Happy New Year!

Upcoming presentations

Tuesday, January 28th at 10:45 a.m. at the Rancho Santa Fe library. The health benefits of wine and chocolate. Wine and chocolate are derived from plants and thus contain nutrients that have specific health benefits. Not all forms of these pleasurable foods are healthy, however. Learn which claims are legitimate and how to select the healthiest forms of wine and chocolate.

Friday, January 31st at 2:30 p.m. at the LIFE program at Mira Costa College in Oceanside, The annoyances of aging. Growing older is inevitable but many of the physical and mental challenges that seniors face are not. More than twenty such topics that range from decreased energy to liver spots, irregular sleep to poor memory can be postponed or even avoided completely. Details at http://www.miracosta.edu/life.

In the news

Is this really our future?

“The obesity rate will soar above 50 % in 29 states.” “…no state will have an obesity prevalence below 35%…” “…about one in four adults are projected to have severe obesity,” which is usually 100 lb. of excess weight. This is the staggering prediction for the year 2030 from the Harvard T.H. Chan School of Public Health in Boston.

Hmmmm! Seems to be a disconnect here as I write this at the end of the holiday eating cycle while announcing a presentation about wine and chocolate! However, if you Google Goscienski make it a gainless holiday you’ll find some redeeming advice, and an ounce of dark chocolate — my usual recommendation — has only 150 calories.

The hazards of obesity are well described even in the lay press. It leads to coronary artery disease, type 2 diabetes, dementia and fourteen types of cancer, and it is a contributing factor in a myriad of other health problems. Is it really beyond our control?

There are two (relatively) painless steps that we can take to rein in weight gain. The first is to eliminate our intake of refined starch and sugar and to replace them with vegetables (not French fries!) and fruit, nearly all of which contain only 50-100 calories per serving! The upside is that they are not only filling but they provide vitamins, minerals and other nutrients that are virtually non-existent in packaged foods.

Eighty percent of Americans don’t get enough exercise but in spite of the crowds we’ll see in the local gym this week – and never again – exercise really doesn’t contribute much to weight loss. Does that surprise you? Consider that brisk walking for an hour will burn about 300 calories, about as many as there are in a slice of apple pie and about half as many as you’ll get in the average restaurant dessert. One of the benefits of exercise is that when you seriously reduce your calorie intake the weight that you lose will consist almost entirely of fat; if you don’t exercise while on a low-calorie diet of any type, much of the weight loss consists of muscle. That’s a lousy trade-off!



Continuing our series on the annoyances of aging: dizziness and fainting

       These have multiple causes but they should NEVER be ignored. Not only are they often the first symptom of a serious medical condition, the fall that often occurs during one of these episodes can lead to a hip or skull fracture, either of which can really ruin your day!

A common reason is a side effect of medication for lowering blood pressure but other causes include an abnormal heart rhythm, low blood sugar or dehydration. If you have ever felt light-headed or dizzy after standing up from a seated position or lying down it may indicate orthostatic hypotension; it’s not serious but it’s still an  indication for getting checked out by a physician.

The bottom line: dizziness and fainting are not normal and always require medical evaluation.

In the news

Work out; get happy!

Since I first began my career in lecturing and writing on matters of health and fitness more than 20 years ago I have doggedly insisted that if persons exercise with moderate intensity four or five days a week, within two or three weeks they’ll feel so much better that they won’t want to stop. A recent article in the online publication by Blue Cross/Blue Shield of North Carolina bears this out – and then some.

The article by Michelle Rogers offers several reasons. The first is that exercise increases blood flow to the brain. Approximately one-quarter of the blood sent from your heart with each beat goes to the brain, providing oxygen and nutrients and removing accumulated waste products. But in addition the extra blood flow causes the release of endorphins and serotonin, chemicals that provide a feeling of well-being.

Physical activity also increases the delivery of blood to muscles and thereby removes chemicals that accumulate during stress and that can negatively affect the brain.

A growing number of studies show that persons with major forms of depression who exercise show improvement in a matter of weeks, either with exercise alone or in addition to prescription medication. Considering that antidepressants often cause considerable side effects, anything that leads to at least a reduction of dosage should be considered.

You have probably heard of “runner’s high”, the euphoria that long-distance runners experience. Fret not – you don’t need to become a marathoner. The feel-good effects of exercise have been documented to occur with only short bouts of exercise a few days per week. Brisk walking fills the bill and won’t leave you needing knee replacements by the time you get that first Social Security check.

The lesson: get moving and get happy.


Another annoyance of aging: dehydration

One of the challenges of getting older is that by the time we reach the half-century mark (!) the thirst mechanism doesn’t work as well to warn us that we need to take in more fluid. That helps to explain why so many seniors succumb to dehydration during extremely hot weather. Dehydration is another reason why we feel fatigued. When our fluid intake lags our thinking gets fuzzy and dulls the signal that we need a refreshing drink. As a result, most seniors experience dehydration from time to time.

There is another risk to frequent episodes of dehydration: kidney stones.

Forget about those mathematical formulas that tell you to take ________(fill in the blank) ounces of fluid __________(fill in the blank) times a day. Ambient temperature, humidity, activity level, prescription medications and medical issues can be so variable that the math is meaningless.

The solution is absurdly simple: drink enough fluid (preferably plain water) so that your urine is consistently a light yellow color with only a slight odor. Dark, smelly urine increases the risk of kidney stones. Don’t overdo it either. If your urine looks like tap water and has no odor it puts you at risk of convulsions, a condition that is commonly seen in long-distance runners at the end of a race when they overdo rehydration.

Dehydration also increases the risk of heart attack and stroke, and for travelers on long trips there is an increased risk of forming blood clots in the legs – deep vein thrombosis, also known as economy class syndrome.

Although plain water should be your beverage of choice, any kind of liquid will do. Keep in mind that most foods consist of 80-90 percent water. And yes, a glass of wine or a bottle of beer will help to prevent dehydration, in case you need an excuse.






Upcoming presentation

Tuesday, December 10, 12:30, Mission Valley Library. Immunizations: The good, the bad and the future. Vaccines have been around for centuries and they are responsible for the eradication of several deadly diseases. They are not entirely benign, however. Immunization is no longer only for children. There are at least two adult vaccines that can save your life. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org.

In the news

We underestimate the need for exercise.

Humans have evolved to require moderately intense physical activity every day, a concept that we discussed in this blog nearly a year ago. Now we have more compelling reasons to be active, in other words, to exercise.

A research team in Norway looked at the lifestyles of more than 23,000 young people and monitored their activity periodically for 22 years. They found that those who were inactive were twice as likely to die during the study and nearly three times as likely to die from heart attack or stroke compared to their fellow Norwegians who were physically active.

What does “physically active” mean? It’s not really intense – 150 minutes per week (2 ½ hours) of moderately intense exercise, being able to just about break a sweat, or 75 minutes (1 ¼ hours) per week of vigorous, intense, aerobic activity. Those who got religion, that is to say that they began to exercise more often and with greater intensity during the study, had survival rates between the figures noted above.

The 150-minute figure is interesting for two other reasons, just coincidentally. Another study showed that persons with prediabetes who walked for about 2 ½ hours per week were much less likely to cross the line to type 2 diabetes in the following several years. In still another study, women with osteopenia, the stage of bone loss that precedes osteoporosis, gained bone mass during the course of about one year with 2 ½ hours per week of vigorous walking.

Does it help to exercise even more than 2 1/2 hours a week? Yes, as we learn from senior athletes, especially those            who compete in various sports. But it’s nice to know that even moderate activity has real benefits.



Another annoyance of aging: alcohol intolerance.

          About the time we approach the end of middle age we notice that we feel the effects of alcohol after fewer drinks than in the past. It bruises our ego a little but there’s more to it. We’ve known for a century or so that driving under the influence of alcohol is responsible for tens of thousands of deaths each year. Alcohol-related falls are also a major problem, especially when so many seniors are on blood-thinning medications and even a relatively minor bump on the head can lead to fatal bleeding within the brain.

So why are we more sensitive to the effects of alcohol? The major reason is that we have a smaller percentage of body water in which the alcohol can be diluted, so our blood levels – and hence brain levels – are higher than they would have been a few decades ago.

The obesity epidemic is having an effect. Most Americans have lost muscle mass by the time they reach middle age and it has been replaced by fat. As with lower percentages of body water, lower muscle mass also results in less volume in which to dissolve the alcohol.

To a lesser extent we have lower concentrations of the enzymes in the stomach and liver that help us to break down alcohol.

The lesson is clear: two glasses of wine or the equivalent should be the limit for most mature adults. You might even have noticed that you’re not quite the same after only one glass of wine. My solution is simple: stop at two glasses and switch to water. It’s good bet that no one will even notice – because they’re still drinking alcohol.











Variety is the price, not the spice, of life

Tens of thousands of years ago, when our body chemistry was evolving, humans had a choice of hundreds of different kinds of plant and animal foods. That is what nature has designed for us so why are we squandering such abundant variety? A more important question: can we afford to ignore the cornucopia that our bodies require for good health?

Our lack of nutritional diversity is obvious in the produce section of any supermarket. Count the vegetables. You’ll find between 30 and 40 – but not really. There are three or four varieties of carrots, lettuce and cabbage and perhaps four or five varieties of tomatoes. The differences between them are really pretty small compared to what our Stone Age ancestors enjoyed thousands of years ago.

Nothing illustrates this better than birds and their eggs. How many species of birds (and their eggs) would you have encountered back in the Stone Age? Certainly more than the only two in our modern markets: chickens and turkeys and only the former provide us with eggs. How boring!

Ninety percent of the worlds’ food supply comes from only 17 plant species. When we discarded the rest we also lost the diversity of protein, vitamins, minerals and antioxidants that a varied diet produces, to say nothing of scores of different flavors. When the first farmers limited their food supply mostly to cereal grains that are easy to cultivate, harvest and store, they became more prone to disease, had smaller stature and shorter lifespans.

A first step in regaining diversity might be to explore genuine ethnic foods – Chinese, Indian, South American and Vietnamese. Take your time to explore your favorite produce department. I’ll bet that you’ll find at least three or four vegetables and fruits that you’ve never tried. It’s a start.

Continuing the Annoyances of Aging: loss of appetite.

          If you’ve noticed that your interest in food has decreased or that you feel full earlier than a few years ago, the most likely reason is that you have become less active and your body just doesn’t need as many calories. Of course if your appetite has not changed in spite of your being less active, you’re likely to gain weight, something that is quite typical in the modern age.

Along with gray hair and wrinkles we begin to lose our sense of taste and smell, so food just doesn’t seem as appetizing. I consider that a plus; nature is accommodating our decreased need for calories.

Several different prescription medications can depress the appetite, including pain relievers such as acetaminophen (Tylenol), opiates, blood pressure medications, antibiotics and chemotherapy.

Sometimes the loss of appetite is a sign of a medical problem and there are two that are rather subtle and have few other symptoms: thyroid disease and depression.

When there are other symptoms such as weight loss, increasing fatigue, a change in urinary pattern or persistent cough it’s time for a doctor’s visit. With early treatment conditions such as diabetes, heart disease and even cancer are likely to have a favorable outcome.
















Upcoming presentations

Monday, November 4, 11:30 a.m. Hidden Crises, creative Cures. What is happening to the healthcare system and how we can improve it. We’ll examine the root cause of the impending meltdown of the healthcare system and what we as individuals can do about it. Escondido Senior Center, 210 E. Park Ave., Escondido. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org

Wednesday, November 13, 1:00 p.m. The True Mediterranean diet. It’s not what you’ll find at your local pizza parlor but it’s a key to a long and healthy life. Point Loma Library, 3701 Voltaire St., San Diego. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org

In the news

From the San Diego Union-Tribune: Can a single pill keep you healthy to 100?

He was no scientist but Ponce de Leon was the poster child for the Fountain of Youth and that’s still a goal for much of humanity. The latest entry is a pill called RTB101 and it works by boosting the immune system. In the few trials on humans so far it improved the response to the flu vaccine and reduced the incidence of colds, bronchitis, influenza and pneumonia.

Unfortunately, infections are far less common as causes of death than heart disease and cancer. A major driver of heart disease, stroke and type 2 diabetes is obesity, which also is a major factor in cancer, osteoporosis and numerous other lifestyle-destroying conditions. The latest survey on obesity shows that it affects more than 35 percent of the population and in some regions it is more than 40 percent!

Don’t hold your breath until RTB101 comes to your local pharmacy. While you’re waiting, you can boost your immune system by shedding a few pounds, adding more protein to your diet and getting more vitamin D. And be sure to protect yourself from infection by keeping your immunizations up to date: influenza, shingles and pneumonia.



Avoid the annoyances of aging; another cause of decreased energy

          Poor circulation contributes to decreased energy for a couple of reasons. When muscles lie dormant for more than a few days the blood vessels that supply them lie dormant too. After all, they have nothing to do. When we become active, increasing the rate and the intensity of the heartbeat, the increase in blood flow causes those vessels to open up to provide more oxygen and thus more energy to muscles. That also removes accumulated waste products. It all adds up to more energy.

Regular physical activity that pushes the heart to send more blood flowing has a long-range affect too: it keeps blood vessels flexible so that in times of stress, those vessels can accommodate increased blood delivery, more nutrients and more oxygen. Your heart and brain will really appreciate that! The result is a greatly reduced risk of heart attack and stroke.

When you begin an exercise program you’ll notice an increased energy level in just a few days, certainly by the end of the second week. Be careful, however, to start slowly if you haven’t been active for a long while. Your first walk should be no more than 15 or 20 minutes; gradually work up to a brisk pace for at least an hour.  At the gym, begin with the lowest weights on the machines or free weights in order to avoid the next day’s muscle soreness.










In the news

Influenza vaccine by the numbers

The flu season is here and the first deaths have already been reported in San Diego. Some unsettling news is that there have been twice the usual number of cases here compared to last year.

“The flu vaccine doesn’t always work.” That’s true but it’s clear from studies over several years that if you get influenza in spite of having received the vaccine your illness will be milder, which means that you are less likely to be hospitalized.

Remember! Most deaths are due to secondary bacterial infection, not the virus, and hospitals are incubators for bacteria, some of which are resistant to most antibiotics.

From the CDC (Centers for Disease Control and Prevention): in a five-year study, vaccination reduced the risk of severe outcomes by 36%; for those over the age of 65 vaccination reduced the risk of admission to the intensive care unit by 28% and reduced the risk for mechanical ventilation by 46%!

“I’m going to wait to get the flu vaccine because it doesn’t last for the whole season.” Although there is a measurable drop-off in effectiveness of the vaccine by the end of the flu season the decline is not worth waiting. You might be one of the early victims. For those over the age of 65 and persons with an underlying condition, especially asthma or heart disease, the wise decision is to get the vaccine in October.


A new series: Avoid the annoyances of aging.

      This is taken from my newest PowerPoint presentation, which has received a very enthusiastic response. So much of what we encounter as we get older is often dismissed as the price we pay for lasting long enough to collect that first Social Security check. Maybe. But some of the conditions in the blogs that follow are symptoms of diseases that can be treated successfully.

There are some things that are inevitable but benign: gray hair, wrinkles, stiff joints and some that will go unmentioned. Sometimes we need a little help from our dermatologist. Some things take a little effort to overcome; some things take lots of effort to overcome. I have identified eighteen of these. It ain’t the Fountain of Youth but you’re bound to find something that will enhance your Golden Years!

  1. Decreased energy. A major reason for feeling pooped much of the time is simply that we have cut back on physical activity – what some people call “exercise.” Put simply, exercise is energizing and there are several reasons for that. Most of us are carrying around more weight than we did in our twenties, largely because we have cut back on physical activity. Seventy-five (the most recent estimate) percent of us are overweight or obese. The average American weighs 29 pounds more than he or she did in 1970. Imagine carrying a 29-pound backpack all day. Of course you’d feel tired much of the time. And if you weigh fifty or sixty pounds more than you did in high school – the current state of nearly forty percent of Americans — the effect is obviously worse.

When we don’t move our muscles vigorously every single day the smallest blood vessels in those muscles lie dormant, meaning that they are are closed, not supplying those muscles with energizing oxygen and nutrients and failing to remove accumulated waste products. Both factors are fatigue-inducing.

The remedy for almost all (!) age-related fatigue is simply to engage in some sort of physical activity most days of the week. I know – that’s easy for me to say. But I can guarantee that within as little as two weeks of about one hour most days of the week of moderately intense physical activity, both aerobic (walking, swimming, etc.) and resistance (exercise machines and weights) activity you are going to feel more energetic and less fatigued.

A couple of caveats: start slowly if you have not been very active. And get some advice from a trainer at the gym if you are going to use weights and machines.

Important! In spite of the above comments, fatigue can be a symptom of underlying disease, especially heart disease, high blood pressure, anemia, diabetes and thyroid disease. It’s a good idea to get a checkup before starting any exercise program.

There are several other reasons why we feel tired a lot and I’ll discuss these in subsequent blog posts.
















Upcoming presentations

Saturday, October 5th, 10.00 a.m. at the Coronado Library, The new shingles vaccine and other immunizations for adults. What you learn may save your life.

Tuesday, October 8, 1:00, OASIS Center, Grossmont Center. Avoid the annoyances of aging. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org. What you think is part of the aging process may be a sign of underlying disease.

Wednesday, October 16th, 10:30 a.m. Escondido Senior Center. Body fat: all that jiggles is not the same. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org

Monday, October 28th 9:30 a.m. Cal State San Marcos campus, Rm. ELB 372, Avoid the annoyances of aging. Sponsored by Osher Lifelong Learning Center. To register see their web site at http://www.csusm.edu/el/olli or call 800-500-9377.

Wednesday, October 30th, 10:00 a.m., OASIS Center, Grossmont Center. Hidden Crises, creative Cures. What is happening to the healthcare system and how we can improve it. Sponsored by OASIS. To register see their web site at http://www.oasisnet.org

In the news

Burgers – the Impossible Burger and the Beyond Burger. Are they ready for prime time?

Meat substitutes have been around for decades but they have never taken hold with the public, perhaps because they really don’t taste like real meat. That may be changing with the arrival of The Impossible Burger and the Beyond Burger. Are they safe? Are they nutritious? Are they better than real beef? That last question might depend on how you feel about the beef industry and GMOs (which are included in the Impossible Burger but not the Beyond Burger).

They are both OK with vegans, so how do they ooze that beef-like juice? In the Impossible Burger it comes from heme that is produced in genetically modified yeast; Beyond Burger’s juice comes from beet extract. No problem with either. In spite of stuff you’ll find in the Internet, GMO foods are entirely safe.

Differences between their nutrient content and beef is not a big issue even though the Beyond Burger has no vitamins – at least at the moment. Both faux meats have more sodium and calcium than beef patties but the former is not excessive and we can get the latter from a variety of sources. Each has about 20 grams of protein in a 4-ounce patty, a little less than beef.

Expect lots of new developments in this area, including meat that is grown in the laboratory. New products are already creeping into the market and the two discussed here are likely to be modified as the market matures.

Red meat is associated with some forms of heart disease and cancer while chicken and fish are not. The angst over energy resources, pollution and cow farts has already led to a decline in the demand for beef. If someone comes up with a really tasty and nutritious burger from something other than a cow you may see a real change in the coming decade.

But will we still call it a hamburger?


Me? A Neanderthal??!!

           I got quite a surprise the other day when 23andMe reported that I have Neanderthal genes.  Not just a trace, which is not uncommon among persons of European ancestry.  It turns out that I have more Neanderthal “variants” than 96 percent of 23andMe customers! Considering that I am tall, thin and have almost no body hair that didn’t seem quite right until I read a little further: those “variants” account for less than 4 percent of my overall DNA.

The Neanderthals disappeared from the planet about 35,000 years ago and anthropologists can’t entirely agree on why. Homo sapiens (that’s the other 96 percent of me) appeared to have better tools and communication skills than the Neanderthals. Some of them probably had enough communication skills to sire offspring whose DNA can still be identified in a cheek swab.

Neanderthals were not the brutes that anthropologists of a century ago described and that you probably recognize if you still remember the comic strip character, Alley Oop. It’s clear from fossil studies that they cared for their crippled and their dead. Even their brains were bigger than ours, although probably not as complex.

I took the title of The Stone Age Doc about 25 years ago when I began writing and lecturing about how far we have drifted from our pre-Agricultural Revolution lifestyle. Little did I know where that interest came from – those genetic “variants.”