Carvings January 15, 2026

In the News

Finally – a more sensible Food Pyramid.

            First comes a symbolic leap – the pyramid is inverted. That’s an attention-getter! But less symbolic and more practical is the array of foods across the top. Broccoli, carrots –not quite everyone’s favorites but carrying important nutrients, including carotene and zeaxanthin for healthy vision. The steak could hardly have been relegated to a position down the pyramid considering Americans’ unquenchable taste for red meat (and the clout of the beef industry). The accompanying saturated fat, once condemned as a major cause of coronary artery disease, has been rehabilitated. In my opinion, its hazards cannot be ignored, but having beef, lamb or pork a couple of times a week is not likely to shorten one’s life. There are many other foods that will.

What’s not there: processed meats, refined flour and all forms of sugar. There is overwhelming evidence that overindulgence in the latter two is mainly responsible for the current epidemics of obesity and type two diabetes and the former is associated with cancer. Food pyramids of the past placed junk foods, sweets and sugary drinks at the top, suggesting that they could be part of a healthy diet. They cannot. It is my fervent hope that as a follow-on to the revision of these dietary guidelines there will soon be legislation that will gradually eliminate them from the food scene.

Almost hidden between a carton of milk and a can of green beans is a flask of oil. Is it olive oil or a cooking oil – presumably an omega-6 variety? Both are healthy but the Standard American Diet (SAD) contains too little of the former and too much of the latter. On the other hand, sources of omega-3 fats are represented by the salmon and shrimp. So is tuna, in that little blue can between the egg – no longer a cause of elevated cholesterol – and the avocado, perhaps the healthiest item in the entire pyramid.

Whole grains are at the bottom. Strictly speaking they are not unhealthy, but we should be aware that humans evolved without them.  The old pyramid displayed not only bread, but a large sack of white flour, white rice and a pretzel. They are gone.

There is much, much more to the guidelines than I have mentioned here. I commend the creators of the new version for their willingness to finally tackle the core problem of the nation’s declining health.

The full report, which is an easy read, can be found on Google: dietary guidelines 2026. Go to the realfood.gov link.

Lifestyle

Stop falling!                                              

            A major cause of falls, even in middle age, is the loss of muscle that is the curse of the affluent, technically advanced lifestyle. Without labor-saving devices and powered vehicles, your grandparents, from childhood through their later years, had no choice but to use muscle power to get anything done. It was a blessing, not a curse. With few exceptions, today’s Medicare recipients began losing muscle mass in their mid-twenties at the rate of nearly one percent per year. If muscles mass diminishes by a third to a half, the body sees no need to maintain as much bone mass to support it, so bones become less dense and more fragile.

            There are other factors that increase the risk of falls. As we get older our alcohol tolerance decreases as our muscle mass diminishes and we are often on the verge of dehydration; there is less body water in which to dilute the alcohol. Most seniors take one or more prescription drugs, some of which lead to drowsiness or dizziness, and some of these medications are potentiated by alcohol.

            As old age creeps up on us slowly we need to make some changes in order to avoid falls. It may be time to get rid of scatter rugs. Have a non-skid mat in the tub or shower. Put night lights in the hallways and bedroom. Wear slippers, not socks, when you take off your shoes.  

            A broken hip might not be life-threatening but a cracked skull certainly is.

Carvings January 1, 2026

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

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

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

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

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 September 1, 2025

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

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 July 15, 2025

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.

Carvings July 1, 2025

In the news

Eat more, weigh less? Are you kidding me??

            It appears that weight loss surgery is more effective over the long term than Ozempic, that new kid on the block, and similar prescription drugs. But no matter how effective these two elements may be in the short term, this is simply not the way to solve the multiple problems – now epidemics — of obesity, type 2 diabetes, cardiovascular disease and osteoporosis. Those who promote these solutions are apparently oblivious to the fact that a century ago, those four chronic, non-infectious conditions were almost non-existent. They don’t have anything to do with aging, nor does osteoporosis, the fact of which I’ll cover in a future post. Ditto cancer, the second leading cause of death, 85 percent of which is due to lifestyle factors and has nothing to do with growing older, according to the M.D. Anderson Cancer Center.

            So if these diseases, which together account for more than one million deaths per year in the United States, are almost entirely due to lifestyle factors, the solution appears to be astonishingly simple: change the lifestyle.

            Obesity is at the root of the other diseases, via multiple mechanisms. The rate of obesity in 1900 was five percent. It is now 42 percent. Although health experts advise us to drastically reduce our sugar intake, that’s only part of the picture. The real solution is to eat foods that fill you up, not fill you out. 

            Our great-grandparents were not obese mainly because their diet was largely based on plant foods and whole grains that had a lot of bulk, giving them full bellies but few calories. The Standard American Diet does the opposite: refined sugar, refined flour and only one or two servings of plant foods per day. (If you’re a teenager you typically eat less than one serving per day of fruits and vegetables.) We take in lots of calories before our appetite is satisfied, especially if those calories come in the form of soft drinks, so we eat more.

            Sugary desserts and soft drinks should be the first to go. Next, add a small salad to one meal a day, later two meals a day when you get used to it. Instead of having a starch (pasta, potatoes, rice) at dinner, substitute a cooked vegetable for more fiber and fewer calories. You’ll be eating more food – and will weigh less.

            Now – how hard was that?

Lifestyle

How dry I am!

            Now that summer heat is here in full force it’s time for a reminder that dehydration is a risk at all ages, but especially as we get older. One reason is that our thirst mechanism is unreliable; our body may require a greater fluid intake but it fails to let us know. Especially in areas of low humidity – e.g., the American Southwest – overt sweating is minimized and thus we are not aware of the fluid loss. When we’re engaged in some activity such as gardening or athletics, we just might not be paying attention to early signs of dehydration, such as fatigue.

            Statistics regarding deaths from dehydration are hard to ascertain since heat stroke is often part of the picture. During a severe heat wave dozens of deaths may be reported in the United States. Infants and the elderly comprise most of the victims. Contributing factors include the inability of the former to express their symptoms. The latter often live alone or are visited infrequently by caretakers. Persons over the age of 65 are especially at risk. Many are taking blood pressure medications that increase the loss of water as well as the loss of electrolytes (sodium and potassium).

            Monitoring a person’s state of hydration, whether an infant in diapers, a healthy adult or an elderly person who needs to be checked at least once daily, the indicators of dehydration are the same. If urine is cloudy, orange-brown and pungent, dehydration is already in progress. Urine should always be clear, slightly yellow and with only a mild odor.

 Repeated bouts of dehydration increase the risk of kidney stones, a malady whose intensity of pain is only matched by the pangs of childbirth – so I’m told!

            You can avoid dehydration even on the hottest, driest days by keeping a glass or bottle of water everywhere – family room, bedroom, car, office. Fruit juices are fine but they all have sugar, so diluting them by about a third will give you the fluid you need with fewer calories. Fruit is mostly water; three or four pieces a day are healthy as well. If you sweat a lot during a hard workout don’t forget to replenish sodium and potassium with an electrolyte drink. Avoid sugary carbonated drinks and alcohol.