Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Antioxidants and Oxidative Stress

Photo by Brooke Lark

Cells produce free radicals during normal metabolic processes that are necessary for the body to function and also produce antioxidants to neutralize these free radicals.

Oxidative stress occurs when there is an imbalance between free radicals and the ability of the body to clear them(the antioxidant defense of the body) leading to cell and tissue breakdown which may cause DNA damage.

Ongoing oxidative stress can lead to chronic inflammation along with chronic medical conditions such as diabetes, chronic fatigue syndrome, Alzheimer’s disease, Parkinson’s disease, hypertension, atherosclerosis, stroke, etc.

Some of the risk factors for oxidative stress are obesity, smoking, alcohol use, intake of processed foods, diets high in fats and sugar, exposure to pollution, and UV radiation exposure.

Prevention is key and includes eating a diet rich in fruits and vegetables(that will provide antioxidants to the body), limiting processed foods, avoiding foods high in sugar and fats, regularly exercising, and maintaining normal body weight.


Although our cells naturally produce antioxidants, diet is also an important source. Eating foods with vitamins and minerals which also serve as antioxidants is important. Here are some examples of foods to eat more of whenever you get the chance:

  • Vitamin C-broccoli, brussels sprouts, berries, cauliflower, kale, kiwi, lemon, orange, papaya, bell peppers, tomatoes, sweet potato
  • Vitamin E-leafy greens, spinach, avocado, almonds, red peppers, almonds, peanuts, sunflower seeds
  • Zinc-chickpeas, cashews, lentils, fortified cereals
  • Beta-carotene and lycopene-beets, broccoli, carrots, kale, bell peppers, mango, oranges, peaches, spinach, sweet potato, tomatoes, tangerines
  • Selenium-Brazil nuts, seafood
  • Catechins-tea, cocoa, berries
  • Flavonoids-tea, citrus fruits, red wine, apples, pomegranate
  • Quercetin-apples, onions, red wine
  • Coumaric acid-spices(cloves, cinnamon, tumeric), berries
  • Anthocyanins-blueberries, strawberries, eggplant
  • Polyphenols-herbs, coffee

In general, the best antioxidant benefits are when foods are eaten raw or lightly steamed. Don’t overcook them! Next time you go grocery shopping, make sure you pick out as many antioxidant containing foods as possible. You will feel good about it and will be doing your body a huge favor.

The Pfizer COVID Vaccine Price Hike

Per Annalisa Merilli published October 22, 2022 in Quartz:

“For over two years now, the US government has purchased all of the covid vaccines administered in the country, in what has become the largest public vaccination campaign in American history. Those purchases have included more than 500 million doses from Pfizer. The first 100 million cost around $20 a dose, thanks to an earlier agreement in which the US government invested $1.95 billion in vaccine production. The remaining doses were bought for around $30 each. But once the US government supplies run out (likely in the first quarter of 2023) and covid vaccines and therapeutics are moved onto commercial health platforms, Pfizer is able to hike up the price of its shots. The company announced on Oct. 20 that it intends to sell the covid vaccine, marketed under the brand name Comirnaty, for $110 to $130 per dose. This is about four times the current selling price—and 100 times the estimated cost of manufacturing the vaccine. According to The People’s Vaccine Alliance, a coalition of over 100 organizations working to end vaccine inequity, Pfizer spends less than $1.20 to produce each dose of vaccine”

A 10,000% price hike of the COVID vaccine which has the power to save lives is hard to digest. Pfizer can talk about packaging and distrubuting costs but really cannot justify a mark up like this. The flu shot costs about $18 to $28, and the COVID vaccine cost will be about $110 to $130. It just goes to show, nothing changes, not even after a pandemic, the number one priority of pharmaceutical companies will be to make money and pad their bonuses.

Screen Time Can Affect Your Health

Photo by Jordan

It’s almost impossible to get away from the screen these days! We have work, computers, video games, social media, televisions, and let’s not forget our smart phones! Screen time is the amount of time spent using a device with a screen. Over the years, that time has increased dramatically, especially since the pandemic.

Adverse health risks associated with increased screen time:

  • Obesity-because of sedentary behavior while using the electronic devices, and this in turn can lead to other chronic illnesses
  • Chronic neck and back pain, poor posture
  • Depression and anxiety
  • Poor sleep-blue light emitted from digital screens interferes with the production of the sleep hormone melatonin in the body.
  • Physical strain to eyes. Remember, Take a screen break every 20 minutes for 20 seconds looking at something 20 feet away(20-20-20 rule) to prevent eye strain
  • Impaired socializing skills

How much screen time is too much?

  • No screen time for kids younger than 18-24 months
  • Children ages 2 to 5 years-American Academy of Pediatrics recommends about 1 hour a day of high quality programming(such as Sesame Street) A study that began in 2018 by National Institutes of Health (NIH) found that children who spent more than two hours a day on screen-time activities scored lower on language and thinking tests, those that spent more than seven hours a day of screen time had thinning of the brain’s cortex that may impact critical thinking and reasoning.
  • Adults-less than 2 hours a day outside of work use

Tips to reduce screen time:

  • Engage in more physical activity-walks, work-outs
  • Play board games with the family, read books, build puzzles, legos, listen to music, cook
  • Set aside times to “un-plug” from electrical devices as a family
  • Keep some rooms screen-free

After Exercise Care

Photo by Karsten Winegeart

We have all had those really great work-outs where we feel amazing afterwards…until the next day…then those muscle aches and soreness sets in.

This is called delayed onset muscle soreness(DOMS) and is normal after a new exercise or taking a familiar exercise up a notch. DOMS occurs about 12-24 hours following a work-out due to small microtears of the muscles. The muscle fibers due build back following these tears and recover and become stronger.

With time(few days to about a week), the muscle pain and soreness will go away. In the meantime, there are some things you can do:

  • Drink plenty of water
  • Continue with light activity-yes, you are sore but don’t just sit on the sofa, you need blood flow to your muscles to help in healing. Do light activity such as walking and stretching exercises
  • Make sure you eat protein-protein is needed to build back your muscle
  • Local pain relief such as heat therapy or cold therapy-for example, a warm shower
  • Massaging tender areas with your hands, foam roller, or massage gun
  • OTC anti-infammatory medication if you are really sore, but be cautious with this. Get yourself checked out with a doctor if you have to take OTC medications for more than a couple of days to make sure you don’t have a bigger injury.

It is sometimes hard to prevent DOMS from occurring but some things that may help or reduce the risk:

  • Don’t forget that 10 minute warm-up before your work-out and 10 minute cool down
  • Go slow with a new exercise routine and build up to the intensity you would like gradually
  • Hydrate yourself with plenty of water
  • Have recovery days where you do light activity such as walking, hiking, yoga, etc

Remember, the most important thing is you keep working on physical fitness and make it a part of your lifestyle.

Exercise and Electrolytes

Photo by Towfiqu barbhuiya

Water is by far the best drink for our bodies. But what about those times when you are are working out vigorously in the gym, playing a basketball game, or going for a long hike? At those times, it may be a good idea to think about the elctrolytes you may need to replenish. When we perspire, we lose electrolytes with that salty sweat. The main electrolytes lost are sodium, potassium, and magnesium. Later on, symptoms such as feeling thirsty, muscle cramps, salt craving, and sometimes muscle twitching can occur.

Prevent electrolyte issues

  • Hydrate early and start with water, let your thirst guide you
  • If you are doing a high intensity work-out, it’s hot outside, or you are sweating alot, then look to either have electrolyte drinks or water with a salty snack and/or banana. The main electrolytes in a sports drink is sodium and potassium which you can get in your snack when paired with water.
  • Beware of the sugar and carbohydrate content of sports drinks which have elctrolytes.

Some altertnatives to electrolyte water

  • Coconut water(unsweetened) is an alternative to sports drinks as you can avoid the sugar but it also contains less sodium than sports drinks do
  • Smoothies
  • Milk
  • Orange juice

The big question to drink electrolyte drinks or not should depend on your work-out, how intense your session is, and how much you sweat. On an average, if you have an hour long high intensity work out, you need to have water with a snack(that will replenish electrolytes such as sodium, potassium, and magnesium) or an elctrolyte/sports drink.

Mechanics of the Proper Walk

Photo by Sincerely Media

Just about all doctors, every chance they get, will tell their patients to take walks as often and as much as they can. Walking is one of the best exercises we can do for ourselves and has many health benefits. It is worthwhile to look at the mechanics of walking to make sure our walks are as effective as they should be.

Proper walking tips

  • Good posture-stand up tall with back straight, don’t slouch, slightly tighten your stomach muscles to engage your core, hold your head up straight, shrug your shoulders and let them relax

  • Let your arms swing naturally with slight elbow bend-opposite arm swing helps to maintain balance

  • Walk from heel-to-toe. Strike the ground with your heel and roll through to the toes

  • Wear proper shoes which are comfortable and tie your laces properly

  • Don’t overstride. Taking a longer step to increase your speed can cause mechanical stress to ankle, knees, and hip joints. You can increase your speed but keep the same walk stride.

  • Choose the right location, it could be your own neighborhood or nearby park-somewhere convenient so you don’t have to go out of your way and will give your more walk time

  • Challenge yourself-walking on a flat surface is nice, but going up and down hills will increase cardiovascular benefits

  • Balance the weight-often, walking to work entails carrying a purse or bag which we often place on one shoulder preferentially. Try to keep things balanced, if you carry the weight of your laptop bag on your right shoulder for 15 minutes, make that conscious attempt to change it to your left shoulder for the next 15 minutes.

Coffee Is Good for the Heart

Photo by Jessica Lewis

International Coffee day is celebrated October 1st and a new study was just published in European Journal of Preventive Cardiology that backs up that coffee is actually good for the heart.

In the study, about 450,000 adults from UK Biobank were followed for a period of 12.5 years and results showed that all types of coffee intake were associated with reduction in death from any cause. Drinking two to three cups of coffee a day was linked to the largest benefit.

In this large prospective cohort study, associations between habitual coffee intake, impact of all coffee subtypes, including decaffeinated coffee, and major cardiovascular endpoints were studied. The main findings from the study are:

  • Ground, instant, and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and all-cause mortality.
  • Two to three cups/day of all coffee subtypes was consistently associated with the largest risk reduction of heart diseasse and all-cause mortality.
  • Ground and instant coffee but not decaffeinated were associated with a reduction in heart rhythm abnormalities.

So, it turns out coffee is actually good for you. Among other countless benefits of coffee, drinking two to three cups of coffee, caffeinated or decaffeinated, will improve longevity and heart disease. So grab that cup of coffee…or two….or three….and enjoy!

One More Reason to Walk

Photo by Thom Milkovic

The first thing everyone should be doing after having that nice big meal is taking a walk. We all know walking is good for us……but many of us may not know that it also helps to keep our blood sugars in check. Now, we have some evidence to back it up.

A meta analysis of seven studies was published in the Journal of Sports Medicine that looked at the impact of sitting, standing, and walking on insulin levels and blood glucose levels.

It found that individuals that had a short walk after eating(could be as short as 2 to 5 minutes) had gradual rise and fall of blood sugar level and also their insulin levels were more stable than either standing or sitting. Standing was better than going straight to the couch but this did not lower insulin in the blood stream.

The key points as quoted in the study:

-“This meta-analysis of seven acute studies found intermittent short breaks of standing led to a significant reduction in postprandial glucose compared to prolonged sitting.
-Light-intensity walking was found to be a superior intervention compared to standing and prolonged sitting.
-The effects of breaking prolonged sitting were more pronounced in overweight individuals compared to individuals with obesity, suggesting an additional metabolic compromise in individuals with obesity.”

To summarize, taking a quick walk after meals was shown to improve blood sugar levels. This is likely because you are moving your muscles which need glucose to function and therefore helps in lowering blood glucose level. If you can’t take that quick walk, standing helps, but is not as beneficial. Sitting right after a meal is a “No No”.

So, this study is telling us so far what every study has. You should walk every chance you get. There are numerous benefits of walking. If you can’t walk, then stand. And all though it may be tempting, don’t go for that sofa right after a meal.

Be Kind

Photo by Dayne Topkin

Some things to keep in mind on National Thoughtful Day on August 28th and to follow all year round:

  • Be kind to others
  • Be considerate about others around you
  • Help others if you are in a position to help
  • Put yourselves in others shoes before reacting or saying something not so nice. Remember words can hurt.
  • Be on time if you have a meeting/commitment/event. Everyone’s time is just as valuable as yours.
  • Smile
  • Be polite

Being thoughtful has many health benefits and your thoughtfulness will not only brighten up someone else’s day but also yours.

“The simplest acts of kindness are by far more powerful than a thousand heads bowing in prayer.” -Mahatma Gandhi.

Ways to Boost Your Metabolism

Photo by Jozsef Hocza

Remember those days in our teens and twenties when you could eat just about anything and not gain a pound, still look and feel good, and fit into your clothes. Well, then we got older and it became a lot harder to maintain that body weight and physique. So, what happened? We may have changed our active lifestyles as the stress of adulthood hit. Also, that thing called “metabolism” slowed down.

Metabolism is the process in which the food and drinks we consume are broken down into energy the body needs to function. Basal metabolic rate refers to the number of calories you burn at rest. The higher your basal metabolic rate, the more calories you burn at rest.

Things that affect metabolism include what we eat, activity status, and body composition, in particulary muscle mass and body fat. Men tend to have higher metabolism women due to having more muscle mass. At a younger age, your muscle mass stores up energy preventing unnecessary weight gain. As we age, that muscle mass decreases and is replaced by more body fat.

Some tips to boost metabolism

  • Exercise more and add high intensity interval training and weights to your work-outs
  • Eat well enough that you are not hungry.
    • Try not to skip meals, especially breakfast (breakfast wakes your body up and also kickstarts your metabolism).
    • You need to eat enough calories for your body to function and not cut into your body stores. If you don’t eat enough calories, your body will actually decrease your basal metabolic rate to conserve energy. For example if your body needs are 1200 calories/day, make sure you eat that much.
  • Get adequate sleep
  • Eat fat burning foods
    • Protein-having protein at every meal helps build fat-burning lean muscle and also helps with post-meal calorie burn
    • Spicy peppers have capsaicin that can boost your metabolism
    • Eat high fiber diet with vegetables and fruit
    • Eat iron rich food(beans, fortified cereals, spinach, broccoli, green peas) as they carry oxygen your body needs to burn fat
  • Drink tea or coffee-has antioxidant catechins, caffeine can temporarily boost metabolism
  • Drink more water-it will temporarily increase your metabolism and help you fill full
  • Stand up more and take walks-sitting burns less calories and has negative health result

There is no easy way to get your metabolism kickstarted but eating balanced nutritious meals, following an exercise routine, and getting plenty of sleep and rest can help. Having a higher metabolism/higher basal metabolic rate will help in shedding off the pounds but finding the best plan that will work may take some trial and error. Keep the big picture in mind…..a version of you that you can be proud of.