Prescribing veggies

Doctors are now prescribing fruits and veggies at local farmers’ markets. Check out this article in the NY Times last week if you haven't seen it yet.

Doctors at three health centers in Massachusetts have begun advising patients to eat “prescription produce” from local farmers’ markets, in an effort to fight obesity in children of low-income families. Now they will give coupons amounting to $1 a day for each member of a patient’s family to promote healthy meals.

Farmers’ markets can be a “hub of preventive health.”

“Can we help people in low-income areas, who shop in the center of supermarkets for low-cost empty-calorie food, to shop at farmers’ markets by making fruit and vegetables more affordable?” said Gus Schumacher, the chairman of Wholesome Wave, a nonprofit group in Bridgeport, Conn., that supports family farmers and community access to locally grown produce.

If the pilot project is successful, Mr. Schumacher said, “farmers’ markets would become like a fruit and vegetable pharmacy for at-risk families.”

The key will be to make it easy for people by bringing farmers' markets into hospital cafeterias, doctors' offices, schools, and churches. Speaking of which, I was so happy to walk into our hospital cafeteria the other day and see this: A table dedicated to produce from local farms!

Perhaps one day doctors will even be able to prescribe farm shares, so that fresh fruits and vegetables can be directly delivered to people each week. 

Good news in the medical world

The Dean Ornish lifestyle change program will now be covered by Medicare (article here, CMS decision memo here). This hopefully means we'll be seeing more diet and exercise programs pop up around the nation, and people will be able to afford them.

Below (or link here) is a 3-minute Ted Talk where Dean Ornish talks about the pandemic of cardiovascular disease, diabetes, high blood pressure, and obesity, and how these diseases are reversible through diet and lifestyle in 95% of people. He also talks about how prostate cancer can be reserved or stopped through diet and lifestyle. 

6 reasons why we need our injuries

My wrist is injured. This means I can’t do my normal yoga practice (can't do regular sun salutations or vinyasas, can’t work on jumbpacks, handstands, or backbends). It’s frustrating.

But in many ways, this injury is good for me. Here are 6 reasons why we sometimes need our injuries:

1. The physical practice does not matter. It's so easy to forget that yoga is not the physical practice. We get attached to the idea of being able to do certain postures, but that is not the point (click here for a perspective on the whole point). It's not about the end goal but about the process.
2. Healthy humbling. Everything is not within our control. Yes, we can plan for the future and take steps to reach certain goals, but we cannot plan everything. We get injured, accidents happen, and things change.
3. Work on things that have been neglected. Injury allows us to refocus on parts of the practice we may have been neglecting: the breath, standing poses, upward facing dog (holding for a few slow breaths rather than rushing out of it), shoulder stand (staying in it for a long time). 
4. Slow down. A daily yoga practice can be intense and our bodies may get over-worked. Injury may be a signal that our bodies need some rest and TLC.
5. Reflection. Times when we don't feel our best are good opportunities to take a step back and evaluate our overall health and happiness. What habits have I been cultivating? Am I eating well? Am I stressed? Am I sleeping enough? Am I spending my time well? Am I spending enough time with important people in my life?
6. Reminder that life is not linear. Things go in cycles. There are going to be ups and downs of my yoga practice just as there are ups and downs of everything else in life (jobs, relationships, moods, weather). Everything has an opposite (think about yin and yang).

How acidic is your diet?

I've heard people (especially yogis) talk about wanting to eat a low-acid diet but never really paid much attention until recently. Then this article piqued my interest, about how a low-acid diet might help prevent osteoporosis.

How could a low-acid diet prevent osteoporosis? Our blood needs to stay within a neutral pH of 7.35-7.45. When the blood gets too acidic, calcium is leached from the bones in order to neutralize it. Too much calcium loss from the bones leads to osteoporosis. Different foods produce different amounts of alkalinity or acidity in the body.

Acid-producing foods include meats, beans, fish, cheeses, and grains. Foods with a high protein content leads to more acid production (especially animal proteins because of sulfurous amino acids). Coffee, tea, beer, wine, sugary foods (things we crave and become addicted to) all acid producing.

Alkali producing foods include fruits and vegetables. Even though lemons and other citrus fruits have acidic juice, when they are ingested they actually have an alkaline effect (result of the potassium and magnesium present).

The typical American diet is highly acidic: meat, dairy, sugar, alcohol, and coffee, while low in fruits and vegetables. A low-acid diet is high in fruits and vegetables, and low in animal protein.

Some are beginning to suggest that it may actually be the consumption of too much meat and animal protein (including dairy) that explains the high rates of osteoporosis in America. Even though dairy products contain calcium, they may actually end up weakening our bones because of their acid-producing effect. Research like this is surfacing, showing that there is insufficient evidence to recommend dairy to children for bone health.

My own doctors have always recommended dairy products to make sure I get enough calcium, but have never talked about the effects of a low or high acid diet on my bones. Have yours? I'm wondering if/how this might start to change over the next few decades.

Are we feeding our own cancer cells?

If you eat a lot of fructose (which most of us do), the scary answer might be yes.

There is a lot of fructose in the American diet, as high fructose corn syrup (HFCS) has infiltrated our grocery stores. The consumption of high-fructose corn syrup has actually risen 1,000% from 1970-1990.

This study just came out showing that fructose actually stimulates the growth of pancreatic cancer cells (CBS news overview here).

Fructose is taken up by cancer cells and used to make new nucleic acids, which are the building blocks of cell growth and proliferation.

The authors of this study write:

“Fructose is a particularly significant dietary sugar component with important implications for patients with cancer, particularly given the significant dietary change that has occurred in human fructose consumption since the mid- 20th century. Our findings provide important insights into recent epidemiologic studies that have identified refined fructose as an independent risk factor for pancreatic cancer, and identify fructose-mediated actions as a novel therapeutic cancer target.”

When I checked the ingredient list on my packaged foods at home, I was shocked at how much had high fructose corn syrup (HFCS) in it... even my "healthy" whole-wheat bagels and my seemingly innocent ketchup and BBQ sauce.

Can decreasing the amount of fructose in our diet inhibit cancer growth? This is the question we need to research now. 

Eliminating HFCS is essentially what the Ornish diet does when they recommend a whole foods, plant based diet. Some preliminary studies show that this diet, along with exercise and stress reduction, may have some effect on the progression of prostate cancer (in addition to reversing atherosclerotic disease).

How much HFCS are hospitals serving patients? I wish we could say zero. I’ve been thinking a lot about Ben’s post and could not agree more that hospitals should provide nutrition labels on their food.

If you’re interested in learning more about this fructose issue, here’s a post and “mini-med school lecture” about it. I’m sure this is something we’ll be hearing more and more about. 

5 Ways to Make Hospitals Better

I’m happy to present this guest post by Ben Gerber, the author of Minimalist Muscle, a blog about muscle development and minimalism (two important parts of a yoga practice). Ben is a minimalist, lifter, blogger, and the husband of one of my best friends. He is now also a cancer survivor. You can learn more about his life and ideas on his blog.

Five Ways to Make Patients Healthier and Happier at the Hospital

Until recently, I'd been fortunate enough to have never stayed in a hospital overnight as a patient. My lucky streak ended this month with a week-long stay. While I was very happy with the treatment I received in this specific hospital, I came away from the experience with a lot of thoughts on how hospital stays could be a much healthier and happier experience. Here are the first five that came to mind.

1. Increase the number of healthy food options available. After not eating for nearly a week, I was excited to receive the hospital menu for my first meal. I had no delusions that hospital food was going to be fine cuisine, but I was shocked at the amount of junk food on the menu. Suffice it to say, the healthiest thing on the menu that day was apple sauce and cream of wheat (both of which I ordered). How hard would it be to add a banana or apple to the menu?
2. Reduce the sodium content of all foods. I like salty food as much as the next guy (I have a weakness for Kettle Chips), but much of what I was served was so salty that it was almost inedible. Any dish that sounded potentially healthy ended up having what I suspect to be an entire day's worth of sodium.
3. Disclose the nutritional value of all foods. It amazes me that fast food and chain restaurants are required to state the nutritional content of their food items, but hospitals are not. After all, you don't go to McDonald's expecting to be healthier after you leave, but you certainly expect hospitals to do everything they can to make you healthier during your stay. If the point of nutritional disclosure regulation is to avoid misleading consumers, the better target is hospitals.
4. Have a designated walking loop. According to my doctor, getting on my feet and walking was one of the best things I could do to recover from my surgery. The problem was that there wasn't any safe place to walk, particularly considering my frail state. The hospital hallways were always bustling, and I was almost plowed over several times.
5. Reduce the amount of junk in hospital rooms. Hospital rooms are tiny and difficult to navigate. I recognize that space is a matter of economics, but the existing area could be utilized much more efficiently. For example, I did not need the massive bedside table. Nor did I need the large rolling food table during the majority of my stay, since I couldn't eat (this coincided with the time in which it was most painful to move around, making the food table particularly difficult to navigate around).

"Take care of your body with steadfast fidelity"

Quote of the day:

Take care of your body with steadfast fidelity.

The soul must see things through these eyes alone,

And if they are dim, the whole world is clouded.

~Johann Wolfgang Von Goethe

Who teaches us how to take care of our bodies? Our doctors? Our teachers? Our parents? Our coaches? Our spiritual advisors (if we have them)?

Does anyone have someone like this in their life? Please share!