Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Incorporate Fiber in Your Diet

Photo by Jannis Brandt

You may have heard that fruits and vegetables are good for you not just because of all the nutrients they provide but also because of their fiber content. Fiber is actually a requirement for your body to function. Dietary fiber include the parts of plant foods that the body cannot digest or absorb. There are 2 types of fiber: soluble and insoluble.


Soluble fiber

  • Dissolves in water to form a gel-like material. It can be metabolized by the “good” bacteria in the gut and function as prebiotics.
  • It can help lower blood cholesterol and glucose levels.
  • Soluble fiber is found in oats, peas, beans, apples, nuts, oatmeal, lentils, citrus fruits, carrots, barley and psyllium.

Insoluble fiber

  • Does not dissolve in water, promotes the movement of material through your digestive system and increases stool bulk.
  • Whole-wheat flour, wheat bran, nuts, beans and vegetables, such as cauliflower, green beans and potatoes, are good sources of insoluble fiber.

Benefits of fiber intake

  • Keeps your digestive system in shape-normalizes bowel movements, reduces risk of developing hemorrhoids, diverticular disease, and studies have shown may reduce risk of colorectal cancer.
  • High fiber diet has been shown to reduce risk of cardiovascular disease(heart disease and stroke).
  • Lowers cholesterol level.
  • Helps in achieving and maintaining healthy weight-high-fiber foods make you feel full preventing increased eating/snacking.
  • Helps to control blood sugar- slows the absorption of sugar and helps improve blood sugar levels.
  • Improves longevity- Studies have shown that fiber, especially cereal fiber — is associated with a reduced risk of dying from cardiovascular disease and all cancers.

Recommendation of fiber intake

  • The American Health Association recommends 25 to 30 grams a day from food, not supplements.

Tips for fitting in more fiber in diet

  • Make breakfast count-look for cereals with whole grain, choose whole wheat bread
  • Incorporate beans, peas, lentils to your diet
  • Eat more fruit and vegetables
  • Snack on nuts, dried fruit, whole grain crackers

Now, before going all in on a high fiber diet, remember to do it gradually over a few weeks. When the gut flora/bacteria ferment the fiber, they produce gases wich can lead to abdominal bloating or intestinal gas. These side effects usually go away with time as your body adjusts. Remember to increase your water intake as you increase your fiber intake.

Our Connection With Our Moms

Per Caitlin Beale, MS, RDN in Motherly “What is microchimerism? Tiny cellular souvenirs may keep you connected to your baby long after pregnancy”.

“They say being a parent is like having your heart walk outside your body. While it may feel true that your baby is now part of you in a figurative sense, it turns out there’s science to suggest that’s literally the case. During pregnancy, fetal cells can pass through the placenta into the mother’s bloodstream and take up residence—a phenomenon called microchimerism.

A mother passes nutrients, air, water and other vital materials to the baby via the placenta during pregnancy. In return, the baby gives mama a tiny present that lasts for years, decades or even her lifetime. You may carry cells from your children and your mother simultaneously—highlighting the deep connection between parent, child and even between generations."

Mother’s Day is a great time to celebrate the literal physical and emotional bond we share with our Moms and be grateful!

Cardiorespiratory Fitness Reduces Mortality

Per ScienceDaily “Cardio-fitness cuts death and disease by nearly 20%”.

“Running, cycling, or swimming – if you regularly exercise, you’re well on track for a long and healthy life, as groundbreaking new research from the University of South Australia finds that an increased cardio fitness level will reduce your risk of death from any cause by 11-17%.

Published in BJSM, the study found that for every 1-MET increase in cardiorespiratory fitness – the amount of energy used for quiet sitting – a person can reduce their risk of death by 11-17%, and specifically, their risk of heart disease by 18%.

Comprising 26 systematic reviews with meta-analysis representing more than 20.9 million observations from 199 unique cohort studies, it is the first study to collate all the scientific evidence that looked at the prospective link between" cardiorespiratory fitness and health outcomes among adults.“

Cardiovascular fitness or aerobic fitness measures how well your heart, lungs, and blood vessels supply and deliver oxygen to your muscles and organs during sustained physical actiivy. Aerobic exercise(running, swimming, cycling, brisk walking, aerobic exercise classes) maintains cardiovascular fitness. The study reinforces the fact that you need to get in that physical activity….. remember something is better than nothing.

Are Young Americans Happy?

Per Solycyre Burga in “U.S. Falls Out of Top 20 Happiest Countries for the First Time Ever”.

“For the first time in the World Happiness Report’s dozen-year history, the U.S. did not rank in the top 20 of the world’s happiest countries.

Out of the more than 140 nations surveyed, the U.S. landed in 23rd place, compared to 15th place in 2023. While the U.S. is still in the top 10 happiest countries for those 60 years old and above, its overall ranking fell due to a significant decline in the reported well-being of Americans under 30.

Finland ranked at the top of the list for the seventh year in a row. Lithuania is the happiest country in the world if you only look at those under the age of 30, while Denmark is the happiest country for people who are 60 and older……..

According to the report, people born before 1965 are, on average, happier than people born after 1980. Millennials report drops in their life satisfaction with every year they grow older, while boomers’ happiness increases the older they get."

The 2024 World Happiness report was released by Gallup and its partners on March 20, 2024 and looked at 3 year average from 2021 to 2023. The U.S ranked 62nd just at looking at the happiness of people under the age of 30 and came in 10th when looking at people over the age of 60. A lot can be said for Finland who has maintained the top spot for the last 7 years. Maybe other nations should learn from them.

Practice Safety During the Solar Eclipse

Photo by Jongsun Lee

The Great North American Solar Eclipse is coming on Monday, April 8, 2024. While there is much excitement and planning taking place with some people even traveling to areas of totality to experience this event, it is first and foremost important to practice safety. Keep in mind that looking at this total solar eclipse, untraviolet and infrared solar rays can cause direct serious, permanent eye damage to the retina. Some of the vision changes that can occur are blurry vision, headache, a blind spot in the central vision, sensitivity to light, changes in color perception, and distorted vision.

Here are some safety tips:

  • Safest way is to avoid looking at the sun directly and instead viewing it indirectly, either through a pinhole projector, colander, or on a television or computer screen
  • If you do plan to watch the solar eclipse directly, use specially designed eclipse glasses. Eclipse glasses must comply with the International Organization for Standardization (ISO) 12312-2 standard. They screen out 99.99 percent of the light, about a thousand times the blockage of standard sunglasses. Do not use damaged eclipse glasses with scratches or tears.
  • Find a safe place to watch the eclipse
  • Have headlights on while driving during the eclipse and beware of vehicles that may be pulled over on the side of the road to watch
  • NASA advices against looking at the sun through regular sunglasses, camera lens, telescope, or binoculars with eclipse glasses or handheld solar viewers as the concentrated solar rays will burn through the filter and cause serious eye injury
  • Remember to protect your skin-wear sunscreen, protective clothing/hats

AI Healthcare Agents

NVIDIA is partnering up with the healthcare startup Hippocratic AI to develop AI-powered “agents” for the healthcare arena. These AI nurses are intended to provide basic medical advice for $9 per hour which is less than the average pay of about $40 per hour for a “human” nurse. Everyone is different with unique healthcare needs so I cannort see this replacing nurses but may be a back up or extra layer for simple things like providing education to patients. As the healthcare worker shortage continues to loom, it will be interesting to see what the future holds and what role these AI healthcare agents take on.

Take Care of Your Kidneys

Photo by julien Tromeur

Kidney disease affects about 10% of the global population and about 1 in 7 Americans. In addition, 1 out of 3 US adults are at risk for kidney disease. As the early stages of chronic kidney disease are aysmptomatic, most people don’t even know that they have it. March is National Kidney Month so a good time to talk about these 2 fist-sized bean-shaped organs.

What do kidneys do?

  • Filters wastes and toxins from the blood
  • Regulates fluid levels in the body
  • Activates Vitamin D which is needed for healthy bone
  • Helps in production of red blood cells
  • Keeps minerals in balance
  • Regulates blood pressure

Who is at risk for kidney disease

  • Diabetes mellitus
  • Hypertension
  • Heart disease
  • Family history of kidney disease
  • Age >65 years

Work on a kidney healthy lifestyle

  • Eat healthy foods
  • Drink plenty of water-about 48-64 oz a day, this will also help to prevent kidney stones
  • Aim to stay active for about 30 minutes a day
  • Get some good quality sleep-about 7-8 hours/night
  • Get your risk factors in control-quit smoking, take your medications, and work with your doctor to get chronic diseases controlled

Pig Kidney Transplant

The kidneys are the most transplanted organ in the US and about 92,000 people are on the wait list awaiting a kidney transplant. Many others are on dialysis which affects their everyday quality of life. Today markes a day of promise for the future.

Walking 15,000 Steps a Week Can Add Up to 3 Years to Your Life

Per Kate Pickles in “Walking just 15,000 steps a week could add three years to your life, claims study”.

“Getting inactive people to walk just 5,000 steps three times a week could save the NHS £15billion, new research suggests.

Replacing lazy lifestyles with moderate levels of activity would make a significant difference to the nation’s overall health, a study found.

Research conducted by insurers Vitality and the London School of Economic suggests adopting habitual exercise can also add up to three years to life expectancy.

Major positive impacts were seen at all age groups, but it was particularly true for older generations.

There was a 52 per cent reduction in mortality risk for over-65s who regularly undertook 7,500 steps three or more times a week, they found.

Sustaining a healthy physical activity habit — at least 5,000 steps three times per week for two years — can add between 2.5 years for men, and 3 years for women to life expectancy, they found

It also led to lower rates of type 2 diabetes and reduced the death risk in those who already had it by 40 per cent.“

The gist of it……get walking!

Blood Test for Colorectal Cancer Screening

Per Allison Aubrey in NPR “A simple blood test can detect colorectal cancer early, study finds”.

“At a time when colorectal cancer is on the rise, a new study finds the disease can be detected through a blood test.

The results of a clinical trial, published Wednesday, in The New England Journal of Medicine, show that the blood-based screening test detects 83% of people with colorectal cancer. If the FDA approves it, the blood test would be another screening tool to detect the cancer at an early stage.

The test, developed by Guardant Health, can be done from a blood draw. The company says its test detects cancer signals in the bloodstream by identifying circulating tumor DNA. “

This study showed the blood test is less effective in detecting the earliest signs of colorectal cancer and only found 13% percent of earlier stage polyps. It would be nice if it could pick up on earlier stages but the test works by detecting tumor DNA making it harder to detect precancerous polyps. Regardless, this would be a much more easier test to get than what we have available. Although the gold standard for screening is colonoscopy, this blood test, if gets FDA approval, may provide an alternative to colonoscopy and stool testing in some individuals.