CHAPTER 6
Step 2—Add Your Support Strategies
IN STUDIES OF POPULATIONS AROUND the world where the inhabitants live unusually long, healthy, productive lives well into their nineties and have less than half the rate of cancer as Americans, very little depression, and almost no dementia, there are a few common denominators. In these “Blue Zones,” people maintain a positive outlook on life, have strong family and personal relationships, and feel part of a close-knit community. They are physically mobile in everyday life, consume fresh, local ingredients, and don’t eat processed food. In the Blue Zone of Ikaria, Greece, fat accounts for more than 50 percent of Ikarians’ daily calories, and more than half of their fat energy comes from olive oil. In Sardinia, Italy, where there’s a community of mostly sheepherders, people spend their days walking, enjoying the company of others, and drinking local red wine with their meals. The famous Okinawan residents of Japan, many of whom live for about 110 years, base their diet on vegetables, drink mugwort sake, and remain physically active as they age. They also honor and celebrate their elders. The only Blue Zone in the United States is tucked just east of downtown Los Angeles, a city notoriously known for its smog and dense population. The community of Seventh-day Adventists in Loma Linda, California, near the big city, defies the belief that you have to live in a pristine, remote area to enjoy a long, disease-free life.
All of these people have mastered the tenets of healthy living without trying that hard or even knowing it. Self-care beyond the diet is sorely neglected in our society, yet factors like regular exercise, more sleep, and distraction-free time for self-reflection can make a huge difference in our health. The fast-paced world in which we live causes us to feel time-deprived and anxious, and during stress we turn to unhealthy habits that push us in the wrong direction and leave us ever more tired, uncreative, drug- and stimulant-dependent, and unsatisfied. Stress adds tremendous pressure on our biological systems, from the gut all the way up to the brain.
With that in mind, let me give you some non-diet-related strategies to boost overall health and prevent brain disease:
Establish an exercise routine you can sustain.
Pay attention to pain, especially in your back and knees.
Make room for sleep.
Reduce stress and find calm in four simple ways.
Detoxify your physical environment.
ESTABLISH AN EXERCISE ROUTINE YOU CAN SUSTAIN
Did you know that you can physically bulk up your brain with exercise and slash your risk for Alzheimer’s disease in half?
The evidence is no longer anecdotal. Every week a new study emerges showing the neuroprotective benefits of exercise. Sedentarism appears to cause the brain to atrophy while simultaneously increasing the risk for Alzheimer’s disease and other types of dementia. Being sedentary has even been shown to be twice as deadly as being obese.
In February 2016, a Finnish study found that being out of shape in middle age is linked to smaller brain volume down the road in later life. Gray matter is where all of your neurons are, so its volume can reflect brain health. Soon after, another study, conducted by researchers at four major research institutions in the United States, found that people with Alzheimer’s disease or mild cognitive impairment (MCI, a precursor to Alzheimer’s disease) experienced less gray matter shrinkage the more calories they burned through their exercise regimen. In other words, more physical activity meant more retained brain volume and less risk of disease. The researchers followed 876 adults over a thirty-year period and kept careful records of the amount and type of exercise that each participant reported. In addition, each of the individuals underwent a rigorous examination to determine brain function. Further, all of the participants had brain imaging done with a sophisticated MRI scanner. Those at the highest level of exercise activity experienced an incredible reduction of risk for Alzheimer’s of 50 percent when compared to those who were more sedentary.
We live in a time when we have been fairly well trained to expect “magic bullets” to resolve our ailments. When it comes to Alzheimer’s, none exists. Yet look at how you can safeguard your brain just by lacing up your sneakers and moving.
In addition to protecting the brain, exercise improves digestion, metabolism, elimination, immunity, complexion, body tone and strength, bone density, and circulation and heart health, and it helps us normalize weight. Just a twenty-five minute walk can cut your risk of dying prematurely by 30 percent; a brisk walk for the same time can add seven years to life. Physical movement is also an emotionally positive experience. It can increase self-worth and confidence and bring us greater energy. It can turn on our “smart genes,” make us feel younger, stave off depression, and generally help us make healthier lifestyle choices, including what we’re eating for dinner.
The last time you tried to get into shape, what happened? Did you succeed? Or did you keep up a routine for a few weeks, maybe right after New Year’s, and then suddenly it was Memorial Day weekend and you didn’t want to be seen in a bathing suit? Maybe you don’t even remember when you fell off the wagon, but it happened.
The problem for anyone trying to get active is not so much the starting part as it is the sustaining part. The key is to figure out what it is that you love to do and that achieves the following: 1) stretches and strengthens your muscles, and 2) gets your blood flowing physically, increases your heart rate, and puts healthy demands on your cardiovascular system.
Check with your doctor before starting an exercise program if you have any personal conditions and/or use medication that might be a factor in this endeavor.
Stretching and strengthening is important because far too many people focus solely on cardio and skip the stretching and weight-bearing exercises. If you don’t stretch and strengthen your muscles, you not only impair bone health and muscle mass, but you also run the risk of injury, which will prevent you from staying active. Starting here, I’ve created a very basic strength-training routine you can do at home. I also invite you to go to www.DrPerlmutter.com, where I provide video clips of these exercises that I encourage you to do in addition to a cardio routine of your choice. These clips cover all the major muscle groups—arms and shoulders, chest, back, abdominals, and legs. Perform these exercises three or four times a week, and have a rest day in between each session.
Ideally, aim for a minimum of twenty minutes of cardio work six days a week. You’ll want to get your heart rate up at least 50 percent above your resting baseline for a least fifteen of those twenty minutes. There are lots of different kinds of heart-rate monitors on the market; and various types of gym equipment, such as stationary bikes, elliptical machines, and treadmills, now include heart-rate monitors, too. Online calculators can also help you find your maximum and target heart rates so you know when you’re in the zone, as well as when you’re pushing the limits. At first you may not be able to hit any reasonable target heart rate or, if you can, you may not be able to sustain it for long. But you can build up to that target. I’ve often said to my patients, “If you can’t run five miles, then at least walk to the mailbox.” You have to start somewhere, and if walking to the mailbox represents your first steps toward improving your health, then so be it. Even people who are confined to a wheelchair can and absolutely should engage in aerobic exercise.
Create a realistic plan that you can maintain. For some, that might mean participating in group classes at a local gym; for others, spending more time gardening, taking up yoga and swimming, joining a competitive sports team in your community, power walking around the mall, or following a workout routine online or on TV. I have been a long-distance runner since high school, and recently I have been using the elliptical machine as well as a stationary bike and road bike for aerobics. I go hard on some days and easier on others. I suggest you do the same: Mix up the days you work out at a high intensity for shorter periods of time and then have those days when you go at a moderate pace for a longer time. The twenty-minute rule should be your minimum. You should be able to add more minutes as you gain strength and physical fitness. Build up to more intense workouts, too. Intensity can be increased through speed (e.g., running or pedaling faster), resistance (e.g., steeper climbs, heavier barbells), duration (e.g., longer intervals of giving it your all to the point you’re out of breath), and range of motion (e.g., deeper lunges, lower bends).
The optimal amount of exercise time, in fact, to gain the most benefits is close to 450 minutes per week. That averages out to a little more than an hour a day, which may seem like a lot, but it’s not when you consider that this amount reflects cumulative minutes of exercise. You don’t have to max out your heart rate for an entire hour, either, but you do need to be moving your body physically for at least that amount of time in total on most days of the week. It’s easier than you think. You might do a twenty-minute jog in the morning, run errands at lunch during which you walk briskly for another twenty minutes, and then spend twenty minutes before dinner tending to household chores that are physically demanding. If you skimp on exercise one day, that just means you go longer the next. It doesn’t really matter how you allocate those 450 minutes over the course of the week. Try to be as consistent as possible with when you plan your formal exercise daily (e.g., twenty minutes of cardio every morning before taking a shower), but don’t beat yourself up if you’re not perfect every single day. There will be days when you’ll need to move the timing of your usual routine and days when fitting in formal exercise isn’t possible. Strive for progress, not perfection.
And you don’t have to get too techy, despite the number of devices available to track physical parameters like heart rate. Just as pain can be your guide to let you know when you’ve overdone it (more on this coming up), how you feel in the moment can be as good as any high-tech gadgetry. Pay attention to your breathing and level of sweating. Does your breath get deep and rapid during your formal workouts? Do you break a sweat? Do your muscles start to burn a little during weight-bearing exercises and feel a tad sore the next day while resting? There is a difference between running and leisurely mowing the lawn, as well as between using 3-pound versus 8-pound weights.
We all think in pictures, and studies show that imagining yourself in the physical shape you want to be in can help you reach your fitness goals. Try to keep a vivid, realistic image in your mind. This will motivate you every step of the way as you work toward your personal picture of health. Think about what it means for you to have a fit, toned body. You’ll be able to participate in life to its fullest and not be constrained by low energy and no strength. Visualize yourself engaged in various fun activities you want to try, including adventures and vacations that make physical demands on you. Consider activities done alone, with a group, or with your family.
Concentrate also on what you’ll gain in terms of vigor, balance, coordination, flexibility, and mental sharpness (and mental toughness!). You’re sleeping better, managing stress more easily, enjoying a faster metabolism, being more productive overall, and spending less time sick in bed with a cold or other illness. You know that you’re doing the best you can to ward off disease. If you are dealing with any chronic conditions, you’re managing them superbly and they are having less impact on you. You’re feeling more accomplished both at work and at home—because you are! And you’re experiencing stronger, more intimate relationships with your loved ones.
How to Create Your Own Gym for Strength Training (No Trainer Required!)
You don’t need much in the way of equipment to get a great strength-training workout. In fact, you don’t even have to belong to a traditional gym, hire a trainer, or spend money on machines and fancy gadgetry to generate resistance against your body. There’s a lot you can do using your own body weight. Classic push-ups and sit-ups, for example, don’t require anything but you and a floor. But to get a full-body strength-training workout, I suggest you obtain a couple of inexpensive free weights. You can buy them online or at a local sporting goods store. Big-box stores like Walmart and Target also tend to carry these items. Choose weights that are comfortable to grip. Start on the light side (3-or 5-pound weights) and add more weight as you gain strength and want to challenge yourself further.
Although there are many muscles and muscle groups in the body to work on a regular basis, it helps to think in terms of upper body, lower body, and core.
Upper body: shoulders, triceps, biceps, chest, and lats (latissimi dorsi muscles of the back)
Lower body: thighs/quads and calves
Core: midsection and abdominals
On the days you choose to do your strength training—again, which you should do three or four times a week—perform exercises from each of the three main areas. While it would be optimal to hit every muscle group during your sessions, if you’re short on time, you can split up the areas you focus on. So, for instance, if you exercise your triceps, biceps, calves, and core on Monday, you can turn to your shoulders, chest, thighs, and more core on Wednesday. Some people like to include strength training in their daily exercise routine, which is also okay as long as you don’t repeat the same muscle groups two days in a row. Give those muscles at least a day or two of rest in between.
I encourage you to include a little bit of core work in each strength-training session. Powering up your core muscles and maintaining their strength is fundamental to health—more so than having toned arms. Your core is largely responsible for keeping you active and able to perform everyday tasks—from getting out of bed to sitting on the toilet, dressing, standing, and walking—as well as for playing sports and engaging in activities like biking, tennis, and dancing. Having a strong core prevents back pain, provides stability and balance, propels your endurance, and supports good posture. You don’t have to aim for ripped, washboard abs. Far from it. You just need to work your midsection and abdominals routinely to prevent weak and inflexible core muscles. In fact, a weak or inflexible core can hinder how well your legs and arms function, draining energy from your movement and impairing everyday activities.
There are dozens of different exercises that will work your upper body, your lower body, and your core. And many exercises will engage the core even though you’re focusing on another body part. Following are some basic exercises for a strength-training workout. Most of these require free weights. Because many cardio routines also place heavy demands on various muscle groups, you’ll find that some of your muscles will be quicker to tone and strengthen because they are getting more of a workout (e.g., taking a spin class will also work your quads and calves in ways that are equivalent to weight-bearing exercises; swimming will work your upper body and back).
Remember to go to my website, www.DrPerlmutter.com, where you can watch me demonstrate these very exercises. You may want to venture out and test other methods of resistance training, either by using formal gym equipment or by taking a group fitness class that is centered on strength training (e.g., Pilates, many forms of yoga, and gym classes geared specifically toward building muscle mass and strength). I usually go to the gym for strength training because I can access a wider array of tools.
Shoulders: Basic Lifts
Stand up straight with your feet hip distance apart, arms by your side. Hold one weight in each hand, keeping your shoulders down and chest open, and maintain good posture. Lift the weights out to the side to shoulder height (as if you’re making a letter “T” with your body). As you lift, with palms facing down, squeeze your shoulder blades together, and then lower the weights. Complete three sets of twelve repetitions (lift and lower twelve times).
Try a variation: Instead of lifting your arms out to the side, lift them up in front of you with straight arms, palms facing down.
Triceps: The Triceps Extension
Hold a free weight with both hands overhead. Try to use a weight that’s at least 5 pounds. Draw your shoulders down and back, and engage your core. While keeping your elbows pointed forward, bend the elbows and allow the weight to lower down behind your head. Then bring the weight back up and overhead by extending your arms. Keep your core and glutes engaged the entire time. Complete three sets of twenty repetitions.
Biceps: Basic Bicep Curl
Stand up straight with your feet hip distance apart, gripping a free weight in each hand. Your starting position is to have your hands down by your sides, palms facing forward. While keeping your elbows close to your torso and your upper arms stationary, lift your forearms up, curling the weights up while contracting your biceps. Complete three sets of twenty repetitions.
Chest: Classic Push-Ups
Lying face down on the floor, place your hands under your shoulders and tuck your toes underneath you. Push up into a plank. Hold for five seconds, then slowly lower down toward the floor, trying to achieve about a 90-degree bend in the elbows. Try not to collapse onto the floor, and repeat the push-up again into the plank position. Complete three sets of twelve push-ups.
Lats: The Wide Row
The best exercise to work these back muscles is to do pull-ups to a raised bar. But another way, using your free weights, is the following. Stand straight, chest up and back flat, while holding a pair of free weights in each hand in front of your thighs with a palms-down grip. Now, slightly bend your knees and lean forward, hinging at the waist. Continue to lean forward until your upper body is almost parallel to the floor. Let the weights hang straight down in front of your shins. With your head in a neutral position and your eyes focused on the floor in front of you, lift both weights straight up, bending at the elbows. This is a rowing-like motion but you’re in a semi-squat. Don’t alter the angles at your knees and hips and lower the weights back after a short pause. Complete three sets of twelve repetitions.
Thighs/Quads: Lunges
Stand up straight with your feet hip distance apart, and have a slight bend in your knees. Hold the free weights down at your sides. This is your starting position. Now, step forward with your right leg while maintaining your balance and squat down through your hips. Keep your torso straight and your head up. Don’t let your knee extend out over your toes. Using your heel to drive you, push yourself back to the starting position. Repeat this motion with your left leg to complete the full rep. Do three sets of twelve repetitions.
Calves: Tippy-Toes
Stand up straight with your feet hip distance apart. Hold a free weight in each hand, with each weight hanging by your sides. Push up onto your tippy-toes, and hold there for five seconds. Return to the start. Complete three sets of twelve repetitions.
Core: The Classic Sit-Up
Sit on the floor with your knees bent and your heels touching the floor. Cross your arms on your chest, making an “X.” Make sure to keep your shoulders dropped and relaxed to avoid tension in the neck. With your feet firmly on the ground, lay back as far as you’re able before rising back up. Maybe you can get all the way to the floor, maybe not. Continue doing sit-ups for one minute, then take a thirty-second break. Repeat for five rounds.
Core: Bicycle Crunch
Begin in the same starting position as the sit-up (see above). Twisting gently, bring your left knee and right elbow toward one another. Return to the starting position. Complete the movement with the right knee and left elbow. Continue for two minutes, then take a thirty-second break. Repeat for five rounds.
Take the time to write down your reasons for making these important fitness changes in your life. Rather than stating, “I want a flatter stomach and toned arms,” go for more meaningful, purposeful goals like “I want to spend more quality time with my family rather than constantly dealing with my chronic pain,” “I want to feel stronger and live longer,” or “I want to do everything I can to prevent the Alzheimer’s disease that my mother has.” Think big picture and be bold and brave with your goals.
PAY ATTENTION TO PAIN, ESPECIALLY IN YOUR BACK AND KNEES
I cannot emphasize enough the importance of not neglecting two parts of your body that are critical to staying mobile and therefore reducing your risk of disease: your lower back and knees. Let’s cover the lower back first.
The numbers are staggering. After colds and influenza, back pain is the second most common reason Americans see their doctor, and it’s the most common cause of job-related disability. Back pain is the second most common neurological ailment in the United States—only headaches are more common. And it’s the third most common reason for emergency room visits. At some point, more than 90 percent of American adults will experience severe lower back pain that adversely affects their quality of life. It’s estimated that lower back pain costs the American economy $50 to $100 billion annually.
In my thirty-odd years of practice I saw lower back pain routinely. Early on in my practice, many of these patients would be referred to neurosurgeons because in those days, it was believed that most lower back pain was caused by “ruptured disks.” We now know that this was completely off base and that, by and large, lower back pain is only rarely caused by disk problems. It is almost always caused by damage in the soft tissues—meaning muscles, tendons, and ligaments.
Although many things can cause back pain, from strained muscles to cancer, I do want to highlight one condition in particular that is extremely common but under-recognized: piriformis syndrome. Your piriformis (from the Latin word meaning “pear-shaped”) is a narrow muscle deep in each buttock. These muscles lie close to the sciatic nerve, so when the piriformis muscle spasms or is irritated, it can aggravate the sciatic nerve and trigger pain to shoot right down the leg from the buttock, as if it were coming from a ruptured disk. Patients are told that they have “disk disease” because of pain going down the leg, called sciatica. They may also experience numbness and tingling along the back of the leg and into the foot due to the irritated sciatic nerve.
It’s hard to imagine how many patients have undergone lower back surgery unnecessarily for what seems to be a disk problem, when the problem was piriformis syndrome all along. Recently, I found myself in a car showroom looking to buy a new car. The showroom manager was clearly in terrible pain. He was hunched over and was extremely reluctant to bear weight on his left leg. I couldn’t help myself. I asked him to follow me to his private office, whereupon I proceeded to have him lie on his back on the floor. Keep in mind that he had no clue that I was a neurologist or even a physician for that matter. He followed my instructions while all of the curious sales staff watched through the glass wall of his office.
I asked him to bend his left knee while turning his chin to the left. I gently stretched his piriformis muscle by pushing the bent knee across his body to the right. It was extremely stiff and even slightly painful when I began the piriformis stretch technique, but after a few moments, the spasmodic piriformis began to release. I then had the manager get up and walk around. His pain had completely abated. This was quite a moment at the car dealership.
I can tell you from personal experience that spasm of the piriformis muscle can be incapacitating. It can keep you from working, exercising, and at times can make it difficult to even get out of a chair. Use the exercises on my website to stretch and work the muscle. It’s the surest way to keep you moving.
Knee pain is also an extremely common cause of disability. It is the number two cause of chronic pain; more than one-third of Americans report being affected by knee pain. That’s more than 100 million people. In the United States alone, more than 600,000 knee replacements are performed annually. By 2030, demand for total knee replacement surgery is expected to exceed $3 million, largely due to older folks staying in the workforce longer and rising obesity rates. There is a time and place for knee replacement, but so often after this procedure is performed, people regret that they consented to it. Surgery should be reserved for the small handful of patients who qualify and who are likely to benefit from it. Most people, however, would do well to avoid it—and all of its risks—and instead focus on strengthening the knees and surrounding muscles.
Lots of people who engage in athletics experience knee pain from something called patellofemoral syndrome. The main sign of this syndrome is pain in front of the knee when sitting, jumping, squatting, or using a staircase—especially going down stairs. Knee buckling, in which the knee suddenly does not support your body weight, is also common. Or you might have a popping or grinding sensation when you are walking or moving your knee. This is usually due to overuse, injury, excess weight, a kneecap that is out of alignment, or structural changes under the kneecap.
So often at the gym, I see people wearing knee braces of various sorts designed to keep the patella in line and alleviate this symptom. Ultimately, though, this tends to make the situation worse. Exercises that can keep the quadriceps and hamstring muscles strong will keep the kneecap where it needs to be, unless there is a significant alignment issue with the legs. Orthotics, corrective inserts in your shoes, may also be helpful.
I myself have had patellofemoral syndrome on both sides, and it is incredible how painful this can be. I once was unable to climb the twenty stairs in my house to get to the bedroom. My orthopedist wanted to inject me with steroids, but I chose to see a physical therapist first, who put me on the path back to health with basic exercises to strengthen my quads. I went from being unable to climb a single staircase to climbing 3,200 feet four months later in just under three-and-a-half hours while traveling in New Zealand.
If you’re experiencing pain anywhere in your body, you need to pay attention to that. That is your signal that something is wrong. It may indicate that you’re simply overexerting yourself during your exercise—whether cardio or weight-bearing—and not letting the body recover enough between sessions. It may be that you haven’t fully stretched for a specific exercise and have strained a muscle, ligament, or tendon. And it could mean that there is an alignment issue that calls for orthotics. If you’re engaging in an exercise and it’s causing pain, stop, and reassess. Take care of pain when it strikes by modifying your exercise routine as needed, resting sore muscles, and mixing up your routine to make sure you’re using different muscles.
When in doubt about the source of pain, get some help from a physical therapist or, even better, a physiatrist. Physiatrists are physicians who treat a wide variety of medical conditions that affect the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. Check out the American Academy of Physical Medicine and Rehabilitation (www.aapmr.org) to learn more about this specialty and find a practitioner in your area.
MAKE ROOM FOR SLEEP
When was the last time you had a good night’s sleep? If it wasn’t last night, then you’re not alone. One in five of us has difficulty sleeping. I’ve written a lot about sleep in the past, as sleep disorders directly affect the brain, levels of inflammation, and risk for brain issues. The quality and amount of sleep you get have an astonishing impact on virtually every system in your body. Just a generation ago, we didn’t think much about the value of sleep other than to refresh the body somehow, like recharging batteries. Today, however, the study of sleep constitutes an entire field of medicine, which has revealed some breathtaking findings about sleep’s significance in human health.
Sleep can be described as a “diet of the mind.” It repairs and refreshes the brain and body on so many levels; it’s no wonder we spend roughly one-third of our life sleeping. Our pituitary gland, for instance, cannot begin to pump out growth hormone until we’re asleep. Natural anti-aging growth hormone does more than just stimulate cellular growth and proliferation; it also rejuvenates the immune system and lowers risk factors for heart attack, stroke, and osteoporosis. It even aids our ability to maintain an ideal weight, helping us to burn fat for fuel.
Indeed, getting quality sleep is a requirement for optimum well-being. The better you sleep on a regular basis, the lower your risk for all kinds of health problems. And, conversely, low-quality sleep has far-reaching adverse effects on the body and its functionality. Studies have convincingly shown that our sleep habits impact how much we eat, how fat (or thin) we get, how strong our immune systems are (and whether we can sail through the cold season), how creative and insightful we can be, how well we cope with stress, how fast we can think, and how well we remember things. Prolonged poor sleep habits are a factor in brain fog and memory loss, diabetes and obesity, cardiovascular disease, cancer, depression, and Alzheimer’s disease.
In fact, while much has been written about the fact that sleep disturbances are common in patients with Alzheimer’s, it was thought that the sleep issues were a consequence of the disease. Newer research, however, indicates that it may be the other way around: Disturbances of sleep may in fact enhance the way the brain makes beta-amyloid protein, a hallmark of Alzheimer’s disease. As the authors of a 2015 study state, paying attention to sleep issues and intervening when sleep is not fully restorative may be a way of modifying a risk factor for the future development of the disease.
Here are a few strategies to make the most out of sleep:
Prioritize and protect your sleep time. Just as you would schedule important meetings, schedule your sleep and be brutal about protecting that time period for sleep only. Because the body metabolizes a lot of waste products after ten p.m. and the immune system revitalizes itself between eleven p.m. and two a.m., it’s important to be asleep during these hours. So figure out what your bedtime and wake-time should be (e.g., ten p.m. and six a.m.), and don’t let anything disturb that pocket of time (see here for more about how to figure out the number of sleep hours you need).
365 days a year. Don’t let weekends and holidays derail your sleep routine. Do your best to keep a rigid sleeping schedule every day of the year, no matter what. Your body—and brain—will thank you for it.
Have a sleep study performed on you. The medical term for this study is “polysomnogram.” This is a painless, noninvasive procedure that has you spending a night or two in a sleep facility. As you sleep, a sleep technologist records multiple biological functions to determine if you have any disorders like sleep apnea (see next page) or restless leg syndrome. You’ll want to find a certified sleep physician who is approved by the American Board of Sleep Medicine. Go to either www.absm.org and check “verification of diplomates” or www.abim.org and look at the “who is certified” section. Another good resource is the National Sleep Foundation, at www.sleepfoundation.org.
Watch what you consume. Avoid caffeine late in the day and be mindful of medications you take that might infringe on sleep. Drugs that can undermine sleep include pseudoephedrine (e.g., Sudafed), headache medicines with caffeine (e.g., Excedrin), nicotine, drugs to treat high blood pressure and congestive heart failure, SSRI antidepressants, corticosteroids, and statins.
Cultivate a peaceful, clean sleeping environment. No electronics in the bedroom. Keep it tidy, neat, and at a comfortable temperature for sleeping, which is 65 to 70 degrees Fahrenheit.
Prepare for sleep. Take time before bed to unwind, disconnect from stimulating activities, and cue the body that it’s time for rest. Avoid screens (computers, tablets, and the like) for at least an hour before bedtime. Try a warm bath, listening to soothing music, light reading, or coloring in an adult coloring book. Before lying down, try some deep-breathing exercises (see here for a quick lesson). For some people, physical exercise can bring on restful sleep, but for many, exercising too close to bedtime can be stimulating, preventing you from feeling tired enough to sleep. If you’re that type, schedule your regular exercise routine earlier in the day, at least four hours prior to bedtime.
Gear up. Wear loose clothing to bed that’s appropriate for the room temperature so you’re not too hot or cold.
Try melatonin. If your circadian rhythm is off, which can happen from time to time if you travel across time zones or force your body out of its preferred sleep-wake cycle (maybe you stayed up too late or had a long nap in the afternoon), you might want to try a melatonin supplement. You can also try melatonin if you have unexplained trouble sleeping for many days in a row, as this may be a sign that your body’s rhythm is off. Melatonin is our body’s natural sleep hormone. But it helps control our twenty-four-hour rhythm as well. Released after the sun sets, it slows body function and lowers blood pressure and core body temperature so that we’re prepared to sleep. You can purchase melatonin as an over-the-counter supplement. A proper dosage would be 1 to 3 mg at bedtime.
Rule out sleep apnea. As mentioned above, a sleep study can help you determine if you suffer from this increasingly common disorder that robs millions of restful sleep. Sleep apnea can be more serious than previously thought. It causes the airway to collapse during sleep. Your breathing gets cut off multiple times and your sleep becomes fragmented. Loud snoring and dreamless sleep are often signs of sleep apnea (see box). In 2015, an alarming new study published in Neurology found that sleep apnea may be a factor in earlier onset of mild cognitive impairment (MCI) and Alzheimer’s disease. MCI often precedes dementia. The researchers of the study found that people with sleep apnea developed mild cognitive impairment nearly ten years sooner than those who didn’t suffer from breathing problems during sleep. The time span for developing Alzheimer’s also seemed to speed up: Those with sleep apnea developed the disease, on average, five years sooner than the sound sleepers. Researchers theorize that the adverse effects of oxygen restriction on the brain may have something to do with this connection, as well as the fact that sleep drives a slew of physiological events that help the brain “freshen up,” do some housecleaning, and clear out proteins that can otherwise gunk up nerve cells.
Signs of sleep apnea:
frequent fatigue and lack of energy
excessive daytime sleepiness
frequent nocturnal urination
nighttime gasping, choking, or coughing
irregular breathing during sleep (e.g., snoring)
morning headaches
gastroesophageal reflux
depression
Scientists have documented abnormal brain changes in people who suffer from sleep apnea. The good news is these changes can be reversed through treatment. Studies show that white matter irregularities, for example, can improve immensely when sleep apnea is treated. This is usually achieved through the help of a CPAP device. CPAP stands for “continuous positive airway pressure”; the device, which you wear while sleeping, uses mild air pressure to keep the airways open. The benefits can be felt immediately, and research has shown that within a matter of months, those brain changes go back to normal and there’s a vast improvement in cognitive function as well as in mood, alertness, and quality of life. Obesity can also trigger sleep apnea, through the extra weight and fat around the neck. People who lose weight often find relief and no longer need the CPAP machine.
People tend to underestimate the value of sleep. It’s arguably more important than what we do during the day. Arianna Huffington wrote an entire book about this subject. I encourage you to read The Sleep Revolution if you want to learn more about sleep and how to achieve the best kind. She writes: “It’s one of humanity’s great unifiers. It binds us to one another, to our ancestors, to our past, and to the future. No matter who we are or where we are in the world and in our lives, we share a common need for sleep.”
I should note that your newfound dietary choices will work in sync with your newfound sleep habits. As you clean up your diet and reduce inflammation, you’ll be increasing your chances for sound, restful sleep. Check out A. K.’s story of transformation:
As someone who watched a bedridden mother die of Alzheimer’s, I have a deep personal interest in preventing this disease in my family. I am always alert for leading-edge information on how to prevent this terrible illness.
Before my diet, I had been consuming lots of processed junk food, including diet colas, crackers and chips, and the daily oatmeal my doctor told me to eat. I was on a dangerous path. Once information about a low-carb, high-fat, gluten-free lifestyle was put before me, I instantly realized this was the information I had been waiting for.
I went to an olive oil store and bought a bottle, started eating grass-fed beef, eliminated grains, switched to green tea, and bought some stevia for (occasional) sweetening. I’ve also begun to eat more organic greens (daily, in fact).
Previously, I also suffered from arthritis in my joints, especially at night, when the pain would wake me up several times. If a change in sleep pattern is any evidence that this diet is working, then it is worth it to me for that reason only. It has only been six weeks, and the change is already AMAZING!!!
REDUCE STRESS AND FIND CALM IN FOUR SIMPLE WAYS
In my book Power Up Your Brain: The Neuroscience of Enlightenment, Dr. Alberto Villoldo and I told the story of how science has come to understand the gift of neurogenesis in humans. Although scientists have long proven neurogenesis in various other animals, it wasn’t until the 1990s that the focus turned to humans. In 1998, the journal Nature Medicine published a report by Swedish neurologist Peter Eriksson in which he claimed that neural stem cells exist within the brain that are continually replenished and can develop into brain neurons. And indeed, he was right: We experience brain “stem cell therapy” every minute of our lives. We’re not stuck with a finite number of brain cells; conversely, the brain is pliable and can continually make new cells and connections. This is known as neuroplasticity. It explains how stroke victims can learn to speak again.
In September 2014, I was fortunate to serve as conference chair for an international symposium exploring the latest research in brain health. Dr. Michael Merzenich, a professor emeritus neuroscientist at the University of California, San Francisco, and one of the leading pioneers in brain plasticity research, explained that lifestyle factors—some of which might surprise you—can indeed affect the ability of the brain to make new connections.
I’ve already discussed the ways in which we can positively affect the brain, such as physical exercise, getting restful sleep, following a ketogenic diet, and adding certain nutrients like curcumin and the omega-3 fat DHA. These techniques also have the added effect of reducing the stress our brains and bodies endure daily. Stress will always be a part of our lives; the key is to keep unnecessary stress at bay to preserve and promote those neural connections. And there are other means to positively impact the brain and its connections that have nothing to do with what you eat, how much you exercise, and how well you sleep. When we take a moment to change how we view the world around us, and to act in particular ways that further reduce the stress on our bodies, we are actually changing the physical and functional structure of the brain for the better. To this end, let me outline the four additional ways that can help support this outcome.
Flex your gratitude muscle.
Maintain strong social networks—mostly offline.
Get out into nature as much as possible.
Flex Your Gratitude Muscle
The science has spoken: The more grateful we feel, the more resilient the brain becomes, physically and even emotionally and spiritually.
Let me explain by way of example how I’ve incorporated the notion of seeking gratitude in the face of adversity into my life. Several months ago, I received an e-mail that linked to a magazine article about me. The article was anything but positive. The author had published the article—a litany of accusatory and derogatory statements about me—just as he was about to launch a new book, so it was clear he was seeking attention for himself and his book. My first response, coming from my more primitive brain center, was one of anger, outrage, and a strong sense of needing to retaliate.
Over the next several hours, I received more e-mails from concerned friends wondering how I would “respond.” I vividly recall being on the phone with my literary agent and publisher, and being asked, “What do you plan to do?” My response to them: “God bless him.” Though I was initially angry that someone could have attacked me like this, I realized that I owed the author of this highly disparaging article a great deal of gratitude, as it allowed me the opportunity to truly experience the fact that I do not let others define me. This experience was quite positive, as it did nothing more than strengthen my sense of self.
Gratitude has been studied in the laboratory. In 2015 researchers at Indiana University looked at two groups of people who were being treated for depression and/or anxiety. One group was asked to participate in a gratitude writing exercise, while the other group, which acted as the control, was not. The people in the gratitude writing group spent twenty minutes during the first three sessions of their weekly counseling writing thank-you letters to people in their lives. Three months after the counseling ended, the individuals in both groups underwent a clever experiment using a brain scanner.
The participants were placed in a specific type of functional MRI brain scanner and were gifted various amounts of pretend money by imaginary benefactors. To add realism, the benefactors’ names and photos appeared onscreen for the participants to see. The researchers told the participants the following: If they wanted to communicate their gratitude for the money, they could donate all or some of the money to a named third party or to a charity. This may seem like an odd experiment because it’s so contrived, but the researchers collected real data by telling the participants that someone would receive real cash minus any amount pledged to another party or charity.
What the researchers found was that, on average, the stronger the thankful feelings a person reported, and the more money a person gave away, the more activity they showed in their brain scans, particularly in areas that are not normally associated with emotions. Which means gratitude is a unique emotion that affects the brain in a unique way. Moreover, the researchers discovered that the gratitude exercise had both short- and long-term effects. Not only did the gratitude writing individuals report feeling more gratefulness two weeks after the exercise, as compared to the controls, but their brain scans showed more activity related to gratitude months later. They were still wired to feel extra thankful.
The takeaway here is that gratitude works mainly because it feeds further cycles of gratitude. It is self-perpetuating. As you practice gratitude, you become more attuned to it, which then allows you to enjoy more of its psychological benefits. In the words of the study’s authors: “… you could even think of your brain as having a sort of gratitude ‘muscle’ that can be exercised and strengthened (not so different from various other qualities that can be cultivated through practice, of course). If this is right, the more of an effort you make to feel gratitude one day, the more the feeling will come to you spontaneously in the future.”
One of the easiest ways to practice gratitude is to keep a journal designated for this very exercise. Spend two minutes daily, maybe right before bedtime, writing down a few things for which you feel thankful. These can be little things that occurred during your day or larger experiences or notes of thanks for named people who have had a positive impact on you. Try writing a letter to someone thanking him or her for being in your life, and send it!
Maintain Strong Social Networks—Mostly Offline
One of my favorite quotes is from the 1948 song “Nature Boy” by Nat King Cole. He sings about love being the most important thing one can ever learn—loving others and being loved. I once read that people who work with the dying in hospice care facilities often hear similar questions: Am I loved? And did I love well? These people are at a point in their lives when all the trivial sources of stress are gone and all that’s left to ponder is their legacy of love. Love is, after all, everything. I am continually reminded of the power of compassion and love—of the social bonds we maintain, whether they are ones that endure for a long time or are brief but nonetheless impactful. Let me share a real-life story that illustrates what I mean.
Thirty years ago, when I had finally completed my residency training, I was offered a job with an established group of neurologists in Naples, Florida. Soon after I began work, I met Mike McDonnell, an attorney who had an office one floor above us. Mike was a well-known personality in South Florida, and we soon became very close friends. We began sharing evenings together, playing guitar, and singing with other friends. Mike became such an important part of our lives that my future wife and I asked him to perform at our wedding ceremony, and in fact, he and his wife, Nina, joined us on our honeymoon. Mike became the godfather of our daughter Reisha.
Mike turned to me for all things medical, and I in turn relied upon him for his incredible legal acumen. In early February 2016, I was unprepared for the text message that I received from his wife. It simply stated, “Need you, Mike is dying.” I rushed to our local hospital and found my friend on a breathing machine with his wife and three of his five children at his bedside. I knew at that moment that I had to assume the role of neurologist and immediately examined him. After reviewing his brain scans, I knew Mike had sustained a massive stroke and had essentially no brain function.
I explained the gravity of the situation to Mike’s family and friends. We made arrangements to transfer Mike to the intensive care unit. There, his situation remained fairly stable while on life support. Fortunately, this allowed all of his children to make their way to the hospital and share in Mike’s last moments of life.
At 11:14 p.m., Mike left us.
I thought about Mike pretty much the entire next day and later that evening. As fate would have it, one of Mike’s close friends, and ours as well, was playing piano at a local restaurant. During his performance, he mentioned how we had lost a close friend the day before. After dinner that night, we spent time with friends talking about Mike and his passing. When we got home, I became violently ill, with shaking chills and nausea. I finally fell asleep about two a.m., and when I woke up the next day, I knew something wasn’t right.
Plans were made to have a celebration of Mike’s life the following day, and we all gathered up our photographs for a retrospective. As it turned out, not only did we have lots of photographs, but we also had a DVD of a performance that our musical group had given at a fund-raiser many years before. After watching the video with my wife and daughter, I felt I needed to lie down on the couch. I wasn’t sure what was going on with me, but I was certainly lightheaded and my heart was racing. I then began to lose my vision. I called for my wife and let her know how I was feeling, and she called 911. Prior to the ambulance arriving, fire rescue was in my living room. A young man asked me how I was feeling, and I explained how my heart was racing. He then asked if I was under any stress or had experienced a stressful event, at which point I burst into tears and explained the loss of my friend. The firefighter believed my symptoms were anxiety related, and he encouraged me to take deep breaths and try to relax. My medical mind, while accepting the fact that I was certainly in an anxious state, nevertheless told me that there was something more going on, especially when I took my own pulse and found that it was not only rapid but irregular.
When the ambulance arrived, it was clear that my heart was beating erratically, with a heart rate as high as 170. I was taken to a local hospital, where medicine was administered intravenously to slow my heart, but it failed, twice. At that point, I was transferred to the intensive care unit. The medicine to slow my heart rate was progressively increased, but my heart rate remained dangerously elevated. Finally, Bob, the intensive care nurse, explained that I had reached the maximum dosage of the medication and that a second medication needed to be added. I knew if the medications failed that I would be looking at having a cardioversion procedure done, which is a nice way of saying I’d have my heart shocked back into a normal rhythm.
As evening arrived, I began having a conversation with Bob. He explained that he had worked as a nurse in the trauma unit of an emergency room and described some of his experiences there. As I listened to his stories, I was so taken by his compassion toward me and his wish for me to get better. He carefully adjusted my medications while continuing to tell me about some of the most meaningful events in his life.
As he continued, I closed my eyes and suddenly felt a wave of intense gratitude, not only for my friendship with Mike, but also for my newfound bond with Bob, who was providing care and sharing his life story with me. I can only describe this feeling as one of love. And it was at that moment, as my body was flooded with this emotion, that my heart rhythm suddenly converted back to normal.
As you can imagine, sleeping in an intensive care unit is difficult. I was in and out of sleep throughout the night, and every time I awakened, I checked the cardiac monitor that was behind my bed to make sure that my heart rhythm remained normal. A little after four a.m. I woke up again, but this time there was no pulse on the screen. It was flatlined. I thought I was dreaming, but I was awake. I reached down and found that one of my heart monitor leads had become dislodged. I quickly reconnected it, which immediately restored my normal heart tracing to the monitor.
By the time the cardiologist arrived the next morning, I had been out of bed doing yoga. My heart and all my vital signs were deemed normal, and I was discharged with no medication except the recommendation of aspirin.
So many times over the years, I’ve been asked the question, “What was it that got you into integrative medicine?” I’ve always said that there was no single epiphany. But I can truly state that the experience in the hospital—first with Mike and then with Bob—has been a major and pivotal event in my life. I left the hospital a changed man. While over the years I have lectured and written about the detrimental effects of stress, those events certainly made a believer out of me. But far more important, they brought me to a place of fully understanding the meaning of love. While we have love for our families and friends, having love and gratitude for others—even strangers—is something that was, at least for me, unexpected but is now fully welcomed in my life. And this was Mike’s final gift to me. He actually passed within the same year my father did. My dad was a dedicated physician who throughout his life emphasized to everyone around him the fundamental importance of compassion toward others.
When you are loved and you love well, every cell in your body is allowed to work at its maximum capacity. If love is the single most important ingredient for health and wellness, then I know of no better way of staying on the path of continual healing than to love as much as you can and enjoy its returns. And you do that by maintaining strong social networks. Be open to unexpected newcomers into your life like Bob, and nourish the bonds that have been with you for a long time. You never know when you might need to call on those people when you face serious challenges or have to endure a tragedy in your life.
Social relationships no doubt also change our physiology and sense of well-being. You’d be surprised by how the nature of our health hinges on the nature of our relationships, from the ones we have with others to those we have with ourselves. We are, after all, very social creatures. Recent research has even shown that the bonds we keep with others can enhance longevity. In 2015 a team of researchers at the University of North Carolina at Chapel Hill sought to understand how social relationships affect health. In particular, they were interested in how social relationships “get under the skin” to influence physiological well-being as people age. Among the questions they wanted to answer: When do these effects emerge in life? What do they entail? Do they change as a person ages? How long do they last?
By synthesizing data from four large surveys of Americans ranging from adolescents as young as twelve to seniors as old as eighty-five—a total of more than 14,600 people—the researchers looked at several parameters. In terms of social bonds, they considered social integration, social support, and social strain. To analyze the biological side to the experiment, they considered four common measurements of health: body mass index (a factor of height and weight), waist circumference, blood pressure, and C-reactive protein to assess systemic inflammation. These biomarkers are associated with risk for many diseases, including heart disease, stroke, dementia, and cancer. The results were not surprising on some levels, but they were astonishing on others. We already knew from previous research that older individuals who had a larger social network tended to live longer than those who didn’t. But this was the first time a study showed that social bonds lowered health risks in everyone—from the young to the old. Among the more surprising findings: social isolation in teenagers contributes equally to bad inflammation as does physical inactivity, and having a strong social network may protect against obesity; social isolation in seniors can be a bigger factor than diabetes in the development and management of high blood pressure; and in middle-aged people, the quality of one’s social bonds is more important than the quantity.
There is a lot we can take away from this comprehensive, innovative study, regardless of which stage of life we are in. The relationships we maintain matter to our health, and quality trumps quantity. How well do you relate to other people? Do you have a trusted set of friends? Is your marriage enriching or a source of hardship and stress? Does bad news or a bully in your circle of friends, colleagues, or acquaintances affect you in a way that severely lowers your quality of life? Do you like yourself?
Cultivating healthy relationships starts with establishing a healthy relationship with yourself first. This will then allow you to extend that inner love to others and all that surrounds you. And the happier you are in your relationships, the easier it will be to make excellent decisions in all that you do.
Even though there are more gadgets and apps to connect with others than ever, there are also more lonely people who harbor feelings of disconnectedness. It seems as though the more artificial connections we make through social media, the less time we spend with one another in person. To this end, try to nourish your relationships in authentic, intimate ways. Plan more time with the people who inspire, encourage, and de-stress you. And don’t rely on social media. Social media platforms have their place in the world, but you can’t substitute them for real, face-to-face interactions. Get out there and do things with others. Try new hobbies together. Some ideas:
Designate a date night (e.g., movie and dinner) with a spouse or best friend at least once a week or twice a month. This doesn’t mean you have to go out. Cook the meal together at home and have movie night on the couch.
Have weekly dinner parties with close friends. Make it a potluck and tell people what to bring.
Establish a hiking or power-walking group with friends that meets weekly on a designated morning.
Pick up the phone on weekends and call at least one good friend who lives far away. Catch up.
Keep a daily ritual with the person closest to you—a spouse, best friend, maybe a child old enough to engage in this exercise. The ritual can be any of a number of things, from simply talking about your day and what’s on your mind to sharing a passage from a book of quotes or proverbs. Each morning, my wife and I share a quotation or passage. For us, it serves to remind us of what is important and meaningful in life. It also helps us to bond. We find that our morning reading stays with us through the day. I often revisit our quote during the course of the day.
Have a few non-negotiable habits in your life, such as leaving work by 5:30 p.m. so that you can be home to have dinner with the kids. Savor Sundays with family by ditching all electronic devices and focusing on those in-person relationships. Have at least one device-free day a week.
Strengthening those personal connections in real life can be as powerful as any other strategy to support health and well-being.
Plan Personal Downtime
Do you ever try to power through feelings of illness, pain, anger, frustration, exhaustion, being overwhelmed, and the yearning to take a break? Do you have personal downtime on a regular basis? It sounds cliché to say “relax” because it will “reduce stress,” but it’s all the more important today because we seem to value busy-ness so much. Technologies provide opportunities to be endlessly entertained and engaged, but also distracted and spent. A few neuroscientific studies are starting to emerge, for example, showing that we may be impairing our reflective abilities by relying too much on electronic devices. We use our phones more than we think: In a 2015 paper in the journal PLOS One, it was found that people sorely underestimate their smartphone use. You might think you use your phone an average of thirty-seven times throughout the day, which is what the study’s participants believed, but that number is closer to eighty-five! And the total amount of time you spend on your phone daily is probably a little over five hours.
More than a quarter of our days are now spent immersed in information overload. Some of that information is valuable, but some of it is the equivalent of junk food for the brain. The massive digital input could be preventing us from learning and remembering information or from being creative. Some of us don’t even take advantage of paid vacation time anymore. But it’s essential that we plan personal downtime to let our bodies recover from stress, renew themselves, and gather more strength and energy. Get into the habit of having insightful, distraction-free conversations with yourself during that downtime. Make sure that inner dialogue helps you to stay positive, upbeat, and present.
Scientists at the University of California, San Francisco, have documented that when rats experience something novel, such as encountering a new area, their brains show new patterns of activity. That fresh experience, however, cannot become a solid memory in the rats’ brains if they don’t take a break from their exploration. The researchers reckon that the findings also apply to how we learn as humans. Downtime allows the brain to take a break and solidify experiences it’s had, turning them into permanent long-term memories. If the brain is constantly stimulated, this process could be hampered.
Self-care begins with self-discovery. It’s important that we stop to collect our thoughts and check in on our goals regularly. This should be done daily, weekly, monthly, and annually. Some ideas:
On a daily basis, set a time during which you turn off your cell phone and don’t respond to non-emergency calls, e-mails, or text messages so you can practice some deep breathing. This will calm your mind and body and help you evaluate how you feel and what you’re thinking. Here’s how to do that: Sit comfortably in a chair or on the floor. Close your eyes and make sure your body is relaxed, releasing all tension in your neck, arms, legs, and back. Inhale through your nose for as long as you can, feeling your diaphragm and abdomen rise as your stomach moves outward. Sip in a little more air when you think you’ve reached the top of your lungs. Slowly exhale, pushing every breath of air from your lungs. Continue for at least five rounds of deep breaths. Then open your eyes and ask yourself whether or not your body feels good and energetic in general. For some, first thing in the morning upon getting out of bed—before looking at any digital device—is an ideal time for deep breathing. Or set the alarm on your phone for three p.m. every afternoon. Make it part of your daily routine. Another idea is to end your deep-breathing session with an inspirational quotation. See the box here for examples.
On a weekly or monthly basis, tune into broader questions about yourself, such as whether or not you’re feeling content, how you’re feeling physically, and the status of your relationships. Is there someone you should spend more time with? Anyone you’d be better off excluding from your life? What in life is causing you a great deal of stress and anxiety? How can you begin to remedy that?
On an annual basis, set new goals and address any challenges. Consider the big goals, such as anything you might want to accomplish that may require long-term planning. What would you like to do in the next year or the next decade? Find a new job? Perfect a skill? Try a new hobby? Start a business? Climb Mount Kilimanjaro? Travel to Europe? Volunteer more? Enroll in an art workshop? Go on a weekend retreat? Write a memoir?
As mentioned earlier, recording your thoughts, goals, feelings, anxieties, and the events most affecting you in a journal can be helpful. It allows you to review later, can help assuage those worries, and gives you accountability (for a list of the journals to maintain, see here).
Get Out into Nature as Much as Possible
Our ancestors used to work and live mostly in the outdoors, but few of us do that anymore. We live and work indoors, usually tethered to electronics, chairs, couches, meetings, and chores. There is a biological reason why going for walks and hikes, for example, or doing anything in the open air can be so invigorating. Being outside and among plants and other living things enhances feelings of well-being through a variety of biochemical reactions, including a real calming effect on your mind and nervous system.
Get out in nature as much as possible during the day, whether you live in a big city or a rural area. Find a park to take a daily walk after lunch. Try to sit near a window with a view when at work, or place a chair in front of the window with the best view from your home. Notice the movement of trees in the wind, the nearby birds and other creatures. Plan your workouts outside when the weather is agreeable. Take in the air and scenery along natural bodies of water or mountainous regions. Enjoy the first light of the day at dawn and the sunsets at night. On clear nights, go stargazing. And don’t forget to bring the outdoors inside. Decorate your rooms and office with living plants (see the next section for ideas). They will keep your air clean and bring Mother Nature closer to you. And as you’re about to read, they will help you to detoxify your physical environment.
DETOXIFY YOUR PHYSICAL ENVIRONMENT
Let me state the obvious. We live in a sea of chemicals. Scientists who measure the so-called body burden, or levels of toxicants in tissues of the human body, tell us that virtually every resident in the United States, regardless of location or age, harbors measurable levels of synthetic chemicals, many of which are fat-soluble and therefore stored in fatty tissue indefinitely. I wish there were more focus on policing these chemicals than on monitoring them. Unfortunately, it takes years—sometimes decades—for studies to gather enough evidence for the government to justify writing new standards or regulations, and even to take dangerous products off the market. In 2014, a meta-analysis published in the Journal of Hazardous Materials reviewed 143,000 peer-reviewed papers to track the patterns of emergence and decline of toxic chemicals. The study exposed the sad truth: It takes an average of fourteen years for appropriate action to take place. We need to take matters into our own hands.
The good news is the Grain Brain Whole Life Plan helps you do just that. Don’t wait until something is officially labeled as being dangerous to eliminate it from your life; when in doubt, take it out of your life.
I’ve already made my case against glyphosate, the main ingredient in Monsanto’s Roundup. Here are some additional ideas to support a cleaner way of life:
When buying canned foods, be sure the cans are not lined with BPA. Look for “BPA-free lining” language on the can.
Avoid using nonstick pans and other cookware. Teflon-coated wares contain perfluorooctanoic acid, or PFOA, which the EPA has labeled a likely carcinogen. Cast-iron cookware, ceramic, noncoated stainless steel, or glass are your best bet.
Minimize the use of the microwave. Never place plastic—including plastic wrap—in a microwave. Don’t put hot foods in plastic, which can release nasty chemicals that are absorbed by the food.
Avoid plastic water bottles, or at least avoid plastics marked with “PC,” for polycarbonate, or the recycling labels 3, 6, or 7 on the little triangle. Buy reusable bottles made of food-grade stainless steel or glass.
When it comes to toiletries, deodorants, soaps, cosmetics, and general beauty products, switch brands when you restock. Remember, your skin is a major entry point to your body, and what you slather on may make its way inside to inflict harm. Look for the genuine USDA organic seal and choose products that are safer alternatives. Use the Environmental Working Group’s (EWG) user-friendly website (www.ewg.org) and I Read Labels For You (www.ireadlabelsforyou.com) to find the safest products. Endocrine-disrupting chemicals, or EDCs, have been shown to disrupt normal metabolism and even trigger weight gain. The most insidious ones are:
aluminum chlorohydrate (in deodorants)
diethyl phthalate (in perfumes, lotions, and other personal care products)
formaldehyde and formalin (in nail products)
“fragrance” and “parfum” (in perfumes, lotions, and other personal care products)
parabens (methyl-, propyl-, isopropyl-, butyl-, and isobutyl-) (in cosmetics, lotions, and other personal care products)
PEG/ceteareth/polyethylene glycol (in skin care products)
sodium lauryl sulfate (SLS), sodium laureth sulfate (SLES), and ammonium lauryl sulfate (ALS) (in a variety of products: shampoos, body washes and cleansers, liquid hand soaps, laundry detergents, hair color and bleaching agents, toothpastes, makeup foundations, and bath oils/bath salts)
TEA (triethanolamine) (in skin care products)
toluene and dibutyl phthalate (DBP) (in nail polishes)
triclosan and triclocarban (in antibacterial hand soaps and some toothpastes)
Select household cleaners, detergents, disinfectants, bleaches, stain removers, and so on that are free of synthetic chemicals (look for brands that use natural, nontoxic ingredients; again the www.ewg.org site can be helpful here). Or make your own: Simple, inexpensive, and effective cleaning products can be made from borax, baking soda, vinegar, and water (see the box here).
Indoor air is notoriously more toxic than outdoor air due to all the particulate matter that comes from furniture, electronics, and household goods. Ventilate your home well and install HEPA air filters if possible. Change your air-conditioning and heating filters every three to six months. Get the ducts cleaned yearly. Avoid air deodorizers and plug-in room fresheners. Reduce toxic dust and residues on surfaces by using a vacuum cleaner with a HEPA filter. Naturally ventilate your house by opening the windows.
Request that people take off their shoes upon entry.
Plants—such as spider plants, aloe vera, chrysanthemums, gerbera daisies, Boston ferns, English ivies, and philodendrons—naturally detoxify the environment. Keep as many in your home as possible.
When purchasing clothes, fabrics, upholstered furniture, or mattresses, choose items that are made of natural fabrics with no flame-retardant, stain-resistant, or water-resistant coatings. (Some states mandate a certain level of flame retardants on products, but do your best to find the most natural products possible.)
Wet-mop floors and wipe down windowsills weekly.
Speak with your local garden store or nursery personnel for recommendations on pesticide- and herbicide-free products you can use in your garden to control pests.
While it may seem like an overwhelming task to clear out your house of questionable products and replace them with alternatives, it needn’t be stressful and you needn’t do it all in one day. Go one room or one product at a time. The goal is to do the best you can based on what you can afford and what you’re willing to change. As part of your daily checklist during the 14-day menu plan, I’ll ask you to do one thing that helps you to detoxify your physical environment.
But before we get to that, there’s one more step to take that will help you pull all these ideas together: Plan accordingly.