Carvings January 1, 2026

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Happy New Year!

In the news

Is a pill the answer?

                The new year is going to see a surge in the oral forms of Ozempic and similar drugs for control of type 2 diabetes and for weight loss. The injectable forms of GLP-1, in spite of their inconvenience compared to oral medications, have been very popular because they are effective and they have relatively few serious side effects.

                The availability of a new class of drugs for the control of type 2 diabetes is welcome. That disease, which is entirely lifestyle related with very few exceptions, is a threat to the financial stability of the healthcare system. If the CDC projection is correct, more than half the U.S. population will be burdened with this disease by 2050 and the cost will reach over one trillion dollars per year.

                What are the practical aspects of the new pills in regard to weight loss? Some studies show a weight reduction of 10-15 percent; the best that I have seen in one trial was 27 pounds. That degree of fat loss does matter. It lowers the risk of coronary artery disease, stroke and the complications of type 2 diabetes.  That’s not the end of the story. A 250-pound person who loses 27 or 30 pound is still obese. They have lowered their risk but they have not eliminated it. The benefits are not permanent. Approximately two-thirds of users will regain their weight within only one year after stopping medication.

                There is nothing easy about trying to lose weight. The new pill has not changed that.

                The hardest “pill” for Americans to swallow is a change in lifestyle. Prescription drugs will help along the way, but only a reduction in caloric intake will eventually eliminate a decades-old accumulation of fat. Nor is exercise the answer. To exercise without cutting food intake is folly. However, it is extremely important to exercise regularly when on a calorie-reduction diet in order to prevent the loss of muscle mass that would otherwise result.

                The holidays are a lousy time to cut back on calories, but the holidays are over. Consider just throwing away all the goodies that were foisted upon you by loving friends and relatives. (A confession: I will not throw away my daughter’s fruit cake! Everything else goes.)

Carvings December 15th, 2025

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In the news

Another win for chocolate

            Well, not exactly. A recent study from Birmingham, England among a small group of volunteers showed that the harmful effects on blood vessels that occur during prolonged sitting can be offset by drinking cocoa. The researchers didn’t use dark chocolate, but a specially formulated cocoa drink that had a high level of flavonoids, the micronutrients that help to maintain the health and flexibility of blood vessels. In short, it was not the kind of hot chocolate mix that is so popular at this holiday time.

            Excellent sources of flavonoids include fruit, berries, nuts and tea, including green tea and herbal teas such as chamomile. These are all far superior to the sugar-laden hot chocolate mix that you’ll find at your local grocery store.

            Sitting, even for short periods – two hours in the study noted – has adverse effects on the flexibility of blood vessels and blood pressure. Decades of such inactivity inevitably lead to the kinds of cardiovascular diseases (heart attack and stroke) that are two of the three leading causes of death in Western society. Unfortunately, many occupations necessarily require long sessions at a desk. Wouldn’t it be nice to know that we can possibly offset at least a little of sedentary living’s hazards by some healthy snacking and sipping?

Lifestyle

            In the previous blog I promised to address the “I don’t have time to exercise” issue. Pardon my being blunt, if not outright crass, by pointing out that those making that argument will have plenty of time – but later – while in rehab, recovering from a heart attack or stroke, or getting around in a wheelchair while waiting for a prosthetic leg to arrive. Gross! I know, but it’s a fact.

            The most obvious lifestyle change is to substitute some TV-watching time for at least one hour of physical activity about four or five times a week. Even that relatively small input of time has been shown to significantly improve your chances of avoiding a cardiac catastrophe. And anyway, the news never changes – only the places where it’s freezing/flooding/quaking/erupting or how many people have been shot/stabbed/arrested.

            Then there are the many other ways of activating your muscles and improving your heart and lungs: stealth exercise. Take the stairs instead of the elevator – up and down. Do you find yourself driving around the parking lot to find the closest one to the entrance to the gym? The gym?!? If you park at the farthest corner of the lot you’ll get a warmup and a cooldown, you’ll never “lose” your car and your car door is less likely to get dinged. Stand up when you’re on the phone. Let your dog take you for a walk three times a day instead of twice on weekends.

            Exercise as if your life depends on it. It does!

Carvings, December 1, 2025

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In the news

I hope that I’m preaching to the choir

        As you know from recent blog posts, the influenza vaccine, though it does not always prevent the flu, is important because it decreases the severity of an infection, likely avoiding hospitalization. You may also recall that an episode of influenza significantly increases the risk of a heart attack or stroke, while the vaccine has just the opposite effect. Another point to emphasize: influenza weakens the immune system, which is the reason why deaths from the flu are almost always due to secondary infection, not viral infection.

                Infectious disease experts warn that this year’s flu season will probably be more severe than most because the current strain is more potent. This is already evident in Australia and the UK. That makes getting the vaccine especially important this winter.

Lifestyle

What hardly anyone knows about exercise.

                The title of this blog might seem somewhat pretentious but the evidence is all around us. Surveys over the years are pretty consistent: about eighty percent of Americans simply do not engage in any form of exercise. An interesting coincidence: eighty present of Americans are overweight or obese. Are they the same eighty percent. Ya think?

                The human body has evolved to require several hours a day of moderately intense physical activity. Before the Industrial Age there was no way around it. Getting to or from anywhere required walking. (Lest you think that riding horseback didn’t require physical activity, be assured that a ride of any distance is a pretty good workout.) Craftsmen used only hand tools; the most mundane household chore required lifting, carrying, chopping, etc..

                Moderately intense physical activity has two major effects: it burns calories and it opens dormant blood vessels. If we use up all the calories we take in there aren’t any left to be turned into fat. That’s obvious but what is not so obvious is that those fat stores are factories (fattories?) for churning out inflammatory chemicals that are the drivers of coronary heart disease, ischemic stroke, type 2 diabetes, cancer and osteoporosis. Another interesting coincidence: none of those conditions exist in pre-industrial societies – not one, except for some cancers!

                When your heart pumps vigorously in the course of intense physical activity, every blood vessel in the body, even those that are “resting”, opens up to accommodate the flow. That ensures that every cell receives oxygen and nutrients and gets rid of accumulated waste products. The ebb and flow of blood also keeps those blood vessels flexible so that they can handle the sudden stress of the kind that might precipitate a heart attack or stroke. 

                Twenty-five percent of the blood that exits the left side of the heart goes to the head, nearly all of it to the brain. Simply put, well-fed brain cells last longer.

                The excuse that I hear most often is “I don’t have time”. I’ll address that issue in the next post.

Carvings November 1, 2025

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In the news

Vaccines and the risk of Alzheimer’s Disease

            Vaccines are among humanity’s greatest triumphs. It is no exaggeration that since Edward Jenner developed the smallpox vaccine in the late 18th century, billions of lives have been saved by his and subsequent discoveries. In recent years a new benefit has emerged: several routine vaccines lower the risk of Alzheimer’s Disease. The new (since 2018) shingles vaccine has been shown to lower the risk by about 20 percent. For the influenza vaccine the benefit is even more dramatic – up to 50 percent. The pneumococcal vaccine has more profound effects. Not only does it protect seniors from what used to be the most common form of pneumonia, it lowers the incidence of ear infections and other illnesses in children, and its routine use in childhood provides somewhat of a herd immunity that protects adults not yet old enough to receive it as well. And it has now been shown to reduce the risk of dementia. Even the DPT (Diphtheria-Pertussis-Tetanus) vaccine, which has been around for nearly a century, shows the same effect, and so does the hepatitis vaccine. Even the new RSV (Respiratory Syncytial Virus) vaccine is now included in that Alzheimer’s-protective group.

            I have not found any articles linking the measles vaccine with such a protective effect, but that formerly common childhood disease causes inflammation within the brain in about half of its victims, and I will not be surprised if there is found to be a brain benefit from that vaccine as well.

            More than likely there is more than one mechanism at work. Preventing those diseases, several of which have been shown to damage brain cells, may be one reason. Another might be that by stimulating the immune system, a parallel effect may lower inflammation within the brain that, over decades, results in Alzheimer’s or other forms of dementia.

            But wait! There’s more! Further exploration of this phenomenon in the years to come may reveal more about the fundamental nature of Alzheimer’s Disease, so that our grandchildren and their descendants will no longer be ravaged by one of the most tragic diseases of elderhood.

Lifestyle

Grumpy old men – a fishy tale

            Grumpy old men, the 1992 film starring Walter Matthau and Jack Lemmon, described the antics of a couple of aging fishermen. It’s obvious from the title of the movie that they didn’t eat their catch. All seafood, especially fish, is an excellent source of omega-3 fats, called “essential” because the body has no or limited ability to manufacture them. Those nutrients are necessary for the normal development and function of the brain and eyes, as well as other elements of the nervous system. Moreover, omega-3s are abundant in the frontal cortex, which is responsible for personality and behavior, as well as short-term memory.

            No wonder they were grumpy!

Carvings October 15, 2025

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In the news

What are we doing to our children’s brains – and ours?

            In the course of doing some research for a PowerPoint presentation titled How the computer affects your brain and your health, I learned some disturbing facts about the effects of screen time and social media. Numerous studies have observed that heavy use of both – and note that the average adolescent spends 8.5 hours a day looking at one kind of screen or another – leads to memory problems, short attention span, decreased self-control and more negative behaviors.

            A Canadian study of pre- and barely-adolescents, 9 to 13 years of age, evaluated six measures of cognitive performance, including reading recognition, picture vocabulary, explicit memory and overall cognitive skills. In every category but one (pattern comparison processing speed) the more time spent on social media the greater the decline in these skills. Even the group with the lowest level of social media exposure showed poor cognitive performance. The authors of the study consider this a “pressing public health concern” and believe that the time has come for public policy action to address the issue.

            I believe that there is more for us to consider. First, the age range studied here is younger than the mid-teens, where social media activity is far greater than the 0.3 to 3.0 hours per day of these younger children. It is not a stretch to say that a similarly designed study among older children would reveal even worse outcomes.

            Second, the detrimental effect of many hours of screen time and social media participation is not limited to the young. The aging process does not shield us from harm. I would argue that we could all benefit from finding better ways to engage our brains.

            A couple of years ago I weaned myself from reading the daily newspaper, having asked if reading it really increased my font of knowledge, and if I felt uplifted by the time I put the paper down. I’m sure you know the answer. I no longer own a television for the same reason. Unfortunately, I still have a “smart” phone – is that an oxymoron? —  on which I had felt compelled to learn what’s going on in the world at least once a day. I recently decided to check the news on Sunday morning – period. I feel more calm already, and my book queue is getting shorter.  

Lifestyle

Exercise, the heart, the brain and the immune system

            It has been known for decades that regular exercise is necessary to maintain muscle mass. What is not known as widely is that persons who do not exercise lose heart muscle, not just the muscle that powers your arms and legs. This has two significant consequences. The first is that as we get older the heart cannot keep up with demand. The result is that fatigue comes quickly; the larger problem is that when the blockage of a coronary artery occurs there is less heart muscle reserve, so when a heart attack occurs there is less chance of recovery. The second is that the loss of muscle can eventually lead to chronic heart failure, a serious and common problem among the elderly.

            In regard to the brain, regular exercise keeps its blood vessel supple, better able to deliver nutrients and to remove accumulated waste products. But regular aerobic exercise such as walking, cycling, swimming, etc., also increases the volume of both gray and white matter in the brains of older persons.

            A third benefit of exercise is that it improves the responsiveness of the immune system to vaccines and to infectious agents, counteracting the gradual decline that most elderly persons experience.

            If you think that you don’t have time to exercise, consider these facts.

Carvings October 1, 2025

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In the news

Prescription drugs and fatal falls

            In the blog posted on June 15th I noted that some prescription drugs caused dizziness, resulting in falls. There is more to the story as noted in a recent publication in the Journal of the American Medical Association (JAMA).

          About 40,000 people over the age of 65 die from falls every year, and many of these are directly related to four groups of drugs: benzodiazepines (e.g., Valium), opioids (e.g., hydrocodone, codeine), gabapentinoids (e.g., Gabapentin) and antidepressants, of which there is a wide variety.  They all have numerous side effects and all of them are associated with drowsiness, impaired balance and loss of coordination, conditions that lead directly to falls. 

          The authors of the study note that overprescribing of these drugs is a serious problem, that long-term use is to be avoided and that safer alternatives are available. In their opinion, more than 25,000 lives could be saved each year if these medications were used appropriately, i.e., that with rare exceptions they should not be used at all in persons over the age of 65.

          Persons taking these medications should consult with their physician to determine if their use justifies the risk.

Lifestyle

          I wrote about this topic three years ago but I’m repeating it here because I have recently talked with two persons in their 80s who have not yet had the shingles vaccine – Shingrix. That’s a serious mistake!

          Elderly persons are particularly at risk of shingles, a painful condition whose complications include severe chronic pain in affected areas, and even blindness when it involves the face. About 20 percent of persons over the age of 60 are going to get shingles. That number jumps to 50 percent at age 85

          The vaccine that was released in 2017 is 97 percent effective in preventing shingles and it probably will be protective for about ten years. (That is my personal opinion based on data to date but we’ll have to wait another few years to be certain.) Two doses are required and most recipients can expect some side effects such as a sore arm, headache, mild fever and feeling crummy for a day or two. These are insignificant when compared with blindness or pain that lasts for years. Those complications are not rare. They occur in about 15-20 percent of persons over the age of 80.

          It is strongly recommended for persons over the age of fifty, even those who have had shingles in the past or who have received the old vaccine (Zostrix).

Carvings September 1, 2025

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In the news

Omega-3s and Alzheimer’s Disease

            Omega-3 fats are critical nutrients for every cell in the body, especially those in the brain and eyes. The main natural sources, fish and leafy green vegetables, are lacking in the diets of most people. Now there’s another reason to ensure that you get what you need. A study of more than 800 Alzheimer’s Disease (AD) patients in the UK revealed that women with AD had fewer omega 3s and more saturated fat in their blood than normal individuals. The authors caution that “this still warrants further research” a CYA phrase that seems to be included in so many scientific publications, but it is consistent with hundreds of peer-reviewed articles that show how important omega-3 fats are. A study that I included in my lecture on avoiding dementia about two decades ago revealed that patients with AD had less omega-3 fats in brain tissue than normal persons.

          Alzheimer’s Disease is enormously complex, beginning with the fact that there are several types of this disorder, that at least one form is strongly hereditary, and that not a single drug has been shown to significantly reverse it or to stop it. All the more reason to do what we can with proper nutrition and lifestyle (see the article below) to slow it down.

Lifestyle

What do knitting and playing the piano have in common?

            Neuroscientists have known for decades that mind-engaging activities can stimulate the formation and connectivity of brain cells, thus developing a “cognitive reserve” that delays the progression of age-related brain shrinkage and Alzheimer’s Disease. Two new studies reveal why activities such as knitting and playing the piano are particularly valuable. They both require the use of two hands, advance planning and fine motor movement. (Note that similar activities such as woodworking, painting and model building are similarly beneficial.) The result of the aforementioned nerve cell connectivity is improved memory, better motor skills and a reduction in stress. Specifically, a study of seniors engaged in piano playing showed improvement in areas of the brain that are associated with memory and language. Brain-associated hormones also showed improvement in the knitters. The stress hormone cortisol was reduced while serotonin and dopamine – the latter associated with Parkinson’s Disease – were increased.

          It’s important to emphasize that you can build a cognitive reserve at any age, and the benefits of these activities have been observed even in persons who are already showing symptoms of dementia or Parkinson’s Disease.

          The adage “It’s never too late” takes on new meaning.

Carvings August 15, 2025

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Pickle juice to relieve muscle cramps? Really?

            Muscle cramps are a universal annoyance but their cause and cure are largely mysteries. They are more common among athletes, pregnant women and older persons. Electrolyte solutions like Pedialyte have been recommended to prevent them but few medications or measures such as stretching provide quick relief. Pickle juice is a recent entry, and it has some scientific backing.

          I was a sceptic when one of my sons urged me to try it when I developed a severe leg cramp during a visit to his home. “Baloney” was my first response but I took two swallows – the stuff is awful – and about three seconds – yes, seconds — later the pain was entirely gone. “Coincidence” was my second response.

          A few nights later I had another cramp, this one deep-to-the-bone painful. I ignored the container of pickle juice in my refrigerator that was foisted on me by my son. “Baloney” I muttered during the ten or so minutes of agonizing walking that it took to resolve most – not all – of the pain.

          The next time a similar, severe cramp hit me I thought “What can I lose? But it probably won’t work.” But it did, within a few seconds – and all the pain was gone this time.

          It didn’t take long to find a couple of dozen articles at the National Library of Medicine site (PubMed) that discussed the merits of pickle juice and the mechanism by which it works. It’s not the electrolytes; it’s the stimulation of the lining of the throat by acetic acid (vinegar) that causes a reflex to inhibit the firing of nerve cells that are causing the muscle fibers to contract.

          Thank you, Steven.

Carvings   August 1, 2025

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In the news

Walking is great – but it’s not enough.

            I commend all those who walk several times a week. Besides improving heart and lung fitness, it strengthens the core muscles (back and abdomen) and adds to the bone strength of the legs, which includes the hips. But if you fall while walking (!) and land on your outstretched hands, it could result in a fracture of one or both wrists or elbows or collarbones. We need resistance-type exercises that provide numerous health benefits, including stronger bones for the upper body.

            When you exercise your biceps, for example, it puts stress on the bones of the arm where the muscle is attached. The bone reacts by becoming thicker and stronger, thus resistant to breakage. But there’s more.  A beneficial by-product of using barbells, dumbbells, elastic bands and exercise machines is maintaining the health of specialized nerve endings attached to each muscle cell that help us to retain balance. One reason why seniors are prone to falls is that when they lose muscle cells because of inactivity they also lose those nerve structures that maintain balance.

            Although a fitness center is ideal, a home exercise program is a good start. Any household item that fits comfortably in your hand, e.g., a can or jug that holds food or juice, will do. Gym memberships are often available for less than $25 a month and some senior insurance programs will cover the cost.

            For persons with a chronic illness such as arthritis or heart disease, a physical therapist can provide a suitable, safe program. Four or five hours a week of regular, moderately intense physical activity, at any age, results in greater energy and a feeling of well-being. You’ll never go back to being a couch potato!

Lifestyle

“Don’t be a spectator, don’t let life pass you by.” Lou Holtz

            Lou Holtz, the famous Notre Dame football coach, is an outstanding motivational speaker. I have modified one of the elements of his repertoire as follows:

            For a meaningful life, have:

                        Someone to love

                        Something to believe in

                        Something to hope for

                        Something to give

                        Something that brings you daily joy

Carvings July 15, 2025

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In the news

U.S. children’s health going downhill

            A very significant paper was published this month in JAMA, the Journal of the American Medical Association. It is the loudest wake-up call that I have heard yet, warning us of a deadly trend: American children from birth to age 19 years are nearly twice as likely to die as a cohort from 18 other high-income nations. Nearly half (!) – 45.7 percent — have a chronic health condition such as autism, sleep apnea, behavioral disorders and depression, among others. Nearly 21 percent of children are obese. (The figure was 5.2 percent in 1974.) The type 2 diabetes epidemic among children shows no slowing trend.

            It’s frightening to think what this scenario will be like two or three generations from now, knowing that the several causes of these conditions are unlikely to be reversed without severe, draconian regulations that no politician dares to propose. The multiple causes have been staring us in the face for decades but there is no national will to eliminate them.

            A major cause of the decline in our children’s health is the lack of outdoor exercise. Kid power is no longer needed for bicycles, skateboards or scooters. Team sports are over-organized, so that the kids expend minimal energy. A study of PE classes in schools revealed that the students were actually moving for only ten minutes out of an allotted hour.

            Processed foods high in salt and sugar have replaced vegetables. More than half of children are deficient in omega-3 fats that are crucial for brain development and function.

            The recent decision to remove artificial dyes from candy and other forms of junk food will have only a minuscule effect on children’s health. It is junk food, not just its coloring, that should disappear from grocery shelves. That is unlikely and so is the prospect that the nation’s children’s health issues will be reversed in this generation. The only hope is that individuals and their families will follow a healthy lifestyle.