Learning to be silent

“Learn to be silent. Let your quiet mind listen and absorb.” 

~Pythagoras, Greek philosopher and mathematician (~ 500 B.C.)

Yesterday was the first day of a weekly meditation session at the medical school. We met in the student lounge and were led through a pre-recorded 10-minute mindfulness meditation.

This worked well because 1) it was not much time out of people’s busy days (about 20 minutes), and 2) not much organization was necessary (all we needed was a recorded meditation on a computer with speaker).

Sitting quietly in a room with people is something we rarely get to experience these days. We walk with our ipods, we turn on the tv at home, our phones are constantly attached to us awaiting the next text or phone call.

One of the things I love most about practicing mysore-style Ashtanga yoga is the silent sharing of space with people. Usually, we actively avoid this space, as we constantly try to fill silences with chatter or background noise. But there’s a lot we can learn and share in silence, too.

Check out this short video of the beautiful silence in an Ashtanga mysore class (from Richard Freeman's 2009 Teacher Intensive):

Pythagoras reminds us of the importance of this silent space. We need it to listen, to absorb, to think, to create. Schools and hospitals are perfect places to provide this… and I can’t wait for the day when the hospital I work/teach at has a morning mysore program! 

How's your health equation?

“Our nation's food choices have produced a population with widespread chronic illness and health care costs spiraling out of control. You cannot escape from the biological law of cause and effect -- food choices are the most significant cause of disease and premature death. We cannot win the war on these diseases by putting more money into medical interventions or drugs. We must unleash the disease-fighting artillery in our own kitchens.” ~Dr. Joel Fuhrman

That quote is from this article in The Huffington Post by Dr. Joel Fuhrman (a Penn Med grad, btw!). 

He brings up the importance of the ratio of micronutrients to macronutrients in our diet. 

• Micronutrients: Vitamins, minerals, phytochemicals which contain no calories but are important for DNA repair, free radical deactivation, immune function, and more.
• Macronutrients: Calories. They provide us with energy in the form of fats, carbohydrates, and proteins.

The higher the ratio of micronutrients to macronutrients, the higher the nutrient density of the food. Eating high nutrient density food prevents over-consumption. Conversely, eating low nutrient-density food leads to over-consumption as our body craves more nutrients. 

He provides a health equation, and argues that the nutrient density of your food predicts your future health: 

The Health Equation:  

Health = Nutrients / Calories

Here are two obvious ways we can improve our health equation:

1. Eat more high-nutrient foods (high-nutrient, low calorie): i.e. leafy greens, colorful veggies, fruits, beans, nuts.
2. Eat less low-nutrient density food (low-nutrient, high calorie): i.e. refined sugars, processed packaged foods.

And while food is extremely important, it's certainly not the only factor in our health equation... so I’m wondering how we can fit things like exercise, sleep, and stress-level into it? 

Medical miseducation

If there was ever a time when doctors need to be as handy with a peeling knife as they are with a scalpel, this may be it. The draft version of the federal government’s 2010 Dietary Guidelines, which will be formally released in December, identifies obesity as the nation’s greatest public-health threat. It also notes the relationship of fast food (and physical inactivity) to unhealthy weight gain and emphasizes the importance of plant-based foods in the diet….

“For many doctors, an uneasy relationship with nutrition starts as early as medical school. Long hours and ready access to fast food, often on the hospital grounds, tends to undermine students’ best dietary intentions,” said Dr. Robert F. Kushner, a professor at Northwestern University Feinberg School of Medicine, where he directs the Center for Lifestyle Medicine. “Even the ones who come in excited about eating well and exercise find that good habits are harder and harder to maintain as time goes on,” Dr. Kushner said.

~From this great article in the New York Times, Doctor's Orders: Eat Well to Be Well

I could not agree more. It is incredibly difficult to develop and maintain healthy eating habits in medical school and residency (long hours in the hospital, sleep deprivation, high stress levels, free unhealthy food all around us, and lack of healthy choices in the cafeteria). 

When doctors don’t eat healthily themselves (and are given little to no education in what this means), then how can they be expected to counsel patients effectively?

Bill Clinton's new diet

Last night, Bill Clinton talked with CNN’s Wolf Blitzer about his new plant-based (basically vegan) diet:

"I went on essentially a plant-based diet. I live on beans, legumes, vegetables, fruit, I drink a protein supplemement every morning. No dairy. I drink amond milk mixed in with fruit and protein powder, so I get my protein in when I start the day out. It changed my whole metabolism, and I lost 24 pounds. I got back to basically what I weighed in high school."

After having heart surgery and having his stents re-clog because of his high cholesterol levels, he started doing his own research (including work done by Dr. Cladwell Esselstyn at the Cleveland Clinic, Dr. Dean Ornish at the Preventive Medicine Research Institute, and Dr. Colin Campbell author of The China Study). 

Clinton learned that 82% of people who go on a plant-based diet (no dairy or meat of any kind) can heal themselves and clear up their arterial blockage.

“We now have 25 years of evidence, and so I thought, well, since I need to lose a little weight for Chelsea’s wedding, I’ll become part of this experiment. I’ll see if I can be one of those who can have a self-clearing mechanism. We’ll see.” 

This is huge to have someone like Bill Clinton being an advocate for a plant-based diet! (I'm wondering if he’s tried yoga yet?!)

Getting entatic

Here’s a new word for you:

Entasy: An introverted and reflexive flow of consciousness.

In everyday experiences consciousness adverts towards the world. It is extrovertive and projects outward toward sensory objects. Entasy, in contrast, denotes an introverted and reflexive flow of consciousness. The yogin’s awareness turns back upon itself and reflects upon its own nature. Entasy is also a useful term because it contrasts with the feelings of excitement associated with being ‘in ecstasy.’ 

(excerpt on entasy from an essay on Samkhya philosophy during Richard Freeman’s Teacher Intensive) 

Entasy is the opposite of ectasy, which literally means “standing outside oneself.”

In the science world, when an atom or group of atoms is an entatic state, it means that it is in a geometric or electronic condition adapted for function.

If we apply this to humans, an entatic state would mean a state in which the mind is shaped and prepared for function.

The practice of yoga and meditation helps cultivate this entatic state by helping us identify our mental chatter, negative automatic thought patterns, illusions, distractions, and more. We then gain more control over our thoughts and become better prepared for general life functioning.

(And now I'm off for some entasy in my first ever Iyengar class in Philly!)

Sunday yoga and the science of love

I can’t think of a better way to start a Sunday than with mysore practice with yogi friends followed by a group coffee date at La Colombe… perfect!

I love seeing our little yoga family growing here: new students, new friends, and new babies! Two of our beautiful ladies are now pregnant, and it’s such a treat to get to practice with them every morning (and have one of them be our amazing teacher)!

This is one reason we chose our latest book club book to be The Scientification of Love, by Michel Odent.

It’s about the science behind love (i.e. falling love, life partnership, pregnancy, giving birth, raising a child). The author, Michel Odent, is a French obstetrician whose research focuses on the primal period (the time of life between birth and 1 year of age), and he correlates events during this time period with health and behaviors later in life.

It’s a fascinating book. Here are some highlights:

1. In some animals, pain during birth correlates with love for the newborn. Research in animals has shown that when painkillers/anesthesia are given during birth, some mothers will actually reject their newborns (they do not seem to recognize it as their own). For example, ewes given epidurals will not take care of their lambs!
2. Oxytocin is the “hormone of love.” You may have heard about this hormone because it’s released during breastfeeding (builds the mother-child bond). In addition, both men and women release it during sexual activity/orgasm. Well, we also release it when we share a meal with someone! (One question that came up: do our oxytocin levels rise when we practice yoga together  each morning?)
3. Love-sickness is a real thing. Anyone who has ever been in love knows this feeling: the physical illness you get when you lose or are separated from your loved one (knot in the stomach, loss of appetite, etc). This is an actual chemical withdrawal of neurotransmitters (i.e. phenylethylamine - PEA), and you are craving them. 
4. Falling in love has chemical similarities to obsessive-compulsive disorder (OCD). You know the feeling: you meet someone, you get crushy, you fall in love, and you develop OCD tendencies with this person (similarly with a new baby). When people fall in love they actually have lower levels of serotonin in the brain, just like people with clinically diagnosed OCD. 

Is this too much?

Check out this commercial by the Physicians Committee for Responsible Medicine (PCRM) on the consequences of fast food:




Too much?

Getting it back

In the movie Surfwise, Dr. Pascowitz defines health as:

“Not meaning the absence of illness but a superior state of well being. Above and beyond simply being but being everything a human being can be so that the brain can be everything that it can be.”

I think we all kind of know what Pascowitz is talking about. We all have times when we feel far from this "superior state of well being." We know when we’ve lost some of our zest and vitality for life.

Lately, my excitement for residency has been taken over by stress, fears, and uncertainty over the future.  I’ve been seeking ways to regain that “superior state of well being.” Here is my working list of things to do to help get it back: 

• Call an old friend. Old friends remind of us of who we are, what we want, why we’re doing what we’re doing, and what we might be missing. Call someone you haven't talked to in a while, call someone who "gets" you. 
• Meet a new friend. Meet up with someone you admire and want to learn from. Get inspired.
• Eat carefully. Food affects our mood and vice versa. When we're feeling down, the foods we often crave can end up making us feel worse. When feeling fragile, I try to stick to the basics: fruits, veggies, and grains.
• Learn something new. A new food, a new skill, a new fact.
• Create something. Try out a new recipe, make a collage, write a journal entry.
• Go for a run. Sweat it out. Get some endorphins circulating. 
• Do yoga. Get up early, make some coffee, and go practice. Hold upward facing dog for longer than usual and do lots of backbends. Remember how Iyengar said, “If you keep your armpits open, you won’t get depressed.” 
• Recognize your destructive thought patterns. Negative automatic thoughts spiral into more negative thoughts and doubts. Try not to get stuck in these thought patterns! First step is recognizing them.
• Do not wallow. Don’t keep sitting there thinking – get up and go do something! 
• Indulge in ‘me’ time. For me this means lighting a candle, taking a bath, and reading some Rumi.
• De-clutter your space. Clean up your clutter. I finally bought hangers and hung up all the clothes that were lying around my room... easy and instant gratification.
• Smile and laugh. Especially when you don’t feel like it. Fake it till you make it. 
• Keep a small journal with you wherever you go. The little pocket moleskine ones are perfect. Write down ideas, questions, quotes you like, lists of things you want to do.
• Go outside. Disconnect from your phone and computer.

What else do you do? Please share!

Negative ions

I spent the weekend at the Jersey shore. As we were lying around relaxing, someone suggested that this relaxed feeling might be because of the high concentration of negative ions at the beach.

What are negative ions?!

Negative ions are molecules with a negative charge (i.e. gain of an electron). This happens when molecules run into each other and break apart. They're present in higher concentrations in places like beaches, waterfalls, and showers. 

Could the presence of these invisible particles help explain why the beach is so relaxing?

This study at Columbia University looked at people with seasonal affective and bipolar disorder and found that high density negative ion generators actually improved symptoms of depression.

Columbia University researcher Michael Terman, PhD, explains in this article:

"The action of the pounding surf creates negative air ions and we also see it immediately after spring thunderstorms when people report lightened moods.”

According to researchers, negative ions may increase oxygen flow to the brain and lead to improved alertness and energy.

Where can we find negative ions? 

• By turning off the air conditioning and opening the windows
• In the shower 
• At beaches, mountains, waterfalls 
• After rainstorms
• By buying a negative ion generator

Low-carb diets: What happens in 20 years?

Are you on a low-carb diet or know someone who is? I've dabbled with this myself and hear friends and patients talking about it all the time.

But I've always wondered: can this really be good for our bodies? We lose weight in the short-term, but what about 20+ years down the road?

A recent study in the latest Annals of Internal Medicine starts to answer these questions. They find that where your proteins/fats come from (i.e. animals versus plants) matters very much for long-term health. 

They compared low-carb diets made up of animal sources versus low-carb diets made up of vegetable sources (in over 100,000 people for over 20 years), and found an important difference in mortality rates.

Low-carb diets high in animal-protein diets were associated with higher mortality (both cardiovascular and cancer mortality), while low-carb diets high in vegetable protein diets were associated with lower mortality overall (especially cardiovascular mortality rates). The authors’ conclusion:

“A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates.”

Low-carb diets can be helpful or harmful. What really matters is everything else you are putting into your body. It seems best to stick to simple and intuitive food rules. Here are my 5 for the day: 

1. Avoid refined sugars (but do not avoid nutritious whole grains!)
2. Minimize animal products
3. Build meals around fresh colorful vegetables (the more color the better)
4. Avoid overeating
5. Chew thoroughly (this helps with #4)

Laughter yoga

I had almost forgotten about the laughter-yoga class I took in India a few years ago until I came across an article about this growing practice in the latest Time magazine.

Apparently there are more than 400 laughter yoga clubs in the US!

What is laughter yoga?

• Laughing exercises
• Breathing exercises
• “Fake it till you make it.” (Fake laughter with other people turns into real laughter)
• No jokes needed 

Here is a short video on the STEPS!

There have been no peer-reviewed studies of laughter yoga, but many people including cancer patients and prisoners are now trying it out.

And check out this short CBS clip about it.

Anyone know of anyone doing this in the Philly area?! 

Things to be desired

I’ve been spending the weekend at home with my parents, and rummaging through my old clothes and journals. This morning, I came across an old journal from college and found this poem (below) glued inside the front cover. I hope you like it as much as I did both today and 10 years ago:

Desiderata

Go placidly amid the noise and haste, and remember what peace there may be in silence.

As far as possible, without surrender, be on good terms with all persons. 

Speak your truth quietly and clearly; 

and listen to others, even to the dull and the ignorant, they too have their story. 

Avoid loud and aggressive persons, they are vexations to the spirit. 

If you compare yourself with others, you may become vain and bitter; 

for always there will be greater and lesser persons than yourself. 

Enjoy your achievements as well as your plans. 

Keep interested in your own career, however humble; 

it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs, for the world is full of trickery. 

But let this not blind you to what virtue there is; 

many persons strive for high ideals, and everywhere life is full of heroism. 

Be yourself.

Especially, do not feign affection. 

Neither be cynical about love, for in the face of all aridity and disenchantment 

it is perennial as the grass.

Take kindly to the counsel of the years, gracefully surrendering the things of youth. 

Nurture strength of spirit to shield you in sudden misfortune. 

But do not distress yourself with imaginings. 

Many fears are born of fatigue and loneliness.

Beyond a wholesome discipline, be gentle with yourself. 

You are a child of the universe, no less than the trees and the stars; 

you have a right to be here. 

And whether or not it is clear to you, no doubt the universe is unfolding as it should.

Therefore be at peace with God, whatever you conceive Him to be, 

and whatever your labors and aspirations, in the noisy confusion of life, 

keep peace in your soul.

With all its sham, drudgery and broken dreams, it is still a beautiful world.

Be cheerful. Strive to be happy.

~Max Ehrmann c.1920

The 7 Conditions of Health?

I went to another free lecture at Essene the other night. This time it was by Macrobiotic expert Denny Waxman, whose book I have just finished: The Great Life Diet.

He talked about the 7 conditions of health as defined by the Macrobiotic founders George Ohsawa and Michio Kushi. They are divided into 3 categories: Physical, Mental/Emotional, and Spiritual. Here they are:

Physical:

1. No tiredness

2. Good sleep

3. Good appetite

Mental/emotional:

4. Good memory

5. Never be angry

6. Joyous and alert

Spiritual:

7. Endless appreciation/gratitude

I thought this was a pretty good list, but there were some things missing for me (friendship, love, community, laughter, learning).

I'm also not sure about #5: Never be angry. Never? I don’t get angry often, but when I do it’s usually for a good reason (in my opinion, at least)!

Does anything else seem to be missing for you on that list?