Category Archives: Vitality

Post #68 – Resources I used to rehabilitate my knee: Part I – Diagnose and Fix Structural Issue

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A little over two years ago, I hurt my knee. I was doing some vigorous aerobic workout style dancing. I might have twisted my right knee and it started to hurt really badly. I thought it would be fine in a couple of weeks by giving it the usual TLC. But it took over two years to heal it. And it turned out to be quite an opportunity to learn.

Whenever I talk to my contemporaries, the topic of knee pain comes up frequently. So, I thought I would share here my journey of healing my knee pain and more importantly the resources I found useful. Trust others will find this information useful.

In this Part 1 of this series of blog posts, I share different resources for diagnose and fix the structural issues with my knee.

History and Background

You see I have been dealing with knee pain off and on for a long time. About 30 years ago, I took up the goal of running a marathon. I started the training. Ran my first 5K and then my right knee started hurting when I would run. Could not figure out how to run pain free. So, that was the end of my marathon running goal.

Since that episode, over the last thirty years, I have been working on bringing my knee functionally to 100%, judging by the capacity and capability of my left knee. It is still not there 100%, but it is the closest it has come to that goal in thirty years.

Resource #1 – Orthopedic Doctors

My first stop was to get my knee checked out by an orthopedic doctor. I even picked a practice specializing in Sports Medicine. They did a quick X-ray, showed me the picture and pointed out that I had a mild case of osteoarthritis in my knee.

So, what do I do then? I was told not to run. And, if I was to run, maybe use a knee brace. I bought a brace. Tried running with it. Did not really work.

Over the years, the pain went away but it did not really allow me to run. However, I became comfortable with a variety of activities, jumping rope, skiing, rollerblading and so on.

And this time around, which is about two years ago, another trip to the orthopedic knee specialist. A quick X-ray, was showed the picture and told that now I had mild-to-moderate osteoarthritis. Nothing broken, nothing torn. This time, my options were: a) Steroid injection in the knee, b) Injecting gel, if I got permission from the insurance company, c) Take ibuprofen, or d) Do nothing.  Learned that the steroid injection was not simply to relieve the pain but was also therapeutic, since it would relieve the inflammation. So, I chose to get the injection.

Other options offered at the orthopedic specialist’s office are arthroscopic surgery and knee replacement surgery.

Orthoscopic surgery was very popular up to a decade or so ago. These have lately fallen out of favor. Clinical trials done during the last few years have shown that orthoscopic surgery is no more effective than the placebo in the form of sham surgery.

Knee Replacement is an option only when the pain is so severe that you can no longer tolerate the pain whether awake or sleeping since the cartilage has pretty much worn out.

My experience – Orthopedic specialists are a great resource to find out if I broke anything or tore anything for which they have solutions. For osteoarthritis, other than a steroid injection basically, wait until the knee is ready for replacement.

Resource #2 – Hyaluronic Acid

A quick take on hyaluronic acid from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469223/

“…Viscosupplementation with intra-articular hyaluronic acid is a treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, but potentially should apply to all synovial joints in order to reduce pain and improve joint lubrication. Exogenous HA can enhance chondrocyte HA synthesis, prevent the degradation of cartilage and promote its regeneration. Moreover it can reduce the production of proinflammatory mediators and matrix metalloproteinases involved in OA pathogenesis. This mini review highlights the evidence of hyaluronic acid in reducing osteoarthritis symptoms and structural damage, as well as its ability to delay prosthetic surgery. Viscosupplementation should be considered as a long-term therapy.”

Basically, hyaluronic acid is a gel that if injected into the knee joint improves joint lubrication, reduces inflammation and may also regenerate cartilage improving the structure of the joint. Treatment may have to be repeated over time as a long-term therapy.

Typically, insurance companies do not cover this therapy. It is known to relieve knee pain and improve joint functions. Some orthopedic specialists may offer it. But mostly these are offered by those doctors practicing alternative therapies, e.g., functional doctors, chiropractors or doctors of osteopathy.

Resource #3 – Platelet Rich Plasma (PRP) Therapy

PRP therapy for osteoarthritis of the knee works by injecting platelet-rich blood into the area surrounding the knee to help reverse existing tissue damage. Blood is comprised of four components. Most of your blood is liquid, known as plasma. The other three components are platelets, white blood cells, and red blood cells.

Platelets play a key role in the clotting of the blood. They also contain growth factors that could help tissues repair themselves by causing new cells to form.

PRP Therapy involves taking blood from the veins, about the quantity typically used for blood tests. They spin it to separate plasma and platelets from the red blood cells. They then inject plasma into the joint, where the cartilage might be damaged, typically where it hurts to touch and/or where inflammation in the joint is.

PRP is still not mainstream as a standard of care. Here is one article, comparting results of various studies on PRP And Hyaluronic Acid,  https://pubmed.ncbi.nlm.nih.gov/34785294/ . The bottom line from this study is: Patients undergoing treatment for hip or knee OA with either PRP or HA injections can expect to experience similarly beneficial short-term clinical outcomes.

My experience – I underwent three different applications of PRP. And found those to be beneficial.

Resource #4 – Stem cell Therapy

Stem Cell Therapy procedures are non-surgical injection-based procedures for people suffering from knee pain due to common injuries to the knee Meniscus, ACL, MCL, and other structures, or who are experiencing degenerative conditions such as Osteoarthritis. These procedures utilize concentrated repair cells that are obtained from your own bone marrow or blood to promote your body’s own natural ability to heal.

I visited folks at StemCellArts to see what they could do for my knee. The procedures they perform are done by orthopedic doctors who have a lot of experience and have developed specific protocols. However, the procedure tends to be quite expensive and is also quite involved, especially the part about extracting stem cells from bone marrow and culturing those cells.

Later, I also learned about the stem cells that are now harvested from umbilical cords, packaged and then distributed for doctors to use. This approach seemed to be rather inexpensive compared to using bone marrow. I underwent this procedure and found it to be quite helpful. In fact, a few months after the stem cell procedure, I asked the doctor if he would recommend repeating it. He recommended that once the joint is seeded with the stem cell, it was more helpful to do a PRP procedure to provide the joint more “fertilizer” in the form of growth factors. That is why I ended up doing the third PRP procedure.

My experience – My knee used to be tender to touch on the left side of the knee, where X-rays showed cartilage had eroded. After the stem cell and PRP procedures the tenderness and accompanying pain totally went away.

Bottom Line:

From my research and experience, I have found that it is important to find out what is the underlying structural issue for knee pain. It could be osteoarthritis, meniscus tears, tendon & ligament tears, overuse injuries or some other condition. In my case, it was osteoarthritis, clearly showing eroded cartilage in certain part of the knee joint. The resources that were useful to diagnose and repair the structural damage were:  

  1. Visit to the Orthopedic surgeon and imaging
  2. Steroid injection for relieving inflammation.
  3. Alternatively, ibuprofen for relieving inflammation.
  4. Hyaluronic acid or PRP treatment for joint lubrication and repair.
  5. Stem Cell therapy for repair or regeneration.

Of course, this is not medical advice, and you should check with a medical doctor about your specific situation.

 What are your thoughts or experience on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

Post #66 – Optimal Health through Optimal Breathing

03 Sunday Jan 2021

Posted by in Aging, Biomarkers for Stress, Breathing, Living to 120, meditation, Mental Health, Optimal Health, Optimal Sleep, Reversing Chronic Diseases, Uncategorized, Vigor, Vitality, wellness, Yoga

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There is an old joke. Question: How do you live long? Answer: Just keep breathing.

Joke aside, when was the last time you gave any thought to breathing?

Are you breathing too much? Too little? Just enough?

Are you breathing the right way?

Are you breathing optimally?  

What kind of impact breath can have on your health?

Can you cure chronic diseases by breathing in a certain way?

Can you cause chronic diseases by NOT breathing in a proper way?

Being a student of yoga and meditation, I have been quite aware of breath and different ways of breathing and subjectively feeling differently when breathing certain way. And I am always curious about finding other methods of breathing.

So, when I picked up James Nestor’s book: The New Science of Lost Art, I thought I might learn a few more distinctions about breathing. I was blown away by how much I did not know about breathing and how big an impact breathing can have on our health.

Nestor describes how the ancient wisdom of breathing, has been discovered and rediscovered over time by people he calls Pulmonauts, i.e., the breath explorers. He beautiful weaves this ancient wisdom with explanations we now know through science along with his personal exploration and experiences.

The book is well worth the read. I definitely learned a lot.

Here are some nuggets that I picked up from this book:

  1. Keep Your Mouth Shut – especially When Sleeping.  As Nestor explains:

“During the deepest, most restful stages of sleep, the pituitary gland, a pea-size ball at the base of the brain, secretes hormones that control the release of adrenaline, endorphins, growth hormone, and other substances, including vasopressin, which communicates with cells to store more water. This is how animals can sleep through the night without feeling thirsty or needing to relieve themselves.

But if the body has inadequate time in deep sleep, as it does when it experiences chronic sleep apnea, vasopressin won’t be secreted normally. The kidneys will release water, which triggers the need to urinate and signals to our brains that we should consume more liquid. We get thirsty, and we need to pee more. A lack of vasopressin explains not only my own irritable bladder but the constant, seemingly unquenchable thirst I have every night.”

So, here is an interesting vicious circle: if you are not getting enough deep sleep, you would wake up more often due to inadequate vasopressin. And, if you wake up more often, you are probably not getting enough deep sleep.

Simple Solution: Tape you mouth shut when you are sleeping. Really!! It is that simple. And watch how you sleep and all biomarkers that good sleep brings improve. It may even improve or eliminate sleep apnea. From his own experience of trial and error, Nestor recommends 3M Nexcare Durapore “durable cloth” tape, to tape your mouth shut. It works great, I can vouch for it.

2. You Can Use Breathing to Activate Parasympathetic or Sympathetic nervous System: As Nestor explains:

“The right nostril is a gas pedal. When you’re inhaling primarily through this channel, circulation speeds up, your body gets hotter, and cortisol levels, blood pressure, and heart rate all increase. This happens because breathing through the right side of the nose activates the sympathetic nervous system, the “fight or flight” mechanism that puts the body in a more elevated state of alertness and readiness.

The left nostril is more deeply connected to the parasympathetic nervous system, the rest-and-relax side that lowers blood pressure, cools the body, and reduces anxiety.”

Now how cool is that!

3. Carbon Dioxide is Even More Important Than Oxygen: I am sure you are saying, ”What?!” – just like I did when I read about this.  When you take a slow inhale followed by a very slow exhale or when you just slow down your breathing, if you feel calm settle over you that is due to increasing carbon content in your blood and tissues. If you are hyperventilating, it is the opposite – that is when you need to breath inside a paper bag to calm yourself down.

This is also how our bodies determine how fast and often we breathe, not by the amount of oxygen, but by the level of carbon dioxide.

Simple Tip: Take long exhales and slow down your breathing. Basically, breathe but breathe less.

4. Optimal Breath: “It turns out that the most efficient breathing rhythm occurred when both the length of respirations and total breaths per minute were locked in to a spooky symmetry: 5.5-second inhales followed by 5.5-second exhales, which works out almost exactly to 5.5 breaths a minute.” This is the pattern of chanting of Om, rosary, chanting of common Buddhist mantras and many other ancient rituals.

5. Secret to Youthful Face is Chewing: “What?!”, you say again. This was definitely new one for me. Here is verbatim from Nestor’s book:

‘Unlike other bones in the body, the bone that makes up the center of the face, called the maxilla, is made of a membrane bone that’s highly plastic. The maxilla can remodel and grow more dense into our 70s, and likely longer. “You, me, whoever—we can grow bone at any age,” Belfor told me. All we need are stem cells. And the way we produce and signal stem cells to build more maxilla bone in the face is by engaging the masseter—by clamping down on the back molars over and over.’

Simple Tip: Find excuses to chew with back molar as often as you can. There you go – 32 chews per bite that mom told us is validated by science now.

6. Hold your Breath to Eliminate Anxiety and Fear:

“…All this suggests that for the past hundred years psychologists may have been treating chronic fears, and all the anxieties that come with them, in the wrong way. Fears weren’t just a mental problem, and they couldn’t be treated by simply getting patients to think differently. Fears and anxiety had a physical manifestation, too. They could be generated from outside the amygdalae, from within a more ancient part of the reptilian brain.

Eighteen percent of Americans suffer from some form of anxiety or panic, with these numbers rising every year. Perhaps the best step in treating them, and hundreds of millions of others around the world, was by first conditioning the central chemoreceptors and the rest of the brain to become more flexible to carbon dioxide levels. By teaching anxious people the art of holding their breath.”

Simple Tip: To calm your anxiety don’t just take a deep breath, HOLD your breath.

Bottom Line: The book has a lot more to offer, but here are some nuggets in summary:

  1. Tape you mouth shut when you are sleeping. Really!! It will improve your sleep and give you all benefits that good sleep does
  2. You can trigger sympathetic or parasympathetic nervous systems by simply breathing through your right nose or left nose
  3. Take long exhales and slow down your breathing. Basically, breathe but breathe less.
  4. Optimal breath is: 5.5-second inhales followed by 5.5-second exhales, which works out almost exactly to 5.5 breaths a minute.
  5. Find excuses to chew with back molar as often as you can.
  6. To calm your anxiety don’t just take a deep breath, HOLD your breath.

What do you think?

Have you explored different ways of breathing?

What worked or not worked for you?

What benefits or difficulties have you faced due to proper or improper breathing?

I and the readers of this blog would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

Post #61 – How much sleep do we need for optimal health?

16 Sunday Sep 2018

Posted by in Living to 120, Mental Health, Optimal Health, Optimal Sleep, Uncategorized, Vigor, Vitality, wellness

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In Post #59, I talked about the lifestyle choices that are important to maximizing health and lifespan:
1. Benchmarking Health
2. Nutrition
3. Exercise
4. Maintaining Musco-skelatal Integrity
5. Maintaining Mind-body Connection
6. Enhancing and Maintaining Brain
7. Stress Management
8. Adequate Sleep
9. Social Engagement
10. Purposeful Living
11. Making full-use of all modalities of medical care
12. Make use of Genetics Science

These were of course not in any particular order. For example, Adequate Sleep would rate much higher in priority, probably towards the top. After all, most of us cannot even function if deprived of sleep over even a few days.

I recently read the book, Why We Sleep by Mathew Walker, Ph.D. He is a professor at University of California Berkeley and has dedicated his career to research in sleep. This is a pretty definitive book on sleep and covers the topic from almost all angles.

Why we sleep cover

I have been generally aware that 7 to 9 hours of sleep is considered a must for optimal health. And, since I learned that I do make the effort to catch that much sleep and when I don’t I would make effort to catch up on that sleep during the weekends.

However, reading this book has been seriously eye opener for me. As a result, I am taking sleep as a lifestyle choice for living for optimal health now much more seriously than I used to.

Sleep Myths – Busted

Here are some myths about sleep that the research cited in the book has busted for me.

1. I can live quite well with 6 to 6.5 hours of sleep. Dr. Mathews is very definitive on research that the range of sleep for optimal health for healthy adults is between 7 to 9 hours. Of course, children have different needs for sleep and so do sick people to allow their body to recover.

He also makes distinction between “opportunity to sleep”, e.g., how long I kept my head on the pillow, and actual sleep. So, if I was “in bed” for 7 hours, it took me half an hour to fall sleep, I got up twice to go to the bathroom and each time it took me half hour to fall back to sleep, then I slept for 5.5 hour. There is some research that more than 9 hour sleep is not optimal, but that research is still controversial.

One test for adequate sleep is that if during the day you close your eyes and see yourself falling asleep, then you are not getting enough sleep.

2. Early morning sleep is more important that the late-night sleep. There are two broad categories of sleep: Rapid Eye Movement or REM happens when we are in deep dream state. In early sleep cycles, which generally happen before and shortly after mid night, most of the sleep is not REM or NREM. In early morning hours, sleep is mostly REM. Each REM and NREM have their very distinct function for brain and our physiology and we need both. The following figure from scielo.br illustrates how amount of REM sleep increases as the sleep progresses and NREM shown here as Stages 1 through 4 decreases.

Sleep Cycle 2

In NREM sleep, for example, our brain takes information stored in short-term memory and shuffles it over to the long-term memory regions of the brain. In REM sleep then our brain builds interconnection with pre-existing long-term elements. If we miss NREM sleep, short-term memory buffers get over-written. If we miss REM sleep, we don’t get a chance to develop ways to access and use the information on the long term.

3. If I don’t sleep enough during the week day, I can always catch up during the weekend. From the REM and NREM sleep discussion above, you can probably quickly extrapolate that if we short change sleep, certain functions are not optimal on a daily basis. Information once lost, probably is lost forever – unless of course you relearn it.

Sleep is driven by two cycles: Circadian clock and a hormone Adenosine, see the picture below (from hackyourgut.com). Circadian clock drives our urge to awake while adenosine drives our urge to sleep.  Adenosine only goes up after we wake up until we clear it again during sleep. More adenosine in our body the more is our urge to fall asleep.  Our body’s energy level changes with change in circadian rhythm. When energy is increasing, we have the urge to wake up.

Two-process-model-sleep-circadian-homestatic-sleep-drive

When we skip sleep, it feels that we have energy to keep going based on our circadian clock. But we may still have the urge to sleep because adenosine is still high. So, when we sleep extra during the weekend, we are clearing up any residual adenosine which clears the urge to sleep. So, we feel like we have caught up on sleep. But remember, we did not really catch up on the mental benefits of sleep for memory capture and reorganization. And, that is the missed opportunity, when we try to catch up on sleep during the weekends.

4. Alcohol and sleeping pills can make you sleep better. Alcohol makes you sleepy, so clearly it must make you sleep better. Right. Wrong. Both alcohol and sleeping pills have similar effect on the brain. They are sedatives and make you drowsy by shutting down you neo-cortex, i.e., thinking brain, activities. When monitored, your brain does not have the same physiology as if you were sleeping in either REM or NREM sleep. Hence, you find that people who take sleeping pills or night caps as sleep aids, are often groggy, lacking motor skills, lethargic, and forgetful during the next day.

5. If I am short of sleep, I will know so I can correct it. And, that is the same thing someone who is drunk would say, ”I am not drunk. I don’t feel drunk.” We just discussed above the effect of alcohol on the thinking brain, which is also the decision-making brain. Lack of sleep has exactly the same effect as being drunk. And, that is one of the reason, lack of sleep leads to car accidents.

In fact, did you know, lack of sleep causes more accidents than drunk driving. If you have slept only 4 hours or less the previous 24 hours, your chance of car crash increase by a factor of 10.

And, if you are short of sleep, it is the micro sleeps that make driving fatal. if you are sleep deprived, brain just shuts down for a second or two. And, a second or two while going at 60 miles an hour is sufficient to cause serious crashes.

6. Coffee, slapping myself, or loud music can keep me going: Turns out that research shows none of these are effective at preventing micro sleeps. The only thing that is found effective is, you pull over, stop and take a nap.

7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time. Half-life of caffeine is 8 hours. So, it can take up to 16 hours to purge effect of just a cup of coffee from the body. So, any caffeinated drink after lunch can probably disrupt the sleep and should be avoided to obtain highest quality of sleep.

8. Melatonin will help me sleep better. Actually this is yes and no depends upon the nuance. Melatonin does not improve the quality of sleep. It does, however, tell your brain and body when it is time to go to sleep and to start to get ready. Generally, it is released as the darkness sets in.

In our modern worlds, where darkness hardly sets in or if our body clock is messed up due to jetlag from travel, it may be helpful to have melatonin supplement to tell the body that it is time for bed. Dimming lights and shutting down screens (TV, smart phones iPads, laptops) as the bed time appraoches is an excellent way of getting your body to start producing its own melatonin.

If you do take mealtonin supplements, just be warned that melatonin pills available over the counter have great variability in the melatonin content when you compare actual vs. printed on the label. In one test, FDA found -89% to +473% variability. I recently learned that a great source of melatonin is raw pistachio. Just a few kernels of pistachio release enough melatonin that is in most pills. Check out this link from NutritionFacts.Org.

Sleep Hygiene – Best Method to Improve Quality of Sleep

Instead of taking any sleeping pills, Dr. Walker recommends the same sleep protocol that NIH recommend, see NIH published Your Guide to Healthy Sleep,
1. Stick to a sleep schedule.
2. Exercise is great, but not too late in the day.
3. Avoid caffeine and nicotine.
4. Avoid alcoholic drinks before bed.
5. Avoid large meals and beverages late at night.
6. If possible, avoid medicines that delay or disrupt your sleep.
7. Don’t take naps after 3 p.m
8. Relax before bed.
9. Take a hot bath before bed.
10. Have a good sleeping environment.
11. Have the right sunlight exposure.
12. Don’t lie in bed awake.
13. See a doctor if you continue to have trouble sleeping

Summary
Sleep is way at the top of lifestyle choices for optimal health. Statistics show again and again that most of us do not get enough sleep.

Dr. Mathew Walker’s book Why We Sleep is a great book if you want to learn about latest on every aspect of sleep. NIH published Your Guide to Healthy Sleep is also a great resource that summarizes healthful practices.

In this post, I covered several myths on sleep
1. I can live quite well with 6 to 6.5 hours of sleep
2. Early morning sleep is more important that the late-night sleep
3. If I don’t sleep enough during the week day, I can always catch up on the weekend
4. Alcohol and sleeping pills can make you sleep better
5. If I am short of sleep, I will know so I can correct it
6. Coffee, slapping myself, or loud music can keep me going
7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time
8. Melatonin will help me sleep better

If you want to improve the quality of your sleep, check out the 13 step Sleep Hygiene protocols that I summarized above. Dr. Walker and NIH recommend this method of improving your sleep quality and is proven to work better than sleeping pills.

NIH published Your Guide to Healthy Sleep and Dr. Walker’s book have more details on this method of improving sleep quality.

What do you think?

Have you learnt something about sleep, that you can share?

I would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

Post #59 – What are our lifestyle choices for maximizing health and lifespan?

11 Sunday Feb 2018

Posted by in Life-Span, Living to 120, meditation, Mental Health, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Puposely Living, Quality of Life, Stress, Supplements, TM, Uncategorized, Vitality, wellness, Yoga

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Lifestyle Choices for Maximizing Health and Lifespan

Unless you have been living under a rock on an isolated island, I am sure you have heard that lifestyle choices have big impact on both your health and how long you live.

Living longer means not dying sooner.  And, to not die sooner, you must take actions that eliminate the various ways one dies.

Living healthy, means taking actions to prevent all the ways one loses their abilities to enjoy day-to-day activities of life. Or, at least postpone the time as far into the future as possible before developing disabilities.

In both case, i.e., living longer and living healthy, lifestyle choices play crucial roles. But what are these life choices, besides the ones you hear all the time:  Eat Better and Exercise.

When I started to systematically pursue this topic of living optimal lifespan possible (my goal being 120 years), with optimal health span (my goal being no disabilities), I started enumerating all areas of life in which one can take some action to make this impact.

Of course, not everything is in our control. We did not come to this earth with guarantees. Unforeseen, random event, or events that are not in our control can ruin all our goals and plans. But the objective is to not let the possibility of events not in our control prevent us from taking actions that are indeed in our control.

So, here are all 13 dimensions of lifestyle that I have discovered so far that impact health span and life span. Each subject is a very extensive topic by itself.  I just very briefly summarize my personal take on these and may be an example of how I am attempting to address them in my lifestyle and where you can read about further in these blog posts.

1. Benchmarking Health: Knowing where you are is where I believe it has to all start. You go to doctor’s office and they take your physical measurements (height, weight), you vitals (pulse, blood pressure), order some measurements from the lab and then compare those with what should be “normal” for you. In Post #7 – Can biomarkers help in the quest for vitality and longevity?, I discuss the various measurements you can use as biomarkers for health. These days I measure:

Daily: Weight, waist, fat near navel and thigh, BP, SPO2, pulse, my over-all subjective state of my physical, emotional and mental health

Weekly: pH, Nitric Oxide, fasting glucose

Quarterly: Bloodwork through my primary physician – CBC (complete blood count), typical chemistry panel, Lipids (Cholesterol total, HDL, LDL, VLDL, Triglysrides), TSH, T3, T4 (Thyroid hormones), Male Hormones (Total and Free Testosterone, Estrogen, LH, FSH), Hydroxy-D, fasting glucose, A1c, PSA (for prostrate tumor screening), CRP, (for inflammation), Homocysteine (for heart condition)

Annually or Biennially: Telomere Measurements (DNA strands that dictate how long cells live), X-Rays of joints if I suspect arthritis etc., Ultrasound Study of Carotid and Aorta arteries, MRI’s to detect any tumors, eye-exam, hearing test, EKG.

Every 5 years: Colonoscopy, Stress-test.    

2.  Nutrition – That is everything that crosses our lips, what we eat or drink. I discussed the topic of nutrition in a series of eight blog posts on this subject of Optimal Nutrition, Posts #22 through #29.  additionally, Post #15, #31 and #32 discuss the topic of how and when to complement the nutrition with supplements.

 3. Exercise – Exercise is indispensable for building and maintaining muscle strength, flexibility, balance, endurance. There is also abundant proof that it helps with the metabolism, overall health and health of specific organs. I discussed this topic of exercise in blog post #30 – How much and what type of exercise do you need for optimal health?

 4. Maintaining Musco-skelatal Integrity: Pains in the back, knees, hips, shoulder, wrists and other various joints creep up. We may think that these pains just come out of nowhere. After all, we often notice that “yesterday it did not hurt and today it hurts”. So, it got be a random event. Right?

Reality is that unless there was a trauma caused by an accident, most of these are the result of repetitive movement in un-aligned joints. The underlying cause could be neglect of the muscles, ligaments and tendons surrounding joints or prolonged asymmetrical movements, e.g., always carrying a bag on the same shoulder, or playing games such tennis or golf that inherently require asymmetrical movement.

Yoga, myofascial massages, Rolfing, rolling with foam rollers, visiting a chiropractor for body alignment, weight bearing exercises for join strengths, e-cise routines designed by Pete Egoscue are methods I have learned for maintaining musco-skeletal integrity.  I discuss some of these in Post #30 – How much and what type of exercise do you need for optimal health? And Post #49 – What is the role of massage therapy in Optimal Health? Also, I discuss how you can use foam rolling for body alignment in Post #39 – Ever heard of foam rolling.

5. Maintaining Optimal Dental Health: Good dental health not only impacts quality of your life, it can also impact how long you live.

The American Heart Association published a Statement in April 2012 supporting an association between gum disease and heart disease. The article noted that current scientific data do not indicate if regular brushing and flossing or treatment of gum disease will decrease the incidence, rate or severity of the narrowing of the arteries (called atherosclerosis) that can lead to heart attacks and strokes. However, many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including heart disease, even after adjusting for common risk factors.

You may also have seen health and lifestyle surveys used for estimating life-expectancy that want to know if you floss daily. If you do the models give you credit for an extra 2 to 4 years of life.

In Post #47 – What does optimal dental health look like and how to achieve it?, I discuss this topic in greater detail.

 6. Maintaining Mind-body Connection: Our mind and body are inherently connected. Maintaining the connection between the two is essential for optimal health. Yoga, Tai Chi, Qigong, are some ways to develop and maintain mind-body connection.  I have very limited experience with Tai Chi and Qigong. I do, however, perform Yoga as part of my lifestyle.  In Post #11 – My first year of experience with Bikram Yoga, Post #12 – My second year of experience with Bikram Yoga, I describe how I incorporated Bikram Yoga into my lifestyle.

 7. Enhancing and Maintaining Brain: If we lose vitality of the brain, the quality of life suffers dramatically. Alzheimer and other forms of Dementia can often be very painful way of living. Evidence is mounting that for optimal brain health, we must keep the brain stimulated with right activities. All my life, I have been very focused on left brain type of activities. As I was turning 60, I decided to do something about it and started taking piano lessons to stimulate my right brain and prevent any premature aging of the brain. I discuss the activities for maintaining optimal health in Post #57 – Optimal Mental Health – what is it and how to achieve it?

 8. Stress Management: Stress is a root cause of many diseases. We have all experienced how stress can bring about disturbances in the digestive systems, back pain, high blood pressures, even heart attacks and strokes. Yoga and Meditation are two of the ways to manage stress. Perspective management is another powerful method. I got initiated in Transcendental Meditation over 30 years ago and I have been doing TM ever since with good benefits. I tackle the subject in Post #16 – What is stress really and why is it bad for longevity and health and Post #17 – Is meditation an effective antidote to stress.

9. Adequate Sleep: There is more and more evidence every day that inadequate sleep can cause all sorts of ailments. 7 to 9 hours of restful sleep is considered optimal. All my life, I thought the object of the game was to get away with as little a sleep as possible. Sleeping more than 6 hours every night is still a challenge for me. Although I am working on it to extend sleeping hours during the week and may be do some catch up sleeping during the weekends. Maybe I will tackle this topic in a future post. In Post #61 – How much sleep do we need? – I discuss the latest in sleep research.

10. Social Engagement: World-wide Study of Blue Zones, i.e., geographical areas where longest living people are clustered, showed a very surprising factor that contributed to long healthy life of people living there. Researchers found that people in Blue Zones are socially very engaged. Centenarians in these areas are engaged with tight knit groups of friends and family. So, the conclusion is that social engagement is an important factor in living longer and healthier.

 11. Purposeful Living: It is well known that death rates spike after the holidays and after major life events. Researchers deduce from studies of such phenomena that people live only as long as they find life meaningful.

Of course, it needs an ongoing effort to figure out what one can derive meaning from. One may find meaning in raising kids or grand kids, contributions to society, being the best spouse one can be or from “slaying some dragon”. Some people find meaning in their faith and service to God. Others find meaning in being of service to mankind or their fellow human beings. Yet others can find meaning in their job or career.

Viktor Frankel in his book: Man’s Search for Meaning, explores this topic beautifully. 

12. Make Full-use of All Modalities of Medical Care: Modern medicine has developed amazing and miraculous treatments. By making use of the modern medicine one can live much healthier and much longer.  In general, the earlier you are able to catch a disease and the sooner you start treatment, better your chances are of a cure or at least minimizing the damage. Mantra for modern medicine is “early detection, early cure”

 Alternative schools of medicine, such as Ayurvedic, Homeopathy, Aquapuncture, Naturopathy, offer valid means for preventative care and whole-person healing.  Leveraging these modalities of medical care as appropriate can offer means for optimal healing and living. Here the rule is the age old wisdom: An ounce of prevention is better than a pound of cure.

I was even able to eliminate my severe seasonal allergies by working with doctors of Naturopathy and thus was able to totally change the vector of my health as I discuss in Post #8 – So, did I you tell you the story of my allergies. Also strengthening your immune system can have major consequences on how your body deals with diseases as I discuss in a series of Posts #51 – 54 – How to Optimize Your Immune System – Part I through Part IV

13. Making use of Genetics Science: There is of course the truth of genetics. Genes do play a role in how long we will live and what diseases we may have the tendencies to develop. Over the last few years, however, scientists are finding that inherited genes often do not determine your destiny, it is the lifestyle that can either turn those genes on or off. This is the exciting field of epigenetics.

 Studies from the filed of epigenetics do  give us opportunities to leverage genes.  Through genome mapping, we can find out what might be our tendencies and to what aspects of our life, therefore, we should pay particular attention. Over the last few years, I have gotten my telomeres measured – these are tips at the ends of genes that are considered to act like our lifespan clocks.  I discussed this in Post #50 – How to optimize your health by maximizing your telomeres. More recently, I have sent for genetic testing to be able to receive personalized genetics bases lifestyle coaching. I will share results of that experiences in a future post.

The percent of role of genes that we cannot do anything about is constantly shrinking all the time. Now it is believed that only between 5% to 15% of lifespan and health span is determined by genes that we have no control over.

Bottomline:

In summary, researchers have shown again and again that health span and life span depend upon one’s lifestyle choices. A holistic look at lifestyle choices means many different and distinct areas of life.

I shared my take on these dimension of lifestyle and some of my experience. Also, gave references to where you can find more information, whenever, I have already discussed that topic in more detail in my blog posts.

  1. Benchmarking Health
  2. Nutrition
  3. Exercise
  4. Maintaining Musco-skelatal Integrity
  5. Maintaining Optimal Dental Health
  6. Maintaining Mind-body Connection
  7. Enhancing and Maintaining Brain
  8. Stress Management
  9. Adequate Sleep
  10. Social Engagement
  11. Purposeful Living
  12. Making full-use of all modalities of medical care
  13. Making use of Genetics Science

What do you think?

Do you think there some other dimension of lifestyle that I did not address here that is also important?

I would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input. 

 

Post #57 – Optimal Mental Health – what is it and how to achieve it?

26 Monday Sep 2016

Posted by in Mental Health, Optimal Health, Stress, Vitality, wellness

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Throughout life, mental health influences how we make decisions, manage stress and interact with others. Similar to physical health, mental health is important for optimal development at every stage of life.

However, before we get deeper into the subject of Optimal Mental Health, it is probably useful to first figure out what is Mental Health. Sometimes, such common terms can be slippery to nail down.  And, that exactly seems to be the case with this term Mental Health.

Mental Health

According to U.S. Center for Disease Control (CDC), Mental Health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental Illness

A related term Mental Illness, on the other hand, is defined as collectively all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.

Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population. It has been estimated that by the year 2020, depression will be the second leading cause of disability throughout the world, trailing only ischemic heart disease, i.e., heart attack. The seriousness of mental health issues was clearly raised in a very comprehensive report, almost 500-page report: U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.

Mental Health Indicators

In the health care and public health arena, more emphasis and resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health. Little has been done to protect the mental health of those free of mental illness. Researchers suggest that there are indicators of mental health, representing three domains:

  • Emotional well-being – such as perceived life satisfaction, happiness, cheerfulness, peacefulness.
  • Psychological well-being – such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships, and
  • Social well-being – social acceptance, beliefs in the potential of people and society as a whole, personal self-worth and usefulness to society, sense of community.

One way to look at mental health and mental illness is that these are points along a continuum and neither state exists in pure isolation from the other.

Mind and Body are Inseparable

In another but related context, everyday language tends to encourage a misperception that “mental health” or “mental illness” is unrelated to “physical health” or “physical illness.” In fact, mental health and physical health are inseparable.

Although “mind” is a broad term that has had many different meanings over the centuries, these days it refers to the totality of mental functions related to thinking, mood, and purposive behavior. The mind is generally seen as deriving from activities within the brain but displaying emergent properties, such as consciousness.

One reason the people continue to this day to emphasize the difference between mental and physical health is embedded in language. Common parlance continues to use the term “physical” to distinguish some forms of health and illness from “mental” health and illness. People continue to see mental and physical as separate functions when, in fact, mental functions (e.g., memory) are physical as well.

Mental functions are carried out by the brain. Likewise, mental disorders are reflected in physical changes in the brain. Physical changes in the brain often trigger physical changes in other parts of the body too. The racing heart, dry mouth, and sweaty palms that accompany a terrifying nightmare are orchestrated by the brain. A nightmare is a mental state associated with alterations of brain chemistry that, in turn, provoke unmistakable changes elsewhere in the body.

A more appropriate and neutral distinction is between “mental” and “somatic” health. Somatic is a medical term that derives from the Greek word soma for the body. Mental health refers to the successful performance of mental functions in terms of thought, mood, and behavior. Mental disorders are those health conditions in which alterations in mental functions are paramount.

Somatic conditions are those in which alterations in non-mental functions predominate. While the brain carries out all mental functions, it also carries out some somatic functions, such as movement, touch, and balance. That is why not all brain diseases are mental disorders. For example, a stroke causes a lesion in the brain that may produce disturbances of movement, such as paralysis of limbs. When such symptoms predominate in a patient, the stroke is considered a somatic condition. But when a stroke mainly produces alterations of thought, mood, or behavior, it is considered a mental condition (e.g., dementia).

The point is that a brain disease can be seen as a mental disorder or a somatic disorder depending on the functions it perturbs.

Fixing the body can fix the mind and fixing mind can fix the body

There is plenty of evidence showing that mental disorders, especially depressive disorders could be caused by many chronic “physical” diseases including diabetes, cancer, cardiovascular disease, asthma, and obesity.  At the same time, many risk behaviors that give rise to chronic diseases are physical inactivity, smoking, excessive drinking, and insufficient sleep whose underlying cause is mental health.

Then Why the Stigma to Mental Health Issues

Stigmatization of people with mental disorders has persisted throughout history. It is manifested by bias, distrust, stereotyping, fear, embarrassment, anger, and/or avoidance. Stigma leads others to avoid living, socializing or working with, renting to, or employing people with mental disorders. It deprives people of their dignity and interferes with their full participation in society.

Explanations for stigma stem, in part, from the misguided split between mind and body first proposed by Descartes. Another source of stigma lies in the 19th century separation of the mental health treatment system in the United States from the mainstream of health. These historical influences exert an often immediate influence on perceptions and behaviors in the modem world.

So, what is Optimal Mental Health?

Just as in the case of Optimal Physical Health, absence of disease, or in the case mental health, absent of mental illness does not seem to be quite adequate to define Optimal Mental Health.  Given that mental illness and mental health is a continuum, it begs some sort of scale to measure one’s mental health.

Here is one scale to calibrate your mental health during a specific time frame:emotional-scale-2

With this scale, if I  yesterday  I was feeling bored that would be a score of -1 for yesterday. Today I am feeling confident, that would be a  score of +2. Etc. For a while, using this scale, I used to keep a journal of my daily emotional state. 

This scale can be a good way to measure impact of any lifestyle changes on your mental or emotional health. For example, if you just added daily walk or daily meditation to your lifestyle, or started taking certain supplements, you could track impact this way.

 

Well-Being as Measure of Mental Health

Another way to measure and monitor is in terms of a more holistic term called Well-Being. Researchers from different disciplines have examined different aspects of well-being:

  • Physical well-being.
  • Economic well-being.
  • Social well-being.
  • Development and activity.
  • Emotional well-being.
  • Psychological well-being.
  • Life satisfaction.
  • Domain specific satisfaction.
  • Engaging activities and work.

A website, you can use to quantify your personal Well-Being and benchmark it against others is: http://www.nationalaccountsofwellbeing.org/engage/. After answering, 50 questions (it only takes 10-15 mintues) you can receive a plot like the following and an overall Well-Being score. You can then compare you score with others. or how it progresses. More importantly, you can explore area of opportunities where you would like to grow and focus your attention for improving your well-being.

about-your-profile-results-_-your-results-_-explore-_-national-accounts-of-well-being

Jack Kornfield on Optimal Health

Jack Kornfield, a bestselling American author, yoga-mediation teacher and Buddhist monk has an interesting definition of Optimal Mental Health.  On his website he has the following description:

We have within us an extraordinary capacity for love, for joy, and unshakable freedom.  Buddhist psychology describes this as optimal mental health. I have seen this optimal wellbeing in many of my teachers. Ajahn Jumnian describes his mind as completely steady, silent and free throughout both his waking and sleeping hours.  He says, “I haven’t experienced a single moment of frustration or anger for over twenty years.” I’ve also observed that he sleeps only one or two hours a night. Ajahn Jumnian describes his inner life quite simply, “When I am alone, my mind rests in pure awareness. I am simply at peace.  Then whenever I encounter people and experiences, the awareness automatically fills with loving-kindness or compassion. This is the natural expression of pure awareness.”  Those around Ajahn Jumnian feel his free spirit and unshakable joy.

Now that is taking Optimal Health to whole different level!

Bottom Line:

We laid the foundation of some fundamentals on how to define and measure optimal mental health. In the next blog post, we will get down to methods for achieving Optimal Mental Health.

A quick summary of what we covered here:

Throughout life, mental health influences how we make decisions, manage stress and interact with others.

Mental health is a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. Mental health includes:

  • Emotional well-being
  • Psychological well-being, and
  • Social well-being

Mind and body are NOT separate.  Each influences and controls the health of the other.  It is a historical quirk in the evolution of medicine that we treat the two separately.  This separation has also led to much stigma to the mental health issues and separation of medicine applied to mind vs. the body.

We could calibrate mental health by using some scale like the one presented in this post to measure mental health as emotional health and track impact of introducing changes in lifestyle.

Ideally, to understand Optimal Health, we need to track total Well-being. You may want to use the nef website to calibrate your total Well-being and explore opportunities for improvement.

Long term meditators and Buddhist Monks define and are able to demonstrate Optimal Mental Health as a state of pure awareness that is full of compassion and love, and is above the daily swings of emotions.

What are your thoughts on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

 

 

Post #55 – Gravity-Based Life Style for Optimal Health

30 Saturday Jul 2016

Posted by in Lean Mass, Living to 120, Optimal Exercise, Optimal Health, Uncategorized, Vigor, Vitality, Yoga

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On Father’s Day this year, my wife gave me an Apple Watch as a gift. And, as you can probably guess, I went straight to the fitness apps.

Apple watch allows you to continuously measure heart rate, daily steps walked, and the distance walked.  You can also set it to remind you to stand up, as I often as you tell it to and it keeps track of how many times you actually did stand up. And, it gives you at-a-boys for hitting and moving toward your goals. So, I starting using all these features right away.

But soon after I was wondering: What does the research say about the benefits of daily activities such as standing, walking etc.? Is their science behind this or is it just a gimmick?

Sitting Kills, Moving Heals

My first step was to carefully read the book we had already in the house: Sitting Kills, Moving Heals by Joan Vernikos, Ph.D., former Director of NASA’s Life Sciences Division.  She spent her whole life working at NASA studying the ill effects on astronauts of space travel and living in space in zero gravity. More importantly, she studied how to minimize these ill effects and how to rehabilitate astronauts when they return to earth’s gravity.

Sitting Kills

And, even more importantly, Vernikos and other scientists also made the key connection that sitting on earth is the same as living in zero gravity. Having made that connection, they found that much of the research for space living becomes relevant to those of us who are earth bound.

According to Vernikos, when astronauts spend time in space, here are the kinds of health issues they develop:

  • Blood volume reduced
  • Body weight and mass decreases
  • Increased calcium excretion
  • Increased risk of kidney stones
  • Heart shrinks – cardiac output decreased
  • Heart muscle wall becomes thinner
  • Red blood cells reduced.
  • Stamina/aerobic capacity reduced
  • Lowered growth hormone response to exercise
  • Muscle atrophy; loss of muscle mass
  • Muscle strength reduced; size of fiber decreased
  • Fat moves in to replace muscle mass
  • Muscle sensitivity to insulin reduced
  • Muscle less able to take up sugar
  • Sense of taste and hearing dulled
  • Biological rhythm disturbed
  • Calcium lost from bone
  • Bone mass and density decreased
  • Increased risk of bladder infection
  • Delayed wound healing
  • Testosterone reduced

The list sounds pretty awful, doesn’t it?  After reading this list, you wonder why would anyone want to go live in space.

But these are the same effects that you see as people age on earth.

And, here is the kicker: Space research shows that these conditions induced through Gravity Deprivation Syndrome (GDS) are reversible once you get astronauts re-introduced to gravity.  It often takes almost one day of re-conditioning with gravity for each day spent in space to fully recover.

What about earth-bound people like you and I? We experience GDS is through sedentary life style. Through sitting and bed rest, we experience zero gravity like condition.

GDS starts as early as age 20.   Using bone density loss as a measure of GDS, earth-bound people experience a bone loss at the rate of about 10% per decade. No wonder, by 70’s and 80’s most people have serious osteoporosis conditions with frail bones.

These sedantary lifestyle induced GDS is the reason we are now hearing catch phrases like: Sitting Kills; Sitting is the new Smoking, etc.

How to Overcome Gravity Deprivation Syndrome (GDS)

Through studies and experimentation, researchers have found that to counter the effects of GDS, standing up often is what matters, not how long you remain standing.

Every time you stand up, the body initiates a shift in fluids, volume, hormones and causes muscle contraction to occur, and almost every nerve in the body is stimulated. If you stand up 16 times a day for two minutes, the body would read that as 16 stimuli, whereas if you stood once and remained standing for 32 minutes, it would see that as one stimulus.

Gym Workouts are No Substitute

Another surprising result: Gym workouts of 30 to 60 minute even daily may not be total replacement for activities required to counter GDS. To counter GDS, one needs to exercise stabilizer muscles that include tendons, ligaments, and other connective tissues. Most folks focus on mobilizer muscles that include thighs, biceps, hamstrings, triceps, chest muscles, abs etc.

James Levine an exercise physiologist at the Mayo Clinic in Rochester, MN, coined the term Non-Exercise Activity Thermogenesis (NEAT). NEAT is defined as the small, brief, yet frequent muscular movements one makes throughout the day, of which changing position is the most effective. Here are some examples of NEAT movements, other than standing up:

  • Bending over to pick up something
  • Squatting
  • Stretching upward to take something off a shelf
  • Getting dressed and undressed
  • Playing a musical instrument
  • Stirring a pot
  • Crossing and uncrossing your legs
  • Waving one’s hands while talking
  • Fidgeting

So, more such activities we do, the more effects of GDS we overcome, even though we do not break a sweat.

Bottom Line

 Extrapolating extensive research conducted for space travels, shows that Gravity Deprivation Syndrome (GDS) has serious consequences to our health.  These symptoms of detrimental health due to GDS are often associated with aging, but actually are due to decreased activity as people grow old. Achieving and maintaining optimal health requires strategies to maximize activities to counter the effects of GDS.

The following is a list of some very effective actions to counter GDS:

  • Stand up sit Down
  • Stand tall
  • Stretch at your desk
  • Walk tall
  • Take the stairs instead of elevator
  • Practice balancing when you put on and take off your pants, shoes and socks
  • Use a broom
  • Play on swings; use rocking chairs
  • Dance
  • Play catch; throw Frisbee
  • Do yoga

Remember that exercise is not for gym any more.  So, as often as possible, inconvenience yourself by:

  • Parking far away from the destination,
  • Taking stairs instead of elevators,
  • Stepping up on escalators,
  • Walking instead of taking people movers,
  • Getting up frequently to reach for things, and
  • Carrying your brief case instead of rolling.

All these action help in keeping your stabilizer muscles in top shape for optimal health.

What are your thoughts on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

Post #53 – How to Optimize Your Immune System? –  Part III  – with Exercise

30 Monday May 2016

Posted by in Aging, Living to 120, Optimal Exercise, Optimal Health, Puposely Living, Vigor, Vitality, wellness, Yoga

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In Post #51, I discussed some basic terminology of the immune systems, how immune system works, and what kinds of issues happen when it does not work.

Things that are in our control to enhance our immunity and also so the immune system does not go haywire are the ones that you have heard about gazillions of time by now and are probably tired of hearing about: Nutrition, Exercise and Lifestyle.

In Post #52, we discussed how to boost your immune system with nutrition.   In this post, let’s focus on how and what type of Exercise can boost the immune system.

Impact of exercise on Immune systems

Quite a bit of research is available on how exercise impacts the immune system, although most of it is about impact of exercise on colds and flu. Based on the available research, here are some theories why exercise helps improve the immunity:

  • Physical activity may help flush bacteria out of the lungs and airways. This may reduce your chance of getting a cold, flu, or other airborne illness.
  • Exercise causes changes in antibodies and white blood cells (the body’s immune system cells that fight disease). These antibodies or white blood cells circulate more rapidly, so they could detect illnesses earlier than they might have before.
  • The brief rise in body temperature during and right after exercise may prevent bacteria from growing. This temperature rise may help the body fight infection more effectively. (This is similar to what happens when you have a fever.)
  • Exercise slows down the release of stress-related hormones. Some stress increases the chance of illness. Lower stress hormones may protect against illness.

Getting a little deeper into the subject, here are some findings from some specific studies:

  1. Exercise can provoke moderate acute elevations in IL-6 exerting anti-inflammatory effects
  2. Exercise increases numbers of Neutrophils, T and B lymphocytes, and NK cells – all key components of the immune system
  3. Exercise improves antigen specific T cell function for better protection from infectious agents and greater immunosurveillance
  4. Exercise enhances a variety of macrophage biology and capacities
  5. Exercise improves gut microbiota,  i.e., the bacteria collection in the gut

But how much exercise should you do?

We have all heard that exercise is good for you.  And, as this blog post is emphasizing, among other things, exercise also enhances the immune system. But how much exercise?

In this study, the researchers examined three groups of people: elite athletes, recreational athletes, and sedentary controls. Their results were kind of interesting:

  • The elite athletes had the most upper respiratory issues (66% got sick).
  • The couch potatoes were next (45% got sick).
  • The recreational athletes were the healthiest (22% got sick).

All kinds of other research has found the same thing, so exercise scientists tend to use a J-shaped curve to model the immune effects of exercise. It looks like this:

immunity vs exercise

So one thing is clear, moderate exercise is significantly better for you than no exercise at all. If you are sedentary, it does not seem to take much to get the benefits of improved immune system. For example, daily walking for one hour at a 60 to 65% maximum heart rate (computed as 220-your age) gets you near the optimal range in the above chart.

From the chart, it is clear that there is a point where the benefit of training stops and the negative effect of over-training on the immune system sets in. This literature review article, goes into much more specifics on the kind of exercise that produces the immune-suppressant, i.e., harmful, response:

  • Relatively long workouts (1.5 hours or more), especially without refueling during the workout.
  • A reasonably high intensity, but not excessively difficult (since you have to be able to keep it up for a while).
  • An inadequate recovery period between workouts.

Basically, the kind of grueling training elite athletes often go through preparing for a competition, such as running a marathon.

This article puts it slightly differently:

“No activity is worse than some, while too much may be worse than none at all. The ideal lies somewhere in between – though not necessarily in the middle, but rather smack dab in the “just enough” section. Can “just enough” be quantified? Perhaps it could be quantified using a battery of round-the-clock tests and measurements of anabolic and catabolic hormones, various serum concentrations, lactate build-up, cortisol, testosterone ratios, etc., but that would be expensive, unwieldy, and completely individualized. … If you want to avoid over-training, there are some grand, overarching principles to follow, but you’ll also want to pay attention to certain personal, entirely subjective cues.

That’s what my trainer and yoga teachers call “listening to your body”. There are days, when I am feeling physically ragged since I may not have slept well, or I may be catching a virus, or am feeling physically exhausted or whatever.   In such situations, I need to carefully “listen to my body” and either take it easier than usual or just totally skip the session.

Bottom Line

To optimize immune systems, exercise plays a critical role. It only takes a moderate amount of exercise to get the optimal benefit of exercise for improving immune system. For example any of these activities or some combination of these done daily would optimize the immune systems:

  1. walking for 1 hour at a pace of 60-65% of maximum heart rate of approximately 220 minus your age,
  2. An hour long yoga routine,
  3. A strength training session with body weight or light weights could do the trick

On the other hand, extended periods of over-training can compromise and may lead to sub-optimal immune system. It is more difficult to define over-training with objective measures and may depend upon many individual factors.  It is best to listen to your body and develop a subjective feel for what level of exercise may be “just right” for you for optimal immune system.

 

What are your thoughts on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

 

Post #51 – How to optimize your immune system? – Part I

10 Sunday Apr 2016

Posted by in Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Uncategorized, Vitality, wellness

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The term immune system is talked about a lot these days in various contexts. On one end of the spectrum people talk about “building” one’s immune system to ward off or overcome diseases. On the other hand, you may have heard conversation about where the disease itself is the result of some “immune disorder”.

Many years ago, when I used to visit my primary physician to deal with my seasonal allergies (which I was able to successfully cure, as I described in another blog post), I would often ask him, what was underlying cause of my allergies and he would say, “It is something to do with immune system.  We don’t understand much about immune system yet.”

Later after doing my own research, I figured out that actually we do know a lot about the immune system and there is a lot we can do about it too. And, that knowledge gave me the impetus to take actions to cure my seasonal allergies. See my post So, did I tell you the story about my allergies?

In this post, I would like to delve into what exactly is immune system and what we can do so it is really a friend and not our foe.

What is Immune System?

Here is a quick summary of some key terms from National Institute of Allergy and Infectious Diseases (NIAID) at NIH website.

The immune system is a network of cells, tissues, and organs that work together to protect the body from infection. The overall function of the immune system is to prevent or limit infection.

Immune system is comprised of multiple organs, cells and response types that include:

Immune System

Skin: The skin is usually the first line of defense against microbes. Skin cells produce and secrete important antimicrobial proteins, and immune cells can be found in specific layers of skin.

Bone marrow: The bone marrow contains stems cells that can develop into a variety of cell types. The stem cells in the bone marrow create two types of immune cells: innate immune cells and adaptive immune cells.

Innate immune cells —neutrophils, eosinophils, basophils, mast cells, monocytes, dendritic cells, and macrophages— are important first-line responders to infection.

Adaptive immune cells—B cells and T cells—that are responsible for mounting responses to specific microbes based on previous encounters since they retain immunological memory.

Natural killer (NK) cells share features of both innate and adaptive immune cells, as they provide immediate defenses like innate cells but also may be retained as memory cells like adaptive cells.

Lymphocytes – B, T, and NK cells also are called lymphocytes.

Bloodstream: Immune cells constantly circulate throughout the bloodstream, patrolling for problems. When blood tests are used to monitor white blood cells, another term for immune cells, a snapshot of the immune system is taken. If a cell type is either scarce or overabundant in the bloodstream, this may reflect a problem.

Thymus: T cells mature in the thymus, a small organ located in the upper chest.

Lymphatic system: The lymphatic system is a network of vessels and tissues composed of lymph, an extracellular fluid, and lymphoid organs, such as lymph nodes. The lymphatic system is a conduit for travel and communication between tissues and the bloodstream. Immune cells are carried through the lymphatic system and converge in lymph nodes, which are found throughout the body.

Lymph nodes are a communication hub where immune cells sample information brought in from the body. For instance, if adaptive immune cells in the lymph node recognize pieces of a microbe brought in from a distant area, they will activate, replicate, and leave the lymph node to circulate and address the pathogen. Thus, doctors may check patients for swollen lymph nodes, which may indicate an active immune response.

Spleen: The spleen is an organ located behind the stomach. Spleen is important for processing information from the bloodstream. Immune cells are enriched in specific areas of the spleen, and upon recognizing blood-borne pathogens, they will activate and respond accordingly.

Mucosal tissue: Mucosal surfaces are prime entry points for pathogens, and specialized immune hubs are strategically located in mucosal tissues like the respiratory tract and gut.

How does immune systems defenses work?

An immune response is generally divided into innate and adaptive immunity.

Immune Types of Response

Innate immunity occurs immediately, when circulating innate cells recognize a problem by expressing genetically coded receptors. Collectively, these receptors can broadly recognize viruses, bacteria, fungi, and even non-infectious problems. However, they cannot distinguish between specific strains of bacteria or viruses. Their key feature is quick and broad.

Adaptive immunity occurs later, as it relies on the coordination and expansion of specific adaptive immune cells. If a B or T cell has a receptor that recognizes an antigen from a pathogen and also receives cues from innate cells that something is wrong, the B or T cell will activate, divide, and disperse to address the problem. B cells make antibodies, which neutralize pathogens, rendering them harmless. T cells carry out multiple functions, including killing infected cells and activating or recruiting other immune cells.

Vaccination, or immunization, is a way to train your immune system against a specific pathogen. Vaccination achieves immune memory without an actual infection, so the body is prepared when the virus or bacterium enters. Saving time is important to prevent a pathogen from establishing itself and infecting more cells in the body.

When immune system is not working as intended?

When the immune system is working well through all the parts and pieces we discussed above, it is a thing of beauty. As a pathogen enters the body, body’s defenses are activated through the appropriate part of the immune system.  The pathogen is recognized and immediately zapped.

When immune system is not working properly there could be different types of issues.

Immune Deficiencies

Temporary Immune Deficiencies: Temporary immune deficiency can be caused by a variety of sources that weaken the immune system. Common infections, including influenza and mononucleosis, can suppress the immune system.

When immune cells are the target of infection, severe immune suppression can occur. For example, HIV specifically infects T cells, and their elimination allows for secondary infections by other pathogens.

Patients receiving chemotherapy, bone marrow transplants, or immunosuppressive drugs experience weakened immune systems until immune cell levels are restored. Pregnancy also suppresses the maternal immune system, increasing susceptibility to infections by common microbes.

Allergy

Allergies are a form of hypersensitivity reaction, typically in response to harmless environmental allergens like pollen or food. Hypersensitivity reactions can be caused by antibodies, IgE or IgG, which are produced by B cells in response to an allergen. Overproduction of these antibodies activates immune cells like basophils and mast cells, which respond by releasing inflammatory chemicals like histamine. And that is why people take antihistamine to stop allergic reactions such as sneezing.

Allergic reactions can also be caused by T cells, which may either directly cause damage themselves or activate macrophages and eosinophils that damage host cells.

Autoimmune Diseases

Autoimmune diseases occur when adaptive immune cells that recognize host cells persist unchecked. Autoimmunity is either organ-specific or systemic, meaning it affects the whole body. Autoimmune diseases have a strong genetic component, and with advances in gene sequencing tools, researchers have a better understanding of what may contribute to specific diseases.

Cancer

Some forms of cancer are directly caused by the uncontrolled growth of immune cells. Leukemia is cancer caused by white blood cells. Lymphoma is cancer caused by lymphocytes, i.e., adaptive B or T cells. Myeloma is cancer caused by plasma cells, i.e.,  mature B cells. Unrestricted growth of any of these cell types causes cancer.

In addition, an emerging concept is that cancer progression may partially result from the ability of cancer cells to avoid immune detection.

So, what can we do optimize our immune system?

Things that are in our controls to enhance our immunity and make sure that the immune system does not go haywire are the ones that you have heard about gazillions of time by now and are probably tired of hearing about: Nutrition, Exercise and Lifestyle.

In the next post, we will talk of specifics of nutrition, exercise and lifestyle that can enhance immune system and also prevent it from attacking itself or the body.

In the meantime, what are your thoughts on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

 

 

Post #48 – Is cancer preventable through optimal healthy living?

10 Sunday Jan 2016

Posted by in Causes of Death, Ideal Body Weight, Living to 120, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Supplements, Uncategorized, Vitality, wellness

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My wife Kimberly was telling me the other day that 2015 has been quite a remarkable year in that we had several cancer episodes among our friends and families.  Even a couple of them died.

So, that got me thinking… is cancer preventable through optimal healthy living?

What is cancer anyways?

According National Institute of Health (NIH), National Cancer Institute (NCI) website www.cancer.gov, cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer.

How does cancer arise?

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Three main types of genes may be involved—proto-oncogenes or genes involved in normal cell growth, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. (Our Cancer Causes and Risk Factors page has more information.)

Inherited genetic mutations play a major role in about 5 to 10 percent of all cancers. Researchers have associated mutations in specific genes with more than 50 hereditary cancer syndromes, which are disorders that may predispose individuals to developing certain cancers.

How to prevent cancer?

So, now finally getting to the topic we started with – how to prevent cancer. Here are the four major ways to help prevent cancer:

  1. Avoid or control things known to cause cancer.
  2. Changes in diet and lifestyle.
  3. Finding precancerous conditions early. Precancerous conditions are conditions that may become cancer.
  4. Chemoprevention (medicines to treat a precancerous condition or to keep cancer from starting).

Let us take these items one at a time.

  1. Avoid or control things known to cause cancer.

Factors that are known to increase the risk of cancer:

  • Cigarette Smoking and Tobacco Use
  • Infections: HPV, Hepatitis B and C, Espstein-Barr virus, Helcobater pylori
  • Radiation: Ultraviolet sunlight, medical radiation, radon gas in homes
  • Immunosuppressive Medicines
  1. Changes in diet and lifestyle

Factors that may affect the risk of cancer:

  • Diet
  • Alcohol
  • Physical Activity
  • Obesity
  • Environmental Risk Factors: second hand smoke, asbestos, air pollution, pesticides, arsenic in drinking ware

Diet is anything we put in our mouths on a regular basis.

Diet is always a controversial subject. Media loves to talk about any new tidbit that comes out through research regarding diet.

Some studies show that fruits and non-starchy vegetables may protect against cancers of the mouth, esophagus, and stomach. Fruits may also protect against lung cancer.

Some studies have shown that a diet high in fat, proteins, calories, and red meat increases the risk of colorectal cancer, but other studies have not shown this.

It is not known if a diet low in fat and high in fiber, fruits, and vegetables lowers the risk of colorectal cancer.

According to American Cancer Society website www.cancer.org, here are the dietary guidelines to prevent cancer:

  • Be as lean as possible throughout life without being underweight.
  • Avoid excess weight gain at all ages. For those who are overweight or obese, losing even a small amount of weight has health benefits and is a good place to start.
  • Choose foods and drinks in amounts that help you get to and maintain a healthy weight.
  • Limit how much processed meat and red meat you eat.
  • Eat at least 2½ cups of vegetables and fruits each day.
  • Choose whole grains instead of refined grain products.
  • Avoid alcohol or drink no more than 1 drink per day for women or 2 per day for men.

T. Colin Campbell, PhD distills his 30 years of research on cancer and diet in “The China Study”. He concludes that a vegan diet minimizes the risk of all types of cancers as well as many other types of health risks.

For Physical Activity, American Cancer Society recommendation is for cancer prevention:

  • Exercise:
    • Adults: Get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.
    • Children and teens: Get at least 1 hour of moderate or vigorous intensity activity each day, with vigorous activity on at least 3 days each week.
  • Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment.

Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits.

  1. Finding cancer or precancerous conditions early. Precancerous conditions are conditions that may become cancer.

Then there is the matter of “early detection and early cure.”

Cancer is a group of diseases that can cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, how big it is, and how much it affects the organs or tissues. If a cancer has spread (metastasized), signs or symptoms may appear in different parts of the body.

 Treatments work best when cancer is found early – while it’s still small and is less likely to have spread to other parts of the body. This often means a better chance for a cure, especially if the cancer can be removed with surgery.

A good example of the importance of finding cancer early is melanoma skin cancer. It can be easy to remove if it has not grown deep into the skin. The 5-year survival rate (percentage of people who live at least 5 years after diagnosis) at this early stage is around 98%. Once melanoma has spread to other parts of the body, the 5-year survival rate drops to about 16%.

Some symptoms, such as tiredness or coughing, are more likely caused by something other than cancer. Symptoms can seem unimportant, especially if there’s a clear cause or the problem only lasts a short time. In the same way, a person may reason that a symptom like a breast lump is probably a cyst that will go away by itself. But no symptom should be ignored or overlooked, especially if it has lasted a long time or is getting worse.

Most likely, symptoms are not caused by cancer, but it’s important to have them checked out, just in case. If cancer is not the cause, a doctor can help figure out what the cause is and treat it, if needed.

These days it is not that difficult to get one’s genome mapped and find out any cancer syndromes that might be present and actively take the necessary preventative actions.

The American Cancer Society recommends these cancer screening guidelines for early detection of cancer  for most adults. Screening tests are used to find cancer before a person has any symptoms.

  1. Chemoprevention (medicines to treat a precancerous condition or to keep cancer from starting).

Chemoprevention is the use of substances to lower the risk of cancer, or keep it from recurring. The substances may be natural or made in the laboratory. Some chemopreventive agents are tested in people who are at high risk for a certain type of cancer. The risk may be because of a precancerous condition, family history, or lifestyle factors.

Some chemoprevention studies have shown good results. For example, selective estrogen receptor modulators (SERMS) such as tamoxifen or raloxifene have been shown to reduce the risk of breast cancer in women at high risk. Finasteride and dutasteride have been shown to reduce the risk of prostate cancer.

Bottomline

Cancer is a genetic disease that may be the result of either mutated inherited genes or the ones occur later due to health, lifestyle and environment issues.  Only about 5 to 10% of the risk of cancer is due to mutated inherited genes.

Yes, healthy lifestyle choices we have been discussing in other blog posts do lead to decreasing the chances of cancer.  To minimize the risk of cancer:

  1. Be of Lean weight
  2. Eat clean with lots of fruits and vegetables and only sparing amount of white meats
  3. Avoid the use of alcohol or tobacco
  4. Avoid second-hand smoke, pesticides and other environmental carcinogens
  5. Stay active and exercise
  6. Get regular checkups and screening tests
  7. In case of any signs or symptoms, get a quick check up to rule out any cancerous or precancerous condition.

 

Your thoughts on this subject?

Would love to hear, learn and share information.

If possible, please do leave comment in the blog itself, so others can share and learn.

#47 – What does optimal dental health look like and how to achieve it?

06 Sunday Dec 2015

Posted by in Living to 120, Optimal Health, Uncategorized, Vitality, wellness

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A couple of years ago, during one of my regular visits to my dentist, I told him that my goal is to live to 120 and wanted to make sure that my teeth will last and stay healthy until then.

He immediately turned to me hygienist and said, “Dr. Thareja here has just given us permission to challenge him to do everything he needs to do for optimal dental health.”

Now I was 35 years old when I visited a dentist for the first time. You see, I grew up in India. My parents taught me that all I needed to do was brush my teeth every day and my teeth will be just fine. But something bothered me all the time.  Both my parents had lost most of their teeth when they were in their forties. They had gotten the last few pulled out so that they could get fitted with dentures.

Turning 35, even though nothing was hurting, I realized that I did not cherish the thought of having dentures in my forties.  Hence the first visit to the dentist.

The dentist was surprised to learn that I had never seen a dentist until that day.  He did a thorough cleaning. Although there was bleeding and pain during the cleaning, there were really no issues – no cavities, no gum disease etc. He told me to regularly brush and floss.

I bought floss and tried it for a few times. I did not really know how to do the flossing or what good it was doing. I did a little bit of reading, but gingivitis, tartar, gum disease, plaque these words did not seem to make any sense to me. So, I stopped flossing and went back to just brushing my teeth. And, continued with my once a year visit with the dentist.

Few years later, a dentist moved into our office building it. I decided to try him out.  My very first visit with Dr. Doug Drewyer’s office was quite different. He asked me that they would like to measure my gum separation before doing the cleaning. After the hygienist had done the measurements, Dr. Doug explained the significance of the measurements. He showed me that for certain teeth gums had separated much more. And, that was not good.

My next question was obvious: What could I do to prevent this gums separating from the teeth?  He told me the key was flossing. Since with flossing, you scrape off any plaque that might cause gums to inflame, lose vitality in the tissue and start separating from the teeth and eventually result in teeth falling out – even when the teeth themselves are healthy.

So then it finally made sense to me: So that’s how my parents lost their healthy teeth even when they were brushing every day!! 

Initially, Dr. Doug told me to floss just twice a week and then three times a week and then every day.  I later learned that he was taking this incremental approach to not overwhelm me.  His experience is that if he tells patients to floss every day on the first visit, very few are able to do that.

You may have heard the dentist joke.  Someone asks his dentist, “Which teeth should I floss?”  Dentist’s snap answer, “Only the ones you want to keep!”

Researching for this blog, I found a website called Mouth Healthy, sponsored by American Dental Association. It has a lot of very user-friendly information that explains all those things that I was trying to learn 15 to 20 years ago. And, if you are not familiar with these basis terms, here is a quick overview:

Your teeth are covered with a sticky film called plaque that can contribute to tooth decay and gum disease. Plaque contains bacteria, which following a meal or snack containing sugar can release acids that attack tooth enamel. Repeated attacks can cause the enamel to break down, eventually resulting in cavities. Check out these fascinating (or disgusting?) pictures of plaque attack close up.

Cavities, or tooth decay, is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form. A cavity is a little hole in your tooth.

Cavities are more common among children, but changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. It’s common for people over age 50 to have tooth-root decay.

Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

Decay can also be the result of dry mouth, which can be caused by certain medication or other health issues.

Plaque that is not removed with thorough daily brushing and cleaning between teeth can eventually harden into calculus or tartar. This makes it more difficult to keep your teeth clean. When tartar collects above the gum line, the gum tissue can become swollen and may bleed easily. This is called gingivitis.

Gingivitis is the early stage of gum disease. Gum disease, also known as periodontal disease, is an infection of the tissues that surround your teeth, and is caused by a buildup of plaque. In its early stages, symptoms may include:

  • gums that bleed easily
  • red, swollen, tender gums
  • bad breath

Some factors that can put you at higher risk of developing gingivitis include:

  • poor dental care
  • smoking or chewing tobacco
  • genetics
  • crooked teeth that are hard to keep clean
  • pregnancy
  • diabetes
  • medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives

Take care of your gums…help your heart?

The American Heart Association published a Statement in April 2012 supporting an association between gum disease and heart disease. The article noted that current scientific data do not indicate if regular brushing and flossing or treatment of gum disease will decrease the incidence, rate or severity of the narrowing of the arteries (called atherosclerosis) that can lead to heart attacks and strokes. However, many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including heart disease, even after adjusting for common risk factors.

You may have seen health and lifestyle surveys used for estimating life-expectancy that want to know if you floss daily. If you do the models give you credit for an extra 2 to 4 years of life.

You may have seen commercial or ads for chewing gum claiming better dental health from chewing gum.  What is that about? Saliva, or spit, plays a significant role in maintaining oral health. It is derived from blood and acts as the bloodstream of the mouth. What this means is, like blood, saliva helps build and maintain the health of soft and hard tissues. When saliva flow is reduced oral health problems such as tooth decay and other oral infections can occur. Chewing is the most efficient way to stimulate salivary flow. It causes muscles to compress the salivary glands and release saliva. Saliva

  • Washes away food and debris from teeth and gums
  • Helps moisten and break down food to ease swallowing and enhances ability to taste
  • Provides disease-fighting substances throughout your mouth to help prevent cavities and other infections
  • Helps keep the surface of your teeth strong by providing high levels of calcium, fluoride and phosphate ions at the tooth surface.

Bottom Line

So, when I asked Dr. Doug to tell me everything I need to do to have my teeth until 120, he incrementally added a suggestion of using tiny gum brush to catch plaque that floss might not catch. But other than that he reinforced the same things that he has told me before – which is very consistent with everything I have learned through my research.

You can help prevent tooth decay, cavities, gum disease etc. and keep healthy teeth for life by following these tips:

  1. Brush twice a day with fluoride toothpaste.
  2. Clean between your teeth daily with floss or interdental cleaner.
  3. Eat nutritious and balanced meals and limit snacking.
  4. Check with your dentist about the use of supplemental fluoride, which strengthens your teeth, and about use of dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth (where decay often starts) to protect them from decay.
  5. Visit your dentist regularly for professional cleanings and oral examination.

And, if you are not sure how exactly to floss, here are instructions from National Institute of Dental and Craniofacial Research: PLAQUE: What it is and how to get rid of it.  You will notice that NIH also recommends brushing (or scraping) tongue in addition to the teeth.

I can tell you from my experience that the above list of five steps works. These days my twice annual dentist cleaning visits are basically cleaning stains and some scarping and very little, if any, pain, bleeding or discomfort. And, it has been getting better over time.

What are your thoughts and experience on maintaining optimal dental health?

I would love to learn from you.