Nature Can Heal in More Ways Than One

Humans evolved in the natural world. We may have retreated to caves or huts to protect ourselves from the elements, but we spent much of our time outdoors, hunting, gathering, cooking, telling stories, and so on. Our lives these days, though, are largely spent cut off from nature.

This way of life has sparked a wealth of studies showing that our loss of contact with nature—dubbed “nature deficit disorder”—has a real impact on our physical and mental health.

So our primary care concierge doctors in Jupiter weren’t too surprised to learn of a new study published this month in the journal Occupational & Environmental Medicine, which found that enjoying nature up to four times a week reduced the odds of needing mental health medications by 33 percent.

It also reduced the odds of using blood pressure pills by 36 percent and asthma medications by 26 percent.

The Study

Researchers interviewed about 6,000 people who live in large cities in Finland, asking about their access to and use of green and blue spaces, including parks, zoos, rivers, lakes, or the sea. 

They also asked subjects whether they could see views of nature from their homes, how often they spent time outdoors as well as how much they exercised while outdoors.

The study also accounted for other possible factors such as traffic-related outdoor air pollution and noise, which have been proven to have an adverse effect on health.

Respondents were then asked about their use of medications for depression, anxiety, high blood pressure, asthma, or insomnia, and correlated these with time spent in nature.

As noted above, the results were markedly better for those who were regularly exposed to green or blue spaces. Notably, those who lived in areas with a lot of green spaces or who simply looked at nature from their windows showed no improvement in any of these categories.

“Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive, and asthma medication in urban environments,” the study authors wrote.

Confirming Prior Research

Numerous earlier studies have found significant benefits from spending time in nature.

One meta-review of 143 other studies published in the journal Environmental Research, for example, found that people with access to green space generally had a slower heart rate, lower blood pressure, and fewer blood levels of the stress hormone cortisol. Researchers also found significantly fewer cases of diabetes and lower rates of mortality from heart disease in the group regularly exposed to nature.

An American Institutes for Research (AIR) study in 2005 found that sixth-grade students who attended three outdoor education programs showed marked improvement in conflict resolution skills.

Another study in China in 2013 involved 60,000 children between the ages of two and 17. It showed that regular exposure to nature, or “greenness” around their schools, reduced the incidence of attention deficit/hyperactivity disorder (ADHD). A more recent study at the University of Illinois produced similar results.

And a 2016 study of nearly 100,000 women conducted over eight years found that having access to the greenest space not only improved the subjects’ mental health but also reduced their death rate by 12 percent.

Nature Deprivation Hurts

Author Richard Louv coined the phrase Nature Deficit Disorder (NDD) in his 2005 book “Last Child in the Woods: Saving Our Children from Nature Deficit Disorder.” In it, he argued that elements of our urbanized lifestyle, including few natural spaces, a car-focused culture, more screen time, changes in the perception of risk (e.g., fear of “stranger danger”), less leisure time, and increased time pressure from work or school, combine to decrease or even eliminate contact with nature for both adults and children, according to the National Institutes for Health (NIH).

“The average young American now spends practically every minute—except for the time in school—using a smartphone, computer, television, or electronic device,” Tamar Lewin reported in a Kaiser Family Foundation study on the subject.

According to the Children and Nature Network (C-NN), which was co-founded by Louv, an expanding body of scientific evidence suggests that nature-deficit disorder contributes to:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity, and
  • higher rates of emotional and physical illnesses

Make the Connection

Unfortunately, to get back to nature, you may need to make a specific effort, because in our harried lives trapped indoors, focused on our screens, we have very little time for real relaxation.

Therefore, it’s often necessary to add nature breaks to our schedules the same way we schedule everything else.

One way is to undertake the Japanese practice known as “forest bathing,” or shinrin-yoku. As Kaiser Permanente’s’ online Thrive explains, “Heading out to a heavily wooded area isn’t required. You could take a trip to a nearby park, your favorite local trail, the beach, or any natural setting. Just be sure to turn off or silence your phone or other devices.”

Psychology Today explains, “Forest bathing is an antidote to pinging distractions, impending deadlines, and never-ending obligations . . . . The idea is to immerse yourself in a natural environment and soak up the many health benefits of being in the green woods.”

However, you manage it, for the sake of your overall health we recommend you take the time to reconnect with the natural world as often as possible.

There’s a Reason Why You’re Feeling SAD

If you’ve been feeling down, sleepy, or hopeless, even with all the holiday merriment going on around you, our primary care concierge doctors in Jupiter want you to know you’re not alone. Health experts estimate that seasonal affective disorder (SAD), or the “winter blues,” affects about five percent of the U.S. population.

SAD is more than just the “winter blues,” according to the American Psychiatric Association (APA). The symptoms can be distressing and overwhelming, and can interfere with daily functioning, the APA reports. 

Affecting more than 10 million Americans, symptoms of the condition usually begin in October or November and begin to subside in March or April. However, some patients don’t feel fully back to normal until early May.

SAD may begin at any age, but it typically starts when a person is between the ages of 18 and 30 and seems to affect women more than men.

Symptoms

The APA lists the following symptoms associated with SAD:

  • fatigue, even with excessive amounts of sleep
  • weight gain associated with overeating and carbohydrate cravings
  • feelings of sadness or depressed mood
  • marked loss of interest or pleasure in activities once enjoyed
  • loss of energy
  • an increase in restless activity (e.g., hand-wringing or pacing)
  • slowed movements and speech
  • feeling worthless or guilty
  • trouble concentrating or making decisions
  • thoughts of death or suicide or attempts at suicide.

The severity of such symptoms can vary from person to person, and not everyone will experience all these symptoms.

Likely Causes

While no one is certain what causes SAD, the lower amounts of sunlight in fall and winter are believed to lead to a biochemical imbalance in the brain, impacting the body’s circadian clock, which triggers sleep and wake cycles.

This process affects the output of serotonin, the so-called “mood” hormone. Studies have shown that the circadian-related output of serotonin drops markedly with the decrease in light during the winter. It also increases the level of melatonin, a hormone secreted by the pineal gland that regulates the sleep cycle.

The cause of SAD may have an ancient survival connection, as humans learned to restrict activity when food sources were scarce. The tendency may still be hardwired into our biology, and people can experience symptoms on a sliding scale from barely noticeable to full-blown clinical depression.

Risk factors include a family history of SAD or another form of depression, having major depression or bipolar disorder, and having lower levels of vitamin D. Vitamin D is believed to promote serotonin production.

Treatment

SAD can be effectively treated in a number of ways, including through the use of light-box therapy, which employs specially built full-spectrum lamps to alleviate symptoms. The NIMH reports that this type of therapy has been a mainstay for treating SAD since the 1980s.

In this treatment, a person sits in front of a very bright lightbox (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. The light boxes, which are about 20 times brighter than ordinary indoor light, filter out the potentially damaging UV light, making this treatment safe for most people.

However, those with certain eye diseases or people taking certain medications that increase their sensitivity to sunlight might need other treatment types.

Other approaches include the use of antidepressants such as Paxil and Prozac, or cognitive behavioral therapy (CBT), a type of talk therapy aimed at helping individuals learn how to cope with difficult situations. In addition, the U.S. Food and Drug Administration (FDA) has also approved another type of antidepressant specifically for SAD: bupropion. In extended-release form, it is taken daily from fall to spring to prevent major depressive episodes.

Self-care

Meanwhile, there are steps you can take to help mitigate milder cases.

1. Stay active outdoors

Exposure to early morning light has been shown to be the most effective at reducing symptoms, as has regular exercise. An early morning walk or run might be all you need to help alleviate your symptoms.

2. Let in the light

If you can’t get outside, at least let the sunshine in as much as possible. Open blinds and drapes first thing in the morning, and keep them open all day. If you can, arrange your home or office so you’re exposed to as much sunlight as possible during the day (but remember that the sun’s harmful UV rays can penetrate glass, so use sunscreen if you’re actually sitting in the sun all day).

3. Eat right

Simple carbs and sugars wreak havoc with your blood sugar, thereby affecting your mood. Lean meats, fruits, vegetables, nuts, and complex carbohydrates will help to keep your brain functioning properly.

4. Take it easy

Don’t try to do too much, which can add to feelings of being overwhelmed. Do what you can, and postpone the rest, or ask friends and family for help with your to-do list.

5. Stay connected

Studies have shown that connecting with others helps improve mood: volunteering, getting together with friends and family, and participating in group activities, are some possibilities.

If your symptoms are interfering with your daily life, let us know. We can help evaluate your symptoms and recommend the right therapy.

organic

Some Common Questions About Organic Foods

Our concierge primary care doctors in Jupiter of course want our patients to eat healthy foods as much as possible.

This typically means a diet low in processed foods and high in fresh fruits, vegetables, nuts, and seeds, along with lean meats and fish.

Does it also mean eating organic foods as well? Many people hear the word “organic” and automatically think it equals “healthy,” but that may not always be the case. So let’s try to clear up the confusion around this widely available—and usually much more expensive—food.

What does the term “organic” mean?

The word “organic” refers to the way the food is grown and processed. The U.S. Department of Agriculture (USDA) has created a set of standards that describe the specific requirements that must be verified by a USDA-accredited certifying agent before products can be labeled organic.

The National Organic Program (NOP), an advisory committee that includes members of the public, develops these rules and regulations for the USDA.

They include several restrictions on farming practices and raising livestock and poultry, as well as on handling and labeling.

In general, the regulations restrict the types of pesticides, fertilizers, and seeds that can be used, and ensure healthy farming practices to protect the environment.

To receive the USDA Organic seal, a product must:

Improve soil and water quality.
Enable farm animals’ natural behaviors.
Cut pollution.
Promote a self-sustaining cycle of resources on a farm.

Certified organic products cannot use:

artificial fertilizers or sewage sludge as fertilizer
radiation to preserve food or get rid of pests or diseases
genetically modified or engineered materials to improve crop harvests or improve pest or disease resistance
antibiotics or growth hormones for livestock
most synthetic pesticides (except in special, USDA-approved circumstances)

Is organic food healthier?

You can find all kinds of persuasive arguments and testimonials online about how organic food is so much healthier for you to eat.

It’s certainly healthier for the environment, because of the sustainable practices organic farmers use.

It’s also undeniably better to avoid products from animals that have been fed antibiotics throughout their lifecycle to promote unnatural growth and suppress diseases that occur from overcrowded conditions. This is one of the things that contribute to antibiotic resistance in humans.

Other than that, though, science has so far not been able to prove that organic foods contain more substantial nutrients than conventionally grown foods.

As reported by Harvard Health, one meta-study by Stanford researchers, for example, found little difference in nutritional content, except for slightly higher phosphorus levels and a higher omega-3 fatty acid content in organic milk and chicken. And the bacteria that can cause food poisoning were equally present in both organic and non-organic foods.

And according to the Mayo Clinic, studies have shown much lower cadmium levels in organically grown grains, but not fruits and vegetables. Cadmium is a toxic chemical found naturally in the soil and absorbed by plants as they grow.

Is the label ‘organic’ a guarantee?

If the food contains the USDA Certified Organic label, that means it was grown and processed according to federal guidelines.

According to the USDA, “Produce can be called organic if it’s certified to have grown on soil that had no prohibited substances applied for three years prior to harvest. Prohibited substances include most synthetic fertilizers and pesticides.

“As for organic meat, regulations require that animals are raised in living conditions accommodating their natural behavior (like the ability to graze on pasture), fed 100 percent organic feed and forage, and not administered antibiotics or hormones.”

The agency performs more than 45,000 onsite inspections per year to ensure compliance with regulations. If foods are labeled “100 percent organic,” that means all ingredients are certified organic. Foods labeled “organic” contain at least 95 percent certified organic ingredients.

On the other hand, labels that say “made with organic” or “organic ingredients” can’t carry a USDA seal, because they contain less than 95 percent organic ingredients.

More confusion in labels

In addition, there is a difference between “organic” and “natural” on a product’s label. The term “natural” may simply refer to products or animals that have been minimally processed and contain no artificial ingredients, but that doesn’t mean they’re organic.

Another confusing term is “grass-fed,” which means animals receive a majority of their nutrients from grass throughout their entire life and have continuous access to pasture during the growing season. It does not mean they have been raised without the use of antibiotics, hormones, or pesticides on their feed.

Likewise, “cage-free” birds are able to freely roam a building, room, or enclosed area with unlimited access to food and fresh water during their production cycle. “Free-range” birds are provided shelter in a building, room, or area with unlimited access to food and fresh water, as well as continuous access to the outdoors during their production cycle. But neither of these terms reveals whether they have been raised without antibiotics or hormones.

So is organic better for you? In some of the ways we’ve listed above, yes. But only you can decide whether the extra expense is worth the small gains in nutritional value, as well as the larger impact on the environment and the animal’s welfare.

pfas

How to Combat the Lingering Danger of ‘Forever Chemicals’

They’re called “forever chemicals” because they don’t break down fully in the environment, and this summer the Environmental Protection Agency (EPA) warned that they are more dangerous to human health than regulators knew.

Within weeks, the National Academies of Sciences, Engineering, and Medicine (NAS) weighed in with its own 300-page report on these chemicals, known as perfluoroalkyl and poly-fluoroalkyl (PFAS) substances, urging doctors to test high-risk patients for PFAS contamination.

Because of the heightened attention on these chemicals, our primary care concierge doctors in Jupiter want to summarize for you what we’ve learned about them, and offer tips on how to reduce your exposure.

The Problems with PFAS

In 1946, DuPont introduced its revolutionary non-stick product, Teflon. By 1950, studies by DuPont and 3M showed that PFAS could build up in the blood, but chose to keep these results secret, according to the non-profit Environmental Working Group (EWG).

Since 1998, when a class-action lawsuit against a West Virginia DuPont factory revealed the extent of the pollution from the factory, researchers have found probable links to such diseases as:

  • thyroid disease
  • high blood pressure
  • kidney cancer
  • testicular cancer
  • breast cancer
  • higher cholesterol levels
  • ulcerative colitis
  • weakened immune system 
  • vaccine interference
  • weight gain
  • changes in liver enzymes
  • decreased fertility
  • growth and learning delays in infants and children

The NAS report encourages doctors to conduct blood tests for these chemicals on patients who are worried about exposure or who are at high risk for exposure or who are in “vulnerable life stages”: during pregnancy, early childhood, and old age. 

They’re Everywhere

As we’ve seen with microplastics, PFAS can begin innocently enough and end up in unexpected places, including our water.

Recently, for example, Consumer Reports (CR) tested more than 100 food-packaging products from U.S. restaurants and supermarkets. They found dangerous PFAS chemicals in many of the products, including paper bags for french fries, hamburger wrappers, pizza boxes, molded fiber salad bowls, and single-use paper plates.

These chemicals are used in a wide variety of products, including waterproof and sweatproof makeup, nonstick cookware, cellphones, waterproof clothing, carpets, and—especially—fast-food containers, where their ability to make products grease-proof has led to their widespread use.

They are also used to make products water-repellent and resistant to high temperatures, as well as in fire-fighting foams used at military installations, floor wax, upholstery, and clothing. The qualities that make items containing PFAS so desirable, however, also make them long-lasting in the environment.

Lingering Threat

“These chemicals are ubiquitous in the American environment,” Ned Calonge, an associate professor of epidemiology at the Colorado School of Public Health and chair of the NAS committee that wrote the report, told CNN.

“More than 2,800 communities in the U.S., including all 50 states and two territories, have documented PFAS contamination,” he said.

Researchers have even detected them in the snows of Mt. Everest, apparently shed from climbers’ waterproof tents and parkas. 

“You are not just exposed in one place or one source,” toxicologist Linda Birnbaum, former director of the National Institute of Environmental Health Sciences and the National Toxicology Program, told The Washington Post. “They are everywhere.”

The problem is that these chemicals build up (or “bioaccumulate”) in the body over time. 

And according to the Centers for Disease Control and Prevention (CDC), which has been conducting studies of the U.S. population, PFAS has been found in the blood of nearly all people they’ve tested. Since the risk appears to rise with the amount of exposure, it’s important to try to limit the amount we come in contact with.

What You Can Do

Because PFAS chemicals are found in so many consumer products, they’re next to impossible to avoid. But there are ways to reduce the amount you’re exposed to.

“The most dangerous way that people are exposed to PFAS is through drinking water,” says Don Huber, director of product safety at CR.

That’s why the NAS report recommended filtering tap water as a major step consumers could take to protect themselves.

“The water filters that are most effective for PFAS are reverse osmosis filters,” David Andrews, a senior scientist for the EWG, told CNN, adding that some carbon-based filters can also reduce some levels.

“The important part is that you have to keep changing those filters,” he said. “If you don’t change that filter, and it becomes saturated, the levels of PFAS in the filtered water can actually be above levels in the tap water.”

The NAS committee also offered these tips:

  • Stay away from stain-resistant carpets and upholstery, and don’t use waterproofing sprays.
  • Look for the ingredient PTFE or other “floro” ingredients on product labels.
  • Avoid nonstick cookware. Instead, use cast-iron, stainless steel, glass, or enamel products.
  • Boycott takeout containers and other food packaging. Instead, cook at home and eat more fresh foods.
  • Don’t eat microwave popcorn or greasy foods wrapped in paper.
  • Choose uncoated nylon or silk dental floss or one that is coated in natural wax.
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