Geridoc

Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Ways to Minimize Jet Lag

Photo by Eva Darron

It is always exciting to go to a new country and see and experience new things. However, it can be difficult to make the most of a short trip when that jet lag kicks in. Jet lag is a constellation of symptoms such as fatigue, headaches, daytime drowsiness, problem concentrating, stomach/digestive problems, which occur when traveling across different zones. Jet lag occurs when your internal circadian rhythm does not match the local day-night cycle. Jet lag can last for days to weeks. On an average, it takes about one day to adjust to 1 to 1.5 hours of time change. For example, taking an 8 hour flight from Chicago to London will take you around 8 days to fully acclimatize to the new time zone.

Don’t shy away from globetrotting and seeing new and exciting places. Be prepared for the associated jet lag. There is really not way to prevent jet lag but there are some tips to minimize jet lag.

Before traveling:

  • Schedule first few days of activities in new time zone knowing you will be jet lagged-don’t overdo it
  • Minimize stress by preparing early(get packed, get documents in order)
  • Get good quality sleep for few nights before travel so you are going in rested and not in sleep debt

In the plane:

  • As soon as you get on plane, change your clock face to new time on phone, watch, and computer
  • Try to sleep when it is nighttime in the time zone you are going to
  • Keep hydrated-mild dehydration is common when traveling by air and will worsen physical symptoms of jet lag
  • Avoid caffeine and alcohol as both promote dehydration and both also disturb your sleep
  • Move around-walking in cabin, standing up, gentle stretching-prevents muscle stiffness and blood clots

At new destination:

  • Adjust to the sleeping and eating pattern of the new time zone as soon as you arrive
  • Get sunlight in the daytime hours to jump start alertness
  • Exercise in the morning if possible and in the daylight
  • Avoid using sunglasses initially in the first day or so as sunlight will reduce the melatonin your body is producing making your daylight activity hours more productive
  • Drink lots of water as anticipate dehydration from the flight
  • Eat smaller meals that are easy to digest, especially for first few days
  • If you are sleepy during the daytime, take short naps only(less than 30 minutes) so you can sleep at night and get your internal clock synced with new time zone

A Car-free Walkable Community in the United States

Per Oliver Milman, in The Guardian, “People are happier in a walkable neighborhood’: the US community that banned cars”.

“If you were to imagine the first car-free neighborhood built from scratch in the modern US, it would be difficult to conceive such a thing sprouting from the environs of Phoenix, Arizona – a sprawling, concrete incursion into a brutal desert environment that is sometimes derided as the least sustainable city in the country.

But it is here that such a neighborhood, called Culdesac, has taken root. On a 17-acre site that once contained a car body shop and some largely derelict buildings, an unusual experiment has emerged that invites Americans to live in a way that is rare outside of fleeting experiences of college, Disneyland or trips to Europe: a walkable, human-scale community devoid of cars.

Culdesac ushered in its first 36 residents earlier this year and will eventually house around 1,000 people when the full 760 units, arranged in two and three-story buildings, are completed by 2025. In an almost startling departure from the US norm, residents are provided no parking for cars and are encouraged to get rid of them. The apartments are also mixed in with amenities, such as a grocery store, restaurant, yoga studio and bicycle shop, that are usually separated from housing by strict city zoning laws."



Driving to places has become a norm in this country unless you live in a major city downtown such as New York, Chicago, San Francisco. However, the cost of living there is up the roof. This new community is being bolserted as a “5 minute city”(meaning residents can reach all of their daily needs-stores, work, school, dining within 5 minutes by bike, on foot, or personal mobility device). It will be interesting to see how the health of the residents over the next few decades will compare to the rest of the country. This community will be encouraging walking, biking, and everyday social interactions.

Being Vegetarian May Be Linked to Your Genes

Per Kristin Samuelson, in Northwestern Now, “Being a vegetarian may be partly in your genes”.

“From the Impossible Burger to “Meatless Mondays,” going meat-free is certainly in vogue. But a person’s genetic makeup plays a role in determining whether they can stick to a strict vegetarian diet, according to a new Northwestern Medicine study….

To determine whether genetics contribute to one’s ability to adhere to a vegetarian diet, the scientists compared UK Biobank genetic data from 5,324 strict vegetarians (consuming no fish, poultry or red meat) to 329,455 controls. All study participants were white Caucasian to attain a homogeneous sample and avoid confounding by ethnicity. The study identified three genes that are significantly associated with vegetarianism and another 31 genes that are potentially associated. Several of these genes, including two of the top three (NPC1 and RMC1), are involved in lipid (fat) metabolism and/or brain function, the study found….

Religious and moral considerations have been major motivations behind adopting a vegetarian diet, and recent research has provided evidence for its health benefits. And although vegetarianism is increasing in popularity, vegetarians remain a small minority of people worldwide. For example, in the U.S., vegetarians comprise approximately 3 to 4% of the population. In the U.K., 2.3% of adults and 1.9% of children are vegetarian."



This study was published in PLOS and is limited to white Caucasian participants so more research is needed to take other ethnicities in consideration. It would be interesting to include people from India where 38% of the total population is vegetarian. We know from recent studies that implementing a plant based diet at any age has been linked to lower cardiovascular risk and despite that the rate of vegetarianism is low. If being vegetarian is not an option, we can all at least try to incorporate more fruits, vegetables, beans, nuts, and whole grains into our diets. After all, that is the diet linked to longevity.

America's Failure in Disease Prevention

Per Karen Weintraub and Adrianna Rodriguez, in USA Today, “America can prevent (and control) Type 2 diabetes. So why aren’t we doing it?”.

“Type 2 diabetes, in which the body can’t properly regulate blood sugar, has become so common it’s almost considered inconsequential. More than 1 in 10 Americans have the disease (though many don’t know it) and another nearly 4 in 10 are at risk for it. In total, half of all adults and a quarter of teenagers have diabetes or pre-diabetes. Its financial costs are astronomical. The country spends more than $300 billion a year to address diabetes, accounting for $1 out of every $4 spent on health care.

America’s failure to address Type 2 diabetes highlights larger problems with our food and medical systems……. A soda costs less than a bottle of water, a double cheeseburger and fries less than a carton of blueberries. Patients wait months for medical appointments only to see the back of a white coat for the short time they’re allotted. Treating disease costs society far more than preventing it but typically provides more profit for insurance companies, hospitals and the pharmaceutical industry."



People don’t realize the cost to their health of eating fastfood and unhealthy foods. It is interesting that Singapore has increased it’s life expectancy by promoting healthy food as healthy food is subsidized and junk food is taxed. The fact that in America, unhealthy food is cheaper and affordable fosters unhealthy habits and leads down a road with poor health outcomes.

Benefits of Cleaning and Organization

Photo by Orgalux

When we come home from a long day, it is with a sigh of relief and comfort and to familiar belongings. So keeping your home a sanctuary and not a mess can be a blessing. There are many mental and physical benefits of keeping your home clean and organized.

  • Decreases the stress hormone, cortisol
  • Allows you to feel a sense of control which in turn give you more satisfaction and decreases stress
  • Relieves anxiety
  • Helps you enjoy the space and provides pleasure in everyday activites at home
  • Boosts your mood
  • Helps to increase your focus, especially if you are working from home. Clutter can cause several stimuli in your brain and leads to distraction.
  • Helps with productivity and helps to gain energy to tackle other tasks
  • Physical order is linked to healthier choices. Per a study, those with cleaner rooms chose healthier snacks
  • Saves time-if you are organized, you are not wasting time looking for clothes or important papers

So you may just want to bring that Marie Kondo spark of joy to your life. You can start small, maybe your desk, a kitchen cabinet, a refrigerator shelf, or a portion of your closet and take it from there. You can even put some relaxing music on or ask a family member to help, Think of ways to make your living space clutter free, clean, and bring in that inner peace.

Obesity on an Upward Trend

Per Deidre McPhillips, in CNN health, “Obesity is becoming more common in a growing number of states, CDC data show”.

“Obesity is becoming more common in a growing number of states, according to new data from the US Centers for Disease Control and Prevention. In 2022, 22 states had at least 35% of adults with obesity, up from 19 states in 2021. Ten years ago, CDC said, no state had an adult obesity prevalence at or above 35%.

Obesity rates were lowest among young adults, with about 1 in 5 people ages 18 to 24 considered to have obesity. Rates were about twice as high among adults 45 to 54, with a prevalence of about 2 in 5, according to the CDC data. Obesity prevalence also decreased as level of education increased."



As a country, we are headed in the wrong direction. Obesity is linked to chronic diseases such has hypertension, heart disease, stroke, osteoarthritis, diabetes, obstructive sleep apnea, etc. It is interesting that obesity prevelance decreased as education level increased which could mean health literacy is something we could work on to bring awareness to more people. It may not be easy to lose that extra fat, but persistence with eating healthy, building in an exercise routine, and self care will make a difference.

What We Can Learn From Blue Zones?

Photo by Daniel Bernard

Blue zones are a term used by author Dan Buettner who has studied areas with long longevity for the past 2 decades. Blue zones are regions of the world where people live longer and healthier lives than average(about a decade longer than the US or Western Europe).

Here are some of the things that individuals in these blue zones are doing:

Okinawa, Japan

  • world’s longest lived women
  • diet plant-based with antioxidants and nutrient-rich vegetables and leaves
  • stop eating when they are 80% full and practice mindful eating(average calorie intake is 1900 compared to US average of 3600 calories)
  • they practice “ikigai” -they have a reason for living and life purpose such as gardening, art, friends
  • gardening is a part of life-get activity in, have fresh produce, and move around
  • traditionally sit on the floor to eat and relax-this means the elderly are getting up and down off the floor several times a day which helps with buliding lower body strength and balance

Sardonia, Italy

  • highest male centenarians in the world(in the US, 100 year old women outnumber men by 6:1 but in Sardinia, the ratio is 1:1)
  • steep towns built on the hillside make mobility and exercise a daily part of life by just walking
  • eat primarily plant-based diet and also consume Cannonau wine which has the highest amount of polyphenols in the world

Ikaria, Greece

  • Island with almost no dementia
  • villages are steep so everywhere they go and walk, they get exercise in
  • follow a Mediterranean diet with lots of vegetables and fruit

Nicoya, Costa Rica

  • splitting logs helps elder stay mobile -walk regularly
  • Meso-american diet-corn, beans, squash
  • spend 1/5th amount on healthcare than the US does

Loma Linda, California

  • live an average of 10 years more than average Americans
  • eat healthy whole foods like nuts, vegetables and beans which is a diet per the faith they practice as this community has the highest concentration of Seventh-day Adventists. Adventists also do not smoke or drink alcohol.

Singapore

  • In addition, Mr. Buettner has proposed Singapore as a new blue zone.
  • now has the longest, healthiest life expectancy in the world
  • promote healthy food-junk food is taxed, healthy food is subsidized
  • promote mobility-driving is taxed, walking is subsidized
  • if your aging parent lives within 500 yards of you, you get a tax break(which helps older people get the care they need in times of need)
  • National Steps Challenge encourages residents to move more and incentivizes by letting them redeem points to use to shop or eat at restaurants.

So, what is the secret to a long, healthy life? It’s not a vigorous exercise routine or supplements. It comes down to eating good food, getting a good night’s sleep, having good friends, and moving around naturally throughout the day.

Here are some of the what stands out in all of the blue zones:

  • Eating good food: Cook yourself! Don’t order out. Focus on a plant-based diet-simple foods containing whole grains, vegetables, greens, beans, and tubers, such as sweet potatoes. Use herbs. Eating a cup of beans a day not only gets you protein and fiber, but associated with living an extra 4 years. Don’t overeat.
  • Don’t shy away from social interactions
  • Move around-you don’t have to necessarily go to the gym, any activity is helpful…gardening, walking
  • Get a good night’s sleep

The Future of Healthcare With AI

Per Hannah Mark & Valentina Simon in Yale News, “Yale researchers investigate the future of AI in healthcare”.

“Picture a world where healthcare is not confined to a clinic. The watch on your wrist ticks steadily throughout the day, collecting and transmitting information about your heart rate, oxygen saturation and the levels of sugar in your blood. Sensors scan your face and body, making inferences about your state of health.

By the time you see a doctor, algorithms have already synthesized this data and organized it in ways that fit a diagnosis, detecting health problems before symptoms arise.

…..Over the past months, Yale researchers have published a variety of papers on machine learning in medicine, from wearable devices that can detect heart defects to algorithms that can triage COVID-19 patients. Though much of this technology is still in development, the rapid surge of AI innovation has prompted experts to consider how it will impact healthcare in the near future. Questions remain about the reliability of AI conclusions, the ethics of using AI to treat patients and how this technology might transform the healthcare landscape."



It is no doubt that healthcare is bound to change with AI, but it should always be used in conjunction with actually seeing a doctor. Time will tell where healthcare goes in the future. For now, we can wear fitness trackers, use health apps on our phone, exercise, eat healthy….all the things we can do to keep us on track to reach our health goals.

Why Eat Superfoods?

Photo by Timo Volz

We know some foods are healthier than others such as a nice leafy salad in comparison to a burger. There are healthy foods that are know as “superfoods” which provide us with a bit of an edge when consumed regularly. A superfood is usually a natural food which is low in calories and nutrient-dense.

Benefits of superfoods

  • Promotes a strong immune system
  • Decreases inflammation
  • Prevents chronic disease and progression of chronic disease such as heart disease and high cholesterol
  • Rich in antioxidants, vitamins, and minerals
  • Some superfoods may also contain fiber, flavonoids(have anit-inflammatory and anti-carcinogenic properties), and healthy fats

Examples of superfoods

  • Grapes-the skin of grapes contains phytonutrients, the skin of red grapes contains Resveratrol which is a polyphenol known to be “heart healthy”
  • Berries-you name it—raspberries, blueberries, cherries, cranberries, acai berries, etc, they are loaded with flavonoids, antioxidants, and vitamins
  • Avocado-rich in fiber, folate, potassium, vitamin E, and magnesium, contains more potassium than a banana
  • Cinnamon-known to reduce blood sugar levels, cholesterol, reduce inflammation, and provide antioxidants
  • Dark, leafy greens-the darker leafy greens are better and rich in vitamins(iceberg lettuce does not pack the nutritional punch that the dark leafy greens do), try to go for arugula, kale, spinach, collard greens, etc
  • Beets-gets the color from betalains, a natural pigment that contains antioxidants, also associated with anti-inflammatory benefits
  • Lentils-low calorie, high protein, contains folate, iron, and potassium
  • Green tea-loaded with antioxidant, catechin
  • Chia seeds-has fiber, protein, antioxidants, vitamins, and minerals
  • Garlic-helps immunity, anti-inflammatory
  • Ginger-contains magnesium, potassium, vitmain C, helps in blood sugar regulation, also provides nausea relier
  • Salmon-provides omega-3 fatty acids which body can’t make itself
  • Yogurt -has probiotics which are good bacteria that support gut health, also has protein and calcium
  • Brazil nuts-contains healthy fats, antiioxidants, vitamins, and minerals, in particularly is high in selenium which has antioxidant properites. It helps in supportiing brain function, improving thyroid and heart health, and reducing inflammation.

Remember, having nutrients from regular food is far better than taking superfoods as a supplement. Try to make a conscious attempt to incorporate superfoods in your every day meals.