best diet

The Best Diet for You

The start of a new year is traditionally the time to turn the page on the bad habits and disappointments of the previous year.

Usually near the top of the list of New Year’s resolutions that people make is the decision to lose weight. And from a health perspective, our concierge doctors certainly applaud that one.

Overweight or obesity is responsible for a host of chronic diseases, from type 2 diabetes to backaches to joint pain. So you want to achieve and maintain a healthy body weight, right? But which diet is best?

The problem with keto

What about the popular keto diet? Studies show that 80 percent of those who try it struggle to stick with it. Why, when it often results in huge and rapid amounts of weight loss?

First, it can it cause numerous side effects—body aches, headaches, light-headedness, nausea, fatigue and lethargy, constipation, and brain fog. Plus, all their friends are eating garlic bread and mashed potatoes (not cauliflower) with gravy and pasta. Or because they lost their job and need a regular intake of brownies to help them feel better. Or because they’re stressed about the pandemic—possible job loss, not being able to see friends and family, worried about catching the coronavirus. And that chocolate cream pie dulls the loneliness and anxiety, at least for a little while.

Because, in short, the keto diet restrictive. It has a long list of quite tasty foods that either aren’t allowed, or allowed only in small portions after a certain time.

“When you are on the keto diet, you drastically cut your carbs to only 20 per day. That’s less than one apple!” nutritionist Lisa Drayer, a CNN contributor, told the network.

The common problem

And this is the problem with all diets. Nearly all of them work as promised, but are difficult to adhere to over time. So you “cheat.” Then you cheat some more. Then you figure, why bother? You then start eating normally again and regain all the weight you lost. And you likely gain back even more.

But here’s the thing: It’s not you, it’s them. In other words, it’s the whole concept of dieting to begin with. Someone once pointed out that diet begins with the word “die,” so even if only subconsciously, the concept has a negative connotation.

In addition, our bodies were built to store calories. That’s because our ancient ancestors never knew when they’d be facing lean times, or even starvation if the mastodons they hunted migrated elsewhere. Even in more recent times, before there was such a thing as a food industry, mankind learned to store food over the winter. But it still wasn’t as abundant as during the summer months.

So we’re biologically built to store up calories to last through the lean times.

And speaking of the food industry, their entire reason for being is to get us to buy more of their product. Stores are laid out with enticing displays of sugary, fat-laden foods. Advertising constantly tempts us with photos and videos of delicious, fattening foods.

We succumb, we gain weight, and then it’s up to us to find a way to lose it. And we try a long list of diets, only to be disappointed with the results. So which one do we recommend?

The only real solution

The best diet is one that works for you, that helps you gradually lose weight, but doesn’t leave you feeling deprived or hungry all the time.

“For any given person, it’s really a matter of what they can stick with,” Michael Jensen of the Mayo Clinic told Psychology Today.

Keto might be the right choice for some people. For others, the Paleo diet, moderation, veganism, intermittent fasting, or simply cutting back on sugar and flour.

Above all, research shows the most successful diet is the one that you yourself designed. This gives you a sense of control, rather than being at the mercy of a set of restrictive rules.

“You have to have joy and pleasure in food,” Stanford University professor of medicine Christopher Gardner told The Washington Post. He has conducted numerous randomized trials to test the success rate of various diets, and found they are essentially the same.

“They agree more than they disagree,” he said. Instead, he counsels, “Limit added sugars and refined grains, and eat more non-starchy vegetables. [I]f you do those two things, you get 90 percent of the benefits.” 

If you enjoy what you eat, you’ll have a much better chance of sticking with it for the rest of your life, he added.

“[The most successful way of dieting] will be different from one person to the next, and there will never be a randomized trial of it.”

We would add that for the most wholesome way to eat, consider the Mediterranean diet. It rates number one in surveys of diets, not only for long-term weight loss, but also for ease of adherence and the healthiest outcomes.

If you have any questions about weight loss, please talk with us. We can suggest the best approach specifically for you.

effects of sitting

Sitting Is the New Smoking

If you’ve been one of those fortunate enough to be able to work at home during the pandemic, you’ve probably been glued to your chair for eight or more hours a day. At least at the office you might have been able to walk around from desk to desk, or take the stairs, or take a walk at lunch.

Whereas at home, our concierge doctors are guessing that you get very little chance to move at all. And that could be detrimental to your health.

Scientists have been researching the effects of sitting…

Researchers have known for several years that sitting for long periods is hazardous to your health. But newer studies have revealed that lack of frequent movement is even more dangerous than previously known.

Some of the results that attributed to prolonged periods of sitting include:

  • organ damage, including heart disease
  • an over-productive pancreas
  • a greater risk for colon, breast, and endometrial cancers
  • muscle degeneration
  • leg disorders, including osteoporosis
  • slower brain function

One 2011 study examined more than 800,000 people’s sitting habits. Those who sat the most during the day found they had:

  • a 112 percent increased risk of diabetes
  • a 147 percent increased risk of heart attacks and strokes
  • a 90 percent increased risk of death from CVD
  • a 49 percent risk of death from any cause

… And they continue to see similar results

Newer studies have confirmed those who spend more time sitting than moving have higher rates of cardiovascular disease (CVD) and certain cancers than people who don’t sit as long. They are also more likely to die early than their less sedentary counterparts.

One study, for example, found that adults who sat for 11 hours or more a day had a 40 percent higher risk of dying in the next three years than those who sat for less than four hours daily.

Another study published in the Annals of Internal Medicine, tracked the daily movements of 7,985 adults. Participants used hip-mounted accelerometers to actually record their activity, rather than rely on self-reported data. As the total time spent sitting increased, so did the risk of death from any cause, regardless of age, sex, race, body-mass index (BMI), or exercise habits.

Those who sat for less than 30 minutes at a time had a 55 percent lower risk of death compared with those who sat longer than that.

So, yes, sitting really is as bad for your health as smoking.

Some good news

But it is possible to counteract the effects of sitting just by getting out of your chair from time to time.

The World Health Organization (WHO) released new guidelines last month to help counteract the effects of prolonged sitting, based on a new study published in a special issue of the British Journal of Sports Medicine (BJSM).

The WHO now says that all physical activity counts toward better long-term health. This could include anything from climbing stairs instead of taking the elevator, gardening or doing housework, taking a walk around the block, participating in a team sport, going for a run or a bike ride, or participating in a high-intensity interval training workout.

The BJSM researchers followed more than 44,000 people from four countries. They fitted each participant with activity trackers. They found that moderate to vigorous physical activity for 30-40 minutes daily brought the risk from prolonged periods of sitting down to levels associated with very low amounts of sedentary time.

What to do for your health

So, while the higher intensity workouts were better, it appears that any movement is better than nothing.

“These guidelines are very timely, given that we are in the middle of a global pandemic, which has confined people indoors for long periods and encouraged an increase in sedentary behavior,” Emmanuel Stamatakis, BJSM co-editor and professor at the University of Sydney, wrote in the journal.

“But people can still protect their health and offset the harmful effects of physical inactivity,” he said. “As these guidelines emphasize, all physical activity counts and any amount of it is better than none. There are plenty of indoor options that don’t need a lot of space or equipment, such as climbing the stairs, active play with children or pets, dancing, or online yoga or Pilates classes.”

There’s one more benefit from any type of exercise that we’d like to point out: stress relief. The pandemic has put us all on edge, and a brisk walk outdoors or a brief period of play with the kids or the dog can go a long way to helping alleviate tension.

So, for better health all around, set a kitchen timer, your watch, or your phone to remind you to get up and move every few minutes throughout the day.

wearing a mask

CDC: Masks Protect Wearer, Too

As Florida closes in on the unenviable milestone of nearly a million confirmed cases of COVID-19, our concierge doctors wanted to share a bit of good news. We’ve mentioned before how critical it is to wear face masks in public to help keep others from becoming infected. People can be contagious for up to two weeks before they begin to show symptoms, which accounts for the rapid spread of the disease.

Now a new scientific briefing from the Centers for Disease Control and Prevention (CDC) confirms what researchers had long suspected: Masks protect the wearer as much as those around them. The revised guidance, released late last month, cites several studies. These show masks reduce the risk of contracting the virus by up to 79 percent.

In one case, for example, a study examined 124 households in Beijing with a single case each of COVID-19. It found mask wearing by the infected individual as well as others in the household reduced secondary transmission by 79 percent. Another case followed two hair stylists who were infected and showing symptoms. They wore masks while interacting with 139 clients over eight days. The clients also wore masks. Subsequent testing showed that not a single client contracted the disease as a result.

An added bonus

In addition to protecting both the wearer and the public, universal mask-wearing can also help the economy, the CDC notes.

“Adopting universal masking policies can help avert future lockdowns, especially if combined with other non-pharmaceutical interventions such as social distancing, hand hygiene, and adequate ventilation,” the CDC said.

Besides pandemic fatigue, another reason people have begun to rebel against stay-at-home guidance is because of the dire effect the early lockdowns had on the economy. Most people need to work, and economic stress is as unhealthy as any other kind of stress.

But the agency cites one recent economic analysis from Goldman Sachs. It found a 15 percent increase in universal masking could prevent losses of up to $1 trillion. This equals about five percent of gross domestic product (GDP).

So it turns out that wearing a mask is a win-win-win proposition.

But which mask is best?

The type of mask worn by health-care workers is the N95 respirator. This is the best at filtering out infected particles, which is precisely why you shouldn’t wear them.

“The CDC does not recommend that the general public wear N95 respirators to protect themselves from respiratory diseases, including coronavirus (COVID-19),” according to the U.S. Food and Drug Administration (FDA). “Those are critical supplies that must continue to be reserved for health care workers and other medical first responders.”

There is a still a severe shortage of such masks, even after all this time. The CDC recommends the public wear others types of face coverings, many of which have been shown to be quite effective.

“Multiple layers of cloth with higher thread counts have demonstrated superior performance compared to single layers of cloth with lower thread counts, in some cases filtering [out] nearly 50 percent of fine particles,” the CDC said.

“Try to get at least a two-ply cloth mask and make sure it’s tightly woven,” Dr. John O’Horo, an infectious disease specialist at the Mayo Clinic in Rochester, Minnesota, told NBC News.

One test of effectiveness is to hold the mask up to the light. If you can see the outline of individual fibers in the cloth, it’s too thin to offer enough protection.

Dr. Scott Segal, chair of anesthesiology at Wake Forest Baptist Health in Winston-Salem, North Carolina, recently partnered with the Wake Forest Institute for Regenerative Medicine to test a variety of cloth materials. They looked not only for breathability and comfort, but also for the ability to filter small particles. They concluded the best masks were constructed of two layers of heavyweight “quilter’s cotton,” with a thread count of at least 180.

What doesn’t work

Now we consider what doesn’t work.

The most ineffective mask is one that doesn’t cover the nose. In fact, there’s little point in wearing one at all if the nose isn’t covered. The resulting nasal exhalations will spread the virus, and also allow the wearer to inhale infected particles. So will face masks with valves. They make for easier breathing, but they also allow the breath to leave the mask without any filtering.

Plastic face shields fall into this category as well. One recent study confirmed that plastic face visors allow nearly 100 percent of tiny airborne droplets such as those emitted by talking or breathing to escape into the surrounding air. Yes, doctors wear them . . . along with N95 masks.

Remember, it’s safest to always assume that everyone you meet outside your immediate household is infected. We now have the promise of two new effective vaccines on the horizon. But until they can be widely distributed, we’ll need to hang on just a little longer. And wearing a mask can help us control the spread of the virus sooner.

benefits of supplements

Supplement Benefits: All In the Mind?

It sounds so easy: Pop a pill (or pills) every day and enjoy radiant health. Unfortunately, our concierge doctors have to caution you that it may not be not that simple. And, according to a new study, the claimed benefits of taking supplements might not even be true.

The study, published this month in the journal BMJ, suggests that the perceived benefits of over-the-counter (OTC) vitamin and mineral supplements may largely be due to the power of the mind.

“The effect of positive expectations in those who take multivitamin or mineral supplements is made even stronger when one considers that the majority of them are sold to the so-called worried well,” lead study author Dr. Manish Paranjpe said in a statement. “The multibillion-dollar nature of the nutritional supplement industry means that understanding the determinants of widespread multivitamin or mineral use has significant medical and financial consequences,” he added.

The financial aspect is obvious. Dietary supplements are a $40-billion-a-year business in this country. And if the products don’t work as expected, that’s a huge waste of money.

The medical impact is less well known. Between 2007 and 2012, the U.S. Food and Drug Administration (FDA) received reports of more than 6,300 reports of serious adverse events linked to dietary supplements. These included 115 deaths and more than 2,100 hospitalizations.

What’s the harm in taking supplements?

This may surprise people who think that because these substances are sold over the counter they can’t do you harm. Others believe that the government wouldn’t allow their sale unless they were safe and effective. However, a 1994 law, the Dietary Health and Education Supplement Act, actually prevents the FDA from regulating dietary supplements or removing them from sale unless it can prove a supplement is unsafe.

But indiscriminate use of supplements can produce serious side effects. For example, Vitamin E and beta-carotene supplements can actually increase the chances of developing lung cancer in smokers.

St. John’s Wort is sold over the counter for mild depression. Some of its potential side effects include dizziness, sun sensitivity, insomnia, anxiety and headaches. It can also reduce the effectiveness of birth control pills and some heart medications.

Fish oil can cause nausea and diarrhea and increase the levels of LDL (bad) cholesterol. It can also increase the risk of bleeding. Some people have suffered such severe liver damage with green tea extract that they required a liver transplant.

Niacin, another popular supplement, has been shown to slightly increase the risk of death from any cause. So have calcium supplements, which one study suggested increased the risk of death from cancer when taken in amounts greater than 1,000 milligrams per day.

Little evidence for real benefits

Then there’s the question of whether these products are effective for the reasons we take them. Various studies have been performed on the efficacy of supplements in the prevention of many diseases. All have shown little-to-no benefits of dietary supplements and vitamins.

Those marketed for the prevention of cardiovascular disease (CVD) have, for example, been studied extensively. In 1996, the Physicians Health Study assigned 22,071 men to take either beta-carotene or a placebo for 12 years. They assessed the effect of the vitamin on the prevention or progression of the disease. The results showed no difference in either CVD occurrence or overall mortality.

A Women’s Health Study found a similar result when it looked at the effect of beta-carotene on 40,000 women. It found no differences in the incidence of heart disease between those taking the vitamin and those receiving the placebo.

Another study published in the Journal of the American College of Cardiology that examined multivitamins, calcium supplements, and vitamins C and D, found no measurable advantage in terms of preventing CVD, heart attack, stroke, or early death. A similar study found no CVD-associated benefits for vitamin D.

Yet the belief persists

Despite these findings, many people still swear they notice a difference in their health after taking supplements. The study this month attributes this to the power of belief. Consumers also point to studies that support their faith in these substances.

An article in Harvard Women’s Health Watch, however, explained that the benefits of supplements that often appear in some studies are based on observational research vs. clinical trials. That is, researchers ask study participants to self-report on their daily habits, vs. performing randomized controlled trials. Because observational studies don’t control for diet, exercise, and other variables, they can only suggest an association with better health benefits from particular supplements.

“People who take supplements tend to be more health conscious, exercise more, eat healthier diets, and have a whole host of lifestyle factors that can be difficult to control for fully in the statistical models,” Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, told the journal.

So whether you’re trying to improve your health or ward off illness, your best bet is to follow the time-honored advice: Consume a balanced diet, including fruits and vegetables, get plenty of exercise, don’t smoke, use alcohol in moderation, and avoid recreational drugs. It really is that simple.

flu shot twindemic

Flu Shots Can Help Avert a ‘Twindemic’

The U.S. Centers for Disease Control and Prevention (CDC) recommends all adults and children older than six months receive a flu shot by the end of this month. The CDC says it takes at least two weeks for the vaccine to become effective. Then it won’t reach its peak effectiveness until another week after that. And children who are being vaccinated for the first time need two vaccines spaced a month apart to become fully protected.

Therefore, our concierge doctors suggest you get your flu shot for the 2020-21 influenza season as soon as possible. While there have been scattered reports of shortages around the country, The Washington Post recently reported a record number of flu vaccine doses—between 194 million and 198 million—have been ordered. Because the vaccine is shipped in stages, more is on the way.

“This year I think everyone is wanting to get their vaccine and maybe wanting it earlier than usual. If you’re not able to get your vaccination now, don’t get frustrated. Just keep trying.”

The CDC’s Dr. Daniel Jernigan, to the Associated Press (AP).

COVID-19 and flu overlap: a ‘twindemic’

We were fortunate the 2019-20 flu season was winding down this spring as the coronavirus crisis began to hit the country. This year, however, we’ll be looking at the possibility of a “twindemic”—both waves hitting at once.

So it’s especially important that as many people as possible get vaccinated for the flu this year. The flu shot won’t prevent COVID-19, but it can help reduce the strain on our already overburdened health care system.

“Since hospitals and doctors’ offices are going to be very busy caring for COVID-19 patients, a flu vaccine can help decrease burdens on the health care system and make sure that those who need medical care are able to get it.”

Dr. Susan Bailey, president of the American Medical Association (AMA) and an immunologist in Fort Worth, Texas, told CNN.

Last year, the CDC estimated that the flu killed 22,000 Americans, and resulted in hospitalization of an additional 400,000. By contrast, at least 215,000 Americans have died of COVID-19 since March.

Hopeful signs

Health experts are hopeful the precautions we’ve been taking to avert COVID-19—hand washing, social distancing, and wearing masks—will mean this season’s flu won’t take as severe a toll as in previous years. But they all insist that widespread vaccinations are necessary.

Even if the flu vaccine isn’t 100 percent effective in preventing influenza, it has been shown to reduce the length and severity of the illness in those who contract it. In addition, if you’re unlucky enough to contract COVID-19, you won’t want your body’s defenses to be weakened by a prior bout with the flu.

This is already present in the Southern Hemisphere, where each season’s flu strikes over the summer. From South Africa to Australia, public health experts reported remarkably low levels of influenza among their populations. They attributed this partly to coronavirus lockdowns and to extremely high participation in influenza vaccinations.

One pharmacy in Cape Town, South Africa, for example, reported that the demand for flu shots was four times higher than in previous years. People were trying to avoid the co-morbidity (simultaneous presence of two or more diseases) of contracting the flu in addition to COVID-19.

“People were lined up outside the pharmacy down to the corner of the street waiting to get their injections. We had to prevent people from coming into the store.”

Ellis Henen, owner of Sunset Pharmacy, told The Post.

Additional benefits of the flu shot

We hope Americans will have the same attitude to this year’s flu shot.

Some people think they’re still protected from the one they received last year. But having received a flu shot last year won’t protect you from this season’s strains of the virus. This is because your immunity from a year ago has deteriorated by now. In addition, manufacturers create a new vaccine each year based on which strains the World Health Organization (WHO) expects to be predominate. This is based on which strains were seen over the summer in the Southern Hemisphere. So this year’s shot will include strains different from those in last year’s inoculation.

It’s important to remember, even if you contract influenza after receiving the shot, it’s likely to be less serious than if you’d skipped being inoculated. And the flu vaccine offers additional benefits, especially among the elderly. For older people and those with chronic health conditions, recent studies show the extra benefits of a flu shot. It’s as effective in preventing a heart attack as quitting smoking, using cholesterol-lowering drugs, or taking blood pressure medications.

So be sure to let us know if you’re interested in getting a flu shot. If you encounter a shortage, we may be able to help you locate a supply nearby.

overcome chronic conditions

Healthy Habits Can Conquer Chronic Medical Conditions

We’ve heard a great deal lately about how those with chronic conditions—diabetes, high blood pressure, and obesity—are more likely to become sicker when exposed to the SARS-CoV-2 virus that causes COVID-19. Even leaving aside the coronavirus, many individuals have thought that having multiple chronic medical conditions such as those or others (cancer, asthma, coronary artery disease, and so forth) doomed them to a premature death.

But our concierge doctors have recently come across some good news for those people. It turns out that healthy lifestyle habits can overcome multiple types of chronic conditions and help extend your life.

Lifestyle impacts on chronic conditions

A new study reported last month in the journal PLOS One followed nearly 481,000 middle-aged adults in the U.K. for up to nine years. Of those, 93,746 had two or more chronic medical illnesses (known as multimorbidity) such as those mentioned above.

The researchers focused on four lifestyle factors: smoking, diet, physical activity, and alcohol consumption. They then weighted each of these factors (some healthy foods vs. a great deal, moderate physical activity vs. a great deal vs. none, and so forth) and broke them into four categories:

  • healthy
  • very healthy
  • unhealthy
  • very unhealthy

Then they assigned each study participant to a category.

Their results show that those who practiced the healthiest habits lived longer than those who did not, regardless of their current medical challenges.

In particular, men with a very healthy lifestyle were found on average to live 6.3 years longer than those with a very unhealthy lifestyle, while women in these same categories were found to live an average 7.6 years longer.

Even those in the third category, unhealthy, saw some benefit over those with a “very unhealthy” lifestyle.

Healthiest habits

Not smoking had the largest impact on life expectancy, according to the researchers. Smokers at age 45 were found to live five to six years less than non-smokers, regardless of other disease complications. Because the screening question asked only if participants were current smokers, it is fair to assume that the large study cohort included many former smokers. This proves quitting smoking at any age does confer health advantages.

Regular physical exercise also showed a significant benefit. Those who engaged in some type of regular physical activity lived longer than those who did not. Even if the exercisers had serious medical conditions. Researchers defined regular physical activity as that which met the global health recommendations: 150 minutes a week of moderate physical activity or 75 minutes of weekly vigorous activity.

Men who engaged in regular physical exercise gained an additional 2.5 years of life on average. The benefit for women was slightly lower; they gained 1.9 additional years of life.

Surprisingly, a healthy diet– defined as consuming at least five different fruits and vegetables daily– and moderate or no alcohol intake demonstrated little benefit in increasing life expectancy.

Never too late

We hope our patients find these results encouraging. They show that—even with multiple chronic illnesses—you can not only influence your life expectancy with healthier habits. And they show you can improve your quality of life by following standard guidance for a healthy lifestyle.

These include:

1. Diet

Avoid processed foods, and consume a diet high in seafood and fresh produce. Include fruits and vegetables, nuts, olive oil, and beans. and low in red meat, dairy, sugar, salt, and saturated fat.

2. Exercise

A daily minimum of a half-hour of any kind of mild-to-moderate exercise is crucial to overall health. If necessary, it can be broken into 10-minute increments throughout the day. Even a daily brisk walk will help.

But for optimal health, we recommend any kind of regular, vigorous movement. Try to add up to 150 minutes (2 ½ hours) per week.

3. Stress relief

When your body thinks it is constantly under attack, studies have shown such chronic stress puts you at greater risk for serious health problems, including cardiovascular disease, cancer, digestive disorders, impaired memory and concentration, anxiety, and depression.Reducing stress is crucial to maintaining good health, so:

  • take time for hobbies
  • practice relaxation techniques
  • exercise regularly
  • eat a healthy diet
  • stay in touch with friends

At the same time, avoid unhealthy stress relievers like smoking, excess alcohol consumption, and illicit drug intake. These practices merely mask stress triggers temporarily. They can cause damage to the body, as well as to your mental health, in the long run.

cholesterol

What You Should Know About Cholesterol

Since September is National Cholesterol Education Month, our concierge doctors want to review the often-confusing facts about this vital blood component.

What is cholesterol?

Cholesterol is a type of waxy, fat-like substance found in every cell in your body. Made by your liver and also present in some foods, it allows your cells to function properly. It helps synthesize Vitamin D in the body as well as some necessary hormones. These include cortisol and cortisone, and the sex hormones estrogen, testosterone and progesterone, among others. It also helps create the bile you need for digestion.

Cholesterol gets transported through the body on proteins called “lipoproteins.” There are two types of lipoproteins: high-density lipoproteins (HDL) and low-density lipoproteins (LDL). The LDL type makes up most of the cholesterol in the body (between two-thirds to three-quarters). The HDL type absorbs excess LDL cholesterol and returns it to the liver, where it gets flushed from the body.

Why is high cholesterol bad for you?

Despite the role cholesterol plays in keeping the body healthy, only a small amount is needed to maintain critical functions. When your body has too much of the LDL-type of cholesterol, it can build up on the walls of your blood vessels. This causes them to become narrow. This in turn begins to block the free flow of blood to and from your heart and other organs in the body. When blood flow to the heart is blocked, it can cause chest pain (angina), a heart attack or a stroke, among other cardiovascular problems. Therefore, too much LDL is “bad” for your body when it isn’t balanced by higher HDL levels.

The confusion surrounding “high” and “low” cholesterol no doubt arises from their names. If we say your cholesterol levels are too high, you might think, “But isn’t ‘high’ cholesterol the good kind?” High-density lipoproteins (HDL) are good, and the higher that number, the better. But when we say you have “high” cholesterol, we’re talking about the “bad” type, meaning the low-density lipoproteins.

To confuse matters even more, triglycerides that are too high further contribute to fatty buildup in the arteries. Triglycerides are the most common type of fat in the body. High levels of triglycerides combine with high levels of LDLs to raise the risk of cardiovascular disease even further.

How to lower bad cholesterol

The optimal mix is low triglycerides, low LDL levels and high HDL levels in the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI), the leading cause of high LDL cholesterol and triglycerides are unhealthy lifestyle choices. Certain medical conditions and medications, as well as genetics, also play a role.

There are a number of LDL lowering drugs available, including the very successful statins. But, as always, it is preferable to try to lower LDL levels naturally first. There are a number of ways to go about this:

  • lose weight
  • avoid trans fats (most commonly found in fried foods and pastries as well as margarine)
  • avoid red meat and dairy products
  • cut sugar consumption
  • keep alcohol consumption no greater than one drink daily
  • keep stress levels low

These steps, combined with increasing HDL levels in the blood, are often sufficient for many people to remain healthy.

How to raise good cholesterol

Medications to raise HDL cholesterol have not proved effective in lowering the risk of heart attacks and strokes. The best way to increase your supply is through lifestyle changes:

  • quit smoking
  • increase aerobic exercise to a total of at least one hour a week
  • consume more monounsaturated fats, e.g., nuts, seeds, avocados
  • increase intake of polyunsaturated fats, e.g., salmon, tuna, trout, and walnuts
  • consume more soluble fiber, e.g., fruits, vegetables, whole grains, beans, and legumes

In addition, avoid drugs that contain testosterone or other anabolic steroids, which have been shown to lower HDL levels.

Because there are no symptoms of high cholesterol, the only way to know for sure if your levels are within acceptable levels is through a simple blood test. This is especially important if you have a family history of heart disease, are a smoker, are regularly exposed to cigarette smoke or have high blood pressure or diabetes. The National Institutes of Health recommends that all adults have their cholesterol levels checked beginning at age 20.

It’s not difficult to keep “bad” cholesterol levels in check, unless you have a genetic predisposition toward high LDLs. Let us help you sort out the confusion surrounding cholesterol and heart health.

proper breathing

Proper Breathing Can Improve Your Life and Help with COVID-19

Most adults breathe incorrectly, especially when they are experiencing stress, whether acute or chronic. The effects of improper breathing may surprise you: increased stress, insomnia, weight gain, high blood pressure, anxiety, a weakened immune system, and fatigue, among others.

In addition, although the novel coronavirus attacks every part of the body from the brain to the toes, it typically first makes its presence known with difficulty breathing. And those who experience lingering effects from its infection also complain of long-term breathing problems.

So our concierge doctors thought we’d offer a primer on correct breathing. Not only will this improve many aspects of your life, but it will also help strengthen your lungs before you contract the virus and assist in recovery afterward. It can also help relieve the anxiety so many of us are experiencing now during the pandemic.

Retrain your breathing habit

Babies breathe right naturally, but by the time we’re adults, we’ve been trained out of it. Between tight clothing, Spanx, or belts and constant admonitions to “suck in that belly,” shallow breathing becomes an unfortunate habit as we grow older.

Add to that the tendency to breathe quickly from the top of our lungs whenever we’re stressed, and you have a recipe for a cycle of more chest breathing. This creates more stress, leads to more chest breathing, more anxiety and so on.

Poor breathing habits disrupt the balance of oxygen and carbon dioxide in the blood. This tricks the body into thinking it’s constantly under attack: the so-called “fight or flight” mode.

Other symptoms of bad breathing can include:

  • frequent sighing or yawning
  • repeated throat clearing
  • lack of concentration
  • fatigue bordering on exhaustion
  • chest tightness
  • tingling in hands, lips, or feet
  • insomnia and disturbed sleep, including nightmares
  • cold hands and/or feet due to poor blood circulation
  • shortness of breath
  • headaches
  • panic attacks

If you are experiencing any of the above symptoms, be sure to let us know. They could signal a serious issue, but it’s possible they’re due simply to bad breathing.

Conversely, breathing from the abdomen, like we do as babies, can:

  • strengthen lungs
  • improve sleep
  • lower blood pressure
  • increase energy
  • aid weight loss
  • lower stress
  • improve digestion
  • improve symptoms of chronic obstructive pulmonary disorder (COPD)
  • strengthen the immune system

Are you breathing correctly?

To see whether you’re breathing correctly, place one hand on your chest and the other on your abdomen. Now take a deep breath. If you’re doing it right, the hand on your belly will rise, while the hand on your chest will barely move.

If you’re breathing incorrectly, the above exercise practiced three times daily will help to retrain your breathing. In addition, you can do it in the car, while waiting in line, watching TV, surfing the Internet, and—especially—at night in bed to help you fall asleep.

Be sure to always breathe in through your nose. Breathing from the mouth tends to encourage shallow breathing. In addition, breathing through your nose allows the cilia in your nasal passages to do their job. They protect you from invading viruses and bacteria.

Pre- and post-coronavirus exercises

If you should contract COVID-19, breath training can help boost the power of your lungs to fight off the illness. Many of those who have been infected find themselves struggling to relieve the congestion that settles in the lower part of this lungs with this disease.

Once you’re comfortable with belly breathing, practice the 4-7-8 technique three times daily for at least two minutes: Inhale (through the nose) to the count of four, hold it to the count of seven, and exhale (through the mouth) to the count of eight. If your lungs are so out of shape that these counts are difficult, lower them at first until you can work your way up to the 4-7-8 sequence.

As you learn to breathe correctly, you should find yourself with more energy during the day and more restful sleep at night.

And if you have contracted coronavirus, the following exercise has been touted by numerous survivors of COVID-19, including TV broadcaster Chris Cuomo and author J.K. Rowling. Developed by a British doctor, Sarfaraz Munshi of Queen’s Hospital in London, they can help the lower part of the lungs to expand and expel mucus. It’s a 5-5-5 twist on the 4-7-8 technique, followed by a strong cough at the end.

Munshi recommends beginning this exercise as early in the infection as possible and performing it five times daily.

Breath in for five seconds, hold for five seconds, then release for five seconds. Do this five times, then once more and cough strongly at the end of the release. Repeat this cycle twice.

The deep breathing followed by a cough helps release the mucus trapped in the lower lungs, a typical complaint of those who have COVID-19.

Finally, lie on your stomach taking slightly deeper breaths than normal for ten minutes. This position, called “proning,” has been used successfully in many hospitals to help coronavirus patients improve lung drainage and breathe more easily.

If you have any questions about proper breathing or COVID-19 recovery, please let us know.

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