Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Practice Intentional Eating

Photo by Jonas Kakaroto

Spring is right around the corner, getting our bodies whipped back into shape and working on feeling and looking better is also. Other than working out, intentional eating can help get us where we want to be. Intentional eating makes us cognizant of what we are putting in our bodies and accountable. Keeping track of what we eat and doing better each day should be the goal.

  • eat more organic if possible, no pesticides
  • eat less sugar
  • avoid processed foods
  • cook at home-you know what is in your food and you can make it healthier and feel better about eating
  • cook extra, you can freeze another meal for another day when you may not have time to cook(this will prevent unhealthy meals such as fast food those days)
  • eat more fruits and vegetables-you can get your vitamins and anitioxidants in them, increase the fruits and vegetable ratio so you get more of them on a plate then the carbs and fat, it will also make you plate more colorful and enticing
  • eat together-this will create time for bonding. It will also teach kids sharing, taking turns, and manners. You will tend to eat slower and not just gulp down your meal as you will enjoy conversation.
  • eat smaller portions-listen to your body regarding satiety and hunger

Tips to Get Better Sleep

Photo by Mpho Mojapelo

Getting that good night’s sleep is so very important, if can affect you and all your activities and interactions the next day. It is recommended that we get about 7 to 9 hours of good quality sleep a night but it may not always be an easy feat. Here are some tips to ensure a better night’s sleep.

Keep it cool

  • it is easier to fall asleep if your bedroom is cooler than warmer
  • set your bedroom temperature to about 67°F, the brain and body need to drop a core temperature of about 1 degree Celcius or 2-3 degrees Fahrenheit for you to fall asleep and stay asleep

Set a regular time to sleep at night for the weekdays and weekends

  • you may like to stay up later on weekends and sleep in but your internal body clock and brain responds best when you keep it regular
  • this helps with sleep quantity and quality.

Identify and implement a bedtime routine or wind-down routine that works for you

  • examples include shower, stretching, meditation, reading a book, journaling

Adjust the light

  • we need darkness at night to trigger melatonin so we need to be mindful about the last 30 to 60 minutes before bed
  • stay away from screens(laptops, phones) about the last hour before sleep, or dim the screens
  • blue light has damaging affect
  • use black out curtains in bedroom to avoid excessive light
  • in the morning, we should have the most exposure to indoor and outdoor light as we need brightness during morning hours to keep circadian rhythm regular

Room atmosphere

  • On top of a quiet, dark, and relaxing room atmosphere, where you sleep and what you sleep in matters
  • comfortable pajamas and bedding can make a big difference
  • invest in a comfortable mattress for you
  • work on a pleasant bedroom environment(furniture, acessories,etc) where you feel safe and at ease

Get recommended exercise

  • physical activity during the daytime helps you fall asleep easier but no intense activity 2 hours before sleep

Things to avoid

  • stay away from caffeine at least 6 hours before going to bed
  • avoid large meals, spicy food, and alcohol hours before bedtime
  • it is best to not eat anything 3 hours before bedtime
  • avoid drinking lots of fluids before bedtime, getting up to use the bathroom at night will interrupt your sleep cycle, especially the later stages
  • avoid loud noise
  • limit bed to sleep
  • be cautious with sleeping pills, sedatives hypnotics do not produce naturalistic sleep and can cause issues with learning and memory including forgetfulness

Consider tracking your sleep

  • We all know that everyone is different but it may be worthwhile every once in a while to track your sleep.
  • there are smart rings, smart mattresses, smart watches that can help
  • You can see how changes are affecting your sleep such as exercise, eating at a certain time, etc and can make changes to help with better sleep quality and quantitiy.

Prioritize a Heart Healthy Lifestyle

Photo by jesse orrico

February is all matters related to the heart, it not only marks Valentine’s Day, but also American Heart Month. February was declared American Heart Month in 1964 by President Lyndon B. Johnson. To understand how we can make our hearts healthy and prevent heart disease, we need to understand what heart disease is, risk factors of heart disease, and how to adopt a heart healthy lifestyle in an attempt to prevent heart disease.

Heart disease or cardiovascular disease is a general term which means disease of the heart and blood vessels. Coronary artery disease occurs when there is narrowed or blocked blood vessels that can affect blood flow to the heart. A heart attack can occur when blood flow is severely reduced or blocked. Symptoms of heart attack may not be clear cut and may range from chest pain, sometimes an “elephant” sitting on your chest, shortness of breath, jaw pain, dizziness, sweating, nausea, heartburn, stomach pain, or flu like symptoms.

Risk factors of heart disease include high blood pressure, high cholesterol, lack of exercise, diabetes mellitus, blood clots, stress, unhealthy diet, obesity, smoking, second hand smoke, genetic risk factors, and age over 65 years.

80% of heart disease is preventable so we all can all do a little something to improve our chances, it does not have to be all at once, but pick one or two things to work at and then pick another, you will be moving in the direction to love your heart.

Tips to lead a heart healthy lifestyle

Get active and stay active

  • American Heart Association recommends 150 minutes a week of moderate intensity exercise. This may not always be possible, but exercise in any form, even as simple as going for a walk helps
  • Sit less(don’t forget about sitting disease)
  • Spending time outside in nature can be a plus and can reduce stress and lower cortisol level

Evaluate your risk factors with the help of your doctor

Going to the doctor helps take care of preventive measures, you can get checked for elevated cholesterol, diabetes, high blood pressure and come up with a game plan.

  • High cholesterol
    • extra cholesterol enters your body when you eat foods high in trans-fat and saturated fat. Too much bad cholesterol(LDL or low-density lipoprotein) causes plaque to form on artery walls(leading to a term called atherosclerosis)
    • Goal: Total cholesterol should be less than 200 mg/dl, work on increasing your good cholesterol(HDL or high density lipoprotein)
  • High blood pressure
    • can strain the heart
    • Goal: blood pressure should be less than 120/80 mmHg
    • lower blood pressure will decrease the force/strain on the heart and arteries and can prevent heart attacks and strokes
  • Diabetes mellitus
    • high blood sugars damage blood vessels and nerves
  • Maintain a healthy weight
    • Obesity leads to major risk factors for heart disease and more
    • Goal: maintain a waist circumference less than 35 inches for women and 40 inches for men

Eat healthy

  • reduce trans-fat highly processed fats that clog arteries and raise LDL and lower HDL
  • avoid processed foods-margerine, fried food, snack foods
  • eat lots of fresh fruit and vegetables, nuts, high fiber diet, olive oil(good fat)

Good dental hygiene

  • bacteria in mouth can cause gum disease and move to blood stream
  • floss daily and brush twice daily
  • eating leafy greens and fiber can also give better oral hygiene

Manage stress

  • chronic stress increases inflammation and increases potential of cardiovascular disease
  • things you can do: meditation, yoga, breathing exercises, laughter, physical contact

Sleep better

  • people who sleep fewer than 6-8 hours a night are twice as likely to have a stroke or heart attack

Quit smoking and avoid second hand smoke

Educate your family and friends and know your family history

Almonds Are Packed With Excellent Nutrients

Photo by dhanya purohit

Almonds are a nutrient superpower for you. We all at some time or another have been encouraged to eat more almonds. February 16th is National Almond Day and a good time to reflect on how you can incorporate almonds in your diet.

Almonds have a ton of Benefits:

  • Improves cholesterol-lowers bad cholesterol(LDL) and increases good cholesterol(HDL)
  • Helps in brain health
  • Anti inflammatory and antioxidant properties
  • Provides satiety, helps you feel full because of fiber, fat, and protein content
  • Lowers blood pressure-lowers systolic blood pressure, helps blood vessels relax and reduces artery stiffness
  • Helps in gut health-act as a prebiotic food to good gut bacteria and promotes good gut flora
  • Regulates blood sugars
  • Promotes skin health

Almond Nutritional Information

  • ¼ cup(or 23 almonds or one ounce of almonds) has about 152 calories, 6 grams of protein, 13 grams of fat, 6 grams of carbohydrates, 1 gram of sugar, and 3 grams of dietary fiber.

Key points:

  • High in protein
  • Has healthy fats-unsaturated fat or monounsaturated fat such as olive oil or olives-improves cholesterol level in the body as well as reduces inflammation in the body
  • Provides fiber
  • Has micronutrients: vitamin E, vitamin A, vitamin B, zinc, potassium, manganese, magnesium, copper, calcium, phosphorus, phytochemicals, flavonols

Almonds provide satiety and make you fill full but they are also rich in calories so be wary of added extras… avoid honey, sugar, added oil, or salt as that will add on extra calories

Don’t shy away from grabbing a handful of almonds and making it a part of your daily intake in some way or another… it as a snack, add some to salads, cooked veggies, cereal, yogurt, or relish them as a topping on ice cream and desserts.

Shoveling Snow and Your Health

Photo by Anna Hill

Shoveling snow can stress your heart similar to a treadmill stress test. Shoveling snow is a vigorous physical activity and can increase your heart rate, blood pressure, and your body’s oxygen requirements. Cold temperatures may increase blood pressure while also constricting the coronary arteries. Those factors, along with the higher heart rate from the extra physical effort, may increase the risk for acute cardiac events.

Researchers looked at hospital admissions and deaths due to heart attack the day after it snowed in Canada during the years 1981 to 2014. This included more than 128,000 hospital admissions and more than 68,000 deaths due to heart attack. Here’s what they found:

  • compared to no snowfall, heavy snow(about 7-8 inches) was associated with 16% higher odds of men being admitted to the hospital with a heart attack, and a 34% increase in the chance of men dying from a heart attack
  • There was no association observed between snowfall and heart attack among women.

Well, if it snows, it snows….but be aware of the dangers, be prepared, and take it easy, including taking short breaks, or letting family members or neighbors help you out.

Tips to Stay Warm in the Winter

Photo by Alex Padurariu

It’s winter and it’s cold out there…at least for most of the country. The cold can cause constriction of blood vessels and increase the workload of the heart therefore putting stress on your heart. In addition, the cold is associated with dry skin, arthritis flares, and also makes us more prone to catch colds. In winter months, the cold makes viruses more stable and they stay in the air for longer and therefore, it is easier to catch a cold.

Here are some tips to stay warm in the winter:

  • Enjoy warm beverages and foods
  • Dress in layers
  • Use blankets and throws
  • Move your body and do indoor activities
  • Cuddle with your near and dear
  • May use heating pads, hot water bottles(but please be careful and follow appropriate precautions, they can cause burn injuries)
  • Seal your windows and doors if there is a draft
  • Use portable heaters if you need to using appropriate precautions(should be 3 feet away from curtains, furniture, blankets)
  • Use fireplaces
  • Make sure there is nothing blocking heating vents or radiator
  • Invest in carbon monoxide monitors, they can save lives

The Power of Positive Thoughts

This shows the impact our thoughts can have on ourselves and others. Goals to live by:

  • Think Positive
  • Be Positive
  • Do Positive

How Long Should You Stay Out in the Cold?

Photo by Filip Bunkens

With it being so cold out there, it is important to not stay out for longer than you safely should to prevent hypothermia and/or frostbite.

You should be looking at the temperature as well as the wind chill factor before leaving for outdoor activities. If the temperature is 26°F and wind chill is 15°F, that means exposed skin will freeze as if it is 15°F outside.

  • If wind chill is above 32°F, it is safe to be outside
  • If wind chill is between 13-31°F, you can be outside for about 20-30 minutes, but then need to have indoor breaks
  • For wind chill less than 13°F, all outdoor activities should be moved indoors as there is a high risk of frostbite

Of note: infants, toddlers, and the elderly are more susceptible to the cold so need to be more careful. When going out in the cold, make sure to dress in layers and don’t forget socks, gloves, hats, and scarves along with your winter coat!

The Winter Blues

Photo by Aaron Burden

It is common for people to feel down or a little depressed in the winter. For many, it is dark in the morning when heading to work, and by the time they head home again, it is dark again. With this, it feels like the whole day just slipped away. The winter blues or seasonal affective disorder actually affects many people in late fall and early winter. The rational behind this is that there are shorter, darker days in the winter with less daylight so there is higher production of melatonin which can cause lethargy and symptoms of feeling down. It is also felt that a drop in a brain neurotransmitter, serotonin, that affects mood may also contribute to triggering low mood.

Some ways to prevent and treat this feeling are:

  • See your doctor, sometimes vitamin D deficiency can make you prone to seasonal affective disorder. The sun is a source of vitamin D. There is a correlation between those with less exposure to sun and depression. Vitamin D produces the happy hormones serotonin and dopamine and with Vitamin D deficiency, there are less of these happy hormones. Make a point to incorporate vitamin D fortified milk, cereal, and juice in your diet and get about 10-30 minutes of sun exposure a day.
  • Stay active-exercise, that boost of energy will make you feel better
  • Take advantage of the sunlight and go out in the middle of the day to be able to get some “light therapy”
  • Socialize with friends and family
  • Eat healthy
  • Pick up a new activity or hobby be it cooking, reading, knitting, piano, or whatever you fancy

Sleep Explained

Photo by Gregory Pappas

With those of us that are wearing smart watches and tracking our sleep at night, it can get confusing with the sleep scores and breakdown provided. What we do know is that sleep is vital. Sleep is one of the most essential things to function and it is important to understand what sleep does for the body. After all, we do spend about a third of our lives sleeping. Sleep allows our bodies and minds to recharge to get us prepared for the new day and all that gets thrown at us in everyday life.

It is recommended that adults get about 7 to 9 hours of sleep a night. During this period, we go through different stages of sleep consisting of a sleep cycle. Each sleep cycle lasts 90 to 110 minutes long, giving us about 4 to 5 sleep cycles a night.

Sleep is divided into non-rapid eye movement(NREM) sleep ranging from stages 1 to 3 which accounts for 75% of total sleep and rapid eye movement(REM) sleep which is stage 4 of sleep and accounts for 25% of total sleep. Furthermore, stages 1 and 2 consist of light sleep and stages 3 and 4 of deep sleep.

Here is the breakdown:

Light sleep

Stage 1(NREM)

  • dozing off stage, we transition from wakefulness to sleep
  • lasts 2 to 10 minutes

Stage 2(NREM)

  • we spend about 50% of total sleep in this stage
  • lasts about 10 to 60 minutes
  • the start of muscle relaxation, slowed breathing, and heart rate

Sometimes, you may feel like you’re starting to fall asleep and then experience a sudden muscle jerk or contraction. This is called hypnic jerk or hypnagoic jerk or “sleep start”. This occurs in stage 1 or 2 of sleep. Hypnic jerks are a type of sleep myoclonus, are common and random.

Deep sleep

Stage 3(NREM)

  • lasts 20 to 40 minutes
  • brain wave activity slows down, delta waves begin to emerge so also known as delta sleep
  • respiration and heart rate slow down as muscles relax further
  • body temperature goes down, blood pressure drops

Stage 4(REM)

  • comprises about 20-25% of sleep
  • lasts 10 to 60 minutes
  • arrives about an hour to hour and a half after you go to sleep
  • first REM period lasts about 10 minutes.
  • each REM stage that follows gets longer and longer
  • eyes move rapidly
  • body becomes relaxed and voluntary muscles become immobilized
  • brain activity increases again, sleep spindles are seen
  • dreams occur

Deep sleep:

  • Is felt to be help consolidate and solidify the information you have learned in the daytime
  • Helps with creativity and insightful thinking
  • Sleep spindles and powerful brain activity help to transition short term memory to long term storage(helps capture memories)
  • Improves immune system, increases amount of immune factors and also sensitivity to those immune factors
  • Cells repair and rebuild to promote bone and muscle growth