Monthly Archives: February 2007

Napping! Stress Reduction Redux: Reduce Your Risk of a Heart Attack 30%

Napping!  Stress Reduction Redux:  Reduce Your Risk of a Heart Attack 30%

Competency # 20 Culture – Lifestyles of the Long-Lived

Reference: Archives of Internal Medicine, Feb 11, 2007

Winston Churchill once said, “Take off all your clothes, slip between the sheets and take a proper nap.  You get two days out of one.”  He was so right.  Here’s the proof.

I personally love to nap and feel like I never get the chance!  I have successfully managed to fall asleep in every class I have ever attended ever since Miss Brennamen made me stand in the corner in 3rd grade for falling asleep.   Having felt guilty about it most of my life, I am perfectly delighted to find evidence that napping is really, really good for you.

This Lenten/Passover Season, I’m doing articles on stress reduction and our inner journey to mental health.  Napping just popped into the news and I couldn’t resist.  This article made the news all over the world.  So I looked it up.

The authors followed over 28,500 men for over 6 years.  Complete data on napping, physical activity, lifestyle variables, diet and other risk factors were all controlled for.  Previously ill persons were excluded, as their napping may be related to illness.  And Body Mass Index was controlled for.  Napping has been epidemiologically connected to the Mediterranean region, as well as to Latin America where it is culturally encouraged.  But no study has taken the rigors of modern statistical analysis to look at detailed co-variables.  It’s easy to say that those who nap follow other good lifestyle habits.  This research took on that challenge.  Other studies have been smaller and have not taken working, midlife adults with no active illnesses as their baseline.  This one is 10 times the size as its competitors, so it has some authority.

The data is straightforward.  For those who nap three times a week, (at least 30 minutes) an additional 30% reduction in coronary artery disease accrues.  They had 133 deaths from coronary artery disease, which made enough events to apply statistical analysis to the men.   They didn’t have enough women to do the same.  Their conclusions: the stress reduction incurred by napping has to be hypothesized to be the variable, in other words, the reason it works.  We know stress, as hard as it is to measure, is correlated with coronary artery disease.  This is one way of reversing it.  It’s intuitively correct.  Now, we can put a number to it.  When 50% of men and women die of heart disease, a 30% reduction in mortality is possible 15 people per hundred living longer.  This is bigger than the positive effect any screening studies for cancers.

WWW.  What Will Work for Me?  It makes sense to me.  If I can get a nap, I’m extra good for an additional 8 hours.  I feel I have a burst of creativity and energy that more than makes up for the time it takes me to nap.  The only problem I have is finding a place that’s quiet and leaves me alone.  What I have found is a remarkable response from multiple people who respond to my suggestion to take hidden chances to nap.  The example I give is the 20 minutes you get on a plane after you’ve sat down and before you leave the gate, take off and then play on your computer.  You are captive, bored, unable to access any media, and sitting quietly.   I’ve suggested they take that time to nap, and to a person, they’ve said it’s their favorite thing to do on a trip.  Do we need to find more hidden places to practice our napping?  Try it out.  It’s evidence based!  And some day, I’m going to ask Miss Brennamen if I really upset her or not!  And if this column goes any longer, I’ll catch you napping.

WWW.  What Will Work for Me?  It makes sense to me.  If I can get a nap, I’m extra good for an additional 8 hours.  I feel I have a burst of creativity and energy that more than makes up for the time it takes me to nap.  The only problem I have is finding a place that’s quiet and leaves me alone.  What I have found is a remarkable response from multiple people who respond to my suggestion to take hidden chances to nap.  The example I give is the 20 minutes you get on a plane after you’ve sat down and before you leave the gate, take off and then play on your computer.  You are captive, bored, unable to access any media, and sitting quietly.   I’ve suggested they take that time to nap, and to a person, they’ve said it’s their favorite thing to do on a trip.  Do we need to find more hidden places to practice our napping?  Try it out.  It’s evidence based!  And some day, I’m going to ask Miss Brennamen if I really upset her or not!  And if this column goes any longer, I’ll catch you napping.

Evidence Based Food for the Soul

Evidence Based Food for the Soul:  It’s a Great Time to Contemplate Wellness in the Larger Sphere

Competency # 21 Meditate;  #22  Friends;  #24  Contribute.

Reference: The How of Happiness by Sonja Luybomirsky

Ok, this isn’t an article on food and nutrition.  But it is about how to keep us well.  As we are in the Christian season of Lent, and many of us are contemplating our own inner life, here is something that rounds out the fullness of wellness.  I find there are beginning to be many articles that are based on sound research that contribute to our sense of wellness.  So, if you would excuse me the stretch.  Here is some food for your own spiritual journey.

Based on research by Sonja Luybomirsky, a psychologist in California who has been widely reported on, here is a list of 9 healthy habits we can try to bring into our daily lives that will go a long way to making you “happier” or more contented.  Dealing with stress, or being distressed, is at the top of our lists for making our lives more livable.  This has worked for me.  Here goes.

You will recognize this list.  It looks like the spiritual journey made holy by many religious traditions.  A spiritual journey is open to all of us.  These are the habits that work.

1.  Attitude of Gratitude.  Count your blessings.  Name them one by one.  Do it once a week.  Write them down.  Put them up on your fridge.  Think about them.  Aren’t you lucky!  Watch your mood lift as you feel the power of recognizing the blessings in your life.  We all have them.

2.  Practice Kindness.  Get in the habit.  Make it part of your life.  Let the person on the road turn left in front of you.  Let the lady at the checkout line with two kids go first. Make being polite and aware of those around you a habit.  Meet their needs, and watch with amazement how the kindness comes back to you.  You change.  That’s the key.

3.  Savor the Joys.  The flavor of a good strawberry.  The smell of a flower.  The giggle of a small child.  The affection of a pet.  Take a mental picture of that moment and impression.  Fill your heart with its pleasure.  Take that picture with you.

4.  Thank a mentor.  Each of us has one.  Someone around you has been a mentor to you.  Pass it on.  You mature as a mentor as you learn to thank those who have made your place possible.  Say it out loud.  Thank you.  In person.  In a note.  In an email.  It’s part of my journey to mentor those around me.

5.  Learn to Forgive.  We’ve all been mistreated.  The wounds last longer if we save the pain.  Don’t take a mental pictures of that pain.  Forgive and erase the file.  Move on.  Forgiveness has much more to do with your place in the universe than remembering and holding the grudge.  It’s an amazing gift to yourself.   Practice with little forgivenesses.  Big ones follow.  You win.

6.  Make Time for Family and Friends.  Just do it.  Strong personal relationships count.  And you can only develop them with time.  Make the time.  Invest in your chosen family.

7.  Take care of your body.  Good food.  Good sleep.  Good exercise.  Good relaxation.  Read this column.

8.  Develop Strategies to Deal with Stress.  Life has stresses.  No matter how rich or powerful.  Think of it as practice to make you stronger.  A chance to live your values.   Believe that you have a reason to live.

Religious traditions are proven supports.  The Buddhists say, “Be grateful for your enemies, they give you a  chance to practice patience.”  I want patience listed in my portfolio.  Beats 100 shares of GM.

9.  Be Involved.  Find out what it takes to make you wake up with excitement.  What do you look forward to.

Every day.  Get involved with something you can dream about.  A cause. A charity. A friend. A project.   Habitat for Humanity.  Big Sister.  Sunday School.

WWW:  What Will Work for Me?  For me to change and grow, I need ideas to think about.  I learned many of these ideas as a child.  I have an inner journey that I need to be on.  Hope these help you too.

Is there a special role for Omega-3 Fats from Walnuts and Flax Seed – ALA?

Is there a special role for Omega-3 Fats from Walnuts and Flax Seed – ALA?

Competency # 13   Fats

Reference: Am J Clin Nutr 2007;85:385-91 Zhao and Etherton at Penn State

Yes.  Ok, you can stop here.  Or, you can understand an interesting study just published in the American Journal of Clinical Nutrition this February by Zhao from Penn State in the Feb edition on dietary effects of ALA (alpha linoleic acid) on your body’s inflammation.

We know that the Mediterranean diet is good for us in that it correlates with a dramatic reduction in heart disease risk.  There are about 50 foods that are eaten regularly in the Mediterranean diet, but olive oil and lots of vegetables and fish are key to much of the diet.  That diet also has an abundance of omega fatty acids in it.  Fish and fish oil are now well established sources of omega-3 fatty acids that I have encouraged you to eat.  What about ALA, an omega fatty acid common in vegetable sources?  Does it help or hurt?   Key to us in North America is the environment we live in that has an abundance of omega-6 fatty acids that seem to be correlated with inflammation.  Can we find a dietary strategy that avoids that inflammation?  We think so.  This study says yes.

What this study did was to examine the inflammatory markers in our white blood cells called tumor necrosis factor and another called IL-6.   These markers drop to the degree that ALA activates something called the PPAR, or the peroxisome-proliferator activated receptor.  You will hear more about the PPAR system sometime this year because it seems to be a key player.  Activating that system turns on the genes in your white blood cells.  Not only does ALA change those inflammatory markers, it changes the ability of our white cells to stick to the walls of our arteries.  It’s that sticking stuff that gets our arteries damaged when white cells attack the artery, and then the LDLs bring in the garbage fats.  That happens every day, after every meal, year after year.

But to get a sense of what this dietary change did, here are some numbers.  In an Average American Diet, your IL-6 is 239 ng/L.  The ALA diet in this study lowered that to 107.  Their TNF went from 18.2, to 10.3.  The study subjects were all a bit pudgy, a bit high on their cholesterol and middle-aged without any active disease, just middle-aged folks.

What did they eat to do that?  About 1.3 oz a day of walnuts and .8 oz of flax seed.  Add a little walnut oil in one of their other groups.  These are not big changes.  But what happened in their blood was big. This study is a physiology study.  It shows how something works.  To prove it reduces artery disease will take a prospective trial that takes years.  I’m not willing to wait.

WWW.  What Will Work for Me?  I think this is pretty impressive.  Walnuts are good for us.  Flax seed is too.  We can now say for certain that adding ALA to our diets makes a difference.  It lowers your inflammatory markers.  Fish oil is on the official list.  I’m predicting, based on this and other similar studies, that the formal recommendation will be for you consistently find ways to add walnuts and flax seed to your diet.  It’s just a matter of time.  Let’s just beat them to it and start sooner.

Niacin: An Unheralded Secret

Niacin: An Unheralded Secret.  One really cool vitamin we should all consider

Competency # 15 Vitamins

Reference: Med Hypotheses. 2007; 69 (1):90-4

There has been a flood of news recently about the fats in our blood and how we have to alter them.  In part, those stories are driven by recent loss of Big Pharma pipeline drugs.  When potential blockbusters go belly up, the stock market talks about it.  And no one ever talks about the cheap stuff.  Niacin is a vitamin that’s generic, cheap and effective.  This may be something we should all be on?

The story is all about the fats in your blood.   We have total cholesterol, that doesn’t really tell us much.  Cholesterol is really split into a couple of different kinds.  The bad kind is called LDLs, or Low Density Lipoproteins.  They pick up cholesterol and take it out and bury it in our blood vessels.  And there are HDLs, High Density Lipoproteins.  They are your body’s garbage trucks.  They pick the cholesterol back up out of your vessels and bring it back to your liver.  The trick is to have a low LDL and a high HDL.  If you can get your LDL below a 100, you are in great shape.  If you can get your HDL above 40, and better yet, in the range of 60, you are in great shape.   You can raise your HDLs with exercise.  And the less saturated fat, less sugar and less transfats you eat, the better your LDLs get.  So, I can change my diet a little.  But I’m already pretty good, well, except when I’m watching CSI, or the Superbowl, or…

Since 1975, we’ve known that Niacin reduces the risk of a heart attack AND stroke by some 25% in those who’ve just had a heart attack, or stroke.  That’s an amazing number.  How come it didn’t catch on?  It’s just a vitamin.  A simple cheap vitamin you can buy over the counter.  Help me with this!  What’s the deal?  If it’s good for you AFTER you’ve had a heart attack, and 50% of us are dying from heart attacks, why isn’t it better for us before the heart attack?  Well, the money was on statins.  We can sell you statins for about $ 100 a month.  They work too, amazingly well.  As well as niacin!

This is how niacin works.  It’s called B3 and its deficiency disease is called pellagra.  Your liver can make it from the amino acid tryptophan if you have enough tryptophan, but it’s slow.  To get deficient, you really should eat only a pure corn diet, so pellagra is rare.  Very low doses are all that’s needed to prevent pellagra.  But in higher doses, it starts to raise your HDL and lower your LDLs.  You put out less garbage into your blood, and send out more garbage trucks.  Your streets are cleaner.  Doctors prescribe 2000 mg a day in a sustained release form.  But you can buy 100 mg over the counter.

The bad part about niacin is that it has a few side effects.  You can flush and have your skin get all hot and itchy, if you start too fast.  But if you start slowly, say with just 100 mg three times a day and build up to 500 mg three times a day, you can lower your LDLs and raise your HDLs dramatically.  For cheap.  A very few people get liver trouble.  It’s probably well advised to ask your doctor about it and have one check on your liver to make sure it’s healthy.

But 50% of us are sitting out there, with silent quite little plaques building up in our blood vessels.  And we don’t think we’re too bad off until that humbling, terrifying first symptom happens.  Well, the people I’m writing this for (you) are each and every one of you important to me, and I’m sort of interested in your hanging out a little longer.

WWW:  What will work for me?  What doesn’t work is my HDL.  Mine is 29.  That’s a lot below 60.   Just got my HDLs measured.  Bummer.  Holly is right.  I need to exercise more.  Hard to do when it’s -8 degrees.  And I’m already pretty good on my diet.  Either I take $ 100 a month of statins, which my doctor says isn’t really all that necessary, yet.   My health insurance deductible kicks in only after I get to about the 10 month mark, before that ,I’m paying that bill.  Or, I just get in the habit of a bit of niacin.  I’m starting this week.  Why don’t you join me?  Add a few pills to the morning wad.  It’s probably a good idea.