Blog Archives

Start Stopping More Often

Nov 25

By now you MUST have heard the news. Gratitude is a powerful emotion for individuals, teams, families, and even corporations. While I'm certain the Thanksgiving story misses the historical mark on more than a few details - it seems the theme, that is, giving thanks, is bigger than most realize - and probably deserves moving from "a" day to every day.

For starters, let's touch on some of the physical health benefits - in a systematic review of the available research published in 2020, a team in New Zealand determined that those who practice gratitude are more likely to enjoy the following:

  • Better Sleep Quality

  • Better Blood Pressure

  • Better Blood Sugar control


In addition, some (although inconclusive) effects on inflammation and physical symptoms appear. But that's not all.

Last year, a team looked at a dataset from a University of California at San Francisco study related to stress and blood pressure across nearly 5,000 participants and found that gratitude (and optimism) predicted lower heart rate and blood pressure, better sleep quality, more exercise, less stress, more positive expectations and reflections, and greater feelings of appreciation toward others. But that's still not all...and here's where it gets cool.

This year, another team investigated whether over a few weeks, either "taking a moment", that is, intentionally stepping back from one's day (decoupling) and practicing mindfulness (via a guided meditation) or journaling twice weekly could improve gratitude markers (measured by survey) and helpful behavior (measured by a survey of a coworker). Interestingly, both sub-studies pointed to a similar finding: Achieving a state of mindfulness, prompted greater levels of gratitude, motivation to help others, and, eventually signs of better teamwork.

Thanksgiving may be a one-day endeavor that features big meals or sometimes entertaining football games. If we let it, it can also be the kickstart we may need to step back, "just be" for a few minutes every day, and, if the research is right, ultimately enjoy better health and more positive relationships with those around us.

We hope your Thanksgiving was a great one.

Have a great weekend,

Mike E.

cause and effect: Food choices and pain

Nov 18

The connection between what we eat and how we feel is not a new discovery. Ask anyone who has had the unfortunate experience of "overdoing" on Thanksgiving and they might be able to shed some light on why lifehacker.com felt the need to publish a "decision support" article on when to go to the emergency room for "post-Thanksgiving stomach". Of course 2011, when that article was written, is nothing compared to this book which connected the notoriously painful condition of Gout with consumption patterns and an "impaired state of the stomach" more than 200 years prior. Yet, as many of us who aren't quite ready to let go of harmful habits are quick to point out - correlation is not causation - and so the pursuit of evidence rumbles on.

Since those early times, many more connections have been made between our dietary habits and bodily discomfort. High-fat diets have a clear connection with spikes in inflammation while diets that include naturally fermented foods have been shown to reduce it. While the specific mechanism is still not perfectly sorted out, the root cause, what we ate or drank, and the ultimate effect, how we felt, are clear.

One theory gaining traction is the impact of foods and drinks on the bacteria in our gut (microbiome). Since high-fiber foods drive anti-inflammatory bacteria, and pain is a feature of inflammation, it may explain the connection between a high-fiber diet and lower levels of pain, in this case, knee pain. On the other hand, high-fat diets, which appear to feed the other end of the spectrum, have been connected to joint pain increases in animal models. Although some of the substances on board (polyphenols) show promise, alcohol may have a net-negative impact as (not unlike cleaning a wound or taking long courses of antibiotics) it significantly alters bacteria in the gut (called dysbiosis), leaving us depleted and susceptible depending on what we put-in next.

However, in a recent development that aimed at gaining an even more specific understanding of the connection between dietary factors and pain, researchers at the University of Texas in Dallas were able to definitively show that high-fat diets, even without obesity or previous injury, sensitized the system and primed the transition from acute to chronic pain in a lab experiment on mice. In plain English, within 8 weeks, diets that were high in saturated fat caused an exaggerated pain response with no history of injury and no changes in metabolic health (such as obesity and diabetes) known to do the same - the diet alone was the cause.

The holiday meal and party blitz is almost here. Do your body a favor and tell the chef to hold the side of pain.

Have a great weekend,

Mike E.

puzzles & Proteins - a whole new twist on "brain food"

Nov 11

Boil us humans all the way down and it's really pretty simple, like any system, we are a series of inputs and outputs. On the input side of the equation are things we eat, things we do, things that we are exposed to (even without "doing"), and, at risk of getting too deep, even things we miss/lack or avoid. On the output side of the equation are thoughts, actions, emotions, sensations, and more. Pretty simple.

Of course, in between the inputs and outputs lies an interwoven, hard to understand, and even mysterious at times "system of systems" - the very definition of complex. The upside is, this gives us plenty to write about each week and with any luck, each wrinkle we can smooth out gives us all a bit closer understanding of how best to care for and maintain it. This week, after an email tip from a reader* and the emergence of a cool new discovery about motivation, we decided to highlight a few cool input/output stories which impact the brain.

First, let's start with another healthy investment of time/effort (input) which has proven to improve our cognitive performance (output) as we age. It's not exercising, nor maintaining a low inflammatory diet, nor getting good sleep this time - although each of those is well proven - this is closer to "brain games", and specifically which have the greatest impact on future brain health. As it turns out (and published here in the prestigious journal NEJM), one and 1/2 years after starting either computerized games designed to challenge the brain or crossword puzzles, the crossword puzzle group outperformed the "games" group on a variety of measures and even saw less decline in the size of the brain in two areas measured (hippocampus volume and cortical thickness). Conclusion? Crossword puzzles were the superior "input" if maintaining healthy cognition is the "output" we're looking for. Open question? Where does wordle fit? Stay tuned, I'm sure someone is studying it.

But what if it's not a knowledge thing - we know what we "should" do - but a motivation thing; we just can't seem to get into gear and do it!?

Well, according to new research from a team in Switzerland, it seems we are closer to a place to start. In a fascinating twist, the team found that a particular area deep in the brain which is known to play a major role in motivation including rewards/aversions/etc (called the nucleus accumbens), is sensitive to oxidative stress, which, way oversimplified, is the higher-than-ideal presence of toxic cellular waste molecules ("oxidative species"). This discovery led to a simple theory: if substances known to combat oxidative stress ("antioxidants") were more abundant, motivation might increase.

The research team focused on a potent brain antioxidant, a protein known as glutathione (GSH) which the body outputs from a variety of inputs (spoiler alert, MOVE and FUEL and RECOVER among others). When GSH levels were low in that area of the brain, so was motivation. When they were high, so was motivation. Then, to tease out cause and effect (and this time in rats not humans) they either input a GSH blocker or booster and found that, right on cue, the output of motivation went down and up respectively.

If the outputs matter, so do the inputs. Now is as good a time as any to pick a good one.

Have a great weekend,

Mike E.

*special thanks to Mike W for sending the NEJM article

Social Contagion is Powerful Stuff

Nov 4

My kids get a laugh any time my wife talks on the phone with her sister. They only hear one side of the conversation of course, but they always know who's on the other side as the tone, tempo, and even word choices my wife uses begin to morph ever-so-slightly and sound, somehow, more midwestern or western US (tones of her childhood) than western Jersey (tones of most of her life).

Of course, in one way or another we all do this with the people around us. The more time we spend around people, the more we seem to merge our mannerisms - to find a cadence and rhythm that works for the situation. When we get around family or close friends we haven't seen in a while it can be like "we never missed a beat" (as the saying sometimes goes). During the early portion of the COVID-19 quarantine, we talked a bit about this 2011 study which seemed to show that under heightened arousal (in this case fire walking) there could even be a synchronization of more automatic functions, like heart rate, among people who were socially close (in this case family).

Over the longer term, it seems this effect might have an impact on our health outcomes. For example, 15 years ago a landmark study showed that across 30 years of observation, bodyweight changes in 12,000 people tended to run along social ties, eventually forming clusters. Said more simply, there was evidence that in the case of body weight (and presumably the actions that influence it), people tended to become more similar to those they had the closest interactions & ties with.

A few months ago, in an interesting twist on the phenomenon, a team showed that future earning potential (as a proxy of financial health) seemed to follow a similar pattern. Individuals who had exposure and close ties with people in high socioeconomic brackets had a significantly higher likelihood of enjoying a higher income over the course of time. More simply, children with fewer finances tended to be higher-earning adults IF they grew up with friends whose parents were already higher-income earners - a phenomenon the researchers called "economic connectedness", which can be explored on www.socialcapital.org.

But what about more classic health behaviors, like whether we MOVE enough during the day to hold off preventable disease?

As it turns out, and as published this week, at the very least, the math modeling says yes. When researchers plugged data into a computational model "Social interactions between sedentary and moderately active populations were the most important social parameter that influenced low active populations to become and remain physically active".

Or in plain English - when sedentary folks became friends with moderately active folks, the sedentary folks started to MOVE more.

Of course, this doesn't mean moderately active folks are immune to the effect. It seems the effect can run both ways. Said more eloquently by the researchers, "On the other hand, social interactions encouraging moderately active individuals to become sedentary drove exercise persistence to extinction".

There is most certainly more to come, but the main point seems to continue to become more clear - our actions, from mannerisms to health behaviors and beyond - are not solely our own; the people we interface with regularly and get close to having a clear impact on our future selves, choose wisely.


Have a great weekend,


Mike E.

3 things you've already heard (that still matter)

Oct 28

It's a bit like the financial planner who tells the story of the person who chose to "set it and forget it" - that is, automatically withdraw pretax money from their paycheck each week and let it use the power of compound interest over time. The conclusion is almost always an impressive nest egg by retirement.

Or maybe it's the story the seasoned coach tells of the (rare) athlete who simply "trusted the process" and logged the training hours even when "base" training seemed too easy to do anything or "breakthrough" sessions seemed like punishment.

The moral of these stories are shockingly similar - slow and steady wins the race, the tortoise often beats the hare, consistency beats intensity, and the "tried and true" got that way for a reason.

With that in mind and in light of 3 new studies that came out this week which reinforced a few of those tried and true concepts, here's what you need to know:

(1) When it comes to MOVE - something is infinitely better than nothing. As shown in research from a group in Canada, "activity snacks", that is, short bursts of movement to break up an otherwise sedentary day, especially when timed after a meal, are surprisingly powerful. The team tracked a blood marker that signifies whether food is being used by the muscles in a healthy way under 3 conditions: sedentary (no activity snacks), air squats (do a sit-to-stand using only bodyweight 15 times every 30 minutes), and walking (brisk 2 min walks every 30 minutes). When it came to the results - squats were better than sitting and walking was the best. Headline? Less than 5 minutes of movement every hour significantly changes how our bodies use fuel.

(2) In the FUEL category - another tried and true message bubbled up to the top of the pile this week. Maybe you've heard us say (over and over and over) to "eat more plants". Of course, we are quick to point out that this is a general statement for "every person" and maybe too general for some. However, the concept is simple and holds true for the vast majority - when we put a little bit more of the inflammation-lowering, gut-health-promoting fiber, which comes from plants, and many diets lack, we get health benefits. As it turns out, for those who don't eat much fiber, "more" could be as small as 2 servings of almonds per day. Researchers from London asked study participants to try it using 56 grams of almonds, either whole or ground, and compared a key indicator of their gut health (butyrate) against a control group. The almond eaters fared significantly better. Of course, it's unlikely that almonds are the only food giving this result but there's certainly more to come. Headline this time? If you're not getting enough fiber, even a little effort can go a long way.

(3) In regards to RECOVER - duration matters. Once again research has confirmed that short sleep at midlife is linked with chronic disease as we age. A team in London confirmed that individuals who routinely slept 5 hours or less per night at 50 years old were 20% more likely to develop a single chronic disease in their retirement years AND up to 40% more likely to develop two or more (termed "multimorbidity") than those who routinely got at least 7 hours of sleep per night. Sleep is one of the most important health tactics we have - we should probably treat it like our (quality of) life depends on it; it does.

If you're already doing these things CONGRATS....keep going. If not, maybe it's a great time for an experiment to see if the tried and true can work for you. Good luck and let us know if we can help.

Have a great weekend,


Mike E.

no shame for snoozers

Oct 21

On average, how many hours of sleep do you get in a 24-hour period?

Over the last 2 weeks, how many days did you unintentionally fall asleep during the day?

During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?

These are just 3 of the questions researchers from The Centers for Disease Control and Prevention ask when they poll Americans to learn about sleep habits and health. Unfortunately, despite our growing understanding of how important it is to RECOVER well each day (with adequate sleep as the primary means), their data shows more than 1 of every 3 American Adults are under-rested, which is sadly enough, an improvement when compared to our high school-aged children. If you listen to the experts, like Matthew Walker of UCal Berkeley as he makes abundantly clear across 16 video shorts, getting enough high-quality sleep is absolutely critical to every system in our body and therefore our future health and performance...helping the conversation evolve from one that emphasizes the importance of getting "enough" sleep (7+ hours per night being the 2015 consensus for working adults), to one that dives deeper into the accurate measurement of it and when needed, its improvement.

Like most areas of life, there are both low-tech (waking up feeling refreshed and energetic) and high-tech (measuring brain waves and hormone levels) ways of knowing where we stand. One "real world" method that often gets discussed is the use of an alarm clock and the ever-demonized snooze button; suggesting that when we are fully rested and in the lighter stages of sleep, i.e. closer to the surface, we will wake up without prompting (no bells, songs or other jolts needed) and minimize the risk of feeling extra tired, aka "sleep inertia" if we force ourselves awake during deeper sleep. Some enterprising researchers have even suggested that a "smart alarm" which adjusts wake time to match sleep stage could help. Few however, have taken on the more widely accepted narrative that "snooze buttons are bad"...until now.

Researchers at Notre Dame University followed several hundred subjects for a full year asking them to use a wrist-based wearable that measured their heart rate, tracked their sleep cycles, and measured their steps. They also surveyed them about their use of the snooze button and a variety of other items.

Interestingly, they found that:

- a slight majority of those surveyed (57%) used the snooze button

- those with a later chronotype aka "night owls" were more likely to use the snooze than "morning larks"

- although those who didn't use/need an alarm at all tended to do a bit better than those who felt they need an alarm to wake, there were no major differences in markers of fatigue (including caffeine usage) between those who snoozed and those who got up on the alarm's first ring

- one possible, although not yet proven, the silver lining for snoozers is that the average total snoozing time (minutes spent in bed after the first alarm) of nearly 27 minutes was within the 15 to 30-minute range most studies estimate that it takes for "sleep inertia" (grogginess and mental fog after waking) to wear off. This raises the question - "are snoozers more alert when they finally get out of bed than non-snoozers?" - more to come, I'm sure.

Here's the bottom line - if we need an alarm to make sure we get out of bed on time, whether we use the snooze or not, we may be under-rested (not ideal) but we are definitely not alone.

With the sun setting earlier and the temperatures cooling as we creep toward winter, now may be the perfect time of year to get some additional rest. Search for "elements guides" on your client website or click here for more sleep tips from the team.


Have a great weekend,


Mike E.

what's wrong with eating late?

Oct 14

We've all heard it before - "If you want to stay healthy and lean, don't eat after 8 PM" Or is it 9 PM? Or does it really matter at all?

The short answer is - Yes it matters - there are many studies that have shown this observation over the course of time - but until very recently we didn't know exactly why. Some evidence says eating late relates to changes in our core body temperature while other research says it relates to metabolic disorders. However new research out this week from a team based in both Boston and Spain has brought a deeper level of understanding than we've ever had before.

According to the research - eating late at night has three important and strikingly negative effects on our systems:

(1) Late eating increases waketime hunger and decreases levels of the fullness-hormone "leptin", which acts as the signal that tells our brain when we are no longer hungry, but that's not all.

(2) Late eating decreases the rate that our bodies burn calories while we are awake (waketime energy expenditure) as well as lowers our body temperature over the next 24 hours, but that's still not all.

(3) Late eating tells the genes that regulate our fat cells to store fat (rather than burning it).

Any one of these effects could be problematic, yet combined, the impact of all three could be very detrimental.

This one is relatively short. There's simply no need to belabor the point - going to bed "empty" is not just for better sleep - it will protect our metabolic health as well.


Have a great weekend,


Mike E.

to shiver or sprint: training to endure

Oct 7

It's no secret that I strongly dislike the cold. "Hate" is probably a strong word, but it gets close at times. So when I was invited to headway North into Canada last winter to try my hand at ice-fishing, I made an immediate trip to Cabella's (like the Costco of outfitters for wilderness sports for those who've never been) to find the warmest possible gear they had. I wasn't afraid to look like Randy from The Christmas Story (Ralphie's little brother who could barely move in his snow suit) if it meant I'd be comfortably warm...or at the very least mostly avoid the discomfort of being cold for hours on end.

But what if that cold was good for me? What if the stress of controlled cold exposure actually turned out to be "good stress" that could start a cascade of healthy reactions that modern life in mostly temperature-controlled environments and warm gear has severely limited? What if enduring other stressors that were far more common to the human experience not all that long ago and less likely today could also unlock health benefits? Would we find a way to fit them into our lives?

As it turns out, there are more than a few things that we might consider stressful (and therefore "preferable if avoided") that can have positive impacts on our health; controlled cold exposure is one. In a research review published a few weeks ago, the authors summarized more than 100 studies that looked at the possible health benefits of cold exposure, specifically cold-water immersion, often in the form of winter swimming. Although many of the studies were small, leading them to conclude the effects were, well, inconclusive, there was enough of an effect to consider it promising. In summary, actively-enduring cold as a mechanism to improve health, especially by helping the body convert less healthy (white) fat to more healthy (brown) fat as well as improve cardiometabolic responses, appears to be gaining support. The authors phrased it this way: "Cold Water Immersion (CWI) seems to reduce and/or transform body adipose tissue, as well as reduce insulin resistance and improve insulin sensitivity. This may have a protective effect against cardiovascular, obesity and other metabolic diseases and could have prophylactic health effects.", while also acknowledging "it is clear that there is increasing scientific support that voluntary exposure to cold water may have some beneficial health effects."


Putting ourselves through the challenge of cold is not the only way to ENDURE our way to better health. In other news this week, it appears that combining 2 tactics which, on their own, each appear to improve health increases the benefit.


Time-restricted eating (TRE), which attempts to compress the "feeding window" for the user rather than the energy consumed (calories), specifically to eat all food in a 10-hour window, appears to have several positive impacts on metabolic health. High-Intensity Interval Training, which similarly compresses the time window, in this case of exercise by pairing high-intensity bursts (traditionally 4 minutes of work with a heart rate at or above 90% of maximum) with relative rest periods (2-3 minutes to recover), has also proven to be effective at improving cardiac and metabolic profiles in those who perform it regularly. This week, a study from Norway showed that the combination of the two approaches helped the women who participated to make significant gains in key measures of cardiometabolic health including diabetes risk (HbA1c) and 2 different types of body fat (total and visceral) after 7 weeks.


We humans are amazingly resilient. The ability to adapt to and grow from challenges is quite literally, programmed into our wiring. We call it the ability to ENDURE and believe it is fundamental to flourishing. It appears that environmental and time/intensity stressors, although not easy to handle or particularly comfortable in the moment, when applied under controlled conditions, can be added to the list of ways we get stronger outside of our comfort zone.


Have a great weekend,


Mike E.

generational health

Sept 30

We can learn a lot from worms; well, a Nematode (roundworm) to be exact. C. Elegans, a particular type of roundworm, is a model organism used to research a variety of biological functions in animals; its involvement leading to a variety of discoveries that have helped us better understand how the nervous system, metabolism, and even the way genes work (or don't). Not a bad contribution for a little animal most people have never heard of.

Earlier this week, the well-studied little critter made science headlines again as the subject of research at the University of California Santa Cruz which showed, with more clarity than ever, that our life experiences can imprint, encode, and can ultimately prove responsible for turning genes on and off, generations in the future. Formally known as "transgenerational epigenetic inheritance", which, admittedly sounds a little complex, the concept is not as hard to understand as it sounds.

In essence, our life's experience (environment, behaviors, etc) has an impact on which of our genes turn on, which turn off, and to what degree. This is called "epigenetics" and it has established a very clear link between our day-to-day health behaviors and the way our bodies adapt to those behaviors - all the way down to our genes. For example, epigenetics helps explain the genetic harm done by smoking or by routinely poor dietary choices and it has been a hotbed of study for the last 10 years or more.

This new research however adds a significant wrinkle - that those changes are NOT something that gets reset in the next generation, but that they are passed down to our children and grandchildren (at least) and possibly even further than that. Said more simply, the expression of OUR genes, at least in part, has been influenced by our grandparents' health choices and the same will be true for those of us who have children and grandchildren of our own.

Not unlike the savvy saver who builds a financial nest-egg that can be handed down to children or grandchildren, the healthy mover (or fueler, recoverer, endurer, and connector - since all of these areas of health are known to influence epigenetics and some generationally) is building a critical asset with value well into the future.

There are very few investments that can give both instant and distant returns. Healthy actions are one.

Have a great weekend,


Mike E.

right system, wrong environment - cravings part 2

Sept 23

Last week we discussed a newly confirmed wrinkle in how food cravings work - that we have 2 unique tracks. The first is driven by the flavors we experience, generally toward the "green light" flavors (sweet, salty, savory/umami) and, at least initially, with caution when "yellow-light" flavors (sour and bitter) are present. The second channel, which has only recently been confirmed applies to our 2 types of energy-producing FUEL (sugar and fat) and appears to be wired to the brain from the intestinal wall where nutrients are absorbed. Even when the "taste" portion of the sensory system is shut off (bred out), mice found their way to the nutrients needed (track 2) in 48 hours and kept going back to get what they needed - a biological workaround in the unfortunate case of a faulty "taste" system.

Simply put, our nervous system is wired to make the hard work of hunting and gathering more efficient, especially in times of scarcity so we are not wasting energy to find energy. However, when we consider this 2 track craving system in the light of our modern food system, with its wide availability of highly flavorful (ultra-processed & hyper-palatable, track 1) foods that are often sugar/fat soaked (energy-dense, track 2), it's not hard to see where things can go wrong. For example, new research out this week showed that if we are anything like the mice being studied and followed our "track-2 craving" for high-energy and infinitely storable fat, within 3 weeks we would begin overproducing inflammatory cells in our bone marrow, which may explain why weight gain is so closely related to low-grade inflammation and the ripple effects which can include heart disease, joint pain, cancer and age-related disease of the brain like Alzheimer's disease.

Of course, a similar "too much of a good thing" path exists for sugar, which also has track 2 wiring. We can pack a fair amount of sugar into our liver and muscles but they eventually get full which, in an oversimplified way, causes a back-up into the bloodstream (one key feature of Diabetes Type 2) which tells the body to begin conversion and storage (high triglycerides, excess weight, etc) which can eventually get us to the same unfortunate place - disease.

So what can we do about this right system/wrong environment problem?

Well, like many challenges we face - we can start by recognizing them and then build strategies that make them easier to control. Here are 3 of my favorites:

1. Go easier on ourselves by being relentless on our environments: This might mean cleaning out that pantry of easy-energy snacks and replacing them with healthier choices so we have to work harder than simply walking across the room to get those track-2 cravings met.

2. Eat nutrient-dense foods FIRST and often: meaning put in the low inflammatory good stuff like fruits and veggies (especially if it is flavorful) to keep track-2 busy working on absorbing all the nutrients present.

3. Train Track 2 with consistency: Like any other nervous system pathway, the "gut-brain axis" is closely related to our wake/sleep cycle (circadian rhythm). Some research has shown that when our eating schedule is disrupted (or lacks sufficient structure and regularity), the gut bacteria that heavily impact the gut-brain axis are also disrupted. Scheduled eating or even time-restricted eating schedules seem to help.

Of course, there's a lot more to it, but if keeping track-2 on track is the goal, it's a solid place to start.

Have a great weekend,


Mike E.

where cravings come from

Sept 16

My refrigerator has ratted me out. OK, that's probably a little sensational. In truth, it has "raised my awareness" of a nasty little habit I've developed. No, it's not some type of smart tech that is designed to keep me mindful...at least I don't think it is...but it seems to work that way for me. See, this 2-door refrigerator (a recent replacement), has a feature where it cannot dispense water when the opposite door is open. Now, this probably doesn't seem like that big of a deal; in truth, it's not. But it was a VERY effective way to point out that I had developed a mindless fridge-trolling habit every time I got up to fill a glass of water. And I do mean EVERY time.

It used to be a simple loop of: start filling the glass (left hand), open the fridge (right hand), and mindlessly scan for a snack - whether hungry or not - at least until the glass was full. I didn't always find something, but I always looked. That is until the loop became: start filling a glass (left hand), open the fridge (right hand), notice the water had frustratingly shut off, close the fridge and get back to work, feeling like something was missing. It was literally a wake-up call.

I wasn't really hungry nor was I craving anything in particular and yet my behavior (once it was made so glaringly obvious), suggested I was always open to the idea of eating. So where does this mindless snacking habit come from? If we could solve this riddle, we might better understand some of why most of us are at risk of steady weight gain by middle age, despite the ever-increasing certainty that over-consumption of particular foods, especially those that are sugar-sweetened or fatty, seem to add both pounds and risk for injury/illness/disease and even dying prematurely. Well, thanks to a team of researchers at Columbia University we have more clues and, as it turns out, it's NOT just as simple as "because they taste so good" (aka hyper-palatability).

This time they found, much like their 2020 work on sugar, fat consumption is driven not only by lighting up the brain by way of taste (i.e. receptors on the tongue) but ALSO by circuits that monitor nutrient absorption in the intestine. Said more simply, even when the subjects (mice) were unable to taste the food (bred without the ability to taste), they learned to prefer foods that were able to provide usable fuel (sugar and now fat) over tasty but unusable fuel (artificial sweetener) within 48 hours. The connection between their gut and their brain (aka the gut-brain axis), although much slower than taste receptors, which helped prove it wasn't the tongue driving the behavior, was still driving them to go back to the source of the sugar and fat....not that unlike my fridge habit.

It may even help us understand why individuals who habitually ingest artificial sweeteners (i.e. tasty but not usable nutrients) may actually have an increased risk of metabolic diseases like diabetes and decreasing consumption of diet sodas (even those with no calories) can improve weight and associated risks ...because we don't only forage for flavor...we forage for FUEL; and since one without the other won't satisfy our needs, we are left craving more.

This time next week it will officially be Fall. Here's to finding some recipes that are both flavorful AND satisfying; perhaps a little less pumpkin spice and a bit more pumpkin! Definitely let us know if you've got a good one.

Have a great weekend,


Mike E.

bumper sticker wisdom (Learning to "Duck")

Sept 9

My brother-in-law Tony was a great human. Living across the country didn't make visiting easy, but, on the occasions when our paths would cross, he was easy to visit with. His was a BIG laugh and an energetic spirit; the kind of person we should all be lucky enough to know. His passing left an unfillable hole for his wife and sons and so when the unmistakably clear ("four-letter", rhymes with duck) bumper sticker came into view on the highway earlier today, I thought about Tony and, as the now leading cause of death worldwide, how common stories like his are becoming. What used to be considered a disease of old-age is becoming increasingly common before the age of 50.

Yet, the news isn't all bad - as we learn more and more about what levers exist, we can fight more effectively when needed and, even better, take powerful actions that minimize our personal risk factors and lower the odds we will be impacted. This week a few really interesting and promising insights worth knowing about made headlines:

1. Brain tumors hijack surrounding cells, which may open the door to new treatments: As outlined in a new paper in the journal Brain, Glioblastoma, one of the most aggressive and challenging forms of brain cancer, appears to recruit and convert surrounding brain cells, essentially turning them against our own health interests. However, as shown initially in mice, when those surrounding cells are removed, the tumor is cut off from its energy source and cannot survive. If this effect holds in humans, it will be an advance in an area which has been slow (if not largely stalled) for decades.

2. Ultra-processed food plays a significant role in colorectal cancer, especially in men: The British Medical Journal published findings drawn from hundreds of thousands of records over the course of decades which showed men who ate the most ultra-processed food had a substantially increased risk of developing colorectal cancer. This was especially processed poultry/meat/seafood and ready-to-eat meals (44% increase) and sugar-sweetened beverages (21% increase). Overall the same effect was not seen in women, however a smaller effect (17% increase) was noted in those who consumed significant amounts of ready-to-eat/heat meals.

3. So much more than strength - exercise produces a natural cancer-fighting byproduct: Lactate, which the body produces when burning sugar for fuel (such as during strenuous muscle work) has been found to combine with certain immune cells to effectively fight cancer growth in mouse studies. Of course, it's far too early to know where this will go, however it certainly lends support to the clear line that the World Cancer Research Fund has drawn regarding physical activity and cancer risk.

Here's the bottom line - many of the same things that we know add-to and subtract-from our risk for injury and delayed healing, like exercise and healthy/low-inflammatory eating, add-to and subtract-from our risk for a major threat to our health, something we can never start too early.

Let those muscles burn today and generate a little lactate. Leave the food with the infinite shelf life right where it sits and pick something high in fiber and naturally low inflammatory. It won't take our risk to zero, but it can shift the odds in our favor.

Have a great weekend,


Mike E.

it's like a lift-gate, in your shirt

Sept 2

Although we don't write about it nearly as often as tactics to stay healthy or ways to improve physiological variables like cardiorespiratory fitness, strength, recovery rates, etc, a big part of our team's work is looking at human movement during particular tasks and finding ways to improve efficiency; broadly, the use of ergonomic principles. Whenever possible, reducing wasted energy, such as finding, based on a person's movement patterns, the easiest way to get a task done, is a worthy pursuit.

In some cases, when the task is highly intense or commonly performed, we might research the tools, mechanisms or materials that contribute to fatigue (for example, glove materials that have less stiffness and reduce the risk of forearm fatigue in our utility clients). In other cases, we might explore mechanisms that make a task more "doable" or enjoyable by a larger population (such as the use of an E-bike to lower barriers to physical activity). In still other cases, such as with traditional athletes, we might be looking for ways to give a competitive edge, such as exploring research related to shoe choice, energy return and running economy in sports like running.

In situations like these, even a "a little help" can go a long way:

- A slightly less stiff glove may keep the wearer below the fatigue threshold and therefore out of harm's way.

- A little bit of assistance from a lightweight motor might make cycling for transportation more enjoyable (and less sweaty) and encourage more people to do it.

- Improved running economy of +/- 3% over the course of a marathon can make a real difference in performance.

So what if these assists were available all the time? Would there be less injuries? Would there be a greater likelihood that more people would engage in physically demanding efforts? Would performance improve overall? It looks like a team at Rice University is betting the answer to at least 1 (and maybe all three) is a strong "Yes". In a recent paper (with accompanying videos) they describe a method for embedding mini-assists into the clothing we wear. Can you imagine a shirt that interprets your movement as "intending to lift your arm" and then helps you do so? They did....and built it.

Of course, it's very early on, and I'm not sure robot-clothes are higher on my list of cool gadgets than a Jetson Car just yet, but there are many possibilities that can make heavy tasks safer and more efficient here, so we'll definitely keep watching for ergo-clothes to hit the market.

Have a great weekend,


Mike E.

plugging the leaks with tea time

Aug 26

The double edged sword of inflammation continues to play a headline role in health. Without a strong-enough inflammation response we couldn't fight off the little "bugs" we come into contact with everyday and something as simple as the common cold might be life-threatening. On the other hand, and far more common due to lifestyles and eating patterns that have been linked with it, when baseline inflammation is high enough that it is always "on" - referred to as chronic low grade inflammation - we experience an increased risk of developing a variety of conditions. With that in mind, finding simple and effective ways to keep inflammation in check can have a range of benefits from helping our tendons heal when they get overdone to to keeping our minds sharp and focused in a chaotic world. What if it were as simple as a few cups of green tea each day?

When combined with stretching, as we've previously mentioned, a compound in green-tea (Gallic Acid) seems to regrow cartilage and improve the health of our joints and when consumed regularly our risk for a variety of cancers gets lower...but that's not all. Green tea has antimicrobial properties that, as shown in this new study from a team at The Ohio State University, appear to hold the potential to rebalance the gut, tighten up leaky cellular junctions (an irritant to our system which stimulates inflammation) and help individuals who are at risk of diabetes to improve blood sugar control over a 4 week period.

We probably shouldn't expect it take the place of some of the most powerful levers we have at controlling inflammation and improving health (exercise, healthy eating and sleep for example), but the pile of evidence that supports green tea continues to grow, so making more time for tea time makes a lot of sense.

Have a great weekend,


Mike E.

first focus on frequency

Aug 19


If you want to improve strength and fitness, which is of course critical to our health now and into the future, it's not super complicated; "just" increasingly load the working tissues using a progression of movements that, when applied at the proper speed, produce the desired outcome. OK, that actually does seem a bit complicated. Now, in fairness, there IS a little more to it than the immortalized tactic of this Planet Fitness strongman, but for those of us who lean more toward "health and quality of life" than the "elite athlete" - it really can be a simple process and it may have just gotten even less time consuming.

First, let's start with a few critical concepts:

"Volume" - which has long been considered the best way to quantify exercise, is made up of 3 key components. Similar to how length, width and height are multiplied to determine the volume of a rectangular container, we consider how often we load the body (Frequency), how much effort is required (Intensity) and how long we are exposed to the load (Time/duration). We use the acronym F.I.T. to make it easy to remember.

"Type" - which, in general, can be considered "how" we apply the loads to achieve the desired volume, includes things like the chosen resistance (body weight vs. external resistance such as weights vs. bands or medicine balls, etc), the particular movement patterns and the desired speed at which we move the resistance through space. When combined, this now updated acronym (F.I.T.T.) acts as the backbone of almost all traditional training plans and not surprisingly, there is a deep well of research that considers which combinations yield the best results for any given training goal.

But what about the "every person" - the human who understands that maintaining tissue strength and flexibility via movement practice is critical to future health - but desires to commit the least possible time in training (aka those of us who "don't have time to exercise") and therefore prize efficiency? Well, so says new research by a team in Japan and Australia, we are best to start at the beginning....and prioritize the "F"....to first, focus on frequency.

In their study, in an effort to test the assumption that equal training volumes produce equal results regardless of how they are achieved, they compared different combinations of Frequency and Time, leaving Intensity and Type constant. One group of participants exercised a little (6 repetitions) on an infrequent basis (only 1 time per week). A second group exercised a little (the same 6 repetitions) on a more frequent basis (5 days per week, for a total volume of 30 max effort reps) and a third group achieved the full volume (30 max effort reps) on an infrequent basis (one time per week). The different combinations produced different results over a 4 week period.

Least surprisingly, the group who did a little bit on an infrequent basis didn't gain strength. HOWEVER, they didn't lose strength either - possibly adding to other research which says weekly efforts can prevent decline (i.e. maintain) certain aspects of fitness. So if nothing else, a little something at least weekly, can slow the effects of aging, sedentary lifestyle or periods of time when more regular efforts aren't possible.

What was surprising however, was the significant difference between the two higher volume groups, despite the fact that they performed identical volume per week. While the once-weekly (high rep) group showed some improvement in muscular thickness (i.e. how the muscle looked), they didn't experience any significant strength gains. On the other hand, the higher frequency (relatively low rep) group improved strength +/- 10% in all 3 critical muscle modes: while being elongated (eccentric), while contracting (concentric) and while holding steady (isometric). A little bit done regularly worked.

To put this in perspective, using 4 exercises to achieve a "whole-body" workout (Squat, Overhead Press, Pull Up and Deadlift) and performing each x6 reps (for a total of 24 reps), in my very unscientific test (I timed myself), a "minimalist workout" took less than 1 minute per exercise and 1.5 minutes of setup time for a grand total of 5 min and 3 seconds.

If we boil it all the way down, maybe Will Durant's famous quote (summarizing Aristotle) with a little substitution applies here too - "We are what we repeatedly do. Excellence Strength, then, is not an act, but a habit." - I'll let you know in 4 weeks how it turns out.

Have a great weekend,


Mike E.

something is way better than nothing... for fuel too

Aug 12

A few weeks ago we mentioned a study (another in the long list) which showed that physical activity is one of our most potent disease-prevention tactics and that there was a fairly clear dose-response relationship, where "more" is generally "better". Yet, also tucked into the findings was one of the most consistent and powerful details - physical activity has a strong front-end benefit - meaning, we get a LOT of the risk-reduction in the very first few minutes of invested time; as much as a 10% risk reduction in the first 60 seconds done with consistency. Yes, compared to those who do nothing, even 1 minute per day can give a positive return on the time and effort invested.

Some past research has shown a similar concept when it comes to eating habits. When people with predominantly highly processed diets begin on healthier food, even a little, their bodies start to reconfigure the microbiome (bacteria and other microbes in the intestine, etc) to produce more healthy reactions almost instantly. It's one of the reasons why we so frequently coach clients to "eat more plants", to take full advantage of the significant front-end benefits of fiber as a "prebiotic". Although mostly indigestible, it acts as a critical FUEL for the good-bacteria in our gut and ushers a cascade of healthy reactions as soon as we add it to the mix.

But what about those of us who may have a harder time getting started? Maybe those who see the inertia of dietary change as a daunting uphill climb that feels like giving up food-favorites or treats that are closer to the elusive "golden-ratio" of salt-sugar-fat known to strike the bliss-chord in our brains? Or maybe those of us who just don't know where to begin when it comes to fresh fruits and veggies? In these cases, the conclusions of 2 new studies from a team at Duke University out this week, may provide a starting point:

Conclusion 1: For individuals at the lowest end of the fiber-consumption spectrum, 3 different types of fermentable supplements (inulin, dextrin [Benefiber], and GOS [marketed as Bimuno]) all seemed to have a similar impact, almost immediately. This impact was not as significant for individuals who started with the highest baseline of plant consumption and (therefore) gut-diversity.

Conclusion 2: Our gut biome seems to have a memory (of sorts). So, not only do we get an almost instant impact when we put "good stuff" in, it gets easier and easier (we get more and more efficient) as we build toward consistency.

___________

If we distill it all the way down to its fundamentals, a lot like what we know about exercise, for those that are not already achieving the optimal pattern (eating lots of fiber-packed plant foods), just about ANYTHING is infinitely better than nothing...and the return on effort is almost instant.

It's a great time of year to reap the health benefits of a strong garden yield. Clearly the research says even a little can go a long way - so if you've got extra, consider sharing. It could be the start of something BIG like it was for this family 20 years ago. If you need inspiration, check out the photo above from our friends in the Bronx, NY!


Have a great weekend,


Mike E.

unraveling the brain-body back pain connection

Aug 5


Patient: "It hurts when I do this (moves arm) doc"

Doctor: "don't do that then"

It's the classic doctor-patient meme, a one-liner originally attributed to comedian Henny Youngman, but the more we learn, the more it seems to capture how a critical component of common and long-lasting aches and pains might go astray; the complex two way street of the nervous system and its many brain-body connections that produce human movement.

In the last 100 years our understanding of human movement has progressed by leaps and bounds. We have moved from the purely mechanical components - the levers and pulleys of muscles pulling on bones to move them at joints - to the contributions of living tissue and the many "little things" that help them to stay healthy, perform near their best and recover well enough to repeat the feat each next day for a lifetime. In the last 10 years another major contribution has come to light; the wider lens of the whole-person and how their unique interactions with their environment, including their perceptions, beliefs and previous experiences (context) impacts their movement, pain and recovery.

It sounds super complex and at some level it is but it's not uncommon. Say for example we over-do some weekend-warrior chores or have gotten to an age as an athlete where our mind thinks we still "can" but our body is less sure (so I'm told ) and we enter into the somewhat grey area of something that "hurts" but is not "harmed", that is, we experience some level of discomfort or pain, but no signs of injury so we try to ignore it, maybe with a little hitch in our movement patterns to minimize the irritation until things get back to normal. Not only is this a natural instinct, but it usually serves us well by giving the area a relative break and allowing it to calm down so we can get back to normal movement and life-as-usual.

But what if we've had this discomfort once or twice in the past and it was intense enough that it left us a little scared to go through it again? What if someone we cared about had something similar that turned out to be longer-lasting and it worried us? Could our unique context and history cause us to respond differently, maybe in a more exaggerated way? If so, could this have more pronounced effects on how we move and therefore (in an ironic twist) actually INCREASE our odds for future and worse episodes of the exact discomfort we're trying to avoid? If so, it would seem that deliberate efforts to restore normal movement patterns and the brain-body connections in the central nervous system that produce them, might actually improve things more fully than an isolated approach to reduce local discomfort. That is, when we retrain a body to move like it "should", we might also retrain the brain's expectations and baseline "settings"...and, so says some new research out of Australia, when it comes to chronic lower back pain, improve healing.

Specifically, the new approach focuses on helping people who suffer with chronic lower back pain (typically defined as lasting >90 days) to achieve 3 goals:

(1) to understand the latest and best information about the causes of chronic lower back pain (and debunk a bunch of outdated and disproven scary stories)

(2) reintegrate the way the brain and back communicate with each other

(3) gradually retrain the brain to reset its "pain radar" and the body to resume normal movement.

Of course, as a first-of-its-kind study, this is just the beginning of a conversation, but, based on everything we know about the impact of movement on health and quality of life, it makes total sense - the way we move plays a major role in how we experience the world. Maintaining, protecting, strengthening and occasionally restoring it when needed is critical to making sure it's a great experience.

If you've had back pain that has lasted for a while and maybe even has you moving differently than you think you should, feel free to reply back and we'll start a conversation to sort it out. Keep moving...well.


Have a great weekend,


Mike E.

What To Do About the Kids?

July 29


In 2018 I read a report that made me pause - it outlined why poor health in US youth could be considered a national security threat and specified that the majority of teens in all states (and as many as 3 of every 4 in some) would be ineligible for service in the military due to poor health and fitness. It went on to quote stats and studies that seemed alarming if not outright unbelievable - such as one study which found "72 percent more medical evacuations from Iraq and Afghanistan for stress fractures, serious sprains, and other similar injuries— injuries associated with poor fitness and nutrition—than for combat wounds". Since that time, I have been trying to keep up with various threads in this story in hopes that there might be clues that can help our clients keep their families on the right side of the risk curve.


In truth, the story line hasn't brightened all that much. The CDC says that 75% of children ages 6-17 are NOT getting at least (the recommended) 60 minutes of physical activity per day and out this week, a new consensus statement from the European Society of Cardiology says that unhealthy lifestyle is the root-cause of as many as 9 of every 10 cases of high blood pressure in youth. Unfortunately it doesn't end with heart health. Consistent with much of the research that helped Canada arrive at its 24 hour movement guidelines which shows a connection to mental health, an Australian study out this week showed that rates of physical activity in children aged 7-15 in 1985 predicted cognitive decline at midlife 30 years later. At the same time, another 30 year study of 100,000+ adults, added more evidence that the recommended "150 or more minutes per week of physical activity" cuts risk by 20% or more. In the simplest terms - it is a global problem with dire consequences but also a largely preventable one with a time-tested and well proven solution.


So how do we get our families, friends and communities to MOVE and ensure the viability of our future military, workforce and leaders in the process? This is the $120B per year question (one estimate of the preventable portion spent each year on health care).


Although there doesn't seem to be a clear answer that works across all scenarios, it does seem two themes are emerging - (1) tools that help us track and understand our patterns and how they are impacting our physiology help (as much as 40 min per day) and (2) taking down social barriers not only where we live but where we learn and play can make it easier for individuals (teens included) to actually DO what we know is important and healthy - that is, when we make the healthy choice the easy (or fun) choice, people are more apt to do it.


It is easy to be sedentary and so we are. One of the greatest ways to protect the health of our future is to make it easy to MOVE...and if you have children or teens in your life, there's no better time to start than now.


Have a great weekend,


Mike E.

defining "health" - Finale, part 3

July 22

4 things to do (or avoid), 4 things to monitor. 8 essential components of cardiovascular health. It's simple but not necessarily easy.

Starting a few weeks back we decided to dive into the American Heart Association's (AHA) "Essential 8", those simple but not easy 8 things that if we do/avoid and monitor/control can increase our odds of good cardiovascular health dramatically.

We talked about the 4 behaviors: maintaining a healthy diet (they place the components of the Mediterranean diet at the top), getting adequate physical activity, avoiding nicotine and getting enough sleep and we talked about the first two of 4 health indicators, body mass index as a proxy for obesity and "non-HDL cholesterol" as an indicator of excess fat in the blood. The remaining 2 indicators or "health factors" as they refer to them include "Blood Glucose" (blood sugar) and "Blood Pressure" - which, like the first two are likely to have reasonable familiarity for most people - seem simple enough.

When it comes to blood sugar, give yourself 100 points if you have no history of diabetes AND are less than 100 mg/dL on a fasting fingerstick test. Give yourself 60 if you have no diabetes history but have elevated sugar (100-125), which is considered "prediabetes", 40 points if you have diabetes but it's well controlled (HbA1c 5.7-6.4), and fewer and fewer points as HbA1c (a marker of longer term blood sugar) goes up.

For blood pressure, give yourself 100 points if you are consistently less than 120 mmHg systolic (top number) AND less than 80 mmHg diastolic (bottom number), 75 points if you have elevated systolic only (120-129 over less than 80), 50 points if you have stage 1 hypertension (130-139 over 80-89), 25 points if you are 140-159 over 90-99 and 0 if you are 160 or higher mmHg systolic or 100 or higher mmHg diastolic. Subtract 20 points from your score if you are on medication.

As we mentioned last week, that last sentence above ("subtract 20 if you are on medication") is important as it subtly acknowledges that in most cases the second 4 act as a "dashboard" or "scorecard" of how well we are doing with the first 4 and that although achieving good numbers via medication IS positive, it's not as powerful for our health as doing so through healthy lifestyle whenever possible.

So where does this leave us? Hopefully curious of what our 0 to 100 score is. It really is a simple and powerful way to know where any of us stand. If so, but manually scoring each item seems tricky, there's good news - the AHA has made a surprisingly fast and simple survey/calculator available for free.

Go to "my life check" at THIS WEBSITE, create an account and password (so you can trend your results over time), answer a few questions, and voila, your 0-100 score will be calculated, along with some suggested areas for improvement if you come up "human" (less than a perfect 100 that is). You'll want recent blood work and/or physical results handy to get the most out of it (to answer the last questions).

We hope you give it a try...and then keep working to MOVE-FUEL-RECOVER-ENDURE and CONNECT your way to the best health and highest possible quality of life.

Have a great weekend,

Mike E.

defining "health" - part 2

July 15

When you look closer at the American Heart Association's (AHA) Essential 8, one of the first things that might jump off the page is that there are really 2 sub-categories, each with 4 items. The first 4 are "behaviors" - actionable things we should either do or avoid. The next 4 are closer to "indicators"; real-time measurements or status checks which the AHA labels "health factors". This is important to differentiate because, as has become fairly conclusive over the years, the first 4 DRIVE the second 4, meaning (at some level) if we really focus on getting the first four right, in many (if not most) cases, the second 4 will take care of themselves.

However, and perhaps as a nod to the fact that very few people succeed in maintaining a comprehensive healthy lifestyle (e.g. estimated as few as 3 out of 100 in 2016), the AHA includes 4 health factors that can provide additional insight. Today we review 2 of each.

When it comes to health behaviors, we agree that numbers 3 and the newly added number 4 are heavy hitters.

Nicotine Exposure (number 3) includes the self-reported use of cigarettes or other inhaled nicotine (vaping, etc) and, like diet and physical activity (profiled last week), falls on a 0 to 100 scoring range. Non-smokers (meaning never smoked) get the full 100 points and on the far end of the other range, current smokers get a 0. If a former smoker, the longer you quit the better the impact on your health and therefore points. Quitting less than 1 year ago = 25 points, 1-5 yrs = 50 and at least 5 yrs = 75.

Sleep Health was added this year - taking the "Simple 7" to the "Essential 8". Although there are MANY ways to slice/dice "good" sleep (restlessness, efficiency, time spent in each stage, restfulness, etc), they have opted for one that is most simple to measure, and perhaps the most obvious: sleep duration. It's been pretty well established that sleeping between 6-10 hours per night is a good target, with 7-9 the desired bull's eye. AHA stayed consistent with this, giving those who typically sleep 7-9 hours the max points (100), slightly less for more with 9-10 hours = 90 points, fewer points for fewer than target (6-7 hrs = 70 points), and those who fall closer to the extremes of under or over-rested even fewer: 5-6 or >10 hrs = 40 points. Those who are chronically under-rested get the lowest points with 4-5 hours = 20 points and less than 4 hrs = 0 points. We think it's great (and maybe about time) that AHA has formally recognized sleep as integral to health. It's been on their radar for a long time, but this makes it official and, with any luck, will continue to push the conversation that lack of sleep is not a badge of toughness (as was once touted) but a march toward predictable health decline.

And now onto the health factors, which sadly, continue to be a major warning sign for the American public, with less than 7 in 100 at the lowest risk by recent estimates of similar factors.

Body Mass Index, which as most know is a ratio of mass to height (kg/m2), relates closely to excess body fat (adiposity) and as a metric that is very easy to calculate in large numbers of people, continues to make the list coming in at number 5 of 8. Unfortunately as recent research shows, this factor also continues to be a significant struggle for many Americans with as many as 42 of every 100 in the category of obesity (BMI > 30). As noted in research at BYU, a particularly high risk of weight gain exists between the ages of 20 and 40 years old so early adulthood (and the years prior) are critically important to future health. Individuals score 100 points if their BMI is <25, 70 if between 25 and 29.9, 30 points if between 30 and 34.9, 15 if between 35 and 39.9 and 0 points if they have a BMI >40.

The second of four health factors (and last to discuss this week) are "blood lipids", which broadly gets categorized under "cholesterol". Although we have to read the fine print to get to the current definition, there are a few key details that might get missed by some. First is that the AHA has settled on "non-HDL" as the key factor, meaning total cholesterol minus HDL ("good") cholesterol. This is important because it gets at the fact that not all cholesterol is bad AND that, like most things in the body, the balance matters. The other key factor here is found in a single line in the scoring index "If drug-treated level, subtract 20 points" - which makes it clear that AHA believes achieving a desirable level via medication is at least 20% less-good as maintaining healthy numbers via healthy lifestyle. This is not AT ALL to throw a wet-blanket on the nearly 4 in 10 Americans who take (or might benefit from) cholesterol lowering medication, but rather to draw attention to the fact that, like many approaches, this one is treatment but not cure.

Next week we'll wrap up this mini-series with numbers 7 and 8, along with a way to quickly calculate our own score to see if we make the "Top 20" by scoring > 80 points, something only 1 in 5 (20%) of Americans can claim.

To be continued...

Have a great weekend,

Mike E.

defining "health"

July 8

It's the kind of thing that we think we know when we see it (or feel it). If you ask people to rate the most important things in their life it's often near the top of the list. There are timeless quotes that suggest it is the most important asset we have or can accrue and according to Merriam-Webster it is defined as "a condition in which someone or something is thriving or doing well : WELL-BEING" - but when it comes to the details, the level that allows for measuring it, we are faced with a tricky endeavor because it has physical, mental, social, financial and even metaphysical (or perhaps spiritual) component parts. It is influenced not only by our present actions and personal experiences, but like the formation of a riverbed, grooved and etched by the choices made and circumstances lived by family members from generations past; people we have never met. In something that resembles a "mushy middle", enjoying good "health" is simple to understand when we zoom way out (we know it when we see it) or way in (the formula to achieve it, if consistently applied is pretty straight forward), it gets complex as we get toward the "gooey center" of what it actually means.

The American Heart Association, over the course of its nearly 100 years, has tried. With an expected emphasis on Cardiovascular Health (CVH) it has helped to decipher many specifics on what it means to be healthy. Although never perfect and always evolving, they have contributed heaps and continue to do so. This month, the group published newly refined guidance on how to define CVH and, tucked into an article in their scientific journal, explained how to score our own health. They call it "Life's Essential 8", which refers to the 8 measurable factors that they suggest lie at the roots, and provide a reasonably easy to follow 0-100 scoring system for each.

With that in mind, over the next 3 weeks we will break down the "Essential 8" and provide both the scoring mechanism and some insights that you might not otherwise get if you only read the headline. This week we'll cover the first 2: FUEL and MOVE...or as the AHA calls them Diet and Physical Activity respectively.

Take a look at the descriptions below and start to estimate your score.

Essential number 1 is Diet. On near-continuous and ever-detailed review of the literature, the AHA agrees with US News & World Report who ranks the DASH and Mediterranean diets as the top diets for health. AHA believes that at the individual level, the modified Mediterranean Eating Pattern for Americans (MEPA) scoring, where a 1 point is given for each of 16 areas and a higher score is better, is the best way to assess diet quality.

Generally speaking, the MEPA gives points for including/increasing the consumption of olive oil, leafy greens, other veggies, berries, fruit, nuts/seeds, beans and fish (as the preferred animal-based protein source). It also gives points for (as compared to the standard American diet) reduced consumption of red-meat, chicken, sweets and processed foods while moderate consumption of dairy products (cheese/butter) and alcohol as depicted on a Mediterranean Diet food pyramid here is acceptable. Those who score the max points on the MEPA (15-16) get the full 100 points on the AHA Essential 8 with reductions in points as MEPA scores fall (12-14 on MEPA = 80 on AHA8, 8-11 = 50, 4-7 = 25, <3 = 0 points).

Category 2 is Physical Activity; specifically the number of moderate (or greater) intensity minutes of physical activity per week, where 150 or more minutes at a heart rate of >50% of maximum (loosely defined as 220-age) gets the full 100 AHA8 points. As moderate-minutes fall, so do points: 120-149 minutes = 90 points, 90-119 = 80, 60-89 = 60, 30-59 = 40, 1-29 = 20 and 0 minutes = 0 points.

One insight worth noting is that even ONE MINUTE of physical activity gives 20% of the benefit (20 points). This is one way that the AHA speaks to something we point out whenever we can - some physical activity (any!) is WAY better than nothing.

There's more to come on this story. We'll outline the remaining 6 over the next 2 weeks. But for now, the takeaway should be pretty clear: According to the latest guidance from the American Heart Association, ELEMENTS 1 and 2 (MOVE & FUEL) account for as much as 25% of cardiovascular health and are critical ways to combat the risks of the number one killer in America. Big rocks.

Get out there and break a sweat today. Even better if it's while picking fresh stuff from the garden for eating later!

Have a great weekend,

Mike E.

A Steady Future in Only 10 Seconds

July 1

Steve Jobs, the famed founder of Apple, once said "Simple can be harder than complex: You have to work hard to get your thinking clean to make it simple. But it’s worth it in the end because once you get there, you can move mountains."

It's one of my favorite ideas because it gets at a critical concept; if we do the hard work of finding the simple truths that help explain the complex world around us, we can overcome some of the greatest challenges we face. At Pro-Activity, finding simple explanations (and ultimately solutions) to the many complex risks our clients face is at the heart of what we do. Whether it is the traditional athlete who is trying to train his/her body and mind to perform at a higher level of competition or an "industrial athlete" who is looking to maintain a high enough level performance to turn a career into a long and healthy retirement, it is often the simple, pertinent and replicable items that become pillars of the best plans.

In a sense, this is where our focus on finding the ELEMENTS of Human Flourishing came from. Like the periodic table in chemistry, we believe that there must be simple ways to explain the highly complex components which go into being "healthy", living the highest possible quality of life and that they are worth searching out. If you've been following along for a bit you've undoubtedly heard us review simple concepts that tell us a lot like "the ability to get down and back up from the floor without using our hands predicts longevity" or "the ability to climb 4 flights of stairs in less than a minute can tell us about our heart health". They make it to our favorite list because they show how simple it really can be and, in these cases, how our movement capabilities consistently predict our future health.

This month, a global team of researchers published some data which reinforced another great one that we use now and again. It takes only 10 seconds to perform, goes after one of the leading causes of death worldwide (falls) and proved effective from a prediction perspective.

Wondering what it could be?

Well, simple enough, it's the ability to stand one 1 foot for 10 seconds. Yep, 10 seconds on either side, just that simple.

The team tracked 1700 individuals from 2008 to 2020 and found that the inability to stand on one foot for at least 10 seconds mathematically predicted those who would die during the study period. After the age of 50 the inability to do so on either foot doubled about every five years with a significant drop-off around 60 years old and less than 1/2 of 70+ year olds in the study group able to do so.

Find a safe place (with something to hold onto if needed) and give it a try. If it doesn't go as well as you think it should, the best time to start working on it is now! Let us know if you need ideas.

If you are celebrating Independence Day with a long weekend, we hope it's a great one. Thank you to all of those working hard to preserve the freedoms that we've enjoyed since then.

Have a great weekend,

Mike E.

There's a Hole in the Bucket (Revisited)

June 24

It was roughly 10 AM and I had to get "across town". It sounds so simple - travel 4 to 6 miles (depending on your route) in roughly a straight line. For a decently large portion of the world, it could probably be done in 35 minutes or less depending on which form of human power was employed (on foot, by bike, etc). Yet, for those of us who've had the pleasure, we know that on most days of the week, getting across Manhattan takes about the same amount of time by car. Why?

We often use the example of an overflowing bucket to explain the same phenomenon - getting beyond the threshold capacity of a given system - or in our case, a system of systems (aka the working body). We use the analogy of a bucket, a finite container that can only handle so much, with a hole in the bottom that acts as a drain. Although slightly oversimplified, if we put too much in and overflow before the drain can clear the contents, we experience illness, injury and the difficulty or lack of ease (i.e. dis-ease) that goes with it. Like a sponge that can't absorb any more without dripping everywhere or a road system that simply has no additional room and begins to back up, each human has a threshold which, once it is surpassed, results in problems until it can recover (drain) on the short term and hopefully adapt (grow the capacity) on the longer term.

This week researchers from the University of Southern California confirmed this concept and showed, as it relates to accelerated aging, that is, getting age-related diseases earlier than expected, our immune system may be paying the price when the bucket overflows. They found that social stressors which occurred in adulthood, defined as "difficult or challenging circumstances that arise from social position and experience that are expected to be stressful" (e.g., daily hassles, life events, and chronic stressors) were connected to a decline of the immune system, even after they statistically controlled for race, age and sex. More specifically they found that those with "overflowing buckets" tended to have a higher percentage of "old immune cells" and lower percentage of "new immune cells".

However, for those of us who feel a little saturated, stuck in traffic or overflowing at times, all hope is not lost. Tucked away in the fine print was the silver lining - "Lifestyle factors [...] partially reduced these effects." - those who put time into exercise, eating well and being deliberate with recovery had better immune function, longer.

Although another promising mouse-study says we're closer to putting exercise into a pill than ever before, until then it's probably best to keep building the bucket through "MOVE, FUEL and RECOVER," so we don't have to mop up messes earlier than we should.

Have a great weekend,

Mike E.

taking the bite out of barking knees

June 17

A funny thing happened to me on my way through the pandemic - my knees started to ache. Not an injury per se as there was no incident that I could remember, just a pair of cranky knees, as if I had aged in place one night and woken up "old". At first I didn't think much of it but as it became consistent and I found myself feeling limited in one way or another (kneeling down was uncomfortable, changing positions was met with a "give me a second" sensation) I started to wonder if the "hard wear" of an active life had taken its toll on my hardware...specifically my joints. After all, I was right at the age when the incidence of arthritis begins to jump significantly, from 7% to nearly 30% in the US according to the CDC.

Then, around this time last year I decided to run a little experiment. Pandemic life had me sitting more than ever and so it was possible that, as bodies do, mine had adapted; in this case to a more stationary/sedentary life. After all, a year of significantly increased sitting time is plenty for soft tissues like muscles and tendons to stiffen and shorten enough for movement to become less free, joints to compress a little, and possibly even surface tissues like cartilage to become less resilient and more sensitive. I decided to spend each day of my vacation working on movement - long bouts of sustained stretching and lots of walking on varied terrain. If some version of soft-tissue adaptation was the source of my achy knees, I should see some improvement (even minimal), for the effort. Instead, I got almost immediate change and within a week, total resolution of symptoms.

This didn't come as a surprise, we've got countless studies showing that a regular and dedicated practice of varied movements (stretching, yoga, tai chi, etc) can have an amazing impact on health and quality of life, but it was a welcome relief.

Even in the last two weeks more studies have come up supporting these three themes:

1. Sedentary Time (as measured across 21 countries and more than 100,000 people for a decade or more), specifically sitting for >8 hours per day, is directly correlated with poorer health, increasing the risk of mortality by as much as 50% in some parts of the world and nearly 20% in ours.

2. Time spent moving (as measured in 1200+ people for 2 years), specifically walking, reduced the symptoms (pain) and progression (joint space narrowing) of knee osteoarthritis at/near midlife by 60% and 80% respectively.

3. Varied movements which require us to adapt to new challenges across muscle groups may have a particularly strong potential. Nordic walking, which features walking with the use of handheld poles, outperformed other forms of exercise (high intensity and moderate to vigorous continuous training) in a randomized trial which measured effects ranging from cardiovascular improvements to quality of life over a 12 week period.

Our knees can tell us a lot. Some studies suggest knee health predicts future health overall. If yours are barking, they may just need to go out for a walk.

Have a great weekend,

Mike E.

buyer beware - metabolism boosters

June 10

It's not the most common question we get but it's up there. "What do you think of _____?"...where the blank is filled in with the name of a particular supplement or vitamin; sometimes one that has recently made the news as being used by a famous athlete or performing artist. It's never an easy question to answer because given the space between regulations and oversight where vitamins and supplements "live" (i.e. not foods per se and not medications), there is a fair amount that can go wrong. Complicating it even further is the fact that history has several high profile scenarios when things have gone wrong enough to be noticed, tested and eventually recalled. The FDA currently lists 48 dietary supplements on their recall website, many containing undisclosed substances. In a study published in 2019 researchers linked nearly 1,000 adverse events to supplement use with the highest risk found in those which claimed to have muscle building and/or fat burning qualities (as much as 3 times the risk of more commonly used supplements like vitamins). With that in mind, we often find ourselves answering with caution, somewhere between trying to not discourage the intent of getting healthier, stronger, fitter, etc but also reiterating that given the relative ease to market and history of negative consequences, there is an almost automatic "warning" flag that goes up in our minds.

This week, unfortunately, the warning reaction gets even more support as a both naturally occurring (high fat diet) and synthetically derived (supplements such as Cardarine) substance sometimes touted as a "metabolism booster" has been linked to a particularly lethal form of cancer. In plain English - the substance worked; it did, in fact, boost energy utilization (metabolism). However, and this is where it gets more nuanced, it not only had the positive benefit of helping healthy cells to use energy, it also had the negative drawback of helping cancer cells in the pancreas use energy...and grow and replicate and become more serious, building on the same findings for other forms of cancer. Buyer Beware.

For me, the standard answer is usually something along the lines of: "I personally love the latitude to make my own choices when it comes to what I eat and what supplements I choose. However, knowing a bit about how easy it is to put something that hasn't been well-studied or quality-tested into my system, I look for either a long history of success with limited negative consequences or I stay away until enough time has passed for that history to be clear".

This is one of the reasons we steer clear of fad diets and promote simple and well established nutritional principles (like "eat more plants"). This is why, when it comes to getting a "metabolism boost" we recommend putting the "big rocks" in first like:

- adding some MOVE to daily life which gets the results at almost any dosage and has only positive side effects if done so thoughtfully, or:

- focusing on sleep at night and exploring a better scheme for rest between sets before taking potentially harmful substances for those trying to get an edge in the gym.

If it sounds too good to be true, it might actually be. This time the science says beware.

Have a great weekend,

Mike E.

endurance and motivation, from the gut!

June 3

"I've got a bad feeling about this".

If you like iconic movie quotes, this one should ring a bell. In fairness, it's rightfully overshadowed by other lines like "may the force be with you" and the ultimate mic-drop "no (Luke), I am your father" but, as outlined here, the "bad feeling" is a staple, even making a crossover leap into the Indiana Jones franchise in 2008. Whether we call it intuition or gut-feel, we've all felt it at one time or another - something deep inside, maybe in the "pit" of our stomach, that raises our awareness and, at some level, influences what we do next.

In a fascinating twist which we are only beginning to really understand, it turns out that the connection between the gut and the brain is not just a pathway but more like a superhighway with many lanes. Therefore, as outlined HERE seven years ago, what is in our gut (types of bacteria, etc) is likely to have a strong impact on our thinking, personality, how we socialize and even our response to stressful conditions. Recent research has connected this "gut brain axis" and negative alterations in gut-bacteria (called dysbiosis) to a variety of diseases and conditions spanning the life course. From Anxiety, Autism and Attention Deficit Disorder in the very early years to Alzheimer's disease much later on the connection has been widely seen (and these are only diseases and conditions starting with the letter "A").

But what about on the other end of the spectrum? Instead of looking at disease, what about performance and achievement? Could there be an "upside" link between our gut and behavior too? This is what a research team from the University of California, Riverside set out to determine by altering the bacteria makeup in mice bred for running endurance and high motivation to exercise, like the marathoners of the mouse world, as compared to more normal mice, like the "Average Joes" of the mouse world (an only slightly less iconic movie reference).

Amazingly, after a course of antibiotics (which is known to alter the gut biome in humans too), the marathoner-mice were less motivated to run and couldn't go as far, more than a 20% reduction from their baseline, a finding which persisted even after the antibiotics were stopped. Interestingly, the average-Joe mice were impacted to a lesser extent, causing the research team to conclude that the marathoner-mice must have had some advantage related to their baseline bacteria, such as better ability to turn food into muscle-energy or even increased motivation.

What does this mean for those of us who aren't mice?

While it's still too early to be conclusive, we can feel confident that the bacteria in/on/around our bodies has a major impact on our health - physical, mental, emotional and even social and quite possibly on our motivation and energy to MOVE, a key pillar of future health. With that in mind, how we care for the health and diversity of this bacteria (the foods we eat regularly, the medications we take and more) has a significant ripple effect worth being aware of. Since we know that healthy bacteria thrives when we eat healthy foods (especially dietary fiber), this is not only important anytime and always but especially after our gut health is challenged like after a course of antibiotics, during the summer heat and during periods when we might not get the healthy intake we otherwise would to rebuild the balance and diversity there.

If you're a Summer green thumb, I hope your garden is off to a great start - you might just be growing motivation and endurance.

Have a great weekend,

Mike E.

brain on the run

May 27

I recently saw a video clip of my Dad. He was doing what he loved. It didn't look exactly like the many times I had seen him do something similar, it was a little slower and a touch less steady maybe, but it was no less his joy - crossing the finish line in a running event. It's been almost a year since I said goodbye to the guy who taught me a ton about endurance (in both a running-related and non-running related sense) and it still seems unfair that a guy who so loved to run would find himself up against a condition which severely limits the brain-body motor pathways required to do so.

Not ironically, now on the days I get out for a jog or a run alongside the youth-athletes I coach, I have found myself feeling especially good. In addition to benefitting from any of the well known effects of physical activity, I try to keep in mind what a gift the ability to MOVE freely really is. From the simplest dynamic warm-up to any number of more regimented training plans, the long-known "irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases" is something worth putting on our side. Of course, the quick and reliable mood lift and the more recent but no less clear links to academic achievement (examples here and here) for our kids are no less important; truly, there's a lot to like about any regular movement habit we can build into our day.

However, it seems there might be something particularly special about running. Late last year a research team noted significant results in brain and nervous system function in only 10 minutes when they tested moderate intensity running (50% intensity) against a variety of the same brain function tests of the sedentary controls. Then, only a few weeks ago another team reported impressive increases in brain-chemicals related not only to happiness and good mood but also brain and nervous system repair when they studied running in non-human (mice) subjects as compared to their sedentary counterparts.

The benefits are impressive and seem to just keep getting better. With any luck we will see proof-positive of the same effects in people as were recently reported in mice which would add another important lever available as we try to stay on the right side of the risks we face. It'd be great if was as simple as putting one foot in front of the other over and over again...seems like it could be.

Get out and test the theory soon.

Have a great, long weekend,

Mike E.

when the sweet of warmth becomes the sour of heat

May 20

With a growing pile of home projects and a few outdoor "kid-chasing" events planned for the weekend I made and almost involuntary "ooof" sound as I pulled up the weather app on my phone. Temperatures jumping from mid 70's to mid 90's in 24 hours. Ah yes, "Spring-time" in NJ. Of course this is not a complaint about the weather - I wouldn't dare. I'd much rather have heat than cold. At least, that's the story I tell myself this early on in the season, before things get really oppressive because, compared to other species, we humans are surprisingly good at functioning in the heat. In fact, some say it may be one of the greatest advantages we have allowing us to even win races on foot against horses. Whether we call it by its proper name (nonlinearity), what it looks like on paper ("U" shaped) or use terms more common to a children's book (Goldilocks phenomenon), some may be good but more is not necessarily better; we are rapidly approaching a time of year when our ability to manage body temperature can be a major difference in whether we perform at our best or struggle more than we need to. This is because cooling hard working tissues shows great promise.

For example, in a 2020 review, a research team from France outlined some of the negative impacts on performance in hot environments as well as restoration of function when certain cooling strategies were implemented.

More specifically these 3 key points are particularly important:

(1) Heat significantly impairs the ability to complete tasks lasting greater than a few minutes or in repeated efforts (e.g. multiple sets), even in elite athletes. Whether researchers measured it in power output, time to exhaustion or fitness testing (VO2Max), as the temperature went up, performance was impaired, somewhere in the range of 10-15% in most studies.

This speaks to why we advocate strongly for raising the fitness baseline before the heat really sets in. A 15% loss of a bigger-than-needed number may provide enough buffer to get by while we acclimatize, whereas 15% loss starting at a lower number may put us on the wrong side of risk.

(2) These losses are not only physical - our ability to concentrate, solve problems and perform cognitively demanding tasks also degrades as body temperature goes up. Specifically, research has demonstrated declines in working memory and errors in judgment and decision-making which of course can have major implications in higher risk or more complex environments.

(3) Cooling the system can make a significant impact. Although bigger differences were seen in "time to exhaustion" tests (up to 50% improvement in some cases), small improvements were also seen in absolute performance such as timed-events (3-9%), heavy muscular efforts (depending on the parameters and starting temperatures) and on cognitive performance.

However, it is important to note that not all cooling strategies yield the same results. Whole body cooling, such as jumping into a pool, may be the fastest but since the body is equipped with features that seem particularly well suited for heat management, it may not be necessary. For example, in the naturally hairless areas of the body such as the palms, soles of the feet and face "above the beard line", we have blood vessels that, when cooled, can lower body temperatures and increase physical performance. Other areas like the head/neck, which send information to the hypothalamus (the brain's "thermostat") can impact how cool we feel, and possibly help us to be more comfortable even in hot environments. Other areas like the chest have also been studied for the ability to quickly cool the system.

The take-away, and although especially true for individuals who do not work in temperature controlled environments, heat is an important risk and performance-limiter we face every year. Managing it better is a key strategy for staying healthy and safe as the temperatures climb. It takes some know-how, but it can be done.

For those who get our monthly webinar and educational resources, we will continue to dive into heat management as a critical preventative strategy.

Have a great weekend and stay cool, literally.


Mike E.

what's the latest on high blood pressure?

May 13

They call it the "silent killer" for a reason. Despite common beliefs related to symptoms like headache, blurred vision, etc (which might but doesn't always happen even in severe cases), most of the time the slow and steady harm is asymptomatic; we simply cannot feel it.

For as much as we might hear about high blood pressure (aka hypertension) given how common it is, affecting as many as 50% of American adults, most folks only partially understand what "it" is, why and when we should care and what we can do to stay on the right side of risk or get back there if need be.

First, the basics, admittedly oversimplified - we are made of soft/flexible pipes.

The human body is under constant pressure. Not of the "stress" variety (although that could be), but rather physical forces acting on us. Gravity is of course the most obvious, but since we are essentially built to be a mostly closed canister, every time we move, cough, strain or sneeze - the force on our tissues and organs changes. Since this is the case, we are built with a pressurized system to make sure blood and nutrients get where we want it to go uninterrupted under various conditions; that is, hoses don't get easily crimped.

According to American College of Cardiology guidelines, the pressure required at complete rest is less than 80 millimeters of Mercury (abbreviated mmHg, the common unit of pressure) to keep the pipes open - this happens during "diastole" when the heart is refilling with blood and is the second (typically lower) of the 2 numbers we get in a blood pressure number. Since this happens during "diastole", we call it "diastolic" blood pressure. The "top number" (usually larger), called "systolic" and best if less than 120 mmHg, refers to the temporary spike in pressure that happens when the heart forcefully contracts to push blood all the way through the pipes to the end reaches of our system (fingers and toes).

But what happens if we need more pressure to keep the pipes open and blood flowing than is healthy? This is where "hypertension" (abbreviated HTN and referring to higher than normal pressure) comes in. Since our vessels are soft & flexible, when the pressure on the inside gets too high it can damage the inner lining, causing our bodies to attempt a repair before more serious harm is done. If this is a one time small event, like many things that challenge us, the repair is made and we go about our business. If, however, we get a micro-injury 60-80 times per minute (every time the heart beats and spikes a pressure), it doesn't take long before we are in a constant state of inflammation and doing irreparable harm.

This is oversimplifying very complex physiology, but, with any luck, these basics can give us a nudge to answer the following questions - and keep us on a healthy track:

1 - What is my blood pressure? This can be read at any number of free kiosks in many pharmacies. HOWEVER, if the numbers seem odd, it's best to rest a full 3-5 minutes and retake. Even if they come up higher than seems right, it's also best to NOT just write it off as inaccurate (they sometimes are) but rather find someone who can get you a better (more accurate) reading. This can include our team! Reply back to this email and we can get the convo going ANY TIME.

2 - What specifically drives high blood pressure? As many people know and have felt, physical/mental/social/emotional loads (aka "stress") can rev us up, tire us out and increase our blood pressure as a result. This of course is not the only thing, but it's real. Other important drivers include inadequate sleep (quality, quantity or both), high-inflammatory diets and/or low fiber diets and, on the other end of the spectrum from over-stressing our system, under-stressing our systems by not getting enough physical activity or having poor fitness.

3. How can I make it better? In addition to more medically oriented treatment (medication), a variety of more conservative approaches can yield good results. Although high-level it's probably reasonable to simply say "the opposite of what was listed above", more specifically - achieving a standard sleep/wake cycle, consuming more plants and the healthy compounds they are packed with (fiber, antioxidants, poly-phenols, etc) and getting out there and breaking a sweat with leisure time physical activity (considered a "first line treatment" in an American Heart Association scientific statement, a benefit that has also been seen in children), these get even better when combined. For example, eating 7 servings of fruit/veggies a day and getting adequate physical activity can cut the risk of high blood pressure IN HALF.

None of this makes blood pressure management easy. Preventing Hypertension takes a good plan and effort. But in many (and perhaps even most) cases, it can be done.

As we draw nearer and nearer to the Summer, now is a fantastic time to pause, get a reading and have a plan. We can help.

Have a great weekend,


Mike E.

was dr. evans right?

May 6

At around 8 minutes and 50 seconds into a video that is slightly longer than 9 minutes Dr. Mike Evans, a physician who originally practiced in Toronto, asks the viewer a simple (but loaded) question: "do you think you can limit your sleeping and sitting to only 23 1/2 hours per day?". The message seems so clear: if we invest +/- 2% of our day getting out of our chairs and instead do what we're built for (movement), we can get the return of significant health and quality of life gains.

That was 10 years and 6 million views ago. Since that time thousands of studies have taken aim at this and related claims around physical activity. Some of the studies monitored trends in the population, others worked to refine broad messaging that works and a few worked to dial in the proper dose, attempting to answer questions like "is 10,000 steps per day arbitrary or actually enough?" and "what is the actual threshold (step count) of a 'sedentary lifestyle'?". Yet, even with all of that, the central themes - "we likely sit too much" and "more movement would be a good thing for most" have remained.

Which gets us back to the question - was Dr. Evans right? Is 30 minutes per day enough to help us stave off disease? Could it be as simple as "save your health by investing in 30 minutes FOR (and in) your health?"

In short: Yes and No.

Yes - the 30 minutes x 5 days per week (150 minutes of moderate physical activity per week) dose is incredibly well established and reproducible for a variety of diseases and risks.

And No - a moderately intense 30 x 5 is not the only combination that works. More moderate minutes (say that fast!) might be better, especially for men and a combination of a lower number of minutes performed at higher intensity, for example 75 minutes at high intensity, works quite well.

The good news is since the video, the Guidelines for Healthy Americans have explored these updates and adapted accordingly.

The even better news which came out this past week in a very recent randomized controlled trial (considered the pinnacle of research by many) is that getting otherwise sedentary people in their working years who were struggling with cardiometabolic disease (combined heart risks like high blood pressure and high cholesterol with poorly controlled blood sugar) to MOVE worked. 50 minutes per day of light physical activity (gentle walking mostly) slowed the progression of their disease in as little as 90 days.

There's nothing wrong with being still, but even a decade later the fact remains: we probably should limit it to only 23.5 hours per day. If we're getting less than 5,000 steps per day (as referenced in one of the studies linked above) or less than 120 minutes per week of moderate physical activity and more than 10 hours per day of sitting (as referenced in the most recent study), doing so can be especially powerful.

Have a great weekend,


Mike E.

get out there and eat better

Apr 29

I saw it again this past weekend. A big yellow school bus pulled into the parking lot next to the lush green athletic field and 30 or so high-schoolers from New York City piled off. The 35 mile bus ride westward doesn't sound that far really, but most people who've made the trip would probably agree that when starting from the Lincoln tunnel, it's far enough to see the transition from the city to the suburbs.

We have a "friendly-rivalry" with the team that piled off the bus. That is, my daughter's rugby club plays them often enough that (despite everyone on both sides definitely playing to win), it feels like more than that, like we've gotten to know each other beyond athletic attributes (fast, strong, aggressive, etc) and consider it a friendship. As is the culture of the sport, the athletes and parents often mingle after the game and this time, with the combination of a nearly perfect Spring day and in celebration of the graduating seniors, we hosted a barbecue, so most everyone lingered and enjoyed the day.

Open green spaces and room to run. Genuine connections with the people around you. A good meal and something to celebrate. We may not know all the details of how exactly, but we're learning, and it's pretty powerful. In fact, if you go to Google Scholar and search for "Forest Bathing" (the term often used for studying the effects of simply being in nature) there are more than 17,000 references...since 2018. One review suggests a wide variety of validated benefits including "remarkably improving cardiovascular function, hemodynamic indexes, neuroendocrine indexes, metabolic indexes, immunity and inflammatory indexes, antioxidant indexes, and electrophysiological indexes; significantly enhancing people’s emotional state, attitude, and feelings towards things, physical and psychological recovery, and adaptive behaviors; and obvious alleviation of anxiety and depression." Not bad. But it doesn't seem to end there. Earlier this month, from a team in Philadelphia, new research suggests that it may even help us improve our eating habits - nudging us toward healthier choices like "dietary diversity" and "greater fruit and vegetable intake".

It would be a bit of a leap to say that the post-match barbecue would qualify as dietarily diverse, heavy on fruits and veggies or even healthy. However, the smiles on the faces, athletes and supporters alike, are definitely proof-positive that getting "out there" with people you enjoy being with has the power to do good things. Whether it is something formal like a hike of mapped trails of the National Parks Service or some green space near home, it's a great time of year to pack some healthy snacks, get outside and take a little nature in.

Have a great weekend,


Mike E.

cancer stopping blood

Apr 22

Heart disease and Cancer. From an overall health-risk perspective, these are the two most ominous dark clouds that loom over the health of the US population and the world. Even COVID19, which has caused immense pain, suffering and loss, hasn't overshadowed their impact, coming in around 1/2 as deadly as cancer and 2/3rds less deadly as heart disease in early analyses of the leading causes of death in 2021 - about as clear a reason to do everything we can to find the tactics that can keep us outside of their path as there is.

If there is a silver lining, it may be in the fact that all 3 of the world's leading killers in 2021 (Heart Disease, Cancer and COVID19) along with various less lethal conditions share major risk factors. Shared risk of course means shared reward if we have strategies that work. With a risk lowering effect on as many as 7 different types of cancer, a well known impact on heart disease, the ability to strengthen our immune system and, as shown earlier this month, a powerful means to substantially cut our risk of depression even at relatively small doses, physical activity can be a very long lever.

Earlier this month, in a small but very cool experiment involving one of the more common and deadly forms of cancer, blood taken from previously sedentary subjects after 30 minutes of aerobic exercise (cycling) substantially reduced the replication of colon cancer cells. When the researchers explored the possible mechanisms, it was clear that a protein which muscles release after exercise is known to reduce inflammation (myokine IL6) and help with cellular repair was playing a significant role.

The American College of Sports Medicine says "Exercise Is Medicine". Although there's always more to learn, it certainly seems like the science this week agrees.

Summer will be here before you know it, it's a great time to get a MOVE on.

Have a great weekend,


Mike E.

a faulty flow sensor?

Apr 15

You don't have to be a plumber, pipefitter or water-system engineer to know that flow matters. Any kid who has ever performed the age-old rubber band around the finger "trick" or the once-popular "hold my breath until I get what I want" tactic knows that flow, whether it be something through a pipe, blood to a fingertip or breath to the body, is an important concept in daily life.

Of course, in today's data-centric world where we rely heavily on real-time data to make decisions we have a wide variety of flow sensors that help us out. Maybe you've had that annoying moment when an indicator on your car's dashboard turned out to be an "O2 sensor" or one of my personal favorites, the tripping of the sensor tucked into our fire-alarms that tells us that the flow of back up electricity is not keeping up...you know, the one which seems to know it's the middle of the night and a loud beep will really get your attention. It can't be only me :)

Humans also have flow sensors. In fact, one group of proteins called Piezo1 exists in our lungs, skin and in our capillaries, the tiniest blood vessels in the body. They are sensitive to changes in mechanical load (stretch/strain, etc) and they supply critical information as our bodies try to prepare and react to the challenges of the day. But what if the sensor stops working correctly? Do we have a warning light? Will the "engine" perform less efficiently?

Well, about one month ago, with an important contribution from researchers from the University of Leeds, we learned more. The team limited this protein in mice and then observed their activities and behaviors. What they found was very interesting - the mice couldn't run as long or as fast on their wheel. It wasn't a motivation thing, the mice attempted to run, they just didn't have the same capacity, as if moving was just harder.

According to the authors, the take home message is clear - if it feels harder to exercise after you've been sedentary for a while, it's likely because it IS. Without regular stimulation of these protein flow sensors (such as blood rushing with hard physical exertion and exercise), the blood vessels adapt and ultimately restrict the flow rate, the amount of blood that can easily pass through per minute...think of the slow pipe and/or rubber band trick at a much smaller scale.

Here's the good news - although a bit harder to get started than to keep going - the adaptation does happen in reverse. Moving regularly and hard enough to be slightly out of breath (but probably not gasping for air) can change flow dynamics temporarily, stimulate the sensors in the process and ultimately start the remodeling needed to allow blood to more easily flow on the longer term.

Now is a great time of year to make a MOVE to improve blood flow. It'll be hot before we know it if it's not already getting there. One of the most effective ways to get heat off the system relies on healthy vessels. A few weeks of effort now will go a very long way later. More to come for sure.

Have a great weekend,


Mike E.

pump up your recover

Apr 8

Think about your bedtime routine. Is there one? Does it happen at a certain time? Maybe it involves finally taking a minute to relax and enjoy a quiet moment to yourself. Are you a glass of wine or chamomile tea type? Are you a TV & doze off in the recliner or a strict bedtime type? Are you a "asleep before my head hits the pillow" or a "take a few minutes to process" type? Are you none of these ever or all of these on any given day type?

Of course, if the goal is to get to sleep quickly and get the most restful sleep, some strategies ARE better than others, as one of the world's experts on sleep, Matthew Walker, detailed in his TED Talk a couple years back. Up until recently however, one strategy was less widely discussed. This probably wasn't because it was unknown in the strictest sense. After all, the phenomenon had been seen in some well-controlled studies as far back as 25 years ago which may have prompted more researchers to study the connection.

As is often the case, as a base of small studies of specific populations began to grow, the phenomenon became more universally accepted and our understanding slowly got more specific. Then, in an even more refined study of an even larger group of people for an even longer period of time the results were more conclusive than ever: Resistance Exercise, that is muscle loading (and not necessarily aerobic exercise), improved sleep duration (time asleep), quality (deep and REM stages of sleep) and latency (how fast we fall asleep).

So, along with a fixed and routine bed/wake time, a cooler environment to sleep in, and severely limiting light to let the brain rest, if we are trying to improve our ability to RECOVER by improving our sleep, it may be time to consider walking away from the nap and toward the weights.

Have a great weekend,


Mike E.

the eyes have it: a connection between daylight and diabetes?

Apr 1

Humans are diurnal - the "up and moving" part of the 24 hour day is counterbalanced by a "rest" stage. For most, the sunlight of dawn is the natural cue to get going, while dusk signals our bodies to slow toward sleep. It doesn't always follow this pattern perfectly. For example, "Night owls" do exist; some by nature (genetic predisposition) and others by physiological-training, such as years of working at night and sleeping during the day. For most of us however, it is the rise and fall of the sun that we set our internal clocks by....natural light, in technical terms is our "zeitgeber".

But what if you can't follow the sun? What if your internal clock and the world around you are on different schedules?

This topic has been a source of debate for a long time. Daylight savings time, when the natural rhythm is thrown off to conserve hours of light, has often been referred to as one of largest and longest standing social experiments in US history. It has been linked with a variety of injury and health risks. However the debate has more recently heated up as congress considers making Daylight Savings Time permanent. The American Academy of Sleep Medicine disagrees with some of the approach, citing a variety of concerns and phenomena associated with these changes.

But what is really going on? Why, for one of the most adaptable creatures on the planet (us), is an hour here or there such a big deal? 2 new studies this week give us clues.

The "eyes" have it.

The human eye is amazing. Not only does it provide the large majority of the information we use to make the day to day decisions, it is a window directly into our central nervous system via the "hardwired" optic nerve. This means that when the sensors of the eye are turned "on" (stimulated), the brain revs up to deal with the information pouring in. Of course, it also stands to reason then that all of the systems that support the brain, including the energy management system known as "metabolism" must also be on. Although this may in part explain why sunlight is such a great cue to set our internal clocks by, it also says in places where some level of light is always on, such as more and more of the earth, the eye, brain and therefore entire human system has a hard time shutting down for rest.

In fact, as the first of two independent research papers pointed to this week, stimulating the sensors of the eye with even partial/low light for 1 night revs up the nervous system enough to reduce the body's ability to process blood sugar the next morning. Unfortunately if a pattern of interrupted sleep and subsequent metabolic changes is extended over the course of 2 weeks , as was the case in study 2, we will not only begin to crave significantly more protein and fat (as might be expected to keep the "machine running"), we will store it around the vital organs in the middle (visceral fat), the least healthy place to do so.

Protecting our future health includes but is not limited to eating right and exercising. One of the most straight forward ways to do so might just be to protect our bedtime and buy some blackout shades.

Have a great weekend,


Mike E.

so how'd we do this year?

March 25

So there it is, a 158 page deep dive into happiness as it stands today across the globe. As has been the case in each of the previous 9 years the report was issued, there are themes that just keep coming up and newer, very well evidenced, information that we can learn from. But before we do that, a quick disclaimer:

158 pages is A LOT to summarize in a few blog-minutes. With that in mind, we are only hitting on the high points and those that relate to the theme we've been discussing these few weeks - that health and happiness are inseparably connected, that the connection flows both ways (health influences happiness and happiness influences health) and, maybe most importantly, that a significant portion of what we experience as "happiness" is not only under our control but can be measured and therefore predicted.....which, once again brings us back to....Finland.

For those that have been reading for a while, we recognize that Finland seems to get special recognition and are maybe even put on a pedestal in this blog. After all, they are the champs...again. For those who don't know the story of their transformation here's the short version - they went from one of the unhealthiest countries on the planet in the 1970's (where men died of heart attack more commonly than any other place in the world, read more here) to not only one of the healthiest by the twenty-teens (e.g. 2013+) but one of the happiest by many measures (see pages 30-58) when the World Happiness Report first hit the presses in 2012. Then, like a sports dynasty, they just kept getting better, achieving an almost automatic top 10 ranking from 2012 to 2016, and then the top ranking every year from 2017 to the present. This hardly seems like a coincidence and is no doubt packed with lessons we can all benefit from, especially those of us from the US, where we've not managed to crack the top ten. This year, we have climbed back to 16, which is still below our highest score in recent years of 14.

So what can we learn from this year's report? What, if the last decade of research has taught us anything, must the Fins be doing right?

Here are three critical points:

1. It's in the genes and it's not. Chapter 5, starting around page 107 of the report, takes a dive into the biological basis for happiness to make a clear case that there IS a genetic component. That is, our genetic code does have an impact on our level of happiness. HOWEVER, it is most definitely NOT purely genetic. The authors reviewed several studies done on twins (some identical, others fraternal, some who grew up in the same environment, some that didn't) and determined that our genes appear to contribute about 40% toward our likelihood of being happy. On the one hand that seems like a large contribution, on the other hand, it means less than 1/2.

2. If it's 60% NOT genetic, our experiences matter a lot. The conditions we live/work/learn/play in matter, as they not only shape our view of the world but how our bodies adapt and ready to navigate it. Just as the experience of exercise creates a cascade of reactions that can ultimately remodel and shape our moving "parts", our sense of safety, stability, structure, positive emotions, optimism and achievements can remodel and shape our well-being parts (including brain, immune response and hormones).

3. We have more control than it may seem. Or, as they say in the report: "A wealth of evidence, based on various research approaches, supports the notion of well-being as changing and changeable – at the individual, group, and national levels". This is of course great news and brings us back to things we can do now for ourselves and our families. We can work to increase our physical activity levels (MOVE) - from mood lifting impacts to energy management, it is easy and our physiology responds quickly. We can eat foods that reduce whole-body inflammation and bolster immune function (FUEL). Fruits and veggies are at the top of the list (as fiber supports an anti-inflammatory gut biome) but not the only ways to get there. We can work really hard to build good sleep habits (RECOVER). One of the most consistent ways to improve key markers known to impact well-being such as serotonin and C-Reactive Protein is with good sleep and it doesn't end there. We can focus on the long term and cultivate our ability to be gritty and have resilience in the face of setbacks (ENDURE). After all, as genetically influenced traits that drive behavior like grit and ambition are "are positively correlated with positive life events, and negatively correlated with negative life events". And last but certainly not least, we can invest heavily into our relationships (CONNECT). One of the most interesting studies mentioned in the report compared twins (same genetics) who had different social-relationship circumstances (marriage vs. not). In both men and women, having a long-term social partner (married) related to both improved well-being scores and a 10+% offset in the role genetic risk played.

Happiness is complex. Who we are (genes) and what we do (behaviors) interact with where we live/work/learn/play (environment). It would be easy to dismiss it as something that happens "to us" and it would be wrong. We can't control all of the forces at play, but we can certainly control a meaningful portion. And Spring is an amazing time of year to do so. Reach out if you're ready to get started.

Have a great weekend,


Mike E.

the pursuit of happiness

March 11

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."


It is one of three examples of unalienable Rights, so says the US Declaration of Independence. Initially written by Jefferson and then edited by a committee of 5 (of which he was one), this paragraph is one of the most widely recognized sections of one of the most prominent documents in our history as a nation. But what does it mean to actually "pursue happiness"? This is a much deeper question, something that is still to this day emerging and is most definitely not as self-evident as the truths the declaration spoke of.


Pursuing happiness starts with the idea of happiness itself - defining its features, component parts and actual definition. Like most complex human experiences, even though we know it when we feel it, the experience can be incredibly difficult to put into words. Try it sometime. Ask someone of almost any age “do you know what it means to be happy?" and they will likely answer "yes". Then follow up by asking them to put it into words and they may struggle.


Some research suggests that this is because we literally have more words to describe threats and negative emotions that we keep top of mind than we have to describe positives. This of course could be some deeply ingrained mechanism handed down from our most distant ancestors that keeps us vigilant enough to outrun the modern-day saber-tooth tigers in our life at a moment's notice. On the other hand, it’s equally possible that happiness is the combination of multiple positive threads at the same time and so putting a simple label on a complex experience just doesn’t do it justice.


In 2019 a group of authors tried to unpack this a little by reviewing the connection of happiness and health. It turns out happiness is the intersection of 3 unique components and not merely bliss or pleasure, which can only account for 1 of the 3 components. Yep, another 3 legged stool.


This first leg, which includes moments of joy & pleasure is called "Affective Well-being" is the sensation we get when we find ourselves in a moment of bliss. Eat a great meal with loved ones or friends? You get some of this (see the idea of “bliss point” mentioned in previous blogs). Watch your team win the big game? You get some of this. Have a young child hit an important milestone (e.g. baby's first steps)? You get some of this. And although not a bad thing, it can be relatively easy to find and so a little overemphasized in our pursuit. For example a high sugar drink can give us a quick hit of bliss without fulfillment just as a funny Instagram Reel or TikTok can leave us laughing out loud (clear bliss) without the satisfaction of being "content", another word used to describe happiness, which gets us to the next type.


Type 2 is called "evaluative happiness" and this is the kind which gives us a sense of satisfaction with the quality of our lives. Instead of answering the question of "are we experiencing bliss, pleasure or joy?", this type of happiness asks whether we are feeling content. Achieving this kind of happiness is like leveling up. Where getting a little bliss or joy can be found with the literal swipe on a smartphone, feeling content requires us to think about what really matters to us and probably let go of a lot. Many cultures, in one way or another, suggest that the pursuit of this kind of happiness requires a "less is more" mindset, walking away from the "keeping up with the Jones' (or Kardashians)" mentality and reflecting on all the positives in our lives until that's what we see first.


Type 3 happiness is called "Eudaimonic Well-being" and it relates to purpose, meaning-making, personal growth and mastery. This is the kind of happiness we get when we work really hard and achieve something, especially if we weren't sure we could. This is also the kind of happiness that puts the "love" in the "labor of love" projects we all have in life. Going to raise a veggie garden this year? It's hard and often dirty work. Yet, ask anyone who does it, and they will often feel a sense of happiness when they show-off and share the fruits (or veggies) of their labor.


So what's the call to action on this one?


Well, take a minute to think about the 3 types of happiness. Ask yourself which you have, which you're a little light on and how you might achieve a more balanced pursuit. You may find you over-pursue type 1 and under-pursue the others (or some other combo). The goal is not necessarily to achieve perfect balance, but a distribution that works for you. What we know is that it relates back to health and therefore injury/illness/disease prevention, something we can all benefit from.


It's our unalienable Right and it might be as simple as getting out those gardening tools and, quite literally, cultivating it.

Have a great weekend,

Mike E.


Inside the Mind of the Happy Doers

March 18


Three weeks ago we started down this 5 week journey into aging well by way of the health/happiness connection. In week one we talked about how exercise can work to reinvigorate our muscles and fat cells to improve their efficiency with supplying plenty of energy as we work to accrue the financial and health assets needed to retire well. In week two we talked about the natural ebbs and flows of happiness as they relate to age, a phenomenon that has been seen around the world. In week three we touched on the three different types of happiness and the fact that pursuing overall happiness may require rebalancing our "portfolio" of enjoyment (affective/bliss), contentment (evaluative/quality of life) and purpose (eudaimonic/meaning-making). This week, the 4th of 5 on the subject, we're going to dig deeper into the mindset of those who are successful at using positive well-being to live longer and ward off everything from arthritis to the flu in the process. Dive in to get the rest of the story.

You know them when you see them. The pleasant doers. They are the "walk it like they talk it" types who seem to both have a certain confidence about them as they go through life, and seem to get "it" (whatever "it" is at the moment) done, smiling along the way. There is a person like this at one of the sites I visit now and again. I've spent more than a few trips out into "the field" with him. He's one of the more experienced members of the team and always has amazing insights he is willing to share. His story definitely doesn't end there. He's also an avid gardener, although that term seems a bit underpowered considering he tends to multiple acres and shares the output generously all summer. He's a laugher, always telling a funny story or cracking a joke and keeping the environment relaxed; and he's definitely a success story - someone who is not immune to the effects of aging or the risks of illness, but has achieved a level of contentment that I'd wish on anyone.

What is it about this gentleman or others like him? What exactly powers them, and how do more of us get more of it? These are the questions in front of us as we step into the fourth part of our 5 part series on subjective wellbeing (aka happiness)....and the answer seems simple, which of course is NOT the same as easy.

It starts with mindset.

According to Dr. Alia Crum, one of the foremost experts on how mindsets/beliefs/expectations can influence our health and physiology, mindsets are "core assumptions we make about the things and processes in the world that orient us to a particular set of expectations, explanations, and goals". In plain English, what we believe and expect in any given situation, or as some call it "the stories we tell ourselves", heavily influence how our bodies operate. This is something Dr. Crum has demonstrated in both exercise and nutritional studies, as well as in her extensive work on the placebo effect. Core assumptions drive our actions, which influence whether our experience of the world is generally positive or negative - which then has a significant impact on our health and happiness. Take infections for example.

Imagine being interviewed and asked how well, on a scale of 0 (not at all) to 4 (extremely accurate) the following adjectives describe how you felt in the last 24 hours: Vigor (lively, full of pep), well-being (happy, cheerful), and calm (at ease, calm) on the positive side, as well as depressed (sad, unhappy), anxious (on edge, tense) and hostile (hostile, angry) on the negative side. Now imagine repeating this 14 days in a row.

Could these scores predict how we approach our daily life? Could they tell us about our baseline happiness? Could they even predict our ability to fight infection?

As it turns out, the answer to all three questions is "yes". These six adjectives and how often we feel them have been shown to relate closely to whether a person sees the world in a generally positive (upbeat, happy) or negative (down, etc) light. Then, in the stuff that sounds like weird science perhaps, the researchers exposed the individuals to the influenza virus via a nasal spray. One group's immune system was more likely to fight off the virus and therefore NOT become ill - the more positive/upbeat group, by almost 3 times even after ruling out the effect of: age, race, sex, years of education, baseline antibody level, BMI, season, and virus type (among others).

What's even more wild is that this impact is not just on viruses or infectious diseases. In another study, those who had higher well-being scores had a significantly lower likelihood of developing arthritis - as many as 9 years later. In a final study, subjective well-being scores taken over time in an aging population predicted how long these folks would actually live.

This of course is not to say that health or even happiness are "all in our mind", but rather, to show that whatever IS regularly in our mind, DEFINITELY impacts the safety and health of the "mobile frame" we are walking around in everyday. If we are willing to learn from those who are already succeeding, the ones who often see the silver lining, the opportunity to learn, the fun that can be found in almost any moment, and the value in living each day with purpose, the stresses of life can be challenges that make us better and maybe even more fulfilled.

The world happiness report drops later today. With any luck, by next week we'll have some new insights that we can all leverage. Until then, we hope you'll describe this week as "full of pep", "cheerful" and "at ease"...or if not, find one of the pleasant doers you know and explore something they do that you can too.

Have a great weekend,

Mike E.

statistically speaking: When will u be happiest?

Mar 4

Non-linear. That's the official way to describe things that sometimes, but not always, go "hand in hand". Seem confusing? It can be, but we see it everyday - something that gets a little worse before it gets better. If we were to graph it out, it would look like a "U" and health often fits in this pattern. Let's say a "Standard American Dieter" (aka western diet heavy on meat and processed foods but light on fruits and veggies), after the topic is pounded on over and over and over in a weekly blog (let's say every Friday) decides they are ready to try more fruits and veggies to improve health (hypothetically of course). In the first few days, as his/her gut bacteria makeup changes and body begins to adapt, they might feel less than ideal. A little worse. But slowly and steadily they stick with it and after a week or two as their body is getting into the rhythm, they notice they feel less sluggish, less hungry for sweets and when they think about it their joints haven't hurt as much. A little better. This is often how it goes and the same is true for exercise. "DOMS" (Delayed Onset Muscle Soreness) is so common after someone starts a new exercise regimen (a little worse) that we could probably make Jan. 3rd an unofficial holiday (DOMS Day) for many people who started their New Year's resolution a bit aggressively. Yet, those who brave it out and stick with it for a few weeks will benefit greatly with greater strength, freedom of movement and lessened disease risk (a little better).

The list goes on. If you look closely enough, which is what a Dartmouth College researcher showed the world in 2021, even human happiness makes the list. You'd have to scroll down to the 33rd page of his fairly exhaustive report - but it's there and it's pretty clear - across hundreds of countries and billions of bits of data, humans get a little less happy in our early working years (15-40-ish) and then progressively more happy as we inch toward retirement (50-70-ish years old). Sadly, we don't really know "why" this happens. There are many possibilities.

Some suggest that the pace of life is more exhausting in the first half and that by the second half we are learning to pace ourselves better and might even have something to show for the hard work, which is satisfying. Others think that in those same years we are searching for and maybe settling into who are really "are" in the first half, deciding what our purpose really is while in the second half, we begin putting more resources (time, money, energy) into living out that purpose which is fulfilling. Still others argue (as we are not the only species that seems to experience the "U") that there may even be a genetic encoding that predisposes us to this pattern. Whew! Heavy stuff.

So what do we do about it?

Well, in the moment, a great first step is get good at recognizing and acknowledging how we're feeling. That is, to literally practice labeling how we are feeling in our mind ("I'm feeling _____"), which just like a workout, gets better the more we do it. This of course, is at the heart of "mindfulness", which not only is a meditative practice known to help us organize our thoughts, but also, if getting older is stressing us out, a very specific and impressively powerful technique which relies on the idea that there are only so many nervous-system resources to go around and has proven to reduce stress, even in the workplace. Thinking about very specific and accurate words forces our brain to turn down the emotional part of the brain, and therefore the stress center, by turning up the logical part of the brain (the language center). It's a bit like controlling our breathing to control our heart rate.

Next, find a few minutes to do the fun stuff of envisioning what 70 years old could be like or about. Will there be travel? Perhaps grandkids? Maybe it'll involve doing all those hobbies you haven't had time for. If you're less than 30 years old and this seems like an eternity - don't worry if it's blurry - it gets a whole lot more vivid as time speeds along.

Then, after feeling both relaxed and (hopefully) energized about what "could be", take a look at where things currently stand. Not at the global level like the World Happiness Report will in a few weeks, but at the personal risk assessment level. This could be as simple as rating on a scale of 1-10 where we're at when it comes to the 3 legs of the stool (energy & motivation, health, finance) or it could be going a bit deeper and taking the annual Pro-Activity survey. The concept is pretty simple overall - when we know where we're going and where we're at can we find the best path forward.

It's a great time of year to start thinking about and planning projects. We can almost see home-improvement ads that will be flooding our content feeds any day now. What could possibly be a better than a little "project investment" into ourselves toward a happier healthier future?

Here's to flattening the "U" by strengthening the "you".

Have a great weekend,

Mike E.


functional fat and layers of fitness

Feb 25

Energy is life. This is not meant to be a bumper sticker quote or a personal consumption confession. It is a physiological truth. Our body's ability to efficiently convert the calories that we consume into usable fuel (chemical) and ultimately the impulses that power our brain and muscle (electricity) through the magic of "metabolism" is at the very center of life. As it turns out, our ability to "do" this conversion efficiently may be at the very root of living that life well into the future and some people do it surprisingly well.

Want to know how they do it? It's pretty simple, they just do (and do and do and do), almost every day. Maybe it's cycling or jogging or something else but those who do it well have built a lifelong habit and layers and layers of fitness "deposits" which they draw from as they age. This part is not super surprising. We've known for a very long time that habitual exercise is one of the closest things we have to a future-health guarantee.. The reason "why" however is getting more clear all the time and it seems highly functional fat cells are a key.

The finding comes from a group of researchers from the University of Copenhagen in Denmark who compared the metabolic efficiency of "highly trained" older individuals (men in this case) as compared to peers who had not built an exercise habit as well as to younger men. They uncovered 2 critical findings:

First, the habitual exercisers did not lose nearly as much efficiency in converting fuel to energy ("mitochondrial respiration") as those who didn't have the exercise habit. The author of the study is quoted as saying: "a high level of lifelong exercise exerts a powerful compensatory effect. In the group of well-trained older men, fat cells are able to respire more than twice as much as in untrained older men".

Next, the habitual exercisers were significantly better at clearing harmful waste products (Reactive Oxygen Species [ROS]) from their cells. This is important because ROS has been linked to cancer, diabetes, cardiovascular and Alzheimer's disease. On this point the study author had the following to say "The group of older people who train most form less ROS and maintain functionality to eliminate it. Indeed, their mitochondria are better at managing waste produced in fat cells, which results in less damage. Therefore, exercise has a large effect on maintaining the health of fat tissue, and thereby probably keeping certain diseases at bay as well,".

What does this mean for those who want to get the benefit but may not have the habit just yet? The best time to start is now.

Building a habit starts with frequency not intensity nor complexity - so try ANYTHING that gets you huffing and puffing a little on most days of the week and work from there. As you go and notice the bump in energy you get (which almost always happens BEFORE any change in the mirror), feel good about the fact that you're changing things at the cellular level and reinvest that new energy back into the process; go a little longer or start to challenge yourself a little bit (like 5-15%) more. When you've built a 6 week streak, use your new found fitness to do something you couldn't do before. Surprise yourself and (maybe even) those around you. Or if you're really stumped - call us any time, we have tons of ideas.

Fitness is built in layers. It's not always about finding muscles or losing fat. Sometimes it's about retraining both to do something they previously knew how.

Don't worry, you can thank us later - with any luck, much, much, much later :)

Have a great weekend,

Mike E.


winning the long game and how they did it

Feb 18

The term "Body Mass Index" or "BMI" as it is often abbreviated, is one of the most universally understood health-markers today. The idea that having a body weight that is not proportional to our height (usually in kilograms per meter-squared) poses a health risk and that many Americans fall into this range has become widespread. It hasn't always been this way.

Although the very first "diet book", a pamphlet which describes the first ever low-carb diet, written by William Banting dates as far back as the 1860s, it really wasn't until much later that elevated body-mass became central to conversations on health risk. There are very few references to BMI in research prior to the 1980s, but in the fifteen years that followed the number of studies which discussed this height-to-weight ratio grew exponentially. By 1995 there were hundreds if not thousands of studies which tried to explain a wide variety of connections between excess body weight and poorer health. Dieting, as both a concept and an industry, exploded with growth. Since that time we've learned a ton about what to do and unfortunately what not to do.

We've learned that it's not just "overweight" that matters for health. Underweight can be just as (and sometimes MORE) risky.

We've learned that body-weight (and therefore BMI) is important but it is not the only and often NOT the most important predictor of future health.

We've learned that just as the topic is not about genetics alone, it's most definitely also NOT about willpower alone either.

And critically, we've learned that dieting - the hope that a temporary approach might give permanent results - is often not as effective as making longer-term changes even if they start small and seem insignificant at first.

But then this week something really cool happened. Someone published a study which explored the topic with first-hand experts; more than 6,000 individuals who have lost weight AND kept it off for an extended period. What they found, using a machine learning approach, was enlightening. Not because it was surprising, but because it paints a clearer picture about the mindset needed to not only make a change, but to help make it stick.

In their words, the three big take-aways were:

Long-game Focus - the "maintainers" (as they were referred to in the study) did not see setbacks as failures, but rather as "temporary interruptions", a part of the journey and a time to reset, which they did as quickly as the next meal or next day.

Good info helps consistency - the maintainers were consistent in trying to understand consumption patterns as fully as possible. They understood how easily extra calories or low quality foods could sneak in and erode success so they tracked their patterns, in one way or another.

Reflect Back and Go Forward - to stay motivated when it got tough, they often reflected on the past, comparing how they felt then to the improvements in energy, mobility and health risk they've experienced since.

None of this makes it easy. We live in a world where low quality foods can be both inexpensive (compared to more wholesome options) and a hyper-palatable sensory experience (see "bliss point"). Achieving and maintaining a healthy weight is, however, possible. With any luck we will continue learning exactly how those who pull it off are doing so. More to come for sure.

Have a great weekend,

Mike E.


the need for speed

Feb 11

Years ago I knew an older gentleman whose initials were "FF". With a wink he would tell me it stood for "fast and furious" a nickname he had picked up during his stint in the Navy to describe the pace he kept while walking around the base where he was stationed. At the time it seemed like an insignificant detail but looking back, it now seems like either a moment of marketing inspiration (since this was before the movie franchise of the same name) or a critical window into his future health because we now know that this very simple concept: "walking speed predicts health" has proven true in a variety of ways.

Whether predicting our risk of dying, the functional toll certain types of lower back pain will take, or our future brain health as we age, walking speed tells us a lot; but it doesn't end there.

It has also been related to how fast older men recover from injury (days in the hospital) and as recently as last month, the the risk and burden of heart failure in women. It is so powerful in fact that some researchers call it the functional vital sign, which has the power to cue us in on important risks far earlier than we might expect. It can even act as a "summary" statement of how well we are aging by the time we are 45.

Maybe the late-great Tom Petty was right when he said "well I don't know but I've been told, you never slow down you never grow old".

Getting and staying healthy is not easy, it takes effort. The good news is that sometimes it can be made simple. We don't need to be furious, but it sure seems like fast could help.

Have a great weekend,

Mike E.


move + recover = achieve more

Feb 4

Everyone has felt it. Maybe it was the energy drag after being called into work when we expected to be sleeping or that phase of parenthood when sleeping-through-the-night is the gold standard. Maybe it was that time we thought it'd be a good idea to pull an "all nighter" in college or the fog in functioning we felt after taking the "red eye" home on a trip. We all know the feeling of fatigue and, whether it be from news headlines or safety talks, personal close calls or tragic stories, we know what a destructive force it can be to our health and a frustrating force for our performance.

But do we ever think about the other side...the upside of rest and the performance enhancing power of a good night's sleep? New research says we probably should.

Here's the summary we feel everyone should know and how we got here:

Disrupted sleep impairs performance: Chronically shortened sleep is a well-documented health risk. 7-9 hours is generally considered adequate, with 7.5 to 8 the usual "sweetspot" for adults. Getting much below 6 hours per night will almost always come with negative health consequences. There are too many studies to list here, but this review is a reasonable starting point.

Exercise can help: Exercise seems to have some ability to counteract the negative effects of poor sleep. In this (non-human) study for example, exercise significantly blunted the negative impacts of sleep deprivation and in this (also non-human) study, memory and other cognitive functions were less impacted in the exercise group. Small human studies like this one have shown similar "protective effects" of exercise, even when subjects are over-tired.

Exercise + Sleep = Best: The latest research used measures of heart stress to determine the impact of hard physical exertion with and without disrupted sleep. In the small study, they subjected otherwise healthy individuals with no history of heart disease to high-intensity exercise after normal sleep conditions and again after disrupted sleep. Troponin, a heart muscle-protein measured in the blood to determine acute heart stress (including diagnosis of heart attack when levels are very high) was, as expected, somewhat elevated after high intensity exercise in both scenarios. However, in the group that got good sleep, it was nearly 40% LESS elevated than after disrupted sleep, a powerful combination.

In regards to this finding, the study's author had the following to say in a press release:

"Today there is no evidence to suggest that it would be harmful to the heart if you exercise regularly when you have slept too little. One can instead turn the argument around: by ensuring that one gets enough sleep, one may further increase the positive impact of physical exercise. While we know that high-intensity training generally has benefits in the long run, our results may be worth considering and exploring in specific groups of individuals. Examples include athletes and the military. These groups may be required to perform at extreme physical levels even under conditions of curtailed sleep. It may be good to further consider the importance of sleep in these contexts, especially as we also know that improving sleep can also improve one's performance, both cognitively and physically."

MOVE + RECOVER = Achieve More.

Have a great weekend,

Mike E.


foods that reverse age

Jan 28

When we think about "age-related changes", many envision things they'd prefer to avoid. Of course aging is not all bad - the idea of retiring, no matter how far off, is usually a fun daydream - but it doesn't take long when people start "doing the math" for a slight fear or anxiety to creep in. Instead of confidence in the idea that we will be strong and healthy enough to go out and do those things we've dreamed of, we might wonder or even worry about our future health.

If you too wonder (and maybe even worry a little) about this, you're not alone. In December of 2021 the Gallup Organization reported that as many as 50% of adults surveyed had specific worries about diseases where age is a risk factor, most specifically cancer and heart-disease. Similarly, the concept of "Dementia Worry", a worry of developing dementia in the future (first identified in 1996) is both common and can have significant impacts on present day function.

If only there were a way to slow or reverse the aging process right?

It's certainly not a new idea. Whether it be Herodotus in 5th century BC or Mark Twain who said "Life would be infinitely happier if we could only be born at the age of 80 and gradually approach 18" there's a long history of desiring to turn back the clock. Although we don't know of any fast or guaranteed method, two promising studies caught our eye this week.

Green-Med: It's like the mediterranean diet, only greener. In a study of the impact of diet on age-related brain change, a diet lower in red/processed meat and rich in "polyphenols" (compounds found in plant-based foods) significantly slowed brain atrophy in people over 50 years old on MRI.

Goji Berries: these small red berries from certain species of Lycium plant have been touted for their medicinal properties, with a long history of use to maintain eye health in Asia where the plants are native. Researchers based at University of California Davis confirmed this with a study that showed regular consumption (28g of dried berries, 5d/wk for 90 days) may offer a "protective effect" by significantly increasing Macular Pigment Optical Density (MPOD), a biomarker associated age-related macular degeneration (the 3rd most common cause of blindness in humans). In an interview, the researcher likened the compounds in Goji berries to "sunscreen for your eyes".

Aging is more than a number but it doesn't have to be nearly as worrisome as it can be. Although we probably can't fully rule out the existence of a "fountain of youth" or "river of paradise", FUELing well is a solid back up plan just in case.

Have a great weekend,

Mike E.


Is Timing "Everything"?

Jan 21

We like to think of exercise as a pretty simple concept usually - just get moving, hard enough to break a sweat, frequently enough to make the habit stick and long enough to accumulate 150 minutes per week in order to send injury/illness/disease into retreat! The best part is, by and large, this is true. However, the part that doesn't usually make the headlines might be the most fascinating....that exercise instantly changes the state of our body, even deeper than the tissue level.....all the way to each and every one of our approximately 37 trillion individual cells.

With that in mind and since the "state" of our cells is constantly adapting and changing to keep us ready for whatever situation we might enter into, it stands to reason that we can get different responses (output) from the same exercise (input) depending on when we do the work. This is super important, because it opens the door to even greater refinement in exercise dosing and therefore precision use of it; which is exactly what a recent "Atlas of Exercise Metabolism" starts to decode.

A team of experts from around the globe studied how exercise had a differing influence on two of the most obvious "states": activation (e.g. early daytime for humans or the opposite for nocturnal critters), when we burn mostly sugar supplied by our food and used by our muscles to do work and the second "state", rest & recovery (typically night) when we tap into sugar storage (in our liver) and start to convert fat to fuel when our sleep storage runs out......essentially running the daytime process in reverse.

They uncovered two particularly key points worth knowing about:

First - exercise indeed has different impacts at different times: In the morning our bodies are typically getting ready for work and food. Since we rely more on fat metabolism for fuel until we eat, if the goal is to burn body fat, exercise at this time of day may be preferable as was shown in the study. Fat used from sources in/around the liver however, did better when the body was ramping down from activity (such as early evening). On the other hand, if the goal is to normalize the body's ability to efficiently burn blood sugar (such as in cases of pre-diabetes) exercising later in the day (or after a meal) when our muscles are more full can be effective as was shown in this earlier work. We can also catch the muscles on the upswing (early AM) as they are naturally ready for work and get great benefits. This list goes on and on but the take home message is - we can turn a good thing into a great thing if we match our input (exercise) with the natural day/night rhythms already at work.

Second - exercise also seemed to "realign" the circadian rhythm at the cellular level. Although not exactly a "clock", each and every cell has timed functions that follow a roughly 24 hour cycle. In certain diseases these cycles get thrown off. It turns out that exercise, similar to winding an analog wristwatch, helped the body realign these rhythms. This was especially true for exercise during the early active hours, which means exercise early in the day might have the greatest impact here for most people.

What does this mean for us?

Well, maybe nothing at all. The simple rule still holds - exercise is such powerful stuff that doing enough of it is a good thing in most cases no matter what time you do it - so first and foremost "just get it in". But for some, the 30-50% who have the habit already and may want to squeeze even better results from the effort, aligning goals with physiological clocks and rhythms may make it easier to achieve them.

Timing may not be "everything" but it is clearly "something". We hope you can make some time to wind up your cellular clocks!

Have a great weekend,

Mike E.


Defining Cold

Jan 14

There's cold.....and then there's COLD. Thankfully, not all of our clients will experience the teeth-chattering "all caps" variety of temperatures touching the single-digits like those in/around the NJ/NY region this week, but many will experience temperatures cold enough to have an impact on aches, pains and health. This may seem surprising. We don't often think about how much an impact even moderately cold temperatures have on our health, but the risk is real. In the summer it's not uncommon for members of our team to remind people that "heat stress is heart stress".....but it's important to remember, especially for individuals who have high blood pressure or other forms of cardiovascular disease, cold stress can be heart stress too.

In 2015 for example, a team of researchers reviewed the impact of temperature across 13 different countries as it relates to health risk and premature death. They found that the risk carried by cold exposure was as much as 17 times higher than that of heat, providing more evidence that although we humans can do pretty well in the heat.....we are far less naturally equipped for the cold. Maybe even more surprising, the greatest risk in each of the countries studied was from the category of temperatures listed as "moderately cold" and not those listed as "extreme cold".

It doesn't end with major health risks. Cold appears to aggravate soft-tissue aches and pains (especially at the back and neck) too. The risk begins at surprisingly mild temperatures and continues to increase the further north a person works and lives. According to the International Organization for Standardization (ISO) in their 2008 document titled "Ergonomics of the Thermal Environment" for example, starting at 10 degrees Celsius (50 degrees F), soft tissues like muscles and tendons are more likely to become irritated underscoring how important priming the working tissues with dynamic movements (a literal "warm-up") can be at work and home.

There's never a bad time to put the odds in our favor......this time of year keeping the tissues flexible and warm should be near the top of the list.

Have a great weekend,

Mike E.


improved health in 4 minutes (resolution part 2)

Jan 7

The challenge, if you choose to accept it, is to follow these 3 steps to investing 4 minutes into yourself......and spend 10 seconds predicting your health when you get there. Here's how:

1. Meet the team whose research sparked a revolution in exercise and the researcher who became a household name in gyms everywhere:

It started in 1996 when a research team in Japan tested a training protocol being used by the national speed skating team to improve the team's fitness in a fast way. They would use 20 seconds "on" and 10 seconds "off", repeated 8 times (4 minutes in total) and they repeated it 5 days per week. The "on" was high-intensity bicycle pedaling and the "off" was rest. The improvements in fitness were so impressive 6 weeks later that the lead researcher, Izumi Tabata, became something of a celebrity. A google search or "tabata workout" for example, yields millions of results.

2. Understand one of the fastest and most reliable methods known to predict future health catastrophe.

A few years later (2002) on the other side of the globe, a team studying data from the National Heart, Lung and Blood Institute in the US determined that although what was happening "during" the exercise was critical for health improvement, what happened AFTER, specifically in the first minute immediately after stopping, could tell a lot about the trajectory and future health of the exerciser. It has become such an important predictor that many of the new fitness technologies we might wear on our wrists are equipped to calculate this "HRR" (heart rate recovery) value. More recently however (2018), the measure has been refined even further to show that the first 10 seconds of recovery after stopping exercise are likely the most important at predicting future health events like heart attack, stroke, etc. The "10" off portion of the Tabata is far more important than a few seconds to catch our breath.

3. Get started, MOVE.

So, if investing 4 minutes per day and building a 6 week streak can have such a substantial impact on our future health and even how much we spend to manage it, say in retirement, what's stopping us?

Probably not as much as it seems at times, but in fairness, getting started is always the hardest part. Here are a few bits of good news that lower the barriers between where we're at and where we want to be even further.

No stationary bike or a fancy recovery watch? No problem. Stairs and counting your pulse is enough to get an effect for most.

8 rounds (4 minutes) is surprisingly fatiguing and seems like too much at first? Dial it down to what you can do and build from there - as we've mentioned in other places, if adding even 1 minute of stair climbing a few times per day can have an impact - even some air squats, wall push-ups or marching in place will get the ball rolling - something (anything) is exponentially better than nothing.

There's more to come on this topic....it's too important for most people not to nudge it forward when we can.....it just so happens, now is a great time of year to get the ball rolling.

Have a great weekend,

Mike E.


resolve to move; let the risks fall where they may

Dec 30

Are you committing to a New Year's resolution this year?

If you're hesitant and even find yourself a bit cynical about the chances of sticking to it, you're probably not alone; many people do in fact fall short.....but if the trend from last year holds, most people will give change a shot over the next few days and weeks.....with health improvement at or near the top of the list.

From our vantage point "in the arena", where success never comes easy or without error and the only way to fail is to not try, the millions who do are a bright spot worth encouragement and respect.

All systems "GO".

If exercise and/or dietary changes are at the top of your list, you're not alone. These are some of the most common targets of New Year's Resolutions, which makes total sense since of the risks we face, either or both will make an impressive impact. For example, new research which once again makes it clear that exercising for an hour and eating a healthier diet can stop the progression of diabetes in its tracks might be strong motivation for the 1 in 3 Americans who are at risk. Of course that's not all - in 2021 we reported impacts on everything from mental health to knee pain and just about everything in between. So if you have found, like this sample of citizens, the last two years have taken a toll on your health habits, now is a great time to literally get up and go.

PLAY....the odds:

But what if the "what" or "why" is not the tallest barrier we face? What if we know all the reasons we "should" but we find it hard to get (or stay) "going"? Well, goal attainment is a funny beast. There is no single formula that works for everyone and when you ask the people who do succeed, they'll often tell you it really wasn't so bad anyway.

Dig a little deeper though and we find that certain approaches do increase the odds of success. For example, goals that focus on what we "will do" (approach-oriented, actions & behaviors) rather than what we will avoid are more commonly achieved and, especially for those that are competitive by nature, making things into a game or using a leaderboard can improve the odds of success. Other tactics like taking on the goal with a trusted friend to improve accountability and maybe even adding a financial consequence seem to be valuable in getting over the inertia.

No need to overthink or over-shoot it.

Pick a trigger (before I sit on the couch I will....), and an attainable action (....climb the stairs 4 times in a row). Track it (a check or tally-mark on the calendar?) and share it with a few friends who are on the same journey (e.g. texting a picture of your current "score").....see who gets furthest on the journey.

Change is not easy but it's certainly not impossible. People do it all the time....now just happens to be a great time to get going.

Have a healthy New Year's.....and a great weekend,

Mike E.


better than a sunny vacation!

Dec 17

Vitamin D is a critical component of human health. New research from Europe links it with heart disease and altered blood pressure. With the "strength of the sun" down a bit this time of year, we may need to find other ways to boost production. Dive into the rest of the story to hear about a few of the most effective ways.


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You might have noticed people bulking up their clothing or a bit more "bite" when you feel Jack Frost nipping at your nose. By next week it will officially be winter which means in this part of the world, the power of the sun (UV index) will be at/near the lows for the year....levels which can be even too low for our bodies to produce the amount of vitamin D needed to keep us at our best.


Vitamin D is tied to several critical functions in our bodies. From stimulating calcium absorption and therefore bone health, to an important role in controlling inflammation and modulating immune function; so having enough circulating through our systems is important to our health. New research even suggests that due to its critical role in cardiovascular health and blood pressure regulation, as many as 4% of the world's cases of cardiovascular disease could be prevented entirely if adequate levels was the "norm". As one of the leading types of disease around the world (and the number 1 killer in the US), 4% of the world's cardiovascular disease is a very very big number (approximately 728,000 in the US alone).


So what can we "do" to get and stay on the right side of the "D-cline" during the winter months?


For starters, there may be some good news. Some research shows that we may have a storage mechanism in our muscles. So if you got a healthy amount of sun-exposure in the other seasons AND you've kept your muscles strong and healthy, you may have stores to draw from. On the other hand, if you're not absolutely sure, from getting some sun to eating particular foods, there are ways to get a boost in the winter months.


The following list comes from a 2007 study which looked at various activities and their relationship to Vitamin D levels over the winter. We've ranked them by their impact, least effective to most:


Dairy Products: People who supplemented 300g of D-fortified dairy products saw a minimal impact (6.2 nmol/L)


"D" supplement: People who took a D-vitamin regularly had a moderate increase, nearly twice that of dairy (11 nmol/L)


Vacation: This one sounds the best of course, and DID have a moderate impact (14.5 nmol/L) but was only slightly better than a supplement.


Fatty Fish*: 2-3 servings of fatty fish per week had the greatest increase (25.5 nmol/L) a 45% increase when this was the only approach being used.


*For those who don't eat much fish, other foods are known to have reasonable D concentrations, with mushrooms near the top of the plant-based list.


If someone asked us "what's better than a vacation to a sunny part of the world in the winter?", 2-3 servings of salmon, trout or herring probably wouldn't come to mind......but, if it keeps us on the right side of health risk and helps get us through the challenges of winter, it might be the right answer.


Have a great weekend,


Mike E.


the tea's knees

Dec 23

Maybe you've felt it before or have a loved one who struggles with it. In the early stages it might just feel like we need the Tin Man's magical oil can after we've been sedentary too long. As things progress, movement becomes more and more achy and doing "simple things" becomes harder and harder, it is known to negatively impact quality of life. But maybe the trickiest part about the progression of arthritis is that we used to think there wasn't much that could be done.....that it was "degenerative".....but that tide may be turning.


It started with some mythbusting of the old adage that loading the surfaces of the joints (usually running) was somehow "bad" for the knees. For example in 2016, contrary to conventional wisdom, this study showed that runners actually experienced a reduction in the inflammatory substances thought to be related to degenerative joint disease. Then, this past year, a review of more than 40 studies concluded that running has "more advantages than disadvantages to knee cartilage".....one of a few different conclusions which reiterated the point of a 2015 article which suggested inflammation might be at the root of the condition and not mechanical loading that comes with (even high) activity. There were cracks in the logic that to be healthy we had to soften-up on our bodies.


Around the same time, in the nutritional sciences, an unexpected phenomenon was emerging which seemed to support the idea even further. Eating healthy, especially diets rich in foods known to lower inflammation (greens, fiber, etc), was linked to improvements in arthritis pain......even without improvements in the underlying cartilage. For example, we've mentioned the very interesting link between blueberry consumption and improved knee health in people with arthritis and around 2010 there was growing interest in a particular compound (Gallic Acid) which is present in Green Tea for its potential. The shift in thinking was beginning it seemed.....even if we did not have all of the details worked out.


Then, a month or so ago, a research team from the University of Washington found something super interesting. When they combined the two - inflammation lowering food substances (again Gallic Acid which is common in a variety of fruits, nuts/seeds with green tea a particularly good source) AND mechanically stretching/loading of the tissues in a lab setting, they found healthy cartilage actually grew. This is another BIG step.....signifying a major potential to give hope and ultimately help the many many people who struggle with joint related pain, especially at the knee.


It's too early to count on anything but for those of us interested in staying active and healthy for as long as possible maybe the lead author of the study said it best: "This provides some evidence that a good diet and exercise actually work," said Abusharkh. "Even for people who have mild osteoarthritis, it's really good to exercise. It's very bad for our cartilage tissue to just lay down or sit the whole day; we have to have a little bit of activity."


So if you're looking to give your body a gift this weekend, cozy up to a cup of green tea and get out there for a walk......and then next week turn it into a resolution. :)


For those that celebrate, Merry Christmas.


For everyone, have a great weekend,


Mike E.


in a fog? take a jog.

Dec 10

When we hear the word "innovation" we might be drawn to think of things that drastically change our human experience. In the 15 years since the iPhone was introduced the massive ecosystem of products, services and information we now tote around in our pockets fits this bill. Of course, for those of us who have grown dependent (and possibly even more so for the generation coming along who never actually experienced a pre-"touch screen" world), it's hard to imagine not having "all this" just a few swipes away.

Of course, it's sometimes easy to forget that this massively impactful innovation started with resistance.....it wasn't an instant sensation. After all, as one argument went, we humans might be lost without the sound and feel of clickable buttons. Big time market research was done. All sorts of products were designed to bridge the divide and some big bets were made AGAINST the concept......but then a small group of early adopters raved about it......they told friends and bought into the sleek design and the wheels of progress started turning. Soon enough words like "app" were becoming common language and everyday life began to change.

What if there was a need for another life-altering innovation staring us in the face? Take for example the need to solve the "problem" of mental fatigue.....something many of us experience every single day (and may actually be made worse by the tech behind the touchscreen). It's a big deal relating to performance loss/errors in work tasks, poorer performance in athletes and even motor vehicle crashes. Some innovators are trying to find a way to predict (and ultimately prevent) it by wiring-up and measuring brain activity......which seems to have some potential.

But maybe it doesn't have to be new "tech" to be innovative.....maybe it doesn't have to be new at all. Maybe an old thing applied to a new problem can be just the innovation we're looking for. Maybe, if we buy-in to some new research, we'll know the time for this fundamentally human innovation is now.....and in 10 minutes we can have the result.

Go for a jog.

Yep, that's it.....a leisurely jog....when applied to the problem of mental fatigue, says the latest research, can have an effect in as little as 10 minutes. Brain activity improved and performance followed.....after 10 minutes of moderate intensity (50% max) jogging. Sure there's resistance to it becoming part of our everyday....we don't always have proper footwear handy, we're not always in an environment where it's easy to jog and it can leave us sore when we're getting started.

But if we could lower our risk of a vehicle crash, improve our physical AND mental performance and give ourselves a mood boost all in 10 minutes or less would we tell our friends and family about it? Maybe we should.....it might even catch on!

Have a great weekend,


Mike E.


get busy... livin'

Dec 3

If you're a fan of movies, this is one of the best. It pulls me in every time. I'm sure there is at least 1 reference to it deep in the archives of this blog. But among the many great quotes and scenes, there's one signature phrase that (at least according to one blog) stands above the rest and may add important details into questions about human aging and longevity - like "what is a long and healthy life?", "how can we achieve it?" and "why does it happen in the first place?".

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Begin with "why"

One of the more unique features of human biology is our ability to live well past the "reproductive" and "child rearing" years. This is NOT common across species and is not easy to explain. It seems to go against common theories like evolution. Some experts like Robert Kegan, a psychologist (Harvard), have suggested that it's possible we need this "extra" time to make meaning of our lives and solve the bigger (sometimes self-imposed) problems our world faces.


"What" even is Healthy Aging?

Other experts, like Gene Cohen a psychiatrist who spent years studying mental health and aging have built models that might explain the "what" of healthy aging....not just maintaining our ability to function on our own but thrive in ever-developing ways, with a special focus on creativity as captured here.

"How can we get there"?

In many ways this is the question the team at Pro-Activity tries to answer day in and day out for as many people as possible. Each of the ELEMENTS (Move, Fuel, Recover, Endure, Connect) have been proven to ward-off injury/illness/disease and the combination of them all with varying concentrations (sometimes heavier on Recover, other times heavier on Fuel for example) is particularly potent. So it didn't surprise us that this recent contribution from another team at Harvard, was on a similar wavelength. The current paper places emphasis on physical activity (Move) as one of the major pillars of "how" to achieve health with aging, but goes a step further to explain the "why" it actually works so well, especially as we age.

In the simplest terms and similar to the "When you Rest you Rust" concept a few weeks back - when we stress the body through physical activity which is properly "dosed" for our abilities (challenging but not excessive), the body takes resources away from processes tied to aging/disease and directs them toward processes that promote health like tissue repair and strengthening.

Turns out Andy and Red from Shawshank Redemption summed it up nicely: "Get Busy Livin' or Get Busy Dyin".... with emphasis on (physically) "busy". Add some MOVE when you can....your future self will thank you.

Have a great weekend,


Mike E.


the 3rd side of the coin

Nov 26

For most people the anchor of this, the 47th week of the year, is on giving thanks.....an attitude of gratitude.....which made its annual "pilgrimage" to the front of our lives on Thursday. It may seem to fly by faster and faster these days, but tucked within its tradition is something to be REALLY thankful for; if we can keep that spirit alive long enough, we might just get a glimpse of the elusive "3rd side" of the wellness coin.

Sure a "three sided coin" seems impossible.....but in the strictest sense EVERY coin has three sides.....it's just incredibly rare to actually "land" on the third side, or the "edge" as we might think of it. But here's the great news - with just the right environment and controls, it can be done.

From a physiological standpoint, if one side of the coin is "fight/flight/freeze" (the somewhat negative stress side) and the second side is "rest/digest/relax" (the somewhat positive recover side) then the thin edge which makes up the third side of the wellness coin, rare as it may be to land on, can be thought of as the "flourish/thrive/excel" (the exceedingly positive, growth side).

See, there is this amazing feature we are all carrying around with us in our highly sophisticated, interconnected tissues - the physical response/reaction after the emotional "strings" are pulled:

Side 1: When we experience the emotions of stress or anger we physically tune up (heart rate, breathing rate, muscle tension) and our bodies get ready for action.

Side 2: When we emotionally slow down or let go (like the feeling of the couch after the big meal) our muscles relax and we send more resources to our digestive system.

Side 3: But when we land on the elusive 3rd side - such as when we practice gratitude - an entirely different phenomenon occurs. Not only do we get the benefits of slowing down: our stress melts away, our heart-rate slows, our blood pressure lowers and our sleep improves, but we also get actual improvements in our wellbeing (mental health) and even our cardiovascular risk.

Sometimes it's as simple as thinking, despite all of the challenges we face, about how much we have to be thankful for.

On behalf of the Pro-Activity team, please know that we are thankful for the small part we get to play in your health journey and we wish you many days that land on the 3rd side of the coin as we wrap up the year.

Have a great weekend,


Mike E.


what age is "old"? it depends on who you ask.

Nov 12

It may not always feel urgent, but at every age, healthy aging is an important topic. We dedicate a significant portion of this blog to picking out new and important research headlines which prove and reprove what we all inherently know - that when we use the right tactics to care for this "self-repairing machine" we're walking around in everyday, it can go a bit longer....a bit stronger.....and that can lead us closer to happiness; or as they call it in the research "subjective wellbeing".


In the US we think aging is so important that we dedicate around $3 billion per year to studying it. We learn (and sometimes relearn) a ton. But sometimes the real learning doesn't come in the lab. Sometimes it comes from the field or in this case....on the trail. The lesson this time is a simple one - it can be done......a whole lot longer than we sometimes imagine. In this case, it's the story of a recent feat by M.J. Eberhart.....or as he's known on the trail....Nimblewill Nomad......the 83 year old retired optometrist turned hiker who just last week broke the record for being the oldest person to complete the 2,000+ mile Appalachian Trail. It required him to "limit" himself to hiking 8 hours per day....everyday.....7 years older than the average life expectancy for men in the US.


He might look a little like Gandalf from Lord of the Rings, but there's less mystery or magic in his story than there is a joy being "out there", moving, and taking in the fresh air and the experience. If you read his bio it sort of sounds like he just decided to get moving (in a fairly grand way).....and after retirement had the time to make up for the many years of not doing so while working in a mostly sedentary job. Not a superhuman by any stretch he even mentions a bit about his health history which, like many, includes some heart disease risk.....and yet, he was still able to cover thousands of miles, millions of steps and write a few books about it along the way. Amazing.


Not everyone will agree with his statement "Put me in the great outdoors, preferably the mountains, and you’ve got a happy camper." or the philosophy that “There are no bad days in the mountains, some just a little better than others.”, but then again, not everyone needs to. There are infinite possibilities of how each of us can live stronger and happier through better health our own way.


83 may seem too old to be hiking 2,000 miles, and it's hardly the norm, but it's also clearly NOT impossible. The human system is amazingly strong and resilient. May we all get the chance to prove it.


Have a great weekend,


Mike E.


if you rest, you rust? sort of.

Nov 5

There you are, walking in the dark and you do the unthinkable.....you stub your toe. WOW! (and maybe other similar terms) you shout, grab your toe, sit down and laugh or cry or both, possibly wondering how such a small part of the body could bark so loudly when it's angry.


Then what happens?


If you're anything like most, you rub it a little and eventually get going on your way only to remember to use the flashlight on your phone next time.....or make some other small modification to be ready should you be in a similar situation.


But what if you went in a completely different direction? What if you sat down, put a splint on your toe, wrapped it thickly in gauze and didn't use it for the next six months - what would happen then?


Seems a bit extreme....and it is.....but in the case of a more serious injury, without overriding our instincts, it's surprisingly similar to what our body prepares to do. The mechanisms are a little different - swelling and pain instead of splints and gauze - but the message we get is basically the same: "leave me alone for a while". Which begs the question - 'how long is a "while"?' and 'is that really a good thing?'.


New research taken from situations involving more serious injuries, in this case ACL tears which are extensively studied, may help us answer the questions. The research group, which spanned multiple universities and states, found that after ACL surgery, the muscle fibers in the leg on the side of the surgery behaved differently. This is a new intriguing phenomenon and a pretty big deal because it goes way beyond the well-known atrophy effect after surgery. Said another way, the muscles in the limb that got surgery started acting as if they were shutting down early.....behaving like a much older person's muscles....which may help to explain why after surgery it often seems that leg "ages faster" (weakness, arthritis, etc).


There is almost definitely more to learn here.....but one thing seems to really stand out: the body has mechanisms, some of which we still don't understand, to shut injured areas down......something that is not great for those of us with many years of healthy functioning in how we envision our future selves.....even after injury.


Without properly stressing the healing tissues (through active efforts like exercise, mobility, coordination, etc), the tissues are happy to rest.....and sometimes that means "rust".....well before their time.


Demand a little more from your body. Stretch it a little further....make a move toward strength. It is an amazing "machine"......it can even repair itself.....but won't necessarily without the proper nudge.


Have a great weekend,


Mike E.


red light green light

Oct 29

I haven't watched 'Squid Game' (the Netflix phenomenon) yet, but if the hundreds of millions of fans are right, it's bound to be good. It is such a hit in fact that Reuters reported this week on the placement of a 13 foot statue commemorating a part of the show that involves a version of "Red Light Green Light" in South Korea where the show was produced.


If you think about it, Red light Green Light is a fascinating game. It's played all over the world in one way or another (although sometimes has different names) and is easily understood by even some of the youngest among us.


Why is that? Is there more to it than a simple & active way to entertain kids?


Well, so says the BBC, some scientists will tell you that the color Red works as a warning because it is more easily seen by the human eye while others will suggest that nature often uses red to warn us because it stands out well against a green background, while still others might suggest it's something we are passed down at an early age and have learned to understand.


Whatever the reason, it seems to work. The Red, Yellow, Green of the traffic light make it very easy to explain "unsafe, caution, safe". You've almost certainly heard our team refer to it when describing how to use our movement inventory - and when to reach out for a consultation.


As it turns out in a study published in early October the approach is effective at guiding food choices too. When foods come with a color-coded warning label, people tend to make healthier choices. When combined with other research that shows particular scoring systems are getting more dialed-in all the time, making sense of the risk associated with our food choices might be getting easier soon.


If "soon" is not "soon enough"......the punchline of the research is that "green" foods (fruits, veggies, legumes, nuts/seeds) tended to be green light......while snacks, sugary beverages, and desserts (high sugar & high process) tend toward red light.


It's never a bad time of year to steer clear of "red light" foods......but with Halloween here and various other holidays on the way, it gets more challenging as we round the final turn of the year. Let us know if we can help.


Have a great weekend,


Mike E.


he really is a fungi

Oct 15

Never have I seen someone so excited about mushrooms. Our team had just finished up some training and we were out in the fresh air trying to "walk it like we talk it" - literally. Dana, one of our physical therapists who you might know as someone often smiling & laughing, was in her element and intensely focused on the ground around the path (but still smiling and laughing).


Every few minutes we'd hear an "oooh" or an "aaah" followed by "this is a great one"....[pause for a picture]....."it's some kind of [put in species here]" as she pointed out the bright colors, strange textures and other features of these little hidden gems most of us had cruised right past without noticing. By the end of the hike many of us were scanning the ground.....tuned-in to the ecosystem at our feet....and laughing and smiling too.


Of course, since both social atmosphere/connectedness and being out in nature ("forest bathing") have been shown to have positive effects on mood and health, I had just assumed the generally light and relaxed atmosphere was due to the fact that we were together with people we enjoy being around which was bolstered by the fact that we doing so outside, in nature......but, maybe as the punchline of many-a-bad-joke goes, it was because we were surrounded by mushrooms.....which everyone knows are "fun-guys" [snare drum, cymbal!].


But seriously folks.....new research says there might actually be something here. Mushroom intake (which indeed are "fungi") has been strongly associated with lower risk of depression in a large study (24,000 participants) that lasted more than 10 years, adding more support for an effect that smaller studies have shown in the past. Although it's too early to tell which particular mushrooms seem to have the greatest impact, the research team is pointing to a potent antioxidant concentrated in mushrooms.


From the press release by Penn State where the research was conducted:


"Mushrooms are the highest dietary source of the amino acid ergothioneine -- an anti-inflammatory which cannot be synthesized by humans," said lead researcher Djibril Ba, who recently graduated from the epidemiology doctoral program at the College of Medicine. "Having high levels of this may lower the risk of oxidative stress, which could also reduce the symptoms of depression."


Although we can't recommend a "pick-your-own" strategy on this one (there are several lists of poisonous mushrooms which can look very similar to the edible varieties), as we move toward winter and the drain it can have on mood and energy, it might be a good time to work some more mushrooms into your diet. If you cross paths with Dana, ask for a recipe, I'm willing to bet she's got a few really good ones!


Have a great weekend,


Mike E.


two sides of the same sponge?

Oct 22

Remember back in 2017 when the humble kitchen sponge became the center of the conversation about "bacteria and germs"? In the author's words "Our study stresses and visualizes the role of kitchen sponges as microbiological hot spots in the built environment, with the capability to collect and spread bacteria with a probable pathogenic potential.".


Yikes! To think we were cleaning our dishes with a "microbiological hot spot". Not great.


Of course, this new information prompted a more serious look at something we had already known for almost 10 years - cleaning methods mattered, even when it comes to the humble kitchen sponge and some are much better than others.


But what about our sponges on the "inside"? That is, our sponge-like body tissues which can also be problematic if not kept "clean"......are there best techniques we should be aware of? The clear answer is "YES" - and like zapping the kitchen sponge with a microwave - we've known about them for a while but new research might make it clear the time is NOW.


1. Zap the negatives with "high octane" fuel - this week a new study that substituted normal "chow" for a diet of highly processed fats and sugars in rats showed a significant body and brain function impact in as little as 4 weeks. Interestingly, those given healthy fats, especially Omega 3's like those found in salmon and other fish (specifically, DHA), were able to "clean out" the inflammatory risks and other "sticky stuff" on the brain.


2. Wring the sponges, at least 5 hours per week - a huge study funded by the American Cancer Society reported that a large percentage of cancers in the US are directly attributable to lack of physical activity.....and that moving the muscles more (the body's version of wringing the sponges) can have a pretty major impact. As it turns out "data show when focusing on specific cancer sites, 16.9% of stomach cancers, 11.9% of endometrial cancers, 11.0% of kidney cancers, 9.3% of colon cancers, 8.1% of esophageal cancers, 6.5% of female breast cancers, and 3.9% of urinary bladder cancers were associated with lack of exercise."


The "environment" that we interface with REALLY matters. Sometimes it's the "built environment" and other times it's the "internal conditions".....either way, turning knowledge into action, there are ways to keep surfaces and the sponges clean.


Have a great weekend,


Mike E.


where it really hurts

Oct 8

There I was, chasing my youth on a beautiful fall day in Wappinger Falls, NY. For those that aren't familiar with the area, you'd just about land there if you took the Hudson river North from New York City for 80 miles. It was a sunny day on a soft grassy area near the bank of a stream and 30 or so of us were lining up to play what is (affectionately) known as "Old Boys" Rugby Football.......or for those of us not quite ready for that title....."Over 35".


Somewhere near the end of the first half I sprinted for the ball and with an outstretched arm dove to "ground" (touch down) the ball when something went wrong......the sudden stop of the ground....before I was ready. With a thud and an instant and intense "warning" (pain) from my left shoulder I unceremoniously jogged toward the sideline and told someone I needed a substitute so I could do what I've done hundreds if not thousands of times, evaluate a potentially injured shoulder.....this time my own. Thankfully, I knew for as much "hurt" as I was experiencing (easily a 7 or 8 on the 0-10 scale), I passed most of my own tests and knew that the "harm" was minimal.


In translation:


It was going to be a really bad night of sleep - it was.

It was going to be an achy week - it has been.

And it would require taking some of my own medicine (stretching and strengthening mostly) to get back to normal - yep.


But thankfully there was nothing severe to worry about.


This is only the first part of the story. The one that most of us who see someone (athlete, co-worker or other) go through from the outside in. And it may not even be the most important part.......because it doesn't address the cascade of other "pain points" felt all the way down to the essence of who we think we are.....including my question "am I getting too old for this?" - which is of course a RESOUNDING "no" :)


It's one of the most fascinating areas in the world of injury rehabilitation - whether the mechanism was sport related, work related or something entirely different......the questions we often ask ourselves on the way back and the mindset required to do it well, play an important role in the quality of the outcome. For example experts on the subject have shown that like many areas related to health there is a definite and strong connection between body and mind after injury and addressing doubts and confidence along with more mechanical factors like strength and range of motion can be an important factor in getting to full recovery.


So what works?


Not surprisingly, some of the same techniques that are known to help us stay focused on any project (well informed goal setting) have shown promise. However, maybe a bit less well-known, some of the same techniques shown to improve well-being overall (guided imagery, mindfulness, etc) by helping us to manage stress, remain focused on what we can control (and not what we cannot) and remain oriented toward progress and function more than pain can really make a difference.


Five days later the shoulder still has pain.......which, if I left it there, might paint a grim picture......but would be incomplete. Because, now the pain is at the very low end of the intensity spectrum, almost solely at the end range of motion......I can once again raise my arm over my head and put my shirt on without a significant jolt....."little big things" only a few days ago.


More importantly, I know that my body is doing exactly what a body does and the pattern is on track. I still have some work ahead of me and if we cross paths you might even see me rubbing my left shoulder now and again, but with the mystery of this particular pain mostly gone, I am confident I will bounce back fully......in time for the next big game with any luck :)


Remember the team is standing by - ready to unravel the mystery of aches & pains.


Have a great weekend,


Mike E.


winter prep for the pump & pipes