Geridoc

Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Layering of Clothes Will Keep You Warm

Photo by Clark Street Mercantile

It’s winter…and it can get really cold out there. Layering of clothes is important to do in the cold. It is a term used to describe wearing garments on top of each other. When planning an outing in the snow or winter, you have to be prepared and pack accordingly.

So what are the basics of layering of clothes? Three layers is what is felt to be just right.

  • Inner layer-you need a base or inner layer which will keep the sweat off your skin
    • Synthetic material-something like polyester or polyamide, water resistant, dries quickly
    • Merino wool-natural material, good aborbent, prevents odors
  • Middle layer-this provides insulation to protect against the cold and retain body heat
    • Fleece, down, or synthetic jackets, fleece leggings
  • Outer layer-protects from outdoor elements such as rain or snow
    • Waterproof coats

Also, don’t forget the appropriate socks, gloves, hats, and scarves you may need depending on where you are off to. It is better to be prepared then not have the right amount and type of clothes. After all, you can always remove outer layers or decide not to wear them. The important thing is to enjoy those outings while staying warm and preventing yourself from getting sick during the winter.

All the Reasons Why You Should Do Push-ups

Photo by Ayo Ogunseinde

You may often hear of people talking of taking part in numerous activities (swimming, jogging, tennis, aerobics, yoga, etc), but not many people rave about doing push-ups on a regular basis. Push-ups are often an overlooked exercise, but something definitely worth considering.

There was a study published in JAMA in 2019 that should make everybody want to incorporate this into their workout mojo. This decade long study of male firefighters aged 18 and above found that those that could do more than 40 push-ups had a significant decrease in cardiovascular disease compared to those who could do 10 or fewer push-ups.

Benefits of push-ups

  • Target multiple muscles-arms, shoulders, core, and back
  • Improves strength-particularly upper body, they help strengthen biceps, triceps, and also abdominals
  • Enhances stamina
  • Does not require specific equipment and you can do it any time of the day at your convenience
  • Helps build muscle and tone, also strengthens joints
  • Improves posture and strengthen lower back
  • Improves flexibility
  • Stabilizes and conditions shoulder muscles
  • Gets your heart rate up allowing pumping of oxygen throughout your body
  • Considered weight bearing exercise so helps build bone density

Why You Should Eat Omega 3 Fatty Acids

Photo by Tom Hermans

There have been two recent studies that have come out that have concluded improved longevity for those who have diets with higher amounts of Omega 3 fatty acids.

What are Omega 3 Fatty acids?

  • They are essential fatty acids that you can only get from your diet.
  • The body uses omega-3 fatty acids to maintain cell function as well as an energy source.
  • There are 3 main types
    • ALA (alpha-linolenic acid) plant based source
    • DHA (docosahexaenoic acid) animal source
    • EPA (eicosapentaenoic acid) animal source

Health benefits

  • Reduced risk of inflammatory diseases
  • Helps with depression and anxiety symptoms
  • Good for eye health
  • Reduces risk of cardiovascular disease
  • Helps with arthritis and reduces joint pain
  • Supports development of fetal brain during pregnancy and reduces incidence of preterm labor
  • Reduces premature aging of skin, reduces risk of acne

Foods that contain Omega 3 fatty acids

Fish oil, fatty fish, flaxseed, flaxseed oil, soybeans, canola oil, walnuts, chia seeds (Flaxseeds and flaxseed oil contrain 45-55% of fatty acids as ALA, walnuts contain about 5-10% of fatty acids as ALA).

Relevant studies

  • A study published in June 2021 in the American Journal of Clinical Nutrtion tracked 2240 people over 11 years and omega-3 levels in the blood checked. It was found that nonsmokers with high omega-3 blood levels had highest survival estimate. Researchers concluded that those over the age of 65 years with higher omega-3 blood levels had a lower mortality rate.

  • A meta-analysis of 41 studies published in the British Medical Journal published on October 14, 2021 found that those with diets with higher levels of ALA had associations with overall lower mortality risk.

Indoor Activities for the Fall and Winter

Photo by Kelly Sikkema

As the weather becomes colder, it becomes more difficult to enjoy all those outdoor activities. Many people have a notable decrease in their activity level because of the weather. So what are some things that can be done indoors and still keep you working on your fitness?

  • Walking around the house
  • Hula hooping
  • Push ups
  • Jumping jacks
  • Running on the spot
  • Sit ups
  • Aerobics
  • Resistance bands
  • Weights
  • Lunges
  • Planks
  • Squats
  • Burpees
  • High knees
  • Leg raises
  • Climbing stairs
  • Yoga

Even if you don’t have a home gym or exercise machine, there are many things that can be done at home. There are a ton of videos online with exercise ideas and work outs, all it takes is effort and some determination.

Chocolate Does Come With Some Health Benefits

Photo by Louis Hansel

Who doesn’t love chocolate? We all have our favorites, be it milk, dark, white chocolate, or another. Most of us are also careful about our chocolate intake due to worries of the calories and sugar that come along with the chocolate bliss.

Mild chocolate and white chocolate have more calcium and protein because of more milk powder content but may also have more sugar. Luckily, chocolate, particularly dark, also comes with some health benefits.

  • Contain antioxidants-the darker the chocolate, the higher the concentration of cocoa and higher the level of antioxidants
  • Contain flavonoids which help stimulate blood flow
    • Increased blood circulation to scalp results in thicker hair
  • Natural source of magnesium (mineral essential for brain health)
    • Can help with concentration and alertness
    • Helps with pituitary gland function, lowers cortisol production, relieving stress and also stimulates serotonin production which makes you feel happy
  • Contains phenolics, an antioxidant that boosts the immune system
  • Can reduce bad cholesterol (low-density lipoprotein or LDL) and improved good cholesterol (HDL)

National Chocolate Day is on October 28th so don’t forget to enjoy a piece and don’t feel too guilty about it! Yes, it does has sugar and calories, but smart choices can be made, for example chocolate with nuts. Like everything else…moderation.

An Apple a Day

Photo by Javier Balseiro

We’ve all heard “an apple a day keeps the doctor away". This proverb initially appeared in the 19th century to get people to eat nutritious foods to stay healthy.

National Apple day, October 21st, gives us the opportunity to review the health benefits of apples.

  • Helps to maintain weight or even lose weight-makes you feel full, on average apple is about 95 calories
  • Contains antioxidants
  • Heart healthy-contains flavonoids which reduces inflammation
  • Helps in digestion as it contains fiber
  • Helps prevent Type 2 Diabetes-soluble fiber can help slow the absorption of sugar
  • Helps with memory and may prevent Alzheimer’s disease because it contains plant pigment quercetin, a flavonoid which protects cells including brain cells
  • Promotes bone density and strength
  • Keep the peel on if you can-it contains fiber and antioxidants
  • Helps your immunity-contains about 10–14% of the Vitamin C you need, also has the flavonoid quercetin which reduces inflammation and regulates the immune system, helps with asthma and allergic reactions

Apples are healthiest when you eat them fresh but get creative if you need. Try out all those apple recipes, be it apple pie, apple crisp, apple sauce….or grab another fruit! Remember that the whole point is to get those nutrients, whatever fruit it may be, so you can reap those health benefits.

How Much Protein Should You Be Eating?

Photo by Caroline Attwood

What is protein?

Protein is one of three macronutrients the body needs in large amounts along with fat and carbohydrates.

Proteins are made of smaller components known as amino acids which attach to each other to form chains. The sequence of these amino acid chains determine the specific structure and function of the protein. Proteins are found through out the body and are needed for growth and maintenance of our tissues, serve as enzymes that work on biochemical reactions, regulate body processes including fluid balance, help form antibodies to fight infection, and serve as transport proteins for nutrients and oxygen.

How much protein should you be eating?

The recommended daily allowance for protein is 0.8 to 1 gram/kg of body weight or 0.36 gram/pound of body weight. The protein need depends on activity level, age, muscle mass, and overall health. Those who exercise regularly and the elderly require more protein.

The elderly and protein

After the age of 40, studies show that skeletal muscle mass and strength decline. The involuntary age-related loss of muscle mass and strength is known as sarcopenia.

50% of elderly adults do not get enough protein which is an alarming number as muscle mass is important in maintaining strength, function, and preventing falls.

Most elderly adults require more protein, about 1.0 – 1.2 grams of protein/kg body weight

Sources of protein

The body does not store protein so it’s important to get it from your diet. Protein in diet is broken down into amino acids. There are two sources of protein: animal proteins and plant proteins.

Animal proteins

Plant proteins

  • Incomplete as they lack one or more of the essential amino acids that the body needs
  • Beans, nuts, lentils, tofu, edamame, quinoa, peanut butter, chia seeds, chickpeas, green peas, oats, vegetables(broccoli, spinach, potatoes)
  • Diet high in plant protein is associated with lower risk of heart disease, obesity, and diabetes

Most people don’t keep track of how much protein they are eating a day but it is one of the things that we really should be doing. Although it is always good to try to get protein from your diet, sometimes that is not enough and you may need to supplement it with protein bars, protein shakes, or eating an extra yogurt serving (be sure to read labels because of the hidden sugar content that can be found in yogurt, protein shakes, etc.).

FDA Urging Less Salt



Finally!!! The salt content in processed food and restaurant food has been incredibly high and contributing to poor overall health for us all. Although the goal to cut average sodium level from 3400 mg to 3000 mg a day over the next 2.5 years is still above the recommended allowance of about 2300 mg a day, this is an important step in the right direction and will make a difference in preventing chronic illnesses.

Hand Washing 101

Photo by Mélissa Jeanty

Throughout the day, we touch surfaces, objects, as well as other people and may accumulate germs which we can then spread to others as well as ourselves by touching our eyes, mouth, or nose. Hand washing keeps us safe and healthy by killing germs. The pandemic has brought the limelight to hand hygiene in the prevention of spread of COVID. Global handwashing day is observed each year on October 15th and is a good time to go over some quick pointers.

When should you wash your hands?

  • When you have been out (touched public doors, elevator buttons, gas pumps, grocery shopping)
  • Preparing food (also before and after eating)
  • After using the restroom
  • After blowing your nose or sneezing
  • Handling garbage
  • Touching your mask
  • Pet care

How to wash your hands?

Use clean, running water for at least 20 seconds with soap and water, forming a good lather and scrubbing the front and back of your hands, between your fingers, and under your finger nails, and wrist. Rinse well afterwards and dry with a clean towel or air-dryer.

Are hand sanitizers okay?

Hand sanitizers are a good alternative when out and about. Use a hand sanitizer with at least 60% alcohol. Hand washing is always better than using a hand sanitizer as hand sanitizers do not get rid of all types of germs.

Should we moisturize our hands?

For those who wash their hands frequently, like healthcare workers, it is important to keep up with moisturizing their hands to prevent dry skin.

Waning Immunity Against COVID-19

Photo by Parang Mehta

On July 30, 2021, Israel became the first nation in the world to initiate a third booster dose of the BNT162b2 vaccine against COVID for those above 60 years of age who had been vaccinated at least 5 months earlier. Now, it has been extended to the whole population. A study published in NEJM found that the confirmed infection rate and severe illness were lower among those who received a booster dose of the BNT162b2 vaccine.

Now another study has looked into waning immunity:

In a retrospective cohort study, electronic health records of about 3.4 million patients 12 years and older from Kaiser Permanente in Southern California from December 14, 2020 to August 8, 2021 were reviewed for SARS-CoV-2 PCR-positive tests and COVID-19-related hospital admissions. This Pfizer funded study published on 10/4/21 in The Lancet showed that vaccine effectiveness dropped from 88% in the first month post full vaccination to about 47% after five months.

Although this shows the reasoning behind the booster dose recommendation for those eligible for it, there are limitations to this study. We don’t know the risk level of those that had breakthrough infections such as occupational risk as seen with healthcare professionals. It also does not take into account adherence to masks or social distancing. It will be interesting to see what conclusions come about from other studies.