Octogenarians

I have been blessed to have the privilege of taking care of elderly patients in my primary care practice. These people have taught me so much. They are full of a lifetime of wisdom and have plenty more to teach me. The ones that really catch my attention and provoke my curiosity are those who may be old chronologically but are young at heart. They tend to be healthy and active and enjoy their lives. They are living the life I would want to have if God lets me live into my eighties.

I have noticed some commonalities in healthy and happy octogenarians. One of the first things I recognized was the majority of these vibrant elderly exercise or lead very active, in-motion lifestyles. None that I can recall were sedentary couch potatoes. Many make it a daily ritual to go for a walk and some of them walk several miles a day, rain or shine. It is a habit for them. A body in motion tends to stay in motion!

Another more elusive quality I noticed is octogenarians tend to live above their circumstances. Many of them have lost spouses, children, careers, fortunes, and some degree of personal health. Yet, they manage not to dwell on their losses or let the losses define who they are.

They have recognized that life is not fair and they deal with it. This is a lesson I hope I have taught my children. Life is not fair. The world does not revolve around any single individual. God's plan for the world does not hinge on me! His plan will be accomplished with or with out me. I think this is one of the most important lessons of life.

I believe learning that life is not fair is the beginning of learning gratitude. Gratitude is another character quality in healthy and happy octogenarians I have witnessed. I think it is hard to be depressed or feel sorry for yourself if you generally are a person of gratitude. We all go through periods of depression and malaise, but generally people who practice or understand gratitude do not stay in those dark places.

I think people who are known for their character quality of gratitude are generally more interested in helping others than in being helped. And I believe this is one of those funny things in life, the more people you help, the happier you tend to be. Our culture today tends to sing a different song.

These healthy and happy octogenarians tend to not hold on to bitterness or anger. They are generally gracious and forgiving individuals. They know that holding on to bitterness or anger will destroy their souls. "Bitterness will dry up your bones." 

I know there are always exceptions, but I do believe if we tend to live an active lifestyle and practice gratitude, we will improve our chances of becoming happy octogenarians. Next time you see someone in their eighties enjoying their day, stop and talk to them. I am betting you will be blessed by the conversation.

Guest Post: 3 Steps to Better Health

 

Molly Bruchez, MS RD is a registered dietitian with a passion for helping others improve their health through REAL FOOD.  She specializes in weight loss, blood sugar control, inflammation, and gut health. Molly’s approach helps individuals to establish a healthy relationship with food without dieting or counting calories. 

Her philosophy reflects a blend of her nutrition degrees, her professional experience, and her ongoing training in functional medicine. Molly translates complicated, research-based information into simple, practical concepts that are easy to implement. 

She received a Bachelor’s degree in Nutrition from Virginia Tech in Blacksburg and a Master’s degree in Nutrition from Colorado State University in Fort Collins. As a dietitian, Molly has worked with individuals of all ages and in many different settings—including schools and universities, nonprofit healthcare centers, and hospitals. 

Molly is both personally and professionally committed to optimal health. 

In her free time, she enjoys running, biking, yoga, and experimenting with new recipes. She lives on a ranch in the beautiful mountains of Colorado with her husband and their two dogs. 

Are you interested in improving your health? Maybe you want to lose weight, boost your energy, control diabetes or high blood pressure. Maybe you simply want to feel better. Get started on your journey to optimal health by following these 3 simple steps.

Step 1:  Embrace Lifestyle Change

The major difference between a “diet” and “lifestyle change” is the approach. If you begin your journey to better health with the mindset that “I only have to do this for X weeks,” you are setting yourself up for failure. The MAIN reason most diets fail is because they are, by definition, temporary. Sure, you may see results while you are following the diet, but what’s more important is whether the results are long-lasting. 

If your goal is better health, the changes you make must be lifelong. In my experience, individuals who start with just one or two changes and continue to build on this are most successful long-term.

Start TODAY. Choose one or two things you’re willing and able to change. Maybe this means starting the day with a balanced breakfast. Or perhaps you decide to kick your soda habit and drink more water. EVERY change counts—no matter how big or small. 

Step 2: Keep Your Blood Sugar Balanced

Not diabetic? DON’T skip this step! Blood sugar control is important for EVERYONE interested in better health, not just for those with diabetes. 

Are you always hungry? Do you feel sluggish after a meal? Do you skip breakfast and overeat later in the day? Is the “eating less, exercising more” method not working for you? These are all signs that you may be riding the destructive, and al- too-common, Blood Sugar Rollercoaster. It’s not just WHAT you eat that counts, it’s also important to consider WHEN you eat. 

Skipping meals, over-consuming carbohydrates, stress and illness are a few factors that can feed this vicious cycle. Our bodies function best when blood sugar remains within a certain range.  While it’s normal for blood sugar to fluctuate before and after a meal, it's best to prevent major spikes and crashes.

Over time, this rollercoaster creates a stressful environment for your body. It can leave you with constant cravings, low energy, unstable moods, and it can make it difficult to lose weight even if you’re eating very little. 

To keep your blood sugar stable, eat balanced meals (containing protein-fat-carbohydrate) that are evenly distributed throughout the day (this means no skipping meals!). 

 Step 3:  Keep It Simple with Real Foods

Get back to the basics of eating mostly real, whole foods. Regardless of what your health goals might be, cleaning up your diet by cutting back on processed foods is one of the most important steps you can take. 

The majority of foods you eat should contain only one ingredient or NOT have an ingredient list at all. No ingredient list?!? What’s left to eat, you ask? Stick primarily to whole foods like meat, fish/seafood, eggs, fruits, vegetables, healthy fats and whole, intact grains and legumes (if properly prepared and well-tolerated). 

Be SKEPTICAL of food products that contain health claims. Don’t fall for sneaky marketing traps.  “Fat-free” and “made with whole-grains” do NOT equal healthy. 

It’s not necessary (or realistic) to avoid ALL foods with an ingredients list. Just be SMART about it. Use the following tips to make better food choices. 

• If it has an ingredient list, the shorter, the better—if you can’t pronounce it, don’t eat it. 
• Key ingredients to avoid: high fructose corn syrup, trans fats (partially hydrogenated oils), monosodium glutamate (MSG), preservatives, artificial colors and sweeteners. 

Embrace lifestyle change, balance your blood sugar, and keep it simple. Use these simple steps to get started on your journey to better health TODAY!

"Wellness is not a medical fix but a way of living—a lifestyle sensitive and responsive to all the dimensions of body, mind, and spirit, an approach to life we each design to achieve our highest potential for well-being now and forever." —Greg Anderson

To contact Molly, please send an email to mollybruchez@gmail.com

How Much Water Should You Drink?

This is a simple question that I am asked frequently. The answer is: “It depends.” I’m sure most people have heard the rule to drink at least 8 glasses with 8 ounces of water a day. It is commonly expressed as the standard amount of water to drink. It depends on several things including your overall health, where you live, and what you are doing.

Water makes up about 60% of your body and is needed in every cell. Slight dehydration can zap your energy away. We can survive a long time with little or no food, but we must have water. Water is essential in flushing out toxins, transporting nutrients, and moisturizing our airways, skin, and joints.

The Institute of Medicine has published its recommendations. They have said that the average man needs about 13 cups (3L) of water a day and the average woman needs about 9 cups a day (2.2L).

There are several factors that can influence the amount of water you need. Moderate exercise may require another 1–2 cups of water. Extreme heat can increase your water demands. Illness such as vomiting or diarrhea increases water demands as well. Some health problems such as congestive heart problems or some types of kidney problems may require you to even consume less water.

Extreme sports such as running a marathon require close monitoring of your fluids and electrolytes. The electrolytes are basically minerals that your body needs to function correctly. A rare but potentially fatal problem for some marathon runners is hyponatremia. This is caused when someone has too much water and not enough sodium. It can lead to heart arrhythmias.

A practical way to monitor your hydration status is to monitor your urine output. You could actually measure the amount and it should be around 1.5 liters a day. A more practical way is to monitor the color of your urine. It should be clear or light straw colored. Darker urine may signify dehydration.

Water is in many things. On average, the food we eat accounts for about 20% of our water intake. Water is in milk, coffee, and other beverages. Some fruits such as watermelon are about 90% water by weight. We can get our daily requirement of water from several sources. Stay hydrated and you should feel a little better and will avoid some future problems.

Vitamin D: The Sunshine Vitamin

I am amazed at how often I find patients with low vitamin D. I do not test everyone, but about 70 percent of the people I test are either low or borderline low.

It has only been recently that the technology has made it affordable and readily available for routine clinical testing.

The classic vitamin D deficiency disease is rickets. I have never seen a case of rickets nor do I know anyone that has seen a case of rickets. The US started fortifying milk with vitamin D in the 1930s and rickets has since become a very rare problem in the US.

Vitamin D is associated with many enzymes and cells in the human body. It helps our intestines to absorb calcium and phosphorous. Some experts have called it a hormone because of the many things it can affect.

There is a growing body of research that indicates that vitamin D could affect cancer risk. It appears to protect against colon, prostate, and breast cancer.

I have frequently found vitamin D to be low in patients complaining of fatigue, depression, and body aches. There is some association with vitamin D deficiency and adult onset diabetes. We certainly think of vitamin D when we are dealing with osteoporosis or osteopenia.

Our bodies naturally make vitamin D when exposed to the sunlight. The amount of vitamin D manufactured depends on the amount of skin exposed to sunlight, time of day, and color of skin. Darker skin blocks the UVB light from penetrating as much as lighter skin.

Vitamin D is fat soluble and can become toxic if you take too much. I have personally never seen a high level of vitamin D, but it is possible. It can cause heart arrhythmias, anorexia, and weight loss.

The US government health authorities have stated that vitamin D deficiency occurs when the levels are below 30 nmol/L. I personally like to see levels above 50nmol/L. It is checked with a simple blood test.

I would recommend that you consider getting your vitamin D levels checked if you are homebound and or otherwise cannot get out in the sun. It is probably worthwhile to check your levels if you have any questions about your ability to get some sun exposure or if you have osteoporosis or osteopenia. You might consider checking your levels if you are dealing with prolonged fatigue or depression.

If you are low, OTC supplements are readily available. Vitamin D3 is the best form to get. It is more easily converted to the active form of vitamin D. I routinely advise patients to take 1-3,000 units daily and often recommend higher doses if levels are low. You should monitor blood levels. I would recommend you to discuss this with your healthcare provider before starting vitamin D.

Go get some natural vitamin D, but do so with caution. Never get sunburned, and remember sun exposure can lead to skin problems, including increased risk for skin cancer.

Natural Treatments for Depression and Anxiety

It has been estimated that over 40 million Americans suffer from anxiety and/or depression. Most people have a combination of symptoms of anxiety and depression. It is like a coin; one side is heads (depression) and the other side is tails (anxiety).

Often the same medications can be used to treat either depression or anxiety. Modern medicine has developed many medications that can help. SSRIs are popular medicines used commonly and are very effective and have few side effects. But what I would like to focus on today is natural ways to help you deal with anxiety or depression.

I believe one of the best ways to begin working on anxiety or depression is to learn to control your thought life. Too many people are captive to their thoughts and let their minds drift in any direction. The Bible has some good advice on this in Philippians 4:8 where Paul tells us “whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable, if anything is excellent or praiseworthy, think about such things.”

Every thought we have has an emotion tagged to it, and we become a product of our thoughts. If someone is depressed or anxious, you can bet they are having many depressed or anxious thoughts. So one of the keys to naturally getting better is to learn to control your thought life.

Most of us will dwell on things that are out of our control. I would estimate that over half of the things anxious and/or depressed people are thinking of are things that are out of their control. The research is pretty clear on this. We have about a minute to deal with a thought when it comes to mind before we start to ruminate on the thought. Human nature is to take a thought and go to the darkest corner. This is one reason solitary confinement is the worst punishment for prisoners. They are left alone with their thoughts.

One strategy is to stop and give yourself about one minute when a thought comes to your mind. If you can influence the outcome; think about it, pray about it, and come up with a plan or get some advice. If, however, you cannot influence the outcome of the thought, do not allow yourself to think about it. Actively move your mind in another direction. Lift up a quick prayer but do not dwell on the thought.

Often when people are depressed or anxious, they withdraw from family and friends. They want to be left alone. While this may be helpful at first to gather thoughts and gain perspective, it can become part of the problem. I encourage my patients to get back to doing the things they know they enjoy. This can seem a little artificial at first, but our emotions usually follow our actions.

It is like a train. Our actions are the engine and our emotions are the caboose. Eventually the caboose gets to where the engine was. If you start acting a certain way, you will eventually start to feel a certain way.

Sleep is a great remedy for anxiety. It is amazing how much better the world appears after a good night’s sleep. Cut back on your caffeine and be sure to get 7–9 hours of good sleep.

Exercise is my favorite way to deal with stress. It has an immediate and lasting impact on my mental state. It is amazing to me how much better I feel after a good, vigorous workout. I think it also helps me sleep better.

St. John’s wort is a common supplement taken by many with some proven results. Another supplement often used is SAMe (S-Adenosyl-L-Methionine). It is made from naturally occurring proteins in our bodies and has had some proven benefits. I take a product from Thorne Research called Methyl Guard. It is full of B vitamins that can improve mood and boost energy levels.

Eat whole foods, get some good sleep, exercise, hang out with family and friends, and control your thought life. I bet you will start to feel better!

Olive Oil and Walnuts

Many people are fans of the Mediterranean diet. The Mediterranean diet is basically a diet high in vegetables and olive oil and low on animal protein. A recent study published in JAMA Internal Medicine seems to validate the benefits of this diet, especially when supplemented with nuts and olive oil.

The study was a small one done in Spain. The average age of the participants was 67. Most of the participants were overweight and had hypertension and/or elevated cholesterol levels. They were divided into three groups. One group followed a low-fat diet. Another group followed a Mediterranean diet supplemented with nuts. The third group followed a Mediterranean diet and supplemented with 5 teaspoons of olive oil a day.

Each group underwent memory testing and cognitive function testing before the diet and at 4 years. The group following a Mediterranean diet with supplemental nuts had significant improvements in memory, while the group adding extra virgin olive oil experienced significantly better cognitive function.

The study was small and definitive answers cannot be given concerning the benefits of olive oil and walnuts on memory and cognition. I do think it is safe to consume both olive oil and nuts such as walnuts or almonds and I believe that they can offer some benefits for brain health.

Olive oil and nuts have antioxidant effects and have long been advocated for brain health. They can reduce intravascular inflammation, which is a major cause of vascular damage. There are no bad side effects from these foods but do watch out for calories. (Nuts in general have about 10 calories per nut.)

So the next time you have a salad, add some olive oil and walnuts!

It's Sugar—Not Fat!

For the last several decades, the government eating guidelines endorsed by many doctors have advocated a low fat diet. As it turns out, this is not a good idea. Eggs were once a banned food for patients with high cholesterol, but not so now.

Recent studies show that those with the highest sugar consumption have the highest risk of heart disease. In a study published in JAMA (Journal of American Medical Association), those with the highest sugar intake were at a four-fold risk of heart attacks. Drinking one 20-ounce soda increases your risk by 30%. The average American consumes about 150 lbs. of sugar a year!

Sugar is hidden in many foods, even in some we consider to be healthy. Did you know that fruit yogurt has more sugar in it than a Coke? The average serving of tomato sauce has more sugar than most cookies. The biggest source of sugar for most Americans is sugar-sweetened beverages. The average teenage boy consumes about 34 teaspoons of sugar a day. This equates to about 545 calories a day from sugar.

Our bodies need about 1,000 mg of cholesterol a day to function. Cholesterol is important for brain function and many other roles in our bodies. Most of our hormones are made from cholesterol. The liver manufactures about 75% of the cholesterol that we need. The other 25% comes from our diet. Some people have a genetic issue that causes them to make too much cholesterol, but most people simply eat too many calories in the form of refined sugars and certain fats that often lead to elevated cholesterol levels.

Sugar is a quick source of energy for our bodies and is used first. Most of the carbohydrates we eat must be turned into glucose for our bodies to absorb them. However, when you consume more sugar than your body needs, the sugar is stored in your liver in the form of triglycerides and glycogen. High intake of refined sugar also lowers the good cholesterol (HDL) and changes the size of the LDL (bad cholesterol) particles. It can lead to insulin resistance and diabetes. Fatty liver disease is often caused by the over consumption sugar. All of these changes increase the risk of atherosclerosis (hardening of the arteries).

I believe that you will lose weight, lower your cholesterol, improve your energy, and decrease brain fog by eliminating refined sugars and high glycemic carbohydrates. Take a look at my 10-Day Diet Challenge and give it try.

The Brain-Gut Connection

Did you know that over 70% of neurotransmitters are actually made in the gut? Science is beginning to unravel the complicated connections in our bodies and one of the more amazing connections is the brain-gut connection.

I think that intuitively we have known about the brain-gut connection for some time. It is even ingrained in our language. You have probably said something like this before: “I have a gut feeling.” 

There is research that shows connections to chronic diseases and to the bacteria in our intestines. Certain patterns are starting to emerge with respect to the types of bacteria in our intestines with certain illnesses.

Several studies have shown a connection to the gut microbiome and many different problems associated with our brains. Parkinson’s Disease, anxiety, and depression are a few that exemplify this connection.

It seems reasonable to me to think about keeping our guts healthy in order to keep the rest of our bodies healthy—including our brains. One of the best ways to do this is to decrease and eliminate processed and high sugar. These types of food tend to cause inflammation that can have a cascading effect throughout the body.

Probiotics are bacteria that are normal and healthy for our intestines. Each capsule will contain millions, if not billions, of bacteria. I often recommend my patients to consider probiotics for intestinal problems. If you are taking antibiotics, I encourage you to also consider taking probiotics. 

I believe that most things that can cause your intestines to be inflamed can also cause some neurological issues as well. These problems may be subclinical, meaning that it is not readily noticeable.

Probiotics will not cure anxiety or depression, but they may provide some relief for some people. If you are struggling with anxiety and depression, try a radical approach and eat healthy and exercise and take some probiotics. Avoid processed foods and sugar for a couple of weeks and see if your energy improves and the fogginess in you clears up. Try my 10-Day Diet Challenge and see if you feel better. I have a gut feeling that you will!

Run to Remember: Life Lessons from My First Marathon

It has been 20 years since the bombing of the Oklahoma City Alfred P. Murrah Federal building in downtown Oklahoma City. One hundred and sixty-eight innocent lives were taken that day, and over 620 people were seriously injured. Countless numbers of lives were forever changed in a moment.

I, along with many of my fellow Oklahomans, believed that somehow here in the heartland, we would be immune to terror. I believed a myth that we were insulated and isolated from the insanity of mass murder. That myth was shattered at 9:01 on April 19th, 1995.

In typical Red Dirt fashion, we endured. We rebuilt. We have grown. We learned. Now we remember.

The Run To Remember is this weekend. We run to remember and to honor those 168 innocent souls and their families. The Run To Remember has been voted one of the top 12 must-run events. Thousands will be running and attending the event this weekend.

I was fortunate to be able to run the very first Oklahoma City Memorial Marathon and it was my first ever marathon. I had just turned 40 years old and found myself overweight, out of shape, and drifting. A friend from my church, Susan, challenged me to run. She had never been a runner and had just had her first baby. She was already signed up for the run and she challenged me in front of some friends. Not wanting to let my manhood be questioned, I accepted the challenge before I knew what I had really done.

I had never run more than maybe two or three miles at a time and generally did not enjoy running. I found it boring and painful. But I had committed to do this and she had witnesses to my commitment. I found an online program for beginning runners and began the plan.

I had no idea what I was in for. I imagined many things that I would soon experience, and some of them came true. I was, however, pleasantly surprised at the many lessons and life truths I learned in my training.

I learned that I could endure far more than I ever dreamed. I experienced worship in a new way. I made many new and lasting friends. My health improved. My energy improved. My attitude improved. I learned that most people, including myself, give up too easily. I learned that there is always someone faster than me! I learned that sometimes hard work is the reward. Success is often just around the corner.

This weekend, I am running the half. I will finish slower than I did last year. My goal is to beat the winner of the full marathon! It is going to be close!

If you have never been a runner, I want to challenge you to start. There are many positive health benefits and I believe you can learn many things about yourself.

Remember the 168 souls and their families.

12 Tips to a Long Life

How long do you want to live? The oldest person in modern history lived to be 122. The average age of most modern cultures have slowly increased over the last 100 years. Worldwide, the average life expectancy is 71 years for men and 73 years for women.

Japan is number one in life expectancy with an average of 86.2. The United States is 36th with an average of 79.8. You can view the remainder at the World Health Organizations’ report on the following website: http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy.

I believe most people would like to live a long life as long as they could physically get around and keep their mental capabilities intact. So, what are some things you can do today that can improve your chances of living longer?

A simple search of the web for longevity can reveal numerous studies and opinions. Many of them are in direct conflict with each other. I believe the answer is not overly complicated.

First of all, there is no one thing that is a guarantee at increasing your lifespan. Some people have a genetic advantage in life expectancy. I mentioned this in my previous blog on Telomeres.

A British Medical Journal study found that sitting for 3 hours a day reduced the average life expectancy by 2 years. A JAMA Internal Medicine study concluded that sitting more than 4 hours a day increased the chance of death by 40% over three years compared to sitting less than 3 hours a day.

In a study by Brigham Young University, it was found that people with weak social connections died at much higher rates than those that had strong social connections. The same study concluded that prolonged loneliness was as bad as smoking 15 cigarettes a day. Elderly people with a large circle of friends were found to be 22% less likely to die over the study period.

According to an article in The New York Times “every single hour of television watching after the age of 25 reduces the viewer’s life expectancy by 21.8 minutes.”

There are several studies that try to estimate the increase of life expectancy with exercise. Most studies will estimate that for every 1 minute of exercise, the life expectancy is increased by 7–8 minutes.

Numerous studies support 7–8 hours of sleep a night to improve longevity. Interestingly, sleeping more than 9 hours is associated with a decrease in potential longevity. Likewise, sleeping under the 5 hours has the same effect.

Depending on the study you read, attending church regularly can increase your life expectancy by 3–7 years.

Laughter is good medicine and can extend your life expectancy. There are many studies that show laughter has a positive effect on blood vessels, hypertension, and the immune system.

There is a strong mind-body connection. A positive attitude can prolong your life. A negative attitude can shorten your life. Many studies look at attitude and patients’ results from various surgeries and medical procedures. There is often a direct connection to positive results with positive attitudes. I know of one surgeon who would cancel a planned surgery if the patient was overly pessimistic about the procedure. He believed attitude was very important.

Married men tend to live longer than single men. No surprise there.

If you live in the “Diabetic Belt,” which interestingly correlates with the “Bible Belt,” you are more likely to develop diabetes and/or have a stroke. There are studies that can correlate the incidence of diabetes to the number of fast food restaurants in a given area. Diabetes can shorten a person’s lifespan by 5–7 years and often is a major contributor to the development of dementia. In fact, Alzheimer’s dementia is now frequently being referred to diabetes type 3.

So, what should you do to improve your chances of living to a good old age and enjoying your golden years? The advice is really simple, and I bet you have heard it before.

1. Get around 8 hours of sleep a night.
2. Exercise at a moderate level for around 3 hours a week.
3. STOP SMOKING!
4. Eat a healthy diet and avoid processed foods. Avoid fast foods. Stop drinkingCoke.
5. Stop watching so much TV.
6. If you develop a medical problem, such as diabetes or hypertension, get treatment and get aggressive with your nutrition.
7. Do not sit so much. Stand up at work when you can.
8. Learn to laugh.
9. Keep a positive attitude.
10. Go to church.
11. Cultivate good friends.
12. Stay married.

Do be careful what you ask for. I was seeing a 96-year-old lady for her first visit with me and she told me when she turned 70, her goal was to make it to 100. Now she was afraid she just might make it!