January Month In Review On Healthy Answers

The Damaging Effects Of Late Night Eating

All of us are guilty of late night refrigerator raids once in a while. Sometimes a stressful day, depression, illness, working late, inability to sleep, or just plain boredom will draw us to the kitchen when we should be sleeping. Many of us eat the equivalent of a full meal in these late night scenarios, often eating more than we do in daytime meals. Both men and women, with studies citing over 40% of men, and close to 60% of women, engage in night eating. So, it seems to have become a common practice amongst a lot of people. However, I’d like to explain to you why I feel all that late night eating is a bad habit best left alone. In fact, it can sabotage not only your sleep, but your weight control efforts, as well as negatively impact other significant health issues.

Now, for those of you who work graveyard shifts and are actively engaged in work all night, this doesn’t really apply to you. The food these people eat during late night hours will likely be used for energy and not pose the same problems. So, I’m aiming this at those of you who keep relatively normal 9 to 5 hours, and find yourself consuming a moderate to large amount of food during the time period you normally would be sleeping or just prior to it. In fact, recent research cited in the Journal Obesity revealed that mice experienced a 48% weight gain when given food during the time periods they normally slept.

Night Eating Syndrome and its Health Costs

Used to be that humans collected their food during the day and consumed all of it before sunset due to lack of refrigeration and other sophisticated food storage systems. These days we have technologically advanced methods of preserving and preparing food, and more and more late-night restaurants and grocery stores cater to our around-the-clock lifestyles. The result is we have the capability to eat whenever we want and, consequently, many of us have gotten into “night eating syndrome”, or NES. NES is a health-impacting habit where we consume 50% or more of our daily food intake after 8pm. It can result in the following health issues:

Difficulty falling/staying asleep: Human circadian rhythms are set to start winding down after sunset so we can fall asleep at nightfall. If you eat a moderate to heavy meal during this time, your metabolism revs up for several hours trying to digest this food and will prevent you from falling asleep and/or staying asleep. This is especially true if you include red meat in that meal as your body has to work harder to digest it. So, the more you eat late at night, the more you habitually disrupt your normal sleep hours. As a result, chronic insomnia and elevated cortisol, a stress hormone, can occur. Elevated cortisol levels can cause you to gain weight in the form of belly fat, the worst kind.

Weight gain: If you eat at night, and have also consumed a regular amount of food during the day, the extra meal that you eat at night will almost certainly be stored as fat. In fact, 1 in 4 people who are 100 lbs or more overweight engage in night eating.
Diabetes/metabolic syndrome: The weight gain from eating additional late night meals significantly contributes to insulin resistance and/or diabetes.

GERD, or acid reflux/heartburn: Eating late at night and then going to bed can be a recipe for acid reflux and heartburn, particularly if you eat anything with chocolate and/or tomato in it. Acid reflux can be severe and cause inflammation of the esophagus as well as keep you awake with its very uncomfortable symptoms.

Sleep apnea: The obesity resulting from excessive late night eating significantly contributes to a condition called sleep apnea. This is the cessation of breathing while sleeping where you can suddenly wake up gasping for air. The stopping of breathing is a result of excessive fat deposits around the airway structures in the neck and laxity of the soft tissues of the tongue and palate. When the head is the prone position, these structures can tilt backward and block your airway. People who experience sleep apnea are also at higher risk for heart attack from the cutting off of oxygen. Sleep apnea sufferers almost always experience daytime sleepiness which can negatively impact their daily activities and cause accidents.

How To Break Night Eating Syndrome

Though there is some debate amongst medical professionals regarding the effects of late night eating, it’s been my experience with patients that they sleep better, have less trouble maintaining their weight, and have less stomach upsets if they don’t eat large meals at night. However, once you’ve established a long-term pattern of late night eating, it may be difficult to retrain yourself. Like quitting smoking, it takes a determined effort. So I’d like to share with you some suggestions that have helped my patients kick the habit of night eating:

Do not eat a large meal after 7 pm. Save the heavy carbohydrates like potatoes, pasta, etc, for lunch or earlier afternoon meals. Stick to lighter, lower fat, meals with more vegetables and grains which are more quickly digested.

Take a 30 minute walk, or some form of light aerobic exercise, after this meal which will help your food digest faster.

Digestive supplements like bromelain can help to more completely digest meats and heavier fats which takes the body longer to break down.

If you must eat a larger, late meal on occasion, avoid heavy fats and spices and wait 2 hours before you lie down to sleep. This will give your body a chance to use it for energy and help prevent heartburn.

If you do experience heartburn and/or acid reflux symptoms, over-the-counter products containing famotidine (available at 24 hour pharmacies) can help alleviate the symptoms. Elevate the head of your bed 6 inches by using a foam wedge pillow specifically created for this purpose. These can be found at some drugstores or retail stores where pillows are sold, or medical equipment stores.

A light snack is okay but time it so it’s 30-60 minutes before you actually get into bed to sleep. Clear, low fat soups like tomato or cream of mushroom, broccoli, chicken, or vegetable are good as hot liquids are more soothing and have an appetite suppressing bonus. Diabetics often benefit from a light, high protein, pre-bedtime snack to maintain even blood sugar levels while sleeping. A glass of low-fat milk with a few peanut butter crackers, or ½ whole wheat bagel, or slice of whole wheat toast spread with a little peanut butter are balanced carb/protein snacks.

Rid your house of easy to pop-in-your-mouth junk snacks like chips, candy, etc. You’d be amazed at how many calories you can unconsciously consume this way.

Stay busy after dinner instead of watching television where most late night eating occurs. Get involved with a project or activity that doesn’t involve food, then go to bed at your usual time.

Brush your teeth! Simply changing the taste in your mouth to one more medicinal like toothpaste, or mouthwash, can help your taste buds turn off for the night.

Normal eating schedules have become harder and harder to maintain. With our 24/7 lifestyles, we may have unwittingly allowed night eating to become an accepted part of how we live. While it’s okay to have a light, balanced nutrition snack before bedtime, consuming larger, heavier meals at night can set us up for some serious health issues. Watch your food intake throughout the day, limit your night eating to no later than 7 pm, get some light activity afterwards, and you’ll be doing a lot to improve both your sleep health and weight control efforts. In addition, you’ll be helping yourself prevent more serious health issues and their consequences.

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

Get Healthy With Good Bacteria

We’ve likely all seen that commercial on television about how eating yogurt with live cultures can help you stay regular and feeling great. Well, it’s true! Our bodies are home to thousands of both good and bad strains of bacteria called intestinal flora. Recent studies have shown that when bad bacteria outweigh the good, it can set the stage for several diseases including stomach ulcers, allergies, asthma, and even obesity! So, I’d like to spend a little time telling you how keeping your good bacteria at optimum levels can keep your immune system functioning properly and keep you illness-free.

The Good, The Bad, and the Healthy

We come into the world with about 90% friendly bacteria onboard that help us ward off illness outside the womb. But once we pass the age of 40, our good bacteria have decreased to about 10-15% of what we originally had as infants. This ratio is almost completely opposite to what we should have. Good bacteria help digest everything we eat and balance the acidic environment of our intestines to prevent yeast overgrowth, bloating, gas, and inflammation. If the good bacteria decrease too much, bad bacteria can overgrow and cause intestinal upsets and possibly lead to more serious illnesses.

Symptoms of Intestinal Bacteria Imbalance

Some tell-tale signs that your intestinal bacteria are out of balance include:

Bloating, gas, constipation/diarrhea, cramps.
Headaches, chronic nasal congestion/post nasal drip
Chronic fatigue
Weight change extremes: Gaining/losing too much.
Joint pain and other inflammatory conditions
Allergies/asthma

What’s A Good-Bacteria Promoting Diet?

I tell my patients to begin with a basically healthy diet that includes 5-10 fruits/vegetables every day; no more than 30% fat (10% saturated, 20% unsaturated); 25-30 grams fiber daily, dairy products for calcium, with adequate protein, and water intake. To that basic recipe, I offer the following suggestions:

Limit simple sugars like high fructose corn syrup (need to read labels), sucrose (plain table sugar), and alcohol (metabolized as a sugar). Bad bacteria thrive on these. Instead, the sugars found in fruit, vegetables, legumes, are the types that build good bacteria.

Limit animal fat as it promotes bad bacteria.

Limit starches like bread, pasta, white rice to a few servings a day, as they can cause too much acid in your system which bad bacteria thrive on.

You can still enjoy meat and chicken, but try to stick to those raised without antibiotics as these types promote good bacteria.

Add 8 oz yogurt, or a drink called kefir (both found in your grocer’s dairy section), daily. Look for the LAC logo on cartons that insure live active cultures that promote good bacteria. Other foods that create good bacteria are sauerkraut, tofu, and soy products.

Maintain adequate B vitamins, particularly folate and B12 which help you absorb nutrients.
Enjoy green or black tea everyday, and add a little garlic to your salads, pasta and fish dishes.

These increase your good bacteria levels.

Take a good multivitamin as insurance to get optimum levels of all the vitamins, minerals and other nutrients you need.

Antibiotics. These deplete good bacteria and can cause intestinal upsets. If I have to prescribe antibiotics to my patients, I also tell them to eat yogurt containing live, active cultures everyday they’re on the antibiotics. This rebuilds their good bacteria and prevents intestinal upsets.

Probiotic supplements can help those over 40 to balance age-related good bacteria deficiencies. Active cultures should number in the 10 billions (read label) and should contain lactobacillus acidophilus, bifidobacteria, and Saccharomyces. However, if you have a compromised immune system from other illnesses, ask your doctor about choosing the best probiotic supplement to prevent ingesting potentially harmful (to you) bacteria.

Maintaining a strong immune system and good health doesn’t have to be a difficult or too-restrictive chore. Remember, it’s all about maintaining a good balance. With a little effort on your part, reading labels closely and following some of my suggestions here, it is possible to create and preserve good health well into old age by simply lending a helping hand to our friendly bacteria!

Stay well,

Mark Rosenberg,

M.D.Institute For Healthy Aging

Hyperhidrosis

Some of my patients sweat excessively on a daily basis. They have a condition called hyperhidrosis. Even when they feel relatively cool and collected, they can get sweaty palms, face, underarms, or feet. This type of sweating can cause considerable embarrassment and distress. It can also cause some physical ailments such as dehydration and skin infections from persistently wet skin. So, I’d like to talk to you about this frustrating issue and share with you the same information I give my patients.

Types of Hyperhidrosis

Excessive sweating usually begins in teenage years or early adulthood (20-25) and can occur in both men and women. Unlike normal sweating, hyperhidrosis occurs spontaneously without seeming cause. There are two types of the condition which are characterized in the following ways:

Primary – can have an emotional trigger, with excessive sweating of:
Hands/feet
Armpits

Facial/head - least common.
Secondary – associated with a medical condition like:
Infection
Diabetes, overactive thyroid, hormonal imbalances
Neurologic disorder
Cancer
Spinal cord injury
Substance abuse (alcohol, drugs)

Current Treatments

For those of you who experience excessive sweating, take heart. There are several treatment options available to bring it under control. Let me explain:

Topical antiperspirants: You know these as roll-on products available from the drugstore. These contain aluminum chloride and work by blocking the sweat glands under your armpits. There are a few over-the-counter antiperspirants that work effectively at decreasing the wetness which may work fine for you. However, there are several prescription antiperspirants that contain a stronger aluminum chloride mixture that your doctor can prescribe for you.
Iontopheresis: This method introduces an electrical current into the sweat glands to disrupt production of sweat. It is moderately successful and must be done frequently. It’s only side effects are some mild dryness or cracking of the skin, and some mild pain.

Medications: A class of medicine called anticholinergics is somewhat successful in treating the condition, but can involve side effects such as dry mouth, urinary retention, constipation, too slow or fast heart rates and/or blurry vision.

Botox injections: A fairly new treatment, Botox is injected into the skin to block sweat production. This method has the most success with armpit sweating. There is minor pain with the injections. Cost may be an issue as they have to be repeated every few months.

ETS: Endoscopic thoracic sympathectomy is one of the most successful methods of treating hyperhidrosis. The nerves on the sides of your chest are either cut or clamped which stops the production of sweat.

Alternative Methods:

Herbal medicine: These include witch hazel for facial sweating; tincture of Burdock decreases excessive bodily fluids generally; tea tree oil, for foot sweating, is an antifungal which prevents skin infections in moist skin.

Acupuncture: In Chinese medicine, the sweating mechanism is thought to be imbalanced causing you to over-sweat. A practitioner inserts hair-thin needles into certain meridians on the body attempting to re-balance this system.

Things You Can Do

Though excessive sweating may require a visit to your doctor, I like to offer my patients a few things they can do everyday to feel more comfortable:

Wear natural fabric clothes like linen, cotton, wool that allow your skin to breathe. Avoid synthetics like polyester and nylon which are tightly woven and can become hot and restrictive and contribute to your sweating.

Invest in good quality cotton armpit shields which absorb sweat before it shows on your clothes. These can be found in fabric stores in the notions department, and underwear sections of better clothes stores. Tailors may also carry these.

Wear good quality socks made of 100% cotton that absorb moisture and keep your feet drier to avoid skin infections.

Leather and canvas shoes are better than synthetic materials.

Antiperspirant type deodorants containing aluminum chloride can be purchased without prescription at your local drugstore. There were rumors that aluminum-based antiperspirants contributed to breast cancer. However, the American Cancer Institute has definitively stated that aluminum chloride antiperspirants do not cause cancer.

Avoid very hot, spicy foods as these can intensify body heat and sweating.

I know hyperhidrosis can be a challenging condition to live with, but as my patients have found, it can be treated successfully. You can live a normal, productive, socially active life and stop feeling self-conscious. If you feel you may have excessive sweating, please see your physician and perhaps try first some of the nonsurgical options listed here. If they don’t afford you enough relief, surgery may be more suited to your particular symptoms. Either way, you can control hyperhidrosis, stop worrying about sweating, and get back to enjoying your life!

In Good Health,

Jay Brachfeld, M.D.

Testosterone, Aging And Good Health

As a doctor with male patients over age 40, I hear many complaints about fatigue, little or no sexual energy, weight gain, irritability and/or depression. When they remark that their symptoms are just part of growing older and that there’s nothing they can do about it, I like to tell them about my 89-year-old neighbor George.

George is a testament to healthy male aging. He is a brilliant conversationalist, full of vitality, with never more than the occasional mild cold. He pursues his passion of traveling the world like a much younger man always accompanied by his lovely lady friend. One day I joked that he must have found the fountain of youth on one of his travels. In response, George told me that he had always eaten a good diet, exercised, and taken vitamins, but had also been on testosterone supplements for many years! I wasn’t surprised, as I knew that good testosterone levels were very important to a man’s physical and emotional well-being at any age, especially as he grows older.

In this first of two-part series, I’d like to talk to you about deficiencies in the male hormone testosterone, the causes and the symptoms. Part II will deal with methods of testosterone supplementation and some things you can do to ensure that your testosterone levels stay optimal. First let’s look at a few things that can contribute to low testosterone.

Modern World Full of Estrogen

There have always been reasons why a man’s testosterone level might be too low including genes you were born with, diet/nutritional deficiencies, and just plain aging in general. We’ll go into more detail about these in Part II. But there is one specific factor I’d like to address here; a side effect of modern technology, that has become a critically important health issue: environmental.

In today’s modern world, we use fertilizers to keep our lawns green, pesticides and hormones to grow our food, and have landfills full of plastic from our microwave dinners, water bottles, and food containers. All of these factors have one thing in common: they contain xenoestrogens, an environmental version of the female sex hormone estrogen. These estrogens get into our food and water supply and can imbalance a man’s testosterone levels. In fact, a 20 year study of testosterone levels in men showed that testosterone levels had dropped 17% overall in the population between the years 1987 and 2004.

Too much estrogen in a man’s system can result in undesirable feminizing effects such as:

Enlarged breasts
Obesity – particularly belly fat.
Inability to get or sustain an erection
Low sperm count
Decreased/lighter facial/body hair

Because they are so widespread in our environment and in our food packaging, it’s near impossible to avoid coming in contact with environmental estrogens. However, here are some simple things you can do every day to avoid ingesting an overabundance of them:

Avoid all pesticides, herbicides, and fungicides. Wash your fruit and vegetables well with a special wash you can buy in most produce departments.

Use a good water filter on your tap water.

Buy hormone free meats and dairy products if possible.

Do not microwave food in plastic containers or use plastic wrap to cover food for microwaving. Heating allows the chemicals in the plastic to leach into your food. Instead buy brands that use only cardboard warming trays. Use wax paper to cover your food.

Use glass or ceramics whenever possible to store food.

Do not allow plastic containers to stay in the sun, especially those containing soda or drinking water. Exposure to heat releases chemicals into your beverage. Discard them if they are heated and do not drink the contents of the bottle.

Symptoms and Health Concerns of Low Testosterone

Testosterone can start to decline in men as early as age 30 but usually it starts in middle age, roughly the late 40’s through mid-60. Current research estimates that 2-4 million American men have low testosterone levels and only about 5% of them are being treated for it. Having low testosterone levels not only make you feel miserable, they can also contribute to some serious diseases like:

Heart disease
Prostate problems
Adult onset diabetes
Osteoporosis
Depression

Many of my male patients come in with the following symptoms and I suggest that we do a simple blood test to take a look at their testosterone levels. Symptoms include:

Unusual fatigue (though this can accompany many health issues)
Erectile dysfunction (may be testosterone or heart related)
Sleep disturbance (too much, not enough)
Decreased/lighter body hair
Sweating
Depression
Decreased stamina, muscle mass, physical recovery after activity
Weak bones, fractures
Weight gain/fat distribution (breasts and belly)
Memory loss

Psychological symptoms can include decreased motivation, impaired judgment, foggy thinking, lack of aggressiveness, apathy.

Should You Take Testosterone?

If you suffer with any of the symptoms mentioned above, a simple blood test can determine your testosterone levels. Although younger men with low testosterone levels frequently receive testosterone injections, there is some controversy amongst doctors whether to give it to older men, even though their symptoms and blood tests may warrant it. Most of the concerns arise from previous beliefs that higher testosterone levels put men at higher risk for prostate cancer. However, the Journal of the National Institute of Cancer recently reported that there is no real cause and effect between higher testosterone levels and prostate cancer.

In the past, the widespread use of a form of testosterone in anabolic steroids amongst athletes and bodybuilders, and its negative effect on heart health was also a concern. However, like my neighbor George, many men have taken testosterone supplementation for years without adverse effect. In fact, it has allowed them to stay active and healthy into advanced years. More about methods of natural and synthetic testosterone supplementation will be discussed in Part II. Although decreasing testosterone levels are a natural part of getting older, you don’t have to live with the quality-of-life affecting symptoms it can cause. Just as many women take estrogen replacement therapy in menopause and regain many health benefits, men too can benefit from supplemental testosterone. As I tell my patients, it is absolutely possible to regain, or maintain, healthy testosterone levels so you can have energy, a satisfying sex life, optimal weight, and a bright mood that puts you back in the game!

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

Low Testosterone Remedies Part II

In the first part of this two-part article we talked about how low testosterone levels:

Affect healthy male aging.
Affect a man’s energy, mood, weight/fat distribution, and sex drive.
Contributes to conditions like diabetes, prostate problems, heart disease, osteoporosis, and depression.

We also talked briefly about methods of testosterone replacement. So, here I’d like to share with you in more detail how you can naturally optimize your testosterone levels with diet and lifestyle changes, and perhaps get help from herbal supplements.

Eat A Testosterone Boosting Diet

Unsightly rolls of belly fat and “man breasts” have become a concerning trend in many of my male patients. As I explained in Part I, one reason men are gaining these feminizing fat deposits is environmental estrogen which has gotten into our food and water supply. Another reason is the very low-fat diets men are eating these days trying to lose their increased body fat. That’s right. A man makes testosterone through cholesterol. So, if his cholesterol levels are too low from a too low fat diet, he will not make enough testosterone.

I always manage to raise a few eyebrows in my male patients when I tell them that in order to lose this kind of feminizing body fat they need to raise their fat intake! The trick is to include healthy, good fats in the diet, at about 30% of daily food intake. These good fats help manufacture testosterone and should come from:

Mostly monounsaturated sources, like nuts, olive oil, avocados.

Moderate amounts from polyunsaturated sources like salmon and fish oils.

Smaller amounts from saturated sources like red meat.

You might worry that eating a higher fat diet and possibly higher cholesterol levels will put you at risk for heart disease. According to recent medical research, inflammation, rather than higher cholesterol levels, appears to be the real factor that determines whether you will develop heart disease and/or suffer a heart attack. Polyunsaturated fats help reduce inflammation in your body and protect your heart. So, allowing more of the right kinds of fat into your diet will not only help you build testosterone they will help protect your heart.

Here are some other diet suggestions to help optimize your testosterone levels:

Monitor fiber intake. 20-25 grams a day is adequate for good bowel health. More, however, and you reduce cholesterol levels too much. Fiber sweeps all fats (even the good) out of the intestines before they are absorbed.

Adequate protein intake: Studies have shown that higher protein, lower simple sugars diets help create testosterone. Aim for at least 0.5 grams of protein for each lb of body weight. If you weigh 200 lbs, your protein intake would be about 100 grams. Read labels to track your protein intake.

Balance carbs: Consume lower glycemic carbohydrates like fruits, vegetables and whole grain bread, yams, etc. Limit high glycemic, simple sugar carbs, such as cookies, cake, and candy to a balanced portion treat once, maybe twice, a week.

Limit alcohol: Excessive alcohol intake lowers testosterone levels.

Modify Your Lifestyle

In addition to diet, and simply getting older, how you live your life can also affect your testosterone levels. I often suggest to my male patients that if they do not feel they can handle stressful life challenges on their own, they might seek counseling. Talking to someone about whatever is bothering you can bring about positive changes in your life and your health. Some issues that can affect your testosterone levels are:

Constant high stress from either your job or relationships
Lack of physical exercise/too much physical exercise such as sport training
Chronic illness
Excessive alcohol consumption
Recreational drug use
Supplemental Testosterone Therapy

If after you’ve made the necessary and positive changes in your diet and lifestyle, you still are experiencing low testosterone and its symptoms, you may want to consider taking supplemental testosterone. These are not the dangerous anabolic steroids of the past which I strongly encourage you to stay away from.

Rather, these are both natural, herbal preparations and prescription only pharmaceuticals. First, make sure your symptoms are truly testosterone related by getting your levels checked by a simple blood test.

Although some controversy exists amongst healthcare professionals as to the pros and cons of augmenting testosterone, you and your doctor can decide if any of these methods would be right for you:

Herbal testosterone boosters - these are products which can contain Chrysin, a bioflavonoid that reduces estrogen in your system and boosts testosterone; Maca, a root herb used by the Peruvian Indians touted to increase sperm and testosterone levels. These herbal preparations do not have the risks and/or possible side effects associated with prescription testosterone preparations and also cost much less.

Topical Testosterone – these are prescription only gels/creams that are applied to the skin. Be aware that you should not allow women (especially pregnant), or children to come in contact with the area of skin where you applied the gel. Doing so can cause birth defects in an unborn fetus, and/or male features in women.

Testosterone injections - these are prescription-only drugs given 1-2 times a month. They need to be administered by a doctor or nurse practitioner. There can be many side effects and risks associated with injections which your doctor can explain to you.

Though there are many reasons why a man’s testosterone levels may decrease, natural aging is the biggest factor. However, as I’ve shared with you in these articles, you do not have to suffer the symptoms and loss of self-esteem that low testosterone levels can cause.

There are many things that you can do to regain youthful levels of testosterone before you consider supplementation of testosterone, whether natural or prescription. Following a diet containing good fats, avoiding environmental estrogens, getting rid of chronic emotional stressors as best you can, and doing regular physical exercise at least 3 times a week, will all help you boost those low-T levels and regain your confidence as a strong and vital man!

Stay well,

Mark Rosenberg,

M.D.Institute For Healthy Aging

First Impressions Count!

“You never have a second chance to make a first impression”! This may be a familiar expression to you but if not, it may resonate with you as it did with me. It takes only about 5 seconds for someone to evaluate you when you first meet. In this short time frame, the other person forms an opinion based on how you look, your body language, your demeanor, your mannerisms, and the way you handle yourself.

With every first encounter, you are being evaluated, and at the same time you are forming an opinion about them. Have you ever met someone who you thought at the time was objectionable, only to have that opinion changed at a later date? There was one time in particular that stands out in my mind that happened a few years ago.

I was working for a franchise corporation when I first met Cindy. New to the company, Cindy started out on the wrong foot by being overly assertive. She liked to order people around and delegate responsibilities that alienated coworkers. Cindy’s take charge approach was very different from the work culture to which we had become accustomed.

During this period of time our company required travel by senior officers to attend conferences, trainings, and other functions. Cindy and I fell into this “privileged” category. As you might have guessed we ended up on the same trip, in the same room together. Deep down inside I wanted to disappear but decided that would be a coward’s way out. Instead, I went in with an open mind and hoped for the best.

We spent time getting to know one another, sharing stories, and by the end of the trip we had bonded. When I stopped pre-judging this individual, I began to recognize qualities that didn’t appear on the surface. Cindy was very smart, witty, funny, and not at all what she seemed to be when we first met. Needless to say we became friends and remain close even to this day.
You may recall a person from your past who became a friend after a less than desirable first encounter. You often hear stories of married couples who literally disliked each other when they first met but somehow got beyond the exterior and fell in love.

My friend, Linda, told me her story at lunch just the other day. She said, “I couldn’t stand my husband when I first met him. He wore an ascot and sunglasses and was so full of himself I wanted to choke. But after being around him for awhile, I thought he was pretty cool. Of course, I was only 19 years old so what did I know?” After many years married, three children and seven grandchildren later, Linda still laughs when she recalls the first impression she had of her soul mate.

The perception we have of others is not always about them. Oddly enough it has much to do with what’s going on inside of us. I was so wrapped up in my workplace comfort zone that I would have shunned any intruder regardless of who she was. Maybe I was threatened by Cindy’s energy and her ability to take control. I wonder if I had met Cindy under different circumstances would my impression of her be the same.

There are other factors that color your feelings when you first meet someone. It has to do with your unconscious negative beliefs and assumptions about others. By that I mean you form opinions based on past experiences, your parents, and people with whom you’ve come in contact throughout your life. You may not even realize that you hold these assumptions until a life changing event alters your thinking.

Linda readily admits that she was taken in by the self-confidence of a man ten years her senior. He was capable, handsome and debonair. It’s understandable that an older man may have appeared arrogant to a young woman just starting her career and naïve to the world. Linda’s experience with men was limited and her role model for the perfect male figure was her father; the complete antithesis of her future husband.

What makes first impressions so important? First and foremost, they represent who you are and can make the difference in landing a job, making a friend, becoming part of a group, or being accepted within your community. Unfortunately we don’t always get feedback on the impression we make on people. I certainly wasn’t going to tell Cindy that I thought she was bossy and abrasive. It might hurt her feelings for one thing, and secondly, my judgment was subjective based on my situation.

My experience with Cindy taught me a few things that I’d like to pass along to you.

“Never judge a book by its cover” – I know this is an old cliché but looks can be misleading. A person in tattered clothes could be a millionaire, how do you know? Move past appearance and get to know what’s on the inside. There are gems to be found if you look hard enough.

“Smile and the world smiles with you” – When you open up and make a gesture of friendship, you put the other person at ease. It allows both of you to relax and be your genuine selves. Set the tone for an open, honest meeting. You have as much to do with their comfort level as you do your own.

Don’t allow limiting beliefs to get in the way – For instance, being immediately turned off by someone’s political beliefs because they are different than your own or pre-judging a person based on color, ethnic background, or religion.

Be a good listener – Stop talking about yourself after the initial meet and greet. Let the other person speak. It is amazing what we learn about someone when we listen.

Next time you form an opinion based on a first impression give it some thought. Don’t jump to conclusions, good or bad. You just never know who that person will end up to be or what the future holds!

Your Healthy Life Coach,

Dale Brown, B.S., M.A., C.E.C.

Aging And Memory Loss

“My memory seems to be going” is one of the most common complaints I hear from patients these days. From losing keys, forgetting appointments, birthdays, anniversaries, where the car was parked, these little lapses in memory are fairly common. When my patients experience these memory glitches, they ask me, “Am I getting old?” My answer to them is both yes and no.
While it’s true that our brains start showing signs of aging around age 40, these momentary lapses of memory are more a sign of stress, over-busy schedules, and fatigue, possibly even depression.

Americans are living much longer these days and current medical research focuses on maintaining good quality of life and brain function to enjoy all those extra years we’re living. So in the first of this two part article, I’d like to discuss with you what I tell my patients about how aging affects memory loss and some things you can do to preserve good brain health.

Your Aging Brain

Our brain is one of our most important organs. It regulates everything our body does from spontaneous breathing to running a marathon. The brain also regulates everything we are, our every thought and emotion. Think of all the information it has stored in it!

As I like to tell my patients, our brains are a lot like a computer’s hard drive. The more information that’s stored from years of learning, the slower it may become in retrieving that memory as we get older. However, we still have the capacity to learn things. It may just take longer to retrieve the new information we’ve learned.

We have three types of memory that are affected differently as we grow older, they are:

Short term/temporary - memory that holds things like a phone number from Directory Assistance. This part of memory pretty much stays intact as we grow older, but we may have to write down or repeat numbers several times to recall them.

Long-term recent - memory most affected by aging. It holds things like what clothes you wore a few days ago, someone’s name you met recently, or what you ate for dinner a few nights ago. With age, we lose ability to remember these things especially names.

Long-term remote – memory that stores older data like your childhood, or what you were doing on historical dates like September 11, 2001. This part of your memory is not affected by aging as much. In fact, you’re more likely to remember something your father told you as a child than what shirt you wore two days ago.

Memory, Dementia and Alzheimer Disease

There are some symptoms of aging memory loss that could indicate more serious medical conditions like dementia and/or Alzheimer disease. Sometimes these two seem interchangeable as they can share some symptoms, but they really are two separate conditions. So, let’s take a look at what dementia and Alzheimer disease are and the differences between the two.
DEMENTIA
ALZHEIMER DISEASE

Dementia is a collection of conditions that cause gradual loss of mental functioning ability in advanced age.
Usually occurs between ages 70-80.
Symptoms include:
Memory impairment
Word finding difficulty
Faulty judgment
Decreased motor skills
Impaired object identification
Can share Alzheimer symptoms.
Blood clots in the brain can destroy tissue and function.

Alzheimer is a form of dementia marked by severe, remote past memory loss, inability to relate to surroundings.
Can occur as early as age 45.
Symptoms include:
Inability to remember things like the names of your parents or children
Inability to remember where you’ve lived for many years
Getting lost in familiar places
Wandering
Laughing or crying inappropriately
Neglecting personal hygiene

Keep A Healthy Brain – Things You Can Do

I tell my patients that if they want to enjoy a long and productive life, they not only have to stay physically fit but they must stay mentally fit. You need to exercise your brain much the same way you exercise your body! Here are some things you can do to not only help you remember where your keys went but perhaps prevent dementia and/or Alzheimer disease.

Exercise 3-4 times a week doing aerobic (running, walking, bicycling, swimming, etc) and muscle strengthening with weights, Pilates, yoga. Produces feel-good hormones in your brain, delivers needed oxygen, brightens your mood, and aids in coordination.

Feed your brain – things like fish and Omega-3 oils repair worn out brain cells and help preserve memory. B vitamins, especially B12, are crucial to good brain health.

Play mind games – things like crossword puzzles, chess, any type of game that requires memory recall will stimulate your brain and help your memory stay sharp.

Get enough sleep - Your brain and other parts of your body replenish and repair while you are sleeping. Keeping a regular sleep schedule will help you stay sharp.

Avoid smoking or alcohol. Research has shown that smokers and alcohol drinkers develop dementia more than nonsmokers. Alcohol kills brain cells that do not recover.

As I’ve explained here, some aspects of memory loss are common and just natural nuisances associated with getting older. Some memory loss, however, is associated with serious conditions like dementia and Alzheimer disease. If you, or a loved one, experience any of the symptoms of dementia or Alzheimer disease, consult your doctor. With early treatment, dementia can often be turned around and Alzheimer disease can be slowed down greatly.

In Part II we’ll look at how prescription and recreational drugs can affect your memory. We’ll also look at how certain natural supplements can help stave off effects of aging on your memory and help keep you mentally alert and sharp.

In the meantime, try to engage in some of the brain-healthy activities listed here. Take a break from your computer, go for a brisk walk, run or bike ride in the sun that will fire up your brain cells with oxygen! Then grab a cup of brain-boosting java, find your daily newspaper, and give the crossword puzzle a try. You just gave your body and brain a good workout and boosted your memory power!

Stay well,

Mark Rosenberg, M.D.Institute For Healthy Aging

Prescription Drugs And Your Memory Part II

In Part I of Memory and Aging, I explained to you how growing older can affect your memory. I also gave you some brain-healthy things you can do to keep that incredible shoulder-top computer retrieving all its data well into your advanced years.

Here in Part II, I would like to talk to you about prescription drugs, and the impact they can have on your brain function and your memory. Then we’ll talk about some natural supplements and how they can help you retain more of your memory.

Each category of prescription drugs has a multitude of individual drugs that can be prescribed to you for common ailments like sinus problems, infections, insomnia, nausea, etc. The effects on your memory can range from temporary short-term memory lapses to broad, long-term memory wipe outs.

In the list below, I’ve included the types of prescription drugs that can damage your memory.

PRESCRIPTION DRUGS THAT CAN CAUSE MEMORY LOSS

AnalgesicsAnesthetics AntianxietyAntidepressantsAntibioticsAntihistamines Antihypertensives
Anti-Seizure medicationsHormones/steroidsNausea Drugs Parkinson Disease DrugsSleep Aids RitalinStatins

Mother Nature To The Rescue

With all the pharmaceutical drugs out there that threaten to damage your brain and your memory, the good news is that there are several vitamins and natural, herbal-derived products that have brain-health preserving and memory boosting properties!

The most significant group of vitamins that enhance brain health and memory are the B vitamins, especially B6, B9 (folic acid), B12, citicoline. B vitamins protect the nerve sheath covering brain cells. They pulverize homocysteine, a nerve cell toxin, and carry oxygen. A healthy diet filled with citrus fruits and dark green, leafy vegetables, and/or supplement, aids good brain function.

Next, antioxidants like Vitamin C, E, and beta carotene, give critical protection to brain tissue by dissolving free redicals that cause damaging oxidation. These nutrients can be found in citrus fruits, yams, and wheat germ/oil and are also a staple of good vitamin supplements.

Beneficial fatty oils, like Omega-3 fish oil, help protect the brain cells by neutralizing inflammation and cholesterol deposits. Fatty fish like salmon or fish oil supplements of 1,000 mg a day ensures optimal brain levels of this nutrient.

Below, I’ve listed several, herbal-derived supplements that are beneficial to your memory.

NATURAL SUPPLEMENTS THAT HELP IMPROVE MEMORY

Alpha GPC - supports attention, focus, recall, and other brain functions.
Adenosine Triphosphate (ATP) – supports concentration and focus.
CoQ10 – helps with overall body energy, supports concentration and memory.
DMAE - helps with alertness and concentration.
Gingko biloba – improves blood/oxygen flow to the brain.
Huperzine A – aids age related memory loss; boosts short-term memory.
L-Carnitine – an amino acid that aids brain energy.
L-Glutamine – works as a brain transmitter, aids concentration and alertness.
Lion’s Mane Mushroom – enhances mental performance. Aids in nerve/brain cell growth.
Vinpocetine – improves blood flow to memory storage center of brain.

What You Can Do

As I’ve discussed here, you don’t have to be resigned to memory loss. There are some excellent natural sources of supplements, as well as vitamins, available that can help keep your brain and memory functioning optimally.

If you take any of the classes of prescription drugs noted here and seem to be experiencing memory problems, please contact your physician to discuss your concerns.

Stay well,

Mark Rosenberg, M.D.

Institute For Healthy Aging

Pain Is Not Always Bad

It doesn’t surprise me when patients come to see me complaining they are in pain. More than 86 million Americans suffer pain and about 80% will experience back pain at least once in their lifetime. Pain is a major reason why people seek medical care. The question is how is it treated and what happens if pain persists?

I tell my patients that pain is not necessarily a bad thing. Pain can be a warning sign that something is physically wrong. Depending upon the individual’s pain threshold, pain can range from mild to severe; occasional or constant. Pain can either be acute or chronic meaning sudden or ongoing. Let me explain.

Acute pain comes on suddenly and is usually sharp in quality letting you know that your body is threatened in some way. Most of the time acute pain is resolved quickly but can persist up to 6 months. It is important to heed the warning of acute pain to prevent it from becoming worse and to develop a treatment plan to alleviate the cause. Examples of acute pain are surgery, broken bones, dental work, burns and cuts.

Chronic pain on the other hand lasts longer than 6 months and may be severe and remain even after the injury has healed. The physical effects of chronic pain can result in limited mobility, lack of appetite, energy level, and muscle tension. Chronic pain can be accompanied by emotional effects as well such as depression, anger, anxiety, and fear of recurring injury. Common types of chronic pain include headache, low back pain, cancer, arthritis, and nerve damage.

It is possible for people to suffer chronic pain even if they have never experienced an injury or have evidence of body damage. As a result chronic pain is more difficult to treat because there is no visible cause to explain the problem.

Treating Pain

There are a number of ways to treat pain, many of which are very common such as non-prescription medications like aspirin, Tylenol or Ibuprofen. When pain is severe, stronger prescription medication may be required including morphine, codeine or anesthesia.

In my practice we work as a team of doctors to find the treatment that best suits the patient depending upon several factors; the history of the pain, its intensity, duration, aggravating and relieving conditions, and the cause of the pain.

Once the origin of the pain is determined, other forms of pain relief may be offered in combination with other methods such as electrical stimulation, physical therapy, surgery, psychological counseling, and behavior modification. In some cases it might be necessary to try various methods to maintain maximum pain relief. An X-ray called fluoroscopy is often used to find the precise location of the pain so that a medical injection reaches the appropriate spot.

What is Pain Management?

As you can see, there is no one solution to treating pain when it persists for a long period of time. The most common way to handle pain following an initial injury or trauma is to prescribe narcotic drugs. The downside to relying on prescription medications as a solution to pain management is the potential risk of dependency. Over time, you need more and more medication to numb the pain. Eventually your nerve cells in the brain stop functioning normally. Your body stops producing its own natural painkillers (endorphins) and waits for the next hit of drugs to take effect.

Although living with pain is not easy, drug dependency is even worse. Everybody is different when it comes to pain related issues as I mentioned earlier. Finding what works best for you is a subject that needs to be discussed between you and your doctor. It is important to consider a number of factors that might be adding to your pain such as lifestyle, diet, exercise, and your weight.

The addition of nutritional supplements and vitamins can also play an important role in helping you feel better without the risk of dependency. Never underestimate the value of natural pain relievers. Here are just a few:

Flax seed – can be taken in liquid or powder form and it is a well-known nutritional supplement that can offer a wide variety of health benefits including joint pain relief.

Flax seed oil – has been successful in helping people with osteoarthritis.

Glucosamine MSM and Omega 3 fish oils – offer natural pain relief and even help to improve prostate health and lower cholesterol.

Another treatment for persistent pain that has become increasingly popular is acupuncture which helps the body to increase the release of endorphins. It has been effective in relieving headaches, facial and low back pain, arthritis and spastic colon.

Along with nutritional supplements and vitamins, other helpful pain remedies include massage, hydrotherapy, hot and cold packs to reduce inflammation and promote healing. Physical therapy and exercise strengthens muscles and allows the body to relax.

If you or someone you know is suffering with chronic pain, don’t despair. The body is a miraculous machine and when given the chance to function properly it will not disappoint you. If your present pain management system is not working for you, talk to your doctor about some of the natural remedies mentioned here. You might find the right combination of treating your pain will get you on the path to making you feel better both mentally and physically.

In Good Health,

Mark Bromson, M.D.

Protect Your Prostate

One of the most common health concerns my male patients have is their prostate and screening for disease. The thought of possibly having prostate cancer is, indeed, scary as statistics show it to be the most commonly diagnosed cancer amongst men.

Prostate cancer affects all ethnic groups of men but rates are highest amongst Hispanic and African-American males. It is the second leading cause of death in all American men. No wonder many men dread the tests that will reveal their prostate health.

However, as I tell my patients who may have some anxiety about testing, I feel that prostate screening offers positive benefits and can help you in the following ways:

Can detect any potential cancer early
Early treatment is more effective

What Is Prostate Screening?

Further, to help my patients feel more at ease with the idea of prostate screening, I like to explain exactly what is involved. There are basically two parts to a prostate screen:
Digital rectal exam (DRE): This is a physical exam performed in your doctor’s office. A lubricated finger is inserted into the rectum. This exam helps find any lumps or other abnormalities. Usually not painful, your ability to relax will greatly aid the exam.

The Prostate Specific Antigen (PSA) test: This is a blood test that measures PSA, a substance made by the prostate gland. Higher PSA levels can indicate possible disease in the prostate.

However, other factors can also create a higher PSA level like:
Age
Race
Infection
Enlarged prostate (noncancerous)

Other medical procedures

Note: PSA blood tests are also available as an at-home test.

Who Is At Risk?

There are certain risk factors associated with prostate cancer. As I tell my male patients, if you have these risk factors, prostate screening is crucial for you.

Your age – as a man grows older, risk for prostate cancer increases
Family history – risk 2-3 times higher in males with affected family members
Ethnicity – as noted above, Hispanic males are at greatest risk for prostate cancer, though this is not known why. African-American males are second-highest at risk, white males next, with Asian/Pacific Islander, Native Americans at less risk.

Should You Get Prostate Screening?

As I’ve shared with you, I feel that prostate screening is beneficial to you as a screening health tool. It may help put your mind at ease to know that over 1.8 million American men are survivors of prostate cancer! That is why early diagnosis is so important.

Ideally, I like all my male patients to undergo general prostate screening at least once a year starting over the age of 40. However, I will also recommend additional screening if, at any age, they start experiencing any of the following symptoms:

Difficulty with urination – starting, stopping flow; weak stream
Frequent urination – especially having to get up a few times a night
Blood present in the urine or semen
Pain upon ejaculation
Continual pain in the lower back, hips, pelvis

Prostate screening can cause a lot of anxiety about the exam, blood tests, and possible outcomes. But, as I share with my male patients, it can also give you peace of mind about your prostate health.

Prostate screening will put the power in your hands and allow you to make an informed decision for early treatment should you need to. Remember, highest survival rates are the benefit of early treatment. Consider it the once a year favor you do just for you.

Stay well,
Mark Rosenberg, M.D.
Institute For Healthy Aging