Yesterday, I wrote about healthy food choices from the perspective of Dr. Neal Barnard. Today we will look at it from the viewpoint of Dean Ornish, MD who is a clinical professor of medicine at the University of California. He is the founder of the Preventive Medicine Research Institute and was a keynote speaker at a medical conference that I recently attended.

His approach has been so successful over the past 35 years, that it has been recognized by Medicare for its success in preventing heart disease and diabetes.

Basically he looks at 4 parameters:

1.       LIFESTYLE

2.       EXERCISE


4.       LOVE

He also touts the benefits of a plant based diet but realizes that most people will still want animal fat as their source of protein. The flexibility of this may be more appealing for the average person. His data over the past 35 years has documented the reversal of aging and atherosclerosis and even curing diabetes. As I mentioned earlier, his programs are covered by Medicare and probably led the way for Medicare to cover nutritional consultations by registered dietitians for not only diabetes and kidney disease but also heart disease, high blood pressure and obesity. Very few commercial insurance companies will pay for this.

To get more information about this, I would suggest you look at




Tai Chi and Health

Years ago we physicians used to advise our arthritis patients to limit physical activity fearing that it would only make things worse. Fortunately, for patients, this couldn’t be further from the truth. Actually, the more you exercise, the better your joints will probably feel. By the way, medications like Advil and Aleve do not improve arthritis—only pain. For the past several years, I’ve been recommending exercise classes to my patients and less individual gym time. Most people know about Yoga but not many are aware of the benefits of TAI CHI.

Tai Chi teaches a series of physical motions that flow smoothly and gracefully. The body remains upright (as opposed to yoga) and the movements are gentle. Most importantly, every muscle of the body is exercised, as opposed to isolated muscles with a regular gym workout.

Not only does Tai Chi help arthritis, but also muscle strength, posture, balance, flexibility and mobility.

Classes are available at most gyms and are either free or available at very low cost to members.

Beginners classes in either YOGA or TAI CHI are plentiful. So, instead of “playing” with all of the weight machines, try taking 1 or 2 classes a week. You’ll be amazed at the difference!



Osteoporosis in men

This study was performed in Hungary but I believe it is relevant for American men, too. Researchers suggest that osteoporosis exists in 20% of men. However, women are diagnosed and treated up to 20 times more often. The reason for this discrepancy is that women are routinely screened for osteoporosis, but men are not. Another reason is that there are no diagnostic screening codes to submit to insurance companies for payment. Yes, if osteoporosis is accidentally discovered, we can than do further testing and treatment. Some risk factors for men include prolong use of cortisone products anytime during their lifetime, low testosterone, chronic kidney disease and overactive parathyroid gland function.

Exercise remains the best way to improve bone density, followed by certain prescription medications. The role of calcium and vitamin D in men is not as clear as it is in women.

We should not wait for a fall and fractured bones to diagnose osteoporosis in men.

Another reason to lose weight

Here is yet another reason to try to lose weight. Researchers have found by monitoring DNA methylation that there is a link between obesity and aging of the liver, including liver cancer. For every additional  10 BMI units, the liver aged by over 3 years.

This may be the reason why many other cancers have been inked to obesity.



Strength training and memory


Acta Psychol. 2014;153:13-19

Research has shown that one brief session of strength training after a visual learning task can improve memory by 10%. 46 people were asked to look at 90 photographs on a computer screen. Half of the people then did active exercises versus the other half who did passive exercise. The investigators showed that the people who did the more strenuous exercises had a better recall of the pictures 48 hours later.

The significance of this study is that it is important to combine both aerobic exercise with strength training your entire life to not only help you physically but also for your mental health.


I exercise 30 minutes a day an eat healthy but I stopped losing weight!

Some people rely on the government recommendation which suggest 30 minutes of exercise such as walking as a benchmark for daily exercise.  However, this is the minimum needed for maintenance and serves as a good starting point.

Better Exercise.

Amount:  In order to burn fat, we need to exercise longer and harder than the government’s recommendation.  A good workout session includes at least 45 minutes of exercise at a moderate-to-high intensity.

Intensity:  Intensity can be gauged through your heart rate and muscle fatigue.  Your target heart rate during exercise depends on your age and can be estimated from a table.  Muscle fatigue results from repeated movements against resistance (weights and reps).  Try to do 3 sets of 10 to 12 reps of resisted exercise using a moderate weight.   If your heart rate remains in the target range and you can complete 3 sets of 10-12 reps before becoming fatigued, then the intensity is moderate-to-high.  Adjust the weight resistance up or down until the intensity is right.  You should be breaking a sweat and breathing moderately hard.

Target body weight:  Your target body weight can be estimated using a BMI table.  As you approach your target weight it becomes increasingly difficult to lose weight, especially at the belly.  The amount and intensity of your exercise needs to be increased as your weight loss plateaus.  If you are 10-15 pounds overweight and are trying to lose the last few more pounds of belly fat you will need to work out more than 45 minutes at a higher intensity.

Variety:  Walking or even jogging for 30-45 minutes is not going to result in significant weight loss.  This exercise might be good for your lungs and heart but a variety of resisted exercises is needed to accomplish meaningful weight loss.  If you build muscle you not only burn calories during exercise, but also increase your metabolism, allowing you to burn more calories even during rest.  BONUS!  The best way to build muscle – and lose weight – is through a variety of resistance exercises that become progressively more intense over time.  Then rest one day to allow your muscles to recover.

Reward:  Reward yourself after exercise with … weight reduction, not with a double scoop of chocolate ice cream.

Power Plate:  Power Plate Vibration Technology allows a person to experience a full workout at moderate-to-high intensity in fewer minutes and with less impact on the joints.

Pointers:   Consult your physician prior to initiating a weight loss program.  Utilize a personal trainer or physical therapist for coaching and instruction.  Consult with a nutritionist for help with further improving your diet.  Reducing stress at home or at work can lead to more rapid weight loss.

A good night’s sleep

The average working American gets less than five hours of sleep a night.  The reality is that we need a minimum of 7 (optimumly 9) hours of sleep.


During sleep, our body releases hormones that regulate our biological clock, and benefit our body tissues by increasing muscle growth and speeds up fat-loss.


During a lack of sleep, our body increases a stress hormone called “cortisol”.  The release of cortisol increases our appetite.  Because of the lack of sleep, our body then has a difficult time metabolizing charbohydrates.  This in turn leads to raised blood sugar, which leads to an increase in insulin.  An increase in insulin is a signal for our body to store fat.


So, what can we do to get a good night’s sleep?


1)  Make the room COLD : Yup, I hate it too, after all that’s why we live here!  But, studies have shown that the ideal temp for sleep is between a chilly 60-68*


2)  Make your room as quiet as possible:  Consider wearing earplugs and keep the TV off, if you can, turn off the cell phone.- the radiation from them can increase the amount of time to reach deep sleep cycles.  Not to mention the distraction created by the incoming text or email. 


3)  Make your room Really Dark:  Our body’s naturally increase melatonin in the absence of sunlight, even a little bit of light can interfere with melatonin levels.


4) Set a sleep schedule:  Avoid intellectually stimulating reading material, TV shows and instead pick up a book you wouldn’t normally choose and read for 15 min. before bed.  To re-establish a normal sleep cycle, avoid sleeping in on the weekend and instead try to go to sleep and wake up at the same time that you do week days.


5)  Sleep on a good mattress and pillow:  A sprinkle of lavender oil on your pillowcase also helps to promote a restful sleep




Can too much exercise be harmful?

Running more than 30 miles per week might actually increase your risk of heart disease. The improvement in blood pressure and cholesterol could be offset by the increase incidence of atherosclerosis and cardiac arrhythmias (atrial fibrillation). Anecdotal concerns about endurance athletics have been building for years. Cardiac conditions that required surgery have forced into retirement two winners of the Ironman Triathlon World Championship. Anecdotal concerns about endurance athletics have been building for years. Cardiac conditions that required surgery have forced into retirement two winners of the Ironman Triathlon World Championship.

The theory is that excessive running leads to inflammation and oxidative damage to the heart.

“As director of a decades long project called the National Runners’ Health Study, Paul Williams has published dozens of scientific articles showing that running—the more the better—confers a variety of robust health benefits. But along with Hartford’s Thompson, Williams just completed a study of 2,377 runners and walkers who had survived heart attacks. Over 10.4 years, 526 of them died, 71.5% of them from cardiovascular disease. What Williams found is that the more they ran or walked after a heart attack, the less likely they were to die of heart disease—until they exceeded 7.1 kilometers of running or 10.7 kilometers of walking daily

Our recommendation-as always– use moderation, whether it is your dietary habits or exercise routine.

The co$t of obesity

It should not be surprising that obesity continues to rise in the US. Regular readers of my blogs are also aware of the many associated diseases that are related to obesity. The government and insurance companies always say how important it is to lose weight but they have no intentions of paying for it.

Check out these numbers from the Centers for Disease Control and Prevention:

ARTHRITIS——$128,000,000,000/year.  Covered

CARDIOVASCULAR DISEASES——$444,000,000,000/year. Covered

CANCER—–$125,000,000,000/year. Covered

DIABETES—-$245,000,000,000/year. Covered (up 41% from 5 years ago)

OBESITY—–$190,000,000,000/year. NON-COVERED


It seems to me that since obesity can play a role in all of the above illnesses, that insurance companies would want to encourage lifestyle changes and weight loss. If only they would pay for it. We recognized the benefits of aggressive weight loss years ago and became one of the first practices in the country to offer our own gym and registered dietitian for our patients. We also supervise very closely every patient  who is using FDA weight loss medications. (Forget OTC supplement-they are scams not only don’t work but may be dangerous) Unfortunately, most insurance companies will not pay for these services. The mentality of the average patient is that if it is not covered, than they do not want to participate. Or they tell us “I know what to do” Unfortunately knowing what to do and doing it are two different things.

It’s never too late to get proactive with your medical care. And ladies, the price is usually less than a day at the beauty parlor and manicurist/month!

Call our office if you would like to learn more about our programs



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