• By Whitney Fetterhoff, Published: February 21

Careful with that plow pose (but don’t stop doing yoga)

“The Science of Yoga: The Risks and the Rewards,“ by William J. Broade

From Bikram to Vinyasa, it seems like yoga has become the exercise experience of choice these days.

In “The Science of Yoga,” New York Times science writer William J. Broad examines the growing popularity of yoga and some of his findings are surprising. According to Broad, while yoga’s “low-impact nature puts less strain on the body than traditional sports, increasing its appeal for younger people as well as aging boomers,” some yoga positions, such as head and shoulder stands and the plow position, raise real injury concerns. “The idea of damage runs counter to yoga’s reputation for healing. Few practitioners anticipate strokes and dislocations, dead nerves and ruptured lungs,” writes Broad, a longtime yoga practitioner who injured his back doing an advanced yoga pose.

To pursue his theme of risks and rewards, Broad cites psychiatrist Carl Jung, who posited that yoga can either improve your mood, or “let loose a flood of sufferings of which no sane person ever dreamed.” Among yoga’s well-known positives supported by actual studies: relaxation, mental calmness, flexibility, reductions in blood pressure and, Broad says, a better sex life. Among the negatives: possible weight gain, because all that yoga-induced relaxation can lead to a reduction in your metabolic rate; joint instability; even brain damage or stroke from positions that demand extreme bending of your neck. Another claim for which Broad says there’s no scientific evidence: Yoga gets more oxygen into your blood.

Broad isn’t saying don’t do yoga. On the contrary, he makes the argument that yoga will — and should — remain a good source of exercise and relaxation, but he says practitioners and teachers alike need to be more attuned to potential downsides.

Fighting chronic inflammation

Vegetarian Times, “Tame the Flame Within,” March

When you sustain an injury, your body sends a host of white blood cells to repair the damaged tissue, which can become red and swollen; then there is chronic inflammation where a variety of triggers cause your immune system to go into overdrive.

“What makes low-grade inflammation deadly is that it can operate in stealth mode for years until it reveals itself as a heart disease or stroke,” according to Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston.

Chronic inflammation is also associated with diabetes, arthritis and lupus.

According to nurse Monica Reinagel, “a major player is a diet that is more pro-inflammatory than anti-inflammatory.” To minimize inflammation, dietitian Matthew Kadey suggests avoiding trans fats, sugary drinks and fruits grown using pesticides; instead, choose inflammation-fighting foods, such as extra virgin olive oil, whole grains and dark leafy greens, as well as turmeric, hemp seeds and ginger.

Another potential cause of inflammation is a food intolerance, such as to gluten or lactose, because the body perceives these as foreign invaders that the immune system must fight off. If you feel sensitive to certain foods, Kadey recommends removing them from your diet for at least two weeks to see if you notice a decrease in inflammation.

— Whitney Fetterhoff

The Incredible, Edible Egg Yolk

by Chris Masterjohn

I’m sure you’ve heard it before. When you think of a "health freak," you don’t think of someone eating egg yolks and discarding the white.

Think again.

Egg Nutrition: Yolk vs. White

Egg yolks are indeed full of cholesterol. Like most cholesterol-rich foods, they are jam-packed full of important nutrients, especially the fat-soluble vitamins and essential fatty acids.

In fact, the slew of nutrients in an egg yolk is so comprehensive that a few a day would offer better insurance than a multi-vitamin. Most importantly, the yolk contains most of the nutrients in an egg.

Egg whites, on the other hand, contain far fewer nutrients. The only thing that could justify their consumption is their attachment to their companion yolk.

Don’t believe it? Below is a table that compares the nutritional value of egg whites and yolks, with data provided by the USDA. I’ve included additional analysis in the last two columns that provides the percentage of the total nutrition found in the yolk and the percentage of total nutrition found in the white.

Table 1: Egg Yolks Versus Egg Whites

Data taken from the USDA Nutrient Database for Standard Reference, Release 15. AA and DHA data from NutritionData.Com. Since the article was written, the USDA has published revisions. The latest, Release 17, can be found here.

As you can see from the table, the yolk contains 100% of the carotenoids, essential fatty acids, vitamins A, E, D, and K (6 items). The white does not contain 100% of any nutrient.

The yolk contains more than 90% of the calcium, iron, phosphorus, zinc, thiamin, B6, folate, and B12, and 89% of the panthothenic acid (9 items). The white does not contain more than 90% of any nutrient, but contains over 80% of the magnesium, sodium, and niacin (3 items).

The yolk contains between 50% and 80% of the copper, manganese, and selenium, while the white contains between 50% and 80% of the potassium, riboflavin, and protein.

It should also be kept in mind that the yolk of an egg is smaller than the white. Where the white contains a slim majority of nutrients, such as protein, this is not due to a greater concentration in the white, but simply to the fact that there is more white in the egg than yolk.

Egg Yolks Would Resolve Americans’ Most Common Nutrient Deficiencies

According to the Executive Summary of the Third Report on Nutrition Monitoring in the United States by the Interagency Board for Nutrition Monitoring and Related Research of the Federation of American Societies for Experimental Biology’s Life Sciences Research Office, the following is true:

• Most groups have a deficient median intake of magnesium.
• Several groups have a deficient median intake of calcium.
• Children aged 1-2 and most groups of females have a deficient median intake of iron.
• Blacks over the age of 16 and Mexican-Americans over the age of 60 have a deficient median intake of folate.
• All age groups and races have a deficient median intake of vitamins A, E, B6, and copper.

Considering this information, the importance of the egg yolk and relative unimportance of the egg white becomes even more clear. The yolk contains the majority of the copper, nearly all of the calcium, iron, folate, and B6, and 100% of the vitamins A and E.

The white, on the other hand, is only useful as an added source of magnesium, or if the diet is on the whole deficient in protein. The simple addition of an adequate amount of meat in the diet would provide for both.

Finally, eggs are an excellent source of carotenoids. These are primarily highly absorbable forms of lutein and its partner zeaxanthin. These carotenoids accumulate in the back of the eye and appear to protect against age-related macular degeneration. There is no RDA for them, as researchers are still trying to understand their importance. All of the lutein and zeaxanthin in an egg is contained in the yolk.

Egg Yolks Contain Essential Fatty Acids DHA and Arachidonic Acid

One important set of nutrients that should not be overlooked is the long-chain essential fatty acids. Egg yolks contain the long-chain omega-3 fatty acid DHA, which is necessary for the brain and proper retinal function in the eye, and the long-chain omega-6 fatty acid arachidonic acid, which is required for the healthy skin, hair, libido, reproduction, growth and response to injury. These fatty acids are primarily needed by young children, pregnant and lactating women, and people with degenerative diseases involving oxidative stress, especially those of the nervous system such as Alzheimer’s. While fatty fish and cod liver oil supply DHA in larger amounts, egg yolks have an advantage over these foods because they also contain arachidonic acid and because they do not contain EPA, which interferes with arachidonic acid metabolism.

According to NutritionData.Com, one egg yolk contains 75 mg of arachidonic acid (AA), 20 mg of DHA, but no EPA. As I describe in my Special Report, How Essential Are the Essential Fatty Acids?, DHA and AA are the two fatty acids essential to humans and other mammals, while EPA interferes with the body’s use of AA and probably does not belong in the mammalian body at all.

Animal foods from animals raised on pasture are likely much richer in DHA. In all eggs, both the DHA and AA are contained in the yolk.

Egg Yolks Do Not Cause Heart Disease — Egg Yolks Are Good for Your Heart!

Concerned about the cholesterol in egg yolks? Worried about protecting your heart health? Egg yolks have long been maligned because of their cholesterol content, but cholesterol itself does not cause heart disease. In fact, while LDL, a major carrier of cholesterol in the blood, does have a role in heart disease, it is when poor metablism, deficient diets, and toxins destroy the LDL particle that heart disease develops. You can read more about this in my extensive article High Cholesterol and Heart Disease — Myth or Truth? Or, listen to my interview with Jimmy Moore on the Livin’ La Vida Low-Carb Show, Chris Masterjohn on the Health Benefits of Cholesterol." No reading required!

And, in fact, the University of Connecticut has extensively studied the effects of eggs on cholesterol levels. These high-quality controlled studies have shown that when people consume three to four eggs per day, with the yolk, virtually everyone experiences either no change or beneficial changes in their cholesterol levels. Dr. Maria-Luz Fernandez has reviewed those studies here.

To Cook, or Not to Cook? The Benefits of Raw Egg Yolks

Many people believe that the health benefits of egg yolks are greater when the yolks are consumed raw. Heat destroys enzymes, reduces the amounts of certain nutrients, and may make the amino acid cysteine less available, which is needed to synthesize the master antioxidant of the cell, glutathione.

Those who eat raw egg yolks report easier digestion, increased stamina, and resistance to illness — not to mention a quicker snack if they’re on-the-go.

That said, there is little evidence beyond such anecdotes that egg yolks are truly more beneficial when consumed raw.

There is also little evidence to support the common belief that consuming raw egg yolks is dangerous. Please see Dr. Mercola’s article on the safety of eating raw egg yolks if you are concerned about this.

Raw Egg Whites Contain Digestive Enzyme Inhibitors and Anti-Nutrients

Raw egg whites should not be consumed. They contain inhibitors of the digestive enzyme trypsin, which are destroyed by heat. Consuming 100 grams of raw egg white with one egg yolk compared to consuming the same food cooked was shown in one study to reduce protein digestion from 90 percent down to 50 percent.

Raw egg whites also contain an anti-nutrient called avidin. Avidin is a glycoprotein that binds to the B vitamin biotin, preventing its absorption. Biotin is necessary for fatty acid synthesis and the maintenance of blood sugar, and is especially important during pregnancy when biotin status declines.

Residual Egg White Avidin — Cooking Does Not Fully Destroy the Anti-Nutrients

It is a myth that light cooking completely destroys the avidin.

According to this study, poaching eggs only destroys one third of the avidin while even frying leaves 30 percent of it behind.

This raises the question of whether there is a net nutritional advantage to eating any egg whites at all. Most likely, it depends on the individual person. There is controversy over whether biotin produced in the intestinal tract is absorbed — if intenstinal biotin production is indeed nutritionally important, then people whose intestinal flora are less avid producers of biotin probably need to be more concerned about the potential adverse effects of consuming egg white.

Finding The Right Kind of Eggs

Pastured eggs, meaning eggs from chickens that are free to forage for grass and insects, are of much higher nutritional quality than eggs from confinement chickens. The marginal increase in value, of course, is found mostly in the yolk.

Insects provide a higher DHA content, found exclusive in the yolk, and grass provides a higher vitamin E and carotene content, also found exclusively in the yolk. Egg yolks from pastured chickens are thus a powerful supplement to a healthy diet — a super-food — providing necessary nutrients in which the Standard American Diet is deficient.

To find a source of eggs from chickens raised on pasture, you can visit LocalHarvest.org and do a search for "eggs pastured" or "eggs grass fed" with your zip code. You can also visit EatWild.com and click on your state for a list of farms that pasture their animals.

Additionally, you may be able to find roadside stands in your area that sell eggs from pastured chickens. Be sure to inquire about the farming practices, to make sure that the chickens are able to forage for both grass and insects.

Back to the Basics: Taste!

The truth is that most satisfying meals one could make with eggs just don’t taste right without both the yolk and the white. Most baked goods come out with a richer taste and a better texture when the yolks are included. Food should provide good nutrition — for which inclusion of the yolks is necessary! — but it should also taste good.

Food should be fun. It should be rewarding to cook, delicious to eat, and relaxing to indulge in.

The anti-cholesterol establishment upholds its poor theory and unjustified conclusions only to condemn us to a bland and unsatisfying diet, the cornerstone of which is "light cooking" with bland and taste-challenged "foods" like the notorious, emasculated, yolkless egg white.

Fear not.

You are now armed with the raw facts from the USDA’s nutrition database that shows that missing out on the egg yolks means missing out on the nutrition in your breakfast. Take heart in this the next time you enjoy the incredible, edible egg yolk.

The study on which the story is based found that adults with higher intakes of milk and other dairy products did better in memory and other brain function tests than those who drank little or no milk.

However, the Mail’s excitement is misplaced – the study did not show that milk was responsible for better mental performance. The type of study reported cannot show cause and effect. All it showed was that, at one point in time, people who drank more milk performed better in mental tests than those who drank less. It is possible that many other things influenced people’s performance in mental function tests, including occupation, stress levels, even how well they were feeling at the time they took the tests.

Milk may be good for your bones but so far there is no good evidence that it improves mental performance.

Where did the story come from?

The study was carried out by researchers from the University of Maine in the US and the University of South Australia. It was published in the peer-reviewed International Dairy Journal. It was partly funded by the Maurice de Rohan International Scholarship, the University of South Australia and the National Heart, Lung and Blood Institute, the National Institute on Aging and the National Institutes of Health, all in the US.

The Mail reported the study uncritically. Its suggestion that milk could help stave off mental decline is not supported by this research. It’s worth noting that the study was released to the press by a US PR company on behalf of the National Fluid Milk Processor Promotion Board, which is an industry-funded organisation set up by the US government to promote milk. This may explain how it found its way into the Daily Mail.

What kind of research was this?

This was a cross-sectional analysis of nearly 1,000 participants that aimed to investigate whether dairy food intake was associated with mental functioning. This type of study can provide a “snapshot” of various lifestyle factors and people’s health at one point in time, but it cannot establish cause and effect. A cohort study that recorded people’s dairy consumption over time and then tested their mental function more than once would provide more reliable results although even this type of study cannot establish cause and effect.

The researchers say that as the whole population ages, cognitive decline and dementia place a severe strain on both families and healthcare systems. Change in diet may have a role in preventing cognitive decline, but they say little attention has so far been paid to the relationship between dairy foods and mental performance.

The researchers say there is growing evidence that dairy products may be of benefit to cardiovascular health. Many experts would dispute this. Some dairy foods are high in saturated fat, which is associated with obesity and heart disease. Most dietitians advise a restricted intake of dairy products or consumption of low-fat varieties.

What did the research involve?

Researchers recruited 1,049 adults of all ages who were taking part in research looking at cardiovascular health and mental functioning. They collected health and lifestyle data from the participants by various methods including self-reports, medical examination, diagnostic interviews, health records and neuropsychological testing.

After excluding those who did not fulfil eligibility criteria (for example, because dietary or cognitive data were missing or because they had suffered a stroke), they were left with 972 participants.

To measure mental functioning of the participants, the researchers used a validated series of tests measuring memory, verbal recall, visual–spatial perception, organisational and verbal skills, and abstract reasoning ability. For dietary intake, they used a recognised questionnaire that included questions about nutrition and lifestyle.

The dietary component of this questionnaire included questions about dairy products. Milk was considered separately from total dairy foods. Total dairy foods were grouped as followed:

• cheese
• yoghurt and dairy desserts
• cream and ice-cream

Participants were asked how frequently they consumed such foods, with six possible responses:

• never
• seldom
• once a week
• 2-3 times a week
• 5-6 times a week
• once or more a day

Participants were also asked which type of milk they consumed – full fat, reduced fat or skimmed.

The researchers used validated statistical methods to analyse the relationship between mental performance scores and dairy intake. They adjusted their results for other factors that might affect the results, including age, education, smoking and alcohol.

What were the basic results?

The researchers report that participants who consumed dairy products at least once a day had “significantly higher scores on multiple domains of cognitive function” compared with those who never or rarely consumed dairy foods. In addition, those who reported eating dairy foods between two and four times a week performed significantly better on some of the tests than those who ate dairy foods once a week. The association between greater dairy food consumption and mental performance remained significant after adjusting for a number of risk factors. There was no significant association, however, between intake of specific categories of dairy foods (such as milk, cheese or yoghurt) and results of the tests.

How did the researchers interpret the results?

The researchers say their results support an association between high dairy food consumption and cognitive function. Although little is known about how dairy foods might influence mental functioning, they say that one possibility is that dairy food consumption may be beneficial for mental functioning through its “favourable effect” on cardiovascular risk factors such as obesity.

Conclusion

Contrary to the headlines, this study does not show that dairy food consumption has benefits for mental functioning. All it can do is provide a “snapshot” of a group of people’s dairy consumption and their mental functioning at one point in time. Some limitations are that:

• It relied on people self-reporting their dairy intake, which introduces the possibility of error.
• It is possible that many other factors (known as confounders) might have affected the results, including exercise habits, alcohol and stress levels, although researchers tried to adjust their findings for some of these.
• As the authors acknowledge, the dietary questionnaire did not specify size of portions or servings, which undermines the accuracy of estimated intakes.

Dairy products contain many nutrients that are needed for good health, in particular for the development of healthy bones and teeth. However, they are also high in saturated fat, which is associated with heart disease and obesity. At present there is no good evidence that dairy foods are especially beneficial for brain functioning.

Find out how dairy fits into a healthy diet using the Eatwell Plate.

Links To The Headlines

The white stuff: Drinking just one glass of milk a day could boost your brain power. Daily Mail, January 31 2012

Links To Science

Crichton GE, Elias MF, Doreb GA, Robbins MA. Relation between dairy food intake and cognitive function: The Maine-Syracuse Longitudinal Study. International Dairy Journal 2012:22;15-23

View article…

AskMen.com
Winter Sleep

Sleep is the critical element that allows you to attain success in your peak performance, weight loss and longevity goals. No matter how clean you eat or how often you exercise, if you’re chronically sleep-deprived and stressed, or if you’re not getting regular quality sleep, you’re sabotaging your efforts.

Zzzzzz…

Early humans got more sleep per night because their circadian rhythms were more closely synchronized with the rising and the setting of the sun. Today we have artificial light to extend our active periods and many other distractions preventing us from getting adequate sleep. Although we all differ in the amount of sleep we need, some experts recommend that we get as much as nine hours of sleep per day. Unfortunately, about a third of us in North America are thought to be affected by chronic sleep loss or sleep disorders. A recent survey uncovered that many who are at risk of insomnia engaged in stimulating activities an hour before getting into bed: 90% watched TV, 33% were on their computers and 43% were doing household chores. That means, presumably, that watching TV shows about household chores on your computer would keep you up all night.

The Goldilocks Principle

Sleep deprivation has profound effects on hormones that control metabolism, appetite, mood, concentration, memory retention, and cravings. It is associated with high blood pressure, elevated stress hormone levels, irregular heartbeat, and compromised immune function, and it drastically increases your risk for obesity and heart disease. Results from the 2004-2006 U.S. National Health Interview Surveyindicated that adults who usually slept less than six hours were much more likely to smoke, drink more than five glasses of alcohol, not exercise, and be obese. Interestingly, adults who slept more than nine hours also engaged in these unhealthy behaviors. Researchers from the University College London found that lack of sleep, or too much of it, more than doubled your risk of death. Scientists are quite familiar with the links between poor sleep and cardiovascular disease, but they’re not sure why sleeping too much is also bad for you. A possible connection to depression and low socioeconomic status has been found, but this needs to be further elucidated.

Cryptochromania

Cryptochromes sound like something out of a sci-fi movie, but they’re actually a very ancient protein that is found in every single plant and animal on our planet. Sensitive to the blue light of dawn and dusk, cryptochromes are involved in our circadian rhythms and are found in the eyes and skin, meaning that our bodies can detect sunshine even if our eyes are covered. Ever wondered how blind folks tell whether it’s day or night? Cryptochromes detect diminishing sunlight and signal the pineal gland to convert serotonin, which has kept your mood elevated all day, to melatonin, which gives you a good night’s rest. When light increases in the morning, melatonin production is suppressed and serotonin rises, allowing you to wake up refreshed and recharged. This is why the use of selective serotonin reuptake inhibitors (SSRIs) is such a popularly prescribed antidepressant. All people really need to overcome some cases of depression and anxiety is more sleep.

Are You Not Getting Enough Sleep?

Light kills Melatonin

Extended exposure to artificial light disrupts the natural rhythm of serotonin-melatonin production that we’ve evolved over millennia of living on earth. Melatonin is inhibited by light and brought on by darkness, so the longer you stay up, the lower your melatonin production will be, and that’s going to have some negative consequences on your mental and physical health. Research suggests that premature aging is related to low melatonin levels during sleep. Melatonin is involved in learning and memory and may be an effective treatment for Alzheimer’s disease. It is a powerful antioxidant able to protect DNA from free radical damage and may prevent the development of some forms of cancer. A gloomy example can be seen in night shift workers. Recent studies show that their disrupted circadian rhythms and low melatonin levels puts them at an increased risk of developing cancer. If you’re a night shift worker, try to offset your diurnal tendencies by adopting a strict diet and exercise plan. If possible, negotiate a way to work the day shift every other month.

Before you rush out and buy melatonin supplements, keep in mind that although this may help in the short term, it will cause your body to gradually produce less melatonin naturally. Nothing, absolutely nothing, is as restorative as natural sleep.

Sleep Habits

Counting Fat Sheep

Chronic sleep deprivation has profound alterations on glucose metabolism. The ability to secrete insulin and to respond to insulin decreases to roughly 30%, identical to early markers of diabetes. Research has shown that it is the disturbance of deep sleep, or REM, that is associated with hormonal disturbances. So it’s the quality of your sleep, not the quantity, that is ultimately important.

Poor sleep increases levels of cortisol, a stress hormone that has several beneficial effects on the body, but when chronically elevated becomes extremely problematic. A high level of cortisol lowers testosterone, impairs immunity, promotes muscle loss, and increases blood pressure. Cortisol also promotes the storage of fat, particularly around the abdominal area, where there is an increased risk of cardiovascular disease and diabetes.

Cortisol decreases the production of serotonin, and serotonin is increased after eating carbohydrates (sugar and starches). This is why many people eat sweets when stressed or when staying up late. Since serotonin enhances calmness, improves mood and lessens depression, this sets up cravings for additional sweets. Calming and positive thoughts also increase serotonin levels and coincidentally lower your desire for food. So close the fridge door and take a deep breath.

For successful weight loss, enhanced energy, better mood, and increased libido, try to keep your cortisol levels down by finding ways to reduce stress. Managing stress is by far the most challenging task in modern society. It can begin with the morning commute to school or work and end by listening to the news before bed.

Join the Dark Side

To get a better night’s rest, practice good sleep hygiene and follow the sleep strategies recommended by the Better Sleep Council:

-Make your bedroom a haven for sleep by making it a place of pleasure and rest, not stress and tension.

-Unwind and relax before going to bed. Write down stuff that’s got you worried so you can deal with it in the morning.

-Avoid coffee and stimulants in the evening. I guess that also extends to household chores.

-Try going to bed at the same time every night, including weekends. Regularity will help normalize your circadian rhythm.

-Don’t eat anything too heavy before bedtime. If you must eat something, choose protein and fat over carbohydrates. Cottage cheese and blueberries is a good choice.

-Keep your room cool, about 16-18 degrees Celsius. A room that’s too hot or too cold is uncomfortable.

-Sleep in a dark room. This is the most important advice since light is such a powerful force that wakes your brain way before your alarm clock goes off. In addition to light-proofing your window, get rid of that digital alarm clock with the LED display and remove any electronic equipment that has those annoying blinking lights. A clinical study published in the Journal of Pineal Research suggests that women who sleep in the brightest bedrooms have an increased risk of breast cancer. Don’t wait around for a similar study to be done on guys; turn that bedroom into a cave as soon as you can.

Remember, we all have a busy lifestyle with tons to do during our waking hours. But your productivity will suffer if you don’t get enough rest. The quality and quantity of the sleep you get can make all the difference in how you’re able to function the next day. And the day after. And the one after that.

February 9, 2012, 12:01 AM

What Doctors Are Telling Us Even When They’re Not Talking

By PAULINE W. CHEN, M.D.

Reza Estakhrian/Getty ImagesWhat does your doctor’s body language say to you?

I recently read through a study published in The Journal of General Internal Medicine on the different ways that African-American and white doctors communicate nonverbally with older patients, and I was reminded of a former colleague, a specialist in brain tumors who stood out from the rest of us young doctors for two reasons.

First, though a relative newcomer to the hospital, he had diagnostic skills equal to those of physicians many years his senior. Second, and not unusual for over a decade ago, he was one of the few African-American physicians there.

One day I asked him to see one of my patients who had recently been given a cancer diagnosis. The patient, who was older and white, was sitting upright in his bed, surrounded by his wife and children, when we entered the room. But by the time we left, the patient, along with his relatives, was doing exactly what I was — leaning over and politely straining to hear what my colleague was saying.

This brilliant doctor’s soft baritone voice was rendered even less comprehensible because he tilted his head down and spoke not toward us but at the door. Every so often he looked up and shared a radiant, even reassuring smile. But then he would look down again, shift his weight and continue speaking too softly to be intelligible.

What puzzled me was that I didn’t normally think of this colleague as being that self-effacing. But when I described his visit a couple of days later to another colleague, a mutual friend, she immediately recounted a similar episode. “It’s weird, isn’t it?” she said. “He’s the smartest doctor in the hospital, but when he starts talking to some patients, it’s like he’s trying to disappear.”

For nearly two decades, teaching good communication skills has beenmandatory for medical schools because of research showing that good patient-doctor communication can lead to improved patient satisfaction and better health care outcomes. To this end, medical educators have developed a host of communication courses and workshops that combine lectures, self-assessments, video recordings and “standardized patients,” or actors in the role of patients.

More recently, many schools have broadened their courses to include “cultural competency,” or the ability to communicate with those from different racial, ethnic and social backgrounds. Studies have shown that while a patient’s race and ethnicity can be linked to sharply different treatment courses and quality, better communication between doctors and patients of different backgrounds can reduce the disparities.

Despite these tremendous efforts, there is one area of communication to which few schools have devoted significant time or resources: body language and facial expressions.

Now a small but growing body of research is revealing that the nonverbal component of the patient-doctor interaction — the subtle gestures, body positions, eye contact, touch and expressions that pass between individuals — is as critical a part of communication as verbal expressions. And nonverbal cues may, in fact, be more reflective of the biases faced by doctors and patients.

In this recent study, for example, a group of medical sociologists analyzed the interactions between 30 primary care doctors and more than 200 patients over age 65 and found that white physicians tended to treat older patients similarly, regardless of race. Black physicians, on the other hand, often gave white patients contradictory signals, mixing positive nonverbal behaviors, like prolonged smiling or eye contact, with negative ones, like creating physical barriers by crossing the arms or legs.

The finding was reminiscent of earlier studies on interactions between female doctors and male patients, in which the doctors tended to give the patients conflicting nonverbal cues, combining, for example, smiles with a negative or anxious tone of voice. These mixed signals, said Irena Stepanikova, the lead author of the recent study and an assistant professor of sociology at the University of South Carolina in Columbia, are a result of dealing with “a status in our society that is devalued.” Rather than being expressed explicitly, biases regarding race and gender tend to be expressed “in behaviors not consciously controlled,” she said.

The researchers also found that despite the contradictory cues, the black doctors were generally more skillful in using positive nonverbal behaviors than their white colleagues. They were, for example, better able to use prolonged eye contact, more open body positions, facial expressions and even light touch to encourage patients and convey respect, understanding, availability and attention. “Patients feel vulnerable and search for nonverbal cues,” Dr. Stepanikova noted. “If the doctor nods when the patient is talking but keeps looking at the chart, the patient will wonder if the doctor is really taking her seriously.”

Dr. Stepanikova and her colleagues believe that greater emphasis on nonverbal communication can help medical educators address some of the social biases that affect patient care. But they acknowledge that the process will be challenging. Research in this area is still relatively sparse, and few medical educators are well versed in this topic. Moreover, even experts like Dr. Stepanikova, who needed to devote several hours to analyzing just portions of a single patient-doctor visit, are unsure of how researchers and educators can measure the nuances and complexities of nonverbal communication accurately, consistently and efficiently.

“We all want to be as egalitarian as possible,” Dr. Stepanikova said. “But what is difficult is knowing what and when to change, because so much of nonverbal communication happens outside of our conscious awareness.

February 29, 2008, 1:12 PM

The Cure for Exhaustion? More Exercise

By TARA PARKER-POPE

Feeling fatigued? (George Ruhe for The New York Times)

When a person is sapped by fatigue, the last thing he or she wants to do is exercise. But new research shows that regular, low-intensity exercise may help boost energy levels in people suffering from fatigue.

Fatigue is one of the most common health symptoms and can be a sign of a variety of medical problems. However, about one in four people suffers from general fatigue not associated with a serious medical condition.

University of Georgia researchers decided to study whether exercise can be used to treat fatigue. The research, which appears in the February issue of the journal Psychotherapy and Psychosomatics, involved 36 volunteers who were not regular exercisers but who complained of persistent fatigue.

One group of fatigued volunteers was prescribed 20 minutes of moderate-intensity aerobic exercise three times a week for six weeks. The second group engaged in low-intensity aerobic exercise for the same time period, while a third control group did not exercise.

The study volunteers used exercise bikes that allowed the researchers to control their level of exertion. The low-intensity exercise was equivalent to a leisurely, easy walk. The more intense exercise was similar to a fast-paced walk up hills. Patients with fatigue due to serious medical conditions, such as those with chronic fatigue syndrome, weren’t included in the study.

Both of the exercise groups had a 20 percent increase in energy levels by the end of the study, compared to the control group. However, the researchers found that more intense exercise isn’t the best way to reduce fatigue. The low-intensity group reported a 65 percent drop in feelings of fatigue, compared to a 49 percent drop in the group doing more intense exercise.

“Too often we believe that a quick workout will leave us worn out — especially when we are already feeling fatigued,” said researcher Tim Puetz, in a news release. Dr. Puetz recently completed his doctorate at the university and is the lead author of the study. “However, we have shown that regular exercise can actually go a long way in increasing feelings of energy — particularly in sedentary individuals.”

Why exercise helps fatigue isn’t clear, but Dr. Puetz said his findings suggest exercise acts directly on the central nervous system to increase energy and reduce fatigue. Notably, the improvements in energy and fatigue were not related to increases in aerobic fitness.

“A lot of people are overworked and not sleeping enough,” said Patrick O’Connor, co-director of the university’s exercise psychology laboratory, in the release. “Exercise is a way for people to feel more energetic. There’s a scientific basis for it, and there are advantages to it compared to things like caffeine and energy drinks.”

Energy and Productivity Boost

Most people who exercise regularly know that working out actually helps boost your energy level, not diminish it, and at least one study shows that working out over the middle of the day can actually help you stay motivated and productive when you clean up and head back to the office.

A study conducted by researchers at Elon University showed that not only did exercisers have more energy after their workout, their cognitive abilities showed improvement as well. Lifestyle blog Greatist (reproduced below) suggests you harness that mental boost by working out over the middle of the day, right when you’re starting to slump, and then head back to the office recharged. The only caveat is that workers who were super-stressed didn’t experience the cognitive benefits, and were actually less productive. So check your stress in the locker room, okay?

Obviously not everyone has the type of job that will let you break for a long lunch to squeeze in a workout at a nearby gym, shower, and then come back to work, but for those people with some flexibility in their hours or an office building with a gym inside or nearby, it could be a good way to break the habit of sitting all day and squeeze a workout into your routine. Do you exercise in the middle of the day, when you get up, or before bed? Which time works best for you?

http://www.greatist.com/fitness/try-a-midday-workout-to-boost-productivity-021612/#footnote_2_28058

Try a Midday Workout to Boost Productivity

by Laura Schwecherl · Fitness

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Falling asleep in front of the computer screen? Creativity crashing by 3pm in the office? The trick to becoming more productive may be to ditch the cubicle and hit the gym. Studies suggest a midday workout can help productivity skyrocket (and even boost job satisfaction!), so we can quickly gain back those hours lost in gym-land.

We Can Work It Out — The Takeaway

Photo by Ben Draper

Don’t just live for lunch breaks. Scientists have found that fitting in some fitness can increase work stamina. In one study, a third of participants who devoted two and a half hours a week to exercise during work hours reported maintaining or increasing productivity (even though they spent less time at the office) [1]. And other research suggests regular, low intensity exercise (like yoga or walking on aninclined treadmill) could dramatically reduce sleepiness and amp up energy— no Red Bullnecessary [2].

Need to think outside the box? Moderate cardio exercise has been shown to deliver a two-hour creativity boost immediately following that workout session. And ramping up the intensity (think: treadmill intervals or a CrossFit WOD) cansharpen the brain without the books: One study found a five to 10 percent improvement in cognitive function for those who hit the gym [3]. Finish the workout off with some stability-promoting core exercises like planks, and plenty of stretching and foam rolling for a pain-free transition back to that desk.

But before lacing up, the super-stressed should take heed. Researchers have found that high levels of stress combined with working out could lead to significant loss in the productivity department. On the other hand, less-stressed workers (what’s their secret?!) who exercised regularly experienced less productivity decline [4]. No harm there!

And while experts are still on the fence about the best time to workout, there’s still this physiological fun fact. Body temperature goes up a few degrees midday, warming muscles and potentiallyenhancing workout performance [5]. Looks like the secret weapon to a great workday and workout may be right around lunchtime. And for those who don’t have more than half an hour to break free, it never hurts to ask!

UMAIR HAQUE

Umair Haque is Director of Havas Media Labs and author of Betterness: Economics for Humans and The New Capitalist Manifesto: Building a Disruptively Better Business. He is ranked one of the world’s most influential management thinkers by Thinkers50. Follow him on twitter @umairh.

Why Love Matters More (And Less) Than You Think

6:14 PM Tuesday February 14, 2012 | Comments (34)

• So, how was your Valentine’s Day? Me? I had an anti-Valentine’s day at my local bar with the ghost of Albert Camus, an existential crisis, and a decent bottle of wine. Here’s what occurred to the four of us while we were angsting out.EMAIL
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I’ve made the point before that our economy seems especially good at mass-producing toxic junk. Food that malnourishes us, entertainment that bores us, "news" that isn’t, finance that blows up our economy, et cetera. So somewhere into the bottom half of the bottle, I found myself sinking into the well-worn mental ruts that are probably familiar to anyone who has ever hated Valentine’s Day: how it’s a suspiciously consumerist celebration of cheesy pink-tinged coupledom that exists for the sole purpose of selling pink (or blue) fuzzy (or smooth) disposable crap (or overpriced blood diamonds). Smile winningly, pledge your troth, and log into the intertubes to breathlessly proclaim "Life goal achieved!!!!<3!!"

Throw The Art of War at me if you must, waterboard me, glue my eyes wide open and dress me in one of Rick Santorum’s sweater vests if you have to, but I’d suggest, when it comes to real human prosperity: the truest denominator of a life searingly well lived is love. And that has nothing to do with pop songs, rom-coms, or candy hearts.

Hence, here are a few things I’ve learned along the way — thanks to a long string of catastrophically failed relationships, imploding corner offices, living in between multiple cities, a couple of fistfights, and long evenings of solitude at the bar. These aren’t the only lessons — or even the "best" ones; just a few of mine.

Experience. There are many kinds of love. The Greeks distinguished between agápe, éros, philía, and storgē. Consider: five millennia ago, a more nuanced conception of love existed than the McLove that surrounds us today. Without experiencing the many forms of love — evoking them in one another, and elevating them for one another — we’ll probably always feel a little empty.

Act. Love is a verb, not (just) a feeling. Love is investing in, sacrificing for, and caring about; seeking what I’d call higher-order returns — igniting the creation of real human wealth in others (and reciprocation in kind). The former without the latter is to love what Mission Impossible 4 is to great film: banal, disposable, and shinily vacuous. Love, above all, must be lived.

Suffer. Love transforms, and transformation hurts. Hence, you probably won’t love if you can’t surrender to a little bit of suffering. You can’t love your work if you don’t suffer for the art and craft in it. You can’t love your partner if you don’t suffer a little bit sometimes when you see them — as if the act of seeing them reminds you of the heart-stopping fragility of life. And I’d bet you can’t fully love if you can’t deprogram yourself from the cult of consumer not-quite "culture" and its relentless cycle of self-loathing. You have to take a deep breath and plunge into the arduous journey of figuring out why you’re really here, who you are — and why it matters.

Mean it. Erich Fromm, after a lifetime inquiring into the meaning of life, famously concluded: "Love is the only sane and sensible answer to the question of human existence." To which Woody Allen tartly replied: "Love is the answer, but while you are waiting for the answer sex raises some pretty good questions."

Sure, it’s possible to divert yourself for a long, long while with money, power, fame, toys, and the other assorted fun and games we’ve used the institution of a consumer economy to produce. But love is not a commodity. Love is the messiest, most singular, least interchangeable, and most transformative idea our species has yet invented. Unlike the humdrum, yawn-inducing stuff our institutions can offer us, love can’t be bought off the shelf in a neatly packaged twelve-pack.

But it can, if you’re very lucky, be earned. So don’t front. At the end of the day — and especially at the surprisingly short end of life — there’s no such thing as a substitute for the real thing. And there’s no better way to miss the real thing than to tell little white lies to yourself about it. So love your partner. Love your friends. Love your family. Love your life. Love your job.

Despite our attempts to trivialize it, commercialize it, and strip-mine it of meaning, love is still dangerously, incandescently meaningful. While we may try to reduce it to a mass-made quasi-luxury we purchase on credit once a year, obediently, in the form of chocolates, flowers, and dinners, it remains vital. While we may try to turn it into an option — one more choice to be plucked off the shelf, depending on whether you prefer the red label or the blue — it remains necessary. And it must be evoked and created, nurtured and renewed, tilled and cultivated — because without it, life is little more than sleepwalking.

Perhaps our celebrations of "love" are so often tinged with a quiet desperation because what we’re really pursuing is a caricature of love. And perhaps by endlessly redrawing that caricature, we ourselves are lessened, little by little; as if we feel we don’t fully belong in the human world, but can’t quite understand why.

None of us belong here. But we are here. And there’s not enough time. Cut the bullshit. Love.

SALT FACTS

Insidious health threat, or innocent flavor enhancer? Take a closer look at the planet’s tastiest mineral

By Maria Masters, Photographs by Greg Broom, Posted Date: October 19, 2010

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America has declared war on salt. The nutrition militia, claiming that the enemy is attacking you and your buddies, points to hypertension stats: More than 20 percent of American men between 35 and 44 have high blood pressure. Even the Institute of Medicine is leaning on the government to set standards for sodium content in foods; and the American Heart Association, along with the City of New York and 30 other cities, is promoting a new National Salt Reduction Initiative.

So should you enlist? It’s a tough battle. "If people want to avoid salt, they really can’t—not unless they skip processed, prepared, and restaurant foods," says Marion Nestle, Ph.D., M.P.H., a professor of nutrition, food studies, and public health at New York University.

What’s more, salt may not even be the true enemy. Before you sign up to fight, tune out the hysteria and plunge into the latest nutrition intel.

Can I live without salt?

Nope

Salt is essential to health. Your body can’t make it, and your cells need it to function, says Aryan Aiyer, M.D., director of the heart center at Magee-Womens Hospital at the University of Pittsburgh medical center. In fact, the Institute of Medicine recommends consuming at least 3.8 grams of salt a day (just over 1/2 teaspoon), mainly for the sodium.

Sodium is an electrolyte, a humble member of that hyped class of minerals that help maintain muscle function and hydration; that’s why sport drinks contain sodium. You’re constantly losing sodium through sweat and urine, and if you don’t replenish that sodium and water, your blood pressure may drop far enough to make you dizzy and light-headed. "Sodium acts like a sponge to help hold fluids in your blood," says Rikki Keen, R.D., an adjunct instructor of dietetics and nutrition at the University of Alaska.

However, people who chug too much water can lower their sodium levels so far that they develop hyponatremia, a potentially deadly condition more common among recreational exercisers than professional athletes, says Marie Spano, R.D., a sports nutritionist in Atlanta. Salt does more than just make our food taste good; without it, we’d die.

Do I need to watch my salt intake like a hawk?

Not necessarily

If you have high blood pressure, you’ve probably been advised to cut back on salt. The mechanism seems clear: Sodium causes your blood to hold more water, so your heart has to pump harder, making your blood pressure rise. If your blood pressure is already high, that’s a problem. (A high intake of salt can also be dangerous for people who are salt-sensitive—that is, they have trouble excreting excess salt.)

What if you’re a healthy guy? The Institute of Medicine is adamant in recommending that people ages 14 and over consume no more than 2,300 milligrams of sodium a day—about a teaspoon of salt. The Institute of Medicine sets a lower limit (1,500 milligrams, or slightly more than 1/2 teaspoon) for middle-aged and older adults, African Americans, and people with kidney disease, hypertension, or diabetes.

But even though the average American blows past both limits, consuming an average of 3,400 milligrams of sodium a day, some experts say that’s not a problem for most men. "I don’t know of any evidence that suggests that healthy men with normal blood pressure should reduce their sodium intake," says Michael Alderman, M.D., a professor of medicine at Yeshiva University.

For starters, reducing the salt content of your diet could adversely affect your health, Dr. Alderman says. In a study review published in the Journal of Hypertension, people who reduced their sodium intake by about 1,000 milligrams experienced lower blood pressure, but also higher heart rates and decreased insulin sensitivity, which can raise diabetes risk. Because of these effects, he says, we need clinical trials to determine whether lowering salt intake actually improves health outcomes in the general population.

And let’s not forget that sodium isn’t the only blood-pressure booster. "The huge message everyone overlooks is that being overweight also contributes to high blood pressure," says Spano.

Read more at Men’s Health: http://www.menshealth.com/health/truth-about-salt#ixzz1mbplPNGs

The 10 Saltiest Foods

by Cassie Shortsleeve February 12, 2012, 07:30 am EST

Doesn’t taste salty? Don’t be deceived. According to a report from the U.S. Centers for Disease Control and Prevention, ten unsuspecting food types account for 44 percent of the salt you’re eating every day. While your intake should generally be no more than 2,300 milligrams (mg) a day, these foods—many of which you’re eating multiple times a day—are skyrocketing that number. (Should you be worried about your sodium? Read The Truth about Salt to learn.)

Here are the ten foods to beware of, and the less salty swaps to accompany them.

Breads and Rolls
We know that bagels aren’t the most health-conscious choice out there, but did you know that Dunkin’ Donuts Salt Bagel has almost 3,500 mg of sodium? The investigators found that 65 percent of our daily sodium intake comes from food bought in stores, so if you’re starting the day at the bagel shop, an onion bagel has just 380 mg of salt.

Deli Meats and Cured Meats
Considering adding salami to a sandwich? Six thin slices has the same amount of salt as 39 Ritz crackers (about 1,130 mg)—and that’s just the meat of the sandwich. Go with shaved honey ham instead. The same amount of meat has half the amount of salt.

Pizza
The ingredients in pizza seem simple enough, but get this: Uno Chicago Grill’s Classic Individual Pizza has almost 5,000 mg of salt. Swapping thick for thin, and slobs of mozzarella cheese for feta can save your waistline—this type of a pizza will have around 560 mg of sodium.

Fresh and Processed Poultry
It doesn’t get any plainer than grilled chicken, right? You need to read the fine print with this one. Check the label on raw chicken for something like “10 percent broth solution.” Translation? 60 mg or more of salt per chicken breast. What you want: No added broth.

Soup
A liquid lunch isn’t scoring you any points when it comes to salt intake—especially if you’re eating out. Researchers have found that 25 percent of our sodium intake comes from restaurant meals. Friendly’s Chunky Chicken Noodle? Almost double what your daily intake should be. Substitute Minestrone—it packs about a third the salt.

Cheeseburgers/Sandwiches
Burgers and sandwiches alike can pack upwards of 4,000 mg of salt in between the buns after cheeses and sauces (we’re talking to you, Quizno’s and McDonald’s). Try something homemade like this Turkey-Swiss-Guac Burger. According to the USDA, naturally occurring salt accounts for only 13 percent of our sodium intake—77 percent is added by food manufacturers.

More from MensHealth.com: 10 Sinister Sources of Salt

Cheese
The perpetrators: parmesan, and cottage cheese—which pack 850 mg of sodium per 10 tablespoons, and 918 mg per cup, respectively. Go with cheddar—it has about half the amount of salt—or low-sodium versions of cottage that have about 30 mg.

Pasta Dishes
Ramen noodle diet? Might be saving you money, but . . . that’s about all it’s good for. Half a package has a little more than 1,000 mg of salt. If you go with Annie Chun’s Teriyaki Noodle Bowl you’ll cut your salt intake in half.

Meat Dishes
Steak can be tricky—Claim Jumpers Country Fried Steak has upwards of 6,000 mg of salt coated in a batter of salt and fat. A filet, on the other hand, has 1,270 mg. Even better? Try this Grilled Steak Red Wine Butter recipe at just 470 mg of sodium.

Salty Snacks (Pretzels, Chips, Popcorn)
Rold Gold pretzels lover? You’re enjoying about 450 mg of sodium per serving—almost 20 percent of your daily intake. Switch to Triscuits—they have about 135 mg of sodium per serving.