Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

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.


  • 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.

COVID on the Rise

Per Julie Bosman in an article published in The New York Times, “Not Over Yet: Late-Summer Covid Wave Brings Warning of More to Come”.

“A late-summer wave of coronavirus infections has touched schools, workplaces and local government, as experts warn the public to brace for even more Covid-19 spread this fall and winter. Hospitalizations have increased 24 percent in a two-week period ending Aug. 12, according to the most recent data from the Centers for Disease Control and Prevention. In communities across the United States, outbreaks have occurred in recent weeks at preschools, summer camps and office buildings.

But for Americans who have become accustomed to feeling that the nation has moved beyond Covid, the current wave could be a rude reminder that the emerging New Normal is not a world without the virus.

COVID cases and hospitalizations continue to increase over the past 6 weeks. Although, many thought COVID is gone, this is a reminder that COVID is here to stay and we need to continue to act responsibly. If you are sick and test postive, you should quarantine to prevent spreading to others. As COVID cases continue to rise, it is yet to be seen if it will take a further toll on the healthcare system/healthcare workers, and what, if any, restrictions may come back.

The Power of Kindness

Being kind and thoughtful has several benefits and can improve your well-being and health. National Thoughtful Day is August 28th so a good time to reflect on ourselves and ways to be kind and thoughtful towards others.

July 2023 Hottest Month on Record

Per Ian Livingston in an article published in The Washington Post, “These places baked the most during Earth’s hottest month on record”.

“July 2023 will go down as the hottest month on record across the globe, and perhaps the hottest in at least 120,000 years, according to climate scientists. During this sweltering month for the planet, countless daily, monthly and all-time record high temperatures were reached in multiple regions, often concurrently. A rash of intense heat domes — zones of high pressure sprawled across the northern hemisphere — plagued Asia, southern Europe and northern Africa, North America and much of the tropics including the Caribbean. Extreme heat was even observed on several occasions across the southern hemisphere, where it is the middle of winter.

NASA has clocked July 2023 as the hottest month on record ever since 1880. It is felt that this severe heat is a combination of the natural climate pattern El Nino and human caused climate change. As the heat continues in some parts of the country, be sure to follow healthy summer tips, protect yourself from the sun, and stay hydrated.

The Primary Care Physician Shortage

Per Julie Appleby and Michelle Andrews in an article published in USA TODAY, “Will the doctor see you now? Maybe not amid the changing health care landscape in the US.”

“The primary care landscape is changing in ways that could shape patients’ access and quality of care now and for decades to come. A solid and enduring relationship with a primary care doctor – who knows a patient’s history and can monitor new problems – has long been regarded as the bedrock of a quality health care system. But investment in primary care in the U.S. lags behind that of other high-income countries, and America has a smaller share of primary care physicians than most of its European counterparts.

An estimated one-third of all physicians in the U.S. are primary care doctors – who include family medicine physicians, general internists, and pediatricians – according to the Robert Graham Center, a research and analysis organization that studies primary care. Other researchers say the numbers are lower, with the Peterson-KFF Health System Tracker reporting only 12% of U.S. doctors are generalists, compared with 23% in Germany and as many as 45% in the Netherlands. That means it’s often hard to find a doctor and make an appointment that’s not weeks or months away.

Though having good access to primary care has traditionally been linked to better health, U.S. investment in that workforce lags behind that of other high-income countries. Today, a smaller percentage of physicians are entering the field than are practicing, suggesting that shortages will worsen over time. Interest has waned partly because, in the U.S., primary care yields lower salaries than other medical and surgical specialties. Some doctors now in practice also say they are burned out, facing cumbersome electronic health record systems and limits on appointment times, making it harder to get to know a patient and establish a relationship. Others are retiring or selling their practices. Hospitals, insurers like Aetna-CVS Health, and other corporate entities like Amazon are on a buying spree, snapping up primary care practices, furthering a move away from the “Marcus Welby, M.D.”-style neighborhood doctor. About 48% of primary care physicians currently work in practices they do not own. Two-thirds of those doctors don’t work for other physicians but are employed by private equity investors or other corporate entities, according to data in the “Primary Care Chartbook,” which is collected and published by the Graham Center.

…..For patients, frustrating wait times are one result. A recent survey by a physician staffing firm found it now takes an average of 21 days just to get in to see a doctor of family medicine, defined as a subgroup of primary care, which includes general internists and pediatricians. Those physicians are many patients’ first stop for health care. That runs counter to the trend in other countries, where patients complain of months- or yearslong waits for elective procedures like hip replacements but generally experience short waits for primary care visits."

Primary care physicians are the first doctor a person should see when they are not feeling well to narrow down what is going on, get started on medications, get tests ordered, or referral to appropriate specialty service. Unfortunately, these prolonged wait times can lead to worsening of a patient’s condition, misdiagnosis, or increased use of urgent care/emergency room visits which can be expensive. The primary care shortage is slated to become even worse in the coming years, especially in rural areas. This is sad.

Microwave Popcorn Is Actually Bad for You

Photo by Georgia Vagim

Enjoying microwave popcorn on movie nights is often a ritual for most people. It is so easy to put the bag in the microwave and it gets done in minutes so really takes no effort. However, what most people don’t realize is that microwave popcorn is actually bad for you. Although different brands vary is portions and other added flavorings, it is best to avoid.

Here is why you should stay away from microwave popcorn:

  • Has high amount of saturated fat
  • Sodium levels are very high-can contain 900 mg of sodium per bag
  • High in calories-contains about 400-500 calories per bag
  • Bag is lined with chemicals called PFAS, synthetic chemicals inside food packaging to prevent artificial butter flavoring from leaking through, but some of these chemicals also get into the popcorn which you in turn eat.
  • Can cause “popcorn lung”. One of the ingredients found in microwaveable popcorn is diacetyl, a flavoring which has been linked to lung disease, bronchiolitis obliterans, a disorder nicknamed “popcorn lung”

So, what should you do instead? Pop your own popcorn! It is really not too hard to do. Next time you head to get groceries, pick up popcorn kernels. You can get creative with seasonings and avoid the extra chemicals, fat, sodium, and calories.

What to Eat in the Heat?

Per Alice Park in an article published in Time, “When It’s This Hot, What Should You Eat?”

“One place to start is to explore how heat influences diets in warmer parts of the world. Why, for example, do the spiciest foods come from the hottest places on the planet? Think southeast Asian curries and peppers, and South American chilis. If spicy foods make you sweat and feel even hotter, why are they such a staple in warmer regions?

…a protein on our cells called TRPV1 acts as a receptor for the active agents in spicy foods, such as capsaicin and capsinoids. The cells that have the highest concentration of TRPV1 receptors are on the tongue and the front of the roof of the mouth. Those spice agents trigger the receptors to send signals to the brain to release norepinephrine, a neurotransmitter primarily responsible for launching the fight-or-flight response. When this hyper-alert response is triggered, the body releases heat by triggering the sweats. That was helpful to human ancestors trying to outrun potential predators thousands of years ago…and also turns out to be useful in adapting to climate change today.There are a bunch of foods and spices that can activate TRPV1.

In addition to hot peppers, sweet peppers and black pepper can also stimulate the receptor. Garlic can as well, through a different chemical called diallyl sulfide, which doesn’t produce the same spicy sensation in the mouth but has the same end effect of activating norepinephrine and generating perspiration. Ginger and galangal, another root vegetable with a sharp, citrusy taste, are other foods—also commonly used in hotter regions—that can cause the same sweating and cooling effect.

Something to keep in mind during the heat is what we eat. In addition to good hydration, hydrating foods such as fruit, don’t shy away from that spicy food!