Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Tips to Stay Cool in the Heat

Photo by Jared Rice

The heatwave continues in some parts of the country and even the globe. Here are some tips to stay cool in the heat:

  • Plan errands and outdoor work/activities in the morning or evening when sun goes down if possible. Try to avoid sun exposure between 11 AM and 2 PM when the sun is the hottest.
  • Place ice cubes in your water bottle if outside
  • Block out windows with curtains or darker sheet during the daytime to keep heat out
  • Spray yourself with water with mist of cool or room temperature water
  • Limit use of stove and oven as it will make your house get hotter
  • Stay hydrated
  • Eat foods that have water content such as fruits. If you have salty foods, drink enough water
  • Eat spicy food-if will make you sweat and therefore cool you down
  • Take cool showers to cool down
  • Dress in loose, light colored clothing, look for UV protection with ultraviolet protection factor(UPF) of at least 30. Look for cotton clothes as it absorbs sweat.
  • Use sunscreen
  • Protect your eyes with sunglasses when outdoors
  • Stay in air conditioned indoors as much as possible

Tap Water May Contain Chemicals

Per John Flesher in an article published in Time, “Drinking Water From Nearly Half of U.S. Faucets Likely Contains ‘Forever Chemicals’ Study Warns”

“Drinking water from nearly half of U.S. faucets likely contains “forever chemicals” that may cause cancer and other health problems, according to a government study. The synthetic compounds known collectively as PFAS are contaminating drinking water to varying extents in large cities and small towns — and in private wells and public systems, the U.S. Geological Survey said.

The USGS report was based on samples from taps in 716 locations, including 447 that rely on public supplies and 269 using private wells. The samples were taken between 2016 and 2021 in a range of locations — mostly residences but also a few schools and offices. They included protected lands such as national parks; residential and rural areas with no identified PFAS sources; and urban centers with industry or waste sites known to generate PFAS. Based on the data, researchers estimated that at least one form of PFAS could be found in about 45% of tap water samples nationwide..

PFAS(per- and polyfluorinated alkyl substances) are synthetic chemicals that are hazardous to human health. They can be found in tons of everyday items we are exposed to… linings of fast-food boxes and wraps, used as grease-proofing agent in microwave popcorn bags, non-stick cookware, used to make clothes and carpet stain-resistant,etc. Exposure has been assocaiated with obesity, cancer, thyroid disease, decreased fertility, liver damage, high cholesterol, and high blood pressure.

So, what can you do? Get educated about your tap water. Look into the water quality report called the Consumer Confidence Report(CCR) if you get municipal water. Those on well water do not get a CCR so would have to get water tested. Consider installing a water filter that is certified to lower the levels of PFAS in your water.

The Nutritional Power of Blueberries

Photo by Joanna Kosinska

July is National Blueberry Month and July 8 is National Blueberry Day so what better time to enjoy those blueberries and see why they have earned the title of “superfood”.

Nutritional facts:

  • Low glycemic index
  • High fiber content
  • Low calorie(1 cup of blueberries(150 grams) provides about 84 calories)
  • Rich in nutrients(high in vitamin C, vitamin K, vitamin B6, manganese, folic acid, potassium)
  • High in water(about 85% water) so hydrating snack

Research has demonstrated health benefits

  • High antioxidant properties-studies suggest blueberries contain the highest amount of antioxidants than other fruits and vegetables. They contain Polyphenols and Anthocyanins(responsible for blue color of blueberries)
  • Protects bone health
  • Improves cholesterol, is linked to reduced levels of LDL(bad cholesterol)
  • Helps lower blood pressure
  • Helps prevent heart disease
  • Improves brain health

Get creative with those blueberries, eat them as a snack, make some nice blueberry desserts, add them to cereals, pancakes, oatmeal, yogurt, salads, smoothies, or something else. The important thing is reaping the benefits of blueberries while enjoying them.

Mediterranean Diet Explained

Photo by Anna Pelzer

There has been a lot of hype about the Mediterranean Diet especially since it’s been found in studies to have lots of health benefits. It was found in the 1950s that heart disease was not as common in Mediterranean countries(countries around the Mediterranean sea) as it was in the U.S which prompted many studies which confirmed that Mediterranean Diet helps prevent heart disease and stroke.

The Mediterranean Diet emphasizes plant-based foods and healthy fats. The diet mostly consists of vegetables, fruits, and whole grains with olive oil being the main source of fat. Olive oil provides monounsaturated fat which lowers total cholesterol and LDL(bad cholesterol). Eating patterns are different across different Mediterranean countries so it is flexible and should be tailored per individual taste.

Guidelines of Mediterranean Diet

  • Lots of vegetables, fruits, beans, nuts, lentils
  • Lots of whole grains like whole wheat bread
  • Plenty of extra virgin olive oil as a source of healthy fat
  • Moderate amount of cheese, yogurt, fish
  • Little or no meat
  • Little or no sweets, sugary drinks, or butter
  • Wine is often associated with Mediterranean diet, but should only be included in moderation and if you don’t drink, don’t start.

Benefits of Mediterranean Diet

  • Lowers blood pressure and cholesterol
  • Supports healthy weight
  • Lowers risk of heart disease(helps arteries stay flexible and resist plaque buildups)
  • Supports healthy balance of gut flora
  • Enhances body’s ability to absorb blood sugar
  • Decreases inflammation
  • Lowers risk of metabolic syndrome
  • Slows the decline of brain function
  • Helps you live longer

Wildfire Smoke Can Affect Your Health

Photo by Ahmer Kalam

This week we saw several states in the US get affected by the Canadian wildfires with concerns of dangerous air quality. In fact, New York City was ranked among the worst in the world on Tuesday and Wednesday.

Unlike normal air pollution, wildfire smoke can linger in the air for weeks and travel hundreds of miles. Wildfire smoke can contain traces of heavy metals, plastics, chemicals, carcinogens, and PM2.5 (fine particular matter under 2.5 microns which are particles 100 times thinner than a human hair). These particles can get deep into airways and leads to more inflammation and tissue damage than air pollution.

  • For healthy individuals with no pre-existing conditions, symptoms range from shortness of breath, wheezing, coughing, eyes irritation, headache, fatique, sinus irritation, itchy skin
  • Those that are high risk include those with underlying lung or heart conditions, elderly, babies, pregnant women
  • Wildfire smoke has been linked to higher rates of strokes, heart attacks, heart failure, weakened immunity, increase respiratory infections.
  • There is concern that the effects of smoke from wildfires can last for few years

What can you do?

  • Check Air Quality Index in your area
  • Those that are living in dangerous air quality areas should stay indoors and close all windows, avoid outdoor activities, and if need to go out for any reason, should be wearing tightfitting mask such as N95 when outdoors.

People Cannot Afford Prescription Medications

Researchers from the National Center for Health Statistics analyzed responses to the 2021 National Health Interview Survey of US households. The report by the US Centers for Disease Control and Prevention found that millions of adults in the United States were not taking medications prescribed to them due to cost.

About 60% of adults aged 18 to 64 years reported taking one prescription medication in 2021. Among those that took prescription medications, 8.2%(about 9.2 million people) did not take medications as prescribed due to cost. Women were more likely than men to not take medication.

The United States is one of the richest countries but the cost of medications, healthcare insurance industry, pharmaceutical companies, all have made it difficult for patients to afford lifesaving medications. It harms the patient to skip medications, ration, delay a prescription refill, or take a lower dose than prescribed and they may eventually end up with other health consequences.

If you are not taking your prescription medication as prescribed, please speak to your healthcare provider, often times there are alternatives available which will cost less or resources available to offset some of the cost.

Changes to Expect With Regular Exercise

Photo by Lucas van Oort

So you’ve been consistently getting in your exercise for the past month and are wondering when you will start to see some results. Don’t stop what you are doing if you don’t see the results. Like anything, this will take time but here is what to expect:

Decrease in heart rate

Like the other muscles in your body, the heart which is also a muscle will get stronger and your heart will pump more blood per beat which will decrease your resting heart rate. You can expect to see this change in a few weeks of consistent work-outs.

Change in blood pressure

  • Going from being relatively sedentary to increasing your step count and getting in some aerobic exercise can decrease both systolic and diastolic blood pressure.
  • After a few weeks, there will also be an improvement in blood pressure for those individuals with borderline elevated blood pressure and those who have hypertension(known elevated blood pressure). However, those with normal blood pressure, will see little overall change.

Muscle fitness

You may notice a little bit of muscle toning in about a month or two, but it may take about 3-6 months to see significant improvement in your muscle fitness when you incorporate regular resistance training in your work-outs. This is because the neruromuscular connetions learn how to more efficiently contract your muscles. Although the results of resistance training are variable from person to person, you will eventually see improvement in strength, muscle tone, and overall fitness.

Weight loss

This again varies from person to person but to really see some significant result, you need to get in 60 minutes or more of activity time.

Improvement in mood

Exercise will lead to an improvement of mood, reduce stress, and help energy levels. It has been found that even a quick 10 minute walk can have these results.

Improved endurance

With continued exercise, endurance will improve. It takes about 8-12 weeks to see improvement in endurance and overall cardiovascular health. There will be more oxygen delivered to the working muscles which will allow for longer work-outs and reduced effort.

Losing That Extra Fat Will Take Some Time

Photo by Siora Photography

It’s been several weeks since you started working out and actually sticking to the schedule but are just not seeing the results. Where and when can you expect to see the results? Each person carries fat differently with genetics, hormones, environment, and lifestyle all playing a role.

Fat is the extra carbohydrate or protein from food that we eat that gets converted into triglycerides and stored in adipocytes in the body. There are 2 types of fat.

  1. Visceral or “hard” fat-this is a dangerous type of white fat that is between, around, and inside organs.
  2. Subcutaneous or “soft” fat-this is located under the skin and is not as dangerous as visceral fat, you can pinch this fat through your skin

When a calorie deficit is created either by reducing oral intake or increasing physical activity, your body draws on the stored triglyceride for fuel but stores are tapped evenly throughout the body so we cannot choose where the body will tap into this.

  • You will first lose the bad visceral fat that surrounds your organs, then you will start burning the soft fat
  • As to where you will lose that soft fat- some say that you lose weight where you last gained it and the first place you gained that fat will be the last to go
  • Spot-training or targeting one body area such as your abdomen does not really work, work on full body work-outs
  • It may be diffcult for women to lose in their hips, butts, and thighs because the fat there is important for child-bearing and related to higher levels of estrogen

How to burn fat effectively

  • Create a calorie deficit(work out and practice intentional eating)
  • Build muscle to increase your basal metabolic rate
  • You need to be consistent and do regular physical activity at least 30 minutes on most days of the week. However to notice significant changes in terms of weight loss, goal will be to be physically active for 60 minutes or more.
  • In about 3-6 months, you will start seeing 25-100% improvement in muscular fitness if you are also doing regular resistance exercise

Remember, it took a long time to build up the fat. It will take some time to get where you want to, but keep with it. You will eventually see that stubborn fat budge away be it in your belly or elsewhere. Your body will look and feel more toned and it will be worth it.

Find That Sense of Purpose

A study published in the journal Preventive Medicine looked at 13,000 US adults aged 50 years and older who self-reported sense of purpose and looked at 8 year mortality risk beginning between 2006 to 2008. It was found that having a higher purpose was associated with lower all-cause mortality. The benefit was evident across gender, race, and ethnicity but was felt to be stronger for women as compared to men.

It has also been found that a sense of purpose in life helps in learning and growth and has been linked to less memory impairment and less functional decline. A sense of purpose not only gives you something to look forward to… be it a goal to achieve, a milestone to reach…. but also indirectly promotes a healthier lifestyle…you will eat better, get more activity in, impart positivity, and laugh more!

What Is Sarcopenia?

Photo by Alexandra Tran

As we age, we lose muscle mass which leads to a decline in muscle strength and function, in medical terms, a condition called sarcopenia. Muscle mass decreases about 5% per decade starting in our 30s. Sarcopenia has been linked to a decreased ability to function in everyday life, to travel, and enjoy activities. It has also been linked to chronic medical illnesses such as hypertension, obesity, type 2 diabetes mellitus, heart disease, and stroke. To help counter these changes, it is important to eat protein as well as work on strength/resistance training, the earlier in life, the better.

The importance of strength/resistance training

  • stimulates muscle growth, function, and enhances muscle tissue quality
  • improves connective tissues strength
  • improves bone mineral density
  • resistance training requires our muscles to contract to lift a heavy object against the pull of gravity. Aim to do this 2 to 3 times a week.
    • weight lifting
    • resistance bands
    • body weight-bearing exercises such as pushups, squats, yoga

How much protein should you eat?

  • 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.
  • Most elderly adults require about 1.0 – 1.2 grams of protein/kg body weight