Tuesday, July 30, 2013

Longevity Debate/Debacle

So we established that three things can increase a person's life expectancy: genetics, activity and natural foods - lets explore those in greater detail.

1. Genetics
People like to blame a lot of things on genetics: to short, to fat, to hairy etc etc etc, and whether you like it or not, genetics does play into longevity, and a lot of how we live our lives and how we maintain our weight, also plays into how our genetic makeup is portrayed. We have all heard someone talk about so-and-so who can eat whatever he wants and not gain a pound and said they were 'genetically thin'. If you actually watched that person closely and took stock of their behaviors you would notice a very different picture of what was actually going on. While these people may appear to pick more foods that the general dieting population sees as 'forbidden' they don't tend to eat portions equivalent to their dieting counterparts, their portions are smaller, they enjoy what they are eating but then don't worry about what the next meal will be. Studies have shown that many of these people also have 'nervous ticks or twitches' while in the seated position. A constant moving or pumping leg is the most common, but some tap a finger, sway slightly in the chair, rub their fingers together etc. All of this unconscious movement can burn 500-600 calories/day and unknowingly to them, becomes an integral part of their weight maintenance. The question here is, do these people choose to make these movements or are they genetically or biochemically predisposed to make those movements?

2. Activity
Some people hate the word 'exercise' other people thrive on the endorphin rush that accompanies it. However you choose to move doesn't matter, its that you move which is important. Children have lots of energy and they should be allowed to move around and use up that energy, not sit inside and conduct stationary activities. Remember what the human body was made to do: hunt down and kill things slower and stupider then itself. It wasn't made to run 20 miles without stopping, so why bother try to make it? Just get out there and use your parts for 30-60 minutes/day in random intermittent activity or you are doomed to lose them. Succeeding at activity is all about creating a routine and sticking to it. You have to like either the activity itself or the routine, otherwise either option will fail you. For an example here is my routine M-Th to get myself to work:
  • 4am: alarm goes off
  • I hit the snooze button 1x (yes even I hit it - I hit it every morning its just part of the routine!)
  • Pee and brush teeth
  • Put on workout clothes
  • Go downstairs, set up coffee - two scoops decaf, 1 scoop regular, 6 cups water - hit the start button
  • Run outside if warm, if cold use elliptical, then stretches, pushups, squats, situps
  • Pour mug of coffee to sip on while shower and get ready for work
  • Before leaving house pack breakfast - homemade granola, almond milk or ricotta cheese or NF plain Greek yogurt (I will pick up blueberries and cinnamon in the hospital cafeteria)
  • 6am leave for work
I do this every day - how boring am I? But this works for me. If I was to leave exercising to the end of the day, I would be to tired and not want to do it at all. I do it in the morning because it wakes me up and gives me energy for the day which makes me feel good! You have to make a schedule that works for you AND STICK TO IT!

3. 'Natural' Foods
So the paleo people are on the right track with their lists of which foods to eat and which to stay away from but they take it both to far and not far enough at the same time. They allow you to eat some meats, some fruits and some vegetables - their theory being that you eat what you would have been able to find in the early days of humanity; but they also want to limit the sugar intake and have control over the fat content of food which no Neanderthal was concerned with. That is where they take it to far. Where they don't take it far enough, is that much of the problem with the food source is is actually with the production of it. We spray chemicals on the plants, inject them into the animals, and then add more during processing and packaging. All those chemicals have an effect on your body: how it metabolizes food, absorbs nutrients, provides mental function, conducts cellular repair etc etc etc. Those chemicals can make you feel sluggish so you won't exercise and can harm your genetic makeup giving later generations the 'I have bad genes' excuse. So should you try to eat like you were a Neanderthal? Sure, it can't hurt, but just remember it would be very hard to do so. We don't have dinosaur meat and many of the primitive grasses and berries don't exist anymore. Rather, try to eat only what you could kill or pick off a plant. If you can't grow your food yourself, try to purchase it from a small farmer nearby, chances of him using chemicals to the magnitude of the big guys is slim (read: that doesn't mean he doesn't use them). Try not to buy food products which have been genetically modified (GMO). The change in the plant or animals' DNA makes it very hard for your body to process the food item properly. Is it the worst thing in the world for you to eat wheat? Definitely not, but try to find a wheat product that is non-GMO also, it will have minimal health risks compared to its commercially grown counterparts.

So what does all of this really mean? Well it depends on how you look at it. We want people to live a life full of QUALITY years and if they get a few extra years out of it that is awesome. It will be more time to enjoy their families and friends as long as all of those people follow the same lifestyle routine and can live the same length of time. If we could still ask Great-grandmother Rose, she would undoubtedly say that she doesn't regret living that long, that she got to spend a lot of quality time with the future of her family, but that in the end the pain of watching so many that were so close and so dear to you expire before you, is not worth the extra time. This may all seem contradictory, but in reality that is what health care is. We have the science and technology to keep people mechanically alive far past their appropriate expiration date, but is that what is really appropriate for the population as a whole? Just some 'fat to chew on' so to speak.

Tuesday, July 23, 2013

Longevity - what does it really take?

A dinner conversation last night with my father about my great grandmother sparked some thoughts about longevity and when the Kenny Chesney song 'Don't Blink' blasted through the radio this morning on my way to work, I found it more like fate that I should write about it. What is it about longevity that makes it so sought after and yet so hard for many to obtain? Is it the actual fear of dying, and the unknown about what happens the moment after physical death? Is it a fear about not having enough time to see what one wants to see and do what one wants to do? Is it an unconscious desire for immortality ingrained in our heads from super heroes or ancient mythology? Or is it a primitive desire to pass knowledge about survival from one generation to another? Humans are lucky, in the respect that we get to grow up with past generations of family and keep those bonds, unlike many species who perish after reproduction or cut ties with their young.

But what happens to us on all levels if we can achieve life to late 90s or into the 100 years?

My great grandmother died at 98 of 'unknown causes related to old age' yet she was in perfect health, perfectly mobile, and could see and hear fine. Her mental capacity was perfect: she spoke 5 languages (Arabic, Turkish, Armenian, French, English) and was a master of card games. So why did she die at 98 if she was in perfect health and if MDs at that time (mid-80s) thought she would live for another decade? Those closest to her at that point said, "She just gave up. She outlived 1 of her children, 3 of her grandchildren, her 5 siblings and their spouses, her husband, his 5 siblings and all of their spouses, and all of her friends. What a terrible thing to be the only one left."

So how does one get to 98 years old and still be in perfect health? That is a question which has been driving research for decades and it is combination of efforts. One does need to be genetically inclined to live past the average life expectancy period (read: that doesn't mean your lifestyle can't kill you first), one needs to be active throughout life, and one needs to consume as natural a diet as possible (read: I did not say a fat-free and sugar-free diet, I said 'natural'). Which obviously is very easily said and not so easy to execute. Since this will be a super long if I delve into everything here - we will do a part 2.

Wednesday, July 17, 2013

Curried Seafood Stir-Fry

Ingredients:
12 oz. fresh or frozen seafood (tilapia/flounder/sole/cod/shrimp/scallops/mahi-mahi), cut into 1” cubes
1 medium green pepper, cut into cubes
1 medium onion, chopped
2 cups chopped bok choy (sometimes labeled as 'asian cabbage')
1 cups sugar snap pea pods (could cut them up if desired)
2 tablespoons olive oil
1 clove garlic, minced
1-2 tablespoons curry powder
1-2 packages (depends on how many people you're feeding) Shirataki noodles, drained

1. In a medium skillet, heat olive oil on medium-high heat.
2.Add the peppers, onions, garlic and  pea pods.
3.Add curry powder and a dash of salt and pepper to taste.
4. Cook until vegetables are soft, about 5-7 minutes.
5. Add the seafood, bok choy and noodles, and more curry powder if desired.
6. Continue cooking until fish is cooked through (translucent - ooo fancy word!), appearing white and flaky, about 5 to 8 minutes; if using
shrimp cook until shrimp just start to curl up and turn pink 2-3 minutes.  Do not stir too much as the fish will shred.

ENJOY!!

Tuesday, July 16, 2013

Medications and Weight - Which do you take?

We all know that different medications can have differing effects on people's waistlines. Here is a list of medications with known/proven weight gain. Read through the whole list, sometimes the classification of the drug is not why is prescribed to the patient, drugs work on multiple symptoms. Remember, your side effects may differ.



Diabetes Therapies: gains of up to 18 lbs in intensive 3 month treatment

  • Insulin (lispro, aspart, glulisine; humalog, novolog, apidra
  • Thiazolidinediones (TZDs) [pioglitazone; actose]
  • Sulfonylureas (glipizide, glyburide, glimepiride, chlorpropamide, tolbutamide; glucotrol, diabeta, micronase, glynase, amaryl, diabinese)

Psych/Neurologic Therapies: average gain of 9 lbs per month

  • Triclyclic antidepressants: amitriptyline, doxepin, imipramine, nortriptyline, trimipramine, mirtazapine; (elavil, endep, vanatrip, adapin, dilenor, sinequan, tofranil, aventyl, pamelor, surmontil, remeron)
  • Selective Serotonin Reuptake Inhibitors (SSRIs): setraline, paroxetine, fluvoxamine; zoloft, paxil, pexeva, luvox)
  • Lithium: eskalith, lithobid

Antisychotics:

  • haloperidol
  • loxapine (oxilapine, clozaril, fazaclo
  • clozapine (thorazine)
  • chlorpromazine
  • fluphenazine (risperdal
  • risperidone (M-tab)
  • zyprexa
  • seroquel
  • olanzapine
  • quetiapine

Antiseizure/anticonvulsants: variable gains of up to 44 lbs

  • valproic acid (depakote, depakene, stavzor)
  • carbamazepine (carbatrol, epitol, uquetro, tegretol)
  • gabapentin (horizant, neurontin)

Steroid Hormones: gains of 4-29 lbs

  • oral corticosteroids (prednisone, cortisone; sterapred)
  • inhaled corticosteroids (budesonide, ciclesonide, fluticasone; pulmicort, alvesco, flovent)
  • Hormone therapy/contraception (estrogen, progestagens)

Misc:

  • antihistamines (diphenhydramine; benadryl, unisom, sominex, nytol, aler-dryl etc)
  • Beta-andrenergic blockers (propranolol, metoprolol, atenolol; inderal, innopran, pronol, lopressor, toprol, tenormin)

Monday, July 15, 2013

Spicy Vegetable Gumbo

RG (a patient, not my horse!) gave me this recipe last week to share with others who are looking for some interesting alternatives to meat. We hope you enjoy!

2 quarts low sodium chicken broth (or vegetable broth if you want a veggie dish)
2 cups mixed beans (soaked over night in the ice box)
8 oz can of tomato sauce (remember to check the labels for zero added sugar!)
1 tablespoon Italian seasoning
1 tablespoon dried rosemary
1 tablespoon Creole seasoning or Cajun seasoning mix
black pepper (to taste)
Fresh vegetables - whatever you like to fill the remainder of the crock pot, might I suggest a combination of the following:

  • eggplant
  • zucchini or yellow summer squash
  • mushrooms
  • kale
  • carrots
  • celery or celery root
  • sweet potatoes
  • parsnips
  • Lima beans
  • bell peppers or cubanelle (not spicy) peppers
  • vidalia onions
  • leeks
Let everything cook in crock pot on high for 8 hours. Eat (perhaps with some fresh cheese grated on top) or freeze.

ENJOY!

Wednesday, July 10, 2013

Asian Apple-Chicken Salad

This recipe came to me this morning from the Produce for Better Living Association and I thought it looked fantastic! You can eat this delicious salad at home or packed it up for a picnic at the beach or park!! The fresh ginger helps to settle upset stomachs, you get chicken for protein, prebiotics from the scallions for all your guy bacteria to munch on (they need lunch too right?!) and a zesty, light dressing to pull it all together!

Ingredients:
2 cups cooked chicken breast, cubed (or you could use rotisserie chicken if easier)
2 cups apples, cored and cubed
2 tablespoons apple, orange, or carrot juice
2 tablespoons lime juice
1 tablespoon sesame oil
1 tablespoon mirin (rice wine)
1 tablespoon low sodium soy sauce
1 tablespoon fresh ginger, finely grated
¼ cup fresh parsley, chopped
¼ cup fresh cilantro, chopped
3 scallions, thinly sliced
1 pound baby spinach
pepper to taste, if desired

1. Place the chicken and apples in a large bowl.
2. Mix the apple juice, lime juice, sesame oil, mirin, soy sauce and ginger together in a small bowl; pour mixture over the chicken and apples.
3. Sprinkle the parsley, cilantro, and scallions over the top and gently toss to mix. (Cover and refrigerate up to several hours, if desired.)
4. To serve, layer the spinach on a platter and spoon the chicken mixture on top.

ENJOY!!

Tuesday, July 9, 2013

So I am back and ready for action! The holidays took me off to great places and to experience some great food from a vegan stuffed acorn squash (carmelized onions, pumpkin and sunflower seeds with herbs), in CT  to fire roasted vegetables over polenta, fava beans with orecchiette, or shitakes with roasted chicken in Lake Placid, and even home grilled steaks and veggies with watermelon or pear and gorgonzola flatbread in San Diego - now I'm back with some new ideas so lets get ready to cook!