Why is Elderly Nutrition So Important?

, , , , , , , , Healthy Living, Lifestyle, Nutrition, Preventative Health

If our primary care concierge doctors in Jupiter could choose the most important thing for elderly care, it would be nutrition. Elderly nutrition is crucial because as we age, our bodies undergo changes that make it more challenging to obtain the nutrients we need to stay healthy.  

Older Age Means More Changes

As we age, our metabolism slows down, our digestive system becomes less efficient, and our senses of taste and smell may diminish, which leads to a reduced appetite and a decreased interest in eating.

Additionally, older adults are more likely to have chronic health conditions such as diabetes, high blood pressure, and osteoporosis, which can all be affected by diet. Proper nutrition can help manage these conditions, prevent complications, and improve overall quality of life.

Get the Good Stuff

Good nutrition is essential for maintaining muscle mass and bone density, which can help prevent falls and fractures. A balanced diet that includes adequate protein, calcium, and vitamin D is crucial for older adults to maintain strong bones and muscles.

Elderly nutrition is essential for several reasons:

  1. Health: Proper nutrition is essential for maintaining good health, especially as we age. A balanced diet that includes a variety of foods from all food groups helps to provide the necessary nutrients for good health, such as vitamins, minerals, and fiber.
  2. Chronic Diseases: Good nutrition can help prevent or manage chronic diseases such as heart disease, diabetes, and osteoporosis, which are more common in older adults.
  3. Immune System: Adequate nutrition is crucial for maintaining a healthy immune system, which can help protect against infectious diseases and illnesses.
  4. Mental health: Good nutrition impacts mental health, such as reducing the risk of depression and cognitive decline.
  5. Quality of Life: Proper nutrition can improve the quality of life for older adults by increasing energy levels, maintaining a healthy weight, and improving overall physical and mental well-being.

Overall, elderly nutrition is essential for maintaining good health, preventing chronic diseases, and improving the quality of life in older adults. 

Learn About this Devastating Mental Disease and How to Stay Ahead

, , , , Concierge Medicine, Health Basics, Healthy Living, Preventative Health

Alzheimer’s disease is a neurodegenerative disorder that affects the brain, causing progressive cognitive decline, memory loss, and behavioral changes. It is the most common cause of dementia and is characterized by the accumulation of abnormal proteins in the brain.


June is recognized as Alzheimer’s and Brain Awareness Month, a time to raise awareness about this devastating disease and to support those who are affected by it. Our concierge primary care doctors in Jupiter want to discuss some important facts about Alzheimer’s disease, as well as tips for maintaining brain health and reducing your risk of developing the disease.

Facts about Alzheimer’s disease:

  • Alzheimer’s disease affects more than 6 million people in the United States, and that number is expected to triple by 2060.
  • There is no cure for Alzheimer’s disease, but early detection and intervention can help manage symptoms and improve quality of life.
  • Alzheimer’s disease is more common in older adults, but it can also affect younger people.
  • Genetics, lifestyle factors, and environmental factors may all play a role in the development of Alzheimer’s disease.
  • There are several different types of dementia, and Alzheimer’s disease is just one of them.

Tips for maintaining brain health:

  • Stay physically active: Regular exercise can help improve blood flow to the brain and promote the growth of new brain cells.
  • Eat a healthy diet: A diet rich in fruits, vegetables, whole grains, and lean protein can help support brain health.
  • Stay mentally active: Engage in activities that challenge your brain, such as puzzles, reading, or learning a new skill.
  • Stay socially connected: Social interaction can help reduce the risk of cognitive decline.
  • Manage chronic health conditions: Conditions such as high blood pressure, diabetes, and obesity can increase the risk of developing Alzheimer’s disease, so it’s important to manage these conditions through lifestyle changes and/or medication.

In conclusion, Alzheimer’s disease is a complex and devastating condition that affects millions of people worldwide. By raising awareness and taking steps to maintain brain health, we can work to reduce the impact of this disease and improve the quality of life for those affected by it.

Surprising Facts About Skin Cancer

, Concierge Medicine, Health Basics, Healthy Living, Preventative Health

You may think you already know everything about skin cancer. But because May is Skin Cancer Awareness Month, our concierge primary care doctors in Jupiter want to share some facts about this often-deadly disease that you may not be aware of.

Brief Skin Cancer Recap

Let’s start with some facts about skin cancer you may already know:

  • Basal cell carcinoma is the most common form of skin cancer, followed by squamous cell carcinoma. Both can easily be cured if caught in time, but they can be disfiguring and expensive to treat.
  • Malignant melanoma is the most deadly type of skin cancer. It represents only about three percent of all skin cancers diagnosed but is responsible for the most deaths. That’s because of its tendency to spread to other parts of the body, including vital organs. But when diagnosed early, its five-year survival rate is 99 percent.
  • The most preventable cause of skin cancer is exposure to ultraviolet (UV) light, either from the sun or from artificial sources like tanning beds.
  • About 90 percent of non-melanoma skin cancers and 85 percent of melanoma cases are associated with exposure to UV radiation.
  • One bad sunburn in childhood doubles the risk for melanoma later in life. Having five or more sunburns doubles your risk for melanoma. A single indoor tanning session increases your risk of melanoma by 20 percent.
  • Even if it’s cool and cloudy, you still need protection, because ultraviolet (UV) light can penetrate clouds.

Odd Skin Cancer Facts

There are other facts about skin cancer that you might never have heard before.

1. For example, did you know that more men than women die of melanoma? The American Academy of Dermatology (AAD) says that one reason may be that men know less than women about skin cancer and that they use sunscreen less than women do.

Men’s skin is also more prone to penetration by UV rays than women’s because they have thicker skin with less fat beneath. A man’s skin also contains more collagen and elastin, making men’s skin more likely to be damaged by UV light.

2. On the other hand, one study found a greater association between white wine consumption and a higher risk of melanoma in women. Those who drink a glass of white wine each day showed a 13 percent increased risk of invasive melanoma (meaning it’s gone deeper than the top layer of skin), while those who drank the most white wine had an increased risk of 50 percent or higher than those who don’t drink any alcohol.

3. UV rays can penetrate glass in windows, both at home and in the car. This helps explain why left-sided facial cancers, especially in men, are more common. It’s all about the position we drive in, with the left side of the body exposed to more UV light. Windshields are treated to block UV rays, but side, back and sunroof windows aren’t. Also, be aware that UV rays can not only penetrate glass, but also can “bounce” under beach umbrellas and reflect off of concrete surfaces.

4. It’s extremely rare for a mole to transform into a melanoma, according to Dr. Ashfaq Marghoob, a dermatologist with the Memorial Sloan Kettering Cancer Center. While melanoma can develop in a preexisting mole, nearly 70 percent do not. At the same time, the presence of many moles can identify those who are at an increased risk for developing melanoma somewhere else on their skin.

That’s why it’s important to apply sunscreen to all parts of the body.

“Some people use sunblock only where they have moles because they think the moles themselves are dangerous,” he says.

5. Caffeine may protect against skin cancer. One study found that women who drank more than three cups of coffee daily were 21 percent less likely to develop basal cell carcinoma (BCC), the most common type of skin cancer. Men were 10 percent less likely to develop BCC.

6. Melanomas are not necessarily brown. Some have no color or are pink or appear as simple bumps on the skin. That’s why it’s important not to try to diagnose skin cancer on your own.

“Be aware of isolated or pink spots, especially if the spot looks different than any other marks on the skin,” Marghoob says. “Pay attention to any spot or mark that has an uneven texture, shape, border, or distribution of colors,” he added. “In addition, any spot that has changed in some way should prompt a visit to your doctor.”

Avoiding Skin Cancer

To avoid getting skin cancer, the most common cancer in the U.S. and around the world, the AAD recommends these steps.

  • Seek shade. The sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow appears to be shorter than you are, stay in the shade as much as possible.
  • Wear sun-protective clothing, such as a lightweight long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses with UV protection. For more effective protection, choose clothing with an ultraviolet protection factor (UPF) number on the label.
  • Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing. Broad-spectrum sunscreen provides protection from both UVA and UVB rays.

If you have any questions about how to protect yourself from the sun or notice new or suspicious spots on your skin or any spots that are changing, itching, or bleeding, let us know.

Is Exercise Better Than Drugs for Mental Health?

, , , , , Concierge Medicine, Health Basics, Healthy Living, Lifestyle, Preventative Health, Uncategorized

If our primary care concierge doctors in Jupiter could prescribe a single treatment for a host of different health concerns, it would be exercise.

For example, one study published in the journal BMJ compared exercise alone versus drug therapy alone and found that for heart disease, diabetes control or prevention, stroke rehabilitation, and treatment of heart failure, regular physical exercise was just as effective as prescription medications in treating many of these conditions.

And according to the Mayo Clinic, some of the disorders that benefit from regular exercise include:

  • Heart disease – In addition to strengthening the heart muscle and lowering blood pressure, exercise can help you be more active without experiencing chest pain or other symptoms.
  • Diabetes – Regular exercise can not only help insulin more effectively lower your blood sugar level, but also help control weight and boost energy.
  • Asthma – Exercise has been shown to control the frequency and severity of asthma attacks.
  • Back pain – Regular low-impact aerobic exercise can help increase the strength of your back muscles and improve endurance and muscle function.
  • Arthritis – Exercise is the primary approach to reduce pain, help maintain muscle strength in affected joints and reduce joint stiffness.

What About the Brain?

It makes sense, then, that the benefits of exercise would also impact the brain.

And that’s just what a new study, published in February in the British Journal of Sports Medicine, revealed. Researchers from the University of South Australia correlated data from 1,039 studies involving more than 128,000 volunteers.

They found that physical activity was 1.5 times more effective for managing depression than either counseling or the leading medications typically prescribed for the disease.

The review showed that exercise interventions that were 12 weeks or shorter were the most effective at reducing mental health symptoms, showing how quickly physical activity can make a difference, Science Daily reported.

“Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations,” lead researcher Dr. Ben Singh said in a statement.

“We also found that all types of physical activity and exercise were beneficial, including aerobic exercises such as walking, resistance, training, Pilates, and yoga,” he said. 

“Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”

Even a Little Bit Helps

This last finding is important because one of the hallmarks of depression is a lack of energy. So asking them to engage in the Centers for Disease Control and Prevention’s (CDC) recommendation of 150 minutes of moderate physical activity every week is akin to asking them to climb a mountain with a broken leg.

Another study, published this month in the journal JAMA Psychiatry, offers similar reassurance that any regular movement can make a difference.

For this study, the researchers looked at 15 studies involving more than 190,000 subjects.

They found that people who engaged in brisk walking for a total of 2.5 hours a week had a lower risk of depression than those who didn’t exercise at all. 

“Most benefits are realized when moving from no activity to at least some,” the study authors wrote. 

“Our findings, therefore, have important new implications for health practitioners making lifestyle recommendations, especially to inactive individuals who may perceive the currently recommended target [of 2.5 hours a week] as unrealistic,” they added.

How Does it Work?

There are several reasons exercise has such a positive effect on depression and anxiety, according to Dr. Antonia Baum, an assistant clinical professor of psychiatry and behavioral sciences at George Washington University, who was not involved in these studies.

It can improve blood circulation to the brain and have a positive impact on inflammation and the body’s immune response, she told U.S. News, noting the connection between heart health and depression. There may also be intangible benefits such as getting stronger or feeling empowered or gaining a sense of well-being.

Yet another recent meta-review of 41 studies involving 2,265 people with depression found that almost any type of exercise substantially reduces symptoms of depression, The Washington Post reported.

“We found large, significant results,” said study leader Andreas Heissel, an exercise scientist at the University of Potsdam in Germany.

Although more exercise produced greater results, “Something is better than nothing,” Heissel noted.

Small Moves

Jennifer Heisz, a neuroscientist and an associate professor in the Department of Kinesiology at McMaster University in Ontario, Canada, who was not involved in these studies, was even more encouraging.

“Any movement, every movement, every step counts,” she told U.S. News.

“It doesn’t have to be as much as you need for physical health,” she added. “You can get by with half of that, and this is very consistent with the literature.”

Heisz suggested that people try to move a little every day, even if it’s just a five- or 10-minute walk, or a two-minute movement break every half hour for those who sit all day.

“That’s how simple we need to get, especially for people who are not moving at all, and to acknowledge that there is this additional barrier of motivation for people who are suffering from depression,” she said.

One final word: It’s important not to try to treat depression yourself. We can help guide you through different approaches or even recommend other professionals that can help.

If you have thoughts of harming yourself, dial or text the new national suicide hotline number 988 for immediate help.

We’re Still Consuming Too Much Salt, WHO Warns

Nutrition, Preventative Health

Our concierge primary care doctors in Jupiter often caution our patients about their salt intake, but now a new report from the World Health Organization (WHO) appears to lend new weight to that advice.

Unless governments act to restrict the salt content in our food, seven million people will die unnecessarily from diseases linked to excessive salt consumption, the WHO warned last month.

“Unhealthy diets are a leading cause of death and disease globally, and excessive sodium intake is one of the main culprits,” WHO Director-General Dr. Tedros Adhanom Ghebreysesus said in a statement.

“This report shows that most countries are yet to adopt any mandatory sodium reduction policies, leaving their people at risk of heart attack, stroke, and other health problems,” he added.

The Damage Salt Does

“Excessive sodium intake is the top risk factor for an unhealthy diet, and it is responsible for 1.8 million deaths each year,” Francesco Branca, director of the WHO’s Department of Nutrition for Health and Development, explained.

“This is really something that doesn’t cost money to anybody,” he said. “It’s a simple intervention, but it’s incredibly effective.”

Science has known for decades that too much salt is harmful.

The American Heart Association (AHA) says, “[T]he science behind sodium reduction is clear. Significant evidence links excess sodium intake with high blood pressure, which increases the risk of heart attack, stroke, and heart failure.”

“Sodium,” by the way, is not the same as salt. Salt, or sodium chloride, is a crystal-like compound that is abundant in nature. Sodium is a mineral, and one of the chemical elements found in salt. Nevertheless, most people tend to use the two words interchangeably.

“If you retain more salt in the body, it slowly puts up the blood pressure,” Graham MacGregor, a professor of cardiovascular medicine at the Queen Mary University of London, told The Washington Post.

“That raised blood pressure then causes strokes, heart attacks, or heart failure,” he explained. MacGregor was not involved in the study, but campaigns in favor of reducing salt intake.

History of Salt

Humans have used salt since ancient times, to preserve food as well as to flavor it. Cities around the world sprang up near sources of salt, according to Wikipedia.

But we’re getting too much of a good thing. The average American today consumes 55 percent more salt than in 1980, large thanks to the proliferation of processed foods.

When food began to be mass-produced, manufacturers quickly discovered that salt not only preserved their products longer and enhanced the flavor of less-flavorful foods, but also caused consumers to crave more of it.

At least one 2016 study on mice by Australian researchers appeared to identify the opioid system in the central amygdala region of the brain as the mechanism linked to our addiction to salt, the same pathway responsible for our addiction to drugs.

“It wasn’t until now known that our natural opioids working in this emotional hotspot drove salt cravings,” neuroscientist Craig Smith of the Florey and Deakin University, told the Sydney Morning Herald.

So salt begets a desire for more salt, and manufacturers are happy to comply. It’s far cheaper to add loads of salt to a product than to use more expensive herbs and spices. 

The Scoop on Salt

There’s no denying that we need a certain amount of salt to live. To maintain bodily functions, we require approximately 500 milligrams per day.

Moderate amounts of sodium also help maintain the extracellular fluid necessary for the cells’ function. Without adequate sodium, the body’s fluids would dehydrate, resulting in low blood pressure and death.

The current dietary guidelines recommend 2,300 milligrams of sodium per day. The AHA recommends even less (about 1,500 milligrams) for those at risk of heart disease. This includes adults ages 51 and older, Blacks, and those with high blood pressure, diabetes, or chronic kidney disease.

Most Americans, however, consume an average of 3,400 milligrams of sodium per day.

According to the U.S. Food and Drug Administration (FDA), sodium attracts water, and a high-sodium diet draws water into the bloodstream, thus increasing the volume of blood and subsequently your blood pressure.

Over time, high blood pressure (hypertension) injures blood pressure walls, leading to the build-up of plaque that blocks blood flow. Because hypertension causes the heart to work too hard, the high force of blood flow can harm arteries and organs throughout the body (heart, kidneys, brain, and eyes).

How to Cut Back

According to the AHA, more than 70 percent of the sodium we consume comes from packaged and restaurant foods.

“That can make it hard to control how much sodium you eat because it’s added to your food before you buy it,” the organization says.

Nevertheless, there are things you can do:

  • Compare labels, looking for the lowest amount of sodium you can find.
  • Pick fresh and frozen poultry that hasn’t been injected with a sodium solution.
  • Opt for canned vegetables labeled “no salt added” and frozen vegetables without salty sauces.
  • Drain and rinse canned beans and vegetables.
  • Cook pasta, rice, and hot cereal without salt.
  • At restaurants, ask for your dish to be made without extra salt.

One final tip: Incorporate foods with potassium like sweet potatoes, potatoes, greens, tomatoes and lower-sodium tomato sauce, white beans, kidney beans, nonfat yogurt, oranges, bananas, and cantaloupe. Potassium helps counter the effects of sodium and may help lower your blood pressure.

Zero-Calorie Sweetener Linked to Heart Attacks, Strokes

Concierge Medicine, Health Basics, Medications, Nutrition, Preventative Health

You may have heard the expression, “There ain’t no such thing as a free lunch.” It means that few things are actually free; there’s often a hidden cost to “freebies.”

Our concierge primary care doctors in Jupiter were reminded of that saying when we heard the results of a new study on the sugar substitute erythritol, popular in keto diets, which suggested it can cause an increase in strokes and heart attacks.

The Study

Researchers from the Cleveland Clinic evaluated more than 4,000 Americans and Europeans who were being evaluated for heart disease. The results, published last month in the journal Nature Medicine, showed that those with the highest blood concentration of the artificial sweetener erythritol were at an increased risk of heart attack or stroke in the following three years.

The researchers examined the subjects’ blood platelets—the type of blood cell that sticks together to form blood clots—and found those with the highest level of erythritol showed increased platelet activity, thereby encouraging the greater formation of clots. Clots in the bloodstream have the potential to cause heart attacks or strokes when they block the normal flow of blood.

The researchers also injected mice with erythritol and found that clots formed more quickly after an injury than those who had been injected with saline.

Finally, they took blood samples from subjects who had consumed an erythritol-sweetened drink and found levels of the sweetener remained high for two days.

“Every way we looked at it, it kept showing the same signal,” Stanley Hazen, a cardiologist at the Cleveland Clinic, who also directs the Cleveland Clinic’s Center for Microbiome and Human Health, told The New York Times.

“People are trying to do something healthy for themselves but inadvertently may be doing harm,” he told the paper.

About Erythritol

Erythritol is a sugar alcohol like xylitol and sorbitol and is found naturally in many fruits, vegetables, and fermented foods. It is also manufactured artificially for use in food products.

It has become more popular than earlier types of artificial sweeteners because it has no lingering aftertaste, doesn’t spike blood sugar, and doesn’t cause the laxative effect common with other such additives.

USA Today reports that it is added to many processed foods and beverages and is commonly found in products aimed at those on the keto diet because it does not affect blood glucose. It is also an ingredient in the sweetener Truvia.

“Erythritol looks like sugar, it tastes like sugar, and you can bake with it,” Hazen told CNN.

“It’s become the sweetheart of the food industry, an extremely popular additive to keto and other low-carb products and foods marketed to people with diabetes,” he added.

The U.S. Food and Drug Administration (FDA) lists erythritol as generally recognized as safe or GRAS. Therefore, it is not required to be listed on a product’s ingredient list, according to Hazen. The label might simply say, “artificially sweetened with natural products,” or “zero sugar.”

Other Research

Robert Rankin, executive director of the Calorie Control Council, an association representing the low- and reduced-calorie food and beverage industry, told USA Today that the people in the study were at higher risk for cardiovascular disease (CVD), so the results shouldn’t be applied to the general population.

“The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe,” he said.

But other studies have raised the question about the safety of erythritol.

For example, Karsten Hiller, a biochemist, and specialist in human metabolism at the Braunschweig Institute of Technology in Germany published a paper in 2017 showing that Cornell University freshmen whose blood contained high levels of erythritol gained more weight than students with low levels, the USA Today reported. Which kind of defeats the purpose of using an artificial sweetener.

“Science needs to take a deeper dive into erythritol and in a hurry, because this substance is widely available right now,” Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, told CNN. Freeman was not involved in Hazen’s research.

Hazen agreed.

“I normally don’t get up on a pedestal and sound the alarm,” he told CNN.

“But this is something that I think we need to be looking at carefully,” he added.

Eating Healthier

Artificial sweeteners in general have been called into question by numerous studies. For example, a 2020 study by a group of Yale researchers found that those who used the artificial sweetener sucralose (found in the brand names Splenda, Zerocal, and others) can result in high blood sugar levels in the blood. The Washington Post reports that sucralose is found in thousands of consumer-packaged goods such as baked goods, yogurt, canned soups, condiments, and syrups.

Another study at the Weizmann Institute of Science last year looked at what happened to subjects who consumed aspartame, saccharine, stevia, or sucralose in amounts well below the FDA’s daily allowances. The researchers found that these sweeteners caused changes in both the function and composition of the participants’ gut microbiomes, the communities of bacteria, viruses, and fungi that live in the intestines, The Post reported.

There’s no question that artificial sweeteners are hard to avoid these days. And we keep trying to have our sugar without paying the price.

But for the sake of your long-term health, we recommend sticking as closely as possible to fresh, natural, unprocessed foods and beverages.

Best Ways to Treat Lower Back Pain

, Health Basics, Healthy Living, Lifestyle, Preventative Health

Whatever the cause of your low back pain—lifting your child, the wrong tennis move, or (often) no reason you can recall—what you want is relief: now!

Our concierge primary care doctors in Jupiter understand because we’ve been there. In fact, it’s estimated that at some point in our lives, 80 percent of us will seek medical attention for that searing pain that flares every time we move.

So we were pleased to learn of a new study that looked at the best medications for treating lower back pain. And there are other ways to treat the pain without drugs, which we’ll explore below.

The Latest Research

The study, published last month in the Journal of Orthopaedic Research, found that the best medications for acute lower back pain was a combination of a non-steroidal anti-inflammatory NSAID) drug and a prescription muscle relaxant. Acute lower back pain is defined as pain that lasts no longer than 12 weeks; chronic back pain lasts longer.

Researchers reviewed 18 randomized clinical trials that looked at various analgesics, including aspirin, acetaminophen, and NSAIDs (ibuprofen, naproxen, and celecoxib). The NSAID/muscle relaxer combination relieved pain and disability the fastest, often within one week.

The main drawback, of course, is that muscle relaxants—which actually tend to relax the whole body rather than just muscles—cause sleepiness, meaning they can’t be taken while driving or trying to function normally throughout the day.

And—as with all drugs, whether over-the-counter (OTC) or prescription—each drug comes with the possibility of side effects, including indigestion, dizziness, liver damage, and internal bleeding, among other risks.

Harvard Health Publishing notes that other drug treatments are also available for those whose pain isn’t helped by analgesics, or becomes more severe.

This includes opioids as a last resort, which are generally safe when taken for a short period and monitored by a doctor.

Certain antidepressants can also be prescribed off-label to treat pain, even if the person is not depressed.

Non-drug Approaches

Because of the risks associated with drug therapy, many people look to alternative methods to help relieve their pain.

Matthew Solan, the executive editor of Harvard Men’s Health Watch, mentions several options.

Cold and heat therapies can work by starting with ice packs immediately following the onset of pain to reduce swelling, followed by a heating pad or a hot-water bottle to relax muscles and increase blood flow.

Limited bed rest, although recently fallen out of favor as the preferred treatment for back pain, can still be helpful if the pain is so severe that it hurts to sit or stand. Try to limit it to a few hours at a time, however, and for no more than one or two days. 

Physical activity can not only help build strong muscles that are less prone to injury but can also help the healing process.

Complementary therapies, often thought of as “woo-woo nonsense,” have been shown to offer relief in many cases. They include:

  • acupuncture, in which needles inserted in precise points on the body are said to release blocked energy suspected of causing pain
  • spinal manipulation, in which chiropractors apply pressure to the body to correct spinal alignment
  • therapeutic massage to relax aching muscles
  • movement therapies such as yoga and tai chi

Another Non-traditional Approach

Nearly 40 years ago, the late back pain physician John Sarno proposed an entirely different approach to treating chronic lower back pain, and eventually pain of all sorts. He claimed that much of the pain was caused by the brain trying to repress unwanted or frightening emotions and that once this was acknowledged, the pain would resolve on its own.

This is a vast oversimplification of his theory, of course, and over the years has been vehemently rejected by pain sufferers who thought he was saying their pain was “all in the head,” which was not his message. Anyone who is familiar with the concept of mind-body medicine will understand the connection between the brain and what happens in the body.

Although the medical community has been slow to warm up to Sarno’s approach, two recent studies tend to lend credence to his theory.

One, published in the journal JAMA Psychiatry in 2021, was a randomized, controlled trial of 151 patients using an approach based on Sarno’s work: “pain reprocessing therapy,” or PRT, which taught patients to reinterpret their pain as a neutral signal from the brain. Researchers found that 98 percent of participants had at least some relief from their pain; 66 percent were nearly or fully pain-free, compared with 10 percent of the control group.

Another study, published the same year, found similar results to Sarno’s approach.

If you’re interested in pursuing this form of treatment, Sarno’s books are readily available online. Although he offered in-person counseling when he was alive, he also claimed that simply reading his books, which explained the theories behind his treatment, worked for many. 

A Final Word

Finally, if you have persistent or severe lower back pain, it’s important that you let us know because it could be a symptom of something serious.

Dr. Akhil Chhtre, who specializes in back pain at the Johns Hopkins Department of Physical Medicine and Rehabilitation, cautions that “in some cases, pain is your body’s way of telling you that something isn’t right.”

He says it could be sciatica, kidney pain, or even cancer (especially prostate cancer). So it’s important to have persistent lower back pain checked. 

Live Longer with Blue Zone Foods

Environment, Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health, Uncategorized

Of all the diet trends available today, one our primary care concierge doctors in Jupiter can highly recommend is the Blue Zone way of eating: fresh, healthy, unprocessed food, from as close to its source as possible, in meals shared with family and friends.

The term “Blue Zone” was coined nearly 20 years ago by journalist and researcher Dan Buettner in a 2005 National Geographic cover story titled, “Secrets of Living Longer.”

His team of anthropologists, demographers, and scientists had traveled the world to find the world’s longest-living people, and to discover the secrets to their longevity.

Buettner’s team found five seemingly disparate places where the people live exceptionally long, healthy lives: on average, around 100. (The term “blue zone” came from the blue circles the researchers drew on a map during their quest.)

The five places are:

Okinawa, Japan
the Nicoyan Peninsula in Costa Rica
the Seventh Day Adventists in Loma Linda, California
Sardinia, Italy
Ikaria, Greece

More than Diet

Of course, healthy eating is key to a healthy body, but the Blue Zone residents had more than good food on their side. Genetics, as always, plays a big role in how long anyone will live no matter where they are.

Other factors the team found the Blue Zones had in common were:

Natural movement: no marathons or gym visits, just long walks, hiking, gardening, etc.
Hara Hachi Bu: an Okinawan term for eating until they’re about 80 percent full
Plant slant: a preference for plant foods over meat
Grapes of Life: one to two servings of red wine daily (except for the Seventh Day Adventists, who eschew alcohol)
Plan de Vida: or “why I wake up in the morning,” i.e., a sense of purpose
Downshift: controlling stress, a sense of serenity
Belong: participation in a spiritual community
Loved ones first: making family a priority
Close tribe: social connectedness

Blue Zone Meals

The Blue Zone diet, which Buettner details in his latest book, “The Blue Zones American Kitchen: 100 Recipes to Live to 100,” is a cornerstone of the Blue Zone program, and closely resembles the Mediterranean diet, but with even less emphasis on fish and meat.

“The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts, and beans. In fact, I argue the cornerstone of a longevity diet is beans,” he told CNN.

Legumes, in fact, are key, he told The Washington Post. They are rich in fiber, which is key to improving cholesterol and blood sugar levels.

“Figure out how to get a cup of beans into your diet every day,” he told the paper. “Just one cup gives you half of all the daily fiber you need.”

What Not to Eat

And even though the Mediterranean diet includes a certain amount of meat and fish, Blue Zone diets contain little, if any.

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only three ounces,” he told CNN. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.”

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino, he said.

In addition, “no more than three eggs are consumed per week,” he told NBC’s Today show.

“The Blue Zone eating pattern is 98 percent plant-based foods—whole food-based and high carbohydrate,” Buettner told CNN.

“But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop. You say carbohydrates and people are horrified, but the healthiest foods in our food system are complex carbohydrates,” he added.

Time and Place Count, too

In keeping with the other factors that affect longevity, sharing meals—especially with family—is another component. While our busy schedules might not often permit this, Buettner says it’s worth doing as often as possible.

“Families that eat together tend to each much more nutritiously, they eat slower, and there’s good research that children have fewer issues with disordered eating if they’re eating socially,” he told The Post.

And it turns out the recent trend toward intermittent fasting appears to have some validity. Buettner reports that people in Blue Zones tend to eat earlier in the day.

Okinawans, for instance, traditionally eat a big breakfast and a moderate lunch.

“They don’t even have dinner,” he told the paper.

And the Seventh Day Adventists in Loma Linda would eat a big breakfast at 10 a.m. and a moderate lunch at 4 p.m. “And then they’re done for the day,” he said.

Small Moves

Of course, there’s more to the Blue Zone lifestyle than just food, as we mentioned earlier. Three of the five Blue Zones are isolated, which forces tight social connections and a lot of walking.

“Walking is one of the best forms of exercise and you can do it without thinking about it,” Buettner told Today, suggesting that people think about adopting a dog as a strategy to encourage regular walks.

“We’re all looking for magic dietary pills or serums or supplements, but you see none of that in the Blue Zones,” he said. “It’s mostly small things driven by the right environment,” he said.

That includes social connections.

“We’re genetically hardwired to crave social interaction, and when you don’t have it, there’s a level of subconscious stress that grates away at you,” he added.

Here’s to Your Heart Health

, , , Disease, Health Basics, Healthy Living, Nutrition, Preventative Health

In recognition of American Heart Month in February, our primary care concierge doctors in Jupiter thought we’d share some facts with you about your heart, and what you can do to keep it healthy.

Surprising Heart Facts

First, from the Cleveland Clinic, here are a few interesting things you may not know about your heart.

Your heart is about the size of your two hands clasped together.
It beats 100,000 times a day.
The beating sound is the clap of valve leaflets opening and closing.
A woman’s average heartbeat is faster than a man’s by almost eight beats a minute.
Every cell in your body gets blood from your heart, except for your corneas.
The heart pumps blood through 60,000 miles of blood vessels.
A normal heart pumps approximately four tablespoons of blood with each beat.
Each minute, your heart pumps 1.5 gallons of blood.
Your heart has its own electrical supply and will continue to beat when separated from your body.
Heart cancer is very rare because heart cells stop dividing early in life.

About Heart Disease

Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S. About 697,000 people in the U.S. died from heart disease in 2020 (the most recent figures available). And every year about 805,000 people in the U.S. have a heart attack; over 600,000 of those are first heart attacks.

According to the Centers for Disease Control and Prevention (CDC), the term “heart disease” refers to several types of heart conditions.

The most common type of heart disease in the U.S. is coronary artery disease (CAD), which affects blood flow to the heart. Decreased blood flow can cause a heart attack. In 2020, about 20 percent of deaths from CAD occurred in adults below the age of 65, known as an “early cardiac event.”

Common Symptoms of Heart Disease Include:

Heart attack: chest pain or discomfort, upper back or neck pain, pain in the jaw or throat, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, a cold sweat, and shortness of breath
Arrhythmia: fluttering feelings in the chest (palpitations)
Heart failure: shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins

The Cleveland Clinic’s Dr. Curtis Rimmerman, a cardiologist, emphasizes that symptoms of a heart attack can vary widely, but adds that the discomfort is usually unrelenting, typically lasting five minutes or more.

“Regardless of where the pain is, people typically can’t find a position that relieves the pain,” he says. “Nor do they find relief by taking a drink of water, popping antacids or taking deep breaths.”

That means it’s time to call 911, he adds.

Increasing Risk

Unfortunately, about one in every five heart attacks are “silent”—that is, the damage is done, but the person is not aware of it.

That’s why it’s important to know your risk factors and what you can do about them.

About half of all Americans (47 percent) have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

In addition, several other medical conditions and lifestyle choices also put people at a higher risk for heart disease, the CDC reports, including:

diabetes
overweight and obesity
unhealthy diet
physical inactivity
excessive alcohol use

In addition, a 2021 study published in the journal Heart found that those who used illicit substances, including amphetamines, cocaine, and cannabis, were far more likely to experience an early cardiac event than those who didn’t.

And another study, published in the Journal of the American Heart Association (AHA) in 2020, found that the chances of developing cardiovascular disease (CVD) were 19 times higher in women who consumed one or more sugary drinks a day. This included everything from fruit juices to soft drinks (not diet) to coffee with sugar.

Lowering Risk

Some risk factors cannot be controlled, such as age or family history of heart disease, but you can take steps to lower your risk by changing the factors you can control.

Have your blood pressure, cholesterol, and triglycerides checked regularly.
Ask us whether you should be tested for diabetes.
Quit smoking.
Limit the alcohol you consume to one drink a day.
Learn how to manage stress levels by finding healthy ways to cope with stressful events.

In addition, there are two other ways that have been shown to dramatically reduce your risk for heart disease.

The first is exercise. According to the Cleveland Clinic, regular moderate-intensity exercise for at least 150 minutes is the single most important—and free—key to heart health.

The second is diet, specifically a plant-based diet. This doesn’t necessarily mean going totally vegetarian, just making plant foods vs. animal foods the main component of your diet.

“I’ve seen people whose diabetes, angina, or blood pressure goes into remission [on a plant-based diet],” Andrew Freeman, a cardiologist and the co-founder of the Nutrition and Lifestyle Work Group at the American College of Cardiology, told The Washington Post.

“I’ve seen autoimmune diseases go away when you cut inflammation,” he said. “The best way to do that is with a plant-based diet, and people get better.”

Is a Neti Pot Right for You?

, , Health Basics, Healthy Living, Lifestyle, Preventative Health

Because our concierge primary care doctors in Jupiter have been receiving more questions about the effectiveness of Neti pots for various sinus conditions, we thought we’d take some time to explore their usefulness—and to reiterate a special warning about their use.

What is a neti pot?

Neti pots are one type of nasal irrigation device that use a saline or saltwater solution to treat congested sinuses, colds, allergies, and congestion from flu and COVID-19.

These devices include the teapot-looking container that originated with Ayurvedic medicine in India, along with bulb syringes, squeeze bottles, and more expensive motorized pulsed water devices.

In general, these devices all introduce salt water (saline) into the nostrils to flush out mucus, allergens, and bacteria. The saline helps thin the mucus, making it easier to expel.

The U.S. Food and Drug Administration (FDA) says that such saline rinsing “can remove dust, pollen, and other debris, as well as help to loosen thick mucus. It can also help relieve nasal symptoms of sinus infections, allergies, colds, and flu.

“Plain water can irritate your nose,” the agency says. “The saline allows the water to pass through delicate nasal membranes with little or no burning or irritation.”

How do they work?

 “There are various ways to deliver saline to the nose,” says Eric A. Mann, M.D., and Ph.D., a doctor at the FDA.

“Nasal spray bottles deliver a fine mist and might be useful for moisturizing dry nasal passages. But irrigation devices are better at flushing the nose and clearing out mucus, allergens, and bacteria,” he says.

Information that comes with each device can give more specific instructions, but in general, the FDA says they all work basically the same way:

  • Leaning over a sink, tilt your head sideways with your forehead and chin roughly level to avoid liquid flowing into your mouth.
  • Breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.
  • Clear your nostrils. Then repeat the procedure, tilting your head sideways to the other side.

While some people experience immediate relief from their symptoms, for others it may take a few days to begin breathing more freely.

And experts caution that—like oral decongestants—nasal irrigation devices are simply a treatment for a symptom, not a cure for the underlying cause.

Some Cautions

Although the FDA says that neti pots and other similar nasal irrigation devices are generally safe, they may not be right for everyone. If your immune system isn’t working properly, the agency advises checking with your healthcare provider before using any nasal irrigation system.

A few users report ear discomfort, nasal irritation, a burning or stinging sensation, and even nosebleeds. But in general, the FDA considers them safe to use, even for children aged two and up.

The most significant warning, however, concerns the type of water used in them. 

“Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated,” the FDA cautions.

“Some tap water contains low levels of organisms—such as bacteria and protozoa, including amoebas—that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections.”

They can even be deadly, the Centers for Disease Control and Prevention (CDC) reports. Since 1993, there have been at least 70 cases of “brain-eating” amoeba infections in the U.S., which are “almost uniformly fatal,” the agency reports.

Safe Use

The safety of neti pots and other such nasal irrigation devices—including the motorized versions—depends on the type of water used and how meticulously the containers are cleaned after each use.

The FDA lists the following types of water as safe to use for neti pots and similar devices:

  • Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
  • Boiled and cooled tap water—boiled for three to five minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
  • Water passes through a filter designed to trap potentially infectious organisms. The CDC has information on these filters here. 

To safely use and care for your device:

  • Wash and dry your hands.
  • Check that the device is clean and completely dry.
  • Prepare the saline rinse, either with the prepared mixture supplied with the device, or one you make yourself.
  • Follow the manufacturer’s directions for use.
  • Wash the device, and dry the inside with a paper towel or let it air dry between uses.

Does it Work?

Most people who use neti pots to relieve nasal congestion and allergies swear by them, especially if they want to avoid using over-the-counter decongestants. 

“Just about any condition that causes irritants and mucus to build up inside the nose will benefit from saltwater rinsing with a net pot or similar device,” Richard Orlandi, a nasal and sinus specialist and professor of surgery at the University of Utah Health in Salt Lake City, told Consumer Reports (CR).

“These include allergies, nonallergic nose irritation, colds, and sinus inflammation and infections,” he said.

The World Health Organization (WHO) reports that rinsing your nose with saline does not prevent COVID-19, by the way.

If saline rinsing doesn’t relieve your symptoms, or if you have a fever, nosebleeds, or headaches while using the devices, let us know.

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