The stomach virus, COVID, cold, flu, RSV and whooping cough are going around. We're in the thick of germ season.

Dr. Vickie Petz Kasper tells you the truth about how germs spread and how you can stay well and avoid catching them. 

Tis the season to be coughing, catching all the germs and getting sick.  Whew, there really is a lot going around right now. So how can you keep from getting sick? 

You've probably heard that the stomach bug is going around. The most common cause is the Norovirus. And January is typically flu and RSV season, and COVID levels are high.

All three are increasing and this is not unexpected. Why is that? Well, because of all the travel and family gatherings, the number of people you are in close contact with on a daily basis usually consists of your immediate family, friends, and co workers. But over the river and through the woods, all those germs are coming to gather at Grandmother's house to spread like wildfire. 

 In this special edition episode, we're going to talk about how these six infections spread and what you can do to prevent it. But first, we need to go to mini medical school and learn about viruses and bacteria.  Pop quiz! Of the six diseases I mentioned, all but one is a virus. Do you know which one is caused by a bacteria? Norovirus, the common cold, flu, RSV, whooping cough, or COVID. Not sure? Well, listen close. I'll tell you as we review each one.

But first, some basics. What is a virus? Well, it's a fragment of genetic information like DNA or RNA, and it's inside this protective shell that's called a capsid. And a lot of them look like a ball with these spiky things on it. They don't have any cells, and they're tiny. Their goal is to perpetuate, and they need a host to reproduce. And humans, well, we're so hospitable. We work great. First they attach to their host, and then they enter the host, and then they start replicating inside the host. Then they assemble more viral particles and whoosh, release them. And that, my friends, is a very, very brief overview and simplistic overview of how they make you sick.  

One more thing. If you have a viral infection, an antibiotic will not do one frazzling bit of good. And that's what it says in all the medical textbooks, "Not one frazzling bit of good." And I know you want an antibiotic because you've got a lot of things to do and you want to get well fast. If you go to urgent care, you can probably snag a Z Pak pretty easily. But, if you have a viral infection, it won't do one frazzling bit of good.

Now, why am I so passionate about that? I'll get to it in a sec, but let's first talk about bacteria. They're different.

Bacteria are also tiny, but they have a single living cell. Some bacteria are actually good, and they keep you healthy.  And that's why taking an antibiotic when you don't need one is bad for you. Because if you kill off all the bacteria in your gut, that upsets the gut microbiome  for a long, long time. And what happens in the gut microbiome? Well, that's where neurotransmitters are made and where the immune system is regulated. I have some links in the show notes from previous episodes if you want to learn more about how the gut actually affects your brain and your mood.  Now, on the other hand, if you do have a bacterial infection, you need an antibiotic. Okay? Got it? Antibiotics are for bacteria, not viruses.

Let's move on, starting with the stomach bug, which really isn't a bug at all. And I bet you already guessed that the stomach virus is caused by one of those spiky little pieces of genetic material that needs you to be its host. 

The most common cause of the stomach virus is the Norovirus, and this one spreads easily, so it's super contagious. People with Norovirus infection can shed billions of invisible viral particles. That's billions, but it only takes a few to make you sick. And it doesn't really seem fair to stack the deck that way, especially since the end result is diarrhea, nausea, vomiting, and stomach cramps, and possibly headache, body aches, and fever.

You get it from sick people, contaminated food or water, and surfaces. Now that last one's really important, and that's the reason that I always, always use the little wipes. to wipe down the handlebar of the grocery cart and I wash my hands as soon as I can.  And once you're exposed to the Norovirus, it takes about 12 to 48 hours to get sick. So it usually makes the runs through the household pretty quickly. You can get infected with Norovirus by ingesting little bitty tiny pieces of feces or vomit from an infected person. Yeah, mom and dad. That's why you're at risk when little Johnny brings this home from school. All that barehanded cleaning and caring for your sick splattering little one puts you at risk for going down for the count, too.

Your biggest defense is wash your hands. with soap and water. Wash them often, and wash them good. And keep your hands out of your mouth, eyes, and nose.  This virus grows really nicely in big Petri dishes, otherwise known as cruise ships. And that's why they installed 974 hand sanitizer stations right in front of the food troughs. Hand sanitizer doesn't really work that great for this particular virus. Turns out good old fashioned hand washing is much better. So, maybe that cart wiping isn't doing much good, but it certainly won't hurt. Anyway, be careful what you touch and keep it out of your mouth and nose, and wash your hands.

Now let's move on to the common cold. Quick question, virus or bacteria? You got it. Virus. Specifically the rhino virus. And remember, rhino means nose  and it's also a type of Corona virus.  That's right. Corona virus first identified in the 1960s and effectively killed by Lysol. Says it right there on the label.  Next question. If the common cold is caused by a virus, will an antibiotic help you recover faster? Nope. Can it hurt?  I hope you said yes, and if not, go ahead and hit rewind.

The symptoms of a cold usually last less than a week, but can last up to two weeks. And they include runny, stuffy nose, headache, body aches, sore throat, fever, coughing, and sneezing. There's a link in the show notes on how to differentiate a cold from allergies.

Different viruses are spread in different ways. The common cold is spread through droplets from an infected person and they find you when that person coughs or sneezes. You can breathe them in or you can get infected by touching a contaminated surface then touching your eyes, nose, or mouth. That's why it's recommended that you cough or sneeze into your elbow. Because if you cover your mouth and nose with your hands and then shake hands or touch something or a surface, then the virus uses that as an opportunity to hitch a ride onto someone else's hands. Then, if they touch their eyes, nose, or mouth, they're infected. So wash your hands and keep them out of your mouth, eyes, and nose.  

Another virus that spreads by droplets is influenza. These droplets are spread when people with flu cough, sneeze, or even talk. You can also get it from touching surfaces than touching your mouth, nose, or eyes, but that's actually less common. Most of the time you catch it directly from another person. These little viral particles are within droplets that land right in your mouth or nose. And, relatively speaking, these droplets are kind of big. They're greater than 5 microns in diameter, so they don't really travel far because gravity just pulls them to the ground within about 3 feet.

Now, once you're exposed, the virus goes to work pretty quickly and you typically get sick a couple of days later. Now, flu season is definitely upon us and it's spreading. When I was young, my mom had the flu and she said, She thought she was going to die and kind of hoped she would. Now personally, I don't ever recall having the flu. But it's serious. It can be fatal. And there are lots of different types of flu, and some cause more severe illness than others. So far this year, there have been 9 pediatric deaths, and it's early in the season. 3. 1 million cases of flu have been reported, resulting in 37, 000 hospitalizations and 15, 000 deaths.

According to the CDC, flu is on the rise.  How do they know? Let's take a look at how the data is collected because it might surprise you.  They look at emergency room visits, hospitalizations, and the number of tests done for certain diseases and the percent positivity. And there are benchmarks for those. But that wouldn't really give us a total picture, would it? Because some people don't go to the doctor or the hospital. 

Want to know a secret?   They're looking at your poop. No, not yours individually, but collectively. They study wastewater and test feces for these viruses. I mean, it's kind of brilliant, albeit really gross.  They even have a poop dashboard. Of course, they have a more sanitized named for it. It's a Wastewater data. There's a link in the show notes if you're interested or if you don't believe me. And honestly, it's pretty fascinating if you're ready to geek out. I just wonder if they advertise on LinkedIn, looking for a CPA, a chief poop analyst. Qualifications must understand virology, statistics, and have a high tolerance for gross things. And maybe they got the idea from Teenage Mutant Ninja Turtles. Who knows?

Okay, enough of that.  Now we call influenza flu for short and moving on, we call respiratory Syntcial virus, RSV for short. And the normal RSV season is late fall to winter, though that, again was thrown out with a lot of other things during the pandemic. 

Wanna guess how it spreads? Just like the flu and the common cold, RSV spreads through droplets. You already knew it was a virus, I mean, it's right there in the title. But, it's the same old viral tactic. Somebody who's infected coughs or sneezes, the droplet travels the short distance between you, and  you breathe it in.

This virus can survive on hard surfaces like door handles and tables for many hours. So, if you touch it and introduce it into your mouth, nose, or eyes, It can spread that way. It can also live on your hands or a used tissue, but not for very long. So what should you do?  That's right. Wash your hands and don't touch your face.

Now, this is important. RSV can infect anyone at any age and more than once in their lifetime. In fact, nearly everyone gets it before their second birthday. But here's the deal. Babies can get really sick from it. And you can give it to them by kissing their face. So yeah, Grandma, this is one reason that new moms tell you, Don't kiss my baby.

The other is the herpes virus, which causes fever blisters, but it can be fatal to newborns.  RSV can cause severe illness, hospitalization, pneumonia, and death in older adults too. So if you're sick, stay at home. Seriously, don't share your germs. When it comes to respiratory viruses, clean air also helps. That means HEPA filters for indoor air, or if you live in the South, you can probably open some windows except maybe those 13 or so days when we get bitter cold and ice. Anyway, just wash your hands and cover your mouth and nose when you cough or sneeze, spray the Lysol, keep your distance, wipe down the surfaces.

There's just not a lot of variety in these recommendations and following them just might protect a vulnerable little baby or a precious elderly grandma. And that logically helps me segue to COVID. You knew we were going to talk about COVID, didn't you?

Transmission rates are really high right now. And here's a test I bet you'll ace. Is COVID a bacteria or a virus?  Bingo. Let's go a step further. COVID 19 is a coronavirus. And remember, there are lots of different kinds, but there is something very unique about COVID, and that is how it's spread. And hopefully you already know this, but let me remind you that COVID 19 is not spread the same way as the common cold, RSV, or the flu.

And this is one of the things that made it so scary and dangerous. You see, COVID is airborne. Instead of hanging out in big heavy droplets that fall quickly to the floor, it floats along through the air. So you can literally get it from someone who isn't even in the same room with you. Think about a small bathroom where someone has coughed and then you go in, breathe in the little viral demons and get sick. It even traveled through ventilation systems in heavily populated apartment complexes.

For the most part, the COVID virus spreads among people who are nearby. Basically, talking distance, coughing, sneezing, singing, and even breathing distance. And the louder you talk or sing, the further these little particles travel. We call it aerosolization.  I mean, think about hairspray in an aerosol can. You spray it, it gets on your jewelry, the mirror, your glasses, your husband comes in and starts fanning the air. Except these particles aren't big enough to declare their presence floating in the air.  Depending on the ventilation, airborne diseases can travel more than six feet and hang around for hours floating in the air. 

Fortunately, there are not a lot of airborne diseases, but there are a few, like tuberculosis and measles. which is also on the rise and will likely continue to increase.  

Remember when we didn't know how COVID was spread? I traveled to my daughter's during that time to see my grandbaby and drove eight hours without stopping to eat and only once to get gas and go to the bathroom. I wore gloves and an N95.  I never got into washing my groceries but I did wear an N95 a lot plus I worked in a hospital so there's that.

Now you can touch a contaminated surface and get COVID through your eyes, mouth, and nose. So do the drill. Wash your hands. Don't touch your face. But it's that airborne aspect that made it different. Besides the fact that it was a novel coronavirus and we just didn't have any immunity.  

The pandemic highlighted the need for America to get healthy too. Obesity was associated with poorer outcomes. And now we have GLP 1 agonists, which are helping people control obesity because it's so much more than willpower and determination. I put a link in the show notes about GLP 1 agonist and obesity, but listen, we still need to be physically active and eat whole food. 

Now, we've talked about five viruses, Norovirus, rhinovirus that causes the common cold, influenza, RSV, and COVID, but what about whooping cough? Virus or bacteria?  You guessed it, whooping cough is caused by Pertussis Bordetella. And this bacteria is very contagious. It spreads easily through the air when someone coughs. And boy, do they cough. Sounds like a big wheeze before this violent coughing fit and a shower of germs. It lasts a long time and people are contagious for two weeks. And that cough can linger for months.

You may be wondering, if it's a bacteria, should you take an antibiotic? And the answer is yes. But, for this one, you've got to take them early.  Not everyone gets that classic whoop. that gives it its name. Some people just get a little tickle and a cough and maybe they don't even know they're sick or their doctor tells them they have bronchitis or a sinus infection. And those are the ones you've got to watch out for because they can spread it.

And like RSV in babies, it can be life threatening. Babies don't cough, they quit breathing. And one third of infants less than one year old who get whooping cough require hospitalization. Wow, that's serious. And that is why, when I was practicing obstetrics, I always recommended that my pregnant patients and everyone who was going to be around the newborn get a booster shot called Tdap. It stands for tetanus, diphtheria, acellular pertussis.

Now let me stop right there. And I want you to hear me.  I really wanted to do this episode because promoting health is the whole goal of this podcast. I want to give you information, motivation, inspiration. to take measures to protect and improve your health.

When it comes to seasonal illnesses, it's important to have a good baseline health and a strong immune system. That means a healthy gut microbiome, a healthy weight, and controlling risk factors like diabetes and hypertension.  I really care about you and I have no intention of wading into controversial waters.

 So, if you have strong emotions when it comes to vaccines, Push stop on this podcast. But I really do care about you and I'm gonna keep this part really short. But if you want to have a further discussion about vaccines, I will literally schedule a call with you.

Just email me, DrVickie@healthylooksgreatonyou.com and we can talk about it. Please don't send me hate mail, but if you do, I'll respond with love and grace  because I don't want this information which is rooted in solid science, evidence, research, medicine, and statistics to interfere with our relationship.  I'm not asking you to respect my opinion or anyone else's because this is not about opinion and it's not about respect.  But you see, that is something that changed with the pandemic. Distrust was sown  and maybe deserved. Maybe there was something nefarious, but there was also a lot we just didn't know. And as we learned and we learned quickly, things changed.

Anyway, talk to your doctor is the best advice I can give you.  I remember when the chicken pox vaccine came out, my son was two years old and he had asthma. And I was a little leery because it was a new vaccine. I talked to my pediatrician and he advised giving it. Two years later, my son's preschool had to shut down because every single kid had chicken pox. Except my one little vaccinated boy. They even had to cancel preschool graduation because yeah, that's a thing.

Instead of telling you what I do or what I know or how I feel, let me preface all of this by saying I've been a medical doctor for three decades. I was chief medical officer of a hospital for seven years, including the pandemic years, and I know what I saw firsthand. I do a lot of research from reputable sources for each podcast episode. So if you trust me, keep listening, but again, if you have strong feelings, now is the time to stop listening and you can tune back in next week. We'll pick up on the dementia series and talk about things we can agree on. I mean, we don't all have to agree on everything to be friends, do we?  

Okay, I already told you that I recommended that all my pregnant patients get Get Tdap to protect their babies, and this is based on recommendations from the CDC, the American Academy of Pediatrics, and the American College of Obstetrics and Gynecology, all reputable organizations. They also recommend the flu shot.

Now, vaccine reactions are real. but they're rare. I don't personally know of a pediatrician who does not vaccinate their children. They see firsthand what these infectious diseases can do.  Now, I'll admit doctors have various opinions because they have various perspectives and we call that bias. Think about it. If a doctor only works in an outpatient clinic, they may have tons of experience treating some infection and what they do supports their beliefs.  But they don't know what goes on in the emergency room or the hospital. And the doctors that do have a different bias. And this was especially true during COVID. 

There were a lot of sayings that went around during COVID, like, what about the obesity epidemic? Why are we not talking about that? And I think we should be talking about it. Or what happened to the flu? Did it suddenly disappear? Well, it turns out that social distancing, washing your hands, wearing a mask, avoiding crowded places prevents the flu too.

It's recommended that everyone over the age of 6 months get a flu shot.  And if you're concerned about mercury or thimerosal, you'll be glad to know that single use vials of the flu shot don't contain any and haven't in many, many years.

Now, remember I told you that I've never had the flu? You see, after my mom had it, she made sure we were vaccinated every year. And I continue to get the flu shot every year. I gave it to my kids every year. It is a killed virus. And you cannot get the flu from the flu shot. And yes, I know, you may have gotten the flu shot and then gotten the flu. And there's several reasons for that. Number one, the vaccine typically is only between 40 and 50 percent effective. Number two, it takes a couple of weeks before it works, and you might have gotten exposed to the flu right before you got the vaccine or right after before your immunity kicked in. You may also get the flu right after you drink a Coke.  That doesn't mean the aluminum can caused it, and I'm sorry if that was a little snarky, but correlation does not equal causation, and that's super important when you're looking at data rather than anecdotal experiences.  

I remember how excited we were at the hospital when the COVID vaccine was delivered. I even took a video on my phone. It made a huge difference in the death rate we were seeing. And as soon as it was available, I got the COVID vaccine and all the boosters until the virus mutated enough to not really cause severe disease in most healthy people. I would still get it if it prevented COVID. But unlike what we thought at first, the COVID vaccine does not prevent COVID or the spread of COVID, just the severity of the disease, hospitalization, and death.  Not that that's not important. 

The RSV vaccine is recommended for people age 60 and over. And there is a form of it that's available for newborns who are at risk. 

Again, Tdap is recommended for pregnant women during every pregnancy and for anyone who's going to care for the baby.  Vaccines in pregnancy, like flu and Tdap, are given later so that those maternal antibodies can help protect the baby when they're too young to be vaccinated.  

I know, attitudes have really shifted about vaccines. I remember when I was in the second grade, they lined us up at school and shot us in the arm with the same air gun to vaccinate us against smallpox. Remember smallpox? That disease has literally been eradicated from the face of the earth by vaccines. We all got it at school, and I'm not even sure our parents knew we were going to get it, but my mom is an ardent supporter of vaccines. Wanna know why? In a word, surely. You see, she had a cousin who was in an iron lung at the age of 17 from polio. It was a dreaded disease and the vaccine was a huge victory against this debilitating illness.  

I guess people have a reason for believing what they believe. If you've seen devastation from an illness or from a vaccine, you're gonna have strong feelings and rightfully so. I've seen what I've seen and you've seen what you've seen. So, please send me an email if you want to continue the conversation. But I think we can all agree, keep your germs to yourself, wash your hands, get some fresh air, don't touch your face, and stay healthy. Because healthy looks great on you.

 

     The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change.

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 Is dementia really preventable? The answer is more complicated than a simple yes or no. There are some things we can control and other things we cannot, but  groundbreaking research shows that up to 40 percent of dementia cases might be preventable through lifestyle changes.  That's nearly half of all cases that could potentially be delayed or avoided.

In today's episode, we'll explore the science behind daily habits that can protect your brain health. We'll separate fact from fiction about dementia and examine the latest research and most importantly, share practical tips you can take today to reduce your risk.

Whether you're concerned about your own cognitive health or caring for a loved one, this month long series will give you lots of information, motivation, and inspiration regarding brain health. And what could be more important than saving the brains.  

But first, let's do a quick mini medical school review about dementia and Alzheimer's. Today's focus will be on Alzheimer's disease because it accounts for 60 80 percent of all cases of dementia. 

There are currently over 6 million people in the United States who are 65 or older who have Alzheimer's disease. It is the 6th leading cause of death in this country, but it moves up to number 5 if we're talking about older Americans.  Over the last 20 years, the incidence has increased by an alarming One hundred and forty five percent. Wow. So, what causes it? Well, that's a good question, and there isn't a clear answer.

One way to think about dementia is to think about the way other organs fail, like heart failure and kidney failure. Dementia is, quite simply, brain failure. Now, the brain is made up of neurons, which are nerve cells, and those are found throughout the body. In the brain, these cells are responsible for complex connections and communication, and that enables us to think, smell, talk, see, hear, remember, make decisions, plan, and move our bodies.

And with dementia, these cells start to die, and the brain begins to shrink.  But listen, brains typically begin to shrink around age 30 or 40 in perfectly healthy people. Then it ramps up around age 60, even more after age 70. We call this shrinkage atrophy, and to some degree it is normal. 

But the good news is that we have some reserve to the tune of about 100 billion nerve cells, 100 trillion synapses, which are the connections between nerve cells and a whole bunch of neurotransmitters, Which are the chemicals that go between nerve cells to make communication possible.

So, this network has some resilience even when there's an overall loss of brain volume. However, Alzheimer's is not normal atrophy. The brain shrinks at an accelerated rate. And no one knows for certain what happens inside the brain of people affected by Alzheimer's disease. But the two most notable things are plaques and tangles. If you've never seen it up close and personal, you may envision someone who doesn't know how to get around and can't remember your name.

But, it's not really like that at first, and it's tricky. It's not uncommon for family members and close friends to get a little concerned about someone's mind, then see times of brilliance and you think, Oh, everything's fine. So, This visual of tangled neurons really helps us understand that. Sometimes you're brushing your hair and everything's smooth and then sometimes you hit a mess and the brush gets hung up. 

These tangles interrupt the transport system in the brain. And it's thought to be related to the Tau protein.

The other process that seems to contribute to Alzheimer's is plaque.  Now, When I say the word plaque, you may think of the dental hygienist prying your mouth open and picking at that buildup on your teeth.

The plaques on your teeth are made of tartar, but the plaques in the brains of people with Alzheimer's disease are made of beta amyloid. And these are just sticky pieces of protein that come from the fatty membrane around the nerve cells. And things that stick together clump together, and these form plaques.

And it blocks cellular communication.  On top of that, there's an immune response where inflammation causes cells to just be gobbled up.  There are going to be some great resources to better understand this process.  I'm going to put all of this together for you and send it out every Friday this whole month so you have all these resources at your fingertips.

And of course, if you aren't on my email list. You should be. You can sign up so you don't miss it. Now that you have an overall understanding of Alzheimer's, let's get back to prevention. When we look at the research, we divide the risk factors into two buckets, modifiable and non modifiable. We're going to focus on the modifiable.

Simply put, it's things you can control versus things you cannot. And this might be a really good time to recite the serenity prayer. Lord, help me to change the things I can. And accept the things I cannot.  Today, we will focus on what we can change. And I'm going to give you a quick list of known contributing factors for dementia.

And this is not a complete list and these are not your practical steps, but I think this is good information for you to have before we really get started.

Number one, diabetes, and it's way more prevalent than you might think.  Next is midlife, high blood pressure, high cholesterol, midlife obesity, smoking, physical inactivity, poor diet, which is the standard American diet, stress, and lack of quality social connectedness.  Notice there's a strong correlation between things that affect heart health and things that affect brain health. 

We often don't think of heart disease or dementia as being reversible. But what if,  what if, that's a question that deserves an answer. What if it's preventable and what if it's reversible? Dr. Dean Ornish addressed that question in the 70s for heart disease. And in June of this last year, he released a small research study showing reversal of cognitive decline.  Let's pause for a minute and let that sink in.

Not only is evidence showing that 40 percent of dementia is preventable, but now we have some evidence that at least in some people and to some degree, It's reversible. And if that doesn't motivate you, I don't know what does.

Now, this study was promising, but small. We're going to dive into the details in an upcoming episode in this series, but we're also going to look at information published by a reputable medical journal called the Lancet Commission, as well as recommendations and facts from the World Alzheimer Report, the National Institutes of Health, or NIH, and the Alzheimer's Association.

If you're interested in more information. , I'm going to put together a list of helpful resources, and some of them have some really cool visual tools where you can tour the brain.

There's a link in the show notes to sign up for my email, or just go to my website, www. healthylooksgreatonyou.com There's some great resources for you there, and episodes on diabetes and hypertension, because those are also contributing factors.

 And if all of this does motivate you to make lifestyle changes, as a bonus, you can sign up for a free mini course that I put together to help you work through making healthy habit changes. It's called seven day kickstart to healthy habits, but let's jump to the bottom line to quote the World Alzheimer's report 2024.

"There is no magic bullet for dementia, but there are tangible steps big and small that individuals can take to reduce risk. And any step is better than doing nothing."  

So let's look at those any steps.  There were nine risk factors that were identified to be modifiable, meaning you can change them, but they've added three more for a total of twelve.

I've divided them up into eight steps. Step one is literally a step, and that's physical activity. Any activity is better than no activity. And I would also say, the more, the better. Aim for at least 30 minutes a day to promote blood flow to the brain, which feeds your brain by delivering oxygen and nutrients.

Most experts have focused on aerobic exercise, which is getting your heart rate up. So, while it's great to walk three miles a day, if you aren't huffing and puffing just a little bit, But you probably aren't getting the maximum benefits. High intensity exercise can optimize the environment for creating new connections between neurons in the brain by releasing something called brain derived neurotropic factor or BDNF. This is a warrior in the brain that goes to battle to fight cognitive decline. 

More recently, strength training is being emphasized, especially quad strength. The muscles in the legs are some of the biggest in the body. According to "The Brain Docs", Dr. Aisha and Dean Shirazi, research has consistently shown that leg strength correlates with enhanced cognitive function. And on top of that, strong legs means less falls as we age and falling is associated with all kinds of bad things besides bruising and breaking bones. 

Another area that is currently being studied is called combined cognitive physical interventions. I'm going to talk more about this later, but it refers to activities that force you to use your muscles and brain at the same time. Now the studies are not conclusive, but the concept is that if you challenge your brain while exercising, you get more benefit.

Some people call it exergames, but think dancing, tai chi, virtual reality games, walking and recall, such as memorizing scripture while you walk. That's something I really enjoy because it's also outside in nature, which is a great stress reliever. And the instructor at the gym where I go comes up with all kinds of things to make sure our brains are being challenged in our circuits class.   And speaking of moving, let's move on to step number two. 

You probably knew this was coming, but the next step is diet. And of course, the big question is always, which diet? Let me just cut to the chase and tell you that lifestyle medicine promotes a whole food plant predominant diet. That means cutting out processed foods, especially ultra processed foods, and eating instead whole foods.

You know, the way God designed them instead of the way food manufacturing industry packages them. And yes, I know it's expensive and confusing and I talk about that in other episodes, but if you want to protect your brain, you've got to nourish it and nutrients come from food. The more the food resembles the way it exists in nature, the more nutrients it contains.

And that seems simple enough, but what does research and evidence tell us exactly? Well, Dr. Ornish says, whole food, minimally processed, plant based diet is best. for preventing and reversing dementia. And listen, his program is intense. The American College of Lifestyle Medicine says we should limit the amount of sugar and saturated fats. And make sure to eat plenty of fruits, vegetables, and whole grains. The World Alzheimer's Report tells us to diversify the food groups you consume and avoid ultra processed foods. In fact, we always say, eat the rainbow. That means different foods with different colors and that provides the different nutrients that we need.

And, by the way, when we talk about foods with different colors, we're not really talking about Fruit Loops, regardless of whether or not they contain dyes. Listen, junk food is junk food whether it's brightly colored or pale.  So what kind of diet? We're talking about diets that are rich in fruits, vegetables, whole grains, and healthy fats.

Those are all associated with better brain health. The Mediterranean diet is a classic example. The Mediterranean diet is rich in fruits, vegetables, whole grains, legumes, fish, and healthy fats, and has been consistently linked to lower rates of Alzheimer's disease. 

And the MIND diet is a combination of the Mediterranean diet and the DASH diet, which is used to treat and prevent hypertension. And it has also been shown to reduce dementia by as much as 53 percent. I have a separate episode on that. 

If you actually read the list of 12 modifiable risk factors, it doesn't specify diet, but instead includes maintaining a healthy weight and diabetes. And both of those are directly related to diet.  

Step number three is don't smoke. I'm not going to spend a lot of time on this one because fortunately most people don't smoke. That's one of the reasons that the rates of heart disease and stroke are decreasing. However, marijuana use is skyrocketing and we are starting to see evidence that it can increase the risk of heart attack by four fold. And I imagine as this trend plays out, we'll see more and more negative effects.

On top of that, air pollution has been linked to dementia. Now, I do have an episode on smoking cessation with some helpful resources. I'll link it in the show notes. You can find it on my website, but suffice it to say that anything that damages blood vessels damages the heart and the brain. Smoking contributes to cardiovascular disease, high blood pressure and stroke. And is clearly a risk factor for dementia. Hypertension is independently listed as one of the 12 modifiable risk factors and so is a high LDL cholesterol.  

Step 4 is meaningful social interaction. We need people in our lives.

Ideally, we could combine all these measures together. Eat your meals with people. Exercise in a class. Stimulate your brain with games that involve another person. There is strong evidence that links social connectedness to overall health in general and brain health in particular. Not only that, the one thing that is the strongest indicator for both happiness and longevity is It's social connectedness. 

I have a couple of episodes on loneliness. The latter focuses on mood and it turns out that depression is also a risk factor for dementia.  To be honest, it's hard to know the difference or which came first,  but it's clear that loneliness is linked to poor health outcomes in general.

Step number five is stay mentally active. Now, people with less education to begin with have an increased risk of dementia. But that doesn't mean that once you graduate, you can stop there. Be a lifelong learner. And this doesn't just mean to sit around and do brain teaser puzzles, although there may be some benefit to that. But there's clearly benefit in learning new things, especially hard things. Challenging your brain helps create new connections, and new connections help maintain reserve during the aging process. Learning a new language is probably one of the best things you can do to challenge your brain. But it's hard. Memorizing is another good thing, and I cannot tell you how much memorizing scripture has meant to me personally. Not only for brain health, but for spiritual health.  

Number six is just protect your body. 

Pay attention to your overall health, that includes your teeth, but specifically protect your noggin. Head injuries are associated with an increased risk of dementia. I'm going skiing this month and I will be wearing a helmet, but also make sure your home is safe. Rugs can be a hazard, so can puppies and bathtubs. Remove clutter and cords so you don't trip.  

Other things that fall under protect your noggin are hearing aids. You see, when sound enters your ears, it goes to your brain for processing. And when you can't hear well, those parts of your brain start to shrink. Wearing hearing aids may help prevent dementia.

And more recently, research has also found an association between vision loss and dementia, likely for the same reasons. So, maximize those inputs to your brain through your eyes and ears and protect your head.  

One of the most common causes of traumatic brain injury is car accidents. Two of the biggest factors associated with motor vehicle crashes are alcohol and sleepy driving. 

So, step number seven is avoid excess alcohol. Previously, evidence indicated that one to two drinks a day was considered safe and maybe even protective. Admittedly, people who live in blue zones often consume red wine on a regular basis. And if you aren't familiar with blue zones, I'll have an upcoming episode, but basically, It refers to five geographic areas in the world where people routinely live to be over 100 years old with vim and vigor. 

Only one of them is in the United States. It's in Loma Linda, California. There's a large population of people there who belong to the seventh day Adventist faith in that part of the country. And their lifestyle is marked not only by faith, but also strong social ties, a vegetarian diet, time in nature, and no tobacco, and no alcohol.

Regardless, there is an alarming trend of increasing alcohol consumption, and excess alcohol is clearly linked to dementia. For more on alcohol, I included a previous episode link in the show notes. There is no controversy in the literature that two drinks a day is the limit. Quitting is hard, but And I've included some resources on my website. 

Lastly, step number eight is sleep. I know, I know I said there were 12 modifiable risk factors. Thank you so much for paying attention. I will list them out, one through 12 in my newsletter. But for this episode, I grouped them together.  

In a recent episode, I called sleep the mood mechanic. But the brain repair work that goes on during sleep is so much more than mood.

Poor sleep is associated with so many of the risk factors for dementia, like diabetes, high blood pressure, heart disease, depression, and obesity.  Poor sleep, especially in late midlife, is associated with an increased risk of dementia. And if this is an area where you struggle, you will be glad to know that I have an entire series on sleep coming up next month with lots of great resources. Some of them are already on my website so hop on over there and snag them. 

The Lancet Commission states that "Our new life course model and evidence synthesis has paramount worldwide policy implications."  And they conclude by saying, "It is never too early and never too late in the life course for dementia prevention." So, no matter how old you are and what your risk factors are, prioritize your physical health and your brain health because healthy looks great on you. 

RESOURCES:

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Preventing Cognitive Decline

Practical tips for caregivers and friends of people with dementia

How to prevent and reverse type 2 diabetes

Control your blood pressure

How to quit 

Sleep - the mood mechanic

Kickstart Healthy Habits in 7 Days

The deadly epidemic of loneliness

From loneliness to belonging

Which diet is healthiest?

 

      The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change. 

 

Food has a big impact on mood.  Why would that be? How does what you put in your mouth that goes down into your stomach affect all that's going on in your brain? 

Carbohydrates are my dear friends. Well, some of them. You know, In every family, there are those people, you know how some people just make you feel good and others, not so much. For example, let's talk about Dorothy. I used to hang out with Dorothy once a week. Sunday mornings, in fact, And after we'd been together, I had bad breath, a headache, and I felt more than a little edgy. You see, Dorothy is a donut.  We parted ways several years ago, but one day I walked into a meeting and there she was dressed in chocolate and still pretty hot and I thought I'd just take one bite. But before, you know, it, I ate the whole thing.  And it didn't take long that I felt physically and emotionally drained.  But here's the deal, that period of absence highlighted the contrast of how I feel when I eat good stuff versus pure junk. And maybe you've noticed, or maybe you  haven't and maybe you just feel kind of bad all the time and you don't really know why. So let's talk about how certain foods affect mood and why. And since mini medical school is going to be pretty intense today, I thought I would turn the science into fiction.  

No, don't meanan the facts aren't going to be true. I mean, fictional characters. To help you remember, you're going to need to use your brain, but bring your imagination along too.

 And don't worry about taking notes, I created a free download for you that. It has a list of mood boosting foods. If you're on my email list. List. I sent it out. And. If not, there's a link to sign up in the show notes. 

It's never too late. You can also go to www healthy looks great on you dot. Com. 

  Now the way that food affects mood is. About altering brain chemistry and hormone levels. 

 And my old buddies carbohydrates, they can  give you a real boost. But, their cousins can really bring you down. So let's talk about the good side of the family first. Food rich in carbohydrates boost serotonin levels.

 The ol' feegood neurotransmitter er serotonin. We're going to call her Sarah for short. Sarah Tonin affects mood sleep and appetite. She is an intriguing member of the neurotransmitter family. And it has both a significant impact, both on mental as well as physical health. Sarah is a happy girl because she regulates mood and makes you feel happy and have an overall sense of wellbeing. 

And she's the one you'll really miss when she's not around. You may feel depressed or anxious. And Sarah's family is a power family. In fact. Mel is another member of the tonin family, and that's super important. Did you know that Sarah tonin is a precursor to melatonin? So think of Sarah as Mel's mother and you need both of them to get a good night's sleep, and yeah, I'm talking to you cranky pants.  Mel is related by marriage to the hormone family.  And his presence is highly influenced by light exposure. And he regulates the sleep wake cycle.  

He squirts out of the pineal gland. And if you're interested in the science of sleep, I'll put a link to that episode in the show notes, "Why is sleeping so hard?" 

And stay tuned because after this series on mood, we're going to focus on sleep.  But here's what happens, Mel gets up every evening and tells your body it's not night, night time. He stays up most of the night and then he drops off in the morning.  At least that's how it's supposed to work. He keeps the bodies internal clock in sync, making sure the circadian rhythm aligns with the sleep-wake cycle; daytime and nighttime. And he serves on the antioxidant team as well, combating free radicals and reducing oxidative stress in the body.  To boost melatonin, you can eat things like tart cherries, grapes, nuts.  And itit's alsoimportant to have good sleep hygiene. 

And again, if. If you're interested in sleep, make sure you're on my email list because there are some really exciting things coming now, let's get back to Serotonin. Do you know where Sarah lives?  Did you say the brain? Well, I hate to tell you, but 90% of the body's serotonin  is actually found in the gut, not the  brain. That may surprise you, but think about that gut brain connection.  Yep. That's why upset emotions cause an upset tummy. 

And since her address is in the GI tract, she affects appetite and digestion all the way to the end of the street.  I'm talking about bowel movements see, now you'll remember all of this science of neurotransmitter, Sarah Tonin. But wait, there's more. Speaking of learning and memory, Sarah affects those cognitive functions as well.

You know, Sarah is the type who can be all work and no play

. Because high levels of serotonin can actually reduce sex drive. And that's why some antidepressants which are called serotonin re-uptake inhibitors can kill your sex drive. It's a balancing act for sure because you need Sarah to have a good sense of wellbeing, but too much can cause intimacy to take a back seat.  Diet can boost our sense of wellbeing by increasing serotonin levels, particularly foods rich in tryptophan. 

 

Sarah tends to run away when they're stress or negative thinking, and that can be a vicious cycle.  Positive thinking and stress management, increase serotonin levels.

And if you need a review class on stress management. There's a link in the show notes.

Now I'd like to introduce you to another member of the neuro-transmitter family. He is the most likable guy you ever wanted to meet. Dopamine is considered to be the reward neurotransmitter thatkes you feel pleasure and motivation and helps with learning too. He's a standup guy. But we still have to nickname him dope. You see, he has a big role in addiction. 

And when I say he motivates, I mean, he really motivates. It's even if it's for another hit of whatever lights you up. Since dopamine is associated with pleasure, it contributes to addictive behaviors. That can be a substance or an activity that is pleasurable. But it drives you to find that pleasure again and again,

and that can lead to impulsivity to find more dope at all costs

regardless of the consequences. When you participate in the fun and games, whether that's eating, exercising, hanging out with those you love, dope is there. He pushes us to take action and pursue goals so we can feel that reward. That can drive us to work harder or it can distort and cause us to go into an endless pursuit. 

Again, it's a delicate balance. Dope keeps us focused, helps us pay attention. So we learn better and become more productive.

He's like a coach. He's also important in coordinating smooth muscle and movement. And people with Parkinson's disease have low levels of dopamine. So that explains some of the features of that disorder. And without dopamine you'll feel depressed and anxious. 

He's good to have around. So where can you find good. Dope.

Well, exercise can boost levels as well as sleep. And food can boost production. It's like a well coordinated family picnic. And if you think dopamine makes you high, I'd like to introduce you to another member of the neuro-transmitter family. Endorphins.  let's call her Endera. She comes around every single time there is stress or discomfort and tries to knock out your pain. It's like she wants to be the fixer in the family. 

She'll pump you up, make you feel great.

She'll even give you a feeling of euphoria when you exercise intensely. You've probably heard of a runner's high even if you've never experienced it. But she also makes you relaxed to fix all that stress and anxiety. She also boost your immune system. So, where is this lovely lady and where can we find her. Like it or not exercise, the more intense,  the better. 

Not ready to start running? 

Well, there's another great way to bring Endera to the party and I'm talking about a good old belly laugh to crank out endorphins. You see, laughter really is the best medicine and Endera loves her some dark chocolate too, as well as spicy foods that contain capsaicin like chili peppers.  She'll rush to your side, if you get acupuncture because yeah, there's a needle involved and she wants to fix your pain. And even if you're averse to such things, just turn on your favorite playlist, Endera loves whatever music you love and  that's why those tunes bump up your endorphin levels and help with mood. Endera the fixer releases endorphins to make you feel good, stay resilient in the face of challenge. The last member of the neurotransmitter family I'd like to introduce you to is oxytocin. Because you see, love love will keep us together. 

 

Oxytocin is the love hormone. 

We'll just call her O for short, she wants us to stay emotionally connected and she's a hormone too. She's the glue of the family. She helps form strong bonds, both between parents and children.  friends and lovers. 

We could call her the big O. Yeah, I did that on purpose. The foundation of any relationship is trust. O brings out feelings of trust and empathy, which is important for social interaction to be more positive and rewarding. She calms us down and reduces anxiety and stress. O plays a critical role in childbirth too. She stimulates the uterus to contract and promote the release of breast milk.. She's a lover, not a fighter. She likes touch any touch -hugging, holding hands, shaking hands, even a high five. All of those things release oxytocin. And this is going to make all the pooches happy, but petting your dog actually releases oxytocin.

You can boost O levels, by enjoying time with the people you love and having conversations that bring you closer together. 

Also do something for someone else and you both get a reward. ' Because doing acts of kindness, stimulates release of oxytocin. Stress tries to steal the joy that O brings. So learn relaxation and stress management techniques to keep her around. And oh yeah. O is important for sex too, in case you didn't get my previous pun. But it's not just casual sex. You see oxytocin promotes monogamous relationships, even in some animals. 

I'm here to tell you that God only desires the best for you. And that's why he created us the way he did.  Now that I've introduced you to some of the members of the hormone family. Let's meet the others. First is cortisol. Good old Cort. He gets a bad rap because you'll find him wherever there is stress, but here's the deal. 

He's got a lot of responsibility on his shoulders. He lives in the adrenal glands and he shows up in an instant when he thinks there's any kind of danger. He is the force behind the flight or fight response. He's in charge of controlling your body's metabolism and how fats and proteins and carbohydrates are used. His job also includes regulating the immune system and combating inflammation in the body. He knows how important blood flow is. 

So he's super involved in regulating blood pressure and cardiovascular function. So that we have the power to run or fight. We need him to survive,. 

especially in stressful situations, but he can be a bit much. Chronic stress.

 leads to persistently high levels of cortisol. Too much of Cort is not a good thing and it's terrible for your physical health, contributing to heart disease, unwanted weight gain, gI problems, anxiety, and depression. He can wake you up all night long and make you sick by lowering  your body's ability to fight off infection. He is a great guy and we need him, but a little goes a long way. If you know what I mean.  Now,  you can get him to chill out by exercising and making sure you have good quality sleep. Managing him isn't easy, but intentional relaxation.

 and combating stress settles him down. And if you eat a balanced diet of whole foods, fruits, vegetables, and whole grains that keeps him from getting out of control too.  And O can help.

So make sure you're tending to your social life and bonds with loved ones and O would  also like for you to meet another member of the sex hormone family. Estrogen.  We can call her Esther. I'm pretty sure you've met her before. And you know how much of an effect she can have on mood as well as energy levels and cognitive function. And when she gets on a roll,  it can cause fluctuations in emotions as well as wellbeing. Her main role is to influence the development of a woman's body during adolescence, then she controls the menstrual cycle during the reproductive years, and then she jumps off a cliff during menopause, but that's one of those family stories we'll talk about on another day. Esther can  be moody. I'm talking PMS, peri menopause. And all the things, female, but she's a protector maintaining bone density and healthy cholesterol levels and supporting cardiovascular health. And she has a twin sister, but they aren't identical. Her name is progesterone. And we're going to call her Polly. I think that's kind of cute.  Polly Polly progesterone. She regulates periods and maintains pregnancy. And that's a lot of Ps.

She also helps balance moody Esther by calming her down and trying to control her mood swings. She promotes better sleep and is just naturally sedating. We like her a lot because she helps maintain skin elasticity.  Now to balance these two wild sisters eat a balanced diet rich in nutrients. F oods high in omega three fatty acids control their behavior especially well, think flax seeds, chia, seeds, and walnuts. And you can add those to oatmeal and smoothies. Exercise. Is another good way to reign them in. And even if they smell stress, they'll go crazy and drive you there too. 

 And of course don't skimp on good sleep because they throw everything out of balance and they'll eat you alive without good sleep. 

The twins have a brother too, his name is testosterone. We're going to call him Rone instead of testy because, well, that doesn't sound good. You probably think of Rone as being a male hormone. And while it's true that he turns boys into men, he    is also found in women, it's just in smaller amounts. Rone can increase energy, motivation and overall mood. He's buff, and supports muscle mass and strength and bone density. 

He can be a lover and a fighter.  It's important in libido for both men and women.  And the last baby in the hormone family is insulin.   We'll call her Sully. She regulates blood sugar, brain function and mood. And she's tried for years to get along with Dorothy. You remember? Sweet, sweet, Dorothy.  She makes you crash and leaves you feeling sluggish and irritable.  And Sully is really just a peacemaker, always trying to control blood sugar and make sure it gets into the cells for energy. If Sully doesn't work properly then the body doesn't move sugar out of the bloodstream the way it's supposed to, and then we develop diabetes.  Sweet Dorothy and all of her sugary friends can sneak up on you and ruin your day. But here's the deal. If you consume sugar regularly, yuou  might not even realize that sugar and other simple carbohydrates. are what's causing that quick sugar spike. 

You eat your biscuit  and jelly and it goes up and then you get a sharp drop, then a crash and this rollercoaster of emotions can cause mood swings, irritability and fatigue. We talked about hangry last week.  Not only that, but a high sugar intake can cause increased inflammation in the body and that's been linked to mood disorders such as depression and anxiety. So we can all agree that chronic inflammation is not good for your brain.  Think about some antioxidant rich foods like berries, all kinds of berries, blueberries, strawberries, raspberries and blackberries. And remember good old dark chocolate. It's gotta be at least 70% cocoa to maintain the antioxidant content. 

And then those nuts, like walnuts, pecans, and almonds. As well as spinach and other dark. Leafy green vegetables like kale and Swiss chard, and lots of beans and artichokes for their antioxidant properties. 

These are feel good foods. Unlike Dorothy. Dorothy sugar gives you a hit of dopamine. Well don't we like that. Yeah, but like everything else, the pleasure is temporary followed by dip, then cravings. And this is why sugar is such a vicious cycle and can be as addictive as any drug. These types of foods aren't good for you. 

And they're often nutrient poor. And replacing in your diet, what could be nutrient dense foods. The standard American diet includes a lot  of sugar. And sugar before bed can affect sugar plums dancing in your head because sleep quality is affected in a negative way by sugar too. And that certainly contributes to mood disorders, including anxiety  and depression. But let's get back to insulin.  Natural ways to increase insulin are a balanced diet with low-glycemic index think fruit. 

And regular physical activity. improves insulin sensitivity and helps maintain a healthy weight.

Foods high in antioxidants include foods that have omega-3 fatty acids because they combat that inflammation. That's linked to mood disorders like depression. So are leafy greens, fatty fish, nuts, seeds, berries, dark chocolate, whole grains, legumes and bananas. They're all rich in vitamins and tryptophan, which is a precursor to serotonin. 

Remember the feel good neurotransmitter serotonin.  It's also found in avocados, which contain healthy fats and vitamin B6, which can improve mood and brain function. 

If you didn't get a chance to listen to last week's podcast.,I talked about the gut brain connection. You see. What you put in your tummy affects what happens in your head, and what happens in your head affects your mood. 

So eat good food to have a good mood and. And be happy and be healthy because healthy looks great on.     

Resources:

Why is sleeping so hard?

Good mood foods

Stress management episode

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Get your good mood food recipe

There is scientific evidence that food affects mood. You probably know how it feels to be hangry. That combination of hunger and anger can drive you to head to the pantry and grab whatever you can get your hands on. But that sets a process in motion that only makes you feel worse. Instead, replace unhealthy snacks with foods that boost your mood and get double the benefit. 

The health of your gut microbiome influences your mental health. All those bacteria that live in your gut produce neurotransmitters that affect brain health and chemistry. Make sure and eat high fiber foods to promote a healthy gut.

High fiber vegetables include broccoli, carrots, green beans and spinach. 

In one study, people who ate fruit frequently had less anxiety. So try keeping a bowl of berries or grapes out and grab one throughout the day. Start your day with good mood boosting foods. You can add oats, berries, nuts and seeds to a smoothie. Or slice bananas or apples and top oatmeal. Bananas contain tryptophan which is a precursor to serotonin, the happy neurotransmitter.

Throughout the day look for ways to add beans to your food. They're high in fiber and keep that gut healthy, which helps keep your mind healthy too.

Also add walnuts, they're great for brain function. Trail mix is a great way to get all these good things together. And the good news is that dark chocolate is full of mood boosters. It's also calorie dense, so a small amount. Make sure it's at least 70% cocoa. 

Avoid alcohol, too much caffeine and fried foods. That only makes you feel worse. Instead, plan ahead and keep the pantry stocked with feel good food. 

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 Special guest Barb Roose is the author of "Stronger Than Stress: 10 Spiritual Practices to Win the Battle of Overwhelm." She's also a speaker,  literary agent, and Bible teacher. According to her website, "She is a real woman who's experienced deep anxiety, parenting challenges, family addiction trauma, and long seasons of walking by faith in unanswered prayer."

Lifestyle medicine has six pillars: restorative sleep, nutritional eating, physical fitness, minimizing harmful substances and social connectedness. But when we talk about stress, it affects all of them. It's an overarching theme to health. 

Barb:  We know that stress is out there and we talk about it openly. "Oh, I'm so stressed." Like if you talk with people, stress is going to naturally come up. And so there's this social acceptedness that there is stress. The reason why I wrote the book and the reason why I want to engage in these conversations is because you and  I are aware of the damage.  And so it's a situation, particularly as women, we just live with stress. And so it is trying to elevate the hidden damage of chronic stress and to convince women not to set themselves on fire to keep everybody else warm.  

The challenge is these days, as women, we want to protect what we love. We want to fix what's broken. We want to get things on track. I call it the good Christian woman syndrome. We will sacrifice ourselves trying to be everything to everybody.   

We keep little people alive or a spouse.   We found keys every day so that a spouse could get to work.  In some ways, there was a season where so much relied upon us, but there are those practical moments where we have to remember that there is a God. And it's not us.   

Dr. Vickie: That is so , absolutely true. There is a God and it's not us. And I think that's the thing. When we take on all that responsibility, we learn to depend on ourselves  and then we think we don't need God until our whole lives start unraveling.

Barb: I use spinning spinning plates as a metaphor for  all of the things that we have happening in our lives. And I recognize the reality that there are some of you listening and you've  got spinning plates. The big picture of the book. is helping us recognize that God can actually take care of us and our spinning plates so that we can take care of ourselves.  

Dr. Vickie: Practically speaking, how does that play out?  

Well, my favorite chapter title of the book is, "Get Off the Cross, Honey. Somebody needs the wood." Sometimes we can't just convince people that they need to change.    They have to feel their need for change.   And what I want to do is create that feel for the need of change by using Jesus' words in Matthew. And so in this chapter, I cover Jesus' words and he says, "Come to me, everyone who is weary and heavy burdened." And, I think that pretty much everyone listening is going to say, yep. I am  weary and heavy burdened. In the original language,  weary was all about feeling like everything was on you. That self-sufficiency, that's what the weariness is that Jesus was talking about, and then carrying heavy burdens. That is about all of the expectations, all of the duties, all of the to-dos and the do mores. And so if you are exhausted by all of that, overwhelmed, Jesus doesn't tell you, you've got to read your Bible  five days a week. He doesn't say you've got to pray for 45 minutes a day. He says, "Come." It's an invitation. And what he wants to give us is rest. He wants to care. The work has to be done, but He wants to teach us how to live in him. So that we let Jesus carry the weight as we do the work of our lives.  

When I think about that verse, like the word picture, Jesus goes on to say, take my yoke upon you. And yoke always felt like this really antiquated word, but yoke still exists. And most of us know that a  yoke is where they have one animal that is  basically harnessed to another animal and the visualization is that there is a more experienced animal that helps teach the younger animal the way to go.

Now, Vickie, I don't know about you, but when I am left to my own  devices and I'm trying to live apart from God,   I am going to wander. I'm going to stomp on things that I shouldn't stomp on. I'm going to go too fast. I'm going to reckon the things. And so when Jesus says. Take my yoke upon you.  what Jesus essentially is saying, let me put  my arm around you, around  your shoulder, because essentially stress has us in a choke hold.

It is a choke hold that is strangling us. We are often, Vickie, sometimes we try to run ahead of what God is doing in our lives. Can I get an amen?  

And so Jesus, he's putting his arm around us and I find it very interesting that on a shirt, the shoulder area of the shirt in construction is called a yoke.

And so Jesus is putting his arm around our yoke and he's saying, learn from me. Let me teach you. He's saying, let me teach you the right pace to live. Let me teach you the path  to follow. Let me guide you so  that you're not trying to run ahead and figure things out on your own.  so Jesus, who has the experience, who is our peace, is teaching us the pace so that we don't live stressed every day.  

I love that picture of pace because I want to be productive. I want to do things. I want people to be able to depend on me. I want to fulfill my purpose. And it's just as bad for our health for us to live without intentionality and without purpose. And so the point is not just to say, Jesus, take the wheel. I'm just going to sit back and do nothing. It's let's walk this out together.  

We have these things that God has called us to do. We, and women, if you're, or whoever's listening, men and women, we  should have purpose. We should have kingdom  oriented goals. We should have people we're investing with. Even if you're retired.

I heard this years ago. This amazing story of a man. He was a neurosurgeon and he developed a spinal condition and after like a dozen surgeries, he was medically disabled.  That  man ran Bible study groups, on Zoom people around the world from his hospital bed in his home. So he still had work that he had to do.  We all  have work no matter where we're at.  

But what Jesus wants to make sure of is that our work is not wrecking us, that we are not running in chaos from sun up till sun down. He wants us to experience his peace.  And the peace is only found in him.  

Dr. Vickie: So true, and peace is really lacking. I feel like so many of us live on a merry go round. And sometimes we're busy without actually accomplishing anything that is of eternal value.  

Barb: Well, yeah, because the urgent over the important. We're just playing whack a mole every day, trying to do the to do list. And again, we're doing it with the best of intentions. But part of why I wanted to write this book on spiritual practices, because  these are the practices that Jesus wants to teach  us so that our days have meaning and value. Because the last thing we want to do is get to whenever the end of our lives are, and us wonder if we made a difference. The way of Jesus is the way to help us make a difference.   

Dr. Vickie: Resting in Him, peace in His methods, and a plan and a purpose  for our lives. It's all built on trust. I think so many times we think, but this is the way I want my life to go. So I'm pushing, pushing, pushing. When God's saying, come to me, slow down. That's, that's not my plan and purpose for you. And we just, we have to rest in that. We really do. And rest has always been a four letter word for me.  

Barb: There is a spiritual practice. that incorporates rest. But if I can share a personal example, I recently had some blood work done. I'm a woman of a certain age now. I had gone into the  doctor to have blood work done so that I  could start hormone replacement therapy. And so she wanted me to have an extra panel done because she wanted to make sure I had all the options available. This was about a month ago. I go in, I get the blood work done and I, it's the day before my book party celebration.   So I have four interns who are in town, who've flown in, and I'm hosting a retreat for them. It was all planned out. No stress. I had my book launch party at my church that next day, all planned out, interns, no, no stress.  That morning when I woke up the day of the party at 7. 30am, the  first message I had was from my mother, who lives two  hours away, who's my emergency contact and said, the hospital lab has an emergency phone, they need you to call them. And Vickie, your listeners won't appreciate this, but you will. It was an emergency because my hemoglobin was only 5.6.

Dr. Vickie: You were running on empty. 

Barb: So here's the thing, no symptoms.  So at 8 a. m. that morning, I get this phone call that says, You are dangerously anemic. And what are you going to do about it? And I was like, well, okay,  the day goes on and there were things that just kept popping up. One of my kids had a sick dog. Another kid was throwing up in the bathroom. I had signs that weren't delivered. I had an ex boyfriend  that I hadn't seen in three years surprise  show up to the book launch party!  And so I share all of this because there are going to be unexpected things that happen.

But what I have learned over the years of the spiritual practices  is what it looks like to keep Jesus' peace at the forefront of my mind. Now, did I feel Some pressure because I was like that's a lot to happen to somebody in one day . And  that's not everything that happened But I learned through the spiritual practices One of the cornerstones in the book is surrender. Most of our stress as women is because we are trying to stay in control of everything .

The title of the chapter is the Surrender Prayer and it's "God, I can't. But you can,  and I will let you." And so I had to really focus on that surrender prayer. And then there's another practice of gratitude. It's in the celebration chapter. I want to keep a spirit of gratitude.

I'm not ignoring  everything that's happening. I hadn't had a symptom. I had been sleeping fine, working out full energy, all of this. And I was like, Lord, I  have no idea what's happening here. My body is not doing great, but God, I feel great. And so I practiced gratitude. And so throughout the day, I was incorporating those spiritual simplicity when my day got chaotic. I was like, okay, Barb, let's stay  focused. You can't do everything, but if you can  only do one thing, what can that do? And so these practices help us to stay focused on what the most important things are, but we have to learn how to use them consistently over time.   

Dr. Vickie: I would say in advance of a stressful moment, you obviously had some practice using those tools when all of that came at you. And I used to have women all the time that would come to me during their pregnancy and they're like, oh, I don't want an epidural. I don't want an epidural and I was like, then you need to go to the classes.

You need to practice the breathing techniques when you're not in pain because all that stuff goes out the window the first time that contraction hits and it's the same thing with our spiritual walk.  You knew, okay, this is what I do. I surrender. I always say the place of perfect peace is the place of perfect surrender and you said that prayer But what I pray is whatever Lord just whatever. You also posted this morning on Facebook  the verse from Isaiah 41:10. It's one of my favorite verses and the reason is that when I got really really sick  I kept seeing that verse everywhere, but it was out of the message translation and it says in message translation, "Don't panic!" Our natural response to a stressful event is panic, because like you said, we're not in control.  

Barb: When I was a pharmaceutical sales rep, one of the drugs that I sold was a very popular antidepressant. And I remember how valuable it was for me to just understand our body's response to stress. And so I cover that at the beginning of the book,  but I keep it at a very high level, but it is  helpful for me to remember that in my natural state, my body will react to what my brain perceives as threatening. And the way of Jesus,  when Jesus becomes our peace and our perfect peace, we feel less threatened by the world around us. And when we feel less threatened, our body is not going to react into  fight or flight as often. And for me, that  was really helpful to keep in mind, because there are going to be, and hear me, there are going to be situations in life when we should be stressed. If the doctor calls and says that your kid has type 1 diabetes, you're going to be stressed. And so stress was actually created by God as a protective indicator to tell us that we're reacting  a certain way to our environment. But chronic   stress, when you're stressed all of the time, afraid all the time, anxious all the time, irritable all the time, That's a spiritual issue, because you have what I take from 2 Timothy 1:7, the spirit of fear. When everything is making you anxious and afraid, that is something that Jesus wants you to address. Does that make sense?  

Dr. Vickie: It makes perfect sense to me, and I love the way that fits into lifestyle medicine because we have all of the neurochemicals  that get released. We that fear area of our brain, like the amygdala and all of the neuronal synapses that can actually get wired or rewired because when you're worried and you're anxious, you literally create a neural  pathway that's like a rut in your brain. You just  keep going down that same rut. And so you have to do something to shift that. And we talk about stress management in lifestyle medicine, but there's no magic wand to make it go away. And even Jesus doesn't just make it go away. You have to have these spiritual practices to come to Him.  

Barb: Right. And I love that you talked about the neuropathways and neuroplasticity. And so I want to share a story. I was in the eighth grade.

Vickie and I have met, actually Vickie and I have a picture  of us standing together because I am  overly tall, which meant that when I was a kid, they immediately said this girl should play basketball. So I was in the seventh grade. I went out for the basketball team. Partly because I wanted to play basketball, but also because that's where all the popular girls were at on that team. And I wanted to be popular. So at basketball tryouts, I could run really fast, but, I wasn't that good of a dribbler and   I couldn't shoot all that well. So I didn't make the team. And I'm devastated. Well, the seventh grade coach, her name is Miss Bednarik, still remember her name. She said, Barb, you actually need to be stronger. She said, you're dribbling skills, you just don't have good muscle coordination or shooting. It's  because you need strength. And so she told me when the kids would go to the weight room. And so Vickie that following Tuesday, I showed up at the weight room at my junior high.  I was the only girl in this weight room filled with stinky, sweaty junior high boys. And, this is the eighties folks. We didn't have great  ventilation. We did not have windows. It was basically boys after school and their Old Spice had worn off by lunchtime.   And have there I was, and I had a choice that that I had to make that day. Was I going to keep showing up? And so I started learning how to lift weights.  As this only girl in these pot bottomed glasses, two giant front teeth, And I am oversized  and I'm there with the scrawny boys and every Tuesday and Thursday. I kept showing up and I had to learn how to lift the weights. And then I would struggle and they would help.

And that is practicing. We're not going to be good at it at first, but what makes it matter, is that  we keep showing  up.

If you just have one minute to read your Bible then read for one minute. The practice isn't valid just because you sit there for 20 minutes.  Just do it for 1 minute. If you can pray for one minute,  pray that one minute as often as you can.  God can do something with that.  Other practices are Sabbath.  Maybe you can't get to taking a whole day but can you take just 2 hours to just sit and  rest? Absolutely. But the most important value of practicing is to keep showing up. And so I kept showing up all that seventh grade year, and I got stronger. And I made the eighth grade basketball team. But more importantly, Vickie, I've been lifting  weights since that girl was in the seventh  grade. And now that I am over 50,  part of what the doctor's office told me when they called me last month,  they just said, it appears that the rest of your overall health is so strong. That's why your body has been covering for you this whole time. 

Dr. Vickie: Now I can smell that junior high locker room.  That is such a powerful memory. I can smell it from here.   

Barb: I can still smell it. And it's been 40 years. Whew! It was rough.

Dr. Vickie: I think about the spiritual disciplines, you call them spiritual practices, but  practice always, always, always requires discipline. So I am super excited about your book and I would love for you to tell up our listeners where they can find you, where they can order your book.

And I'm going to look and see if I can find that picture because I'm standing on the hearth, and you're standing on the floor, and you're still taller than me, and that's not saying much because I'm not very tall. 

 Barb: We made quite a sight together. My friends, I have to say, we looked as cute as cute could be, but definitely, one of us is, is, is super  action packed. That's me saying that you're short: Action packed. And then one of us is just real, real tall.

There is actually a Bible study that goes with the "Stronger than Stress" book,  I am primarily a Bible study author. So for those  of you who do love Bible study, there is  a six week Bible study with video that you can access. Both book and Bible study are available anywhere you love  to purchase your books and Bible studies. 

You can do them separately, what I recommend is that you get either a book club with some friends, or a Bible study group with some girlfriends so that you can all talk and journey together.   

Dr. Vickie: Yes, there's so much power in together.  

Barb: There is, there is. And, if women want more information or maybe they just want to check things out, uh, you can check over to barbroose. com. I have a link there where you can check out the book and the Bible study group.   And on top of that, you can actually watch the  first video session, so that you can decide whether you want to share that with some friends and say, Hey, do we want to get a group together and talk about how we can live less stressed with more peace every day?   

Dr. Vickie: That is so awesome. Well, I appreciate you coming and talking to us about stress management. And I think it just fits perfectly with lifestyle medicine. I always say that that's one that you just absolutely cannot do without Jesus.   

Barb: Amen. I love that wisdom. Love it.

 Dr. Vickie: Wow, what words of wisdom from someone who has such a passion for following Christ. And I hope that that will make you want to dive into God's Word a little bit more. And if the Bible is unfamiliar to you, take a peek for yourself, because there is a peace that passes understanding, and there is a rest that is possible through Jesus Christ.

And I would challenge you to check it out for yourself and see. But Barb really didn't tell  you all there is to know about herself. Go to her website.   You're going to want to know more about her. It's barbroose. com. I'll put a link in the show notes. 

 This is an edited transcript of this episode. 

BarbRoose.com

Stronger Than Stress Book

Stronger than Stress Bible study

 I've been doing this for about nine months now. And I think it's time that I shared a little bit more about how I got here, and maybe that'll help you on your own health journey. I'd like to think about where you are now, where you've been and where you want to go. So let me tell you where I've been.

 I started my OBGYN practice when I was 30 years old. I had a daughter who was just starting kindergarten, and a little boy who was about to turn 2. And my practice ramped up really fast, And back in those days, drug reps often brought lunch to clinic, and they didn't bring healthy stuff. They brought things like pasta with alfredo sauce, and they brought a lot of cheesecake. And I love cheesecake. Especially turtle cheesecake with all that caramel sauce over it. Mmm.

It's delicious.  And so every time that they brought dessert, I indulged in dessert. And my life was kind of busy.  I began to gain weight. And I developed migraine headaches. And I wasn't sleeping very well. And of course you can't sleep well when you're an OB doctor anyway, but that's a different story.

And so I really felt terrible. On top of that, every single time it was somebody's birthday at the office, we pot lucked and the potlucks weren't much healthier than the drug rep lunches. And they always included birthday cake because after all we were celebrating. But every celebration isn't my own special occasion.

But I didn't realize that. So I just plowed on through and next thing you know,  I gained about 15 pounds. Between ages 30 and 35, I felt worse than I had ever felt in my entire life. And I looked it too. I was miserable. My clothes were tight. I didn't have any energy. And I just felt bad.

And I discovered a book called, What the Bible Says About Healthy Living, by Dr. Rex Russell, M. D. And so I read this book and it talked about how we should eat things in their natural state. And back then we didn't really use the term whole foods, but eat food in its natural state. And so what Dr. Russell said is that butter is better than margarine, and that vegetables are better than processed foods, and that things that are refined have lost their nutrients, such as white rice, white flour, and sugar. And so I went on a pretty radical diet and I changed my eating habits completely. And the three things I cut out were white rice, white flour, and sugar.

And not only did I lose the weight, but my migraine headaches went completely away. Now, I wasn't pure about it. I would obviously indulge every once in a while. And I learned just about how many bites of something I could take before I'd get a headache. So, I would pre decide what I was gonna do if there was a potluck at work.

And there was cake, or there was that turtle cheesecake that I could never resist, and I would tell myself, Four bites. That's all you get. Four bites. And most of the time I would stick to that, but every once in a while, I'd just finish the whole piece. And you know what? I'd get a migraine headache. And so, that was a good feedback thing for me to say, You know what? That's a headache on a plate. I don't even want it. Now, I didn't follow what Dr. Russell recommended exactly, He recommended very small intake of meat, but I just kind of ignored that part and the dairy part he recommended butter. So I really lathered the butter on and I did switch to whole wheat. I bought a mill and I started milling my own wheat and making bread. 

I discovered a lady named Sue Becker that does bread baking and I had a whisper meal. You just put whole wheat in the top of it and, Grind it up and you get fresh whole wheat flour. And I made bread with olive oil and honey and it was delicious. And so I did that for many, many years and taught my kids to eat healthy.

And I'm so thankful for those foundations because My kids have pretty good eating habits, and I think those early years of us eating more whole food was good, even though we ate a lot of vegetables out of the can. We did, because we were on the go, go, go. But we ate vegetables, and we didn't eat a lot of junk food.

I followed most of the principles from this book. One of the things he said is that God gave us all of these laws for a clean diet. And then Jesus came and set us free from all those laws, but God knows our body. and he knows how they function best.  And so I followed this diet for many, many years and felt great. I got really fit in my forties and I started exercising after I lost that weight. I felt so good. I wanted to exercise. And so I started cycling and I rode my bike all the time. And then, when I turned 50, my whole world turned upside down.

I developed a rare autoimmune disease called Myasthenia Gravis. And it came on pretty suddenly, and I had a severe case of it. I could walk across the room, but I couldn't walk very far. And I couldn't use my arms very much either. And I was very disabled. And to treat me, they put me on a lot of different medications.

I had surgery, I had infusions. And, one of the medications made me severely diabetic, so I was on Januvia, Metformin, and insulin for the diabetes. And, to some degree, I think I thought, well, pfft, I ate healthy all those years, what good did that do me? Now, I only paid attention to nutrition, diet. and physical fitness and I treated rest like a four letter word and I did not sleep and I'm not sure if that contributed to my autoimmune disease or not but there is some data that shows that that is a risk factor

I kinda threw my hands up in exasperation and said well I've eaten healthy all these years forget it I'm just gonna eat whatever I want but because of the diabetes I couldn't do that. Now it was steroid induced diabetes And I was on prednisone, so my face was as big as a moon. I gained about 8 pounds is all I gained, which is pretty good for that high of a dose of steroids.

But it was all from the collarbone up. I mean, it was awful. And to keep my blood sugar from going up too high, I found some things that I could do, like eat nuts, that kept me feeling full, without getting a lot of sugar and unhealthy carbs.

And so I was able to avoid an excessive weight gain on the prednisone. And after I got off the prednisone, the weight came off, the diabetes went away, and I went about my merry way eating whatever I wanted to, because the migraines went away with menopause, and like I said, my health was kind of tanked anyway.

I thought, what difference does it make?  

And then I had some routine blood work done, and it showed an elevated cholesterol, which runs in my family. Everybody in my family has it. I've had it since I was in my 20s. And it also showed an elevated hemoglobin A1c. And so when I went to see my doctor, he looked at me and he said, Are you willing to make some radical changes?

And I said, I will do anything to not be diabetic because I knew how terrible I felt when I was diabetic.  And he recommended that I read a book called, How Not to Die, by Dr. Michael Greger. And so I read the book and I started implementing the things that he suggested. And lo and behold, my hemoglobin A1c, normalized and my cholesterol went down as well.

And so a little bit after that, I discovered the entire field of lifestyle medicine and the six pillars, which are nutritional eating, and it is plant based, and physical fitness, social connectedness, stress management, restorative sleep, and minimizing exposure to harmful substances. And so I became board certified in lifestyle medicine in December.

My lifestyle is pretty good; overall I feel pretty good for 60 and I exercise. I have had a few other health scares recently. And so I decided that I was going to get really strict. And you can probably guess that I read a book. Because I always read a book. And so I read Dr. Neal Barnhart's book, The Power Foods Diet. And I started doing what he recommended in that book, and boom, like that I lost eight pounds. Did I need to lose 8 pounds?

Yeah, I did. I mean, I was pretty comfortable in my clothes, and I had been the same weight for, gosh, so many years. But I had developed some belly fat after menopause, and it melted away in a very short period of time following that diet. And he's vegan, and there is a difference between vegetarian and vegan.

Vegan is to protect the environment. and to make sure that animals are not mistreated.   And you can eat a vegan diet that's very unhealthy. You can eat a Pop Tart and that is vegan, but it's not healthy. Vegetarian means that you only eat vegetables and you don't eat meat. And I'm not a vegetarian. I eat plant based.

And what that means is I get the majority of my calories from whole foods that are nutrient dense. that are plants.  Do I eat meat? Well, sure. I eat meat, just not very often. And originally, when I started doing this, I was cooking for myself and for my husband. And so, for example, I would make stir fry, and then I would do a little chicken for him to add.

Or, you know, whatever dish I was making, I might do black bean tacos or mushroom tacos, and I'd do a little ground beef for him. And then he said, you know what, I think I want to try one plant based meal a week. And so we started having one plant based meal a week. And then as my cooking got better, because my cooking has definitely got better, in the plant based department.

I learned to make meatballs that don't have any meat in them and they're delicious. And so now he said,  you know, I think I could do two nights a week that are plant based. And I never said anything. I didn't say, Hey, I want you to eat like I'm eating. But I feel really good now. Am I a hundred percent healthy?

I'm not, I have issues, but I want to preserve my health as best as I can as I age.

And I want to feel good and be able to do all the things that I love to do. And so, I hope that this helps you know that you're not going to do it perfectly. And there's a lot of conflicting information out there. And one of the things I do on this podcast is try to help you sort through the noise. The podcast is really growing and I appreciate everyone who takes time to listen.

I'm offering a couple of new things. Number one is the Healthy Looks Great On You Lab. Think of the podcast like the classroom, because we always go to mini medical school and learn something.

Think of the Healthy Looks Great On You Lab as the field trip. It's where we go out of the classroom and actually do things that make a difference, because that's my goal. I want to give you information and motivation and inspiration to make changes that make a difference.  So I hope you're on my email list so you get an invitation to the Healthy Looks Great On You Lab.

It's going to be so much fun. And if you're like me and you struggle with sleeplessness, I have a webinar coming up that will be free. on sleep. It's called the Sleep Solution. I'll put a link to sign up in the show notes. Registration is open now  and I hope you'll join me for this important information. 

And since we didn't go to many medical school today, let me take you behind the scenes and on a day in the life of a doctor. Every morning, I got up, got my kids fed, got them off to school, sometimes took them to school, went to the hospital, made rounds, checked on anybody that was in labor or did surgeries that I had scheduled, then went to the office and saw 40 patients a day, and I never got through before 1 o'clock, so when I did eat, I was rushed, I was just cramming something in my mouth real quick, and go, go, go, go, go, until I got off in the evening, and then home to eat dinner.

Then football games to watch my daughter cheer or track meets to watch my son pole vault. Then we'd come home and go to bed and I might get called out two or three times during the night  to deliver a baby.  And we'd get up the next day, whether I'd slept or not, and do it all over again. 

I'll be honest with you, it's not an easy life.   But it is so worth it. I always say, nothing compares to the feel of newborn baby feet, except the look in a mother's eyes when she touches them for the first time.  I loved being an OB GYN doctor, And I got some unique insight into a woman's soul. 

I consider it an honor and a privilege. And I consider it an honor and a privilege to educate you about lifestyle medicine. I hope you'll stick with me on this journey. We're going to have a great time. Sign up to get my emails. Sign up for the sleep webinar.  There'll be more to come. And I hope to see you in the Healthy Looks Great On You lab. 

Because healthy really does look great on you. 

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Do you get enough protein? There are protein powders, protein shakes, and protein bars. But how much protein do you actually need? Then there are high protein diets. Are those good for you?  Are you getting enough protein in your daughter? Maybe too much stay tuned to find out if you're getting the right amount.

It seems like we're just bombarded with this message to make sure we get enough protein and yes, you definitely need enough protein. But chances are you get plenty.  The average American diet is 16% protein. Well, that translates to 80 grams a day. If you follow the recommended 2000 kilo calorie diet. On top of that, most Americans eat protein that is packaged with fat. And that definitely has some negative health consequences. 

Today, we'll discuss the amount of protein that's right for you and the best sources

We do need protein if you don't get enough protein, you can have brittle hair and nails. You can feel hungry all the time or your muscles can be weak. Your immune system can be compromised, so you get sick a lot. You can even have trouble thinking or changes in your mood, or stress fractures in your bones.  

So let's go to mini medical school for a review course. There are three essential macro nutrients that our bodies absolutely need to function. Fat carbohydrates and protein. And gosh, when I say those three together, I think the protein hype comes in from the bad rap that fat and carbs get. Remember one gram of protein is four kilocalories.  Same for carbs and fat is nine. But you do need all three macros and like everything in lifestyle medicine, it requires balance.  And on top of the macros, there are lots of micronutrients, but here's the deal protein is never a solo act. I mean, you can't really just eat a protein. 

Proteins are macromolecules. Well, that just means they're big old suckers made up of long chains of amino acids, and you may have heard them called building blocks. There are 20 different amino acids and we need every single one of them to live. but your body can make 11 of them. So nine of them are essential in your diet. A complete protein has all nine of them, Most protein in our diets are not complete. But not to worry your pretty little brain about that. We will talk about how to get a complete protein.

Amino acids are kind of like Lego's, they fit together to make proteins, but unlike Legos, they don't make you cuss when you step on them. And like Lego's for mothers of little boys. Amino acids are everywhere and you can snap proteins together to make muscles, hair, enzymes, and antibodies. They break stuff down in chemical reactions in the body and they're important for DNA replication. 

We need protein for every organ in our body to function like it's designed the heart, the brain, the skin, the immune system. And it's especially important for the musculoskeletal system. Adequate protein intake helps build repair and maintain muscle. And that's not just for bodybuilders who want big ol honkin muscles because as we age. Staying strong becomes even more important. Protein may play a role in appetite control. And that's why a lot of these diets focus on high protein for weight loss. And we're going to talk about that in a few minutes. But not getting enough protein can lead to hair loss, skin breakouts and breakdowns, weight loss, loss of muscle mass and weakness.  This is most likely to happen in people with eating disorders or the elderly who have an inadequate caloric intake. Now let's get to the bottom line. How much protein do you need? 

 You're going to need to know how much you weigh in order to do the math and the simple answer is that you can multiply your body weight in pounds by 0.36 and determine the minimum number of grams of protein you need. Of course, there are situations where you need more  like how old you are, whether you're a man or a woman. Your activity level and pregnancy.  Okay, active adults need 0.6 to 0.9.  Older adults need a little more too. They've got to maintain that muscle mass. So 0.8 times, your body weight in pounds. And the reason older adults are at such risk again, is because of decreased appetite, decreased calorie consumption, and the importance of staying strong. So you don't fall, or you can open a jar and all the other things you need to get done in a day. Okay. What about athletes? Well, they do need more. 1.2 to two. So let's look at that just a little bit different way. And for those of you who are on my email list, I'll send this out in print because it's so much easier to look at that way. 

Sedentary adults need 10 to 15% of their calories from protein. Active adults need 15 to 25%. And athletes should consume protein as 25 to 35% of their diet.  And with all the hawking about protein, you'd think we're all deficient. But on average Americans get  the amount of protein they need. In general, if you're eating enough calories. You're probably eating enough protein. Can you get too much? 

Well, yeah, too much isn't good either. In fact, men aged 19 to 59 typically get more than they need from chicken eggs and of course burgers and the steak.  But what about that meat eating man who pumps iron and sweats on the treadmill, you may be surprised to learn that even athletes do not need a supplement to get enough protein, they need more calories to fuel their workout. But they can get that protein in food. Isn't that such a beautiful design.  Now I mentioned in kind of a fancy way that protein contains nitrogen. So your body needs fluids to process nitrogen and too much protein can make you dehydrated. It strains your kidneys and people who have kidney disease need to be really careful about finding that balance between not enough and too much.  And protein, especially from animal sources can upset your tummy and cause either constipation or diarrhea. 

So maybe you were worried about getting enough protein and maybe you're worried about getting too much.  But let's talk about protein powders that people add to shakes. The most common ones are whey, pea, and soy. And they're  processed, they're  sweetened, And they all contain a lot of other ingredients. Whey protein is made from milk protein. It has flavors in it and sweeteners and preservatives and emulsifiers like lecithin and thickeners like xanthan or guar gum. And some of them add vitamins and minerals. 

What about soy protein? Well, it's made from soy protein concentrate. It has natural and artificial flavors, sweeteners, emulsifiers, like soy lecithin, preservatives, and thickeners, and sometimes vitamins and minerals.  What about pea protein? It's made from yellow split peas. It also has flavors, sweeteners, emulsifiers, thickeners, preservatives, and sometimes vitamins and minerals.

You know, with all those sweeteners, flavors, emulsifiers, and thickeners, what if you just got your protein from food? Isn't that a great concept? Now I totally get just putting powder into a shake because it's faster. It's easier. And it's just so convenient. Soon I'll have a recipe ready for a protein smoothie that tastes delicious and doesn't have all of that extra junk in it. It's going to be available through the healthy looks great on you lab. Right now it's by invitation only. But if you're interested, make sure you're on my email list. I'll open it up soon to everyone. 

 And here's the deal. Variety is the secret to getting complete proteins. So we always say, eat the rainbow. That means eat food with different colors, oranges, purples, blues, greens, reds, yellows and everything in between.

I mean, who doesn't love a colorful package?

And that brings me to a term I want to introduce you to. Protein package. Hello protein package, it's nice to meet you.  Because remember, you can't eat a protein by itself. So basically, a protein package refers to who the protein is hanging out with. 

Let's make it specific and go back to that pile of chicken that was on my Korean rice bowl.  One cup of chicken breast has five grams of total fat. Which is another one of the essential macros. 1.4 grams of it is saturated and 1.7 grams is monounsaturated, and 1.1 grams is polyunsaturated.  It has a total of 43 grams of protein. Based on my weight and activity level, that's about half of what I need in an entire day.

Chicken breast is a lean protein source, so a lot of people eat it on the Mediterranean diet. Now, edamame is made from young, green soybeans. And they are so good for you. And they're very versatile as well. They have 188 calories. compared to 231 for a cup of chicken breast. They have 18. 4 grams of protein, which is not nearly as much as chicken.

 But I can guarantee you that I'm going to eat more than one time a day,  but here's the real kicker.  Edamame has 8 grams of fiber. And fiber is super important if you're trying to lose weight, or you want to maintain gut health. It's good for your immune system, and your digestive system, and your body in general.

In  fact, edamame is a complete plant protein. Remember, I told you a complete protein has all nine amino acids. And it's rare to get a complete protein in plants, but edamame is the package that does it. You can add it to salads, you can put it in stir fries, you can put it in soup, you can just eat it as a snack. It also has lots of vitamins and minerals in it like folate, vitamin K, and iron. And for your heart, it contains healthy fats that include omega 3s and omega 6 fatty acids. And those can actually help reduce bad cholesterol levels. And remember, cholesterol is not found in plants and fiber is not found in animal products. 

 If you get most of your protein from animal products, you're likely getting a lot of fat with it. And we all know that too much saturated fat can increase the bad cholesterol in your bloodstream. That's the LDL cholesterol. And that can lead to heart disease. Saturated fat also causes inflammation throughout the entire body. And that ups your risk for just about everything. On the other hand, plant based proteins, which come from things like soy or edamame, nuts and seeds and beans and grains, those are lower in saturated fat, but they're high in the all important fiber, 

Here are some good plant-based sources that are complete as well. Besides that edamame or soy is buckwheat, hemp seed, and quinoa. Look for ways to add these to other things in your diet. I'm going to have more specific information on that in the healthy looks great on you lab coming soon.  

The bottom line is, more protein isn't better, better protein is better. So we should focus on quality and not quantity. And, we should get our protein from food. Because all of those protein powders that people add, those are considered supplements, and it is big business.  And that's probably why protein is being marketed to us as if we all have a shortage.  And even if we do, we should get our protein from food. Whole food is best. Now, let's go ahead and compare plant protein to animal protein. 

Let's start with animal based proteins. This includes chicken, turkey, beef, pork, fish, eggs, dairy products like milk, cheese, and yogurt. All of those contain protein.  The most complete proteins come from animal sources. And they're actually more likely to contain complete proteins because animal proteins have all nine of those essential acids. So that's a good thing, right?

It is.  And they often have other nutrients like vitamin B12, which isn't found in plants, as well as iron, which you need to maintain a good red blood cell count and keep from being anemic. As well as omega 3 fatty acids, especially in fatty fish, like salmon. 

Now, the more processed a meat is, the less healthy it is for you.    Red meat is worse than poultry. And all animal protein is packaged with its good old buddy fat, which we already talked about.  Now, comparing that to plant based proteins,

that's better for your heart. They're rich in fiber, which we talked about, but what we didn't mention before was antioxidants. Plant protein sources are excellent sources of antioxidants, and those are the cleanup crew in the body that get rid of cells that can cause damage and disease. They can even lower your risk for heart disease, stroke, as well as cancer.

Now, the problem is, there aren't too many complete proteins in the plant world. But, I gave you the secret earlier, do you remember what it is? You don't even have to go to mini medical school, you learned about this one in elementary school.  The rainbow. Eat the rainbow. If you eat a variety of plants, You'll get all the amino acids that your body needs. 

So, don't just eat one kind of plant, don't just eat spinach all day long. I mean, Popeye did have big muscles, but,  you should also eat grains, and beans, and legumes, and nuts, and seeds. 

If you're eating a completely plant based diet, you  need a B12 supplement, and you do need to be more mindful of your protein intake. Because it's definitely more of a challenge, especially if you're active, and I sure hope you're active.

Before we wrap up, I want to mention one more thing, and that's timing.  It's really better for your body to get protein spread throughout the day, ,  instead of eating a big steak for your evening meal, and getting it all at once. Our bodies don't really store protein. Like they do fat. So you only need as much as you need for one day. 

Generally speaking, you should get about 15 to 30 grams of protein  per meal and spread it out throughout the day. There are some studies that show if you eat more protein in the morning, it decreases hunger and cravings throughout the day and that can help with weight management.

While I'm on the subject, I want to mention high protein diets for weight loss. Studies show that they are effective in the short term. So, think of them as a kickstarter, not a way to live, because in the long run, they're not good for your cholesterol, and they're not good for your heart.

If you missed the episode comparing the different diets, I'll put a link in the show notes to which diet is healthiest, or you can go to my website and search for it.  

The most important thing is, don't buy into the marketing schemes.   Just make sure you're getting enough. And remember, if you're using a protein powder, it's got a lot of other junk in it, and it's really considered to be a protein supplement. You probably don't need it. You need to eat more protein in your food. So let's look at the top plant foods that contain protein.  One of the highest sources of protein in the plant world is one of my favorites.  Did you say edamame? No, that was a trick question. It's lentils. Remember, I love lentils. And one cup of red lentils has 18 grams of protein.  In addition to all that fiber and phytonutrients and vitamins and minerals.  And remember, no cholesterol.

Now, edamame is second on the list at 17 grams of protein, and another favorite of mine, black beans, comes in at 15 grams of protein. Moving on down to some nuts, almonds contain about 6 grams, peas are 5 grams, and even a baked potato has 5 grams of protein.  You know what I do?

I put black beans on top of a sweet potato. It's delicious. I'll share my recipe with you sometime. Spinach has five grams of protein as well so don't forget those leafy greens.  Now how does that compare to animal protein? Well, we already talked about chicken and we talked about a cup. But even just three ounces of steak has 25 grams and it has all that cholesterol, saturated fat, and no fiber in it.

Salmon has 20 grams of protein for just a 3 ounce serving, and it's better than red meat. And an egg has 6 grams, so you can have a cup of spinach, a cup of peas, and get nearly the same amount.  Now, since protein is being marketed to us as if we all have a shortage, let's talk a little bit more about a comparison of plant protein to animal protein.

There was a study published in 2020 in the Journal of the American Medical Association Internal Medicine Edition that suggests that where you get your protein really does matter. In fact, they looked at almost half a million people over the age of 50 who got their protein from either plants, red meat, or eggs. And they watched them for 16 years and guess what? People who ate mostly plant protein instead of red meat protein had a 13 to  24 percent lower risk of dying from all causes.  That's impressive. In this particular study, the effect was even more pronounced on men. For every 10 grams of plant protein they ate per 1, 000 calories in their diet, they had a 12 percent reduction in their risk of death. And if they ate more, likely that number would go up even higher.  

 Remember, better protein is better. Plant protein is healthy.

 And healthy looks great on you.

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Do you want to get healthier? Do you want to maintain or improve your health? Setting goals is crucial. But what if you struggle to follow through?  Then you're in the right place. Stay tuned to learn three easy steps to reach your goal to get healthier.

Here we go again. You've decided you want to get healthy. Maybe you want to start exercising or eating better, lose a few or maybe even a lot of pounds. You want to sleep better and feel rested and energized. So you get started on your journey to get healthier.  And before long, or maybe not so long., you fizzle out. Or maybe you never even got out of the starting gate and you're thinking, "Good grief. What is wrong with me that I can't get it together?"

What if I told you you're doing it all wrong. There is a way to succeed and it's not hard.  Don't believe me. Well, let me prove it.  I'm going to show you three easy steps to reach your goal to get healthier.

First let's talk about what it means to be healthy. What does get healthier mean to you?  Seriously, I'd like for you to camp out on this question and don't just listen to my voice. If you can, I would encourage you right now to push pause on this podcast and brainstorm some thoughts about what it means to you to get healthier and then come back.

I could give you a textbook definition of healthy. It just literally means to be in good health. That isn't much clearer, is it? So, while I've got you on the hot seat answering questions, let me ask you this. How would you know if you are healthier?  Hmm, that brings it into a little bit clearer perspective, doesn't it?

You see, if you can't define it, and you can't measure success, then it's really not a plan. It's an idea. It's a hope. You know, I hope my blood pressure gets better and I don't have a heart attack or a stroke. Or, I hope I can stay on a diet and fit into that dress that's too small. Or, I hope I can sleep better and feel rested. 

I hope so too, but I'm pretty sure it's hard to achieve goals that are so broad and so vague. Because, if you don't know exactly what you mean by get healthy, then I'm confused about what your goal is and you really aren't clear either.  I know. I know it's hard. It's hard to stay on a diet or be faithful to an exercise program or have good sleep habits or manage your stress or be intentional about meaningful connections and cut back or eliminate your alcohol intake or sugar or junk food. 

So what is it,  specifically what is it, that you are trying to accomplish when you say I want to get healthier?  And I hear a lot of people say, well, I want to be able to keep up with my kids or my grandkids so that I can play with them. And other people say, I don't want to be like my mom. She was confined to the recliner for the last 10 years of her life due to poor health. Those are great motivators.  But they aren't really specific goals either.

Why do you want to get healthier? Because once you figure that out, you can use it to motivate you to make changes that lead to better health.

Too many times we think we just don't have enough motivation, or persistence, or willpower, or self discipline to achieve our goals. Or we get sidelined by ever present stress in our lives. Or we just slip back into old habits and give up.  But what set us up for failure in the first place was we didn't know exactly where we were going. You have to have a clear destination in mind, a clear goal in the first place if you're going to achieve success. 

If you're going to get from wherever your current health is to wherever you want it to be, you're going to need details. Lots of them. So start with nailing down the destination.

Do you want to get your blood pressure normal? Do you want to be able to run a 5k? Do you want to lose 5 pounds? Do you want to sleep through the night? Get clear and get specific and then get more specific.  Lifestyle medicine has six pillars.  Nutritional eating, restorative sleep, physical fitness, Social Connectedness, Stress Management, and minimizing exposure to harmful substances. Pick one to really work on and start drilling down to get to the place you want to end up in.  And yes, they're all interconnected. If you want to lose weight, then not only do you need to focus on nutrition and physical fitness, you also need to focus on your social circles and your restorative sleep and managing your stress. They are interconnected, there is no doubt, but you likely will not be able to make sweeping changes all at once. 

 You need a specific destination and you need directions on how to get  from here to there. And that can't mean I want to get healthier so I'm going to clean up my diet and exercise. If you don't know exactly where you're going, I guarantee you, you will never arrive. And that's what happens to most people. And here's the deal, when it comes to health, who arrives? I mean,  Health is a journey with mountains and valleys along the way and twists and turns and detours you didn't expect.

If you set unrealistic goals, you set yourself up for failure and disappointment. And then you'd say, I tried, I tried, and it didn't work. And really what you tried to do was never going to work.  So it's important to set a goal that you know that you're absolutely confident you can reach. 

And I know you may say, Oh, Dr. Vickie, I've tried and failed every time and I have no confidence in myself at all.  Then start small.  Nope, smaller than that.  Nope, even smaller than that. 

Now, if you're someone who has seen success in making changes, changing your identity maybe, and seeing yourself as a healthy person and developing healthy habits, Then you might be able to set a bigger goal and take a bigger bite.  But if you're disgusted with yourself because you always quit, then do a reality check and set a goal you can reach.

Set a goal that wouldn't surprise you if you reached it. It wouldn't even surprise your friends or family if you reached it. 

Once you have a clear goal, a clear destination, you know where you're going, you have a clear plan on how to get there, the next step is to define the steps. 

 So what are the tiny steps you need to start taking? 

You have to do some prep work too.

What is the next tiny step you need to take? Do you need to wake up 10 minutes early every day and take a brisk walk? I'm talking about heart rate at 140, arms pumping, feet pounding the pavement.  Or do you need to do some prep work and clean out your freezer and cabinets and refrigerator and get rid of all the ice cream and cake and cookies?  do you just need to power down your TV and computer and smartphone an hour earlier so you can get some more restorative sleep?

Do you need to put salt substitute in the salt shaker? Do you need to add more fiber to your diet so you don't get hungry and eat everything you can get your hands on in the heat of the moment?  And by the way, if that's your answer, I have a free download on fiber and where you can find it.  And so this would probably be a good time to tell you that I offer lots of resources to my listeners who are on my email list.

You can go to healthylooksgreatonyou. com to sign up  and I'll put a link in the show notes.   There's also several episodes on all the lifestyle medicine pillars that you'll probably find helpful in helping you get to your destination.

Do you see how specific these steps are and how small they are? They're not the goal. They're steps that move you toward your goal. Now you've probably heard of the term smart goals, but we're going to review it anyway, because it's such a foundation for developing good habits.

S stands for specific, and we've kind of harped on that. M stands for measurable. Remember at the beginning I said how are you going to measure that? A stands for achievable. We've talked about that as well. R stands for relevant. Like if you're going to try to lower your blood pressure putting salt substitute in the salt shaker is relevant to achieving your goal. And then T is time bound. Nothing  And I mean nothing motivates me more than a deadline. So give yourself a deadline. If you need to do some prep work and get your pantry cleaned out and your refrigerator cleaned out and go to the store and buy some different healthy foods to stock it with, then do that. But give yourself a deadline. We all need a timetable.   You can actually put this on your calendar. I put everything in my calendar on my phone. If I think I need to eat oatmeal on Monday morning to fill my belly up with some fiber so I don't get hungry at 10 o'clock in the morning and go looking for a Pop Tart, then you know what? I can put that in my phone on my calendar. Eat a bowl of oatmeal.  Right there on my calendar. I check it every day it's more efficient and it works better than putting something on your to do list. 

Now, I want to give you a little bit of encouragement.  You need to celebrate your wins.  And you need to mark your progress. And don't celebrate your win with something that's contrary to your goal. In other words, if you go a whole week eating only whole food, don't reward yourself with processed and junk food, but reward yourself and just celebrate, celebrate your wins.

Some people use chips. We talked about in our episode on Unwinding Pain, putting paperclips together. This is an important concept in the recovery world for people who are trying to quit smoking or trying to quit drinking and they celebrate how many days of abstinence they've gotten to, 

but here's the deal. Sometimes you're going to fall off the wagon, whether it's having a drink when you had planned not to, or grabbing that bowl of ice cream right before you go to bed when you had sworn off ice cream.  Listen, give yourself a little bit of grace.

And also, understand this. There are unexpected detours on the way, but just because you're on the detour doesn't mean you're not heading in the right direction  And what about accountability?

Yes, we all know how critical accountability is. So if you can get someone in your life to give you accountability. That's fantastic and you can celebrate your success with them as well.

I have a course called 7 Day Prescription for Change. It has a downloadable workbook and it's all free. And you get an email with a little bit of homework every day to help you work through some things like ambivalence. You know,  those feelings of I want to do this but I can't. But I want to do that and those things keep us from changing.

We need to learn a little bit about our own selves and our behavior if we're going to make changes and some techniques like habit stacking where every single day I know I'm going to. Put on my socks so I can put a set of hand weights in front of my sock drawer and say, I'm not going to open that drawer until I do 10 bicep curls.

Just little things like that, that you connect habits together are powerful ways to help you achieve success.  And if you need accountability from a professional state, then you can visit my website, EquilibriumTelehealth. com. I have a medical practice where I help patients one on one. 

But I believe you can get to wherever it is you want to go, by following three easy steps to get healthier. Number one, set a small, specific, achievable goal that you can start moving towards. tomorrow. Know your destination clearly. Hey, take a picture when you get there. And if you can't picture it in full color,  keep painting until you know exactly where you're going.   Number two is start heading there. Identify three very small things that you know you can do every single solitary day to help you move forward. Three little steps. Never, ever, ever stop moving forward. And then when you've seen success in those three areas, celebrate it and set three more steps that keep moving you in the right direction.  

Now, number three, and this, we haven't talked about it yet, but this is the single most impactful thing that will help you reach your goals. This will make more difference than anything else. 

Write it down.  Writing it down  increases your chances for success  by 50%.  I mean, how easy is that?  Just write it down. And better yet, write it down and share it with someone because then you've got a little accountability.

 You know, this episode is almost over and we haven't even been to mini medical school, but let's step into the neuroscience classroom for just a minute and talk about why writing down your goals make so much difference. 

You see, there is this biological process called encoding. We receive sensory input from our sense of smell, sight, touch, taste, and sound.  And all of these things travel into our brain into an area known as the hippocampus.  And that's where they're sort of analyzed and we make decisions about what we're going to store and what we're going to just forget about. 

And when we write something down, we're using another sense. We're not only using our eyes because we see it, but we're using the sense of touch because we're writing it. And if we say it out loud, then we're adding an auditory component. 

And all of this adds to the importance that our hippocampus attaches to what we're doing.  And that stores it deeper in our memory. It encodes it more specifically into our brain.

That's why the smartest people you know always take notes when they're attending a lecture or some type of seminar.  So get out your pencil and write down those goals, encode it in your brain, and you'll be more likely to succeed.  Those three steps are a formula for success. Healthy is a journey. It's not a destination. But it's worth the time and effort and investment to get healthy. Because healthy looks great on you  

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Fiber, fiber, fiber

Equilibrium Medical 

 

You've booked your flight, reserved your hotel and packed your bags. So don't let jet lag, keep you from enjoying all the wonders on your itinerary. In this episode, you'll learn how to phase shift your circadian rhythm. So you can make memories that last forever. 

It's kind of fascinating to think about jetting around the globe. We can hop on a plane and be on the other side of the world by tomorrow. Or is it today? What time is it again?  The problem is that our internal clocks. can't keep up. And it knocks the circadian rhythm for a loop. When your internal clock gets out of sync, it causes jet lag. Which can make us sleepy when we're supposed to be awake and enjoying our wonderful vacation or lying awake when it's bedtime in our dream destination. Either way, there are things you can do to lessen the effects.  

Jet lag causes insomnia by the de synchronization of the circadian rhythm. Well, that was enough 25 cent words to cut into your vacation budget, but don't worry. We'll go to mini medical school in a bit and learn more. But jet lag causes more than insomnia during the night and drowsiness during the day. It also causes GI upset, brain fog., bad mood and just feeling ick, in general.  And even if you don't change time zones, it's hard enough to sleep in an unfamiliar place where there's light noise to contend with. And it can be made worse if the pillow is too flat or too thick. 

On the other end of the spectrum is daytime sleepiness. You've planned all those amazing excursions. And now you're struggling to stay awake and actually enjoy your trip. Jeez. And don't forget GI upset.  Mostly it's decreased appetite and constipation due to eating at times you're normally sleeping, but some people get diarrhea and that's never a good travel companion. On top of that brain fog sets in which can make you and everyone around you and a bad mood. Decisions about where to go and what to eat, seem harder. And emotions get the best of you and sabotage your trip.  

So let the adventures begin.  Whether you've personally experienced jet lag, have an upcoming trip, Or, just want to live vicariously.

 It's time to go to mini medical school.  I always like to get started with a definition. Let's start with circadian rhythm. It's the 24 hour process that helps our bodies react appropriately to day and night, light and dark as the earth spins on its axis. Normally melatonin levels start to increase when light starts to decrease. 

Ideally, this happens about two hours before bedtime. And the term for this is dim light melatonin onset, or DLMO. This secretion in melatonin causes a drop in core body temperature, which in turn makes us a little groggy.  This signals our body that it's time to get tucked in beneath the covers and get some shut eye.  The rise in melatonin continues and it hits its max level after about seven hours. This peak coincides with the lowest level of core body temperature. And these two things happen about three hours Prior to wake up time. In the morning, the melatonin levels drop to zero and our core body temperature starts to warm up, and this starts the wake cycle, which lasts about 16 hours. The sleep wake cycle can be modified and the internal clock can be reset.

Guess what the most powerful tool that resets the circadian rhythm is?  It's bright light. In the natural order of things, the sun comes up, the rooster says cock a doodle doo, the farmer gets out of bed, works 16 hours, and everyone goes to sleep. The cycle starts over the next morning. But then we invented all kinds of things that screwed it up from light bulbs to night shifts, to screens that emit blue light. And that has a huge impact on melatonin secretion, which is what gets this whole ball rolling.

When it comes to light, timing is everything. Let me introduce another term, entrainment. This is our ability to synchronize our internal clock based on external input from the environment.

This makes your body's physical functions line up with your daily routines to coincide with day and night. And that's why typically people don't have the urge to empty their bowels during the night. It's also why your gastrointestinal tract can be all messed up when you travel.  But other things besides light can help entrain circadian rhythm too, like exercise, meals, and social contact. Think about it. How many times have you stayed up late talking to friends? And then falling asleep when you're home alone or bored.  Get out your notebook now because here's the science you need to know about jet lag. It's all about phase shifting. Either delaying or advancing depending on which direction you're traveling.

Bright light packs the biggest punch when it shines during what should be night time. Because that's when melatonin is secreted, remember?

In normal people, the lowest core body temperature is in the evening. So bright light after the low core body temperature, moves that circadian rhythm forward. That's called a phase advance. Bright light after the DLMO, the dim light melatonin onset, and before the lowest core body temperature in the evening,  moves the sleep wake  cycle backwards.

That's called a phase delay. Got it? No? Okay. One more time.

Bright light after the body cools down moves the internal clock forward. And bright light after the dim light melatonin onset, but before the body cool down. You moves the clock backward. The problem is that even though bright light shifts the internal clock, this effect is delayed.

So when you fly to a different time zone, your body needs several days to adjust. The more time zones you cross, the more time it takes for your body to naturally reset. And all this talk about melatonin just might make you wonder, Can I take melatonin to help shift the internal clock? I'm so glad you asked.

The answer is  yes, but the action depends on the timing. Melatonin is a phase shifter.  What time of day it's taken can affect the sleep wake cycle. So, if you take it late in the afternoon or early in the evening, it That causes a phase advance and if you take it in the morning, it causes phase delay. 

Melatonin can also be sedating. The power of sedation and phase shifting is greater when melatonin is taken at a time when the body's pineal gland is not normally secreting it. That's why melatonin is more effective for jet lag than it is for sleep at bedtime. 

 We'll talk more specifics about melatonin doses in a minute. 

   Even without treatment, your circadian rhythm will adjust on its own. Hopefully, that happens before your trip is over. How long will it take? Well, that depends on how many time zones you cross and which direction you travel.  People who jet set around the globe for a living may experience more long term health effects than those of us who occasionally take a big trip.

Typically, it takes about one day to to adjust for one time zone if you're traveling eastward. So, if you cross more, it takes longer. Westward travel is a little easier and your body can compensate for 1. 5 time zones per day.  Your body's less confused when you travel west because the days are lengthened rather than shortened like they are when traveling east.

And if you're wondering why that matters, it's because Your internal clock is not exactly 24 hours, it's just a tad more. So stretching out a day more closely matches the natural rhythm. Go west young man, you'll feel better. 

Now, if you can sleep on the plane, you'll get a head start, but most of us just nap and wake up with a stiff neck. So, let's transition to treatment. The goal is to sleep at night and stay awake during the day. So, your internal clock needs to align with where you are instead of where you've been. It will happen naturally, but wouldn't it be nice if you could speed up the process and hit the ground running in paradise. 

Then go straight back to work when you get home. If your trip is shorter than three days, then forget it. You'll have less jet lag when you get home if you just stay on your home time zone so you don't miss a beat when you get back. You can try to take a sleep aid at night then power through the day with caffeine but of course there are risks with that. 

But let's assume you're traveling for more than three days and you want to treat or prevent jet lag. Treatment depends on which direction you're going. We will start by focusing on eastward travel, and remember that's the one that's more challenging. West is best and east is a beast when it comes to jet lag.

So you've booked your flight, hotel, maybe even some dinner reservations in advance,

And now it's time to prepare to reset your internal clock. For eastward travel, your circadian rhythm needs to advance to the new time zone. Remember, it's all about timing of light and melatonin. During the times you need to avoid light, you might try a sleep mask. Start three days prior to your scheduled departure, and I recommend just put it on your calendar.

There are even apps you can use. But here's the prescription. Three days before takeoff, set your alarm one hour earlier than you normally wake up. Get up. Get some bright light exposure. If the sun isn't up yet, you really want to maximize the effect, you could use a light box.

But try to mimic the time you'll wake up in your destination by getting maximum light exposure at that time. Then, darken the room and go to bed one hour early. and get that dim light exposure one hour before your new sleep time. Then each day move it up another hour. When you arrive at your destination, be intentional about light.

If you're crossing three to five time zones, avoid sunlight early in the morning,  but soak it up when you're up and around. If you're crossing more than five time zones.

Avoid bright morning light altogether and wait until afternoon to get out in the sun. The idea is to ease into the new time zone. Having said that once your phone changes to the new time zone, don't think about it. Don't even talk about what time it is at home. When in Rome, do as Romans do and live in their time zones without saying, okay.

Well, back home, it's 3 a. m.  Food is important too. Eat a hearty breakfast about 30 minutes after your new wake up time. If you do want to use melatonin, I recommend 3 milligrams. Pack it in your suitcase and don't take it until the evening after you get there.   I am not a big fan of taking benzodiazepines or sleeping pills, but if you do, Don't take melatonin with them because it might cause over sedation and impaired ability to think or drive.

 And you might want to skip that glass of wine on the plane too. Because that just compounds the problem. If you're like me and you're addicted to  caffeine, you'll need a jolt  to get you going in the morning. Don't overdo it, but a couple of cups of coffee or tea when you get up will help you feel more alert.

And if you're going far, far away and crossing eight or more time zones, then just try to delay rather than advance your sleep wake cycle. Get up and get sunlight first thing in the morning, and start dimming the lights in the early evening.  Let's talk about going west, and remember, traveling west is easier.

I'll say it again so you can remember, west is best and east is a beast. The goal with traveling west is to delay the circadian phase. Just try and stay up later and use light to cue your body that it's daytime and not bedtime. Keep the lights on and get as much sunlight as you can in the afternoon and the early evening.

Keep the lights on until about an hour before you get under the covers and then only dim light. After the new bedtime, avoid bright light. And melatonin doesn't really help much with westward travel unless you're going to the ends of the earth on the far side. Then you can take three milligrams at bedtime.

Always try and balance naps and caffeine for optimal effects. And as far as breakfast, the same rules apply. Eat a hearty breakfast within 30 to 45 minutes after wake up time. Eat a complex carbohydrate rich diet two to three hours before the new sleep time. And when you get back home, Melatonin may help you recover.

You can take 0. 25 mg about 3 to 4 hours before bedtime. If about an hour before you're trying to sleep you're still wide awake, repeat. 0. 25 milligrams.  This is a lot of information on top of your itinerary and your packing list, so I've tried to make it easy with two free downloadable graphics. One for eastward travel and one for westward travel.

This has been a lot of information and you may be thinking, well, that's really interesting, but would you just tell me what to do? Okay. Here's what's on the guide. If you're traveling east, remember east is a beast. So you might want to prepare about three days in advance, go to bed and wake up 30 minutes early or an hour early. 

If you can do that avoid light in the evening. But get bright light exposure. As soon as you get up. And when you travel, set your clock to your destination time, nap and rest on the plane and be sure and stay hydrated. Then sleep during the destination sleep time when you arrive, you want to avoid early morning light and get that sunlight exposure late in the morning. 

We're in the early afternoon, you can take melatonin at bedtime. If you need it short naps and caffeine in the morning may help. And while you're up, stay active. Okay. Remember west is best.

But again, about three days before your trip,  you can delay your bedtime as well as your wake. Time by about 30 minutes. Get your light exposure in the evening, not the morning. Again, set your clock to the destination time and avoid light and screens during what is going to be nighttime. Stay up when it's wake time, be sure and stay hydrated. 

Stay active. And have a cup of coffee to help you wake up if you need it.

Make sure your passport is up to date and most of all, enjoy your trip. Stay safe and stay healthy because healthy looks great on you.

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Unwinding Pain with Bonnie Lester. Episode 134

Chronic pain is not only debilitating, but also isolating. It can cause depression, feelings of hopelessness, and can be very difficult to treat.  Often, doctors only try to manage the symptoms. But Bonnie Lester came up with a process to unwind the pain through neuroplasticity.

 When you've experienced something, there's a there's a huge difference and I often hear from the clients I have my doctor doesn't know what it's like to live every day in pain If they'd only know and then when I meet doctors who have had bad backs or bad necks or some other challenge They are more empathetic And more understanding, that's for sure.

So what initially led to your issue with chronic pain?

Well, I was a 33 year old mom. I was newly remarried. I had a great relationship with my ex husband. We were co parenting, and my new husband was a great stepdad. I just purchased a house in California, driving home one night, a stop in traffic, and a drunk driver plowed into me and shook up my body.

And that my life changed in the blink of an eye.  Yeah, I developed something called complex regional pain syndrome a few months later. That's a trauma to the nervous system. They at the time back in 1986, they had no idea of what to do with it. They did experiments on me, including surgery that spread the condition and the condition is agony and pain and burning and your skin texture changes.

You have temperature changes where my left hand, my dominant hand was icy cold.  And even though it didn't feel cold to me, if anyone touched it, it would be icy cold. It would turn red and it swelled. And they did some surgery on me thinking they were going to cure the pain. And it spread that same condition throughout my body, um, all the way down to my left foot.

So what I had at that time was a wonderful doctor who looked at me and said, Bonnie, my mom has ALS and she has to have courage to live with it. And I'm telling you with complex regional pain syndrome, you're going to need the same type of courage. And that was the best thing he could tell me. You know, because that's what kept me going.

And it's only recently that the American Pain Association identified what pain is and it can have an emotional and psychological basis. Not that it's generating the pain, but it affects all parts of you that way. And when people say, Oh, it's all in your head, they get insulted that I'm making it up.

But actually, the brain is in the head part of the nervous system, your spinal column and your brain. So in a way, yes, it's in your head because the actual pain sensations are in your head. You're not imagining it. So I always tell people, your pain is real.  And that's, that's what people say to me. I wish people would understand that it's real.

 had things like old fashioned tricyclics, which are antidepressants, and that was for the nerve pain. And then I also had muscle relaxants. None of that touched the pain. But in 2006,  they said, come on in, Bonnie, you're a good candidate for high levels of fentanyl. which you hear about nowadays, and Norco, and I was living on six different things like that.

And that's what I was living on, but it was prescribed, um, it was legal, and thank goodness I had great medical insurance because it's very, very expensive.  And so I was on it for nine years. And that's why I say, look at me and say that I look alive because when people hear, you know, most people die, you know, after a year or two, it's a very dangerous medication to be used the way they wanted me to use it. 

And so the way I understand it is, does it even really relieve your pain or do you just have Well, that's the ironic thing. Even when they, they kept upping the dose to see what would help the pain. It helped low back from, you know, I used to have, I did have back surgery years before I had my car accident.

And so I'd always get kind of spasms. They took care of those spasms quite nicely. but not the CRPS symptoms at all. And it came with a host of other horrendous side effects. Um, you know, hyperhidrosis, which is over sweating in the body. And of course, having to live on laxatives. And then always worried about getting the prescription refilled when holidays would come around and they couldn't give me, you know, refilled like two or three months in a row.

I had to go to the clinic every month. And then if I couldn't get it, then I'd start going into withdrawals because, gosh, you know, darn it, uh, Thanksgiving came and the clinic was closed for three days in a row and I was supposed to get my script three days, you know, before. So I was at the mercy of the medications, which really weren't helping me at all.

I've been off of all medications since 2015. I'm hearing many stories because the laws have changed and how doctors view prescribing that and they're all really suffering trying to, because they were, some people would do well on opiates. I have to say that I can't say nobody's going to do well.

That's between a doctor and a patient, not the legislator, I think has my personal view.  If someone's on opioids, their family members and their caregivers should know about Narcan in case there is an unintentional overdose. And that's really important.

How did it make you feel to be in pain 24 seven as a mom, as a wife, as a member of society?

I felt like I wasn't part of society. I couldn't, I had lost the use of my dominant hand. So I couldn't be involved on the computer and all this new thing called social media. Yeah. I couldn't participate while the rest of the world was going on. And I think the best way I can describe it is my sister, who's very active and 10 years younger than me would come and visit me.

And I'd look at, at her car and it would have a bike hooked up on top and then some other equipment. And she was coming to see me on her way to go to a music show. And then they were going to go bike riding up the mountain. And then they were going to go to the beach. And I was like, I felt like I was 90 years old.

 Being a mom in pain is very difficult. But I do have to say that my son and then my eventual stepkids have a lot more empathy and understanding and compassion because they had me in their life when I was in such terrible pain. So even though I felt like a failure as a mom, they're, they're all three are doing really well, but I really judged myself.

And I want to point out something about people who have chronic pain. We're often people with really perfectionist attitude. We have to be the best. 

And so what I do now is give myself grace. And if I make mistakes and if I don't reach that high level, I wanted to, that's all right. And that's letting go. And that's the mind stuff that you have to start working on when you have chronic pain. 

Now, neuroplasticity is this wonderful big long word that everyone's talking about. I discovered neuroplasticity in 2010 when my husband had a medical event. he had transient global amnesia. Now the mind through neuroplasticity is rebooting itself, getting back his memory. 

Neuroplasticity is the brain's ability at any age to rewire itself as if you're a highway, picture a highway and you have all these freeways going in your head, but you do a sensory stimulation and you create healthier, more vibrant freeways.

And then the old ones that are transmitting the pain, when we're talking in context of chronic pain, then they're not going to be used. So suddenly your pain is going to be going down. And that's how neuroplasticity needs to be applied to any good program with pain management. 

But  it's far more complex than mind over matter. It's not a matter of saying, I'm not going to pay attention to this terrible spasm on my back. No, no. You've got to start retraining your body for chronic pain. You have a sensitization  going on, meaning it's overstimulated.

And when people hear neuroplasticity, they immediately say, what's the easy way? What do I do? And it's a daily thing that you start giving input into your body using all your five senses. I started inventing ways for myself because I couldn't find any a practitioner who was going to help me.

I got off all six pain related medications including Very high dose of fentanyl the Norco and all the tricyclics and plus that does the Prozac I got off of all of that I don't have any medications that I take for pain now So  that is incredible and it does offer such amazing hope for people who are living with chronic pain So if you have someone face to face who's at the very beginning of their journey, maybe they've thought that they were relegated to a life of chronic pain.

I'm going to talk to you and give you hope and seeds of hope and seeds of faith. Hope is yes. You're going to be able to feel better and faith in yourself that you have the skills within yourself to work on yourself to feel better. You don't have to spend a lot of money.

Time to go ahead and talk about the five senses. My first day out when I told my body, okay, this is it. You've got to change. Here's what you're going to do. I was walking my neighbor's dog at the time. Because I needed some activity, some movement. 

And besides my doctor saying to me, courage is going to get you through this. Is that my training back in the day was in what they call lifestyle medicine, which now has six pillars. Back in the day in the 1970s when I was in public health, there were only four pillars. It was physical, mental, social, and spiritual.

So I was doing movement under physical. That was my little bit of walking, which was very difficult. So that very first day I grabbed some sugar free mints.  I put them in my pocket, and I was wearing a TENS unit at that time.

So that day I changed the side of the electrodes, popped a mint in my mouth, and I would not listen to that voice in my head. And instead I said, Oh, this mint is cold. And I move it around with my time. Oh, it's sharp now. And Oh, it's melting. When I suck in the air through my nose, Oh, it feels cool. And that was, and then, you know, the pain would keep shouting, but I, I'd say, I don't hear you.

And I kept, you know, responding to that. And the, the test came when I had to bend down to clean up after the dog and I put another mint in my mouth and I bent down and I didn't feel any pain cause I was talking to myself about the mint. And then I almost forgot to throw the bag into a receptacle. I was so amazed.

And so that was the very beginning of, Oh my goodness. I can make a difference with my pain. And so, you know, the five senses, you know, visual, sensation, taste, smell, hearing, so I put special music in the next day. Every day, I kept adding every couple days another thing. But throughout the day I did other things besides just the neuroplasticity.

You cannot be grateful and angry at the same time, but it almost seems like you can't hurt and enjoy a pleasant smell, a pleasant taste, a pleasant sound. 

I teach people how to do the neuroplasticity and change their thinking patterns. It's not magic and it's not science fiction. It works, it's neurochemical. When you think about things, it's like a cat, you can have a release of neurochemicals that change your mood, which can change your perception of pain.

I talk to my clients and in the book I have something called D. O. S. E., which stands for dopamine, oxytocin,  serotonin, and endorphins.  And it's to remind yourself throughout the day to build in things that are going to stimulate, I call them the happy chemicals. Endorphins, endorphins, endorphins.

And I call it baking your cake in the morning. Before you get out of bed in the morning, you make layers in your head. These activities are going to improve my day. So you don't live randomly of saying, Oh, I'm in so much pain. I can't move. You can't, you got to get in the head of the pain.  You take charge of it.

Well, let's talk about your book. It's called Unwinding Pain and I love the title because to me, it paints a picture of many, many years of neural pathways that are going towards that pain and back and forth. If you have pain in your arm, that pain is getting sent to your brain and then re stimulated back and forth.

50 percent of the proceeds from the book will be donated to animal rescue organizations in the name of my neighbor's dog Jingles. Who walked with me every day, and because of jingles, I peeled myself off the bed, even when I felt really bad because she had gotten used to me walking her,  and I knew she'd wag her tail. 50 percent of the proceeds from the book will be donated to animal rescue organizations in the name of my neighbor's dog Jingles. Who walked with me every day, and because of jingles, I peeled myself off the bed, even when I felt really bad because she had gotten used to me walking her,  and I knew she'd wag her tail.

Up until that point in time, I had allergies to dogs. So it was a providential thing that suddenly I didn't have allergies and my neighbor needed someone to be involved with his dog and I was the right person at the right time. So that was a blessing. 

that's cool because you didn't have all the tools you needed if you needed to be outside walking a dog, and you didn't have a dog, and you did not need the responsibility of caring for a dog, because cats will take care of themselves. But yet, A neighbor who had a need and you were meeting his need and the dog's need.

I want to circle back to another important thing about, when you said when someone comes to talk to me and how can I make them feel better is that having purpose is really important. Having purpose and go beyond a diagnosis label that you don't introduce yourself. Hi, I'm so and so with, with whatever fibromyalgia, neuromotor arthritis, lupus, that's just part of what you're dealing with. And help people find a purpose. And that makes all the difference in the world.  That is so important. And that is something that I teach in lifestyle medicine, to have purpose, to have social connectedness, to manage your stress and even nature.

And the reason Dr. Vickie keeps talking about lifestyle medicine is in my book, the two things that I really harp on is neuroplasticity and all the six pillars of lifestyle medicine in conjunction with  cognitive behavioral therapy and some of the other strategies that will really help you. More people are understanding about it and adopting a healthier food plan to cut down on the inflammation in their body. They're learning about the importance of movement. And social connection is so important and sleep. I have a huge, huge chapter on sleep, which really can amplify your pain.

And even though you have chronic pain, believe me, you can learn how to sleep as you start lowering your pain levels anyway. So please remember that whether you buy my book or not, learn about sleep. 

Cause it's so essential. Like we can't do without sleep and yet we have to educate ourself and train ourself. And so I have an episode on sleep, but I have an upcoming episode just on insomnia.  Well, I'm so excited about your book. I'm excited to share this hope with our listeners. And, you really have a step by step process that I think people who read the book can go through.

Oh, definitely. Okay. I, you, because your audio and you're not watching this, but I'm holding up my, a long, a long paper chip or a long paper clip chain.

This is to learn a new behavior. And when I started doing my dog walking, I was starting from zero, you know, challenging my body, but I put a nail on the wall. In my kitchen. And I started putting paperclip in and added another paperclip and added another paperclip. So I got a chain and I knew by seventh paperclip, I was going to feel better.

And so I've used that ever since with many clients and they send me pictures. I have hundreds of pictures that come in, people's paperclip chain. And they'll tell me I did this new pain management behavior. Thank you for the paperclip chain, you know, idea. And so people really sparkle about that. And so I have them in different colors.

One gentleman started doing his in different colors.  Oh, and a neat thing, because he said, well, Bonnie, I have green to do this one. And then I have, you know, that's my food. And then I have purple for my movement one. And then because I'm doing that sleep thing, how many hours a night in, but I'm making sure to down regulate my body.

So I fall asleep. So every time I remember that I give myself a paper clip. So you need,  I think  value and marking the journey. And I've heard it referred to as an Ebenezer stone that you pile up those stones and say, this is the place where. Things change, and I know in programs like, um, Alcoholics Anonymous or Celebrate Recovery, you get a reward token to say, you know, it's a mile marker.

It's a, I've come this far, and even if you relapse,  you can say, I did it. Yeah, I actually, I saw the clients I work with, I, they consider the work with me as, 12 step enhancement. And I know about their chips. They're very proud. They call them the chips. And someone wrote to me, said, I just got my 25th year chip.

I mean, hallelujah, you know, so I know the term chip for that. And it is so true. And it's a dopamine release too. You've achieved something, you know, it's a wonderful celebration. Exactly.  Yeah. Celebrate success is for sure.

Well, anything else about the book or about neuroplasticity? Well, I have no financial interest in a company called Trainpain and they, Connected with me, uh, for pain coaching, and they have a targeted app for, um, neuroplasticity training, which I wish I had in 2010.

It's a small device with wires and you tape it onto different parts of your body and you start identifying different sensations. And then there's a, it's a gamification where you, on your phone, you download a game and you progress through it, and what you're doing is getting concentration in your brain to start thinking different about the neural pathways that are giving you the messages.

 And then I'm at bonnielester. com if you want to go on and find out more information about me. And if you're interested in pre ordering the book, you could go to Amazon or any of your favorite book selling places.

Plus I have an online store at unwindingpain. com. So that's another way you could do it. And I'm on Instagram and people love my Instagram postings because I show my exotic birds and I have a famous garden and some, I'm very quirky. I make my own jewelry so that it resonates with some people. I'm at Bon Bon Lester. So follow me on Instagram.

 I like it. Well,  I will be sure and put all the links in the show notes so that my listeners know how to find you. Uh, there is a lot of you were through the book and I appreciate that. And, and I've, I look forward to my listeners getting to follow you on Instagram and especially if anyone does have chronic pain knows that there is hope.

And to get started moving forward and, and attaching paperclips together and celebrating once in a while. Yes. It's, it's been great. Yeah. Well, so much for sharing your wisdom with me. This has been delightful connecting with you and chatting to your audience. Thank you for having me. I appreciate it.  It was great talking to you too.

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All of 10 at the deadliest conditions that affect Americans can be influenced by lifestyle choices. Every single one. Stay tuned to learn more about the 10 things, most likely to kill you. And what you can do about it.

Are you one of those people who are proactive and health conscious. Or does it take a wake-up call for you to get serious about taking care of this one bag of flesh and bones that you're going to live out all of your days in.

the number one disease that claims the most American lives is heart disease with a grand total of over 700,000 deaths per year, a whopping 20% of all deaths are attributable to the old ticker. 

 if you did not answer heart disease for the number one cause of death. You probably answered with the number two cause. Cancer. Cancer retained its number two spot on the list, but there is some bad news. Unfortunately cancer deaths are increasing. And cancer is affecting younger people at an increasing rate.  Here's what the research suggests lifestyle especially increasing alcohol consumption, sleep deprivation, sugar, sweetened beverages, sedentary, lifestyle, and eating ultra processed foods. And other than alcohol. All of this starts in childhood.  Cancer is a dreadful disease that causes 17% of all deaths in this country claiming over 600,000 lives.  And there've been so many great advances in the treatment of cancer, as well as early detection. 

And yet. It remains in the number two spot.  

Next on the list is stroke, there are two types of stroke, hemorrhagic and embolic, and let's camp here for just a minute and go back to mini medical school to learn a little more because the death rates from stroke are decreasing due to educational efforts to recognize symptoms early. 

And the development of effective treatments. In medicine, we say time is brain because every minute that the brain is without blood flow and oxygen results in more damage.

 If you only remember one thing from the podcast today, remember. Be fast. B stands for balance. 

E stands for eye F stands for face. A stands for arm S stands for speech and T stands for Thunderclap. You heard that right? Thunderclap. Well, let me break it all down for emphasis. Remember strokes happen pretty quickly and the damage is done pretty quickly too. So be on your toes, be fast, B balanced. 

This is when someone suddenly loses their sense of balance. E. Is for eyes sudden loss of vision in one or both eyes F is for face. You can see the side of the face drooping. A is for arm and the arm may be weak or even hanging down, but it can also affect the leg. I guess be flast was just too hard to say.  S is for slurred speech or confusion and back to T for Thunderclap. 

This is a sudden severe headache that people describe as the worst headache of my life. Fortunately hospitals participate in stroke accreditation programs that give them access to experts, buy telemedicine, even in remote areas. So if someone you love is experiencing symptoms of stroke, call 9 1 1 and let the ambulance take them to the nearest hospital because. Time is brain. 

Some things kill you fast and others are slow. Coming in at number five is chronic lower respiratory disease.

This includes COPD, asthma, emphysema, and pulmonary hypertension. Chronic respiratory disease takes the life of a hundred and forty thousand people a year. Mostly over the age of 65. Five times more adults die of asthma than kids. But of course, it's especially tragic in children.

Access to adequate treatment is important. And listen, some of these medications are really expensive.

next up is Alzheimer's.

 If it seems like more and more people are being diagnosed with Alzheimer's, it's true. Like cancer, the rates are increasing. Currently, 120, 000 adults die from brain failure every year. Most people die within 8 years of diagnosis, but some people live up to 20.

Over the last 20 years, deaths from Alzheimer's have increased by 55%.  You heard that correctly. In this country, there are 6. 5 million people living with Alzheimer's. Although there is no cure, lots of research is being done and there are new treatments. Contributing genetic factors have been identified, as well as early diagnostic tests. But here's the good news. Just because you have a gene for Alzheimer's does not mean you can't modify your risk with Lifestyle changes.

Diabetes is the seventh leading cause of death, claiming 100, 000 lives a year in the United States. And it's not just us. In 2021, there were 6. 7 million deaths worldwide attributed to diabetes.

That totals 12 percent of all deaths in the world. And it's probably underestimated because it's the underlying disease that causes the other diseases that kill you. In fact, on this top ten list, at least four of them can be pretty closely linked to diabetes and maybe more. Some people even call dementia type 3 diabetes.

Finishing at number 8 on the list is kidney disease, which is directly impacted by both diabetes as well as hypertension. Total lives lost is about 58, 000. 

Barely trailing is number 9, chronic liver disease and cirrhosis,  Mostly caused by an increase in alcohol consumption, accounting for a loss of nearly 55, 000 lives per year. Not to mention the toll on relationships, jobs, life fulfillment, and productivity.  

And number 10, which used to be number four, is COVID 19. In 2021, it was number three, then it moved to number four, then it fell to number ten. The mortality of COVID has plummeted due to immunity, but don't discount the fact that it still holds the number ten spot.

 Sometimes disease just sneaks up on us, and there's not much we can do. But let's talk about the things we have the power to change by walking through the six pillars of lifestyle medicine and their impact on the leading causes of death. Heart disease, cancer, accidents, stroke, chronic respiratory disease, Alzheimer's, diabetes, kidney disease, liver disease, and COVID. 

Getting healthy and staying healthy is hard. But it's so worth the effort because healthy looks great on you.

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Do you ever struggle with anxiety and thoughts that just spin out of control? Today we're going to hear from someone who is an expert in the field of anxiety and depression. Please welcome my very special guest on the podcast,  Dr. Michelle Bengston. She's a clinical  neuropsychologist, speaker, author,  coach, and she hosts her very own podcast, "Your Hope Filled Perspective." And she understands anxiety and depression from personal experience. 

Dr. Michelle - I've been a board certified clinical neuropsychologist for over 30 years now. The field has changed a lot since I got into it. But what I've had the pleasure of doing is walking alongside patients who have had any kind of brain dysfunction, whether we're talking ADHD or learning disabilities, depression, anxiety after they've had a stroke or a head injury, or even in the senior years when  there's a question of, are we dealing with dementia or  are we dealing with depression? So it's been my pleasure to evaluate patients, figure out what's going on with their brain functioning, and then get them on the path to optimal wellness. In terms of their cognitive health.  that's given me the opportunity also to speak into their lives in terms of things like stress management. Where are your thoughts and what are you focusing on and how does that impact for better or for worse your daily functioning? 

Anxiety has gotten more pervasive over time. Because 30 years ago, when we didn't have the internet, which could relay the news in a split second or be there live, we had to wait until the six o'clock or 11 o'clock news. And if we missed it, we missed what was going on in the world and we'd have to catch  it the next day in the headlines. Today is  so in our face and it's in our face when we don't get together or go to the event that all of our friends are and then they post online. And then we've got this angst about the fact that we weren't there, but we had other things that we needed to do. So, this has increased the anxiety.

Anxiety has not only increased, but it has  across the age span, whereas we didn't used to see it in the elderly, nearly as much or in our young children. Now we're diagnosing it earlier and earlier. Pseudo increased social connectedness because of social media that doesn't really build that innate longing that we have for social interaction and the older our  seniors are living, the less social  interaction they're getting. And I think that's contributing to their anxiety, the fear of loneliness, fear of how I'm going to live out my last days, fear of what diagnoses I'm going to be.

Anxiety often does run in families, just like depression does or many other mental health disorders. But it's not all because there's a genetic component. There  is a genetic component. And we can see from the  research that if you have a 1st degree family member, like a parent who has struggled with depression or anxiety, there is an increased likelihood that that you will contend with depression or anxiety, but it's not just because of the genetic link.  There's also the factor of modeling. 

Some people are more predisposed, predisposed to anxiety, to worry, to get anxious, to become fearful. But it's not a weakness. God knew that we would struggle with this because his number one command in scripture is do not worry. Do not be afraid. Be anxious for nothing. It's in the Bible over 300 times. And I thank God who created us.  So  he wasn't chastising us, but he was saying, hold on just a second, don't go down that path.

Dr. Vickie - I love the beauty of your background in neurobiology and how that has obviously impacted your faith and your faith has impacted. Your professional life with that background in neurobiology and in lifestyle medicine,  the component of gratitude, the power of that is widely recognized in people who are believers in Christianity and people who are members of other faiths. There is no question about the benefit of gratitude. 

Dr. Michelle: Anxiety rewires our brain. We can get stuck in a rut, going down a certain  path,  being a complainer, for example,  are always seeing the negative of a situation.

But when we will stop in the middle of that, And we will think, no,  can I look at this differently? And we can look at it through a lens of gratitude. It actually does rewire the brain. And the more we do  that, the more that becomes our  lifestyle and the more we reap the benefits from it. That's why scripture tells us to take every thought captive.  can't afford to just think and not pay attention to what we're thinking because scripture says that out of. The heart, the mouth speaks  and scripture also says that our  words have the power of life or death.  That's a lot of power. So we have to be observant and pay attention to what it is that we're thinking  then determine whether or not that aligns with the word of God or someplace else.  

Anxiety is really a misappropriation of our attentional resources. Now, what do I mean by that? When we become anxious, we're focusing on what we lack or our perceived lack instead of focusing on God and the fact that he promises his mercies are new every morning. He promises he will be our provider.  And when we fall into the trap of worry,  fear and anxiety, it's usually  because we're forecasting a future that doesn't have God in it. So one of the biggest things that I can recommend  trust,  specifically trusting in God. Now, what does that look like? I developed a trust acronym because it was.  At a time when I was really struggling with anxiety that I needed to get a handle on this. And as I was praying about it, I felt like God really impressed upon my  heart.  Michelle, if you don't trust me in the small things, you  don't trust me at all.  was kind of a wake up call. I'm like, but I do trust you. And he's like,  you?  if you really trusted me, you wouldn't worry. You would know that I've got this handled. So the trust acronym is

T to take God at his word. We either trust that the word of God is true, or we don't.  And if we don't, then we've got nothing to stand on  when those situations arise that tempt us to become  worried, fearful, or anxious. 

R is rest in God's presence  his promises.  has never gone back on a promise. Yet, and we can rest that his promises are yes and amen and trust that he's going to bring them about 

U -understand  that the outcome doesn't depend on  us. Those  of us who tend to be driven and somewhat type A and we like to be in control, we have the misconception that if we do everything in our power, then the outcome that we want is going to happen. When in actuality, God doesn't hold us responsible for the outcome as long as we're obedient to him. So if I will do what I know God has called me to do, then Then I can trust that the ultimate  outcome is his responsibility, and that  takes a huge weight.

S is accept that God is sovereign. Either he's in control or he's not.  if he's in control, then we don't need to worry or fear. And then the last T is turn to the testimony of previous experiences. I've gone through a lot of difficult circumstances in my life.   But when I look back, I realize   that I made it through every difficult circumstance a hundred percent of the time. So if God has been faithful through every other difficult circumstance,  would I not trust that he's going to continue to be faithful to get me through what I am or will go through?

T is taking God at his word, resting in his presence and his promises. Understanding   that the outcome doesn't depend on us except   that God is sovereign and then remember the testimony of previous experiences.  we will put that into practice,  will do so much towards lessening our worry, fear and anxiety, and we'll be more aware when that starts to crop up. So we can either decide in the moment, yeah, I'm going to go ahead and worry about that, or I'm going to trust that God's going to get me through it.  

Dr. Michelle Bengston

Website includes links to: 

Your Hope Filled Perspective Podcast

Sacred Scars

Hem of His Garment. 

Today is going to be a good day

Breaking Anxiety's Grip

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  Every year, Christmas carols promise joy and magic. But for many people, they're just soundtracks to the silent screams of stress.  Today, we're turning those festive tunes into a real survival guide to take you from bah humbug to fa la la la la la la la la.

And it's gonna be fun.

  I'm Dr.Vickie Petz Kasper. I'll give you practical steps to start your own journey toward better health because healthy looks great on you.  

 Have yourself a merry little Christmas. You may be thinking, yeah right. There's shopping, and eating, and staying up late, and people. People. Though connection is crucial, some people clearly belong on Santa's naughty list. And they get seated right next to you at the dinner party.

Today, I'm going to give you a survival guide that will help you have a holly jolly Christmas this year. Because, even when you're singing Joy to the World, all that rockin around the Christmas tree can turn into a big crash. And I'm not talking about Grandma getting run over by a reindeer. You know, that song is pretty disturbing if you think about it.

And while you might not be worried about a collision with a four legged beast with antlers, you probably can make a list of things that bring stress instead of comfort and joy. Let's start with those weeks leading up to the holidays. I started decorating the day after Thanksgiving singing to myself, It's beginning to look a lot like Christmas.

When I put it back in the attic, I'll sing, It's beginning to look a knot like Christmas.  I know, I know, my kids would say, I just set off the corn o meter. Ding, ding, ding, ding.  But let's face it, decorating and planning sets us up for festive fatigue right at the outset of the season.

Yes, of course, it's the most wonderful time of the year and How's that working to set unrealistic expectations? What happens if the illusion of everyone else having a blast only magnifies what you're really feeling?  It's a setup for disappointment. Like a kid who asked for a trampoline and got a history book for Christmas.

And speaking of Santa Claus coming to town, there's some pressure. Gotta be good, or you'll get a lump of coal in your stocking.  Do you hear what I hear?  Sometimes we hear sleigh bells ring ring ringing and jing jing jinging, but sometimes we hear snippy comments and conflict, all because I'll be home for Christmas.

Which may involve travel, and frankly, being around people you don't particularly like. Being pulled in so many directions you feel like a gingerbread man about to break apart.  If you missed the episode on navigating connections during the holidays, I really want you to meet my fictional Aunt Edna. She's a hoot.

Now, if you're like me, this year we've been dashing through the snow.  Actually, it's been so warm we've rarely even worn a coat, and we don't have a one horse open sleigh, but we do have a golf cart. But literally, my social calendar has been as full as Santa's pack when he leaves the workshop. 

I'm an extrovert, so I love it. But, as a result, my sleep is off, I've gained three pounds from eating Christmas crack, and no, I am not going to share that recipe, and it's not a whole food, and it's not plant based,  and Jingle Bell Rock, it needs to happen at the gym, but honestly, I feel like I need to sleep in.

 This month is halfway over and there are only a few days left to finish my shopping. And silver bells sound like, Cha ching!  Cha ching!  Whether you're braving crowds or surfing the internet to find the perfect gift for all the people in your family.

Your credit card is asking for at least one silent night.  And maybe you're dreaming of a white Christmas, longing for days gone by when your stocking was full of walnuts and oranges. Things were simpler then. Nostalgia is sweet, but let's face it, our minds tend to idealize the past and sometimes what we really need to do is let go and embrace the present. 

And speaking of presents, whether all you want for Christmas is your two front teeth or peace on earth, managing holiday stress is important. Now, you've already been to mini medical school and you know that stress causes increased cortisol levels, compromises your immune system, causes upset stomach, and disrupts your sleep. And that's just the physical stuff.

Anxiety and depression symptoms increase, and the Polar Express brings emotional exhaustion with brain fog pumping out the smokestack.  If you missed the class on how stress increases your risk for cardiovascular disease and pretty much everything that you wouldn't wish for, there's a link in the show notes. 

But if you're navigating complex family relationships, trying to avoid conflict and triggers, or Feeling social pressure to attend all the parties, or if you're feeling left out by all the perfect celebrations on social media, or you have FOMO and you always say yes, plus you have to get up and go to work the next day, or if you're feeling the financial strain of too much shopping, this is the episode for you. 

Since this is a lifestyle medicine podcast, let's take a quick peek into the packages and see what lifestyle factors contribute to more holiday stress.  Unhealthy coping mechanisms.  Overindulgence in alcohol and unprocessed food, especially sugar, which increases inflammation and maybe just maybe that's why your joints are hurting more.

Comfort eating. Don't be like Santa and feel obligated to eat the cookies just because they're on a plate in front of you. Avoiding exercise because you were up too late wrapping presents or watching Hallmark movies. And you know what that holiday mythology about perfect holidays can do? Set up unrealistic expectations.

The comparison trap is like the Grinch stealing the Christmas tree and comparison is the ultimate thief of joy.   Irregular sleep patterns because you're reviewing your grocery list or your shopping list instead of dreaming of sugar plums dancing in your head. 

By the way, if you want to learn more about how to turn off your mind and turn on restorative sleep, then I have a free cheat sheet for you. There's a link in the show notes. 

Another thing is poor boundary setting.

Some people just have difficulty saying no, so they overcommit. They're the people pleasers. Any of that sound familiar to you? Well, here's your holiday survival guide. We're going to look at practical tips to keep you from turning into Scrooge. Let's start with bills. No, not bells, bills. You know, electric bills, and mortgage payments, and gas, and groceries.

I just want to remind you, those bills aren't going to take a holiday break, so Obviously, you don't want to spend money that you need.  And let me tell you a story. One year before Christmas, I asked my kids to name their top three favorite gifts from the previous Christmas. Try it. See what kind of answers you get.

Most of the time, they can't even name one. Unless we spend it on an experience, rather than a tangible gift. And I highly recommend that, but listen, experiences can be expensive. So, survival tip number one is, it helps to have a holiday spending budget.  You need an emotional budget too, but we'll get to that in a bit.

First, finances. There are budgeting apps you can use, you can put those on your phone.  You might think about dividing your spending into categories and setting limits for each. And when it comes to gifts, remember, three was enough for Jesus, it's enough for your little one too.

Or, if you want to splurge, use the four gift rule. Something they want, something they need, something to wear, and something to read.  Let me give you some advice about a common mistake. Do you think that you have to spend the same amount on everyone?  Listen, this is a never ending merry go round of trying to even it up.

And I hope my kids are secure enough in our relationship to know that if I spend more on one than the other, it's not a reflection of anything except that I only bought what I thought they really wanted.  And what about family gifts? You know how everyone money launders gift cards for all those teenage boys in your family?

It's kind of silly and we quit doing it years ago. No gifts for anyone except immediate family and that has made the holiday season so much more enjoyable. We play games instead of exchanging gifts.  But if you think you can't give it up completely, try some homemade gifts, like a scrapbook, homemade jelly, or if you're handy with a hammer, maybe a birdhouse.

It's so much more meaningful. And it won't be forgotten by next year. Or maybe do a Santa gift exchange with a reasonable spending limit. Or if you really like each other, plan an experience together.   And if you need a small gift, you might want to buy my book, Dressing the Wound, Give Yourself the Gift of Forgiveness.

It's a short book I wrote, and it's available on Amazon for about 5. There's a link in the show notes. Another idea is to donate to charity in someone's name. Yes, it still costs money, but it takes the pressure off of searching for something for hours, spending money, and then wondering if they're even going to like it. 

You could also give the gift of yourself and services. Offer to babysit or cook a meal.  Now, it's a little late for this strategy, but it might help to start early and spread out your expenses over the year. Hey, you could even start right after Christmas this year and hit the sales for next year. One thing you need to watch for.

Sometimes you buy a little along the way and then you forget, so you buy more. So keep track of it.  And there are ways to save money. Often, if you're shopping online, you can get discounts for signing up for their email list. Speaking of email list, are you on mine? If not, sign up and you'll get a discount on the next podcast episode. 

Just kidding. The podcast is free for you, but I do have lots of bonuses for  subscribers.  Cashback programs. I use Rakuten. You can earn points by using a credit card and set it so that you pay it off automatically at the end of each month or you might end up spending more in interest and it's a good way to get in over your head quickly. 

 Practice saying no to unnecessary spending and focus on meaningful connections over material gifts. But listen, give. There are so many people struggling to make Christmas happen for their kids and there are elderly people in nursing facilities who are in need.

 Christmas is a time to give a year end gift to missions, your church, or a charitable organization. It is truly more blessed to give than receive.  And in addition to a financial plan and budget, you need to manage your physical, mental, and emotional energy too.

And part of that involves navigating relationships and communication.  Can I just be honest for a sec?  I totally failed at this one this week. So, this advice, it's for me. But, I suspect you could use it too. Tip number two for your holiday stress guide is set expectations. You know, blessed are those who expect nothing because they're never disappointed.

Okay Eeyore, let's just be realistic. We all have expectations and they can lead to more conflict. The goal is to set realistic expectations and to clearly communicate those expectations. In advance. This requires a conversation. You can do it on the phone, in person, or you might even try an email thread or a family group text to have a discussion in advance about expectations, limitations, and boundaries.

This needs to be non confrontational and the language should be neutral and collaborative.  Man, I wish I would have had this guide earlier this week.   After your better than I did discussion, send a follow up gentle reminder message outlining the plans you agreed on.

Provide context for your decisions and offer alternatives when possible. And once you've set realistic expectations, It's time to establish boundaries. Be clear and be kind. Use I statements and explain your personal needs without blaming someone else. Remember, this isn't a wish list for Santa's elves.

This is trying to connect with the people you love. So provide rationale for your boundaries and again, offer compromise where appropriate.  None of this is a guarantee there won't be conflict. So let's look at some conflict resolution strategies.  Active listening techniques go a long way. When you're listening, you need to look like you're listening, and you need to act like you're listening.

This is super important. Tip number three is communicate. Probably most of us have finished all of our Santa shopping only to hear our little darling declare that their most wanted Christmas wish wasn't even on our radar. The problem with communication is making the mistake of thinking that it actually happened.

Learn to listen.  It helps to reflect, repeat back what you've heard, ask clarifying questions, show genuine interest and validate other people's feelings with phrases like, I understand why this is important to you, I can see why you might feel that way, and your feelings are valid. Emotional intelligence comes into play, but everyone's not playing on the same field.

So recognize your own underlying emotions and separate intent from impact you see, we tend to judge others by our intentions and then we judge others by their actions. Don't assume you know what someone is thinking. Avoid defensive responses and practice empathy.  It takes practice. This doesn't always work, so

if you do get into a difficult conversation, try to de escalate by maintaining a calm, soft voice without accusatory language. And if the tension really rises, take a break. Try to find common ground. Try to find a win win solution, but be willing to compromise and focus on preserving the relationship because that's what really matters. 

Tip number four is budget your energy. Over commitment leads to overstressed.  Learn to say no, but do it politely. I appreciate the invitation, but I won't be able to make it this year.  Now, let's talk about physical well being. Tip number five. As much as possible, try to maintain your routine. Your routine for eating, sleeping, exercising, and managing stress.

I know, I know, trust me, I've seen the big hand on the six and the little hand on the ten twice as often as normal just this week. But, I've also felt the effects. Try to maintain your movement or exercise routine and don't forget nutrition. Listen, the most important advice I can give you is start your meal with fiber.

It's critical for gut health and it helps even if you're going to eat those bacon wrapped crackers afterwards. And remember, sleep matters. Sleep hygiene can help unless you already suffer from insomnia. Then, maybe not so much. You're going to want to stay tuned for the next series. It's going to be on sleep. 

If you need a resource, visit my website and grab that tip sheet on how to turn off your mind.  All six pillars of lifestyle medicine have an impact on your holiday attitude. Let's wind up this series with this focus on stress. And we've already discussed managing expectations and setting boundaries with your time and energy.

Now, let's look at some practical tips for regulating your emotions. Tip number six. Since we're using Christmas carols to frame this episode, how about singing to relieve stress and reset your mood? 

I'd like to read you a text I got from my son in law. With his permission, of course.   Hopefully this time I can read it without choking up. 

He was talking about his oldest son, my little grandson. And he said, we like to shut off all the lights, put the Christmas tree in the fireplace, and play Christmas songs. He asked me for a special one tonight. Not a Grinch one, lol. There's one that stands out. It's not catchy or particularly memorable, but my grandpa loved it.

He used to look like he was a thousand miles away when he played it on a vinyl record. He told me on Christmas Eve, 1944, he had gotten a letter that one of my grandma's brothers, his future brother in law, was unaccounted for at the Battle of the Bulge.  Another brother was at Bastogne, with the 101st Airborne and the 3rd was in the Philippines.

His unit sat down to eat and this song played and they were all choked up.  Just a bunch of 20 something year olds trying to hide it. A few weeks later, he'd start prepping for D Day. Most of those men didn't make it.  He said, oddly, Christmas was simpler, a reminder of God's blessings. of family and home.  I thought of it last week and sat downstairs at your house one night and after everyone went to bed, listened to it. 

It was nice to be home with y'all. 

Okay, I got choked up a little,  but if you're like me and you can't sing, listen to music. And tip number seven is  remember to breathe.  There are some specific breathing exercises that help manage stress. The 4 7 8 breathing method where you inhale for four seconds.  Hold your breath for 7 seconds,  exhale slowly for 8 seconds. 

Repeat this if you're feeling overwhelmed or do the box breathing technique where you inhale for 4 seconds, hold it for 4 seconds, exhale for 4 seconds, hold it for 4 seconds. And you know what?

Even if you can't hit the high notes of heavenly peace, sing anyway.  Tip number eight is read the Christmas story and meditate on its truths and pray.  And tip number nine is  practice gratitude. You want to know why we always recommend practicing gratitude?  Because gratitude equals contentment.

And I can hardly think of anything that alleviates the stress of the holidays more than contentment. Be content with the gifts you buy and content with the gifts you receive.  Love the home you have and all that is in it, including the people.  Accept the family you have. Not the family you wish they were.

When you don't feel grateful, take a walk. God reveals his very self to us in nature, and that goes a long way in resetting your mindset.  

I hope you'll follow me into the new year.

We're going to start 2025 by focusing on a good night's sleep,  but we're going to keep focusing on all the pillars of lifestyle medicine. You are such a blessing to me. 

Tip number 10. Don't get overwhelmed. Don't overindulge, but don't miss the moments. Keep Christmas simple. Sit on the stairs, turn off the lights, listen to music, but also embrace the opportunities.

 Like eating the toffee that my neighbor gave me yesterday. After all, it's Christmas and managing expectations may mean making some exceptions. The bottom line is, stress is inevitable during the holidays. You cannot avoid it, but you can manage it. It's a skill that can be learned, but like any skill, It takes repetition and practice.

So if you cry and pout, give yourself some grace because it is a wonderful life. Really? Because though there's no miracle on 34th street, there is a miracle. That is the reason for the season. And don't forget, that's what we're really celebrating.  The birth of Jesus brings perfect peace. He came to earth to do for us what we can't do for ourselves.

So, hark the herald, angels sing, glory to the newborn king, peace on earth and mercy mild, God and sinners reconciled. Have a merry, healthy Christmas because healthy looks great on you.  

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Are you ready to change?  I mean, are you really ready to make a change? Sidney Harris says, "Our dilemma is that we hate change and love it all at the same time. And what we really want is for things to remain the same, but get better."

We want to call apple pie, a serving of fruit and be thin. We want to dump salt on our food and have normal blood pressure. 

We want to watch TV and have big muscles, and we want to scroll through Instagram reels for an hour before bed and then sleep good and feel rested. We want to let our minds spin with anxiety and have peace. We want to wave a magic wand and poof, all of our stress disappears. We want to have several drinks and not feel hung over. We want to nurse a grudge and be included with our friends. We want to live long, healthy, and happy, but we also want to have our cake and eat it too.  So again, the question is, do you really want to change?  Tony Robbins says, "Change happens when the pain of staying the same is greater than the pain of change."

Change is painful.

Today in mini medical school, we're going to a short class in psychology and it actually starts with a test to figure out if you're ready to make a change, to get healthier and change your lifestyle. So, which of these statements describes you?  

1. Nope. I'm not doing it.  

This means you're just not really ready to make a change in your life now. And if this is the stage you're in. That's okay. What you mainly need is more information because you need to understand the consequences of changing versus not changing. So keep listening to this podcast so you can learn more about the impact of lifestyle medicine on your health.. Now we call this the pre-contemplative stage. You're not planning to make any changes in the next six months. 

2. Yes, I want to change.

You're the type of person who knows that you're going to make a change within the next few months. And you understand it's not going to be easy, but you don't really have a specific plan yet. You're just kind of gearing up. We call this the contemplative stage. You're thinking about making a change soon.  

3. My mind is made up.

You're determined you're going to make a change and you're planning to start soon. You believe you need to make a change. And so you're taking small steps to prepare. We call this the preparation stage. You're going to take action in the next 30 days. 

4. I'm doing it.

You've recently taken those first steps and made some changes. It's all still new to you, but you're gaining ground. We call this the action stage. It's where you're taking small steps in a new direction.

5. I did it.

You succeeded at making a change, but you're guarding against going back to your old ways. You understand you're vulnerable to relapse. We call this the maintenance stage.  This is where you've sustained change for at least six months.

6. Stick a fork in me. You're done.

You're confident that the change you made will last. And the temptation to go back to your old ways doesn't pull you in anymore. We called this the termination stage. Where you have no desire to return to your old ways.

The problem is sometimes we want to change on the one hand, but on the other hand, there are some benefits to staying put. That's called ambivalence. And it's important to work through that. So let's get it out in the open so you can deal with it.   In order to do that. I think you should think about all of the positive reasons for staying the same. I mean, we all probably enjoy things that are not good for us. For example, if you love a bowl of ice cream after dinner, watching shows on TV, drinking a cocktail, being alone and staying up late.  There are some benefits of staying the same because you obviously enjoy those things.  So list them out. Let's put them out in the open. 

Maybe what you really need is a reason to change. Your core values affect your choices in life.  Let's explore your why? Why do you want to change? 

Maybe it's because you've seen the parent grow old and not be able to get up out of a chair. And you don't want to be like that. Or maybe you looked in the mirror and said, who is that? I don't want to be that person. Or maybe you're going to the pharmacy and picking up a sack full of medications and they're expensive and they have side effects. And you're wondering if you made some changes,

if maybe you could get off of some of that stuff.  Or maybe you look outside and you see your kids or grandkids playing. And you wish you could participate. Or go on a hike with your family. Explore what matters most to you? And that will help you identify your pain point. And think about your, why. What gets you up every morning? I mean, we all need purpose in our lives and purpose often drives us.  It may be meaningful relationships or a fulfilling job or a calling to serve others. You need to explore your strengths values, and maybe even write out a personal mission statement, then you can tap into your gifts and strengths and determine your reasons for making a change. Good reasons to change include better health because it's a valuable asset. 

If you lose your health, you lose your ability to do anything else. 

Until you identify a specific problem, it's hard to tap into that pain point that drives successful change. And most of us just have this vague idea when it comes to health, we want to be healthy, but that's really an abstract concept. It's not a fully formed plan.

And that is why most attempts fail.

 Maybe it would help if you filled in these blanks because I have______. I am at risk for _____, or if I don't change _______. I can't do ______. 

 

Okay, this is a little hard on a podcast. 

I actually have a course called seven day prescriptions for change. It's completely free. It has a downloadable workbook where you can fill in these blanks on paper. If that's easier for you, I'll put a link in the show notes seven day prescription for change, or you can find it on my website. 

But let's get started with those eight healthy habit hacks.

1. Identify your goals and you need to be specific. And on top of a specific goal, you need a specific plan. Make SMART goals. Write it down.

2. Start small, think big.

I don't think we necessarily have to start small. We just have to identify what the steps are that move us from point A to point B. But we could start big in one department and that's our identity. Start viewing yourself as a healthy person.

3. Create a routine. 

4. Use associations and do habit stacking. I recommend James Clear's book, "Atomic Habits."

5. Track your progress.

6. Have an accountability partner. 

7. Learn from your mistakes when you relapse. Don't let failure define you. 

8. Celebrate milestones because I know you're going to get there. It won't be easy, but you're getting the tools you need to make changes that make a difference.

Say goodbye to quick fixes and embrace a personalized plan for longterm health. Because healthy looks great on you. 

RESOURCES (may contain affiliate links)

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The secret to staying on a diet. Here's how to fool proof your diet.

Have you ever started a diet only to be derailed by the feeling that you're going to starve? Hunger will sideline the best diet plans and willpower usually isn't enough to overcome it. So, what is the secret? I'll give you a hint. It's not drinking more water. Stay tuned. So you can learn how to stick to a diet and not get hungry.

Whatever diet you decide is right for you. Hunger is your worst enemy. If only you could eat until you feel full and stay feeling full. Wait. You can. I'll let you in on a little secret. The key is fiber.  Every year 45 million Americans go on a diet, whether it's to lose weight or get healthy, most people are lucky to last six months.  And if it's a strict diet, it's even less than that.  There are a lot of good reasons to diet besides losing weight. Like managing high blood pressure, controlling diabetes, lowering cholesterol, and preventing dementia and cancer.

Not only does fiber keep your belly feeling full. 

It keeps your bowels regular and promotes a healthy gut microbiome which can influence auto-immune and allergic responses as well as help maintain a healthy weight.

Soluble means it's going to dissolve in liquid, either water or bodily fluids. And this type of fiber  is found in foods like fruit, oats, and beans. It's made up of carbohydrates, but your body can't digest it. On the other hand, insoluble fiber does not dissolve in water and other bodily fluids. It's found in the cell walls of plants like wheat and other grains think bran. And your body can't digest it either. 

Instead it stays in the colon and does its job. 

since one of the biggest things that will derail your efforts to stick to a diet is hunger. I have some great news for you. If you're hungry, you should eat. That's right. Starving yourself. It's not necessary. 

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Facts and Myths about Water, Weight Loss and Health

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How Not to Die by Michael Gregor

 

Keep moving to maintain flexiblity as you age with Brian Murphy, Doctor of Physical Therapy and owner of Pinnacle Physical Therapy

Physical therapists are capable of really helping patients avoid surgery, avoid the need for medication. We are going to discuss the need to invest in the body's ability to move and to be strong and to allow people to do the things they really enjoy. 

People are on devices and social media so much now that positions where your head is forward and rounding of your upper back. What's interesting about the human body is that there are alternating patterns of joints that are supposed to be very mobile. And joints that are supposed to be very stable. So when you think about your back, your neck is a mobile joint. It's supposed to be able to rotate. a lot. In those circumstances with those prolonged positions, unfortunately we we lose the mobility because we're only working in one plane of motion.

We're working in the sagittal plane. Our head stays still. We don't ever work in the frontal plane and we don't ever work in the transverse plane  we don't have to.  That is a particular area that I see a lot of patients who are having neck pain complications with neck pain, headaches. And then also low back is another great example. The low back is a very stable joint. It's only meant to bend forward and extend,  but the areas above it, the thoracic spine and your hips are both very mobile joints, or at least they should be.  I have seen clinically numerous times patients will come in complaining of pain in their low back. But the problem is arising from the stiffness in their hips and in their thoracic spine, from base of your neck, kind of down to the lower back. If you lose mobility in those two areas,  your low back has to do a lot more work. It's doing some things that it's not meant to do. So Instead of just treating where the pain is located, we've got to get those ball and socket joints moving again.

Motion is lotion.

We've got to keep mobility in our hips. We've got to keep rotation in our thoracic spine.  got to get out of these rounded postures  flexed postures and work on the opposite motions. A lot of times we have to work on extension.  So  some of this stuff isn't rocket science, but unfortunately patients just don't realize that. Once again, the human body is meant to have this beauty of variety of movement, and when we relegate ourselves to very stringent movements,  we lose those capabilities that are inherent,  that is going to be problematic.

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Which diet is healthiest? Diet has a huge impact on health, but it's hard to know which diet is best. There are a lot of conflicting opinions. Should you eat fruits and vegetables, or meat? In this episode, Dr. Vickie discusses the Mediterranean diet, anti-inflammatory, Keto, Carnivore, Paleo, Vegan, Vegetarian and intermittent fasting. Whether you want to protect your heart, your brain or lose weight, examine the evidence to make informed choices when it comes to eating. And get practical steps for clean eating. 

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What causes obesity? Is it genetic? Is it lifestyle. And what about choices? You've probably heard that weight gain occurs when someone ingest more calories than they burn, but that's certainly not the whole story.

Genetic factors contribute to the risk of obesity. But, many people who carry obesity genes do not become overweight and healthy lifestyles can counteract these genetic effects. It's hard for some individuals who have addiction to sugar. Dopamine levels are involved and it's just hard because of the way our society is wired. But let's look at recent upward trends of obesity. Our genes really haven't changed enough to explain that. So what has changed? Our food, which is a subject for another day, but also our activity level and our social eating patterns. Since the 1970s, the average caloric intake has increased by 500 kilocalories per day. Tracking rod, along with the increase in obesity. The standard American diet contains more fat, more sugar, more protein, more grains, and less fruits and vegetables. We've replaced nutrient packed foods with fast convenient food. And sweetened drinks. 

There's a big study called the nurses health study. And for every two hours women in this study watched TV, the risk of obesity was increased by 25%. Now do the math. If you watch four hours of TV a day, your chances of being obese are increased by 50%.  

You will never reach a place where you can slack up and eat whatever you want and not gain weight. It's not going to happen. So here are some practical tips. Replace your couch time with something you enjoy that's active. Get up and march or dance or do squats. And eat more fiber. It fills you up, keeps your gut healthy and suppresses your appetite.  Eliminate ultra processed foods from your diet as much as possible. They're loaded with fat and sugar to bring you back for more. Lastly, eat at home. Portions at restaurants are out of control and healthy choices are harder to make. 

You got a prescription for the shot and now you've replenished your wardrobe with smaller clothes then comes the bad news. Either your insurance no longer wants to cover your medication for weight loss. Or you have side effects that make it intolerable. Without making changes, you will gain all that weight back. You lost weight with the shot, now what?

Lifestyle modifications with healthy diet and exercise are important. It even says so on the package inserts. There are differing opinions about what constitutes a healthy diet. The bottom line is avoid ultra-processed foods and eat whole food. Low fat diets are not associated with weight gain and are healthier for your heart and lower the incidence of breast cancer. 

Everyone is different. Some people can lose weight with lifestyle changes, others need help from surgery or medications. The GLP - 1 agonist generally help people lose 5-22% of their BMI. They aren't without side effects and they are expensive. Obesity is a chronic disease that puts your health at risk. Lifelong treatment is required. Healthy Looks Great on You, lifestyle medicine podcast tackles this tough issue. 

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Often these illnesses are invisible, but the symptoms are real. On this podcast episode, we will look at what happens when your immune system turns on you. I know from experience how it feels to struggle with autoimmune disease. 

Those shopping cart memes that paint people who don’t return them as jerks, still hits a sore spot with people who have invisible illnesses.

Do you have a bunch of weird symptoms and no one can figure out what is causing them? Maybe your own immune system is attacking you. It’s designed to protect you, but can also try to kill you. Be your own advocate and be specific when discussing symptoms with your doctor. Eight million Americans are affected by autoimmune diseases. The symptoms range from annoying to debilitating. The gut microbiome is thought to be a big contributor, as well as stress, exposure to toxins, infections and sleep.

Invisible illnesses can be isolating. Many of us fake being well. Awareness campaigns help spread the word.

Facts and myths about water, weight loss and health. Get hydrated! Are you drinking gallons of water to help with weight loss? Well, you might be surprised to learn how much water you need to be healthy and what effect it has on weight loss. And it's not normal to be thirsty all the time. Dr. Vickie explores the causes of excess thirst on Healthy Looks Great on You, a lifestyle medicine podcast.

There's a simple way to tell if you are hydrated. Learn about the history of bottled water, as well as how hydration affects health. Because healthy looks great on you. 

Don't fall and break: Understanding Osteoporosis, From Causes to Treatments This podcast episode delves into osteoporosis, a condition characterized by decreased bone mass, explaining its impact, risk factors, and prevention methods. It highlights the significance of bone density, risk factors like age and family history, and the role of calcium and Vitamin D in maintaining bone health. Lifestyle changes, dietary recommendations, and the importance of weight-bearing exercises are discussed alongside the Fracture Risk Assessment Tool (FRAX) and various treatments, including medications. The episode emphasizes the importance of balanced nutrition, regular exercise, and  medication use to prevent fractures and maintain overall bone health.   RESOURCES (may contain affiliate links)

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00:00 Introduction: Have You Ever Broken a Bone? 00:18 Understanding Osteoporosis 01:45 Global Impact of Osteoporosis 02:35 Risk Factors for Osteoporosis 03:02 Bone Strength and Structure 05:03 Bone Mineral Density and T Scores 07:14 The Importance of Falling 10:47 Who Should Get a Bone Mineral Density Test? 14:22 Lifestyle Changes for Bone Health 15:59 Calcium and Vitamin D: Essential Nutrients 22:53 Medications for Osteoporosis 26:24 Conclusion: Maintaining Strong Bones and Muscles

Is Salt a Four Letter Word? Understanding Sodium's Impact on Health

In episode 122 of 'Healthy Looks Great On You,' Dr. Vickie Petz Kasper delves into the complex relationship between salt and our health. Despite its essential role in bodily functions, overconsumption of sodium is a widespread problem that could lead to serious health risks including high blood pressure, heart disease, and stroke. Dr. Kasper explains the physiology of sodium in the body, its dietary sources, and strategies for reducing intake. Additionally, she examines several scientific studies that highlight the impact of sodium on longevity and chronic disease prevention. Listeners will also gain practical tips for healthier eating habits, especially when dining out or choosing packaged foods. Join Dr. Kasper on this educational journey and discover how to balance your sodium intake for a healthier life.

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00:00 Introduction to the Salt Dilemma 00:16 Host Introduction and Personal Journey 01:09 Episode Overview: The Salt Question 01:25 Understanding Salt and Sodium 03:19 Physiology of Sodium and Fluid Balance 06:19 Impact of Aging on Sodium Balance 07:49 Global Sodium Consumption and Health Risks 09:24 Sources of Dietary Sodium 13:47 Practical Tips to Reduce Sodium Intake 15:42 Research and Studies on Sodium Intake 21:26 Conclusion and Final Thoughts

Have you ever snapped someone's head off simply because you are a sleepy head?  Our fuses can get pretty short when we're sleep deprived.  We need dream time therapy to hit reset on our emotions. And without it, look out. Sleep is so much more than rest. You and those around you can appreciate the benefits of good sleep on emotions and mood.

Sleep is so much more than rest. You and those around you can appreciate the benefits of good sleep on emotions and mood.

I'm Dr. Vickie Petz Kasper, I help you make changes that make a difference. Healthy Looks Great On You podcast takes you to mini medical school so you can learn the power of lifestyle medicine.

Sleep is hard work. And I don't mean getting to sleep and staying asleep is hard work, though it often is. I mean, there's a lot of work that goes on while you sleep.  Sleep rebuilds your mental landscape. What happens when you sleep affects your emotions while you're awake. The brain undergoes active processing and healing while you're getting your Z's.

You need sleep for emotional maintenance. The physiology is absolutely fascinating. So let's start right off the bat by going to mini medical school and learning about how sleep affects mood. Now, don't worry. I'll make it fun so you don't sleep through class.  Let's start with sleep cycle basics. There are two primary types of sleep that alternate in cycles throughout the night.

And those are REM and non REM. That probably already sounds familiar. REM stands for rapid eye movement  and  they each have different functions. Non REM does the work of physical restoration and recovery, while REM does the emotional processing and cognitive maintenance. It's divided into three stages.

Now this is going to be super easy to remember because the stages are called N1, N2, and N3. But let's peek under the covers and explore each of them a little more. Stage N1 is light sleep. And this is a transition between being asleep and being awake, and it only lasts about 5 or 10 minutes. In this stage, your muscle activity slows down, though you might twitch occasionally, and you can be easily awakened and even somewhat aware of your surroundings. You're actually asleep, but you're just in that lightest stage of sleep.  Stage N2 is moderate sleep, and this accounts for about 50 percent of total sleep time. During stage N2 sleep, your body cools down. The temperature actually gets lower, and your heart rate slows, and your brain waves slow down, and this is so important for memory consolidation.

In fact, stage N2 sleep has a huge impact on your ability to learn, remember, and retain new information. The cognitive impact also includes decision making skills. Without adequate stage in to sleep, Memories don't get consolidated, and processing speed is slowed down, and so this causes increased difficulty with complex cognitive tasks.

Lack of adequate sleep doesn't just affect your cognitive ability, though. It also affects mood. It makes us more susceptible to the effects of stress, both physically and emotionally. And emotionally.  Poor sleep disrupts emotional regulation, so we're more reactive.  The next time someone's voice goes up a couple of octaves in response to something you said, maybe, just maybe, They didn't sleep well last night. 

I don't recommend mentioning it.  Even more serious than becoming a soprano during a conversation, without good sleep, people have an increased risk of mood disorders like depression and anxiety. And at the very least, the symptoms of anxiety are heightened without adequate shut eye. And listen, everyone reacts to having their buttons pushed, but when the work of sleep is on strike, our emotional resilience is kaput. 

 And the fruit of the spirit just goes right out the window. No peace, no patience, no kindness, no goodness, and definitely no gentleness.  Now, emotional reactions can be dangerous, but the physical health consequences of poor sleep can be deadly. Without good quality sleep, the immune system is weaker, metabolism is wrecked, Inflammation skyrockets and even hormones get out of whack.

We need sleep for healing and recovery every single time the earth revolves around the sun. Think of your brain as a computer. You know, it has to be charged in order to function. Without recharging through sleep, there are several neurologic effects on your brain. Those grouchy neurons in your head quit communicating effectively.

This leads to impaired synaptic plasticity. The dampening of the pathways in the brain to adapt and rewire themselves. It causes the brain to filter and organize information much less effectively. This leads to decreased productivity, more errors, and accidents.

This process is crucial for emotional learning, adaptation, and developing resilience to emotional challenges. And don't we all have emotional challenges?  Stage N2 sleep is critical for overall cognitive and physical restoration. Chronic deficiency can lead to cumulative negative effects on mental and physical well being.

Now before you put your head down on your desk for a little nap, Now, let's move on to the deepest subject, stage N3, or deep sleep. This one is essential for feeling refreshed. And here's the deal, you can't really skip over stage N1 and stage 2 to get there.  You can probably guess that this stage of deep sleep is the most restorative.

It's harder to wake up during N3. It's so critical for physical recovery,  strengthening the immune system and promoting growth and repair of tissues.  You know how they always do road work at night? Well, your brain kind of does the same thing. And just like highway repair, it's never ending.

Now, let's shift gears a little bit and talk about REM sleep. The brain undergoes a sophisticated process of emotional memory integration. And this just isn't passive storage, but it's an active recalibration of all of your emotional experiences.  And as implied by its name rapid eye movement. The eyes move rapidly beneath the eyelids and the brain is actually highly active, but the body is temporarily paralyzed.  

This part of the sleep cycle is critical for cognitive functions like memory consolidation, emotional regulation, learning, and creative problem solving. I mean, have you ever woken up in the morning and just had a better perspective on things?   I certainly have. But while your eyes are dancing, your brain is sorting and processing emotional experiences. And this is what leads us to be more clear headed and in control of our emotions during the day. And without it, you're probably going to wind up on Santa's naughty list.  So, how does all this work?

Well, that little maintenance crew in your brain goes to work in your prefrontal cortex. When the work of sleep is disrupted, emotional processing is impaired, which causes heightened emotional reactivity  and the reduced ability to manage stress.  No wonder we get irritable when we're sleep deprived.  Even more serious, during this phase of sleep, traumatic or intensely emotional memories are processed, and they're gradually detached from their immediate emotional intensity.

So think about that. If they don't get detached, you just keep reliving it over and over with all of the emotional intensity attached.  That's miserable.  The brain essentially sorts out these emotional experiences and helps reduce their psychological impact.

And that prevents us from being overwhelmed and it keeps us resilient.  Now that you understand how this neurochemical rebalancing of sleep has a direct impact on mood, Let's step into the lab for a sec and just look at a little bit of sleep chemistry.

You see, sleep keeps neurotransmitters and hormones in balance to stabilize mood. Everybody's always worried about their hormones being out of balance. Well, how about trying a good night's sleep? Things like serotonin, the happy hormone, cortisol, the stress hormone, and dopamine, the motivating and pleasure hormone.

All get regulated during sleep. What happens is, sleep replenishes the serotonin and dopamine while clearing out the excess cortisol.  When these neurochemicals are out of balance, due to poor sleep, there's more inflammation in the brain.   And that can increase anxiety and depressive symptoms. In fact, studies show that chronic sleepyheads are ten times more likely to experience symptoms of depression. 

So, there's this little cleanup crew in the brain that's supposed to haul all of those inflammatory proteins to the dump. We call that the glymphatic system. But without good sleep at night,  they  don't get an opportunity to come in and clean up all those messes created during the day.

As a result, there are more mood swings and more mood disorders. And here's the deal. It doesn't take a lot of sleep deprivation to cause a pile up. Even mild sleep deprivation can affect emotions. Just one night of poor sleep can increase negative emotional reactivity by up to 60%.  

 The bottom line is that sleep is so much more than rest. It's actually hard work. It's an active and very complex process coordinated by the amygdala. which is the brain's emotional processing center, as well as the prefrontal cortex, and that's where we make rational decisions. Or if we're sleep deprived, it's where we make irrational decisions. 

The brain's nightly housekeeping crew, which occurs most effectively during deep sleep, helps maintain and restore emotional control. It's necessary to reset communication patterns, and reduce impulsive outbursts.  

 Think of it as a nightly emotional tune up for your brain, helping you process, adapt, and maintain psychological balance. And we all need balance, don't we? But like everything in life, this is no quick fix. Adults go through four to five complete sleep cycles every night, and each one of them lasts about 90 to 120 minutes. In other words, it takes some time to get there.

 REM sleep tends to be shorter early on in the night and gets longer as the night goes on. It can last up to an hour. So, if you're feeling big feels that are out of proportion to the situation, take a look at your sleep quantity and quality. 

Maybe your crankiness is a result of imbalance caused by lack of good sleep,  or depression, anxiety, or plain old stress that impacts sleep which interferes with that critical maintenance that goes on during shut eye.  Are you struggling with this area of your health?  If you have trouble with spinning thoughts that keep you from lying down in perfect peace, then grab a sleep freebie from my website.

 This cheat sheet will help get you started turning off your mind so you can turn on restorative sleep. There's a link in the show notes or you can just head on over to my website www. healthylooksgreatonyou.com and look for the sleep freebie. If you want to feel rested, restored, and refreshed during the day, you need a good night's sleep.  

It will help you feel in control of your emotions instead of them tricking you into making mountains out of molehills. Getting enough shut eye is crucial for your health, and healthy looks great on you.  

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Terri Edwards is a certified Food for Life Instructor and the content blogger behind Eat Plant Based. She shares her favorite recipes and discusses her training with the T Collin Campbell E Cornell course. 

Dr. Vickie invited her to share her insight into transitioning to plant-based eating. Terri recounts her own journey and the benefits she immediately experienced with sleep, adult acne and sleep.

Transforming Your Health with Plant-Based Nutrition: Featuring Terri Edwards

In this episode of 'Healthy Looks Great On You,' host Dr. Vickie Petz Kasper converses with Terri Edwards, the creator of 'EatPlantBased.' They delve into the immense benefits of plant-based eating, covering its positive impacts on heart health, brain function, blood pressure, mood, sleep, and more. Terri shares her personal journey, motivated by her own health challenges such as high blood pressure, high cholesterol, and joint pain, which led her to embrace a plant-based diet and experience transformative results. The discussion highlights practical steps for starting a plant-based diet, the importance of proper medical guidance, resources available for beginners, and recipes that make the transition easier. This episode offers valuable insights and actionable advice for those looking to improve their health through plant-based nutrition.

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00:00 Introduction to Plant-Based Benefits 01:37 Meet Terri Edwards: The Face Behind EatPlantBased 02:29 Terri's Personal Health Journey 04:00 Discovering Plant-Based Nutrition 07:41 Teaching and Spreading the Plant-Based Message 11:27 Resources and Certifications for Plant-Based Nutrition 14:03 Practical Tips for Starting a Plant-Based Diet 20:38 Terri's Favorite Recipes and Cookbook Plans 26:17 Encouragement and Final Thoughts

Why Doctors Prescribe Pills Over Lifestyle Changes: Unveiling the Reality

In this episode of 'Healthy Looks Great On You,' host Dr. Vickie Petz Kasper delves into why doctors might opt to prescribe medication instead of recommending lifestyle changes for chronic diseases. Drawing from her extensive experience as an OB-GYN, patient, and healthcare administrator, Dr. Kasper explains the systemic pressures doctors face and highlights the potential of lifestyle medicine. The episode also celebrates the 20th anniversary of the American College of Lifestyle Medicine, discusses the impact of lifestyle on health, and explores the six pillars of lifestyle medicine: sleep, social connectivity, avoidance of harmful substances, stress management, physical fitness, and nutrition. Dr. Kasper emphasizes the need for a shift towards lifestyle medicine to prevent and manage chronic diseases effectively.

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00:00 The Big Question: Why Pills Over Lifestyle Changes? 00:35 Introducing Healthy Looks Great On You Podcast 00:46 The Transformative Journey of Dr. Vickie Petz Kasper 01:47 Diving Into Lifestyle Medicine 02:59 The Stark Reality of Chronic Diseases and Healthcare Costs 04:35 A Glimpse Into Medical Education and Its Shortcomings 07:27 The Modern Doctor's Dilemma: Internet Diagnosis and Overbooked Schedules 14:28 Exploring the Six Pillars of Lifestyle Medicine 15:04 The Importance of Sleep and Social Connections 17:10 Addressing Harmful Substances and Stress Management 19:21 Physical Fitness and Nutrition: The Final Pillars 21:20 Closing Thoughts: The Challenge and Reward of Lifestyle Changes

Lowering Your Risk for Breast Cancer: Insights and Strategies

In this episode of 'Healthy Looks Great On You,' host Dr. Vickie Petz Kasper, a former obstetrician gynecologist turned lifestyle medicine advocate, discusses the prevalence and risk factors of breast cancer, emphasizing its substantial impact on women globally. With breast cancer being the most frequently diagnosed cancer worldwide and a leading cause of cancer death among women, the episode sheds light on various aspects including the higher occurrence in older women, the importance of lifestyle factors alongside genetic predispositions, and misconceptions about risk factors. Dr. Petz Kasper also breaks down complex medical terms and concepts for easier understanding. The core of the episode focuses on six lifestyle adjustments that can potentially lower the risk of breast cancer, ranging from breastfeeding and alcohol consumption to diet changes and physical activity. Additionally, it touches on the importance of weight management and diet in reducing risk. The episode also navigates the role of hormone therapy and hormone contraception in relation to breast cancer risk, aiming to provide a comprehensive guide on prevention strategies. The information is presented as educational and encourages listeners to maintain follow-ups with healthcare providers.

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00:00 Understanding Breast Cancer: Statistics and Risks 00:24 Meet Your Host: A Journey from OB-GYN to Lifestyle Medicine 04:33 Mini Medical School: Demystifying Breast Cancer 09:05 Risk Factors Beyond Your Control 10:11 Six Ways to Lower Your Risk for Breast Cancer 15:47 Diving Deeper: The Impact of Diet and Lifestyle 20:32 Conclusion: Empowerment Through Knowledge

Seasonal Allergies: Immune System Battles and Lifestyle Medicine Solutions

In Episode 118 of 'Healthy Looks Great On You', host Dr. Vickie Petz Kasper explores the theme of seasonal allergies and the immune system. The episode delves into the high prevalence of allergies, detailing symptoms, the economic and health costs involved, and the biology behind allergic reactions. Dr. Kasper contrasts seasonal allergies with perennial allergies, discussing the impact of regional flora on allergy patterns. The podcast further discusses the role of the immune system in allergies, offering insights into lymphoid organs and the production of antibodies. The episode then transitions into lifestyle medicine, examining the relationship between allergies and lifestyle choices, including exercise, stress management, and diet. Dr. Kasper emphasizes the importance of understanding allergies from a medical standpoint and presents practical advice on managing symptoms, the potential of allergy shots, and the significance of dietary choices in mitigating allergic reactions. Additionally, the episode underscores the necessity of distinguishing allergies from infections like colds or COVID-19 and touches on the broader implications of allergic conditions on mental health and cognitive function.

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00:00 Welcome to Allergy Season: Understanding the Yellow Tint 00:22 Meet Dr. Vickie Petz Kasper: From OB-GYN to Lifestyle Medicine 01:15 Diving Into Seasonal Allergies: Symptoms and Suffering 05:29 The Immune System 101: A Mini Medical School Session 06:40 Allergy Anatomy: Exploring the Lymphoid Organs 11:16 The Physiology of Allergies: How Your Body Reacts 14:07 Identifying and Managing Allergies: From Symptoms to Solutions 22:40 Lifestyle Medicine and Allergies: Exercise, Stress, and Diet 25:44 Nutrition's Role in Allergy Management: A Deep Dive 29:48 Closing Thoughts: The Importance of Medical Advice

Navigating Menopause: Myths, Medicine, and Lifestyle Choices

Hosted by Dr. Vickie Petz Kasper, 'Healthy Looks Great on You' delves into the complexities of menopause, debunking misconceptions and exploring symptoms, treatments, and lifestyle adjustments. Dr. Kasper, with her vast experience as an OB/GYN and her journey through health challenges, offers insights into the benefits of lifestyle medicine in preventing and treating diseases. The episode covers various facets of menopause, including hormonal changes, symptoms like hot flashes and mood swings, and the impact on women’s health post-menopause. It also touches on the concept of andropause in men. Dr. Kasper discusses the importance of diet, exercise, stress management, and social support in managing menopausal symptoms, alongside the pros and cons of hormone replacement therapy (HRT), guided by the latest research findings. The objective is to equip listeners with knowledge to make informed decisions about menopause management with their healthcare providers.

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00:00 Introduction to Menopause Misconceptions and Journey Ahead 00:22 Dr. Vickie's Personal and Professional Journey 01:15 Understanding Menopause: Symptoms and Experiences 02:58 Navigating Perimenopause and Its Challenges 04:23 Exploring Different Types of Menopause 07:51 The Impact of Menopause on Health and Lifestyle 12:45 Lifestyle Medicine and Coping Strategies for Menopause 17:14 Addressing Men's Experience: Andropause 18:11 Sexual Health and Pelvic Floor Function Post-Menopause 23:28 The Science and Debate of Hormone Replacement Therapy 33:59 Making Informed Decisions on Hormone Therapy 36:11 Conclusion: Navigating Menopause with Knowledge

You might be surprised to learn that motivation doesn't get you very far when it comes to fitness. Learn how to get started with group fitness without being intimidated. The more you do, the more you'll want to do. Get fit and get healthy, because healthy looks great on you. 

Recommended reading: Atomic Habits

Don't be fooled by marketing gimmicks. Learn the secret to reading a food nutrition label. It's important to understand food labels so you can make healthy choices. There's a little bit of history, and a little bit of science in this episode. Whole foods are the key to nutrients that impact health. Read a label like a pro and know how to interpret nutrition facts, ingredient lists, and all those claims on the front of the package. Then you'll go to the grocery store ready to make informed choices and not be confused by misleading claims. 

Episode 115: Mastering Food Labels for Better Health

In this episode of 'Healthy Looks Great On You', Dr. Vickie Petz Kasper dives into the intricacies of reading food labels, providing listeners with the knowledge to become savvy shoppers. She shares her personal journey from a board-certified obstetrician-gynecologist to a lifestyle medicine advocate after experiencing health issues. She emphasizes the importance of a plant-based diet, informed by the recommendations of the American College of Lifestyle Medicine and other health organizations, highlighting the benefits of a Mediterranean diet. Dr. Kasper discusses the history and evolution of food labeling regulations in the U.S., introduced by the FDA to help consumers make informed choices. She breaks down the standardized Nutrition Facts Panel, updated in 2016, and teaches how to interpret serving sizes, calories, and the percent daily values of nutrients, adhering to the '5-20 rule'. The episode also covers the misleading nature of front package labeling and how to scrutinize ingredient lists, ultimately guiding listeners to make healthier food choices. Dr. Kasper concludes with practical advice on navigating grocery store aisles, debunking common marketing gimmicks, and choosing foods that truly benefit one’s health.

00:00 Decoding Food Labels: A Guide to Healthy Eating 00:22 Meet Dr. Vickie Petz Kasper: From OB-GYN to Lifestyle Medicine Advocate 00:50 The Power of Lifestyle Medicine: Preventing, Treating, and Reversing Disease 01:12 The Basics of Reading Food Labels 01:36 Understanding Food Processing and Its Impact on Nutrition 02:54 The Importance of Eating a Variety of Whole Foods 04:05 A Brief History of Food Labeling Regulations 06:50 Navigating the Nutrition Facts Panel and Ingredient List 07:54 Deciphering Front Package Labeling and Marketing Claims 24:31 Practical Tips for Smart Grocery Shopping 25:17 Closing Remarks and Disclaimer

Reversing Diabetes with Lifestyle Medicine

In episode 114 of the 'Healthy Looks Great On You' podcast, titled 'Reversing Diabetes,' Dr. Vickie Petz Kasper introduces listeners to the critical issue of diabetes—specifically, type 2 diabetes—that is affecting millions of Americans, many of whom are undiagnosed. Dr. Kasper shares her personal experience with diabetes following high doses of prednisone and how it led her to discover the benefits of lifestyle medicine. The podcast delves into the causes, risk factors, and long-term effects of diabetes on health, including its link to conditions like dementia, kidney failure, and heart disease, while emphasizing that prediabetes serves as a wake-up call for prevention. Key topics include the significance of understanding glucose metabolism and insulin's role, the impact of lifestyle factors such as diet, physical activity, and sleep on diabetes management, and the relationship between diabetes and other health risks like obesity, family history, and stress. Dr. Kasper encourages adopting a whole-food, plant-based diet, increasing physical activity, and managing other lifestyle factors to not only prevent but potentially reverse diabetes, highlighting the power of lifestyle medicine in combating this pervasive disease. The podcast concludes with reminders that lifestyle changes are crucial and encourages listeners to subscribe for more insights on health and wellness.

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00:00 The Alarming Reality of Diabetes in America 00:36 Meet Your Host: A Journey from OB-GYN to Lifestyle Medicine 01:32 Understanding Diabetes: Types, Symptoms, and Risks 06:31 The Science of Sugar: How Our Bodies Process Glucose 10:09 Turning the Tide: Preventing and Reversing Diabetes 13:30 Dietary Do's and Don'ts for Diabetes Management 23:17 Exercise, Sleep, and Stress: The Other Pillars of Diabetes Control 31:28 Final Thoughts: Taking Control of Your Health

 

 

Chances are, you know someone with dementia. Whether you're the caregiver, or a friend of the family, or a friend of the patient, this episode is for you. You're going to learn about some resources that you did not even know existed

that can help you keep the home safe, keep the patient safe, or just minister to your friends.

  ,  

You're listening to Healthy Looks Great On You, a lifestyle medicine podcast. I'm your host, Dr. Vickie Petz Kasper. For two decades, I practiced as a board certified obstetrician gynecologist, navigating the intricate world of women's health. But life took an unexpected turn when my own health faltered. 

Emerging on the other side, I discovered the transformative power of lifestyle medicine. And now I'm on a mission to share its incredible benefits with you. 

So buckle up because we're going on a journey to our own mini medical school. Where you'll learn how lifestyle medicine can help prevent, treat, and sometimes even reverse disease.  

This is episode 113, 

the Heartbreak of Caring for Someone with Dementia.  And today I have a very, very special guest. My guest today is Haley Buller.

Haley lives in Illinois where she is an occupational therapist one of the areas that she specializes in is helping with patients who have dementia. 

  Welcome, Haley. I'm so glad you're here with me today. I can't wait to talk about caring for Alzheimer's patients and also caring for the caregiver. I think that's something you have quite a passion for. 

Thanks for having me today. , yes, I am an occupational therapist, and I work in outpatient neuro. I, help run the outpatient portion of our dementia program here at our hospital.

 That's great. So tell me exactly what you do if someone has dementia and they come to your clinic. You're doing an evaluation to make sure that they're safe in the home and that they can age in place, right? 

Yes. So our primary goal is to keep them at home as long as possible and to keep them as independent as possible. So we do an assessment as an OT. I'm mainly looking at their daily activities. Can they bathe, dress, take care of themselves at home, , function within their home and then making their home. a safe environment. 

We also initially will always do a caregiver assessment. It's a caregiver burnout assessment to see how the caregiver is doing in their own life with dealing with caring for the patient.   

So I think that is super important, and honestly, there is a void in that space. Caregivers are burned out. It's a lonely disease, isolating, and really just heartbreaking. So first of all, talk about what it looks like when people are burned out, and also what you can do about it, or even how you can prevent it. 

So the main thing that I hear is loneliness,  especially if the caregiver is  caring for someone who is their spouse, because that's been their partner. They've been living life together for a long time, and then all of a sudden that person is still there, but who they are is gone. So a lot of caregivers are experiencing a deep loneliness because of this void that they have.

That was once their partner.  A lot of times their friends  isolate them as well, and that's always unintentional, but we see  people not being invited to things because  it's a lot of work to get out of the house or people stop coming over because maybe they don't know what to say.  

That's a really good point and I think it's important for us to talk about what friends can do. And you know, I think traditionally what we do is we take a meal, but we don't stay and eat.

Or we send a card, but we don't have a conversation. And so there are multiple opportunities for people to minister to their friends who are dealing with this by just being there for them. Not calling and saying, Hey, if there's anything I can ever do, give me a call, but truly continuing to do life with them. 

Yes. So there are two different approaches to look at this. And one is being there with them in the home. So just going over, this is so important for the patient as well, that you can listen to their stories, even if those stories aren't making sense, just being in their world, giving them, , some friendship and some companionship that also may allow the caregiver to have some time to themselves, some time to not listen to those stories that they've heard several times. ,  but just to give a little reprieve. The other thing you can do is to take them out. So if they have someone else who can give them an hour off, ask them to go to lunch, or like you said, take lunch and then also stay.  

 So you brought up the stories and living in their world. One time I heard someone say, fall with them. Don't try to prevent them from falling, but fall with them. Because I think the tendency is to sort of correct when someone tells something that's not true, or if they're trying to tell a story that's really not plausible. 

 And you want to say, no, no, you're at home, you're not at the store, or whatever. And so, can you talk a little bit about that? 

This is an area that I am so passionate about. Whether someone has a cognitive disability or a physical disability, as we age, the one thing that's in common with all human nature is we want to preserve our dignity. We want to still be ourselves and we want to have something to give. So the thing we want to avoid doing is correcting, ,  to make someone feel belittled because  early on, especially in the diseases, , of dementia and Alzheimer's,  they're a little bit aware that something is going on. They have some awareness that they have this diagnosis, that their memory or their functions are slipping. And so they want to hang on to who they are and their dignity.

  It's interesting that you would say that because yesterday I was in Bible study and we were studying 1 Timothy and how to take care of widows and one of the things that it said is that you need to meet their needs. And I spoke up and said one of their needs is to have purpose. But how do you see that playing out in a practical way with patients who have dementia? 

It really depends on the stage. So early on,  people want to still have something to offer. So even asking advice when maybe that advice you take lightly is so important or things that they've always worked on or that they're an expert in. So take someone who  you mentioned Bible study, you know, knows the Bible well, continuing to ask them about those things.

Hey, tell me what you think this verse means, or tell me what, uh, you know, about the story of David. And just asking them a thing that they're an expert in so that they still feel like they have something to contribute  Later on that looks a little different because communication is different. So, even a stuffed animal or a baby doll later on, it might look like giving that to them and making them responsible for that or a puzzle or just something to hold so that this is what I want you to keep up with for today. Anything to do with their hands can be helpful. 

  That's beautiful. And I know that your grandmother had a sister who had Alzheimer's and she would go and visit her in the nursing home and just sing hymns to her sister. And her sister really couldn't do anything else, but when she started singing those hymns, she would join in. And I think that's just a beautiful way to connect with someone. 

It's amazing. Just as a side note in my experience,  I have seen people sing hymns  and pray long after I thought that they shouldn't be able to anymore. And it's really a beautiful thing to see and hear.  

It is. I feel like they're just reaching deep into the recesses of their mind and the things that are deep in their soul and it's really touching. But let's talk about home safety. I mean, we can't ignore the fact that sometimes people don't need to be driving or if they're at risk for falling in the home.

How do you go about evaluating home safety? 

Sometimes I will go into the home. , the first thing I always do with patients is to talk about,  or with caregivers rather, is to always talk about the unsafe things in the home. So we start at that very top level of guns, knives, what could be weaponized in the home. Even if you're not to a point where you think that the, the patient, will use those inappropriately start early, get a safe, get them out of the house. Whatever has to be done.  The 2nd thing we would look at would be things.  That are a fall hazard, so simplifying the layout of the house, what furniture can be  moved to make a walkway wider. If the person shuffles their feet, making sure we pull up throw rugs.  , as a side note, and I think someone mentioned this in a comment on the Facebook post,  sometimes throw rugs can  seem like a black hole.

So any kind of surface change can really throw someone off. So the less, , The less surface changes throughout the home, the easier it's going to be for that person to navigate, , the floors.  

The problem is people love their throw rugs. People never want to get rid of throw rugs, right? 

That's right. You, , mentioned my grandmother earlier. , I tried to simplify her home at one point in time. And the next time I went over, she had a throw rug on top of a throw rug. So you just never know, but we can do our best.    Another thing I want to mention is a lot of. dementia and Alzheimer's patients have visual perceptual issues. So some kind of visual perceptual deficit, whether that be, , a visual scanning. So just being able to look, think of your pantry shelf. Can you look back and forth across the shelf and find what you're looking for? , it can also be a depth perception, , or something like a visual memory.  Something that can help is again to declutter. So if you're looking in a drawer, only putting what is necessary and maybe that top drawer so that they can find things more easily, you can also do a high contrast background. So making sure there's a, if it's a white object, putting it on a dark background, Or vice versa, 

 Wow, who knew there was so much medicine and science to taking care of just the home environment. I think after this episode, everybody's going to want you to come to their house and help out. And I think we need a service, you know, where you could take an iPad around and show people the home and have a full home evaluation to make sure that it's safe. 

That's something to consider for sure.  

 Anything else for home safety? Do you recommend things like a life alert type device? 

Yes. So going back a little bit, we were talking about kind of the different stages and how care looks different in those different stages. While we don't want to call someone out for their mistakes, those early stages, we definitely want to keep them as oriented as possible. So orientation daily is important. And what I have recommended in the past is something like an Alexa or a Siri  that you could ask the date. So if you have an Alexa in your home, you can say,  Hey Alexa,  what is today?  And she'll tell you, or you can say, what do I have on my schedule today? And she'll tell you.  Siri and Alexa also have capabilities to call a caregiver. So if you were  to fall and need to call a caregiver, Those devices can be helpful for that later on. I would definitely recommend the life alert.  It's easier. , it can detect a fall.  It can be pushed  in an emergency and those are great devices, 

 You know, an Apple Watch has that feature as well, and if you fall and you have service on your watch, it can call 911. 

Which is also nice early on because a lot of people don't want to look old. Let's be honest, in an age of Botox and, , hair dye, no one wants to look old. And the life alert from the commercials of, help, I've fallen and can't get up, , we think of that as elderly. So the Apple Watch can be a really nice, , younger person  device.

 Yes, I think it has the connotation of not only elderly, but just the dependents. You know, if I've lost my independence and now I have to have a device in case I can't get up by myself. 

yes. The Apple Watch also has,  GPS capabilities. So if you're worried about someone getting lost  and someone not carrying their phone with them all the time,  the watch can be a nice option.

 Yeah, and the phone has tracking devices, so you can share your location. And I wanted to mention something I think is important for everyone, not just people with dementia. You can go into the health app on your phone, it looks like a little heart on an Apple phone, and enter all of your health information there.

And you can put in there, dementia as a diagnosis, and you can put all of the medications. And then if there's an accident or any kind of emergency. When emergency personnel come, they can actually open that app, if you set it, right, without having to use the unlock feature on your phone, so then they can have access to understand all of your medical history.  

You make a good point there too. We think a lot about what happens if something happens to the person with dementia. But another thing with home safety that we have to talk about is what happens if something happens to the caregiver,  if something happens, , can the patient figure out how to call, is there an emergency button like the life alert that they could push, , or is your information somewhere so that when emergency services come, they don't have to rely on the person with dementia. To give your history and your contact information. 

There's so much to think about. It's almost like you need a handbook that starts at the very beginning and walks you through every step because there are so many facets of life that are affected at different times and in different places and have different needs.

It's part of the reason I think that this disease is so very challenging for caregivers. 

What I would say when someone is early diagnosed  is  find support.  It is not  a taboo disease. So it's okay to talk with your close friends. It's okay to talk with your church family or your blood family as well to talk with them, let them know what's going on, be open about it. And that will allow for a lot better communication, a lot better teamwork moving forward. The other thing is support groups. , some people don't like support groups. And so online has become a great resource, whether that's through Facebook  or finding other online groups, , finding community support groups. Support is so important. 

 

It is important, but it really isn't that easy. I mean, you may tell your church, and you may tell your friends, and your family, and honestly, you may be disappointed. I think when I was sick with a rare disease, I needed people who understood what I was going through. And I found really great support in Facebook groups.

And so, you know, we talk about how social connection  in social media doesn't take the place of in person connection, but when you have a common experience or diagnosis that brings you together and you're truly engaged with those groups, it's actually very good for your mental health. 

And the caregiver just needs as many resources as they can get, and unfortunately, there aren't as many support groups and support programs as we need. 

Another barrier would be being able to leave and go to this support group. So  online groups can be accessed anytime. And. they're they're a great option. 

That's true, because if you're going to a support group meeting, who's going to take care of your loved one who has dementia? And if you do have someone to take care of your loved one with dementia, wouldn't you rather go to lunch?  

And let's talk about driving. 

Oh, driving. , 

this is something that I do in my practice. So, an occupational therapy referral can be a good place to start.  In my practice, I do off road driving assessments. So, I go through a battery of tests as well as using a driving simulator to figure out Are there any red flags for driving? , I do not get behind the wheel with a patient, nor do I really want to, but there are occupational therapists who are driving rehab specialists and will get in the car with someone and see, are they really safe to drive?  , so an OT can be a great starting point because we can do a screen and then what we will typically do is ask the family member or the caregiver to do supervised drives.  If we don't see any red flags,  , one thing I will look for is I always try to watch the caregiver's face while I'm doing  off road driving assessments to see, do they have concerns? Do I need to maybe look a little deeper into the cognition? , Also, you can feel free to send your provider, whether that's a therapist or your doctor,  a message or give them a phone call ahead of time.  Let the medical professional be the bad guy. I know in my practice, I am happy to tell someone they can't drive so that it preserves the relationship with their caregiver.  

That's a big deal, taking away someone's privilege to drive. But it's important not only for their safety, but for the safety of others on the road. Even strangers and other people with their family and their children that may be in the car. It's a huge deal. 

So some things to watch for would first be  if they're getting lost, that's a big one, but also  taking a look at the car regularly. Usually, as someone is starting to lose their ability to drive, there will be unexplained scratches, unexplained dents, evidence that they might be having some trouble.

 I think a lot of people don't realize the resource that you are. I would imagine that referrals to an occupational therapist for people with dementia are terribly underutilized. 

Thankfully, in our hospital system, we have a great program  because it has been funded by a family. And we have really good education to our neurologist, but I would guess that in the grand scheme of things, you're right, that it is underutilized.  

You know, I think a lot of people don't even see a neurologist. I think a lot of people just see their family practice doctor who may or may not understand the benefits of medication and the need for evaluation and support and education. And I imagine the average family practice doctor doesn't have the connections or the resources that you're providing.

And that just leaves people more on an island, trying to navigate this all by themselves. And it's, it's sad really. It's a tragedy that we don't have more support networks. And I think you're bringing up a good point that someone funded your program. And we can always give back out of the struggles we've been through.

If something has affected you or your family, sometimes that's just an opportunity to increase awareness. If you don't have money to fund a program like that, Then start your own support group or if you can be an advocate for education and connecting others with resources. 

you mentioned being an advocate, advocate for that neurology referral. There are memory clinics all over the country. I know there's one in Little Rock close to you  And one here in Illinois, that's about an hour from where I live. , but there are memory specific neurologist out there.

You just may have to ask for it, look it up and advocate for that referral.

 That's really good advice, and I think it's super important.

Wow, I think there's so much more we could talk about, about all of this. And I'm just going to encourage anyone that's listening to this to connect with others who are dealing with the same issue. On my Facebook page, there's been a lot of discussion and several people have chimed in that their loved ones have had dementia.

And sometimes it's a grandfather who's already passed away and sometimes it's a spouse that they're currently caring for. But when people are just in the throes of it, If you're one that's on the other side of it, be there for those people who are still in the middle of it. Because I think connection is super important, and I just really commend the work that you're doing, and I think there's such a need for this, 

and I appreciate you taking the time out of your day to talk to our listeners about it. 

Thank you for having me.

People have shared a couple of resources with me, so I'm going to put some helpful links in the show notes. Check it out.  

the information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or healthcare provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change. 

Show notes and Resources (*may contain affiliate links)

Alzheimer's support groups

Alexa Echo show

Alexa Dot

Apple watch

Coach Broyles Playbook on Alzheimer's

The 36 hour day planning guide

Mobile Medical alert device

All episodes of Healthy Looks Great on You

 

00:00 Introduction to Dementia Care and Resources 00:28 Meet Dr. Vickie Petz Kasper: From OB-GYN to Lifestyle Medicine Advocate 01:16 Special Guest Haley Buller: A Deep Dive into Dementia Care 02:37 Understanding Caregiver Burnout and How to Support Them 04:21 Embracing the World of Dementia Patients: Compassion and Connection 08:36 Home Safety and Adaptation for Dementia Patients 11:46 Leveraging Technology for Safety and Orientation 15:27 The Importance of Support Networks and Advocacy 17:25 Driving Assessments and Safety Considerations 19:31 Expanding Access to Dementia Care and Support 21:59 Closing Thoughts and Resources

SHOW NOTES:

Save the Brain: Lifestyle Medicine and Dementia Prevention

In this episode of 'Healthy Looks Great On You,' Dr. Vickie Petz Kasper delves into the critical issue of dementia, a condition affecting millions worldwide. She emphasizes the importance of early detection and lifestyle changes in preventing and managing dementia, including Alzheimer's disease. Dr. Petz Kasper, drawing from her transformation through lifestyle medicine, shares the potential of exercise, restorative sleep, and dietary modifications like the MIND diet in preventing up to 40% of dementia cases. She highlights the dire need for social awareness around dementia, which currently impacts over six million Americans, with rates doubling over the past 20 years. The episode also dismantles misconceptions surrounding dementia, informs on recognizing early symptoms, and underlines the significance of modifications like hearing aids and engaging in regular physical activity. Moreover, it offers a deep dive into the evidence-supported MIND and Mediterranean diets and their role in neurodegenerative delay, alongside strategies for stress management, enhancing sleep quality, and fostering social connections to bolster brain health.

00:00 The Shocking Truth About Dementia Prevention 00:38 Welcome to Healthy Looks Great On You! 01:29 Understanding Dementia: More Than Just Memory Loss 03:24 Breaking the Stigma: It's Time to Talk About Dementia 07:04 The Science Behind Dementia: Types and Causes 14:59 Lifestyle Changes: The Key to Preventing Dementia 15:17 The MIND Diet: Your Brain's Best Friend 22:49 Exercise and Other Pillars of a Healthy Brain 25:56 The Don'ts: Avoiding Risk Factors for Dementia 28:02 Final Thoughts and Caregiver Support

RESOURCES (may contain affiliate links)

Previous episodes on high blood pressure, cutting out tobacco and alcohol, stress management and more can be found HERE

To download card, MIND diet and MIND diet checklist, subscribe to emails HERE. You'll get weekly emails, plus 7-Day Prescription for Change. Next week's podcast episode is for caregivers and will include all downloads. 

How Not to Die by Michael Gregor

How Not to Die Cookbook 

How Not to Diet by Michael Gregor

Smoothie Blender

Black Bean Brownie Recipe

TRANSCRIPT:

Did you know that lifestyle modifications such as exercise and restorative sleep and controlling blood pressure can prevent up to 40 percent of dementia cases in the world?

Dementia is one of the most dreaded diagnoses, along with cancer. And just think, breast cancer and prostate cancer can be treated if caught early. But listen, it is just as important to treat and prevent dementia. Save your brain! Now is the time to make changes that may prevent the development of this terrible disease., ,

You're listening to Healthy Looks Great On You, a lifestyle medicine podcast. I'm your host, Dr. Vickie Petz Kasper. For two decades, I practiced as a board certified obstetrician gynecologist, navigating the intricate world of women's health. But life took an unexpected turn when my own health faltered.

Emerging on the other side, I discovered the transformative power of lifestyle medicine. Now, I'm on a mission to share its incredible benefits with you, so buckle up because we are embarking on a journey to our very own mini medical school, where you'll learn how lifestyle medicine can help prevent, treat, and sometimes even reverse disease.

This is episode 112, Save the Brain.

When someone is diagnosed with dementia, it doesn't just affect the patient, but the caregivers and the entire family as well. It's likely you know someone with dementia because 1 in 3 seniors has been diagnosed with this. And when people think of dementia, they think about memory loss. But it's really much more than that.

 It's also fatal resulting in the death of more people than breast and prostate cancer combined. In fact, it's the seventh leading cause of death in the United States.

And do you think it seems like more and more people have dementia? Well, it's true. Over the last 20 years, deaths from dementia have doubled. By contrast, death from heart disease, which by the way is still the number one killer, have decreased over that same period of time. If you or a loved one is experiencing symptoms of dementia, don't feel alone.

Right now, more than six million Americans have been diagnosed with dementia. And the numbers are rising sharply. About 33 percent of people over the age of 85 have some form of dementia. It's not part of the normal aging process and it doesn't affect everyone, but it is more common. Back in the old days, people said, they're just getting senile, but now we know so much more.

10 percent of the people over the age of 65 have symptoms of cognitive decline. Progress is slow and affects different people differently. Most people with dementia over the age of 65 live 4 to 8 years, but others live as long as 20.

Typically, older people are affected, but not always. There are rare cases of early onset dementia that occur in midlife, which is particularly tragic, isn't it? But, people often don't seek treatment. Why do you think that is? Well, for one thing, there's a weird stigma associated with dementia.

I mean, like, if your heart is failing, you'd tell your friends, right? But if your brain is failing, somehow that's embarrassing. But dementia is literally brain failure. Second, there's a misconception that nothing can be done. Ready for some good news? There is. While dementia cannot be cured, it is possible to slow progression.

And prevention is also possible. And obviously, most important. How do you know if you're experiencing symptoms of dementia versus just being forgetful? Which can happen for a variety of reasons. Memory loss is a hallmark sign of dementia, but it's so much more. It's things like poor judgment. And this one is really dangerous, especially if people continue to drive.

It can be dangerous in other situations as well. And I may or may not have a story about fireworks, catching a field on fire, and the fire department coming and, um, we really weren't sure who to blame, but we won't talk about that. Another symptom is confusion. People may think they're somewhere that they aren't. Or they may call people or their pets by the wrong name. And they may have trouble finding the word they need.

Along with trouble writing. and understanding what they read. They may wander or get lost and have difficulty handling their finances, paying the bills and keeping up and writing checks. I mean, that's hard for everyone, but it can be so much worse if you're experiencing cognitive decline. Some people repeat the same question over and over.

They may say, “When is my hair appointment?” And then five minutes later, “When is my hair appointment?” Sometimes they'll use unusual words to refer to familiar objects. Another key feature, which has only recently been brought to the forefront, is slowing down. People who used to walk really fast, suddenly walk slower.

People who used to eat very fast, eat slower. And everyday tasks, like getting ready in the morning, take forever. Also, there can be a loss of interest in normal, everyday stuff. A change in appearance because the person may quit caring so much about their hygiene.

For instance, someone who was meticulous about their hair suddenly quits brushing it. There can be hallucinations, delusions, or paranoia. A common one is, they took my money. And then they tell their friends and at first their friends don't notice that they're having problems and so they believe that someone took their money.

Another thing is not caring about other people's feelings. They might say, “Look at that woman, she's ugly and her baby looks just like her.” That can be really embarrassing for the family members.

 One thing that can help is to get little business cards that say, “Thank you for your patience. The person I am with has dementia.”

I created a little template and I put a link in the show notes for you.

Another thing that can happen is impulsiveness and this can be worse than a teenager. They may have trouble controlling their emotions and may experience a personality change. Someone who is usually really sweet may become mean and vice versa. They may have problems with balance or movement and this can be really dangerous because it can make them more likely to fall.

And a lot of times the symptoms are not noticed by the person who has the cognitive decline but by their friends and family members. But nobody wants to talk about it. And that's unfortunate because this disease has a huge impact and it needs attention. Before I give you some good news about what can be done to prevent dementia or possibly even slow progression, we need to review some science.

You didn't think you were getting out of mini medical school today, did you? First of all, what causes dementia? Well, that depends on the type. There are several different types of dementia, and the most common and most familiar is Alzheimer's. Now, pay attention closely. It's not Alzheimer's. It's AllTimer's.

Well, that's a weirdly spelled word, isn't it? Turns out, it's somebody's name. A German man, to be exact. Alois Alzheimer was a psychiatrist who first described the disease in 1905. Good job. Think I would hate having my name associated with such a terrible disease. So if you insist on saying All Timers, I'll forgive you.

Maybe. Not all dementia is Alzheimer's, but Alzheimer's is always dementia. Did I just hear you say, huh? Let me explain. Think of it this way. A poodle is a type of dog. And while all poodles are dogs, not all dogs are poodles. Got it? Alzheimer's is a type of dementia, but You're welcome. But not all dementia is Alzheimer's, there are other types. So what are the other types of dogs besides poodles? Well there are German Shepherds, Beagles, Dachshunds, oh wait, never mind, we were talking about types of dementia. But I hope that analogy helps you remember that not all dementia is Alzheimer's. Alzheimer's is a type of dementia. The others are things like frontotemporal dementia.

Now that may sound familiar because of Bruce Willis, you know, the actor from Miami Vice who starred in the action packed Die Hard movies? His family announced that he had Frontotemporal Dementia. There's also Lewy Body Dementia that looks similar to Parkinson's Disease with shuffling, tremors, and hallucinations.

It can be particularly devastating and it's rumored that that's what Robin Williams had. Vascular dementia is caused by disease in the blood vessels, like little mini strokes. And then there's mixed, where dementia is attributed to multiple causes. How do you determine which type of dementia is present?

Well, it's not that easy. Lewy bodies are really specific, and they're a clump of protein that is found inside the brains of people with this type of dementia. The problem is, you can't see them, except on autopsy. And since it's related to Parkinson's There are clues to the diagnosis, like the inability to draw a clock face.

This is a fascinating thing. Certain parts of the brain are responsible for certain cognitive tasks. So there are neurologic tests that can help your doctor make the right diagnosis. It starts with a complete medical history and physical exam, and there are specific memory and psychological tests that evaluate certain areas of the brain.

 Some of these can take hours to complete, and that's exhausting. So a lot of people don't want to pursue it. But the doctor should check your reflexes, watch you walk, check for balance and sensation. Didn't you always wonder what that tuning fork was for? It's to see if the patient can feel vibration. And patients are sometimes diagnosed with depression.

There are also mental performance tests that check memory and thinking skills. Imaging studies like MRI may be helpful, but they're not usually conclusive. The definitive way to check for Alzheimer's is a spinal tap because there are amyloid proteins in the cerebrospinous fluid. Now I know that sounds awful, but it's really not that bad.

If you had an epidural when you had a baby, that's a much bigger needle than the one used for a spinal tap.

Another symptom that some people have is confabulation. That's a really big word that means making up stories. But the tricky part is that some people are really good storytellers.

 So good storytellers who get dementia may be able to tell fantastic stories. The trick is to know when they're telling the truth or not. At first, with dementia, the symptoms often wax and wane. And it's super easy to attribute it to something else. So, why do the symptoms come and go? Well, think of it like tangles in your hair. The neurons in your brain get tangles in them sometimes.

Other times, thinking may be clear. Don't you wish we could just spray some no more tangles on the brain? Although, I'm not really sure that stuff worked well anyway. I remember it still hurting when my mom brushed my hair when I was little now, for people on Medicare, the annual wellness visit requires an assessment of cognitive function.

And it can be very brief and simple. There are several different questions to choose from. So that may explain why sometimes your doctor is asking you weird questions. So, what's the point? Well, it's to identify people with cognitive decline in the earliest stages so that interventions can be made. And guess what the most effective interventions are?

I hope you guessed lifestyle changes. There are medications that slow progression and there are some promising treatments on the horizon too. We'll talk about both later, but first just a little more terminology. MCI stands for mild cognitive impairment. And this is usually the first thing noticed by the patient, family, or friends.

Don't panic, but this is stuff like losing your keys or your cell phone.

Now, don't talk to my husband about how many times I lose my cell phone. But it's also forgetting important events or appointments, trouble coming up with words and forgetting names. Another thing is a loss of the sense of smell can happen with early disease.

And of course that's become a lot more complicated in the era of COVID. But the

key time for intervention is early disease or mild cognitive impairment. Oh wait, there's one thing even better, and that's prevention. Whether you are trying to arrest or slow progression or minimize your own risk, the treatment is the same. I promise we'll talk about that soon, but let's discuss who is at risk first.

Women are at greater risk. Two thirds of people in the United States with Alzheimer's are women. For women at age 45, the lifetime risk is 1 in 5. And for men, it's 1 in 10. And not only are women at greater risk for developing the disease, they carry 70 percent of the caregiver burden. Older African Americans are at greater risk than older whites, and older Hispanics have a 1. 5 percent increase in rates of dementia compared to older whites. We often talk about modifiable risk factors versus

non modifiable risk factors. Those are the ones you can't control, like your gender, ethnicity, or genetics. When we see a parent or a grandparent experience dementia, it feels like looking in a mirror at our own fate. But it doesn't have to be that way. Lifestyle interventions for prevention should begin as early as possible, even in childhood.

In other words, if you're concerned about your family history, then make changes together with your whole family. Let's talk about modifiable risk. First of all, the number one preventable contributing factor to the development of dementia is wait for it. Hearing loss. Did you hear that? Now, you can't help it if you can't hear well, but by golly, you can get some hearing aids.

I've had them for about six years and my hearing isn't terrible, but I don't want that part of my brain that processes hearing loss - the spoken language to start shrinking. So I wear them. Well, I wear them most of the time. All right. Now let's talk about lifestyle modifications. Whew, finally, right? All six pillars of lifestyle medicine are important in preventing cognitive decline. Diet, stress management, exercise, social connectedness, minimizing harmful substances, and restorative sleep. First, let's talk about diet. Hmm, you probably knew that was coming. There is some evidence that the MIND, M- I -N -D, diet may prevent dementia and even slow its progress, especially in early stages.

This has been headline News in Forbes and U. S. News World Report. It was developed in 2015 by a nutritional epidemiologist named Martha Claire Morris and her team. Geez, I don't even know any nutritional epidemiologists. But anyway, MIND stands for Mediterranean DASH Intervention for Neurodegenerative Delay.

Whew, that was a mouthful. Let's try that again. MIND stands for Mediterranean DASH Intervention for Neurodegenerative Delay. That's a mouthful. Basically, what she did was combine two well-known diets, the Mediterranean diet and the DASH diet. If you listen to my podcast on hypertension, you know the DASH diet stands for Dietary Approaches to Stop Hypertension, and it focuses on lowering salt in the diet.

I'll put a link to that in the show notes.

The MIND diet is similar to Mediterranean with less emphasis on fish and fruit with the exception of berries. If you remember one thing today, remember berries. Now, let's go over the specific recommendations of the MIND diet. And don't worry about taking notes because I've put a downloadable printout in the show notes along with a smoothie recipe that helps you knock out some of these things all at once.

But here's the weekly dose. Six servings of green leafy vegetables every week. You know, Popeye never had any cognitive decline. Uh, maybe that's a terrible example, but hopefully it helps you remember. Spinach, kale, arugula, collard greens. Swiss chard, turnip greens are rich in folate, lutein, vitamin E, beta carotene, and other nutrients that protect cognition, especially as people get older.

You need at least one other serving of vegetables that aren't starchy, so not potatoes. Think more broccoli, squash, asparagus, beets, bell peppers, cabbage, carrots, eggplant, and okra. Also, five servings of nuts, or more, weekly, and I think just make it simple and eat a handful every day. Almonds, Brazil nuts, cashews, pecans, pistachios, or walnuts.

Nuts are good for the brain. And, they're a rich source of vitamin E, B vitamins, healthy fats, as well as minerals such as magnesium, potassium, and calcium. Now, I mentioned before, berries are important. Eat at least two servings a week? But I say more. Put some blueberries or raspberries on your oatmeal or eat strawberries for dessert.

Berries are great for making smoothies and you can drink all those antioxidants which are not only good for your brain but your body too. For Valentine's Day this year, I served Nice Cream. It's a recipe I got out of the How Not to Die cookbook. I'll put a link for that in the show notes too.

You need a minimum of four servings a week of beans. I know that's a lot, but they're so, so good for you. Lots of protein in a great source of fiber too, so you feel full and there's such variety. You can incorporate beans in creative ways like chickpeas in hummus or pinto bean dip. White beans, make a good salad mixed with cucumbers and olive oil and vinagerette.

Kidney beans go great in soups, and if you've never made lentils, look up some recipes. They're easy, versatile, and delicious. Black beans make a great meat substitute, and you can even make brownies with them. And don't knock it unless you've tried it. They're really yummy. I'll put a link in the show notes.

When cooking, always use olive oil instead of canola, vegetable oil, or safflower oil. When it comes to whole grains, you need three servings a day. The other recommendations are for the week, but this one's daily and it's hard to eat whole grains because most breads and cereals are processed.

So try quinoa, oatmeal, and brown rice. They're chocked full of vitamin B and vitamin E and a good source of fiber. I still think it's a challenge to get in three servings a day, but if you start your day with oatmeal, that works. You can add oatmeal to a smoothie by the way. At least one serving of fish each week is included on the MIND diet.

Now these should be fish that are high in omega 3s. Typically those are your fattier type fishes like salmon and tuna. Chicken or turkey twice a week, and I hope it goes without saying that we're not talking about chicken nuggets and we are not talking about fried chicken. And originally they recommended one glass of red wine a day, but there's been some uncertainty about whether or not this is beneficial, and certainly limit it to one.

Now, here's the what not to eat list. butter and margarine and gosh it kills me to even say that. You would not believe how much butter I like to cook with. Actually, I don't cook with it like I used to because the evidence is so good that diet can prevent dementia. I've cut back. The limit is however one tablespoon a day.

 Now you may not be slathering it on your bread or toast, but think about sauces. And such as that. And here's a good substitute. If you want to smear something on a piece of bread, try a mushy avocado. It tastes delicious. And if butter was hard, the next one's even harder.

Cheese. Ugh. Only one serving a week. Now, one thing I've done to help with this is swap it out for nutritional yeast. It has a cheesy taste and it's used in a lot of cheese free recipes to give it that flavor. Red meat on the MIND diet is recommended no more than three weekly servings. But we know it's not good for your blood pressure or heart and it increases the risk of cancer.

So I would skip this one. Last on the limit this list is sweets and pastries. It says no more than four times a week, but personally I think that's generous. For me, I need to go pretty much all or none. Once I start with sweets, I want them more and more. So I'd say limit to a very small amount on very special occasions.

And remember, you're going to have to define what is a special occasion. Do you think you could follow the MIND diet? How about a little more motivation? In one study of approximately a thousand older adults, there was a 53 percent lower risk of developing Alzheimer's in those who followed the MIND diet compared to those who didn't. 53 percent is impressive. The MIND diet has only been around for about 8 years, so there aren't as many studies on it as there are on the DASH and Mediterranean diets. But there was a really big study published in a British medical journal in March of 2023 that showed that the Mediterranean diet reduced the risk of developing dementia by 25%.

And that's even in people who were genetically predisposed. And when I say big study, there were 60, 000 seniors in this one. That's powerful data. And there are other benefits to following either of these diets too, such as prevention of heart disease, diabetes and cancer as well as lower blood pressure and improved digestive health.

If that's not convincing enough, then you should know that whole foods and those with high fiber also help you lose weight. Alright, maybe we can do without the cheese and butter, right? Now that we've talked about diet, let's move on to an equally important pillar of lifestyle medicine. Exercise. It is well known that physically active bodies have sharper minds.

We need 30 to 60 minutes of activity per day, but any amount reduces your risk and it's dose dependent. A Harvard study showed that even light activity such as running errands or getting up and cleaning the house is a lot better than doing nothing.

A lot better. According to an article published in the Journal of Neurology in 2022, The reduction of risk from just getting up off the couch is 21%. But aim for 150 minutes of moderate to high intensity exercise each week because that's associated with a 35 percent reduction.

This means you're exercising hard enough that it's hard to talk without being breathless. But again, every little bit helps, so just get started. And do something you like. Involve your kids or grandkids because the earlier you start, the better. Okay, now that you're motivated to eat healthy and get more exercise, you need to look at your sleeping patterns.

I covered restorative sleep in one of my earlier podcasts. I'll just put a link to that in the show notes. And what about stress? Does that affect our risk for dementia? Well, here's something particular when it comes to the risk. Recurrent negative thoughts. And that's a hard habit to break. So listen. If the news or the social media has you all riled up, then it's time to unplug.

 Complaining is another attitude that becomes routine. And you know what else? It is contagious. Be sure you don't get together with your friends and complain. Practice gratitude instead. It's the polar opposite. And you can't complain and be grateful at the same time. And think of this as a mental exercise to build a healthy brain.

You can work on some positive psychology if you want, but for me, I like to focus on the Bible verse that says, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable.

If there is anything excellent or worthy of praise, think about these things. I don't know about you, but I think nature is lovely. So get outside and enjoy the trees, the flowers, the mountains, or lakes. It is literally good for your brain. You might think about social connection being important in the prevention of dementia, but studies show that people who have engaging relationships with family and friends

are less likely to experience cognitive decline. One study showed that the type of people who talk to the checker at the grocery store have a lower incidence. You know the type, right? Yes, that would be me. I actually had a great conversation with an elderly lady who scanned my groceries. Her name was Barbie, and she walks her dog every day for exercise.

Tell her I said hello next time you go to the store. It'll be good for both of you. Now we've talked about the do's. Eat the MIND, diet, exercise moderately 150 minutes a week. Manage your stress. Make sure you have good sleep hygiene. And nurture your relationships with others.

Now let's talk about the don'ts. We know that the use of tobacco and tobacco products is bad for the heart and lungs, but what about the brain? Well, duh. It worsens hypertension and vascular disease, which clearly aren't good for you. The World Health Organization estimated that 14 percent of dementia cases worldwide would be prevented with smoking cessation.

That's the good news. If you quit, your risk diminish too. Listen, I know it's hard. If you need help, I put a few resources in the show notes. And I also have a link to the podcast that covered that

now, let's wrap up with the association between alcohol use and dementia. Heavy drinking can increase the risk of developing dementia

or, alcohol related brain disease. When I was a kid, I was told that alcohol damages your brain. And it turns out that's true. Alcohol can damage memory and speed up disease in the blood vessels in the brain.

 There is even a specific form of dementia associated with heavy alcohol use over a long period of time. It's called ARBD, alcohol related brain damage. There was a large study in 2022 of nearly 37, 000 middle aged and older adults with no major health problems. Those who consumed more than three units of alcohol per day had less white and gray matter in their brain.

In fact, it made their brains look three and a half years older. What's a unit of alcohol? Well, it's half a pint of beer or a small glass of wine. So the most prudent thing to do to protect your brain is to abstain altogether or at least limit your alcohol to no more than one drink a day. You know, drink a smoothie instead.

Cheers to your health.

If there's one change you can make on the do list, it's eat more berries. If there's one change you can make on the don't list, eliminate ultra processed foods. And in the end, say the serenity prayer, God help me to accept the things that I cannot change. To change the things that I can change, and the wisdom to know the difference.

 I also think it's important for us to address caregivers. I have an upcoming episode on that. But for now, remember, the MIND Diet, stay active, both mentally and physically, and be social, because a healthy brain looks great on you.

The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or healthcare provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change.

Do you ever feel like you have no one in your life?  Even if you spent the holidays with family or friends, maybe you've decided that you're okay with isolation. Today we're going to discover why it's not okay to be alone and some practical ways to connect with others to improve your physical health and overall quality of life. 

Episode 147 from loneliness to belonging with Dr. Vickie Petz Kasper.

 It's easy to believe you're the only one, and think that others are leading perfect social lives, while you're sitting at home, feeling isolated. Loneliness is considered an epidemic, and it affects people of all ages and all backgrounds, But when you're isolated, it's hard to know that what you're feeling is common.

 So even if you feel alone in your feelings, remember, you're not. Let's take the argument that you're the only one feeling this way off the table and talk about loneliness and how common it is. It is a human emotion that does not define your worth. People often internalize their loneliness as a personal failure or flaw, but it's not. 

There's a loneliness cycle. I'm okay by myself, followed by isolation, which then fosters a fear of being misunderstood or dismissed, and then that prevents you from opening up about loneliness.  Isolation can actually feel comfortable and safe.  There are lies we believe, like no one cares or I'm fine on my own and I don't need anyone. 

Even God said it's not good for man to be alone. We are created to be in community with others and prolonged loneliness can have significant consequences on your health. So I'm going to give you some practical tips on connecting with others. And listen, it's never too late. Certain ages and stages are harder than others, but meaningful relationships are possible. 

After I got really sick, and then I got divorced, and then there was a pandemic, I felt lonely. And I didn't want to admit it. It seemed like a weak word to tell people, I'm lonely. But I was.  But you know what? When you admit it, Sharing your feelings can lead to unexpected support and understanding. 

C. S. Lewis said, "Friendship is born at that moment when one person says to another, What? You too? I thought I was the only one."  And that's what loneliness can do to you. Now, before I give you a prescription for connection, let's go to Mini Medical School for a quick overview. And if you have not heard my previous episode on loneliness, I would recommend it and I'll put a link in the show notes. And also, if this episode is a little heavy, listen to last week's. It was funny. 

Chronic loneliness is linked to increased inflammation in the body, and that can damage your blood vessels and lead to cardiovascular diseases and increase the risk of high blood pressure, heart attack, stroke, and even dementia.  Loneliness also increases cortisol levels, and it also damages blood vessels and weakens the immune system.

And all of this can impair cognitive function. The amygdala gets sensitized and communicates with the prefrontal cortex. This is where we make decisions about our social behavior and It shows reduced activity when we're lonely and that is why it can impair cognitive function and decision making. And the nucleus accumbens, which is the brain's reward center, becomes less responsive, making activities that once brought you joy feel less rewarding.  

The impact on your physical health is significant as well. Social isolation and loneliness are linked to a higher risk of developing type 2 diabetes. The lack of social engagement can lead to unhealthy lifestyles, such as sitting in front of the TV, not being active, and eating junk. Loneliness can elevate your blood pressure, causing hypertension, and the stress response triggered by loneliness can lead to long term heart issues. Chronic loneliness can weaken the immune system, making you more susceptible to infections and illness.

Cortisol, the stress hormone is the culprit  and chronic inflammation contributes to a lot of different health conditions including autoimmune diseases  Loneliness can impact your quality of life leading to feelings of emptiness and dissatisfaction. Lack of social connectedness affects your mental and physical well being. Social isolation and loneliness can impact your health as much as smoking 15 cigarettes a day. Your lifespan can actually be shortened by loneliness. It's also linked to an increased incidence of depression and anxiety, which can lead to persistent worry and sadness. And, of course, the most serious thing is an increased risk of suicide. Social isolation is also linked to a higher risk of mortality associated with cardiovascular disease as well as cancer.  Overall, there's a 29 percent increased risk of dying early if you're lonely.

You can be around people and still be lonely.  It's the quality of connections that matters, not the quantity. So seek out relationships with depth and meaning. 

But even brief, positive encounters with people can release oxytocin. And that makes you feel good. So, try to be intentional about connecting with people, even in little short bursts. Speak to the clerk at the grocery store. Have a conversation while you're waiting in line. Smile at people and shake hands when you can. Even those small little doses can make a difference.

Loneliness can be a temporary phase, But chronic loneliness requires proactive steps to overcome. Don't ignore loneliness because it has serious issues for your health. And asking for help is a sign of strength and not weakness. It actually takes courage to acknowledge loneliness. So if you're feeling lonely, admit it and just recognize it's part of being human.  And if you are lonely, what you need is people. 

I know, kind of a no brainer. So, where are there people? Well, there are people in classes. So, could you maybe take a class? Here are some ideas. Take a dance class. This is such a fun way to get some exercise and meet people. Or maybe take an art class where you paint together and tap into that creativity. You can even take a class at a community college or university and learn about something like history. That would be a great way to meet some people.  There are cooking classes and interior design classes and pottery classes where you put your hands in the clay together. But, here's the deal, don't take a private lesson. You know, that kind of defeats the purpose. But any new hobby, usually you can find a class where you will meet other people who are at your same skill level. 

So that brings me to my second idea. Join a club. Something like a running club. Women can run or couch to 5K are beginner runners who work together for a common goal. And the key word there is together. When you have a sense of accomplishment, that can really help form a strong bond between you. Or just go to any kind of fitness class and meet other people. But don't think you can come in late and leave early and stare at the floor and meet anyone. 

You're going to have to put yourself out there. And interact with people and it may not work the first time or the second time or the third time be persistent  Don't give up. It's so important for your health Maybe join a quilting club if you're so inclined or if you can sing join the church choir. Bible study is a great way to meet people. There are also master gardener groups that are well connected. Hiking clubs that get out in nature. So there's added benefit there too.  

And you want to know what's all the rage right now? Pickleball. Learn to play pickleball and I can promise you, you will meet people. Another popular thing right now is Mahjong. And I don't have a clue how to play it but they say it's really fun and it uses your brain so that's super important. The same can be said about playing bridge. So find a bridge club. And if you don't have a hobby or a skill or anything like that that interests you then maybe a book club is the answer. I bet you could find a local book club or you could start your own.  

I just moved to a new town about a year ago and I'm in a new bunko group. My old bunco group played together for nearly three decades. Here's the thing about bunco, you gotta have 12 people to play. So if you can't play, you have to get a sub, which ensures that there are always 12 people there. It helps maintain the cohesiveness of the group. And I think bunco is a great way to form connections. In my group, we've celebrated babies and grandbabies and weddings and graduations. And we've mourned loss and supported each other through illness and surgery. So grab some dice, set up some card tables, and invite some people over to play Bunko. And you just might find your tribe that way.  

During my season of intense loneliness, I started the Interesting People Dinner Series. I lived alone  and I would just invite a group of people to sit around the table and have dinner. People who maybe didn't know each other. And we had some of the most interesting conversations. 

And here's a super simple idea. I recently interviewed Kathi Lipp about her new book called Sabbath Soup. And she says you can always just send a message to someone and say, I made too much soup. Can I bring it over?  Taking soup or any type of food is a great way to connect with your neighbors.   I'd love to hear what your ideas are for connection. Make sure you're on my email list and just reply to one of the emails and let me know what you've found to connect with others. And give yourself some grace. It's not easy. Sometimes it takes time and effort and it can be super discouraging, but it's worth the effort because loneliness has such an impact on your health and social connectedness will make you healthier, and healthy looks great on you. 

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How could a woman feel overwhelming sadness when she ought to feel joy?  Trust me, that's the same question she's asking herself when it comes to postpartum depression, postpartum anxiety, or even the baby blues. Guilt is the  overarching emotion. If you are someone you love as a new mom or about to be, you're in the right place to learn more.

Whether you're a parent, a grandparent, an aunt, uncle, or a friend. There's always something to learn.  

You're listening to Healthy Looks Great On You, a lifestyle medicine podcast. I'm your host, Dr. Vickie Petz Kasper. This is episode 111, "When a bundle of joy makes you feel guilty about not feeling joy." You're going to step into the thoughts and emotions of new moms so you can better understand what they are going through. And how to help. 

 

Congratulations! You just gave birth to the most beautiful baby on the entire planet and now he snuggles up to you and smiles, the birds sing, and everyone is blissfully happy.  Or, at least that's the script you had in your head. But then there's the reality. And it's not the pretty picture you envisioned, is it?

Postpartum depression makes you feel guilty about not feeling happy. You want to be happy. You feel like you should be happy. But you're struggling. Struggling with juggling all the things that come with a newborn and now you're supposed to take care of yourself and the rest of your family.  On top of that, you're cramping, bleeding, trying to heal from stitches either in the most private area or on your belly, which still rolls over beside you in bed.

And your breasts are so engorged they feel like they'll explode. Meanwhile, your grandmother's pastor comes to visit along with the neighbor you've only met once to, uh, you know, celebrate with you. Good grief, it's no wonder 

postpartum depression overwhelms new moms. And that's just the physical stuff. We haven't even gotten to the effects of hormones yet.  One woman described it like this.  Postpartum depression is locking yourself in your house because you're afraid something bad will happen to you or your baby if you emerge.

It's being a mom because you're obligated to and not because you want to. You want to want to, but you feel so disconnected and you don't know why.  Postpartum depression is being in bed all day with debilitating fatigue and lack of interest. It's isolating yourself from everyone and everything. You're merely existing.

Surviving, but nothing beyond that. It's unexplainable, relentless sadness. It's not uttering a word to anyone all day because you have nothing to say. It robs you of what should be the best moments of your life.  Zero out of ten recommend.  Postpartum depression is serious and it affects 10 - 15 percent of women in the first year after giving birth. 

The baby blues are much more common and experienced by 65 - 85 percent of women. What's the difference between postpartum depression and the baby blues? Well, both occur after delivery, but the blues are usually mild and go away pretty quickly. The onset is typically about 2 3 days after delivery. Peaks over the next few days and resolves within two weeks.

During that period of time, it can look very similar to postpartum depression with regards to a down mood. As Elton John sang, I guess that's why they call it the blues. Also,  the inability to concentrate, and you can't stop crying. And insomnia, but I hate to even mention that because who sleeps with a newborn in the house anyway?

You just slug through the day and don't enjoy that bundle of joy.  Sounds scary, doesn't it? It's actually very common to have big mood swings in that first week or two. Some people feel anger. Others describe debilitating fatigue. The baby blues are heavy, but the cloud usually lifts in a couple of weeks. 

One woman described it like this. I cried every day in the shower at 4 p. m. when the sun went down. It was a terrible guilt I felt for being sad when I should have been rejoicing in the goodness of God. Lasted about a month.  And that's typical of the Baby Blues. They come, they go, and life moves on.  What can you do to get through the Baby Blues?

Well, first of all, give yourself some grace. Your body has been through a lot. As much as possible, don't neglect taking care of yourself. You may think, but I don't even have time to eat, much less take care of me. I know, I know, but try to rest when you can. If your baby is sleeping and you can rest, do that instead of trying to get everything done around the house.

Unless, of course, you're taking care of other kids, then encourage quiet play. And if someone offers to help, this isn't the time to be independent and tough. Let your church family bring meals, let grandparents take older kids places, and don't turn down offers to help from family or friends.  Try and have some protected time for yourself, even if it's just a long, hot shower.

And remember, alcohol makes mood swings worse, so that doesn't solve anything.  If breastfeeding is a struggle, talk to your health care provider about a lactation consultant. Most hospitals and doctor's offices can provide resources. And connect with other new moms, preferably before you deliver.  And I'd also like to mention that there is a medication called Reglan, or metoclopramide, that is sometimes used to help with milk production.

Just be cautious with it because it can worsen postpartum depression.  But most of all, don't beat yourself up. What you're feeling is common and will likely resolve if it's baby blues.  But what if it's more than that? 

While the baby blues are pretty common, 1 to 2 out of 10 women experience postpartum depression. It's much more serious than the blues. 

It's characterized by difficulty concentrating and trouble making decisions along with bad mood.  One of the hallmark signs is loss of interest in things that should bring pleasure. The medical term for that is anhedonia. Women with postpartum depression often feel worthless or experience excessive guilt.

They may feel guilty about feeling depressed. Talk about a vicious cycle. 

At the extreme end of the spectrum, new moms may feel like their newborn and their family are better off without them.  That can lead to thoughts about ending their own life. One woman shared this story: "Drowning. That's what it feels like. The waters are constantly rising and you can't breathe and you don't know who you are or why you are feeling the way you are.

You're numb and also incredibly angry at the same time. I was just going through the motions of what I knew I was supposed to do, take care of my baby and family. But all I wanted to do was not exist anymore." If you or someone you know is experiencing thoughts of suicide, either go to the emergency room or call 9 8 8. 

You can even text the number to get help. Again, that's 988, and it's not just for postpartum women. It's for anyone contemplating suicide.  Now, I know that anyone with a crib in the house has limited energy and time, so I'm going to keep mini medical school pretty brief today. But, let's talk about the hormonal withdrawal that really does a number on a new mom's body and mind.

Just think about it. One day, you're carrying a little human inside your own body. It's uncomfortable during the day and  can significantly disrupt sleep at night.  Then one day, the little one makes her arrival and boom, you aren't pregnant anymore.  It's mind blowing to think about all that happens throughout pregnancy, delivery and the postpartum period.

 Hormone levels fluctuate during pregnancy. And when the little bundle of screaming, peeing, pooping, eating, I mean, I mean joy arrives, estrogen and progesterone levels plummet.  Other hormone levels change too, including cortisol, which is the stress hormone, melatonin, the sleep hormone, oxytocin, which is the love hormone, and thyroid hormone, which affects the metabolism at every level. 

Sleep is super important and those who struggle are more at risk for postpartum depression.  

 I have an episode about melatonin in sleep. I'll put a link in the show notes.   That big hormonal upheaval after delivery always happens. But  It doesn't always have the same effect on everyone.

Some women are just more sensitive to abrupt changes in female hormone levels in the bloodstream.  And then there's the placenta.

It releases placental corticotropin releasing hormone. And those levels have been correlated to postpartum depression too. And if that's not enough to start the downward slide, neurotransmitter levels can get out of whack too. The enzyme monoamine oxidase A in the brain metabolizes neurotransmitters like dopamine,  norepinephrine, and serotonin, all of which are associated with postpartum depression.

And we really don't know why some women are more affected than others, but there are some known risk factors. If you struggled with PMS before you got pregnant, or had anxiety and depression before your pregnancy, or with a previous pregnancy, you're definitely at increased risk.  

But even  if you've experienced postpartum depression before, it increases the risk, but it doesn't always happen, so that's the good news. There were times when I had patients who had really bad postpartum depression with one pregnancy. They didn't have it with the next, but they were so anxious that they were going to, that it almost looked the same. 

Big stressors open the door for postpartum anxiety and depression, like a rocky marriage, financial strain, poor social support, or other disruptions like, say, a pandemic.  The prevalence of postpartum depression appears to be increasing with an uptick to almost 20 percent during the pandemic. Yeah, that one threw us all for a loop.

It's not clear what other reasons are contributing to the rise, but we know that pre existing mental health issues are also on the rise, and they go hand in hand. 

One brave woman shared this experience. "Severe sadness, loneliness, angry, and just so exhausted. I lost myself. I let myself and my home go. No longer cared. My house was dirty. Laundry piled up. No one checked on my mental health. No one looked at my now ex husband and asked why he wasn't helping me. I feel like everyone looked at me for all the answers and it was my fault.

I felt alone."  It's heartbreaking to hear women tell their stories. Women with Seasonal Affective Disorder are more likely to develop postpartum depression too, as well as those with a pre existing anxiety disorder. As if there weren't enough already to worry about, now you're responsible for a fragile baby's life.

And by the way, they're not really as fragile as you think, but there are endless things you can worry about if you're so inclined. And we can't cover everything in this episode, but one woman described postpartum anxiety like this.  "I felt an insane connection to my babies and was loving postpartum life.

And it's my anxiety and lack of trusting others and need for control over my child's safety that would prevent me from using childcare to get a moment outside the home without my kid. I took him everywhere and I needed a break. And I would see others freely living their lives and truly questioned Why they weren't concerned about the things I was in regards to safety, and at the same time, I would also feel frustrated that my anxiety held me hostage.

I know for some, postpartum depression and postpartum anxiety can both exist, but for others, it's predominantly anxiety. While we truly love being a mom and love spending time with our babies, and don't have the majority of our days with low energy, motivation, or lack of connection with our baby."  I think that's an important distinction, 

but speaking of things to worry about, fear of childbirth increases the risk of postpartum depression. I took care of about 5, 000 pregnant women during my career, and some of them were absolutely terrified of the delivery process. And of course, you know, people love to repeat horror stories about labor.

Why?  I don't know. But they do.  And younger moms and single moms are more likely to be overwhelmed with the responsibility of motherhood, no matter how mature they might be. And that bumps up the risk for postpartum depression. And so does having a house full of kids or having an unintended pregnancy. And the past matters too.

A family history of depression puts you at risk for postpartum depression. And of course, a history of abuse.  You're more likely to have postpartum depression if your baseline health is poor or if you have body image issues.  The postpartum body is not for the faint at heart.  And if you already struggle with what you see in the mirror, then it may throw you into a downward spiral.

Motherhood is tough, but for some it's brutal. Women who have trouble breastfeeding or have a fussy baby also have a higher chance of postpartum depression.  When does it go away?  

Even without treatment, postpartum depression may go away, or it may turn into persistent depression.  It lasts about 12 months for half of women who experience it. And man, a lot happens in a year, especially in the first year after having a baby, and it can have a big impact. Women with postpartum depression may not eat right, which can further interfere with breastfeeding, bonding with their baby, or even caring with their baby.

And in extreme cases, it can affect the baby's development.  The relationship with her other kids and her husband can suffer, too. Depressed moms are less likely to read to their kids or play peek a boo with their babies. Here's the deal. It's not your fault. Please don't be shy about mentioning it to your doctor.

You aren't the only one, and it's important to get the treatment you need. One woman shared this: "I was feeling so alone and just the deepest sadness, maybe even hopeless. And I remember my doctor telling me that I needed to call him if feelings of sadness lasted more than a few weeks. But I was afraid to call because I didn't want them to think I was crazy and take my baby away." 

Listen, that's not how this works. If you're experiencing what you think may be postpartum depression, please let your doctor know. And your OB doctor may ask you questions to determine if you have postpartum depression. Normally, when screening for depression, we ask about things like fatigue and changes in appetite and sleep.

But I don't recommend asking any new mom these Captain Obvious questions. Who wouldn't experience that with a newborn in the house?  But remember that term anhedonia? 

It's an important marker of depression. Your doctor may ask if you have lost interest in things that should bring you pleasure even your sweet newborn. Your health care provider may ask if you feel down, depressed, or hopeless. 

One of the tools used to screen for postpartum depression is the Edinburg. postnatal depression scale. Let's step into the classroom for a minute and let me explain the difference between a diagnostic test and a screening test. When developing a screening test you don't want to miss anyone. So, think of it like one of those old timey fishing nets that they used to throw over the side of the boat.

And if you don't want to miss any fish, then you make the holes really really small. Now, when you pull the net up, you're going to have to sort through what's in there to get to what you need. So screening tests are designed like this to capture everyone who might have the condition. Then the physician or provider has to drill down to the level of a diagnosis to see which ones are caught in the net with the small holes actually fit the criteria.

Does that make sense? The Edinburgh Postnatal Depression Scale is a screening tool, not diagnostic. It's 10 questions to see who needs further evaluation for postpartum depression. It takes about 5 minutes to complete and there are 30 possible points. There's a link in the show notes. 

And if you score more than 10 or 11, you may have postpartum depression. Please just talk to your healthcare provider. Help is available. And be persistent. Some clinics have this down better than others. Here's another comment. 

"At what time periods do OB doctors check in with women? I filled out a form for baby blues in the hospital when I was still riding the hive giving birth. For I saw my OB at six weeks postpartum when my days were full of snuggles and I was binge watching my favorite shows and people were bringing meals.

Life was great. My postpartum anxiety hit at month three or four when I transitioned back to work and had to rip the band aid off of , having my kids at daycare with strangers."  So,  This brings up another point. There's a role for pediatricians because they continue to see moms long after the OB doc has released them to come back for their yearly exam.

Fortunately, there is a lot more awareness now, and I think that helps with those who feel embarrassed or uncomfortable bringing it up. So, if you do have postpartum depression, you probably need to talk to a mental health counselor. And don't let the term psychotherapy make you feel weird. It's literally just talking to someone who's an expert at helping you cope with your feelings, deal with your problems, set achievable goals, and learn to respond in a healthy manner.

Let's face it, everyone has difficult relationships and this is often magnified when a new baby joins the group. Talking to someone who is objective can be healing. Now before we move on to the lifestyle medicine recommendations, I want to mention something that will sound strange.  Unless, of course, you've experienced it.

And here's the deal, at least 70 percent of new moms do experience what's called intrusive thoughts.  And they're usually about infant harm. Half of moms have intrusive thoughts about intentionally harming their babies.  A leading psychiatrist attributes this to the mom's worst fears bubbling up uninvited to the surface. 

Hormones push them into consciousness and sometimes it's a struggle to push them back down. These are often disturbing visual images that make you feel like you're losing your mind. And if none of the 70 percent of new moms who've actually had it admit it, then you think you are broken. The most common examples are of the baby falling or getting dropped, flying out of their car seat, or suffocating.

But sometimes they're even violent, like throwing the baby against the wall and smashing their head.  That can trigger self doubt and make you think that you're an unfit mother. Insecurity already makes women doubt their ability to get this whole thing right.  But if these thoughts just pop into your mind and repulse you,  then definitely talk to someone, but don't think you have to have yourself committed.

While this may sound like an oversimplification, the recommendations are exactly what I said before about baby blues. Try and get enough sleep, ask for help around the house, take a little time for yourself to relax, reduce stress, and don't try to do it all alone. Sometimes you need to distract yourself. 

Play games on your phone, do brain teasers, puzzles, get out and walk, listen to music, , and again, talk to someone you trust. Here's the best advice I can give you. Remember this, it won't always be this way.  Women with postpartum depression may need to take medication, but sometimes they barely get through the day. It's a hard place to make decisions from, especially if you're worried about the effects of breastfeeding. Since this is a lifestyle medicine podcast, we are going to review how lifestyle interventions may help.

First, start with physical activity. I know, I know you're exhausted and you've got a baby on your hip, so do something that involves the baby and any other kids, like take a walk with a stroller. Get outside and move, even if you're just creeping along at first.  And if it's not your first baby, think about activities that involve your older kids.

When my second child was born, we watched Barney the Purple Dinosaur and marched and danced around to the songs. It was a way to involve my toddler while getting my heart rate up a bit, to avoid screen time for your newborn, put them facing you rather than the TV. 

To manage stress, you need time for yourself. It may not be much time, but grab moments when you can. Prioritize what you really need to do. The dishes and the laundry can wait. Let go of unrealistic expectations that you can do everything you're doing now and everything you were doing before. You aren't Superwoman. 

You have a deep need to feel human right now, not just a caretaker for a very needy baby. So, trust someone else to take care of your little one and get out of the house.  Read a book. Don't neglect a hobby you enjoy. Schedule a date night or an outing with friends. Go shopping, get coffee, see a movie.  Let me tell you about a movie not to see.

"Beaches." You're probably too young to remember it, but after I had my first baby, I couldn't stop crying. It wasn't postpartum depression, but it was serious baby blues.  I wanted to watch a funny movie. Now, this was way back in the day when you went to the grocery store and rented a VHS tape.

Okay, Google it if I just lost you. Well, he came home with the movie "Beaches" and swore it was in the comedy section. Listen, it's a movie about a mother who has a terminal illness  and she is handing her child over to her best friend, so no, it did not help me stop crying. The point is, be careful what you watch, or what book you choose.

This is a sensitive time, and you don't want to activate your triggers. And also remember, you're not alone. 

Admit your feelings to your spouse, mother, grandmother, or a trusted friend. Isolation only worsens your symptoms. They'll be more sympathetic and helpful if they know what you're going through. And they may have some advice about soothing a fussing and crying baby. So, listen, ask for help. Let me say it again, ask for and accept help. 

And you may not be eating for two anymore, but your diet has a huge impact on your mental health. So, eat a lot of fruits and vegetables, whole grains and olive oil, and avoid red meat and processed meat, as well as refined grains, anything that has the word enriched on it, sweets, high fat dairy, butter, potatoes, gravy, and fried foods.

Some say no eggs, meat, fish, or even low fat dairy. So, if you eat those, at least make it in small amounts. And fiber makes you feel full, so eat nuts and plenty of beans.  Time is premium with a newborn around, but Fast food does not make matters better, and in fact,  can make it worse. Mood can improve in as little as two weeks if you follow a strict vegetarian diet.

If you can't do without meat, at least increase your fruits and vegetables. There is statistical evidence that that makes a difference.  You may not be able to completely avoid the bad stuff, but it is dose dependent. So don't beat yourself up about that bowl of ice cream. Just try some mango next time.

 And here's why. Mango is high in that all important omega 3 fatty acids.  In pregnant women, there is a positive association between low omega 3 levels and a higher incidence of maternal depression.  Brain chemistry is regulated by levels of the neurotransmitters serotonin, norepinephrine, and dopamine.

Brain derived neurotropic factor, or BDNF, causes the membrane of every cell to be more or less fluid. which affects production of these chemicals, as well as reuptake.  Omega 3 fatty acids affect how the cell membrane allows for things to go in and out.  Besides mango, omega 3 fatty acids are also found in seeds, like flax seeds and chia seeds, lettuce, nuts, 

 especially walnuts and also beans. Kidney beans are the best. If you're eating fish, think salmon.  Studies have shown improvement in mood with intake of saffron, turmeric, probiotics, and carbohydrate rich evening meals., but think good carbs.  Among women of childbearing age, deficiencies of folate, vitamin B12, calcium, iron, selenium, zinc.

And Omega 3 fatty acids are more common among depressed versus non depressed women.  Vitamin B12 is not found naturally in plants. So if you're eating a plant based diet, you may want to add fortified whole wheat cereal or bread. And as far as supplements, just keep taking your prenatal vitamins.  Calcium is found in dairy products, but it's better to get it from fortified plant based milk like almond or soy.

But watch the sugar content because many are sweetened. Another good source is black beans. And did you know you can make black bean brownies and they're delicious?  Think green when it comes to veggies. Broccoli, bok choy, spinach, collard greens, and kale. Sesame seeds contain calcium too, so add those or use tahini, which is basically sesame butter. 

Zinc is found in pumpkin seeds and baker's yeast, and if I haven't convinced you to try black bean brownies, black beans contain zinc too. I'm going to put a link in the show notes to a recipe for them.  Selenium is found in Brazil nuts, and you don't need many. Oatmeal is good for breakfast. Add a little sorghum on your oatmeal for iron.

Lima beans contain iron too, but probably not on your oatmeal.  This mineral is also found in whole wheat pasta and brown rice, which is a good way to load up on those carbs at dinner, which may help you sleep better. Restorative sleep is so important in refreshing your mind. Try and keep your newborn on a schedule so you can get some rest, but realize  some level of sleep deprivation is inherent in motherhood.

This too shall pass.  Once you've arrived at the depression destination, you may need medication to fix the chemical imbalance inside your brain. Your doctor may prescribe it and listen, you don't want to miss this precious time. If you need it, take it. Don't try to gut it out. This is about chemistry, not about how strong you are. 

If you're prescribed a medication while breastfeeding, your doctor will take that into consideration when choosing the antidepressant. The bottom line is, do the benefits outweigh the potential risk?  And remember, folate or vitamin B9 can help in the production of serotonin and dopamine. And when used with antidepressant medications, it's been shown to improve the efficacy and shorten the response time. 

Food really high in folate includes legumes, asparagus, leafy green vegetables like spinach.  And if you don't like it, add a little to a smoothie. It turns it a very unappetizing color of green, but you can't really taste it.  Other sources include papaya, citrus fruits, and beets. And don't knock them if you haven't tried them.

But remember, they can turn your urine pink, and that can be alarming.  Broccoli, Brussel sprouts, nuts and seeds contain folate too. So does whole wheat, bananas, and avocados.  So pay attention to your diet, ask for and accept help, 

 That's a lot of information for a worn out new mother, so I created a download you can print that highlights the nutritional recommendations we've discussed. If you're taking a meal to a new mom, you could use this as well. 

 Feel free to pass this along so your friends and family don't bring you food that makes you worse. If you're fixing your own meals, remember, push the easy button. When you can, buy frozen, pre cut fruits and veggies, and give yourself a whole lot of grace during this time.

Restoring health may be slow going, but it's worth it. And healthy looks great on you, Mama. 

RESOURCES: Download postpartum nutrition guide

Edinburgh Postnatal Depression Scale

Black Bean Brownie Recipe

Call 1-833-TLC-MAMA (1-833-852-6262) for 24/7 free confidential support for pregnant and new moms.

 

 The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medications as prescribed. Though the information in this podcast is evidence based, new research may develop  and recommendations 

 When should kids start eating healthy? The answer might surprise you.  We all know the rates of childhood obesity are increasing, along with the rates of childhood diabetes and fatty liver. Did you know the rate of childhood obesity has quadrupled in recent years?  But how do you get picky kids to eat their vegetables?

What about Attention Deficit Disorder? Does diet affect that? 

Learn more in my interview with Dr. Angela Black. 

You're listening to "Healthy Looks Great On You," a lifestyle medicine podcast. I'm your host, Dr. Vickie Petz Kasper, and this is episode 110. What Should Kids Eat?  I'm so excited to introduce to you today my guest, Dr. Angela Black. Dr. Black is a board-certified pediatrician on a pathway to become board-certified in lifestyle medicine. She received her medical degree from the University of Texas Health Science Center in San Antonio and completed her pediatric residency in Miami, Florida. She currently practices in San Marcos, Texas and has a strong interest in promoting excellent nutrition for her patients. She recently discovered the subspecialty of lifestyle medicine and her long term goal is to shift her practice to a lifestyle medicine model and incorporate food as medicine to help families add more produce into their diet.

She's also the host of a great podcast called "Eat Your Greens with Dr. Black."

Welcome to the show, Dr. Black. I am so excited to have you here today, and I think we're going to have a really big challenge before us because there has been so much interest in the things you have to say. 

Dr. Angela Black:

Thank you so much, Dr. Vickie, for having me on "Healthy Looks Great On You." I'm really excited to Be here and talk to you today. And I was really impressed by your listeners,  questions that they had and, really appreciated some of their questions. 

Dr. Vickie:

Yeah, I think they're going to have to tune in to your podcast, I've listened to several episodes and I think my daughter subscribed and it's just very interesting and it covers a lot of topics and I'm not an expert on pediatrics, so we needed you here today. 

Dr. Angela Black:

Oh thank you. And  I hope people enjoy it. I hope they find it and, and like it.

Dr. Vickie:

 So I have to start out by telling people how we met. And that was at the Lifestyle Medicine Conference in Denver. And we literally just sat down at the table and had dinner together one evening and kind of hung out together the rest of the conference.  

Dr. Angela Black:

 I had met your hotel roommate. And basically I crashed your dinner with her. You guys were going into the restaurant to have dinner and I just invited myself along and we got to know each other and discovered how much we had in common. 

Dr. Vickie:

That's right, and that was awesome. I'm so glad you did that.  Well, I think I'd like to start out by talking about attention deficit disorder. There was so much interest in that on my Facebook page, and specifically about red dye, and there was a little bit of interest about autism as well. So, could you just start by outlining your approach to treating a patient who has ADD or ADHD? 

Dr. Angela Black:

Well, my approach has definitely evolved over the years, and I would like to just start by saying that there's a lot of misconception about what ADD or ADHD actually is.  It's been taken over a little bit in the pseudoscience community, the lay community as being not necessarily a real syndrome.  And it definitely is.

There are patients whose brain, and if we want to get nerdy, we can talk about the prefrontal cortex and the areas of our brain that are involved in planning, organization,  maintaining attention, resisting impulses, things like that. And, definitely there are people,  both children and adults who just have a dysfunction of that part of their brain. 

So, it is a real entity. It's not just bad parenting. It's not just too much TV. Definitely electronic media has its role in contributing to the development of it and the symptoms. So, just to start out by saying, it is a real entity.  I do treat it with medication. But my approach to doing that  has evolved over the years where we start out with an in-depth evaluation.

We,  look at the symptoms in the home, we look at the symptoms at school, and in other settings. Can the family go to restaurants, or do they never get to go out and enjoy time in public settings because of the behavioral issues? The impulsivity that goes with ADHD, things like that. Can they go to church or their, or their local religious organization and participate? So we want to see that the symptoms occur in multiple settings. The symptoms need to have started before the age of seven. So we really want to make sure that the child meets the diagnostic criteria. And then we also want to see that they've been evaluated for learning disabilities, intellectual disabilities, other diagnosis that may be affecting their ability to  pay attention in class, and follow along. Because if it's a matter of not being able to understand the material and the child is bored because they just can't follow along, it's going to look like ADHD. They're not going to pay attention. They're going to be bored. They're going to get up out of their chair. So we want to make sure we're ruling out other diagnosis and really doing a good job that the child meets the diagnostic criteria. And then we talk about treatment, and that's either going to be pharmacologic medication or non pharmacologic, and both have their role. 

Non-pharmacologic treatments definitely work best in the younger child. So we write a letter for the school and the parent can sit down with their educational team and develop what's called a 504 plan. 504 is under the Americans with Disabilities Act, and it applies to children with any diagnosis that affects their ability to participate and learn in the classroom setting that's not intellectual disability. So they may have Asthma; asthma would qualify for a 504 plan if the child has to have frequent absences or  has such a severe disease that they can't learn in the classroom and they need some change to their plan that would help them do that.

So,  the parents will sit down with the educational team and develop a 504 plan so that the child has accommodations to their educational plan that help them reduce those impulses, maintain focus, stay on task. And that's individualized from child to child. There are some tips and tricks that we tell families that they can do at home, for instance, helping them get through homework time, things like that.

And then when available, if we can get them in with a child psychologist who specializes in behavior to help the families develop a positive discipline plan to help reinforce the desired behaviors and minimize the undesired behaviors. But as we know, mental health care in this country is another health care crisis. 

You know, accessing that is simply not  realistic for many people.  So that's all of the non- pharmacologic treatments. I do also talk about some dietary changes that we can make and I know that's what many of your listeners had questions about - the dietary recommendations. And then, when appropriate, we do prescribe medications. There are both stimulants and non stimulant medications available.

Dr. Vickie:

  You know, I think that's important to say because medications definitely have a place. And this can be a debilitating disease. It can make a child completely fail.  And medication can mean the difference between success and failure. But I think the frustration is the knee jerk response to prescribed medication rather than to either trial other things, or to do the thorough evaluation to see if medication really is necessary and if that's really the diagnosis.

So I think that's the frustration, not just with the medication, but with the healthcare system in general. 

Dr. Angela Black:

Right, and unfortunately, it is faster, easier, more efficient to just write a prescription. Now, as you know, physicians don't get any, like I'm not selling the medication. I don't run a pharmacy. I don't get any financial incentive to prescribe medications. I do get some financial disincentive to do the right thing and really spend that time with the parents because unfortunately, insurance, especially Medicaid, just don't reimburse very well.

And so the amount of time that it takes as a primary care physician to really sit down, have those conversations, explore what non-pharmacologic treatments are going to work and what accommodations the child might benefit from, that that's my time. That's not really being reimbursed very well by the third party payers.

So there is actually a disincentive for me to practice medicine the best way. And it is true that with the high rates of physician burnout, many doctors just don't have the time, the energy to put into it. And it's just a lot easier to write a prescription. So it's not that they're, purposefully not practicing good medicine. It's the system is definitely, unfortunately weighted against primary care physicians.

Dr. Vickie

  Well, that brings up a good point, and I share that with my listeners often. It's not just the doctor, it's the patient too. As a patient, when you call, you want an appointment, and you want it soon because you've got an issue. And if the doctor is spending a lot of time with each of their patients, then it's going to take longer for you to get in and get an appointment. And then when you get there, you don't want to sit in the waiting room all day long while they talk to someone for an hour about lifestyle changes.  And I think that's why lifestyle medicine is really coming to the forefront, because it does need to be a subspecialty in and of itself because of the time constraint on other physicians and the shortage of primary care physicians. 

Dr. Angela Black:

Right. Exactly.  

Dr. Vickie:

So let's go back and talk about diabetes and fatty liver and childhood obesity. I love one of the things you said on my Facebook page today, and that was that healthy eating for a child starts..

Dr. Angela Black:

Before they're born. 

Dr. Vickie:

 Right, prenatally. So now you're touching an issue that's dear to my heart because I was an obstetrician.  And so, let's talk about the impact of prenatal diet, because there is some evidence that a mom who has obesity is more likely to have a child who has obesity  independent of how they eat afterwards. 

Dr. Angela Black

 Those nutrients or not nutrients are crossing the placenta and affecting the baby in those critical stages of development when the baby's brain nervous system are developing. So there's that. And then there's mounting evidence that the health of mom's gut microbiome also can affect baby's development. Not only do those bacteria that in mom's gut produce chemicals called short chain fatty acids that also cross the placenta and affect baby's development, but even the bacteria themselves. Apparently there is some evidence that they can leave mom's colon And cross the placenta and the baby starts developing their own microbiome, even in the womb. And for centuries, we thought that that was a completely sterile environment and there was no bacteria at all. And that may not be true. So there's a number of ways that the mother's diet affects the baby. And then last, again, I try to rein it in, but sometimes I get a little too nerdy about things, there's something called epigenetics, right? So our genetics is our DNA, it's the blueprint for everything, every aspect of our being, but epigenetics are the genetic switches that get turned on and off that dictate whether or not a gene will be expressed or not. And there are genes that impact our rates of obesity, diabetes, heart disease, and those epigenetic switches can get turned on or off based on the mom's environment, her diet, her stress levels, sleep levels.

You know, so many factors go into that and that's what really plays a big role in why  you're going to see certain diseases like obesity, heart disease, diabetes run in families.  

Dr. Vickie:

Oh, I love that you talk about the science. My listeners are used to me taking them to mini medical school, so they've come here to learn. 

Dr. Angela Black:

 Great. Well, I often talk about  the rates of things like diabetes. When I was in medical school and training, this was in the early to mid-nineties, they were just starting to recognize that children can have type two diabetes. Back when I was in training, we called it adult onset diabetes. And  there was a lot of skepticism about whether or not. children could get type two diabetes. Now, fast forward, I don't even want to say it - almost 30 years later, it's not in doubt. It's not even rare. I diagnose this in young teens. I have diagnosed children as young as 10 years of age with type 2 diabetes. And I definitely see pre-diabetes very often. Several times a year we'll have a teen in our practice develop actual type 2 diabetes. So the rates have really skyrocketed. The Lancet recently came out with a publication documenting that the rates of diabetes have quadrupled since the 90s, in children aged  12 to 19 year old, and they're continuing to climb. And so it's really becoming a healthcare crisis.  Not only because of the diabetes itself and the cost of care, the cost of insulin, the cost of blood sugar monitoring, but also the secondary effects of having a high blood sugar on the person's health over time.

Right? So if you're 60 and developing type 2 diabetes, how many years do you have to develop kidney damage, eye damage, damage to your blood vessels. Now we're talking about kids in their teens. So they're really going to have a shortened lifespan. The quality of life is going to be greatly impacted. They're going to be developing those other chronic diseases so much younger than what we have seen in previous generations.

Dr. Vickie: 

So what symptoms should parents look for if they're concerned about type 2 diabetes in childhood? 

Dr. Angela Black:

Type 2 diabetes specifically, now it is a myth that people who have a normal body weight cannot develop type 2 diabetes. Type 2 diabetes is caused by insulin resistance. So your pancreas, the organ that makes insulin, is working fine, but the cells can't use that insulin to take the sugar out of the blood and use it for energy.

So some of the signs that the insulin level is starting to rise are  Acanthosis nigricans. So that's darkening of the skin in the creases. Often it starts on the back of the neck, but you can also see it in the armpit folds, under the breasts, around the waist. So if you're starting to see what looks like dirt that doesn't wash off on your child's neck, you might want to talk to your doctor about having some blood tests.

Dr. Vickie:

 So when my daughter was probably in junior high school, we spent a lot of time out in the sun and we were in the pool and she had what I thought looked like acanthosis in her armpits. And I made her go in and have blood work done. And she was like, mom, you're always finding stuff wrong with me.  

Dr. Angela Black:

On the other hand, I did recently have a child come in whose parent was really concerned about diabetes because of some brown on their neck and it was on the front and usually acanthosis is on the back. And I was looking and I got a little paper towel and scrubbed it and yeah, it was actually just dirt.

So it's not always a bad sign, maybe they're just not scrubbing enough in the bath. Now  as it progresses what you're going to see that if the child is actually developing diabetes is the common symptoms associated with a high blood sugar will be increased thirst and increased urine output.

So if they can't be more than two feet away from their water bottle, they're waking up three or four times a night to pee, or they're having wetting accidents, That's another reason to consider getting their blood sugar checked. And that's true whether it's type one or type two diabetes because the increased sugar causes more water to be put into the urine. So they're peeing more and then as a consequence, they're more thirsty. Also, if they don't have energy, they're feeling sick a lot of the time. If they have some skin  infections that aren't healing well, even early in diabetes. I think the most common time that I've diagnosed kids with type 2 diabetes, they came in for an ingrown toenail that wasn't getting better. And I asked them about other symptoms and checked their blood sugar and sure enough, it was over 400. 

Dr. Vickie:

Wow, that's really interesting. Also increased hunger. I've actually been diabetic before when I was on prednisone. And then I had pre diabetes. And I'm normal weight, but it runs really strong in my family. 

But when your blood sugar is going up, your body is actually starving because your body can't move that blood sugar into the cells for energy. And so, it increases your appetite, which becomes a vicious cycle. And I reversed it with plant-based eating, and that's when I really became a believer in that.

And I'm not exclusively plant-based by any stretch of the imagination, but I try to get the majority of my calories from plants. And that's what I always try to explain to people. It's not necessarily vegetarian and it's not necessarily vegan. It's plant-based. And so if you can get the majority of your calories from plants, because I feel like there's some resistance among parents to try to feed their kids a plant based diet. 

Dr. Angela Black:

Right. And I did see some questions about how to do that, especially if your child is picky. How do you get a picky kid to accept healthier foods? And, I give my families a similar message to what you're saying, you don't have to go 100%. Now I do think that's the gold standard. Just like we would never tell somebody, "Oh, you know, just cut back to half a pack of cigarettes a day. That's fine. Just, you know, smoke every once in a while." We're not saying that for a reason. I do think that the more plant-based, the more plant-based foods that you can incorporate and the fewer ultra processed foods and high fat animal foods that you can put in your diet, the better. So I would hold out a 100 percent whole food plant-based diet as the gold standard. But I also know that that's not accessible to many people and it's not going to help them, make changes for me to say that. So I usually say, any movement you can make in that direction, you're going to get some health benefits. And then you build on it. So some tips for getting kids to accept more variety of plant based foods: Number one, sorry parents, but you're going to have to eat it yourself. You have to set the example. You have to have it in the house and with the meals every single day and that's a really good way. Kids will eat what the family eats often. So, I have plenty of parents that tell me, "Well, he keeps sneaking my soda." I'm like, well,  why are you drinking soda? You know, so they are setting the example. And then the other two techniques that are really effective are, getting the kids involved in the planning and cooking process. So let them go on the internet and pick some recipes that they think would taste good that include fruits and vegetables, and then let them at an age appropriate level, chop and prepare and, and work with you in the kitchen, and then make family dinner time a priority. Make it happy and fun and really make that part of the routine.

Those have been shown in the data, in the science. And I try to always look at the actual evidence to be some of the most effective ways of getting kids to actually accept and eat the foods that you're trying to make. So you don't have to sneak it in there and they won't even know those vegetables are in there. Well, that is a good technique that I recommend often while you're working on the other things, right? We want them ultimately to be on board with eating them and enjoy it without you having to hide it, or sneak it in their nuggets. But, definitely in the short term, being a little sneaky is never a bad idea.

Dr. Vickie:

I think it's important in developing the palate because both of my adult children eat fairly healthy and I think they just grew up eating that way and that's what they're used to but what I've seen in my grandkids and this is interesting because my oldest grandson is four and he just loved to eat vegetables. He just loved it and they did the baby-led weaning and so he just ate whatever they were eating and they ate healthy stuff. But then, he went to daycare, and at daycare they were feeding him pizza rolls and French toast sticks. And his palate changed, and suddenly he didn't want vegetables anymore.

He just wanted junk food because he had gotten a little taste of it at daycare. And that's a challenge, because what are you going to do? I mean, daycare is expensive, and food is expensive, and they're trying to take care of a lot of kids, and just keep costs down, so they're going to buy the cheap stuff, which unfortunately is the ultra processed stuff.

Dr. Angela Black:

Right. And it's a good point because those foods are designed to really hit that right combination of sugar, fat, and salt that releases that flood of dopamine and really lights up those pleasure centers in the brain. And unfortunately, broccoli just doesn't. does not do that. So when kids get introduced to those foods, it can be difficult, which brings up a few of the points.

First of all, going back to good nutrition starts before birth. Some of those flavor molecules from the food that moms eat also cross the placenta and babies can start tasting very early in gestation. So those receptors on the tongue are actually active. And then once they're ready to start solid foods, introducing a variety of different flavors between six months and a year, not only flavors, but textures. And make sure you include bitter things like kale and broccoli. And really those first thousand days, the first three years of life to the extent possible, lay a strong foundation of good, healthy eating with a variety of healthy whole plant-based foods. Even if they go through those picky phases later, they're more likely to come back around and accept those healthier foods later. 

Dr. Vickie:

 And I think it's so important because I've eaten healthy for a number of years even though, like I said before, especially years ago, I wasn't necessarily eating plant-based, but I didn't eat ultra processed food. And in fact, one year, I even put dried fruit in the kids Easter basket. And they were like, Mom, you've gone too far. We want chocolate bunnies. And I said, OK, OK, you're right. And, you know, today's Friday, but yesterday was Pie Day. And so, I said this on Facebook, Just go ahead, have a slice of pie.

Dr. Angela Black:

Have your pie on pie day. I already had mine and it was not vegan. I don't bake myself and so I'm not going to make a vegan pie crust. I just got a yummy, it was fruit based, at least there's that. But traditional cherry pie from my grocery store and I had my big piece of pie. 

One of your, listeners on Facebook asked, "How rigid should we be?"

When it comes to allowing kids to have foods at school, should you try to cut it out entirely? And that has really been shown to backfire. So if you are super rigid, we never eat this food, I'm going to send your special food to school with you. What about birthday parties? Things like that. You know, especially as they get a little older, preteens, teens, it's really important for them to be similar to their peers. And if you are too rigid in excluding those foods, they're going to rebel. They're going to hide it and sneak it. And they're also going to develop an unhealthy relationship with food that may set up feelings of guilt and shame and could even set them up for eating disorders. So again, what you do most of the time, what you do at home on a regular basis is really the important thing and having some flexibility, will ultimately lead to kids with healthier eating habits in the long run. So I would avoid being overly rigid.

Dr. Vickie:

So my kids were right about the Easter basket and the chocolate bunnies.

Dr. Angela Black:

They were right.

Dr. Vickie:

Darn it. 

Dr. Angela Black:

Right.

Dr. Vickie:

My daughter was the one that actually asked about daycare because that's an issue right now. Her youngest is going to be one in April. And she's like, what do I do? They're going to be eating what they're going to be eating. And she's tried to talk to them about, okay, if you're having pizza, mashed potato, and peas, eat the peas, eat the mashed potatoes, but skip the pizza. And you know they're not going to follow that. They have too many kids to take care of. So I guess she just does the best she can do when she's at home. 

Dr. Angela Black:

You do the best you can. Now, I have had families in a similar situation. I have written letters for daycare because the daycare director said, "Well, we can't feed them anything different without a doctor's note," meaning they have to have some medical diagnosis. And this is a perfectly healthy child with no lactose intolerance or something. So I have been known to write letters stating, this child must be allowed to have healthy foods brought from home and should limit intake of ultra processed foods. Like, it's stupid. But I have written that letter. Here's a note from my doctor stating my kid has to have vegetables. 

Dr. Vickie:

I think that just gives us a little insight, a little window into the mentality that we have. Like, I just think about it in the past, it seemed like kids could eat whatever they wanted and get away with it. And then you went to college and gained the freshman 15. And then there came a time when there was a day of reckoning and you had to make some changes because it sort of caught up with you. But now it seems like kids are just affected so much younger.  

Dr. Angela Black:

There are so many reasons. It's very complex, right? And it's not just bad parenting. It's not ignorance on the part of the parents. By and large, parents want to do what's right for their children. They want their children to be healthy. They want to feed them healthy foods. And we really have to be careful not to make judgments about why families aren't feeding their kids healthy. 

There is a significant problem with food insecurity in our country, especially in marginalized communities or in people of color. And paradoxically, obesity goes hand in hand with food insecurity because of access. They don't have access to healthy foods and they would love to feed their kids healthy foods if they could, or they're exhausted, working several jobs. They don't have the energy to put into cooking. And so they're resorting to ultra processed foods, fast foods, things like that. So we know that. Eating a whole food plant-based diet is the best way to ensure health, to maintain a healthy weight, and so the cause of obesity and these chronic diseases is not in question. It's definitely our diet. The reasons that we eat an unhealthy diet or feed our children a less than optimal diet are very complex, and they're going to require changes at really the national level, the community level, you know, ensuring that people really have access to healthy foods. And, that's a whole 'nother podcast episode, but so many changes need to be made.

I mean, it just shows what what doctors like you and I are up against. We're trying to promote lifestyle medicine and healthy lifestyle choices, but gosh, I mean, even at the daycare level, it's, it's very difficult.

Dr. Vickie:

And so it's part of a bigger complex issue. It's not just, oh well, everyone just needs to eat plant-based because that's so unrealistic. You have to make other changes to facilitate that. And, and some of those can be very expensive. It's much cheaper to go to the grocery store and buy a box of macaroni and cheese than it is to buy enough vegetables to cook, and then time is a factor before. And like you said, that's a whole 'nother podcast. 

Dr. Angela Black:

So it's like many things in life. You can actually make a plant-based diet cheaper than an ultra processed food diet. In fact, when they've studied it, it can be up to $500 per year cheaper for your grocery budget. People who follow a whole food plant-based diet actually spend less on their groceries. But what you sacrifice is the time for planning and cooking and prepping. So just like many things, you have to pick one. 

Dr. Vickie:

It's the convenience factor. We all live in a fast paced world. I mean, I'm semi retired at this point, and I can cook every day, and I can go to the grocery store every day, and it takes a huge chunk of my time. Huge. And you know, when you're raising a family and working a job, and your kids are involved in extracurricular activity, it feels nearly impossible.

I had a friend one time whose son was having significant GI distress at a very young age. He was 8 or 9 and just had constant stomach problems and acid reflux. And the doctor asked, "What do you eat?" And they said, "Well, we eat hot dogs at the ballpark every night because we're playing travel baseball."

Dr. Angela Black:

Right, right.

Dr. Vickie:

And it's so hard because we eat on the go and parents who have kids, especially with ADD, they want to know, can we just eat carrots or can we just eat blueberries? Is there something in particular that we can eat to make it better? Or does red dye make it worse? So, can we talk about that a little bit? Or autism.  

Dr. Angela Black:

There was a lot of questions about dye. And I really, that was the one question that I really appreciated because when I recommend dietary changes for ADHD, I do start by saying, unfortunately, there's not. One food or type of food that you can add or remove and expect to see a big difference.

There's a lot out there in the junk science world. You know, a lot of supplements on the market and people say, "Oh, I cut gluten out of my child's diet and they did better." You know, if your child doesn't already have a reason to be sensitive to gluten or not tolerate gluten, scientifically, the evidence does not support that gluten is a cause of ADHD. So you really do have to do a whole food plant-based diet and variety is key. And again, that goes back to the microbiome, including a variety of different plants and their associated different types of fiber supports a higher diversity of gut bacteria. And that in turn can affect a lot of things, including brain health, cognitive health, memory, focus. Even they're looking at some studies on Alzheimer's, things like that. Having said that, the reason I was very grateful to your listeners, I had never actually looked to see what the science says about dyes specifically, because if I'm going to advocate for a whole food plant-based diet, that's automatically going to cut dyes out.

So I hadn't looked. And my assumption was that there was no evidence to support that. And I was wrong. There are good, randomized placebo controlled trials showing that dyes not just red, also blue, and so I suspect, by extension, any of them. Children can have worsening ADHD symptoms, and, conversely, an improvement in their symptoms.

When those are removed, so there is actual data supporting that dyes can contribute to ADHD symptoms, but again, it's not changing my recommendations because I recommend a whole food plant-based diet with a variety of diversity of various plant based foods.

Dr. Vickie:

 Right. Apples are red. You don't have to add dye to make them red, and blueberries are already blue.  

Dr. Angela Black:

And you mentioned autism. There are some studies in rats where the female was fed a junk food diet equivalent to an ultra processed diet like humans eat here in the West, and the pups had behavioral symptoms consistent with autism. There is some evidence that the mom's diet can play a role in neurodevelopment and development of autism. It's very complex, though, again, because we don't really understand completely what causes autism. It's a complex disorder that likely has many causes, not just one.  So the evidence is emerging and it's being studied. 

Dr. Vickie:

 That's interesting.  Now, I want to be sure we cover all of the topics and the questions that we got on the Facebook page and one of them was about the food that kids are given if they're in the hospital. And this is something that I've recently experienced, I had a family member who had surgery and was given a breaded chicken patty that was so tough that I couldn't even chew it. And so, I really think it's more of a systemic issue. 

Dr. Angela Black:

It is, you're right. It's a systemic issue. You know, if it was a cardiac cath patient or somebody who was hospitalized for a heart attack, the doctor is going to write dietary orders, you know, low salt diet or whatever special diet for that disorder. But when it comes to children who don't necessarily have those diseases, they're going to say regular diet is the orders that they're given.  It's really up to the individual hospital, what kind of foods they have in their cafeteria, what they're offering. And I do think that is an area that the consumer has some input, you know, people can talk to their hospitals, they can ask for healthier options.

I have a special needs daughter.  She has a genetic syndrome with epilepsy and we've been in and out of the hospital a lot over her life. She's a young adult now, but we always were given a menu. So I could at least choose slightly healthier options if I wanted to, but, yeah, burgers and nuggets were always high on the list and the kids menu in the hospital. And so I do think that at the educational level for health care professionals, whether it's even dieticians, physicians, definitely, a big change needs to happen in education. My daughter has a G tube, so, she was having very active seizures and she couldn't really eat. She would have lots of seizures overnight, she would get lots of drugs to stop the seizures, and then she would sleep the whole next day and not eat. And it was very difficult and she wasn't gaining weight, so we ended up having a G tube placed so we could give medications and fluids and then feed her on those days when she wasn't able to just wake up and eat. 

G tubes, you know, it's a tube that goes directly into the stomach and you can put either formula or different foods. And one of the things that people do is what's called a pureed diet where you can take healthy food, you know, spinach, broccoli, healthy sources of protein, blend them up in your high speed blender and And give that as the meal instead of the commercially prepared formulas, which are often high fructose corn syrup and,  things like that. And there's families that want to do that. And I actually had a family whose dietician  refused to let them do that because it had never been studied. It's like, well, if the kid could eat by mouth, we would be giving them these foods. What's the difference putting it in the mouth and swallowing it versus putting it directly into the stomach through this little tube? There's no difference. But the dietician would not allow it. 

Dr. Vickie:

Protocols, protocols, and I also think if you're a patient, or if your family member is a patient, you have to be an advocate. I remember when I was in the hospital and I was a diabetic, they brought me chocolate cake. I was like, really? Chocolate cake? That's the last thing I need.

But really, to be honest, 9 out of 10 families would probably say, Bring me the chicken nuggets and the fries. But there's definitely an opportunity for education among healthcare professionals.

Dr. Angela Black:

Right. And they've, they've done studies, actually, it was at a presentation at the Lifestyle Medicine Conference that we went to in Denver where they went into communities and worked with some restaurants and they still had the nuggets and fries available, but on the menu in the kids section, they listed the healthy options and if the parents wanted nuggets and fries, they had to ask for them.

"Do you have this?" And then they say," Oh yes." And you know, they could serve it. But, when the healthy options were just placed on the menu in an area of prominence, people ordered it more often and the kids ate it.  But what we do is that the chicken nuggets and fries and burgers  you know, here's the kid's menu and that's all it is. And we just assume that's all they're going to eat, but it's not true. Kids will eat healthier food. Often when given the option.  

Dr. Vickie:

Yeah, and that's just marketing. 

Dr. Angela Black:

Yeah, that's marketing. So just making if we can, if we can, you know, go in and talk to our local restaurant owners and say, "I would love to eat here more. Have you considered making this change?" You never know. They might be willing to give it a go. And the restaurants reported that their revenues did not drop.

That was the important thing because initially there was pushback, like, "Oh, we're not going to make any money. People aren't going to come here." And that was not the case.

Dr. Vickie:

 I'm sure a contributing factor is just eating out in general and how convenient that is and so very bad for you. I know that's one of my weaknesses. I mean, I can be much more strict about eating plant-based when I'm home. But when I'm eating out, it's a lot more difficult to choose. Also the portions are so huge, so that's a problem. And also, you can eat plant-based and be very unhealthy. 

Dr. Angela Black:

 Right? Exactly. Yeah, processed plant-based diet is almost as unhealthy as a standard American diet and restaurant food is, terrible and expensive.

So I have one episode and I hope to do more where I find local restaurants in our community here in Central Texas where they offer whole food plant based options. It's not necessarily a vegan restaurant, but they have options on their menu. And I interviewed a local restaurant owner and it was actually one of my most successful episodes to date.  So I think people really want to hear about that. Where can we have the convenience of going out to eat but still be healthy.

And where can we go? We just don't know. So I hope to have more of those episodes where I look at local options here around the Austin to San Antonio area. 

Dr. Vickie:

 I like that. I love the community advocacy. That's so important.  

 I'm sure there are other things that we didn't touch on, but I think we could probably talk for six or eight hours. Hopefully, this will give you some ideas about things to feature on your podcast, "Eat your greens with Dr. Black," and of course I will put links in the show notes  can find Dr. Angela Black and her podcast.

Dr. Angela Black:

We could go on and on. So  I think we covered the bases and answered most of the topics that your listeners were asking. And it was great talking to you too. Thank you very much for inviting me onto your show.  

Dr. Vickie:

And I would encourage anyone to just talk to their pediatrician if they are interested in pursuing a healthier lifestyle for their kids.  Because I promise you, your doctor wants you to be well, and they're interested in your kid's health. Even if they're rushed, and even if they have a waiting room full of patients, they will welcome your input, and they will work with you. 

And like Dr. Black said, your kids will follow your example. So if you're ready to get started with a healthier lifestyle,

You can sign up to receive this podcast by email. And as a bonus, you'll get "Seven day Prescription for Change," which is a downloadable workbook and seven days of emails to help you identify what lifestyle changes you'd like to get started with and how to implement those. Just look in the show notes for a link.

The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or healthcare provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change. 

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00:00 The Urgent Need for Healthy Eating in Kids 00:35 Introducing Dr. Angela Black: A Pediatrician's Journey to Lifestyle Medicine 02:57 The Battle Against ADHD: Understanding and Treating with Lifestyle Medicine 10:42 The Prenatal Impact on Childhood Obesity and Diabetes 15:32 Confronting Type 2 Diabetes in Children: Symptoms, Causes, and Prevention 19:04 Embracing Plant-Based Diets for Kids: Strategies and Challenges 34:46 Navigating the Complexities of Healthcare and Diet in Children's Lives 41:36 Conclusion: Empowering Families for Healthier Futures  

 

    

 

 

 

 

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Lifestyle Medicine In episode 109 of the 'Healthy Looks Great On You' podcast, Dr. Vickie Petz Kasper addresses the common issue of fatigue that affects a significant portion of the population. She explains the distinction between physical, mental, and emotional fatigue, as well as decision fatigue, highlighting their impact on productivity and wellbeing. Dr. Kasper discusses various possible medical and lifestyle causes of fatigue, stressing the importance of a proper diagnosis. Through lifestyle medicine, she offers insights into how changes in sleep, diet, exercise, stress management, and social connections can combat fatigue. The episode emphasizes the difference between acute, chronic, and subacute fatigue, examines the role of various conditions and deficiencies in causing fatigue, and offers practical tips and a seven-day prescription for making impactful lifestyle adjustments.   RESOURCES (May contain affiliate links)   GET STARTED with 7-Day Prescription for Change and get podcasts by email   Sacred Rest by Dr. Saundra Dalton-Smith   12 minute workout You Tube video   Episode 102 Sleep   Episode 103 Fitness   Episode 104 Manage Stress   Episode 105 Time to quit

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Episode 106 Loneliness

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Episode 107 Nutrition

 

  00:00 Introduction: The Problem of Fatigue 00:46 Understanding Fatigue: Causes and Effects 03:08 Medical Perspective on Fatigue 03:43 Personal Experience with Fatigue 04:31 The Role of Stress and Depression in Fatigue 08:11 Medical Approach to Diagnosing Fatigue 14:16 The Importance of Rest and Connection in Combating Fatigue 17:07 Lifestyle Medicine and Fatigue: A Deep Dive 20:24 Practical Tips for Managing Fatigue 26:27 The Role of Physical Fitness in Battling Fatigue 30:12 Conclusion: The Journey to Overcome Fatigue

Understanding and Controlling Hypertension: A Lifestyle Medicine Initiative

In the podcast episode titled 'Four Reasons to Control Your Blood Pressure', Dr. Vickie Petz Kasper examines the basics of blood pressure and the dangers of hypertension. Hypertension is a common condition that can lead to heart disease, stroke, kidney failure, and vision loss. Due to its often asymptomatic nature, it is dubbed a 'silent killer'. Dr. Vickie calls attention to the importance of regular blood pressure checks and understanding the meaning of blood pressure numbers. Moreover, she discusses risk factors for hypertension, such as age, obesity, high salt intake, physical inactivity, and insufficient sleep. Strategies for managing hypertension, including lifestyle modifications—dietary adjustments, regular exercising and stress management—are also discussed. A brief review of prescription medications is provided. Dr. Vickie emphasizes the need for a supportive healthcare provider to facilitate successful implementation of these lifestyle changes.

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00:00 Introduction to Hypertension: The Silent Killer 01:07 Understanding Blood Pressure: The Basics 02:26 The Importance of Knowing Your Numbers 07:57 Risk Factors for Hypertension: What You Can and Can't Control 09:17 The Physiology of Blood Pressure: A Mini Medical School Lesson 12:09 The Consequences of Hypertension: Why It Matters 14:16 Lifestyle Modifications for Hypertension Control 19:56 The Role of Diet in Managing Hypertension 21:43 Reducing Sodium Intake: A Key Strategy for Blood Pressure Control 22:48 Action Steps for Managing Hypertension 23:04 Conclusion: Your Health is in Your Hands

Healthy Looks Great On You: Post-op Nutrition

In episode 107 of the Healthy Looks Great On You podcast, Dr. Vickie Petz Kasper discusses the importance of nutrition for post-op recovery, highlighting that traditional comfort food often brought to recovering patients may not be the most beneficial. She explains the increased requirement for protein after surgery and also the importance of vitamins, minerals, and hydration for healing. She shares that the type of surgery can affect dietary needs and may lead to common post-op issues like decreased appetite and constipation. Dr. Vickie suggests turning to nutrient-dense, easily digestible foods and drinks like smoothies, soups, grain bowls, and naturally flavored water. With numerous food suggestions which include their corresponding nutrient values, Dr. Vickie encourages listeners to consider nutrition when preparing meals for post-op patients.

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00:00 Introduction to Post-Op Nutrition 00:31 Understanding the Importance of Post-Op Nutrition 01:23 Common Post-Op Problems and How Nutrition Can Help 02:11 The Role of Hydration in Post-Op Recovery 09:37 The Science of Healing and Nutrition 12:40 The Role of Protein in Post-Op Healing 18:46 The Importance of Micronutrients in Healing 21:28 The Role of Diet in Blood Clotting and Healing 22:59 The Importance of Calories and Energy in Healing 25:13 Conclusion and Final Thoughts on Post-Op Nutrition

 

Healthy Looks Great On You: Understanding Nutrition and Health

In episode 106 of the lifestyle medicine podcast 'Healthy Looks Great On You', Dr. Vickie Petz Kasper explains the importance of understanding nutrition for maintaining health. She talks about the confusion surrounding food advice, using eggs as an example of how advice can change over time. Dr. Kasper highlights the dangers of the Standard American Diet (S.A.D), which is high in saturated fats, refined carbohydrates, processed foods while being low in fruits and vegetables, leading to chronic diseases such as obesity, heart disease, stroke, and cancer. Dr. Kasper shares her personal journey of reversing her pre-diabetes with a healthy diet. She then explains macronutrients (protein, carbohydrates, and fat) and micronutrients (vitamins and minerals). The episode concludes with practical tips on cleaner eating through shopping the perimeter of grocery stores, eating at home and choosing less processed and more plant-based foods.

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00:01 Introduction to Healthy Eating 00:44 The Confusion Around Eggs and the Western Diet 01:10 The Impact of the Standard American Diet 02:47 Personal Journey with Diet and Diabetes 06:06 The Importance of Nutrition Education in Medical Training 11:26 Understanding Macronutrients and Micronutrients 18:31 The Role of Fiber in Our Diet 20:12 The Benefits of a Plant-Based Diet 21:28 Practical Tips for Healthy Eating 23:20 Conclusion and Future Topics

The Deadly Epidemic of Loneliness: The Vital Role of Social Connections

In this episode, Dr. Vickie Petz Kasper shares extensive insights on the lethal effects of loneliness, isolated living, and lack of social connections on both mental and physical health. Likening it to smoking 15 cigarettes a day, she details how social isolation links with diseases like type 2 diabetes, depression, anxiety, heart disease, stroke, and dementia. She also outlines the impact of loneliness on dopamine and oxytocin, the 'love hormone', and highlights the importance of meaningful social interactions and relationships. The episode sheds light on ways to combat the 'loneliness epidemic', encouraging the cultivation of friendships and shared experiences, volunteering and finding common interest groups. Dr. Vickie additionally touches on the potential negative effects of social media on these connections, and emphasizes being aware of our thoughts and actions. Overall, she advocates for nurturing and prioritizing our social health as it's a key survival tool and a major determinant of longevity and happiness.

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00:01 Introduction to the Importance of Social Connectedness 00:41 The Deadly Epidemic of Loneliness 01:20 The Impact of Loneliness on Physical Health 02:06 The Increasing Rates of Loneliness 03:14 The Importance of Positive Relationships 03:56 The Role of Lifestyle Medicine in Addressing Loneliness 05:08 The Importance of Trust in Relationships 06:01 The Impact of Loneliness on Lifestyle Choices 06:04 The Physiological Effects of Loneliness 06:41 The Role of Oxytocin in Social Connections 10:14 Strategies to Improve Social Connections 12:12 The Role of Social Media in Social Connections 27:01 Conclusion: The Power of Social Connectedness

Addiction, Dopamine, and Lifestyle Choices: It's Time to Quit

 

Dr. Vickie Petz Kasper hosts the episode titled, 'It's Time To Quit' on her podcast, 'Healthy Looks Great On You', discussing various addictions including smoking, alcohol, marijuana, and opioids. Citing that dopamine is the underlying mechanism of addiction, she delves into the concept of addiction and its potential for treatment. Dr. Vickie further expounds on the role of environment, habits, and the desire to quit in overcoming addiction. She provides insights into various resources and methods to combat addiction - from medical treatments to support groups, highlighting the significance of lifestyle changes for better health.

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00:22 Introduction to Addictions 00:53 Understanding Dopamine and Addiction 01:38 The Impact of Tobacco Addiction 05:46 The Consequences of Alcohol Addiction 11:54 The Role of Dopamine in Addiction 17:15 The Influence of Environment on Addiction 21:17 The Power of Recovery Programs 24:21 The Role of Medication in Addiction Treatment 32:19 Conclusion: The Journey to Recovery

Manage Your Stress: Unpacking the Stress Response and Practical Tips To Gain Control

In episode 103 of the podcast 'Healthy Looks Great On You', hosted by Dr. Vickie Petz Kasper, she discusses proven ways to take manage stress. She outlines the different types of stress (good, neutral, bad) and their effects on our physical, emotional, and spiritual health. Importantly, Dr. Kasper delves into the physiology of how stress affects our nervous system. She concludes by sharing actionable techniques for stress management, such as conscious breathing techniques, maintaining positivity, regular physical activity, involvement in social and creative activities, maintaining good spiritual health, and journaling. Chronic stress can damage health and learning to manage its effects are critical. Note: While these techniques are useful and important, they are not treatments for diagnosed mental health disorders. The episode emphasizes awareness and active management of stress to ensure it does not take control of your life.

Resources:

PERCEIVED STRESS SCALE

 

7-Day Prescription for Change

Dressing the Wound; Give Yourself the Gift of Forgiveness

"Breaking Anxiety's Grip" by Michelle Bengston

“Winning the Worry Battle” study of Joshua by Barb Roose 

Music | Some Guy Named Robb | Singer Songwriter | United States (sgnrobb.com) 

"Prayer Starters" by Suzie Eller

"Beginner Gardener" by Jill McSheehy

"Overwhelmed" by Kathi Lipp and Cheri Gregory

Adult coloring book 

Back, shoulder, neck massager 

Verilux happy light

Essential oil diffuser 

 

00:00 Introduction to Stress Management 01:15 Understanding the Different Types of Stress 04:01 The Impact of Stress on Your Health 05:28 The Science Behind Stress: A Mini Medical School 06:17 The Role of the Autonomic Nervous System in Stress 10:53 The Consequences of Chronic Stress 13:04 Assessing Your Stress Level 13:37 Effective Coping Mechanisms for Stress 14:10 The Benefits of Writing and Other Creative Activities 16:42 The Power of Gratitude and Positive Thinking 18:02 The Importance of Breathing Techniques 19:16 The Role of Relationships and Spirituality in Stress Management 24:51 The Impact of Stress on Physical and Emotional Health 30:29 The Importance of an Action Plan for Stressful Situations 31:15 Conclusion: Managing Stress for a Healthier Life

Healthy Looks Great on You - Episode 102: Get Fit, Start Moving

Dr. Vickie Petz Kasper continues her lifestyle medicine podcast, emphasizing on the importance of physical fitness in our lives. In this episode, Dr. Kasper shares the startling fact that physical deconditioning is the leading cause of preventable death worldwide. She encourages listeners to get up, move, and feel the immediate benefits of physical activity. She discusses the four types of exercises: aerobic, strengthening, flexibility, and balance. Dr. Kasper explains in detail how these exercises impact health, quality of life, and longevity. She also explores why meeting the minimum recommended amount of exercise among Americans is low and the increased health risk posed by prolonged sitting. Furthermore, she provides tips on setting realistic fitness goals, increasing the intensity of your workout over time to prevent injury, and the importance of continuously moving to reduce sedentary time. She underscores that any amount of physical activity is better than none, and its benefits start immediately. The podcast ends with a call for listeners not just to listen, but to act and start moving because fitness looks great on everyone.

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00:00 Introduction to Physical Fitness 00:49 Understanding Physical Fitness 01:07 The Importance of Exercise 01:46 The Current State of Physical Activity 02:32 Understanding Different Types of Exercise 03:08 The Benefits of Aerobic Exercise 04:48 The Impact of Exercise on Longevity 05:24 Understanding Exercise Intensity 07:15 The Benefits of Strength Training 08:09 The Importance of Balance Training 09:48 The Role of Flexibility in Fitness 10:24 Understanding Metabolism and Exercise 12:22 Creating an Exercise Prescription 14:05 The Dangers of a Sedentary Lifestyle 14:51 Setting Goals for Physical Fitness 15:56 Conclusion and Final Thoughts

The holidays are coming fast. I hope you're looking forward to gathering around the table, but sometimes family conflicts can Social anxiety and just the pressure to meet expectations can make you feel a sense of dread rather than anticipation.

Stay tuned for practical tips on navigating connections through the holidays.  This is episode 146, Navigating Connections During the Holidays.  Holiday stress is real.  I'll bring the sweet potatoes, you bring the cranberry sauce, and someone, I'm not naming names, will bring a grudge, an attitude, or some equally distasteful dish. It can be challenging when we bring all our different personalities around the table.

 Whether it's family, co workers, or friend groups, it's enough to make you dread social gatherings. But it doesn't have to be that way. Today you'll learn some practical tips to help you navigate holiday gatherings so you get that boost of oxytocin that makes you feel oh, so good. By the end of this episode, you'll be prepared to handle whatever is served this year. Except maybe fruitcake. No.   But I hope you'll look forward to gatherings in anticipation and not dread. 

What is your family tradition? In my family, we joke that if we ever do something one time, my mom will say it's a tradition and she will want to do it that way from then on. And listen, this is a double edged sword. On one hand, traditions are comfortable. We know what we're doing, when we're doing it, where we're going, and there is no need for discussion or decisions.

And that can be nice. No pressure, right?  Well, the problem is, things always change. Kids grow up and get married. Or, people move away and have to take time off work to travel home. Or get divorced and kids have to split their time with each parent. Trust me, I know about these things. And to be honest, sometimes it still makes me mad. But I know it's even harder for my grown kids. Feeling the pull of obligation is no fun. So, I try to be flexible to ease their stress. And some of you may not have family or a close knit group to celebrate with.

And that can magnify your loneliness. Isolation during the holidays is especially painful, and I've been there too. My kids live far away, and I was single for many years. And though I'm blessed to have a very loving family that get along, it's not the same as it used to be when I set up card tables throughout the house, complete with tablecloths and centerpieces in my grandmother's beautiful China. 

Now, maybe you're one of those people who likes paper plates. I'm going to tell you the truth. It just hurts me. I mean, what is China for if it's not for special occasions?  Okay, here's what I just did. I inserted my expectations and my vision for the ideal holiday right here in the middle of the podcast.   While some of you think there's incredible beauty in just walking to the trash can after a big dinner and dumping it all without having waterlogged hands from washing all those dishes.

And that, my friends, is a perfect example of conflicting expectations. No wonder it's stressful. We just got crossways and I'm the only one doing the talking. Well, yes, and you see, that can be a problem too. Listen, stress during the holidays is nearly universal. In fact, it's reported that the majority of adults deal with an extra dose of stress during the holidays.

For people who already struggle with their mental health, this can be serious.  Depression and anxiety can reach critical levels.  Loneliness during the holidays is often worse than loneliness on a pretty summer day. And loneliness increases the risk of heart disease, dementia, high blood pressure, stroke, and premature death. 

While we're on the subject of physical health, let's go to mini medical school and walk through some areas of the brain where we feel dread and anticipation. And yes, It's in the same location, the amygdala. It's a little almond shaped part of the brain that's located deep in the temporal lobe and it's part of the limbic system.

And this means that it's intricately involved in processing memory and emotion. And boy, oh boy, don't those two things go together like turkey and dressing.  Here's what happens. You know that Aunt Edna has been invited to dinner. Aunt Edna, who criticizes what you cooked, your weight, and the color of your shirt.

That, Aunt Edna. You remember her, don't you? Well, your amygdala certainly does, so it sends signals to other parts of the brain, like the hypothalamus, which mobilizes the troops and dumps cortisol and epinephrine into your system.  We call it the fight or flight response, but your mama isn't going to let you fly away and she's certainly not going to let you fight Aunt Edna.

So you'll just have to sit there, heart pounding, palms sweating, and teeth clenched in dread.  But remember, anticipation is experienced in the exact same part of the brain and the amygdala plays a crucial role in that. in our responses, tapping into our memories from past holidays filled with either conflict or delight. 

Knowing neuroanatomy isn't going to help you navigate holiday dinners, so what are we to do?  First of all, don't ever let people push the buttons they installed. You know what I mean, they say this, you do that, rewind, repeat. Happens every time. In fact, you can see everyone's face right from the start.

You've seen this play out before, I'm sure. So instead of dreading it, anticipate it. And, rehearse a different response.  She says, have you thought about trying a new diet? Or, I cannot believe you voted for,  Or, did your husband ever find a job so he could support you?  Without a plan, there's usually a reaction and sometimes it's nuclear.

Either sulled up and not talking or saying the exact same thing you said last year. Word for word.  But that's not going to happen this year. Why? Because you're going to have the tools to redirect the conversation. First of all, push pause. Remember lining up dominoes as a kid? You'd tap the first one and watch the chain reaction.

And that is exactly what Aunt Edna is doing. She's tapping the dominoes, ready to see them fall. But, if you put just a little more space between her comment and your response, then you have the power to interrupt the cascade.  Try taking a deep breath in this space. In through your mouth, out through your nose, that's it, one more time.

Now, smile.  It's unexpected. Throws everyone off balance. I dare ya.  Now, you're ready to respond because you've prepared a script for this in advance.  You knew she'd bring it up. She always does. But this time, you've rehearsed a different response, and you're ready.  Don't forget, your response is kind and it decompresses the tension. 

See? Wasn't that easy?  No?  Okay, keep rewriting and rehearsing your response until you get it down.  And try asking questions. This is a non threatening form of conversation that can steer things in a different direction. You see, when you ask a question, multiple areas of your brain start to engage.

You start viewing the topic from a different angle and exploring different perspectives and you get a surge of serotonin, the happy hormone. The person being asked a question is now in the driver's seat and it feels good with serotonin relaxing the brain, which results in thinking more clearly and having better insight and understanding.

of the whole picture. Now, that really was easier, wasn't it?  Need more neurotransmitter weapons? Well, when you ask a question, the areas of the brain that are associated with reward and pleasure light up. Because curiosity is activated.  And, to top things off, dopamine is released. And that's better than whipped cream on pumpkin pie. 

Oh, you don't like pumpkin pie? Well, you probably don't like my shirt either, but we're not going to discuss that at the dinner table.  But think about it. When someone asks you a question, it interrupts the negative highway that your brain is traveling down and that's And that can help with anxiety and stress and change the direction of your emotions.

When we're trying to answer a question, we self reflect. And we get a grip on our emotions and run away thoughts. And the end result is better emotional regulation.  Asking questions helps you create openness and positive emotional connections with others.   And that releases oxytocin and love fills your home along with the aroma of roasting sweet potatoes.  Strong social connections increase our chances of longevity and boost our immune system by reducing inflammation, which is responsible for lots of negative health conditions.  It's also associated with mental health benefits.

Lowering anxiety and depression, and boosting self esteem, empathy, and trust.  It all works to create a positive feedback loop. And it's not just about having people around, it's about the quality of those connections and how they contribute to our overall quality of life. 

So, next time you find yourself reacting, take a deep breath, smile, Rely on your rehearsed response and ask genuine questions. And listen, if they aren't genuine, you've defeated the purpose. And the purpose is a better sense of mental and emotional well being for all.  Let's don't stop there. Let's look at some of the other pillars of lifestyle medicine and how they can help you make a holiday memorable.

In a good way.  I hope you're going into this holiday season with some good health habits like good quality sleep, regular activity, and nutritious eating. And listen, it's not too late to start. There are some resources for you in the show notes to help, including an episode about how food affects mood. So let's take a peek in the oven.

Many traditional holiday foods are packed with vitamins and minerals. Things like sweet potatoes and green beans. Also pumpkin, Brussels sprouts and cranberry add color and nutrients. On the other hand, fatty foods and rich sweet foods can lead to a sugar induced roller coaster of emotions. And overindulgence in caffeine, sugar, and alcohol don't help either.

And neither do foods that are too high in salt. And all of this is more of a challenge if you're a stress eater. The best advice I can give you is, fill up on the good stuff, and then enjoy all of your favorite foods in moderation.  Cook your sweet potatoes without heaps of butter and sugar and top with black beans instead. 

I'm sharing a recipe with my email followers, so sign up today if you aren't on my list. And maybe leave off 3 pounds of cheese in the vegetable casseroles and just enjoy the taste of the vegetables instead.  It's easy to just eat mindlessly, but instead, savor your food,

making conscious choices to maintain your health and mental well being.  And get up and move around. Incorporating physical activity into your holiday routine will give you an instant boost. Try it. You'll actually have more energy. Physical activity helps you manage stress and improves mood by releasing endorphins and lowering cortisol. 

And you know what else helps? A good night's sleep. And here's the deal. Many people get less than adequate sleep, especially during the holidays. Well, let's face it, some people just constantly struggle, and if this is you, you're going to want to sign up to receive three simple steps to create the perfect sleep sanctuary. It's a good way to get started getting your Z's 

When you don't sleep, you can't regulate your emotions as well.  And we all know what happens when Aunt Edna pushes your buttons, and you're sleep deprived. Handling holiday stress is hard enough without the added challenge of trying to function after tossing and turning all night. Decision making, problem solving, and memory are all part of the process.

You are all impacted by poor sleep. Don't test your limits of dealing with difficult people and situations by staying up too late. You'll be better able to control your reaction, plan and focus with a good night's rest. Plus, without sleep, your immune system is weaker and a few germs are sure to be on the guest list at parties and holiday gatherings. 

Bronchitis?  Ain't nobody got time for that.  I don't mean to make it sound like getting together is hard. It's hard. I mean, it can be, but it can also be super rewarding. Social interaction is crucial for good health. It's worth the effort. So stay connected to family and your community.

During the holidays, there are extra opportunities to engage with church and philanthropic activities. And that goes a long way in reducing feelings of isolation and loneliness.  But listen, you can't please everyone, so stop trying.  Spend some quality time with people who bring out the best in you. Enjoy the moments and be grateful.

 Gratitude goes a long way in bringing joy to the season. If you're focused on thankfulness, you'll be more resilient and less susceptible to stress because it lowers cortisol levels. Gratitude strengthens relationships, and you get a boost of oxytocin as a bonus.  If you missed the episode on gratitude, there are some practical tips there that I think you'll find useful.

So I put a link in the show notes, but also make sure you're on my email list because I created a lovely card to use to express your gratitude for others. And I believe this one action has the power to transform your holiday gathering. Be sure and sign up today. I hope you'll take a moment to reflect on this past year and shift your focus to all the blessings that you've had.

And even if you're struggling, take a hike, literally, get out in nature. You might be surprised at the difference being in God's creation makes. And lastly, manage your expectations.   That starts with clear communication in advance. But don't  think your plans are concrete. Things happen. Be flexible and let go of perfection.

Trying to control all the details will make you and everyone around you miserable. The holidays can certainly bring mixed feelings and extra helpings of stress. So, set some boundaries for yourself when you need to. My oldest daughter turned 35 this week, and I remember when she was born, just a little bit before Thanksgiving. Our pediatrician recommended that we not travel even the 30 minutes to feast with family. And listen, after the delivery that I had, I was just fine with that,  but my in laws showed up anyway with leftovers in Tupperware containers and they passed my little baby around from person to person.

I was exhausted emotionally, physically, and mentally. And the last thing I needed was wall to wall people in my tiny little apartment. So guess what I did?  I went to bed and I took my baby with me. Yep, it might have been 6 p. m., but I was at my limit and I knew it and that is how everyone got out unharmed.

So give yourself permission to shut the door and lay down if you need to.  And remember to be flexible. Thanksgiving 2020 fell in the middle of the COVID pandemic. I was chief medical officer of a hospital and the toll the virus took on my little community was enough to give me pause about hosting my elderly parents, Toddler grandbaby, and everyone in between.

So guess what I did? I covered my patio tables with tablecloths, hauled my dining room chairs outside, and carefully put china and silverware at each place setting. Because we weren't going to use paper plates. Fortunately, it was a balmy day and we sat together as families. And here's the deal.

Thanksgiving's run together in my memory But that one stands out. So embrace the opportunity to be flexible. You might just make a lasting memory, rather than allowing an inconvenience to ruin the season.  But if you have particularly difficult challenges, It might help to visit with a counselor to help you navigate your dread.

Because if you prepare, you can look forward to the holidays with a jolly, healthy attitude. 

And remember, if you missed last week's episode, I highly recommend it. Of course, there's a link in the show notes, and if you're on my email list, you'll be getting that downloadable card to help you focus on the positives and be grateful for the people in your life. And you know, if you have difficult people in your life, Be thankful you have people in your life.

Pray about it, show compassion, empathy, patience and appreciation, and see if it doesn't change the atmosphere. If you can go into the holidays with a healthy attitude, it can be a blessing for you and your family, and healthy looks great on you.  

   

 

 

Understanding Sleep: The Science and Tips for Better Rest

Dr. Vickie Petz Kasper speaks on the science behind sleep and its importance for our health, from weight management to disease prevention. She gives insight into the causes and complications of insomnia, outlining how both physical and mental health is impaired by insufficient sleep. She also shares how daily choices, such as light exposure, and timing of exercise and meals can influence one's quality of sleep. She emphasizes some changes for better sleep, such as keeping a regular routine, managing stress, maintaining darkness and quiet in the sleeping area, and minimizing evening fluid intake. She ends with a note on seeking professional help for severe sleep problems.

 

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00:00 Introduction to Sleep Problems 00:52 Understanding Insomnia 01:26 The Impact of Sleep on Health 02:41 The Cost of Sleep Deprivation 03:14 The Risks of Insomnia 09:33 The Science of Sleep 12:55 The Role of Light, Food, and Exercise in Sleep 19:32 Understanding the Physiology of Sleep 21:53 Lifestyle Changes for Better Sleep 25:00 Conclusion and Final Tips

Learn about lifestyle medicine and its benefits. It emphasizes the importance of personalized lifestyle modifications in controlling and preventing diseases. The six pillars of lifestyle medicine include healthy eating, physical fitness, restorative sleep, stress management, minimizing exposure to harmful substances, and positive social connections. Each pillar is interconnected to improve overall health. 

 It's that time of year. 30 days of thankfulness and a whole month focused on gratitude. Does it ever feel like life isn't so great as everyone else's? Well, stay tuned, friends. I'm going to show you the way to a grateful heart and how it changes your brain.

I don't know about you, but I always check my Facebook memories.  It's a repository of the seasons of my life, both good and bad.  And I remember one November, I accepted the challenge to post 30 days of thankfulness.  And about this time of the month, I posted, "Today, I am thankful that I resisted the urge to run over someone in the grocery store with my cart."

Nothing like a little honesty. Let's be real. Sometimes, the holidays can make you feel down and anxious. There's cooking and shopping and parties to go to.  Or, maybe not, and that's equally depressing.  This has everything to do with your health. Not only is social connectedness super important but gratitude can literally change your brain.

So, instead of fantasizing about ramming that person who irritated you in the grocery store, how about a changed heart?  Out of the overflow of the heart, the mouth speaks.  So, that's a pretty good diagnostic tool about where you are right now. And listen, if you're struggling, you're in the right place.

I've been there and I can help you see the bright side. But first, let's go to mini medical school and learn some brain anatomy and physiology. And by the way, if you want to meet some cutthroat people, hmm, med school is the place. But, we won't dwell on that.

I've had the privilege of working with so many wonderful doctors and nurses during my career, and I'm grateful for it.  Let's start in the middle of the brain. Now move down below the thalamus, but above the brain stem, and you'll find an area of the brain called the ventral tegmental area.  Now why are we here in this deep place in the brain?

Well, you see, This area of our brain is our built in reward center. It's involved in not only reward and pleasure, but also motivation, emotional regulation, learning and cognition, which is a fancy word for thinking. Hopefully, if you've been listening to this podcast for very long, some of this is going to sound familiar.

 The ventral tegmental area contains dopaminergic neurons.  That just means nerve cells that make and release  dopamine. Yes, good old dopamine. That fuels our sensation of pleasure, motivates us to seek more and feel that good reward. 

If you've missed some of the recent episodes of Mood, you might want to go back and listen to them. And, by the way, don't miss another episode. Sign up for the email list, and I'll send them straight to your inbox, so all you have to do is push play.  You know where the ventral tegmental area is, what it does.

Now, what does that have to do with gratitude? Think of it as buried treasure. Deep in the brain, this connection of pathways is a treasure trove of pleasure. Dopamine gets released when you practice gratitude, and it just feels good to be grateful.

 A friend of mine always told her children, put that in your treasure chest of memories. I think that's good advice. In other words, make deposits so you'll have something special to pull out. This reward circuitry is like buried treasure with connections to other structures in the brain called the mesolimbic pathway. 

This network includes the nucleus accumbens, the prefrontal cortex, the amygdala, and the hippocampus.  Okay, before we get lost, Suffice it to say, gratitude activates the ventral tegmental area to release dopamine to the nucleus accumbens. And listen, you're gonna like it. In fact, your brain will like it so much, it'll make you want to do it over and over again.

And just think, being grateful is what activates it.  Gratitude can lead to better mental health, including less depression and anxiety. Overall, emotional well being tends to be higher in people who practice gratitude. Let's face it, when we focus on being thankful, it changes our perspective and helps us be happier, or at least have more positive emotions than negative ones.

Gratitude can also improve sleep quality, which of course affects mood. I mean, who isn't grouchy when they don't get enough shut eye? Sleep is so important, but it can be complicated. And if you struggle to get a good night's sleep, I have some resources for you. Check it out in the show notes.  When you have an attitude of gratitude, it also affects your relationships.

People who are focused on what's right, instead of what's wrong, tend to have stronger bonds with friends and spouses and any romantic relationship.  There's more of a sense of trust, connection, and commitment. And social connectedness is one of the pillars of lifestyle medicine because it's crucial for good health, both physical and emotional.

In fact, the effects on physical health are so significant.

People who are full of gratitude tend to have a stronger immune system, as well as lower blood pressure.  Gratitude makes us more resilient, so we can control our emotions when we are faced with stress and trauma.  Now, I'm going to give you some practical ways to start practicing gratitude. But first, a little neurochemistry. 

Gratitude has the power to reduce cortisol levels. Now, who remembers what cortisol is nicknamed?  If you said the stress hormone, you get an A.  Gratitude helps us relax and be more calm and peaceful. In the episode on how food affects mood, I nicknamed all the neurotransmitters to help you remember. And if you forgot or missed that episode, there's a link in the show notes, but all of them are involved in regulating mood and all of them are affected by gratitude. 

Gratitude causes your brain to release dopamine, which is associated with pleasure and reward. This makes us feel happy and satisfied. And guess what happens then? Well, you feel grateful. And that sets it all in motion again.  In health, we often talk about a vicious cycle.  This is a victorious cycle. 

Serotonin levels also increase with gratitude. And remember, serotonin is the happy hormone. It helps alleviate anxiety and improves mood and makes us feel calm. Yes, I'll take some of that, please.  Oxytocin is also released when we feel grateful, especially in social situations. And remember, oxytocin   is the love hormone.

So when we're grateful, levels go up, that strengthens trust, and trust is the foundation of any relationship. So more oxytocin means more connectedness, And that's great for your health.   Another benefit is the release of endorphins. And those are those natural painkillers that lower stress and make you just feel good all over.

And just think, you don't even have to run a marathon to get a runner's high. Now that's something to be grateful for. Okay, now that I've convinced you that gratitude is a mood booster, let's talk about some practical things you can do. But first  You have to shift your focus. If you focus on things that are good, that you can be grateful for, then you can practice gratitude. 

And it may take some practice like anything else.  

Once you've shifted your perspective, and you're looking for things to be grateful for, you'll find them. And here's how you can practice gratitude.

1. Count your blessings out loud to yourself.  There is something powerful about saying it. When I was so sick, I could hardly walk and my life was crumbling around me. This practice was a lifesaver.  Listen, I was at the edge of despair, but every morning before dawn, I'd drag myself to the front porch and sit there and count my blessings out loud, starting with Thank you Lord that I was born healthy, because many are not.

Now this is scientifically proven to improve your life, and one of the studies was even on people with neuromuscular diseases.  The autoimmune disease that I have that caused my illness was a neuromuscular disease and I thought that was pretty cool. 

2. Talk about it with others. Tell other people what you're grateful for and thank them for being in your life.And trust me, they'll want to be around you more if you're focused on the good in life.  Now listen, this is not Pollyanna pretend everything is okay when it isn't. That's called toxic positivity. You need friends in your life who can help you shoulder your burdens. That's real connection. But, if you constantly vomit your story of woes on people, they're not going to want to be around you. And you need to shift your focus. Express your gratitude for friends who help you through the hard times. 

3. Write it down for yourself. Keep a gratitude journal. Write down at least three things every day that you're thankful for, and preferably do this first thing in the morning to start your day with your brain circuitry working for you rather than against you. Studies show that this helps lower depression and alleviate stress and it's associated with positive emotions, life satisfaction, and optimism. And we all need a dose of hope, don't we?  Keeping a bedtime gratitude journal is a great way to improve sleep. This is a fantastic way to start and end the day. 

4. Write it down for others.  Literally send thank you notes or even just a text message to people in your life who you care about. Writing gratitude letters has been proven to improve your health.  And not only that, it will improve the lives of those people who are in your world.  So what are you thankful for?  Here's the deal. One of the areas of the brain in this loop is the prefrontal  cortex. 

This is the area of the brain right behind your forehead where we make decisions, solve problems, and control our emotions.  Think about it.  See what I did there? If you're going to think about it, you're going to think about it in your prefrontal cortex.  

And gratitude enhances the brain's ability to see the world with a positive outlook and improve mood and emotional regulation. All of that happens right there. And gratitude helps your thinking brain dig into that treasure chest in the middle of the brain to activate all those pathways to release feel good chemicals.

The ventral tegmental area will start cranking out dopamine and activate the nucleus accumbens and that floods you with the warm fuzzies.  And then it motivates you to live that way. It becomes a habit. But here's the deal.  You have to choose it.  And, why wouldn't you choose it?     I hope by understanding the neurochemistry of gratitude, You're ready to put it into practice and improve your mental and physical well being, as well as your relationships. Remember, it's all a matter of focus.  Incorporate gratitude into your daily routine with prayer, journaling, and expressing thanks to others.

In fact, I have my own thankfulness challenge for you.  Now, I don't know if you send out Christmas cards, But, how about sending out an actual thank you card to someone just because?  This year, I'm hosting Thanksgiving dinner, and I'll have a card for everyone around the table. And, if my family is tuning in, maybe they'll have some too. 

Wouldn't it be nice to give and receive thank you cards for Thanksgiving and all year round? 

And if you're up for more of a challenge, here's an idea from one of my listeners. A gratitude jar. Start on New Year's Day with some type of jar, and every time you're thankful for someone,  put a little note in the jar. And then at the end of the year, send it to them. I got one of these notes one time, and it was so meaningful. It blessed both of us.  

If you're on my email list, I'll send out a lovely card that you can download and give to those you care about. And if you aren't, it's not too late. I'll send it out every week until Thanksgiving.  You can sign up at www.healthylooksgreatonyou. com  

Download it and pass it on. Give it a try and see if it improves your mood and your health. Because healthy looks great on you.    

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Sleep resources

How food affects mood refresher

  Mood swings. Things they can trap you in an endless rotation of anxiety, the blues and a big old energy crash. But how do you break out of the cycle and stabilize your mood? Stay tuned.

   I'm Dr. Vickie Petz Kasper. I practiced obstetrics and gynecology for 20 years until I landed on the other side of the sheets as a very sick patient. When my own body betrayed me, I took a handful of pills to manage my disease and another handful to counteract the side effects. My health was out of control.

Through surgery, medications, and lots of prayers, I regained my strength only to face another diagnosis.  My doctor challenged me to make radical changes through lifestyle medicine. Now I feel great and I want to help you make changes that make a difference. Healthy Looks Great On You podcast takes you to mini medical school so you can learn the power of lifestyle medicine.

If you're ready to take control of your health, you're in the right place. Whether you're focused on prevention or you're trying to manage a condition, I'll give you practical steps to start your own journey toward better health. Because healthy looks great on you. 

 This is episode 1 44. How caffeine, alcohol and sugar affect mood.   

The problem with mood swings is that they trick you into turning to things that feed them instead of helping you get out of the cycle.  Ah, I guess you could say that moodiness is hungry and greedy.  When we feel down or anxious, we "need" something to feel good or heck even feel close to normal. Think about it. 

Do you ever grab an extra dose of caffeine to feel more energized. A glass of wine to feel more relaxed. Or do you just treat yourself to a little dessert or a snack to boost your spirits.  Today in mini medical school, let's do some dissection. Except there won't be. Any nasty formaldehyde involved.

Do kids even still do that in school? I remember getting that little kit with a dull scalpel, some forceps that wouldn't grab tissue and scissors fit for kindergartener.

We had all get a white mouse stiff and stinky. I don't know about you, but that sure brings back some memories. And I'm sure of one thing you either loved it or hated it. Ah, I'll give you one guess about me. Yeah, it was fascinating to peel back the layers of skin and muscle and fascia. Okay, enough review of history. 

Let start peeling back the layers of how caffeine, sugar and alcohol affect mood.  I'm going to start with my drug of choice. Caffeine. And this one is really pretty complex because here's the deal. There are a lot of studies that show that coffee and tea have significant health benefits.  So please hear me. 

I am not telling you to avoid them. Today, we're just discussing the role that caffeine plays to influence mood.  And like many relationships. Caffeine's relationship with mood and mental health is complicated.  We all know that caffeine can boost our energy, help us focus and motivate us to tackle that to do list. And if you're like me, you can't even function until you've drained a couple of cups of coffee in the morning. And listen. That's not a problem, unless you're stuck somewhere in a coffee desert. Once I went on a mission trip and the women stayed in a bunk house on one side and the men stayed on the other. And here's the part that's really unfair. The kitchen and therefore the coffee pot, were on the men's side and it was absolutely off limits until the lights came on. Now we were two times zones away, so my early bird self was wide eyed and bushy tailed at 3:00 AM.  I managed to lay there for a couple of hours, but by five am, which was two hours past my normal waking time, I was desperate. And when I say desperate, I mean, desperate. Fortunately, I never travel without a little sleeve of instant coffee.  Yeah, I know. The problem is all I  had was a bottle of room temperature water that I had sipped out of the day before.   

 Yes I did. I emptied those glorious grounds into that plastic bottle and started shaking it.  One of the ladies literally opened one eye and said,  You have a problem, don't you.  Maybe.  But as a general rule, regularly consuming coffee or tea is not a problem. Unless you start using caffeine reactively for energy dips, deadlines, or excessive fatigue. 

  The truth is. Is 90% of all adults in the entire world consume caffeine daily.  Before we move on, let's go to the classroom and study caffeine.

The benefits come from polyphenols, catechins and flavonoids

here's how it works. It amps up the nervous system, both the central and peripheral nervous system, by blocking the adenosine receptors and that in turn causes the release of neurotransmitters that excite the nervous system. 

And individuals who regularly drink coffee and tea, actually perform better

on cognitive performance test. They can have a better reaction time. 

And they can have better processing of what they see. 

Caffeine makes you more alert, gives you mental energy, helps you concentrate.   And yeah, it helps when you're fatigued and your're sleep deprived. 

And it can eliminate headache. And that's why it's actually included in some headache medications, but that can be a vicious cycle and you can get a withdrawal headache. 

When you drink caffeine, it can also make you more nervous, more sweaty. It can interfere with your sleep. It can make you irritable.  And sometimes it can even elicit a panic attack.  Especially in people who already have some anxiety or are susceptible to the effects of caffeine. 

Now safe levels are considered to be 400 milligrams a day. Heavy coffee use is considered to be more than five cups of coffee a day.  It can increase your heart rate. And it can aggravate symptoms of gastroesophageal reflux disease because of its acidity.  And timing matters too.

The half-life of a cup of coffee is about five to six hours. Meaning that if you drink coffee at three o'clock in the afternoon, it will affect you at 9:00 PM.  

 And also you can develop some tolerance, so that it takes more and more to get the same effect. You know,  too much of a good thing always is a bad thing. Normally I drink two cups of coffee every morning, black, by the way, that's  a total of 280 milligrams. My husband makes it the night before. 

So it's at my fingertips as soon as I slip my feet into my house shoes and walk into the kitchen. But the other day, he forgot to make the coffee.  When I woke up the pot was dry.  Instead of making a pot of coffee, I popped in K cup so I could instantly get my fix, then I did it again because it was five 20 in the morning and he didn't have to go to work until late that day. But when he got up and brewed a pot it's smelled so inviting. I thought.  I'll just have one more cup. 

Now, normally I don't consider myself prone to anxiety, but my life has been invaded. By termites. Yes termites. Apparently they'd been chewing on my house for awhile. I'm talking through the window frame downstairs, the window frame upstairs and all the way to the studs. The front of my house  has been boarded up. 

My dining room table has been in the entryway. And there have been people inside my house, sawing hammering and vacuuming for more than a week.  Oh, on top of that, my neighbor has a big project going on and they decided to repave my street. The smell of fresh asphalt, the fact  that the garbage trucks couldn't get through to pick up my trash and the sound of beeping trucks and people working was enough to drive anyone nuts.  But you want to know what the final straw was for me?  That third cup of coffee. I sweated. 

I snapped. Even at my sweet mother.  Maybe you haven't noticed that dramatic of an effect. But maybe you just haven't made the connection. And there is no doubt that caffeine can trigger anxiety. And make existing anxiety worse.  And it affects sleep 100% of the time. You may fall asleep, but studies show that the quality of your sleep is undeniably affected by caffeine.  And speaking of sleep,

if this is something you are interested in, or if you struggle with it you're going to want to make sure you're on my email list because I have some exciting things coming soon about sleep. There is a link in the show notes to sign up to get the emails, or you can go to my website, www healthy looks great on you dot. Com.

 Lack of sleep has a profound impact on your health. In fact the risk of dementia and stroke are markedly increased if you don't get seven hours a night. 

 And here's another thing, if you're exhausted, what you need is rest, not something that masks your fatigue and pushes you to do the opposite of what your body needs. 

Occasionally it doesn't hurt to get a little extra boost from a cup of coffee or tea. And I'm addicted to caffeine without it, my head hurts, my brain shuts down. And I will hurt you.  Like many substances, there is a dependency cycle. Now I have no desire to cut back on coffee, but. I do recognize that two cups is enough. No more. No less, because if I indulge in more, you might not want to be around me.  I know that my circadian rhythm is in sync with this consumption between 5:00 AM and 6:00 AM.  It's important for everyone to have a cutoff time and it should be no later than 2:00 PM, because if you think you can drink a cup of coffee and go straight to bed and sleep.  You're fooling yourself because the quality of your sleep is affected even when you don't realize it.  

And to be clear, although there are health benefits to black coffee and unsweet tea, there are no benefits to sugar sweetened, caffeinated beverages.  

 I'm talking about mountain Dew, Coke, Dr. Pepper, and. I guess if you live somewhere where it's socially acceptable, Pepsi.

And listen. The biggest. The source of added sugar in the U.S. Diet is drinking it.  I'm talking

soft drinks, energy drinks sports drinks, even things like vitamin water. They have a lot of sugar in them and it's a lot of unnecessary calories and that can cause weight gain and type two diabetes, which increases your risk for heart. Disease and stroke. 

And the connection is really very strong. 

There's a, there's an increased risk of dying early, especially. Specially from heart disease. How much more? Well, if you drink. Two or more a day it's actually over 30% higher. And it's worse if you're a woman.   Energy drinks usually contain around 200. Milligrams. So a couple of those is pushing the limits. 

If you're drinking too much caffeine or sugar sweetened beverages. You may have to wean slowly to avoid withdrawal.  Start by switching to half caff

or drinking only half of your soda. 

It's important to make mindful adjustments and try not to use caffeine to medicate fatigue. Be aware of how caffeine affects your mood and sleep. And be sure to hydrate with water.  Food helps too, especially getting some protein in your stomach because coffee on an empty stomach can be very acidic. It can also. Interact with medications affecting absorption. 

So be sure and talk to your pharmacist or doctor about that.  So, what do you do when you get that afternoon slump.  Well,  it up and move. Often people feel fatigued in the afternoon because they're sitting or maybe they're just bored. So try getting your blood pumping to give you a boost of energy. And make sure and get sunlight in the morning to ensure that your circadian rhythm is optimized.  That means having good sleep hygiene.  And remember if your body is screaming for rest, rather than overriding your body's signals with caffeine learn to work with your natural energy rhythms. 

  Before we move on to sugar's impact on mood, let's talk about alcohol.

And adult beverage can make you relax and give you relief from feeling tense. It can even make you feel happy. But then it turns on you making anxiety and depression worse. It even depletes your serotonin levels. And it has a huge impact on your circadian rhythm disrupting sleep, which only makes matters worse. It's a double-edged sword. 

You have to drink to relax then you need to drink to relax. Alcohol is a temporary escape from stress. And it tricks you into thinking it will help you unwind and sleep better. But it doesn't.  Using alcohol as a coping tool for stress, anxiety,

or social situations. Can lead to dependence.  Now in the short term, it boosts gaba, which is a calming neurotransmitter. That's why you feel relaxed and it increases dopamine, which is that reward hormone that makes you feel temporary pleasure.   It reduces activity in the part of your brain called the prefrontal cortex. That's where the worry cycle spins and spins. So it settles that down.  And then it disrupts glutamate which impairs your judgment. And then it has a rebound effect. 

GABA levels, drop anxiety increases.  And cortisol goes up. 

There's an inflammatory response in the body that affects mood. And it has a long-term impact on mental health, depleting serotonin which increases the risk of depression. And the natural stress response system is disrupted. 

Overall, it weakens your resilience to life stressors by changing the brain's reward circuitry. And creating a dependency cycle for emotional regulation.  So, what do you do? Well, it might help to keep a diary. Like see what your mood is in relation to your intake of alcohol. Awareness is key. And note the three R's. What is the reason you're drinking? 

What is the response to drinking and what is the result to drinking. And maybe track your sleep quality too.  Practical steps would be established some drink free times. 

And see if that makes a difference.  And sometimes you have to create a new ritual. Instead of responding to those triggers by fixing a drink.

 Here's the scary thing.

Excessive alcohol use is the leading preventable cause of death in the United States now.

And yet it's the most common substance used among people aged 12 and over in the United States, in fact, 85% of all adults drink alcohol. And the effects are worse in women.  You have to learn radical acceptance and radical honesty  and learn to sit with uncomfortable emotions.  And don't forget those natural endorphin boosters, like exercise and laughter and music.  And learn stress management techniques like breathing and meditation and prayer.  Building your emotional regulation skills  will keep you from using alcohol.  to control your mood. Because, you know, it doesn't work. Alcohol actually borrows happiness from tomorrow. So building natural resilience, let's you.  own your joy today.  Okay, now let's talk about sugar.  Who hasn't felt blah, and reached for a sweet treat t to reward yourself.  Honestly, this gets ingrained in kids at an early age. I mean. What did you hand out to the trick-or-treaters at your door? And worse than once a year, we send our kids to church on Sunday and they feed them donuts, goldfish and apple juice. 

And then we wonder why they have a meltdown in the car on the way home. It's a great way to ruin a Sunday, whether you're a kid or a grown-up.  Sugar puts you on an emotional rollercoaster. You get the thrill of a quick release of dopamine. And followed by a drop in blood sugar, which causes a sugar crash: irritability, fatigue and mood swings. And it's not just external. 

There is a lot of research on sugar and inflammation and what it does to the brain, not just for short term mental health, but for long-term cognitive function.  Here's what happens. There's a rapid spike in blood sugar and you get an immediate lift in your mood and energy. Then there's an insulin surge, which causes blood sugar to crash.  That triggers the dopamine reward system in the same way that any addictive substance does. It causes that inflammation and affects brain chemistry. 

It can cause a craving cycle.  And then you can get into an emotional eating pattern that gets reinforced by all of this.  The long-term effect can be an increased risk of depression and anxiety. Not to mention disrupting the gut microbiome because of all the effects of neurotransmitter production. 

And when you eat food, that's not good for you, it takes the place of food that is good for you. So you can get nutrient depletion and that certainly affects mental health. 

So what's a person to do. Number one -understand your triggers. 

Know what triggers you to reach for caffeine or alcohol or sugar to treat your mood.  And really be aware of emotional eating patterns. Or drinking patterns. There are certain times of the day when we're more vulnerable to these things than others. So rather than reaching for a drink or going to the pantry to treat your mood,  develop other habits that are better, like exercise, social connectedness and even just laughter.

In the end, you'll be happier and you'll probably live longer. 

 Recognize the connection that alcohol, and sugar and caffeine have on your mood and look for hidden sugar sources because this one can really sneak up on you. 

Make sure you're getting a diet that's rich in fruits and vegetables and whole grains, so that you have a healthy gut microbiome. There are some other episodes you may want to listen to, to get a more detailed review of this. 

Make sure that you have tools to regulate your emotions and to manage your stress. You might need to make gradual adjustments to find alternatives and establish new routines and sustainable habits. But in the end, your energy levels will be stable, you will be genuinely relaxed and you'll have emotional balance. 

It's better to regulate your mood.  naturally, so you feel healthy.  And healthy looks great on you. 

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