weight loss and weight maintenance.”

Finally, focus on your intent to be a Better Than Before you. “Downsize! Raid your pantry and part with the oversized packages of foods and beverages high in sugars, refined carbohydrates and sodium. Likewise, raid your closet and discard any too big, old clothes,” Jacqueline concludes. “When you think smaller and take baby steps in the process, you’ll celebrate each little accomplishment along the way.”

And when it comes to seconds on matzoh balls, remember the chorus of that ancient Passover song. Dayenu! (Enough!)

Get Active: 5 of the Best Cities in the US for Cycling

cyclingAs time goes on, an increasing number of people have started leaving their cars in the garage and grabbing their bikes instead. As populations grow, streets become more crowded. Rising gas prices make driving in a car more expensive. Cabs can cost a fortune, and nobody enjoys riding the bus. That leaves a lot of people looking to their bikes for transportation. But what cities accommodate such a decision? Let’s check out some of the most bike-friendly cities in the USA.

Madison, Wis.

Madison began turning itself into a bike-friendly city around 1972 during an oil crisis. Since then, the cycling situation has consistently improved. The city now has a well laid out network of paths off the street as well as bike lanes all over the city. Madison draws some of the top cycling companies thanks to its bike friendliness such as Planet Bike and Saris. Motorists have gotten used to the cyclists over the decades. The city has also implemented a “Safe Routes to School” program designed to help children safely walk and bike to class.

If you head just outside the city, you can find pastoral and hilly terrain, which is great for riding. Also, if you’re into competition, Madison hosts the Ironman Wisconsin triathlon, which usually draws around 2,500 each year and has one of the most difficult bike courses in the country.

San Francisco, Calif.

This city has recently become one of the biggest biking places in the country. It’s not just cycling enthusiasts; it’s the business men too. Twitter–headquartered in San Francisco–claims that 25 percent of its employees use their bikes to commute. The company even leased a building near one of the main bike-ways to help accommodate them, and probably to encourage others to join.

Recent innovations in 2010 included 20 miles of new bike lanes, 25 bike parking corrals and traffic signals to help give bikers right-of-way. These led to a huge increase in cycling over the past five years; around 71 percent more. But with those increases in cyclers came a rise in bike crash statistics, despite the heightened level of safety offered by these lanes.

Chicago, Ill.

In 2011, Chicago got Washington’s progressive transportation director, Gabe Klein. Together with the new mayor, they set an ambitious agenda to refuel the city’s bike network. The call the plan the Streets of Cycling 2020.

One of the main goals of the plan is to install 100 miles of separate bike lanes in the next four years. So far, they installed a protected bike lane on Kinzie Street, which only took six weeks. Fifty one percent of traffic during rush hour now consists of bike riders. Elevated railways should soon become bike paths, and the bike-share system should soon expand to 5,000 bikes.

Minneapolis, Minn.

The bike culture in Minneapolis thrives thanks to the Stupor Bowl Alley Cat Race, wintertime cycling tours, the Bicycle Advisory Committee’s thousands of volunteer hours, and a general enthusiasm for biking around the city. What started off as a simple cultural phenomenon has now become a community attitude. It’s made the city one of the best places to cycle in the country.

You’ll find the 4.57 mile Cedar Lake Regional Trail as one of the largest biking trails in America. The trail also connects to other biking and walking paths. It’s got two one-way bike lanes and a pedestrian lane running from the Mississippi River through the Minnesota Twins’ Target Field and into the suburbs in the west.

Portland, Ore.

Portland has long-held the title of best biking city in America. It often serves as the only American city on lists of the world’s top places for cyclists. It’s the only big city (with a population of over 600,000) to earn a “Platinum” status from the “League of American Bicyclists” thanks to 180 miles of bike lanes and 79 miles of off-street bike paths.

You’ll find a bike-rack or bar just about anywhere you go in the city. In Portland, sometimes it seems as if bikers have more control over the road than cars. When huge groups of bikers roam the streets, cars simply have to back off and wait for them to get through. Motorists have spent so much time around bikers, they’ll often let you into the road when no bike lane exists.

If you’re looking for a place where you can rely on cycling, you can’t go wrong with any of these cities. Find one that sounds like it best suits your riding style and enjoy fully embracing the healthy lifestyle.

The Power Of The Positive Flow

When I find myself in times of trouble
Mother Mary comes to me
Speaking words of wisdom, let it be
And in my hour of darkness
She is standing right in front of me
Speaking words of wisdom, let it be
Let it be, let it be
Let it be, let it be
Whisper words of wisdom, let it be

I stood outside in the yoga class and listened as a young woman told her friend, “well if it’s meant to be, it will be.” As I always do, the words from the Beatles above filled my head. “Let it be.” One of the lessons I have learned on the journey is that indeed, it is often to let things be.

But there is a second level of the process of more to it than being a passive observer of your life, and this is another very important lesson that I think gets lost in the desire to be in the flow, and to let things happen. I have learned this the hard way as well.

It’s almost a two-step process – especially for Westerners. We live in a society with technology at our fingertips. We’ve modified the organisms of the food chain. We feel that we are in total and complete control of our destiny and of the world around us. We’re not. We need to understand that as much as we think that we have controlled the world – the world still has mysteries and secrets that we will never understand.

Usually, this then translates, in yoga studio lobbies, to men and women talking about other men and women and debating the outcome of a relationship. It usually involves party A who has been trying too hard to force the relationship with party B whom they’ve either been dating, been wanting to date, been wanting to marry or procreate.

Faced with obstacles and frustration, they then declare that “if it’s meant to be, it will be.” It’s as if they have decided that it’s out of their hands and in the universe’s. This is, in my mind, a simple bastardization of the concept of flow and the role it plays in our lives.

To me, to be in the flow is first to listen. You have to understand what is happening around you, and most importantly, within you. You have to eliminate the chatter of the world and most importantly, the chatter within you. You might think that the reason you are nervous / scared / anxious about an issue or person is clear-cut and simple – it almost certainly isn’t and if you think you can see and understand what you are feeling and why without serious quiet and introspection, I’d be careful.

Let’s say you are deciding what you want to do for a new career. You need to think about it and ponder the pro’s and con’s in a logical way. How much money will you make? Where will you live? You will not become a yoga teacher by chance – it takes conscious action.

Once the input has been entered, then it’s time to sit down, meditate and think about it. How does it feel? What does it look like? What direction can you give yourself with the input entered?

If it feels right still, then here’s the important part – the power of positive flow.

I described it once to a friend in Burma last year like this.

Imagine you are standing on a river bank and the water is moving by you. You won’t get anywhere if you just stand on the river bank. The water is not going to come out and get you and pull you in.

You have to step into the water.

Then, you have two choices.

You can go against the current. And here I often think of my friends who are lawyers, and are miserable being lawyers (not all are, but a lot seem to be.) They turn into the stream and trudge hard against the current. They try to swim and fight upstream. They won’t succeed.

So you turn the other way, you are in the river and you let the river take you.

Here’s where positive flow comes in.

The river will take you but you will get there faster if you move with the river. If you have ever swum downstream in a river that’s moving fairly fast, you know that a leisurely swim moves you quickly – it’s almost as if you are flying down – that’s what you want to do.

If the man or woman you are interested in moves to another city, you can’t simply hope it will work out. It’s going to take real work and real effort. I have learned this recently with this wonderful woman in my life. It’s work to talk and communicate and share – more work than I have experienced before. It’s not just simply going to happen.

I also learned a lesson a few years ago. A woman I really enjoyed was flying to South Africa and the schedules got topsy turvy and I wasn’t going to be there for much time at all when she was going to be there. I debated changing my ticket home (I was on a business trip with a good friend.) My friend advised me not to. “If it’s meant to be, it will be.” And I left. The last email that the woman flying in sent was “Wait, we’re not even going to have dinner?”

I should have stayed.

So now, I feel that it’s a combination of swimming and floating. Of listening and acting. Of holding and letting go. The right place for me is a pulsing between the two. I listen now to myself and to the people important to me.

I always make sure that I am in the river. And I always make sure that if I am headed in a direction that feels right, I don’t mind floating and watching the world move by me.

But I also don’t mind putting my head in the water and slowly helping the river push me.

Better Than Before: Recovering from a Cruise Excursion

cruise buffetA few weeks ago, I was invited to go to an 80th birthday party. Among the select group of fellow guests were important political figures, judges and lawyers. Now, one would naturally assume that this distinguished assembly of New York City notables would have preferred something equally elegant, say a staid steak house or an upscale Italian eatery. Nope. The destination of choice was, wait for it, a ‘Cruise to Nowhere.’ That translated to one night on the Norwegian Cruise Line’s Norwegian Gem, a massive modern ship that normally sails to the Caribbean, Canada and the Bahamas. On this voyage, however, the ship simply goes a few miles out to sea – and back. Enough distance, though, to be able to gamble and shop at a duty-free store. Who knew that sailing to New Jersey (or at least safely offshore from the Garden State) could have such lucrative advantages – and be considered “international” waters?

There was one minor problem, though — I have been known to get seasick in a hot tub if the jets make too many waves! So I was understandably hesitant to accept this invitation. But then I read the trip’s description on NCL online: “Leave all your cares on land and slip away for a cruise to nowhere,” it beckoned. “Enjoy dinner and dancing, take in a show, win big in the casino, party the night away or spend some time in the spa to relax and rejuvenate!” It had this overly stressed journalist who hasn’t had a vacation in years at “leave…” So off I went – with my own Lawyer in tow (not that he needed a lot of convincing to take part in something that pretty much promised an open buffet for the entire time). Besides, I was determined to prove to my readers that it is possible to go on a cruise – and return in shipshape, no matter what the temptations. While 18 hours on board isn’t much time to get out of shape,  I still considered this an opportunity to test the waters for the longer lasting versions. Detective Beauty was on the case!!

We have all heard horror stories about these types of trips. As one would naturally assume with something informally known as a “booze cruise,” they either attract the college crowd who stay up all night and drink wherever they are, or those who could be deemed the “Real Housewives of 7-Eleven.” And upon boarding and looking around, I had to admit that this particular excursion lived up to that reputation. There were drinks of every form offered on practically every deck – for an extra fee. Even though it was only 1pm in the afternoon, it seemed as if many cruisers had already had a few — or ten. Of course, when somebody dressed in a full dolphin costume came over and put his or her (hard to tell) arm around me to pose for a ship photo and I happily submitted; smiling broadly at the ridiculousness of it, it no doubt appeared to others that I might have knocked back a few myself.

Let’s skip to lunch. Unless you want to go to a specialty restaurant onboard, which is also extra, it’s basically what you’d expect for cruise food – and lots and lots of it. That means unlimited amounts of whatever is on the menu, much of it not terribly good for your health. Suffice it to say, though, that The Lawyer was in seventh heaven. Restaurants with All-You-Can-Eat buffets, you see, usually have to check with their bankruptcy counsel whenever he and our sons descend upon them. “Jane, should I have a steak?” he asked, knowing that I was sitting next to him and would kibosh the order, but decided to see if I mellowed in the negative ions of the ocean air. Here’s a tip: Look for the options with checks in front of them signifying that they are ‘heart healthy.’ Okay, maybe not what you would get at, say, Sweet Greens organic salad bar, but good enough to not gain ten pounds or fill any arteries left unclogged. And order triples on vegetables. That was all I actually ate, but the waitress nonetheless commented that I had a “hearty appetite.”

There is a long list of possible activities that my group of women and I scanned during our meal. I strongly suggested for them, and for those of you who follow this nautical path, a visit to the gym and spa. Every top-of-the-line ship has them and they are a perfect way to while away the hours instead of going to a bar or playing afternoon Bingo. The gym is open from 6am to 11 pm and offers everything from Thighs, Buns and Tum hour, to Fab Abs, yoga, Pilades, body shaping and all things in between. Everything you would find at a full service gym is right there. I loved the TRX workout, a revolutionary method of suspension training that is brought to us by the Navy Seals, and will make it a point to find a class here in the city that offers something similar. So take advantage of a unique opportunity to try different exercise options.

Finally, visit the spa. This cruise had a particularly gorgeous one — the Mandara. Splurge on a hot rock massage, an oxygen facial, acupuncture, or a cleansing thermal wrap. (And if you’re not Gwyneth Paltrow, how many of us realistically have all those hours to devote to detoxing?) I knew where The Lawyer would be – undoubtedly at the afternoon buffet — so I didn’t have to worry about him honing in on my “me” time. I still remember one year when I was certain that he was at the marina of a French resort taking note of the topless human condition, I called down to the hotel spa to arrange for a treatment. “Impossible, Madame,” was the reply. “Your husband is at this moment on the massage table about to start the very last appointment.”

Yes, I was a little sick to my stomach; but it was because the waters were particularly choppy, not the fact that I caught the dreaded Norovirus. But, at the end of the day, I disembarked the morning after looking and feeling Better Than Before. And if you just plan your cruise activities accordingly, you can, too. As for The Lawyer, he’s still annoyed that I didn’t let him eat any birthday cake. 

Super Spring Detox Foods

detox foodsI live in a northern climate so the end of winter signals a new season of fresh produce and nutrition-rich foods.  Even though all these foods are available from the grocery store in the winter, getting them straight out of the garden or fresh-picked at a farmers’ market early in the growing season can’t be beat.

When it comes to cleansing your body of harmful toxins, food really is the best medicine.  Many of your favorite foods also cleanse the liver, kidneys, skin, intestines, and other detoxifications systems.  Add more of these nutritious and delicious spring time foods to your diet to help ward off the harmful effects of pollution, food additives, second-hand smoke, and other toxins.

Artichokes—increase bile production. Bile helps the intestines eliminate toxins from the body. They also contain a substance that helps the liver break down fatty acids, reducing its already immense load.

Asparagus– an excleent source of vitamin K and folate.  Asparagus also contains vitamins A, C, B1, B2, B6, niacin, folate, manganese, potassium, magnesium and selenium.  Due to its high folate content it is a particularly good option for pregnant women.

Garlic—helps cleanse harmful bacteria, intestinal parasites, and viruses from the body, especially from the blood and intestines. It also helps cleanse buildup from the arteries and lowers blood pressure. Garlic has anti-cancer and antioxidant properties that help detoxify the body of harmful substances. It also helps cleanse the respiratory tract by expelling mucous buildup in the lungs and sinuses. I am referring to fresh garlic, not garlic powder, which has virtually none of the above properties.

Onions—demonstrate powerful antioxidant and anti-cancer activity. Onions also thin and cleanse the blood and lower LDL cholesterol without lessening HDL cholesterol. Onions also help detoxify the respiratory tract and fight asthma, bronchitis, hay fever, and diabetes. Onions help cleanse the body of viruses and the intestines of harmful bacteria.

Watercress—increases detoxification enzymes in the body and acts on cancer cells in the body. In a study at the Norwich Food Research Centre in the United Kingdom, smokers who were given 170 grams of watercress per day eliminated higher than average amounts of carcinogens in their urine, thereby eliminating them from their body.

Adapted from Weekend Wonder Detox by Michelle Schoffro Cook, PhD, ROHP (DaCapo, 2014)

Check out my new book 60 Seconds to Slim.  Subscribe to my free e-magazine World’s Healthiest News to receive monthly health news, tips, recipes and more.  Follow my blog on my site HealthySurvivalist.com, Twitter @mschoffrocook and Facebook.  

Be Present in a World of Constant Connection

presentThe bus from Yangon to Mandalay was packed and I was the only foreigner on it. As such, I was given a seat up front, among the monks dressed in their dark orange robes. Slowly we made our way north on the toll way. In Myanmar, there aren’t any radio stations or satellite radio to be played as the miles crept by. The country has the lowest mobile phone penetration in the world after North Korea and, well, considering that that country is on permanent lockdown, Myanmar has the lowest mobile phone penetration of any country where you can actually buy a phone.

This means as the miles roll by, the people on the bus start to converse and talk. The conversations start muted, whispers from two people sharing a thought or secret and then they slowly built. By the time we were an hour out of Yangon, people were standing in the aisles, talking, laughing and sharing snacks. By the time the bus stopped for lunch, everyone piled out together and shared tables at the the roadside restaurant.

I thought of that trip last year as I sat at the airport in Boston recently. All around me were my fellow passengers on the journey, glued to their phones and computers, listening to music and shut off from the world. There wasn’t a single conversation happening around me. No one had met anyone or shared a story of their day. No snacks were being pulled out and traded.

In Myanmar, they are anxious for the chance to buy the latest phone. They lament the lack of Internet and how slow it is when it does exist. They wonder how much better their lives would be if they had more wifi, more connection and more technology.

In the States, I don’t think that collectively we understand the impact of technology on our lives. I have learned a lot during my yoga practice about being present, about being on the mat. At one of my favorite yoga studios in the world, there is often a sign on the blackboard about how you can’t do anything tomorrow and you can’t do anything yesterday, today’s the day.

We speak in the Internet and the ability to be in touch with everyone in our collective worlds as being “connected.” Partially, that’s true. The technology and the platforms that are at our fingertips do make it easier to stay in touch with family, friends and business colleagues – especially the ones that are at a great physical distance from us.

But it comes at the cost of disconnecting from where we are now. At the airport in Boston, I watched as people messaged, emailed and called people who were not around them physically. I realized that every person around me was trying to connect electronically with a person or a place – they all were trying to be somewhere else, or with someone else.

When a hundred people gather to get on a plane, and everyone is trying to be somewhere else, there is no chance of true connection. There is no chance to meet someone interesting or perhaps, meet a new partner or even future spouse. My parents met in Washington, D.C. at the airport. My mother was flying up to New York for the weekend and my father was heading home to Boston. Would they have even met if they had both had their heads down texting friends? I doubt it.

The advent of wearable technology, Google Glasses and the like, will make the situation even worse. At least when people have to look at their phones or computers, there is the chance that that they might make eye contact with someone. If they are wearing their phone, that low chance is completely gone.

In Myanmar, they anxiously await lower prices for cell phones and improvements in the Internet. All that does is make me want to return there before it happens so that I can enjoy a people and a culture that is still truly connected.

Better Than Before: A Hypochondriac Discovers von Willebrand Disease

 von Willebrand DiseaseThe worst thing you can tell a hypochondriac such as myself, is that there is another illness out there waiting to be experienced. Case in point: The little-known bleeding disorder, von Willebrand Disease (vWD). While it sounds like something you can only catch from effete German aristocrats, it is, in fact, named after Erik Adolf von Willebrand, a Finnish pediatrician who first discovered it in 1926. And the only reason I am writing about it now, is that it turns out that I know someone who actually suffers from it, and she recently described her symptoms to me. (Note: When innocents start doing this and my husband, The Lawyer, is present, he desperately, tries to stop them before I personally start to manifest the symptoms!) Amazingly, it is remarkably common – if not well understood – and by some estimates, affects as many as 1 in 100 people. A genetic disorder, it is non gender-specific, meaning men and women are afflicted equally. Most cases, though, go undiagnosed because the symptoms tend to be very mild.

In order to find out more about vWD, I consulted with the specialty-trained clinicians in the Express Scripts Bleeding Disorder Therapeutic Resource Center, offered through Accredo, who have disease-specific expertise. They help patients understand and manage their condition and treatments. In other words, they are good for me to get to know. (Both the experts and the treatments, that is!)

Here is what Leslie Oygar, a clinical nurse liaison in the TRC, tells me:

Von Willebrand factor (vWf) is one of the key components of the process that helps blood clot. It is produced in the bone marrow and the lining of the blood vessels, where it is also stored. In 99% of us, VWf is released into the blood when an injury occurs and works with platelets to start the clotting process, which ultimately stops the bleeding. If the supplies of vWf are inadequate, it can result in uncontrollable, or poorly controlled, bleeding.

There are three types of vWD. Fortunately, a vast majority –roughly 75% – of patients have Type 1. These patients typically experience less severe symptoms. Type 2 is caused by a qualitative dysfunction of the vWf. There’s enough clotting factor but it does not function the way it should. Type 3 is the most serious, and rarest, of vWD. These patients have a a severe deficiency of clotting factors, and experience significant bleeding –including joint bleeding. Type 3 requires treatment with an intravenous clotting factor containing vWF.

Now for the scary part as far as I’m concerned! That would be the actual symptoms. According to Oygar, these can range widely depending on the person’s gender and type of vWD.

“They can be as minor as light bruising or small knots under a bruised area,” Oygar says.

The more alarming ones include bleeding from the gums and prolonged bleeding after a dental extraction, blood in the urine (kidney bleeding) or bleeding in the stomach or intestines. Female patients, as one would imagine, can have additional signs including prolonged or excessively heavy menstrual bleeding, which are in some cases very serious, requiring blood transfusions until it is under control. Postpartum bleeding is of concern as well.

The good news? vWD is treatable, Oygar points out. How? Glad you asked, because Oygar has answers.

• Symptoms of Type I and some forms of Type 2 are often treated with an intranasal spray, Stimate, also offered in injectable form.

• Oral medications, like Aminocaproic acid and tranexamic acid, are available to help prevent the clot formed from breaking down after the bleeding stops. They are often used before and after dental procedures.

• Some other forms of Type 2 and Type 3 may call for an intravenous plasma-derived clotting factor.

For patients with any form of vWD, however, below are six useful medication management tips to help ensure that their condition is well controlled. They are important suggestions to keep on hand on your journey to feeling Better Than Before:

1) Be on the alert: If you have vWD, as with so many conditions, the first step is prevention. Similar to people with hemophilia, obviously avoid activities that can lead to cuts and internal bleeding. Less obvious is food-intake related actions. Sharp-edged foods, such as corn chips, may scratch or pierce the soft tissue inside your mouth and cause bleeding. Chewing gum can lead to biting your tongue. And if you are already bleeding, avoid hot foods and beverages, as they can cause vasodilation, causing bleeding to worsen.

2) Have First-Aid handy: Keep popsicles in the freezer as a first line of care for oral bleeding until medication can be administered as ordered by the hematologist. The ice-cold treat aids in vasoconstriction, which is part of the first stage of coagulation. Ice packs for topical use on other areas of the body should be in the freezer as well.

3) Cover all contingencies: Especially in the case of your children who may have vWD, have a plan and discuss it with the school nurse or teachers, and other caregivers. Ensure that medication is available in the school clinic for any episodes of bleeding.

4) Use as directed: Nasal sprays, injectables and intravenous medications for vWD require a hematologist’s supervision and approval and should be used exactly as prescribed. Over-dosing or under-dosing can be dangerous and potentially fatal. Always consult a hematologist or an appropriate clinician for questions about dosing changes. Missing doses or discontinuing the medication could cause the bleeding to resume.

5) Monitor fluid intake: Over-hydration in patients on a nasal spray or injectable form of medication can cause seriously low sodium levels which could lead to seizures.

6) Talk to your clinician: Heavy menstrual bleeding can be dangerous and must be reported to the hematologist or clinician. Let your hematologist know at least 2 weeks prior to surgery or dental work. Be sure to report any symptoms or changes.

As for me, I’ve decided that from now on I probably should stay away from sharp knives; and just to be sure, all cooking utensils! The Lawyer will just have to fend for himself in the kitchen. (Who cares if the odds are 99 to 1 that I don’t have vWD!)

Better Than Before: How Diet Effects Mood with Elizabeth Somer

Elizabeth SomerQuite frankly, with the type of winter we have had so far in New York – and continuing to have, now into March – I sometimes think that only a trip to a Caribbean island will make me feel better! Thoughts of a swim in the warm ocean, lying around the sun-drenched white sand, and having one (or ten) of those drinks with the little umbrellas will undoubtedly do the trick. But obviously most of us can’t hop right on a plane to a tropical island. And, snow and cold aside, why aren’t we enjoying winter, anyway? Sledding, skiing, skating aren’t just for watching during the Olympics! And after all, being Better Than Before is all about living in the moment.

I took my query to Elizabeth Somer, author of the bestselling Eat Your Way to Happiness, and highly sought-after and respected source of nutritional information and lifestyle changes. I was hoping she could share some good news on how to keep in a good mood – not to mention not gain twenty pounds from all those hot chocolates with mini marshmallows – while we wait and wait…and wait, for spring.

JWM: Let’s start with the obvious basic question: Why does our mood often plummet during the winter?

ES: At its foundation, it’s biological. The seasonal drop in sunlight throws brain chemistry out of whack, making some of us more anxious, depressed, and tired this time of year. We snap at the kids, sleep more, crave sweets, and as a result, gain weight.

JWM: Can depression, mood swings, and chronic irritability be symptoms of more serious problems than just winter blues? Other than PMS or menopause, that is.

ES:. Yes, it could be Seasonal Affective Disorder or SAD. The winter blues and SAD rest on the same continuum, differing only in their degree of severity. In other words, a person suffering from winter blues might feel grumpy and tired, while someone with SAD suffers serious depression, with feelings of desperation, anxiety, and exhaustion. If your depression interferes with important aspects of your life, such as your job or relationships, or if you have feelings of hopelessness, these are possible symptoms of SAD that should be discussed with a physician.

JWM: Who suffers from it? Other than we confirmed hypochondriacs, of course.

ES: Approximately 10 to 20 percent of Americans battle the winter blues. The reasons why our moods slip and our appetites take over by mid-winter could be simply that we’re cooped up, bored, and restless; or it could have a deeper cause, resulting from a drop in serotonin, a brain chemical that regulates mood and hunger. Whatever the reason, most people have some kind of behavior change in the winter. Children and teens can suffer from the winter blues, too.

JWM: What could be some of the signs?

ES: The main ones are obvious – depression and fatigue that lingers. Or, ask yourself the following: Has your mood plummeted along with the temperature? While you stare forlornly out the window at another bleak, winter day, is your spouse dozing rather than playing with the kids? Do you find yourself power snacking on Skittles by the 5th day of rainstorms. If so, you could be battling winter blues or SAD.

JWM: Are there foods and activities — other than Skittles– that you recommend that can boost our mood in these darkened days?

ES: Absolutely. First of all, you might consider finding more light. If your mood improves while vacationing down South, for example, it’s probably more the sunshine than the trip. [Or the drinks with umbrellas.] The researchers at the National Institute of Mental Health in Bethesda, Maryland, are among those who have linked dark winter skies to low levels of serotonin, which makes some people drowsy and more prone to depression. Ample sunshine hitting the retina of our eyes triggers a cascade of events in the brain that raises serotonin levels. Voila! Moods improve! Up to 80% of SAD and winter blues sufferers report at least some relief when exposed for 30 minutes to 1 1 /2 hours daily to sunlight or a specialized light box that emits light 5- to 20-times brighter than typical indoor light. Check out the internet for a local resource for these lights.

JWM: How about diet? Any suggestions?

ES: Eat Regularly: Don’t attempt to skip breakfast in an effort to cut calories. You’ll overeat later in the day, struggle more with mood swings and fatigue, and battle a weight problem in the long run. Be sure to eat breakfast, but make it light and include some carbohydrates, such as cereal, fruit, and milk. Then have lunch. Something as simple as a sandwich, nonfat milk, and a piece of fruit will fuel your brain, body, and mood.

JWM: One way a lot of us make the cold hours pass better is with something to nibble on. What about snacks?

ES: Snack, but not on sweets. A voracious sweet tooth during the winter months also might stem from low serotonin levels. Chowing down on sweets works temporarily – serotonin levels rise and we feel better. But that high is followed by a crash, setting up a roller coaster of highs and lows that causes overeating and weight gain. Replace these foods with more nutritious sweet treats, such as fresh-sliced kiwi mixed with nonfat strawberry-kiwi yogurt, a half papaya filled with lemon yogurt, fresh fruit layered in a parfait glass and topped with a dollop of low-fat whipped cream, or nonfat milk whipped in a blender with fresh fruit and a sprinkle of nutmeg.

JWM: But how about people who have a sweet tooth? As you said, sugar is counter-effective in the long run. What should they do?

ES: One way to sooth your mood and save your waistline is to switch from fatty sweets to high-quality carbs, such as whole grain breads and crackers, brown rice, oatmeal, or starchy vegetables like corn or potatoes. Plan a mid-afternoon all-carb snack, such as half a whole wheat English muffin with jam, 3 fig bars, or drizzle honey over a toasted cinnamon bagel to counteract the desire to eat sweets at this crave-prone time of day. Also include carb-rich foods in your meals, such as pasta primavera or marinara, whole wheat couscous, or yams cut into strips and baked on a cookie sheet to make ‘French fries.’ (Serotonin also improves sleep, so a serotonin-boosting evening snack, such as air-popped popcorn or a scoop of sorbet, will help you sleep better, too!)

JWM: There is a lot that has been written about omega-3 fat DHA elevating your mood. How do you feel about that?

ES: You can definitely boost your spirits by taking either omega-3 fat DHA supplements of food rich in it. Research shows that this fat helps boost mood all year long, especially in the winter. In fact, DHA curbs depression by up to 50% in people who are the most difficult to treat; and even helps those who just battle a bit of grumpiness. Interestingly, researchers have found that people who are depressed have much lower levels of omega-3 fats in their blood, fat tissues, and brains — up to 36% lower than happy people. In fact, as omega-3 levels drop, so do levels of serotonin, leaving people grumpy, blue, and downright depressed. If your DHA levels are low, you have a 2.6 times greater risk of getting really crabby and blue compared to someone who keeps those levels high. On the other hand, up your intake of omega-3 fat DHA and serotonin levels rise and mood improves. The evidence is so overwhelming that the American Psychiatric Association in 2006 recommended omega-3s be included in any treatment for depression.

JWM: What are the best foods for omega-3 fat?

ES: You can get all the omega-3 fat you need from flaxseed, walnuts, canola oil, leafy greens or soy to help lower your risk for heart disease, but those foods will do nothing for your mood or memory. That’s because there are three omega-3 fats, and they are not all created equal. It is only the omega-3s in fish, especially DHA, which will boost your mood. Aim for 2 servings of omega-3-rich fish such as salmon every week, choose foods fortified with DHA, and/or take a daily supplement that contains at least 220 milligrams of DHA.

JWM: If we don’t see any improvement in our mood or appetite after a few weeks on a high-carb menu, what should we do?

ES: Try substituting some of those carbs for more protein. New research from the National Institute of Mental Health shows that some people don’t experience a mood boost when they eat high-carb diets. So, if you still feel grumpy after a week’s worth of the high-carb choices, try cutting back on the carbohydrates and  increasing protein intake by adding a slice of turkey or a glass of milk to the meal. Protein has a satiating effect that keeps you full longer and curbs cravings in some people.

JWM: A lot of people drink coffee to improve their mood. But for some, like me, it has the opposite effect. What are your thoughts about this?

ES: It’s better to limit coffee. While caffeine is a great pick-me-up, if you are drinking more than 3 small cups a day, it could be fueling fatigue. For the person who is sensitive to sugar or caffeine, simply removing these substances from the diet may be all it takes to reduce or even eliminate depression, according to research from the University of South Alabama. How coffee affects mood is unclear, although caffeine is a drug that affects the nervous system. Cut back or eliminate coffee, tea, chocolate, cocoa, colas, and caffeine-containing medications, such as Excedrin, Dristan, and Dexatrim.

JWM: We spend so much time in heated rooms in the winter, leading to not only dry skin, but dry everything. Is that a factor?

ES: Absolutely. Actually, the first sign of dehydration is fatigue, which is the stepping stone for depression. Many of us are mildly dehydrated, because thirst is a poor indicator of your body’s need for water. Drink twice as much water as it takes to quench your thirst, or at least 8 glasses daily. Drink even more water if you exercise intensely or drink a lot of coffee and tea.

JWM: Are there any other supplements that you recommend that can affect our moods?

ES: It is difficult in winter to constantly keep up the proper quantities of fresh vegetables and fruit. So several nutrient deficiencies, including the B vitamins, are more common in the winter that indicate a link to impaired mental ability and mood swings. More than one in four patients with depression is deficient in vitamins B2, B6, and B12, and folic acid. B-rich foods include chicken, legumes, fish, bananas, avocados, and dark green leafy vegetables. A moderate-dose multiple vitamin and mineral, supplies these B vitamins and can fill in the nutritional gaps on those days when you don’t eat perfectly. In addition, preliminary evidence suggests that low vitamin D levels, which can occur due to lack of exposure to sunlight, might contribute to winter blues. So make sure your supplement has at least 1000IU of this important nutrient.

JWM: What about exercise? Please don’t say to take a spin class or use the elliptical machines, my two fitness nemeses in any season!

ES: Any kind of exercise is good. It’s well proven that people who are vigorously active almost every day are at much lower risk for developing any form of depression, including winter blues.

Now if I can get my husband, The Lawyer, to sprint to take omega-3 supplements while drinking a gallon of water, I might have some peace around here before springtime!

Getting started, again

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We started off the year with high hopes.

We were going to find love!
Start new jobs!
Let go of old hurts!

Now that it’s March, it’s time to do an evaluation.
Are you any closer? Are you have the sort of realistic conversations with yourself that are going to stop you from repeating the same old, same old? Or are you still back in 2013?

I hope as you’re reading this that you are thinking back on the short time since the turning of the year and you’re already proud of how far you’ve come, but in case you aren’t, here are some ideas to help you get back on track.

1. Time to affirm your intent. Remember the feeling and place you were in to make you set a big intent in the first place? Maybe you were worn out. Maybe you were on fire with the passion of a new idea. Even if you’re not in the same place you were when you originally made you’re intent, affirming it means you’re still saying “yes!” to that idea. Regardless of where you are today, you are just as committed to your dream.

2. Set visual reminders. I’m not above taking a page out of a teen girl’s book and leaving decorating my walls with reminders. Whether that’s notes on the bathroom mirror or refrigerator to remind myself of a new mindset or empty boxes in my bedroom to remind me to finally purge my closet of all the things I don’t need, a visual reminder is a tangible shift from seeing things the way they’ve always been.

3. Make an appointment with yourself. A boss I had taught me how invaluable it can be to make appointments with yourself, especially living in our fast-paced culture. You have someone asking you to get coffee (not necessarily a bad thing) and so you look down at your calendar and find an open place. If you’re like me, this might happen half a dozen times in a week and so you keep filling up the open places in your calendar with meaningful conversations and meetings. But then you arrive at the end of the week and realize you’ve left no time for your own plans or progress. Before you make it to Monday, sit down and find a block of time that can be added to your calendar that is reserved for the tasks that are hanging over your head. Writing? Organizing? Going to the gym? Sometimes it feels selfish to save time for you, but you would never tell a friend that making their own positive progress was selfish, so why is it for you?

So where are you getting started?
It’s possible you don’t feel progress being made because you never set an intention to begin with.
Check out this Year of Intent intention made my Mallika Chopra:

Screen shot 2014-03-03 at 2.02.44 PM(click the image to see the entire intention)

Since originally posting about her new book, Mallika has been updating, affirming and responding to the comments left by other users. It keeps her motivated and, most importantly, focused on accomplishing a satisfying task- her newest book.

If it’s March and you lasted a good week on your resolutions and intentions, that’s fine. We’re here to get you started again.
So, again, I’ll ask where are you getting started?
What’s it going to take to get going?

Interested in checking out other Year of Intent goals? Check them out here.
Then set your own at Intent.com!

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