Blog Archives

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's too important for most people not to nudge it forward when we 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 just happens to be a great time to get going.

Have a healthy New Year's.....and 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" 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.

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.


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.

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 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 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?".


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 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'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.

if you rest, you rust? sort of.

Nov 5

There you are, walking in the dark and you do the 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" 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.

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.

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 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.

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 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

Oct 1

Happy October! The tenth month of the year (even though its name translates to 8), the sixth with 31 days and the month that often reminds us that daylight savings will be coming to an end soon, that "old man winter" is almost at the door and that it's time to revisit techniques to prevent high blood pressure.

OK, it's possible you don't associate October with that last's not nearly as commonly discussed.....but maybe it should be. When we consider that nearly half of US adults suffer with high blood pressure, that it is considered the leading cause of more than 500,000 deaths each year and that this powerful but often "silent" (no symptoms) disease has a well documented seasonal component, it's worth our attention.

The prevailing theory which attempts to make sense of why blood pressure readings tend to be higher in the winter months is that cold weather causes constriction of the blood vessels requiring more force to push blood through the arterial "pipes". Others point out that deeper analysis links particular conditions ("air mass") and day to day weather volatility to these changes. Either way, since these changes often start in October when there is still PLENTY of time to do something about it.....means NOW is the time to get ahead of it.

Here's the good news - as published this week by the American Heart Association, even in the toughest cases, those who do not respond to as many as 3 different medications simultaneously, exercise and improved dietary habits seems to work. Specifically, when individuals exercised 3 times per week at 70-85% of their maximum (as measured by the Karvonen formula) and they ate healthier using the DASH diet as the model, they made significant improvements.

On average, after a few months, they lowered their systolic blood pressure (top number) by 12 points and their diastolic (bottom number) by 7, enough to take a person from high risk (e.g. 140 over 90) to nearly normal. Of course better sleep, stress management and even breathing exercises have also been shown to make an there are a lot of ways to get started; let us know if you need a hand.

Have a great weekend,

Mike E.

mind your diet, mend your health

Sept 24

Last year we decided to raise honey bees. After meeting a few folks who were hobbyists and watching the fascinating process of "hive to jar", my son and I were intrigued enough to buy a "packet" (about the size of a shoebox) of approximately 10,000 bees, get them started in a set of hive boxes in the corner of the yard, and try our hand at honey production. It has been surprisingly engaging.

Watching the bees from Spring through Summer as they zoom in and out of the hive and battle the elements (weather, other pests, etc) to build a winter survival system that has worked for hundreds of thousands, if not millions, of years, makes it clear that these little bugs, even without the "advanced individual intelligence" of humans, can do amazing things.....something that some say our human brain even with its 85 billion neurons and trillions of connections can learn from.

As it turns out, much much smaller "bugs" and their hives ("colonies" for accuracy) living on the "inside" might be using a similar tactic....and are already impacting the way that we feel and think.

The "gut micro biome" and its trillions of bacteria living in our digestive systems, has an impressive impact on our health.....and, as research continues to point out, even the way that we think. Specifically, research in the last few weeks has shown that if we have plenty of health-promoting (generally speaking, inflammation resisting/reducing) bacteria calling the shots in our gut, our immune health, cognitive health from when we are infants all the way into older age and even our mental health (including risks of anxiety, depression and other significant disease) can be significantly impacted.

The take home message of all of this research, surprisingly similar to how the bees operate, is to create an environment that feeds the "good" (health promoting) bacteria so that it will get strong, link up, and work in coordination......which, as the authors of the latest paper showing the benefits of a "MIND" diet means:

"to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day -- along with a glass of wine -- snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week."

And to

"limit intake of the designated unhealthy foods, limiting butter to less than 1 1/2 teaspoons a day and eating less than a serving a week of sweets and pastries, whole fat cheese, and fried or fast food."


Or in the spirit of Keep it Simple September - boil it down to "more or less": more fiber, less sugar, more natural, less processed.

If you haven't been apple picking yet this year, the Fall is officially here which means the window is closing......if they're especially good - thank the bees!

Have a great weekend,

Mike E.

Rise Up for metabolic health

Sept 17

As we continue our September theme of finding little and/or simple things that can make a difference in health, new research related to metabolic efficiency, insulin sensitivity and risks associated with diabetes type 2 may deserve a standing ovation… Several times a day.

Could it be so simple as spending more time standing than a typical day to lower insulin sensitivity?

Well, additional research will be needed to confirm the findings, but this week at least one study on adults between the ages of 40 and 65 has shown a very clear link between time spent standing per day and insulin sensitivity, one of the major precursors four diabetes. ( )

The short and sweet of it is that after measuring fitness levels and body composition (body fat percentage) researchers had participants wear a device that measured physical activity, standing and sitting time for several days and compared the findings to regular blood sampling.

Although they expected to find a connection between Fitness as well as total physical activity (as measured by steps) they were surprised to find a significant correlation between standing time per day and insulin sensitivity as well. Perhaps even more intriguing, after statistically adjusting for other variables the link remained strong….. meaning the time spent on our feet each day seems to have a link to how well prepared our body is to process blood sugar.

Although engaging the muscles regularly through exercise is a far more well-established strategy, rising up and standing may be a simple and practical tactic that we can incorporate frequently throughout the day….. and improve a key component of our health in the process.

Simple is good. Consistently doable is great. Maybe it’s a good time to get up and stretch those legs.

Have a great weekend,

Mike E.

slow down to speed up?

Sept 10

Imagine you were the one. The person who had to step into the batter's box this time of year, say, when your team was a game (or less) back from a playoff spot, deep into the 8th inning, in a situation that could give your team the go-ahead run. There you are.....taking in countless streams of information.....deciding if, based on everything you know.....and everything your racing heart is telling you.....a hittable pitch is on its way. Then, somehow, in the midst of what could easily be over-stimulating chaos, with split second timing and near perfect coordination you decide.....and might just make history.

If that seems nerve-racking, well, as we learned this past week from new research, in the truest sense of the phrase, where the word "racking" comes from the Middle Dutch term "recken" (to stretch), it is. In the study, when physiology was manipulated to force a high heart rate (like setting the idle on a car much faster), decision making was consistently slower. Brain resources were pulled away from the task of decision-making and shifted toward the task of keeping an eye on the "system status" overall.....stretching the remaining brain resources (nerves) as we try to decide what to do in any given situation. This helps to explain why serious errors occur more frequently in high stress situations and training ourselves to better regulate these reactions could even be the difference between life or death depending on the context of the situation.

Most of us will never find ourselves in a situation quite like the baseball moment described (very few people pack stadiums full of fans who pay to see them work); but in jobs that are safety-sensitive or involve emergency responding or high-stakes decision making in highly stressful situations, from a physiological perspective, we've almost all "been there". Most of us can recall a big life-moment or decision that included a racing heart rate. If so, it was likely that at that moment our reaction time was a little "off", our words might not have been exactly "right" and we may have even felt a little uncoordinated or clumsy. These are all signs of hyper-arrousal, the physiological state when we are so amped up (whether excited or stressed or scared, etc) that we blast right past the performance sweet-spot (the "zone" or the "flow state" as it is sometimes called). In this situation we need to literally slow down (our bodies) so we can speed up (our minds).

As part of our September emphasis on simple (and quick when possible), evidence based tactics to achieve performance gains - this week we highlight the long exhale. As this study showed, better performance on business related tasks was achieved when 2 different intentional breathing patterns (slow even inhale/exhale and prolonged exhale) were used and another study, in law enforcement and military personnel, showed that under "active" conditions, prolonged exhale was correlated with better outcomes.

What does this mean for all of us?

In moments of stress or when you feel yourself revving up (but there isn't actually a need to fight/flee/freeze) - regulate your breathing to quickly reset your nervous system. If you need a particularly easy to remember tactic - try extending the exhale to help slow the engine and speed the brain.

Have a great weekend,

Mike E.

saving for the future: little big things

Sept 3

3 simple principles with the potential to change the trajectory of a person's life. Sounds sensational maybe.....but the exciting part is that they closely follow what we know to be intuitive AND what the research proves out. This week, as part of our September commitment to uncovering and sharing more of these "little big things" (simple and/or time-saving tactics that have shown a significant impact when studied), we will dive a little deeper.

1. For Sweet's Sake - you may have heard us explain the benefits of maintaining a "more or less" diet - which takes the bulk of modern nutritional research and condenses it into a principle which we can build on. It's a pretty simple concept - add "more" items that are known to have a positive impact (plants via fiber, polyphenols and flavonoids) and consume "less" of the foods known to harm us (highly processed foods, added sugars). Well, if this concept makes sense to you, the good news is, more research points to it as a viable approach. Prefer the "more" column? Well, we'd suggest a handful of walnuts per day (shown to lower "bad" [LDL] cholesterol) or adding in more whole-fruits which has a significant positive impact by feeding the healthy bacteria in our digestive tracts (this study showed 2 servings per day lowered blood pressure). If you prefer the "less" column and know it's time to take some sugar out or minimize the processed foods - THIS study lends some strong support. It showed that at the population level, if we were to reduce the sugar in our food by 20% we could save millions of lives (via heart disease and diabetes prevention) and billions of dollars in unnecessary healthcare costs. Of course, this is all inline with the article we flagged last week which got 5,800+ foods down to the minutes of life gained or lost.

2. MOVE is for more than muscles - this is an incredibly important concept, but easy to miss. When we think "movement" and the therapeutic effect it provides, it is natural to think about the muscular portion of the system. But there are so many more benefits to deliberately maintaining or incrementally improving movement. Techniques like Yoga, Tai Chi or even participating in a simple daily dynamic warm-up impacts the entire system. For example - this study from 2020 showed that the "warm-up" effect of daily stretching stimulated lasting blood flow changes in those that maintained the practice for 12 weeks. Specifically, blood flow to the extremities improved and blood pressure decreased. Interestingly, this very recent study showed that making the moving parts work even without "officially" moving them (isometric exercise), can have a blood pressure lowering effect.

3. No strain, no gain? We often think of "strain" as a negative term......the state when we've overworked our tissues to the point of delayed recovery......or even worse yet, true injury. However, in the truest sense strain is the physical/mechanical version of "stress" (or "load" if easier to keep straight) and depending on the duration and the intensity, it's often a good thing. The line between "stimulating" the body enough to stay strong but not so much to create harm can be a fine one. We often talk about the "sweet spot" of training loads and the "goldilocks phenomenon" (not too hot, not too cold, just right) which helps to explain the "nonlinear" threshold on how we respond to physical effort: some is good, more is a point. This week we saw more evidence that the principle continues to ring true. In the largest study of its kind, researchers showed any movement (e.g. walking) is beneficial to reduce the effects of sedentary time but it was the individuals who "pushed" themselves into moderate or vigorous efforts (exercise level loads) that maintained the critical level of fitness required to fight off injury and disease. If you're one of the many who find it hard to get started, here is some encouraging news - a new version of "muscle memory" has been discovered - so even if it's been a while, you may bounce back faster than you think......and for those who haven't ever had the habit.....some new research says that although you might've missed a little bit of the "compounding interest" that comes with long-term (health)'s NEVER actually too late to start.

Have a great "unofficial end of summer",

Have a great weekend,

Mike E.

Exertion Sprouts

August 20

Whether you're watching the well-known whiteboard YouTube video from Dr. Mike Evans or any number of Ted talks on subjects that hover near similar themes, there is one thing that almost everyone agrees on:

Physical Exertion (most commonly in the form of exercise), in the right dose (not too little, not too much), is good for our health and quality of life (aka thriving).

And although we often debate how much is the right amount, why consistently fitting it into daily life is a challenge and what strategy is best suited to take down the barriers, most everyone sees the value... or can EASILY find a good answer.

Buy why exactly is it so important? What exactly does it do to protect us from the negative effects of heart disease, high blood pressure, anxiety, depression, injury, infection and any other number of health concerns? These questions can be less clear.

Part of the reason why is because there seem to be so many beneficial effects. Exercise can impact hormones and gut bacteria which can lift our mood and tamp down inflammation. It can help us get more fuel-efficient by nudging the active tissues to soak up excess blood sugar and burn fat as fuel. It can improve our physical function by changing the resting tension and balance of our soft tissues and it can even tell our cells to make more energy while turning genes on and off. But one of the most important things exercise does is the one we can almost instantly feel when we start doing it... something we probably don't pay much attention to (although maybe we should) during normal activities, but becomes obvious under exercise conditions.....the Oxygen cascade.....which is a fancy way of explaining how we grab oxygen out of the air and efficiently bring it to the working tissues to help breakdown fuel and unleash energy.

This week we got a few new insights into how this process, when we activate it through exercise, can have beneficial effects. Although oversimplified - the gist of the new research led by a team from Switzerland is that exercise (due in part to an increased demand on the oxygen cascade) almost instantly kicks off a series of reactions in the blood vessels of dark-red (type 1) muscle fibers telling them to create even more vessel-cells and literally "sprout" new micro-pipes (capillaries) - a process known as angiogenesis.

More capillaries means more efficient blood flow to the working tissues.....which means easier delivery of nutrients, better energy production and more efficient removal of cellular waste... all critical components of thriving.

Need a motivator to get started? Go back and read THIS 2016 Article (one of our all time FAVORITES) which showed that, if you get started in the next couple weeks, even 1 minute of exertion per day, 3 times per week, may be enough to give you a 20% boost by Thanksgiving!

Have a great weekend,

Mike E.

New Traditions or Superstitions?

August 13

Last Sunday we saw athletes from all over the world put the proverbial "bow" on the long-awaited 2020 Summer Olympics. There were some great performances, some heartbreaking moments and up until the very last day, a question mark as to whether the delegation of athletes from the United States would once again claim the most gold medals, something it has done more than any other nation, 18 times (and now 3 times in a row) since 1896.

Although the preparation and commitment it takes even to qualify is amazing, for the geeks among us (namely, the Pro-Activity team), the real question becomes - when a split second is the difference between gold and silver (such as when Gable Steveson scored a buzzer beating takedown to win the 125 kg wrestling final) or when multiple people break the world record but only one can win, such as in the 400 meter hurdles where NJ's Sydney McLaughlin broke the WR for gold and so did NY's Dalilah Muhammad for silver.....which also happened in the men's 400 m hurdles, what is the difference-maker?

This question is at the very heart of performance.....and it's really complex, which is one of the things that makes it fun to discuss, debate and maybe (when effective) to experiment and learn from.

For example - questions like the following come front to mind:

What sorts of new approaches were coaches and professionals recommending to keep athletes cool in what seemed like unbearable heat? How did the mindset play in - was it harder to perform when there wasn't the roar of the crowd present? How come we didn't see nearly as much cupping and kinesio tape this time?

Some of the hacks & trends we saw on TV have a growing foundation in science (like finding ways to cool the body quickly and effectively), others are still emerging (like blood flow restriction training, something used in rehabilitation and seen a bit this Summer) and still others may have an effect that is hard to quantify/measure (aka "non-specific effect") - maybe something that seems more superstition than new tradition (today IS Friday the 13th after all).

And so the debate as to which of these tactics, tweaks and hacks might actually be worth the effort, rages on.

With that in mind we decided that in September, as part of our monthly content, the team would tackle some of the "biohacks" that we think might have particular benefit for the rest of us - the "working athletes" who may not ever get a medal or a podium to stand on, but rely heavily on our bodies and minds to design, make, study, distribute, maintain and refine to win the day everyday. More to come.

Have one you're interested in? Let us know.

Have a great weekend,

Mike E.

Genetic Tune Up in 30 Hours?

August 6

And just like's over. The long awaited 2020 Summer Olympics from Tokyo, Japan is almost completely in the history books with closing ceremonies this coming Sunday.

As we've come to expect, along with reports of excessively hot weather, there were some triumphs and some heartbreaks, some world-record setting performances and a handful of new names to add to "Greatest of All Time" conversations across several sports. With any luck, along with renewed respect for exactly how much needs to go right to be at the top of a sport at any given moment, millions of viewers around the globe were inspired by the focus and athleticism on display, feeling an urge to get out and MOVE.....and now might just be the perfect time.

With the (historical) peak of heat in the rearview we are rounding the turn and starting the second half of the Summer 2021 season, leaving about 6 weeks until Fall. According to some new research, that's just the right amount of time to stimulate a health tune-up that can give us a boost all the way down to our genetic code before the next peak (Winter) comes into view.

1 hour per day

In order to test a potential link between exercise and how our genes function, subjects performed 60 minutes of moderate intensity exercise ("spinning" for 1 hour, 5 days per week at 70% of their capacity).....accumulating 30 total hours of exercise in the six week training period. Then, after a 2 week settling period, researchers tested a wide variety of their genes to see if there was any notable response; to determine which (if any) had been turned "up" and which had been turned "down".

What they found was that this "dose" of moderate endurance exercise was enough to kickstart remodeling in the genes of skeletal muscle, a clear link between exercise and the body's ability to fight disease and promote future health.

If we stack this new finding onto existing research which clearly shows that as fitness goes up, the risk of a severe reaction to the SARS-COV2 virus goes down now, as things appear to be ramping back up, may be the perfect time to get all the great benefits of improved movement fitness.

It's a fantastic time of year to invest an hour in your future self. As always, if you need support (or a plan), reach out!

Have a great weekend,

Mike E.

Ebbs and flows - cultivating resilience

July 23

It's one of those questions that will get asked a lot as the Summer Olympics (scheduled for this morning at 7A ET ) takes over our attention these next few weeks - "are those at the top of the podium just "born with it"? Or did they scratch and claw their way - cultivating success by adapting and continuing to climb year by year?"

It may seem like a sports-related question, but it has important implications for anyone who is working toward a long term goal - athletic or not. Maybe it is paying off student loans or a mortgage. Maybe it's saving enough for retirement. Maybe it's getting through a full year or more without an injury. Maybe it's helping a child advance education or career. Maybe it's all of these and more - the question remains, can we really predict who will actually cross the finish line successfully and who might give up early and never quite get "there"?

The answer seems to be "yes AND no".

On the one hand, "grit", which is defined as "perseverance and passion for long-term goals" by psychologist Angela Duckworth and colleagues (who published works in 2007 and 2009 on the subject), is believed to be a personality trait, something that is generally considered a stable characteristic which predicts success, especially when effort and stamina to persevere amid setbacks is required. But an interesting new study from NC State may refine this understanding somewhat.

More like a muscle?

In a nutshell, the researchers determined that resilience is dynamic, not static. That is, it ebbs and flows, influenced by the context of a situation, sometimes stronger and other times not as a sense more like a battery which can run low or a muscle which can get tired depending on what it's trained for. Of course, this only gets more interesting when we consider those who run low on resilience (as defined by scoring low on THIS 6 question survey) also tend to have more negative health impacts from stress.

So how can we make sure our resilience muscles are all charged up and ready to perform at their best?

The short answer (another lesson from the pandemic), seems to be in the combination of "will power" (the ability to get started and stay the course) and "way power" (the ability to see a path forward in challenging situations). In psychology, this combination is called "hope"....and it can be measured (here).

People who are more hopeful tend to be more resilient....and people who are more resilient tend to be more successful and healthier longer.

Need something to spark some hope? Historically speaking, the hottest days are mostly in the rearview, the experts predict "our team" will win the most gold medals and more of us feel like we are "thriving" than any time in the last 13 years.

Have a great weekend.....and share some hope with your loved ones!

Mike E.

Going the Distance with Immun-ercise?

July 16

She led a pretty remarkable life. Partially because of the experiences along the way, but to all of us looking from the outside in, mostly because of the fact that it was the longest on record. Jeanne Louise Calment was 122 years and 164 days old when she passed, the world record for lifespan. She lived 56% longer than the average in her country of France at the time (1997) and about the same percentage longer than the American average today.

It might seem hard to imagine what it would mean to have four decades of life beyond what is typical. It might seem hard to imagine more than 60 years of retirement (the average age is 61 years)... but if you are a longevity researcher, it's not as hard as it might seem. In fact, some recent work on the subject says we will almost definitely see Calment's record broken during this century and there's even a chance someone might live to be 130. Maybe you! Whoa.

But what are the factors that separate those who live such long and robust lives from the rest of us? Are they health freaks - doing everything perfectly? Do they hide-away from the rest of the world and the risks it brings? Well, if you believe some recent work being done at Stanford which used computer models to develop an "Inflammatory clock of aging" on a group of 1,001 individuals aged 8 to 96, it may be the immune system which holds the key.

The team found a small signaling agent called CXCL9, which is known to (at some level) regulate our cellular response to infection, was the strongest predictor of aging.....and....perhaps more importantly, that when it was blocked, stopped many of the changes associated with aging.

What does this mean for us? How can we use this information here today?

At the simplest level the connection between immune system health and inflammation is critical. Things that help our bodies dial-in the inflammation goldilocks (not too much, not too little, just right) are important. In addition, just like finding the sweet-spot which challenges our working tissues to stay strong and flexible without overdoing it can keep us near the top of our game, "exercising" our immune system both figuratively and literally, in a similar way, may be more important that we realize.

More to come.

Have a great weekend,

Mike E.

Climbing July's Peak

July 9

It can be a great time of the year to get things done. Daylight that starts early and ends late puts project season in full swing.....if only we could bypass the fatiguing heat, late-day thunderstorms and risk of injury. Since the good comes with the not-as-good, making sure we are staying on the right side of the injury/illness risks that we face is critical - here are 3 simple tactics that can help:

1. Cool things down - July is the hottest month of the year. Temperatures tend to peak around the third week, so controlling body temperature is critical for staying below the risk threshold. Although this is especially true for those working in the heat, almost everyone experiences an uptick in fatigue as the temperatures soar. This is why one of the most effective strategies this time of year is to keep cool - before, during and after any outdoor work. Cooling our systems before, during and after hard work can make a difference. For example, exercise performance in the heat improves by as much as 2-6% when temps are lowered prior to the event and muscle soreness is reduced if we apply ice/cold to bodies that have been worked hard immediately following activity.

2. Protect your sleep - since we are fatiguing faster (or more fully) in the heat, the more hours we have to recover via sleep can play a big role in whether we can safely climb July's "peak" or get bogged down along the way. Since extra sleep is a strong performance enhancer, going to bed early is high on the list of available tactics. Other tactics like naps or improving deep sleep by making sure the bedroom is dark, quiet, cool and free from other sensory cues (like strong scents) can help. Although (thankfully) there doesn't seem to be a compounding effect of reduced sleep quality and heat, we know that each has the potential to impair work capacity, and since some people find it more difficult to sleep in the summer, doing our best to make sure sleep is a priority is critically important this time of year.

3. Kidney Kindness - it probably goes without saying that hydration is our best cooling mechanism, which makes cool fluids a critical lever as we work through the heat. However, one detail that is easy to miss is that in addition to keeping us cool, staying hydrated is critically important for filtering organs like our kidneys. Unfortunately, in extremely hot environments the risk of kidney injury and kidney stones both increase. What does this mean for those who are working in the heat? Backpain from working hard and kidney pain from being dehydrated can easily mimic each other. Keep an eye on urine color and volume. Aim for pale yellow. If output seems low, consider increasing your volume to normalize it. If you are a healthy eater and are not on medications that interact with salt, consider adding a bit to your food if you are sweating profusely. If you are unsure, we are happy to troubleshoot with you over a consult.

What's the bottom line?

The risks are real but the human body can handle almost everything we throw at it, including hard work in hot environments. Simple tactics to stay cool, make sure we are hydrated and fully recovered as we step into it can help make sure.

Have a great weekend,

Mike E.

Redline Foods

July 2

I'm sure it sounded plausible but maybe a little crazy the first time I mentioned it to someone - our food choices have a direct impact on the number (and intensity) of aches and pains we experience. Specifically, everything we know about how food interacts with our physiology suggests that eating foods that are highly processed (additives, sugars, etc.) and/or what we now call a "high inflammatory index" (low in fiber, low in nutrient density, high in certain fats, high in refined carbohydrates) can "rev us up", causing our bodies to run in a more sensitive state, where foods that are on the opposite end of the spectrum (fruits/veggies, whole/high quality, lean, etc.) tend to give us what we need to slow down, repair and recover from the daily grind.

It seems obvious in some situations - no one ever questions the "rev up" effect we get from foods that contain known stimulants (caffeine for example) and anyone who has ever seen kids or grandkids spike and crash after eating too many sweets understands - but other connections are met with much more surprise. For example - the links that show consuming summer favorites like berries seems to lower the risk of knee pain (whether blueberry or strawberry) is almost always met with a little shock when we tell people. Similarly, no matter how many times we explain the second-order effects - that certain foods impact blood sugar and fats (first order) and both poorly controlled blood sugar AND poorly controlled blood fats (e.g. cholesterol and triglycerides) have been linked to soft-tissue injuries and pain (especially tendon conditions, here and here respectively) and might even slow the recovery process after injury (second order), people seem skeptical.

But now, with contributions from researchers from a variety of fields over a 5 year period, a study anchored at the University of Texas has shown conclusively that certain foods, particularly those high in the inflammatory fats that come from highly processed foods which are high in Omega 6 (examples here) can turn the sensitivity of the nervous system up to a level that increases pain incidence and, when removed, completely back it down again. Although the study was performed initially in mice (which means it still has to be replicated), it makes a very clear link between food and pain; something that will have a very big implication for those who experience inflammatory (e.g. joints/soft-tissues) or nerve-related (neuropathic, e.g. diabetes related) pain.

There is still a TON to learn in this area, and we expect it will get much more specific over time, but for now we can confidently say that how we FUEL not only impacts our cardiovascular (heart disease) and endocrine (diabetes) systems, but has a direct impact on how we MOVE (pain free vs. not) and therefore should be a consideration in any plan we put in place to maintain the highest quality life as long as we possibly can.

We are about 2 weeks into the 13 or so of summer. Stay cool and keep recovery at the top of your priority list - even if that means steering clear of foods that can redline our nervous systems.

Have a great weekend,

Mike E.

Well-being and the Work of Grief

June 25

He was a fantastic person. A firm believer in our mission at Pro-Activity and one of the first people to invest money, time and energy.....he was always near the front of the pack whenever we needed someone to lend a hand, and he didn't care whether he was in a position of authority or the guy sweeping up after the day was done, he was just happy to be a part of it, to see the great work that could be done when people choose to invest in their health and community. Tom was both a biological father (to a few) and a father figure (for others) during our nearly 24 years as a team. He was a founding partner, our number one fan and someone we could never be quite ready to lose. So it was under the weight of deep sadness that, in person or in our hearts, the team said good-bye this week.

As one of the first sentences of M. Scott Peck's book The Road Less Traveled captures it so accurately, "Life is difficult." - it most certainly is... but since Tom was the ultimate teacher, finding the lesson or teachable moment in every situation, we figured a great way to honor him would be to learn what we can in this moment; one which we all must face at some point.

Although we all experience it differently, what doesn't get talked about much is the physical impact that grief has... the toll it can take... As the authors of THIS 2020 review showed, grief can impact a variety of our psychological and physiological processes. From temporary changes in our cardiac and nervous systems that go hand in hand with stress, to ramping up (at first) and eventual suppression of our immune responses (when prolonged), grief impacts our defenses including our ability to maintain healthy actions (eating well, sleeping, etc.).

It's not just the impact of grief but how we handle it that matters too. There is a predictive power in how we grieve, whether we accept the support of others as we process through the stages, can actually tell us a lot about how lasting the impact will be physiologically. Not the kind of thing that is easy or comfortable to think about, but something that absolutely impacts our well-being and therefore worth exploring. In this particular case, the exploration leads past the immediate sadness to many reasons to celebrate - because this member of our team had learned his unique answer to the ultimate human question ("why are we here?") long long ago... and he lived his life fully and struggled-well in line with his principles and according to that purpose, something we know sits at the very heart of happiness. It doesn't make it easy, but maybe easier.

Life IS difficult. Grief is difficult; but with faith in something bigger than ourselves, hope in the dawn of every new day and love in our work, for our friends, our family, our country and our world, never impossible.


Whether your tradition is prayer or thoughts & energy or something entirely different - if the words in this blog or the actions of our team have ever made an impact on you or someone you love, send something positive in Tom E's name... we've never talked about it and he'd never take the credit, but many of the principles and concepts track back in one way or another to him.

Have a great weekend,

Mike E.

Leveraging What We've Learned

June 18

There are so many reasons to wish the COVID19 pandemic never happened. Whether it be the heart-wrenching 3.8+ million lives lost across the globe, the new stresses we collectively had to endure and adapt to, or the many "little big things" (graduations, gatherings, etc.) that had to be put on the shelf, it's probably safe to assume when we tell the story to the next generations it will be one that highlights how real the struggle was.

In the spirit of silver linings however, there is always something to be learned; something we can leverage in the future, whether it's in the face of this virus or another and whether it remains at the level of a global pandemic or downgrades to "endemic" (like a seasonal flu) as some experts expect it will.

Maybe going forward we will keep the importance of human-connection and close contact as it relates to overall well-being in focus. Or, with any luck, perhaps some of what we've learned about what drives our susceptibility and/or resistance to severe infection will be used for our benefit.

For example, this recent study added more evidence to the growing pile which demonstrates the connection between what we eat and our risk of severe illness. In this case, health-care workers (physicians and nurses primarily) across six countries who were heavily exposed to the SARS-COV2 virus were asked to report their dietary habits as well as their infection status & severity. The analysis revealed that who ate diets known to lower inflammation and improve immune responses (diets high in fresh fruit, veggies, nuts/seeds, legumes with or without fish) had lower likelihood to become infected and experience a severe reaction when compared to peers who ate diets that were more inflammatory (high protein/low carb or more highly processed) and worked in the same or similar conditions... and this is likely just the very beginning.

We hope over the next weeks & months the disheartening peaks and struggles of recent history continue to get smaller and smaller in the rearview. We look forward to a summer (officially kicking off on Sunday) which feels more normal and the chance to appreciate the little things that may have previously been easy to take for granted. We are confident that as we continue to find and apply the lessons learned we can increase our chances to thrive.

Happy Summer!

Have a great weekend,

Mike E.

Building a Pyramid

June 11

"If we can predict it, we can prevent it." - When it comes to the world of prevention (accidents, incidents, injuries, etc.), this is one of our most tried and true principles. It sounds so simple.....and it is on paper......but in order to actually pull it off, we have to dive a little deeper, which, as the latest research tells us, is mostly about 3 critical things. Whether you call them bases of they pyramid or legs in a stool, these three concepts, when they come together, can keep us healthy and injury free.

First - consider "load": The idea of measuring the amount of total exertional stress we are under is a great concept. It's primarily used in elite sports, but is starting to be more common in specialized work settings and the military. Perhaps the best part is that it can be done using low-tech or high-tech methods to determine the total load and the rate at which it is changing which, with a little math, allows us to predict what a body can reasonably absorb before overdoing it. When load is well-managed, we have 1 strong leg of the stool in place.

Next - to really predict soft tissue discomfort, we have to consider any history and or symptoms a person is experiencing. As we've discussed in previous posts, there are almost too many components to consider here. The good news is there are efforts in the research community, such as in the development of this tool from England, which makes this prediction easier and more streamlined by understanding the nature and behavior of any discomfort, how it is impacting a person's ability to move and even their worries associated with it.

Last - and ALWAYS critical, we have to consider baseline health. There was a time when it was easier to separate these in our mind, that sprain/strain/pain was only a factor of the external forces placed on the body. Now we know the external conditions can never be fully separated from the internal conditions. Simply put, younger and/or healthier bodies (and minds) tend to absorb more before reaching a point of harm. This was reiterated in a very recent review of injuries within military personnel which showed that age, overweight, a history of injury and poorer fitness (running test) were the strongest injury risk factors.

Now is the time of year to lean on a strong foundation. If one of the sides of your pyramid is not as strong as it should be, let us know.

Have a great weekend,

Mike E.

Reset The Timer...

June 4

I started watching a movie last weekend. It was long, got a little dry and I decided I valued sleep more than knowing what happened. BUT... they made a very big (cinematic) point to show the flipping of an hourglass as a means to keep track of time. An early stopwatch I suppose. Although the movie wasn't super compelling, it did make me think about how much we rely on time to orient us... to keep us on track and on schedule... and how much power that little timer carries.

It can be the source of intense pressure (running late for an important meeting or appointment). It is often the subject of very human discussions (knowing it's ultimately limited, what might we do if we knew we were running out of it?) and in the really good moments, it might even be something we try to distance ourselves from (guideline for a great vacation - hide your watch!).

This time of year, the timer, or calendar-countdown really, plays an incredibly big role as day by day we check off the second (Winter being the first) of 2 peak risk seasons... the 100 days of summer. Sure it's unofficial... despite the tradition of marking summer as Memorial Day to Labor Day, we won't actually get to summer for two more weeks (June 20), but the 98 days between the two brings with it a very unique risk set that can push us to the physiological limit... but if we're savvy, not beyond it.

You'll hear more along these lines as we progress... but here are a 2 keys and 1 "truth is stranger than fiction" type hack to unlocking a healthy summer:

1. Respect the ramp - we've covered this in the past. We'll cover it in the future. It's just so important. Ramping up to meet the demands of heat is hard work. It takes 2 weeks of steady exposure to acclimate... and that means... expect to be tired. Want to "win the summer"? Go to bed early... it may even protect against major depressive disorders.

2. Eat low inflammatory - a few weeks ago we highlighted research that shows how eating ties back to mental health. Although it may seem intuitive that if it's good for the brain, it's good for the body... strawberries might be particularly potent this time of year... this study showed an impressive impact on knee pain related to osteoarthritis.

3. Try the pink drink - seems too strange to be true but in a recently published study, a pink colored beverage increased exercise performance approximately 5% more than the exact same solution without the coloring. Although we certainly can't endorse "pink drink" as anything particularly special... maybe this study reminds us that we are stronger than we think... and sometimes, little things allow us to unlock that strength.

We'll keep touching on this topic as we check off the remaining 95 days... but most importantly, the timer has flipped and we are entering a performance peak - it'll be challenging but goes fast - as always, the team is here if you need us.

Have a great weekend,

Mike E.

Part 4 - Change Your Thinking, Change Your Brain

May 28

We've all got them. The days that go sideways. Maybe it's something at work. Maybe it's something at home. Maybe it's someone who just has an uncanny knack for rubbing us the wrong way. Maybe it's all of the above and more. Whatever "it" is.....the irritants in life exist and sometimes they find a way to occupy more space in our lives than they should, causing us stress, displeasure or, if it goes on for a while, unhappiness. These are the opposites of well-being...and they are the kind of thing that can take a toll on our health and quality of life. With that in mind, the questions become - what can we do about it? What are the tactics & personal "experiments" (structured attempts) that have proven to be effective.....because if we can determine what works for us....we can continue to progress.

Brain Physiology

One of the critical underlying concepts in this arena is neural plasticity - that is, the adaptability of the nervous system (including the brain) to changing stimuli. Said another way, the brain is not a muscle.....but in a sense it can be trained like one. where reps are practice... and practice builds habits; so whatever we ask the brain to do regularly, is what we ultimately get "good" (efficient) at.....and whatever we withhold from our routines, like any old habit, gets rusty and weaker. Take for example this AMAZING 2015 STUDY which showed that there were structural differences in the brain of optimists AND that these folks had some level of protection against anxiety... literally their brains were different.

Of course it might be tempting to conclude that they were just "born" that way....the lucky few. Although possible, other studies, like those conducted and described HERE by one of the experts in the field suggest otherwise....that optimism can be learned, practiced and therefore, made stronger.

Optimism Exercises? Replace PPP with TIE

One key to cultivating optimism is to reframe the situations we are in - that is, to listen to how we are explaining a given situation ("the story we tell ourselves") and explore alternatives replacing the "3 Ps" of pessimism: permanence, pervasiveness and personalization with something less harmful. Specifically, when something doesn't go our way, if we slip into the trap of thinking it is permanent (unfixable), pervasive (crosses into many/all aspects of our life) and personal (a part of who we are, something we "own"), we are much less likely to be happy. On the other hand if we conclude that it is temporary ("this too shall pass"), isolated (a bad experience at home doesn't HAVE to cross into work life and visa versa) and that with effort we can work out of it, we are much more likely to be resilient in the challenging times and notice and appreciate the good times more fully. This video breaks the concept down further.

Of course, these aren't the only ways to exercise these parts of the brain. Working on attention by focusing on neutral or otherwise non-emotional context in a given situation (Focused Attention) as well finding silver linings (Cognitive Reappraisal) showed promise to improve well-being AND brain structure.

Boiling it all down

So, after 4 weeks of information on well-being, what can we say we know?

(1) Well-being (happiness) can be both measured and impacted.

(2) The life stressors known to impact it (work, health, finance, relationships, community) are surprisingly universal and interconnected (therefore compoundable)

(3) Physical Health is an excellent starting point since it impacts nearly all domains and the entire system (brain & body) which controls stress. It is well proven in this regard.

(4) If prioritizing physical health is not possible at the moment or we are ready to level-up, mind-based exercises - that is, working on the internal conversations we have and the way we explain things to ourselves - can be very powerful in not only shaping our thoughts... but even our brain!

And with any luck, you've got a long weekend to give it a try!

Special gratitude for anyone who is remembering someone specific this Memorial Day.

Have a great long weekend,

Mike E.

Part 3 - A Foundation of Physical Health

May 21

Stronger, Happier People through Better Health. That's it. Our mission at Pro-Activity... our "why". It took us a while to land on that mission statement, but the day we got the words "just right" we knew it. We chose the words "stronger and happier" because they have depth. To some, stronger means the ability to generate force - i.e. the ability to physically (and safely) do work... which is of course central to our purpose; but under the surface, it also means robust or resilient against stress - the ability to handle what life throws... including the occasional "curveball".

We chose "happier" for both the obvious reason, that when we peel back the layers most people just want to be happy.....but also for a less obvious reasons, as an acknowledgement that in a world as complex as the one we're in, being happy is a moving target; it's often the pursuit and the progress-gained that matters most.....and so "happier" (than yesterday or last year, etc.) can be an achievement in itself.

Finally, by putting "stronger and happier" next to each other (since they have such an amazing compounding effect) and trying to be clear on the "who" (people) and the "how" (health as a lever), it resonated... and it just happens to fit perfectly when it comes to this, our third week in National Mental Health Awareness month because although a good & fulfilling job was the most powerful driver Gallup found, physical health, even if only a few minutes per day, is at the root especially when work is physically demanding or requires intense focus; it's the base we build on.

Does research agree? Yes.

MOVE: Not only is the achievement of fitness important to increase the odds of happiness, but the consistent practice of investing time and energy into it matters.

FUEL: There is a clear link between healthy eating and mental health. This 2017 review and this 2018 review both showed connections between the inflammatory index of a person's diet and their mental health. This review showed the effect is not limited to adults but extends to adolescents as well.

RECOVER: The link between sleep (both quantity and quality) and mental health is well established. In 2017 a randomized controlled trial (often considered the gold-standard of research) even showed that improved sleep was a driver of improved mental health. Although we don't know all of the ways in which they are linked, it appears that stress (as measured by increased heart rate while sleeping) may block our ability to get the full recovery we should while we are asleep, something that can be even more pronounced depending on a person's childhood experiences.

With all of this in mind - May is a great time to not only be aware of mental health, but to take some steps toward happiness and greater well-being. We'll wrap up this series next week with a handful of "personal experiments" that can get the ball rolling.

Have a great weekend,

Mike E.

Start Simple: Where Do You Stand?

May 14

I don't know much about the sport of rowing....but it seems simple enough right? While keeping yourself perfectly balanced in a boat that is just barely big enough not to tip over, use a stroke technique that "grabs" the water without digging in too much (but remains as aerodynamic as possible), while keeping the boat on a straight line against wind & current, at a pace that is both fast enough to win but physically sustainable, all while ignoring the burning and pain associated with oxygen depleted muscles.....oh, and if you're in a boat with multiple people (a crew)....this all needs to be perfectly synchronized across 2 or 4 or even 8 people doing the exact same things.....

Fair enough, it's actually really complex.....which is why (along with the cost almost certainly) so few people are successful.....but if you've ever read the book "The Boys in the Boat", which tells the story of the US Crew that went to the 1936 Olympics in Berlin, at another time of stress and strife in the US, it's clear that even complexity can be overcome with simple strategies applied in a dedicated and caring way.....and that hurdle by hurdle (or perhaps in this case stroke by stroke), when we pull together, we can get through the challenges and emerge even stronger.

So where do we start? Could it be as simple as 2 questions?

Not unlike the C.A.T. (calm, assess, test) method to determine if an injury was present (described a few weeks back), one of the very best strategies for any scenario as complex as subjective well-being ("happiness") is to understand where we are currently and the driving forces that have put us there so we can decide if a course correction is needed.

The Gallup Organization who has surveyed millions of people across the globe to understand well-being uses a simple, 2 question survey to do this. Based on the Cantril Ladder we talked about last week (developed in 1965 by H. Cantril), they use the image of a ladder with the lowest rung as "0" (worst life) and the top as "10" (best life) they ask people to rank:

(1) Where they see themselves today

(2) Where they think they'll be in 5 years

Seems simple enough right? Sort of like - "just get in and row.....and try to pull together".....but just like there is hidden complexity on the crew, our past and the conditions we developed in, our present and the environments we spend the most time in (live/work/learn/play/pray) and our future opportunities all add up to our ultimate "satisfaction".

If after we rate ourselves we reflect on the scores given and why we can be holding the keys to climbing. For anyone who didn't rate themselves a "10" on both, asking ourselves what currently stands in our way and what sorts of things we can do to remove those barriers is a strong place to start. Gallup says there are 5 key areas (which they too call "elements" and have a lot of overlap with Pro-Activity's 5) that drive the overall score:

Career (work & purpose; ENDURE), Social (love & relationships; CONNECT), Financial (economic stability; ENDURE), Physical (health and energy; MOVE, FUEL, RECOVER) and Community (engagement where you live; CONNECT).

Anything that improves one without limiting another improves the overall score and drives happiness. Nearly 2 of every 3 people rank at least 1 of the five areas high. Sadly, only 7 of every hundred rank all 5 high.

Take a minute to ask yourself where you stand - it might be the first step toward an upward climb.

Have a great weekend,

Mike E.

Thriving From The Inside, Out

May 7

Is it just me or are things looking a little brighter lately? Maybe not sunshine and rainbows just yet (is it ever?), but in general, as the sun literally shines brighter and longer in the sky it's a great time of year to take a moment, reflect on how much of a challenge the last year has been, find gratitude where it fits and ready ourselves for the next part of our journey.....which fits perfectly, since May is Mental Health Awareness Month.

With that in mind and throughout May we will be using the weekly blog to highlight some of the important information that relates to mental health, stress management, well-being and the connections to our physical health.


Abrupt change is hard....all over the world

The World Happiness Report, which is a deep dive into subjective well-being (the more scientific term for happiness) across 95 countries and going on for nearly a decade, showed a very clear trend, in 2020 negative emotions were more common across more than 40% (including the US) of the countries studied while less than 10% had fewer negative emotions.

In fact, as the USC Understanding America Study showed, mental health concerns like anxiety and depression along with stress and distress all rose significantly in the early phase of the pandemic but have since leveled off considerably.

But the news is not all bad. In terms of overall well-being, so many have shown incredible resilience and resolve, ranking their life satisfaction (using a tool called the Cantril Ladder) near the threshold of "Thriving", the highest category, which factors into an overall ranking of well-being as 14 for the US which represents progress over the course of time.


3 Practices that can help

Perhaps one of the most important aspects of well-being is that it can be cultivated.....that is, we can work on it and improve it over time.....and as we do we enter into an upward draft....getting more resilient to the stresses we face. Here are a few practices that really jump out as effective from the literature:

(1) CONNECT - building relationships that you can rely on with people you can trust is critical to our sense of security and well-being. Although this can be family, it doesn't always have to be. The most important thing seems to be the effort made and the trust gained over time. Whether it be picking up the phone to check in with someone or sending a simple text letting someone know you care, staying connected even in a distanced world is KEY.

(2) Self-care - energy management through personal health practices (MOVE-FUEL-RECOVER) are a major pillar in nearly all evidence based well-being strategies. Small steps can go a surprisingly long way. Whether that's a walk, a healthy meal or just a good night's rest, physical health stimulates mental health. Try to build a streak!

(3) Letting Go of the Unchangeable - This can be incredibly difficult.....but also amazingly effective. Working to understand the line between what is under our control and what is not consistently enhances personal well-being. Working to accept the things we cannot change is a well known tactic.....step by by day.

There are of course many many more tactics. We will explore more next week......but if you want to learn more before then, check out some of the Tools2Thrive developed by Mental Health America, one of the nation's leading non-profit organizations in this area of health.

Until then, have a great weekend,

Mike E.

Put it to the Test - Part 3

Apr 30

Maybe you grew up hating tests - if so you're not alone. There's a reason why more than 35,000 academic articles carry the terms "test-taking anxiety" when we searched Google scholar....and that only included items published since 2020! But depending on the circumstances, most people would likely agree that tests are not a bad thing. They're how we measure progress and how we know something (or someone) is what it (they) claims. And in the situation when we are trying to differentiate between something that hurts and something that is harmed..."testing" is how we pinpoint.

In terms of aches/pains, there are a few tests that, when performed at the right time and with the right intensity, are particularly important... something we feel everyone should know about. They are the last bit of info in our Calm, Assess, Test (C.A.T.) method we've been covering these last weeks as we wrap up April and, if the area has already calmed a bit, and the self-check came up mostly clean, putting things to the test is all that's left to do. Here are 3 of my favorite:

(1) The body heat test - this test is exactly as it sounds... it's about generating a little body heat... that is, priming the body to MOVE and getting the blood pumping a little. The best part about this test is that it is indirect - we don't actively stress the achy area beyond "natural movement" but rather see what that area tells us after we stress some other area. For example, if the shoulder is the sore area we might say go out for a good walk, enough to get out of breath some or break a sweat....let your arms swing naturally as able, but nothing more specific than that. After 10-15 minutes, how does the achy area feel? If it has improved (or even stayed the same but didn't get irritated), you've passed the test - this is great news.

(2) The RECOVER Rate - after test 1, this is one of the most important tests as it tells us if the area is still sensitive. We go a bit more directly at it this time trying to "stress" the area a little (but not fully) and see how fast it returns to baseline. For example, if the back is the achy area and the self-check has come up clean, it's a great time to do something that will stress (but not strain the back), like perform a series of light exercise tests such as the first 45 seconds of this video where Ali describes the "90 90 hold" and the "deadbug" exercise. If you get through the activity and (even if it creates some discomfort initially) you return to your baseline within a few minutes (but definitely less than 10), you would have passed and know you are ready to "level up" to the 3rd and final test.

(3) Resistance Test - if we've gotten this far things are looking pretty positive.....which means it's time to put some final tests in place. For this test we are going right at the achy area and are going to make it our world we call this "loading" the area. Now, to be clear, the goal here is not to overload or even fully-load (after discomfort it's best to build up to that), but rather put some stress directly on the body area and see how it responds. This usually looks a lot like the exercise you might do in the gym, whether with weights or a medicine ball or something else, but the idea is to put some resistance on the area as a test. We might start with a light number of repetitions (3-5) at a low level of resistance and then add repetitions or additional resistance. The RECOVER rate is important after this test too, but typically it will be a day or two (similar to the soreness after going to the gym for the first time in a while).

If you pass all three tests - you are ready to proceed with confidence as there is a very low likelihood of injury. Of course, this doesn't mean that all's well and the ache can be ignored but rather more activity or training is probably needed to increase the resilience of that body area and lower the likelihood it will be irritated again in the future.

With any luck if you've been following along you've gotten past the "T" in C.A.T. Let us know if you need some additional support or something more specific.

Mike E.

Easy As C.A.T. Part 2

Apr 23

Sometimes when we try to explain "normal wear and tear" from a body perspective we use the analogy of "wrinkles....on the inside". It's surprisingly accurate because we can see them (sometimes called "wear and tear" on images like MRI) and, like the ones on the outside, whether we dislike the way they make us look or OK with being "refined" they are more a sign of time than damage, everyone gets them and if left up to nature they're more likely to multiply than go away... and so we don't worry all that much.

Last week we jumped into this a little and talked about how to know when an ache or pain is of more the "inside wrinkle" type than harm and we used a simple formula of C.A.T.; calm, assess, test. Although the "calming" phase is the first window and can last a few days (or even a week)it's really the assessment and testing that helps us to get where we need to go... back to full ability and on the road to flourishing.

So how can we perform a proper self-assessment?

In fairness, we could never fully cover this topic in a blog post. But in the same way you don't have to be a trained mechanic to know a flat-tire when you see one, you don't have to have a health-professional license to know when it's time to get checked by one. So although we are not referring to performing an "evaluation" here, working through some of these key points can help to determine when the situation is "red light" (have a professional evaluation), "yellow light" (proceed with caution) or "green light" (nothing to worry about). Here are my top 4.

Signs of harm - injuries have tell tale signs. Things like significant changes in temperature (heat or cold), swelling, changes in color (usually redness) or bruising fall into this category as "red light" signs. An area that doesn't look or feel "right" is also worth paying attention to. Sometimes these are obvious, sometimes they take time to show up, so watching for a few days is wise.

Weakness or Persistent Sensations - although pain or even numbness/tingling does not necessarily mean harm (last week we mentioned the pain of stubbing a toe!), when these symptoms are constant or travels/radiates without changing either with rest or altered positions/postures, they are worth diving into more thoroughly. This is the case for persistent weakness as well. Although temporarily (like when an arm falls asleep and feels numb and weak) doesn't always usually mean much, if it lasts, it's best to consider it "red light".

Response to movement - if normal movement (even lower intensity) keeps the symptoms the same (or makes them better) it is usually a good (green or yellow light) sign. It's one of the reasons we encourage movement in many cases of stiffness reduces, things often feel better. On the other hand if most or all movement makes the symptoms considerably worse, or normal intensities seem to aggravate/irritate things, having a closer look to determine why makes sense.

Interrupted Rest - an achy body part can get in the way of good rest. This can be a bit of a downward loop because poor rest (in-turn) makes everything hurt more as well. This is not the kind of "merry-go-round" we want to get on. With that in mind, if something is keeping you from getting rest, it's best to classify it as a "red light" if for no other reason than to explore tips/tricks to get more comfortable.

One of the more important keys to remember is that the "A" portion of the C.A.T. approach is on-going. It's not a one-and-done kind of thing. The body often gives us patterned responses to look for which is one of the reasons we often recommend a few trial items and follow-up after a few days when we are consulting on a case. This of course is the bridge that gets us into "testing"... and the direction we will go next week.

As always, we recommend staying on the side of caution.....if you're not sure, that's why we're here....give us a call.

We'll finish up with "T" next week. Until then, have a great weekend,

Mike E.

Body Barking? It Might Be As Easy As C.A.T.

Apr 16

A few months ago I had one of those moments. The kind where I only remember stepping a little "funny" when out for a run but, after waking up and putting my feet on the ground the next day, realized something wasn't right. My right knee was really stiff... painful even... and for the next several weeks (and a little now and again) it barked at me when I stressed it (especially squatting or kneeling for longer periods). For someone like me who tends to be "on the go" a lot, this was really tedious.....I had to slow down, think about, and even prepare for activities and movements I normally wouldn't give a second thought. I had to decide whether doing something a certain way was likely to irritate my knee and if so, explore options for a less stressful way to minimize my risk of setting things off. Ultimately I had to decide whether this "hurt" (pain) was going to resolve or whether these were the signs of "harm" (actual injury).

Not only is this limiting (and tedious), but it can even get worrisome. Somewhere in the back of our minds a little voice might ask "is this going to be a lasting problem?". We wonder if maybe we are just "getting old" and might even begin to worry that if we don't "do something" we could make the situation worse. Even for someone with a good, working understanding of the healing process, determining how best to proceed can get complicated really quickly.

All that glitters is gold?

The more we learn about the human body and how miraculous it is at healing, the more we realize how much more there is to learn. Even things that seem obvious like soft-tissue injury found on MRI isn't always what it seems. For example, in a 2017 study which evaluated episodes of knee pain like mine (as well as shoulder pain) using the gold-standard MRI, came up short in people over the age of 40. As it turned out, in more than half of cases studied (159 out of 294 people) even though the scan "found something", in side-by-side comparison, the MRI was worse on the non-painful (uninvolved) side than the painful side. Said another way.....the risk of a "false-positive" for knee and shoulder pain goes up dramatically after the age of 40. Another team arrived at a similar conclusion around the same time for lower back pain, replicating a common enough finding for groups like (which rates the effectiveness of health care services) to warn against MRI for lower back pain.

So how do we actually know what to do?

The short (and often best) answer to this question is: C.A.T. (Calm-it, Assess-it, Test-it) and so, with that in mind, we will dive into each of these components over the next couple weeks. Let's start with "C".

C, "Calm-it". Pain (alone) is not injury. It can go hand in hand with injury, but strictly speaking, they are not the same. Anyone who has ever stubbed their toe, hit their shin, or felt the burn in their muscles when they've done something really hard knows that pain can be incredibly intense, but after it subsides there's not much to worry about. On the other hand, pain IS a warning system....the brain's way of forcing us to press pause on whatever we are doing and direct us away from what appears to be a potentially harmful situation..... If it's unclear if something is harmful, pain acts as a strong motivator to fight, flight or freeze. With this in mind, step one at getting to the other side is calming that response down a bit, allowing the body to turn off the fight/flight/freeze instinct so we can get a good assessment of the situation.

Sometimes this involves first-aid tactics like rest/ice, sometimes it involves something to reduce the chemical irritation in the area (over the counter anti-inflammatory and adding in healthy foods and water for example) and although not exercise per se, it often it involves gentle movement to prevent stiffness and promote circulation. This usually takes a few days with age, health status, fear, fatigue and more all potentially speeding or slowing the timeline.

More to come. Next week we will dive into the "A" in C.A.T.; "assess it"..... of course, in the meantime if this hits close to home and you've got a 40+ year old knee (or shoulder or back, etc.) that's barking back.....don't hesitate to give us a call or schedule a consult with one of the professionals on our team who can provide more specific guidance.

Have a great weekend,

Mike E.

The Focused Mind? It Matters.

Apr 9

In 2013, Daniel Goleman, a well known psychologist and author, published the book Focus: The Hidden Driver of Excellence, where he dove deep into the skill of "attending" (deciding what to pay attention to) and made the case that it was, or would, become one of the most important skills for the modern world. He could've never known then exactly how valuable our attention would become. In an age when we can be interrupted hundreds of times per day (and that's only our phone pick-ups), we know that staying aware of what is going on around us (situational awareness) and bringing our mind back to the moment we are in when our focus wavers (mindfulness) are two critical strategies we use to get through the risks we face each day and get home safe at the end of it.

But where does this come into play from an injury/illness/disease perspective?

The short answer to this question is: It's never as simple as "mind over matter"... but where we focus our mind, matters, a lot when it comes to healing.

Excess Stress Slows Healing: This review, first published in 2019, makes it very clear that individuals who are under heavier emotional stress (mind), heal more slowly (body). The authors reviewed 21 different studies and were able to piece together findings that support and build on work like this article from two years earlier which showed that stress, as measured by heart-sensors which can capture changes in heart rhythm associated with physiological stress (heart-rate variability), was related to delayed healing for individuals with diabetes after a wound.

Rebounding from Injury: The phenomenon also seems to hold true in the workplace. In a brand new study from a team in Canada, full recovery from a musculoskeletal disorder (injuries like sprains/strains) was slower for individuals who were recently diagnosed with conditions that more classically fall within the realm of mental health than physical health driving home the point that the separation between the two may not really exist.

So if healing is delayed after injury when all resources (mind AND body) are not focused, it stands to reason the same thing is happening even if we are below the "harm" threshold (wound on skin or muscular strain). This is one of the critical reasons why we recommend that everyone, not only the folks who feel stressed, work on the skills of resilience which we call ENDURE.

Getting Started

A surprisingly easy place to start is to foster a "conversation" between the mind and body... literally getting them better connected; helping the mind to become aware of what the body is feeling and help the body to concentrate its feedback. In more technical terms this is called a "body scan" and is often a part of mindfulness-based stress reduction practice. Check out this short (12 min) guided version.

We (humans) are complex systems made up of complex component "parts" trying to navigate an increasingly complex world. Unfortunately, staying safe and out of harm's way takes energy, effort and focus. The good news is, it can be done. The better news is, even a small investment of time can pay big health dividends.

Have a great weekend,

Mike E.

Building Strength: I yam what I yam?

Apr 2

Every once in a while I have to "go to the videotape" to give my kids a little view into history. Thankfully we have YouTube for occasions like this. Recently, in trying to explain the phrase "I yam what I yam", I searched some old clips of Popeye the Sailor because they didn't know who he was. After the disbelief (and grief for my youth) wore off, I explained the saying, the basic storyline and (of course) the role of spinach in Popeye's arsenal in fending off Brutus (or Bluto if you're REALLY a connoisseur). They were only marginally impressed.

This week however a couple of studies emerged which might prove that ol' Popeye who, unlike "Wimpy" of course, was never reaching for burgers to get strong, might have been more evidence-based than we ever knew.

Here's why:

(1) When a team from The University of Illinois at Urbana-Champaign tested previously untrained 50-ish year old adults to see how strength training combined with high protein (1.6 grams of beef-based protein per kilogram body mass) compared with strength training combined with the average/recommended protein (1.1 grams per kilogram) they found that both groups increased their strength an almost identical level.....showing that the strength training worked but the bump in protein really didn't add much.


(2) When a different team, this time from Australia, looked at the strength and functional balance of individuals at around the same age, those who regularly consumed high amounts of dietary nitrate (which was about 80% from plant sources like spinach [and other leafy greens], beets, veggies, etc) had significantly higher scores than those with the lowest consumption.

This is a fantastic time of year to increase your strength.....and even though the yams aren't typically ready for harvest until the end of summer, the Popeye FUEL starts early!

Have a great weekend,

Mike E.

Much Ado About Something...

Mar 26

More than 400 years ago William Shakespeare wrote "Much Ado About Nothing", and shined a light on how easily something which seems (but maybe isn't?) important can emerge from "nothing" when people add energy, focus and time. On the one hand, maybe he was trying to explain the late-1500's version of a slow-news-day. Or, on the other hand, maybe he was providing an especially important warning to pay attention to what matters most, something that we can easily get wrong as we continue to work-through and adapt to the information age. I like to think he was talking to those of us who try to make sense of health-risk and research now :)

Making health research practical and usable is tricky at times. The incredibly specific nature of research which is required to find something "statistically significant" among all of the potentially confounding factors makes it very easy to get lost in the mostly-useless details (trees) while missing the important application (forest). Of course the opposite problem can be equally tricky; flying over the forest (over-generalizing) and never getting into the trees (study design) can lead to sensational sounding headlines only to find an "all sizzle, no steak" situation or something so specific it's only usable in the lab... which is why we like one of the very recent contributions made by an Oregon State University team.

The Headline? Everyday people, doing reasonable things, can get immediate results.

The details? 15 healthy (but not particularly fit) individuals in their late 20's were asked to ride a stationary bike for 60 minutes at an easy pace (easy enough to talk through the effort, but too hard to sing). Researchers took muscle cell samples before and after to determine whether this exercise volume (intensity x time) would change how their bodies burned sugar and/or fat.

The Findings? After an hour-long exercise session, participants were consistently burning +/-12% more fat and +/-15% more sugar (measured at the cellular level).

The Connected Dots? Last week we highlighted research that showed the benefits of being able to maintain our balance at mid-life, walk fast as we age, and battle back the 12 hour ramp up in fat-production by our liver after ingesting added sugar. This week's research makes it clear that investing even a small sliver of time (about 4% of our day) into light-to-moderate exercise can go a very long way at hitting the reset button on personal health.

The Take-away? When it comes to improving health risk through exercise, "something" is infinitely better than "nothing".

Whether you're shaking off the winter doldrums, ramping up to be ready for projects at work or at home, battling back health risks or trying to meet the needs of our bodies.....NOW is a fantastic time of year to do something on the MOVE.....anything hard enough to be slightly out of breath, building up to an hour or more can immediately change our physiology.

Have a great weekend,

Mike E.

Healthy Headlines: Beware the Triple S

Mar 19

Over the last few weeks we've tried to consolidate a variety of themes: (1) movement matters across the lifespan, and relates to viral susceptibility. (2) Viral susceptibility can also be impacted by food choices, sleep, stress and social connections. (3) Common inflammatory conditions (especially high blood pressure, heart failure, diabetes and obesity) have been closely linked to severe COVID19 reactions and surprisingly simple things, like (4) eating 3 veggies and 2 fruit servings daily can help reverse the risks.

Again this week, the case got even tighter on the fronts of viral susceptibility and severity, using the way we move to predict health and longevity and how food choices today are driving health problems of tomorrow... and it comes down to a triple "S".

Speed: Want to know if you're at a higher risk of serious COVID19 reaction? Assess your walking speed.

With now a year of connecting dots related to resilience in the face of COVID19 under our belt....1 simple question rose to the surface this week: How would you describe your usual walking pace? (i) Slow pace, (ii) Steady/average pace, and (iii) Brisk pace’

This question, asked 10-15 years ago was found to predict health across hundreds of thousands of individuals in 2017. Now it has also been related to severe COVID19 reactions (including hospitalizations and mortality) in several of the same individuals. People whose self-rated walking speed was a "slow pace", had the highest risk of a severe reaction, more than triple the odds in some cases. If you have an iPhone you can find your average pace in the "mobility" portion of the Health App.

Stability: Want to improve your odds of a long/full life? Work on your balance.

Info this week confirmed again that movement today (or stabilizing to be precise), predicts health tomorrow. The ability to balance ourselves under varying conditions at or around the age of 40 predicted longevity more than a decade later in a study of nearly 6,000 people. It may seem surprising that something simple like brushing your teeth on one foot or standing heel-toe while washing your hands can make a difference in how long we will live... but they can.

Sugar: If changes in metabolism drive change in weight... what drives changes in metabolism? The answer is - sugary beverages and the effect lasts for a WHILE.

Maybe you've heard us recommend a "more or less" eating plan for health. That is, more fiber by adding fruits/veggies, less sugar by eliminating processed foods/beverages. Last week we focused on the "more" side of the equation, this week the case for "less" became even more clear. It started in Canada where a "which came first?" riddle about altered-metabolism and weight change came into better view. Metabolic changes drove weight gain.....not the other way around. But in order to answer the question of "what drives altered metabolism?" a team in Switzerland went to sugary beverages. They found that under tightly-controlled conditions the equivalent of 2 sodas per day for otherwise healthy folks was enough to spike the production of fat in the liver and keep that production spiked for as long as 12 hours even without changes in total calorie intake. Added sugar hits us hard....and lasts for a while.

We hope you can put these findings to use and share them with friends & loved ones to stay on the right side of risk. Be sure to send us health headlines you see and we'll try to dive in and see what the science behind them is telling us!

Have a good weekend,

Mike E.

The Long Lever of Spring- A COVID-19 Update

Mar 12

Last week I provided an update on physical activity and a variety of newly published studies which continue to make the case for MOVE across the healthy lifespan. One of the articles I mentioned was THIS ONE, which was essentially a recap (by the lead research) of decades long research which fairly conclusively demonstrated the factors that predict whether a person who is exposed to a virus would actually develop symptoms... that is, who, in terms of their physiological state, was a "viable host" for the virus to complete its sole mission of "replicate and spread".

What's particularly fascinating to me about Dr. Cohen's 30+ years of contributions in this area is that he has uncovered, using experimental designs that actually expose volunteers to viruses (mostly the common cold and/or flu) and quarantine in order to understand more, risk factors in EACH of the 5 ELEMENTS we so often touch on:

MOVE: Physical Activity - those who are physically active have less than 1/2 the risk than those who aren't

FUEL: Nutrition - those who consumed (via food not supplements) the vitamin C equivalent to 2 oranges per day cut their risk in 1/2.

RECOVER: Sleep - those who get enough (7 hours) and are at least 80% efficient (stay asleep most of the night) are 2.5 to 3 times LESS likely to become infected.

ENDURE: Stress Management - those who have strategies to manage (or even grow from) the stress in their life have about 1/2 the risk of those who are chronically exposed. Alcohol consumption lowered risk when kept moderate (1/2 risk) but increased it when it stressed the body via over-consumption and smoking tripled the risk.

CONNECT: Relationships & Social ties - matter... a lot. Those who had the highest number and variety of social connections (family, work, school, social, volunteer, church, etc.) 1/4 the risk of those who were the most socially isolated or had the least support.

And if that's not enough, here is where it gets REALLY interesting. In a study of nearly 1 million hospitalizations due to COVID19, more than 6 of every 10 were attributable to 4 (largely preventable) conditions - Diabetes type 2, Heart Failure, High Blood Pressure (Hypertension) and Obesity - all of which respond to healthy actions like those listed above.

So where should we start?

The simple answer is - wherever you can build a habit.

But if that sounds ambiguous, boring or like a heavy lift - or if the sun peeking out a bit and the feeling of Spring in the air is enough of a nudge, one of the best options might be to start planning a garden with an eye on consuming 5 servings (3 veggie + 2 fruit) per day all summer long. That's right, another MASSIVE study, this time comparing the health trajectory of 2 MILLION people, found that 5 servings per day of the fresh stuff had a significant impact on the same category of conditions at the root of severe viral reactions.

Whether it's the 35 years of expertise being distilled at Carnegie Mellon, the nearly 1 million COVID19 hospitalizations, or the 2 million lives studied over a generation, the message is clear - we are figuring this thing out... we just need to pull the right levers.

We are in the final week of Winter... bring on the vibrancy of Spring!

Have a great weekend,

Mike E.

Choose to MOVE: A Solution at Every Age

Mar 5

Welcome to March, the journey-marker that says we are nearing the first official day of Spring. Maybe it was the cold weather or the apparent release of years worth of pent up snowfall that was our test. Or perhaps it was the unique challenge associated with the pandemic which came back strong during the colder months that pushed us the most. Either way, there is good news: with more than 80% of a Winter that clearly delivered on its promise to test us now in the rearview, the times, as one of the great poets once said, are a changin'.

Whether it's already a loud voice spurring you on or just a whisper in the back of your mind that still needs to be amplified a bit, there are many good reasons to use March as the time to start your MOVE toward thriving in 2021. The best news is that the benefits hold for every age across the lifespan. With that in mind, here are some of the headlines worth knowing about:

Early Life - starting with the little little ones in our life, HERE is a great reason to run, jump, climb and play - as published last month, preschoolers with greater fitness had better cognitive and academic scores.

In adolescents - it is clear from THIS STUDY that physical activity between 12 years and 18 years of age is linked with markers of health. It is also (unfortunately) clear that the COVID19 effect in this age group has been generally negative with a particular impact on mental health. Given that physical activity is associated with better well-being in this age group, it's a great lever if your teen is feeling the effects of a long winter. Specific to COVID19, this was also found to be the case for college students.

At midlife the theme continues. A very recent study shows that individuals who have a solid physical activity habit at midlife have better brain scans (MRI) in later life. This builds on important work from a couple years ago which showed that leisure time physical activity (i.e. not work-related) was directly correlated with better cognitive function and a lower likelihood for dementia as we age. Couple those with the many benefits for our cardiovascular, metabolic and other systems and a few minutes per day of MOVE can go a long way.

Still not convinced? How about taking the word of one of the world's top researchers on immune function and the likelihood to get infected with viruses that we are exposed to. Yep, after 35 years of work in the space (including running "The Common Cold Project"), the senior researcher wrote a paper which cautiously (but directly) suggests that physical activity among other things may lower risk of infection with viruses causing COVID19.

Late life - and what about our parents, grandparents and other most seasoned citizens? The story continues along the same line. Even at very low intensities regular movement in women aged 63 to 97 was significantly associated with better health outcomes including preserved mobility and function as we age.

Longer days with warmer sun are on the way. 84% of one of the more challenging winters in recent history is now history too. It's time to get moving. Let us know if you need some ideas.

Have a great weekend,

Mike E

Limiter or Lever? It's The Little Things.

Feb 26

A couple weeks ago I touched on the idea of performance longevity. I used stories of 3 different athletes who had been able to both attain AND maintain an incredibly high level of performance as examples of how, with a focus on the right variables and emphasis on deliberate practice, it is possible to hold off the physical effects of aging to allow for a maximum timeline of "productivity". What doesn't get talked about as much is when longevity actually IMPROVES performance.....which, in this case, brings us to a few stories about bricklayers.

Like many physically demanding jobs, the construction related fields are known for taking a toll on the people who do the work. Heavy equipment, environmental conditions that can accelerate fatigue and a variety of other demands that stress the working tissues can cut a career short. In some cases, such as professional masons, even 5 years can be a long time. Knowing this, as reported in 2017, a team of researchers studied bricklayers to see if there were any notable differences in the way work got done. What they found surprised them -- a "U" shaped phenomenon between safe technique and experience. Those with the least experience (less than 1 year) and those with the most (> 5 years) were at a lower risk of injury, but those in the middle of the experience spectrum (1-3 years) appeared to have a greater risk of injury. Why?

The answer probably shouldn't surprise us. It was about striking the balance between "ergonomically safe" work technique and "productivity". Those with the least experience were still learning so although they tended to practice the safe techniques they were taught in training they tended to be less productive. Those with the most experience had mastered the fine balance of BOTH getting a lot done AND doing it with safe technique. The risk of injury noted in the middle-experience group appeared to be related to handling heavier loads and possibly sacrificing safe technique in hopes to get more done, a common trap.

What made this research extra interesting however was a more recent and expanded study which added in even more experienced bricklayers. As it turns out the most experienced masons, those with more than 20 years of work experience, made subtle changes to their work technique as the job progressed; they adapted and adjusted their postures and positions as the conditions changed in order to maintain ergonomically safe technique.

The punchline of course is that not only did years on the job undoubtedly help the master-craftsman hone their skills, but doing so with a primary focus on safe technique helped supply them enough time to actually pull it off. Said another way, the case of bricklayers appears to supply proof that minimizing risk for injury/illness/disease isn't a limiter (for example of productivity) but a lever for longevity.

Have a great weekend,

Mike E.

Ready for Reset? Start Priming.

Feb 19

I was talking with a friend from Northeastern Nebraska this week and the topic of winter weather came up. I shuddered as he told me of temperatures reaching 25 degrees BELOW zero without the wind. We agreed that even with snow falling, my 25 degrees ABOVE zero sounded nearly balmy by comparison and that we were both ready for the season to change. This, of course, is one of the funny things about change - as hard as it can be most of the time, when we are ready, we can go from resisting it to seeking it out and even celebrating it.

Late winter is one of the times of year we might really feel the urge, ready to shed the layers and feel the sun. This, of course, is not just a "pandemic life" sensation. As I've touched on in other places, the root of the word February (Februa) relates to a roman purification festival known to happen around this time of year suggesting that even a few thousand years ago people were ready for change right about now. Couple this with other widely celebrated events that have happened in the last week, whether the spring festival commonly referred to as Chinese New Year or the transition from the party mode of Mardi Gras to a period of intense self-reflection between "Fat Tuesday" and Ash Wednesday, and it seems history and tradition support the notion too.

So if the world is beginning a seasonal reset....what are the things we can do now (or at very least prepare for) to make sure we hit the Spring in stride 30-ish days from now when it arrives? After a little time poking around what's new in the health research and keeping in mind the ages old QQS success formula I reintroduced last week (the right quantity of high quality effort combined with a spirit of growth & development), there were 2 that seemed to jump off the page for me:

1. Ramp up the MOVE - most of us feel an urge to get out and do something when the sun starts shining.....start priming now! There are too many good reasons to list, but in the last 30 days alone research has concluded that shaking off the rust and working those skeletal muscles can turn on genes that control how we use and store fat, stimulate 12 times more production of hormones that directly impact the aging process and of course lead to fitness which has been linked with future inflammatory auto-immune conditions.

2. A Long Winter's Nap - it may seem counterintuitive, but if you really want to improve performance, a final bit of hibernation may do the trick. I came across this study earlier in the week. It's not brand-new (2011), but the results are so impressive it's worth knowing about. Stanford University researchers wondered how closely sleep was related to physical performance, so they recruited some basketball athletes and asked them to maximize sleep over a 5-7 week period. The change they saw was impressive - shooting accuracy improved by nearly 10 percent both from the free-throw line AND from 3 point range and the athletes reported greater physical and mental well-being. If you want to be ready to do more in Spring, get your sleep.

It may be hard to believe, but Spring will be here in about 30 days. If we start priming our systems now with the right inputs, our bodies can be ready to embrace the reset in seasons when it arrives.

Have a great weekend,

Mike E.

Keep Growing - Performance Longevity

Feb 12

Being our best in the long term is really hard work. It takes a relentless drive to improve, a focus on the little things, and the ability to amass a vault of practice repetitions without extended setbacks from injury, burnout, or a variety of other obstacles. Maybe this is why there aren't many examples of people who've done it. Yet if we look back, even as far back as 8 decades, we might be surprised at how steady the fundamental formula has been.

Dive in to learn more.


The Rest of the Story

On the one hand, as a LONG suffering Miami Dolphins fan (last playoff win 20 yrs ago) who grew up spoiled watching Dan Marino do amazing things, it is VERY hard for me to type the next statement.....Tom Brady may actually be the greatest quarterback of all time. Winning a SEVENTH Superbowl at 43 years old, taking a team of mostly non-stars (1 pro bowl selection) who were on track for a good (but not great) season in terms of wins and losses at the midpoint and leading them to wins over multiple opponents who they had previously been beaten by and turning it into a Superbowl championship run is impressive work. Sure, he's only one person on a team of great athletes, coaches and staff, but on the other hand, as a person who is absolutely fascinated by top performing people who do it consistently over the long term, I find stories like Brady's, or Deena Kastor who set marathon records into her 40's, or Josh Waitzkin's who essentially did the same starting with chess (remember the movie?) and then in martial arts (really!), to be opportunities to learn from the few who seem to get better and better wherever they spend their time and effort.

So what does it take to defy the odds like Brady or Kastor or Waitzkin?

Well if you like history and you go back to one of the most well-known self improvement books of all time (originally published in 1937), you will very likely find some outdated ideas, word-choices and syntax. After all, the world has changed a bunch since then; but you might also find yourself intrigued by the staying power of some of the simple fundamentals like the "QQS" formula which boils down to: doing things right (Quality) as close to every time as possible (Quantity) which, when combined with a positive & growth oriented attitude (Spirit), yields amazing results.

Fast-forward 80 or so years and contemporary experts suggest some incredibly similar things:

1. Quantity - The idea of balancing "load" and "recovery" is not new; we talk about it a lot because it's the basic foundation of just about every growth activity for humans. When it comes to strength training, we overload the current capacity of our muscles to stimulate growth BUT THEN we back off and let a full recovery happen. If we don't overload a little? No growth. If we don't recover fully? Less growth. It's not just the hard push-forward, it's the pull back that lets us attain performance longevity. Just ask Kastor who is known for logging a massive number of miles in training - as many as 140 running miles PER WEEK! If that sounds intimidatingly huge, that's because it is. How'd she'd get there? She built up to it with ebbs and flows: "She describes this system, visually, as a “roller coaster.” Her weekly mileage might go: 70, 80, 75, 90, 80, 100." - any of those weeks are intense, but maybe the most impressive thing is that if we give the body a chance to pull back, it can do impressive things.

2. Quality - because quantity alone is never enough, doing the little things right matters. A few years ago (after winning the 2017 Superbowl), Brady said "When I was 25, I was hurting all the time, and I couldn't imagine playing as long as I did, just because, you know, if your arm hurts every day when you throw, how can you keep playing?". Maybe he has the perfect genetics for American Football... or maybe he's onto something in trying to put in a steady high quality effort at staying healthy. I'm admittedly skeptical about some of the specifics he adheres to, but the way he approaches it, deliberately with intense focus on improving, is almost definitely a big part of what's worked for him multiplying the effect of the volume of effort alone. After all, the often hyped 10,000 hour rule of mastery (if you read the some of the original work) was never only about the amount of time logged but the exacting nature of the practice itself....."how" it was being done, deliberately was the game changer.

3. Spirit - How does a child prodigy in a mental game like chess become a champion athlete/coach in an entirely different (physical) game in one lifetime? Well if you ask Waitzkin who achieved both of these things before midlife - the answer is that winning is a learning process first. In his 2008 book on the subject, Waitzkin makes it clear that learning for him is about getting outside of his comfort zone.....which often means doing the hard things that he knows will ultimately improve his results: “Growth comes at the point of resistance. We learn by pushing ourselves and finding what really lies at the outer reaches of our abilities.” Ask Carol Dweck, one of the world's experts on achievement through mindset, and you'll find a remarkably similar concept.

Of course, Brady, Kastor, and Waitzkin are not experts in what it takes to be safe or healthy in all domains. Throwing a football, running a marathon and dominating a chessboard are not the same as dodging strain risk, working long hours in sometimes harsh conditions, or strategically navigating through the complexities faced when working with industrial grade tasks and risks, but the principles are remarkably similar... at home, at work, and in life.

Performance longevity is not easy. It takes a focus on quality, a willingness to endure large volumes of effort, and a mindset that seeks out continuous improvement.. Some measure it in championships or records set... others measure it in healthy and safe days, everyday, season by season... culminating in the "wins" of more time doing the things that matter with the people we love.

We are +/- 60% through the Winter. Keep growing.

Have a great weekend,

Mike E.

Digging Deep - Respect the Surge

Feb 5

Predicting the future is a tricky business but this time they got it right... inch after inch and in some places, foot after foot... the snow fell just like the meteorologists said it would. By 9P on Sunday, I was ready to make a first effort at keeping up with the task - it wasn't going to be my last. 10 hours later was round two.....and then every four to six hours until it was time for sleep on Monday night. Thankfully, my 14 year old son was willing to tag team the task. At 6A on Tuesday when I looked out the window, I wondered if it would ever stop... but thankfully by 11A and almost 2 feet of snow later, the Northwest corner of NJ was mostly through it.

Great for the skiers.....rough on the shovelers.

Shoveling is hard work. First, it's a repetitive loading activity concentrated at the upper body which makes it more demanding from a cardiovascular perspective than even the same amount of work when done with the lower body. Second, it relies heavily on the (relatively) small muscles of the arms which are better at positioning and mobility than lifting as compared to the legs. So, muscle fatigue is always a lingering risk. Last, the task is often completed in a "leveraged" position, which mechanically speaking, means the load (end of the shovel) is further away from the fulcrum (hips/back/elbow) than the working tissues (muscles). With all that in mind, it's no surprise that shoveling safely requires a solid base of fitness (roughly equivalent to jogging) AND good technique AND the ability to use exhaustion preventing controls like breaks... and that's on a moderately cool day in reasonably uniform soil.

Add in slippery surfaces, large shovels built for pushing (more than lifting), and air temperatures that tend to cause less than ideal changes in blood flow patterns (vasoconstriction), and the stats that tell us large snow storms bring substantially increased risk of heart-related hospitalization and even death across the lifespan (but especially in men) don't seem all that far-fetched. But the risks don't necessarily end when the storm does.

This massive (276 page) review uncovered a variety of risks worth knowing about. Here are a couple that really jumped out at me:

Soft-tissue (musculoskeletal) injuries during shoveling accounted for about 55% of all injuries, with lower back pain the most common at 1/3rd of the total. Injuries are more common in men, peaking between 35 and 55 years old, and unfortunately, the trend has gotten a bit worse over time.

Fractures were 2.5 times as likely when at least 70% of the sidewalks were covered with snow. Upper extremity fractures were an eye-popping 15 times more likely! And since melting ice is even more slippery (lowest friction) than hard ice, injuries from slips, trips, and falls were not necessarily most common on the day of the storm or even the day after but peaked between 2 and 7 days AFTER the storm.

What's the take-home message this week?

Simply put - a surge in physical demands adds risk, so does a drastic change in our routines and environment. Whether it's a weather related event like a snowstorm or an unplanned surge in work (outage, etc.), ramping up quickly toward our physiological limits is a demand that can bring risk in the moment AND for a surprisingly long time after the event ends (e.g. firefighters show similar responses). So if we can't steer clear of the risks, we should do our best to be prepared with strategies that work - here are a few when workload surges:

1. If it's not an emergency, there's no need to make it one - pace yourself, listen to your body, and look for signs of fatigue in yourself and your coworkers.

2. We humans are not machines, in some ways we're even better... because with rest, we self-repair - Respect your rest and get enough of it.

3. The mental milestone of a finish line is critical. It's best to envision the finish as 7-10 days AFTER the storm ends - the risks linger and so must our focus. Heightened risk requires heightened awareness all the way to through the finish.

Stay safe. Get some rest. Schedule a consult if we can help.

Have a great weekend,

Mike E.

Zoomies for Humans: Resolution 5

Jan 29

Are you a dog lover? If not, do you know someone who is? If so, you may have heard of the term "zoomies", or even seen it in action. It's those times average Fido morphs into Super-dog, bursting at the seams with energy - running around uncontrollably or wildly chasing its tail. Of course, the AKC tells us there's a technical term, Frenetic Random Activity Period (FRAP), but it's not nearly as fun as "zoomies". Entertaining as it might be to watch (if youtube videos over 1 million views can be used as evidence), the reason why dogs click into this behavior, to release energy and work through stress, is something we can learn from... which, as we wrap up January 2021, gets us to our final micro-resolution, number 5.

The Power of Zoom

As a social species, we are made up of bonded individuals (families, tribes, organizations, communities, etc). We're not exactly the same as the family pooch, yet in some ways we are remarkably similar. One of those ways is how we achieve the right balanced/rested state we need to thrive. Just like a lack of energy (fatigue) is not ideal for our overall performance and risk, too much energy (or too much of the wrong kind), is also not ideal. Our bodies are built with a variety of control mechanisms, some involuntarily happening in the background while others are triggered by things in our experience. The state of the world and the continued need for distancing make it easy to feel a bit disconnected - physically (solitude), mentally (lonely) or even spiritually (seeking greater purpose in a challenging world) which can leave us feeling out of balance - but, just like the dog who finds a way to get all that pent up energy off the system - there are things we can do.....even without running around in a frenzy.

With that in mind, here are a couple "human zoomies"- ways to add or release energy as we work toward building longer term healthy habits:

First Zoom Out - CONNECT with the world around us. How we internalize the world around us (which is at the root of whether we are energized or disengaged) starts with how we receive and filter the information coming in. Each of our senses matters here. What we see, hear, smell, taste, and touch informs our reality as information passes through the filter of our personal experiences. Excessive inward (self) focus tends to inhibit our performance as shown in a classic 30+ year old paper on public speaking. Practicing an outward focus - putting our attention on what is happening around us in a highly objective but non-judgmental way (facts only, no interpretation) takes focus and energy. If recent studies on the brain activity of highly skilled meditators are accurate, it may even remap the default "idle" setting of our nervous system. If you've got the chance to do so "out there" and enjoy some nature in the process, even better. Combining the health and well-being benefits of physically being in nature (aka forest bathing), even in the winter with the outward sensory focus is a potent combination.

Then Zoom In - CONNECT with ourselves. If you tried the Positive Affect Journaling (PAJ) exercise I profiled last week you may have noticed it takes a real effort to look inward and dive into the details of the day and how it all played out. For many of us it feels easier to get stuck on the negatives and threats. Without diving too deep into why this type of thinking may have been an imprint handed down from our ancestors, what we now know is that having a structured approach to work through those thoughts, see them for what they are but not more than they need to be, a process called cognitive restructuring, can have an impact. Using a "What am I thinking?" exercise, as found outlined in this document can be a benefit. You might be surprised how the technique can help us tackle a variety of challenges - like building an exercise habit - which, with some emphasis on core strength for the abdomen and lower back (as discovered in this fantastic 2016 study) can have an extra large and direct impact on our stress response.....bringing us full circle to resolution 1 - short bursts of MOVE.

There's a lot there.....but if instead you just want to follow the dog's lead, to "let go" and spin around in circles, we'd suggest a dance party (because it works!) or at the very least, making sure the area is safe.....of course, we'd also like to see the video :)

We are nearly 45% through the winter, keep moving strong!

Mike E.

A Watched Pot Never Boils: Resolution 4

Jan 22

We're in the fourth week of January and so onto our fourth week of micro-resolutions. This week we build on last week's dive into chamomile with some enhancements that can add power to the time spent.

Did you try it? Did you run out to the local store and get some chamomile tea? Well, in case you missed it, last week I touched on some of the impressive medicinal effects of chamomile tea. Known mostly for its calming impact (with evidence that it helps generalized anxiety disorder), I was equally impressed with its impact on blood sugar in folks who struggle to control it.

But that's not all.

If you read closely you may have noticed that I alluded to this week's micro-resolution with a recommendation to carve 15 minutes out for the process of bringing the water to a boil, steeping the tea and enjoying it....but since everyone knows "a watched pot never boils" (as Ben Franklin's alter ego says) it's probably best to do something more valuable with the time. With that in mind, here are 3:

1. Put pen to paper - spending 15 minutes journaling using a technique known as Positive Affect Journaling (PAJ) has been shown to improve mental well-being, counteract distress and, if you can keep up the habit for 2 months, improve resilience (the ability to bounce back from adversity). Not bad for 15 minutes of time. Want to know how to do it? Try answering one these two prompts "What are you thankful for?", "What did someone else do for you?". The authors suggest there are 5 others although we've not been able to find them....yet :)

2. Breathe.....slow - did you ever count how many breaths per minute you average? It's a critical vital sign used all the time in health-practice and it can tell us quite a bit about our current state. Most experts agree that a normal range for most adults sits between 12 and 16. Most experts on breathing exercise agree that practicing a slower rate (like 6 breaths per minute for 6 weeks) can calm our physiology and change a variety of stress parameters. One of the tools we like to help pace yourself can be found here (the default is 4 in + 6 out = 6 breaths per min).

3. Breathe....part 2 - does the 6 breaths per minute seem a bit slow for you? Not to worry - some very interesting research from a team in Belgium showed that even at 12 breaths per minute (the lower end of the normal range), when individuals practiced an extended exhale (for example 3.5 sec exhale for a 1.5 sec inhale) they reported a greater relaxation even than the slower 6 breaths per minute group. There were also notable improvements in a variety of physiological parameters known to relate to stress.

Q: is a 15 minute investment of time worth the effort?

A: Maybe....but as Yerkes Dodson shows us (and this article highlights)....not always.

We wrap up the micro-resolution series next week when we will be marching toward the end of January (already!) and adding to our "Win the Winter" countdown clock (which has moved past 35%).

Have a great weekend,

Mike E.

Resolution 3: Make Time For Tea

Jan 15

We started off January as many do - with a focus on change.....not monumental change of the transformation variety, but little things, micro-resolutions, that have powerful evidence backing them up in hopes to march strongly through the winter and come out safe and healthy on the other side.

Week 1 we covered MOVE - and talked about how even 1 minute of stairs could make a difference.

Week 2 (last week) we dove into FUEL - and gave a hat-tip to "the most important meal of the day" with a special focus on the evidence related to oatmeal's ability to counteract cellular stress.

This of course gets us, right on track, to RECOVER and a micro-resolution that, with some boiling water and 10-15 minutes per day can have an impressive impact on several health markers. It starts with a flower that looks a lot like the common daisy. After a bit of drying and maybe some additions for flavor, it is steeped in hot water for up to 5 minutes to produce a pretty impressive (and widely available) cup of warmth known to all of us as "Chamomile Tea".

Maybe you've heard that Chamomile Tea has some medicinal properties - in fact, it does. There is some interesting evidence that it can be a help for those who may be struggling with type 2 diabetes when taken after meals. It also appears to have a calming effect when we are feeling stressed. In this study, which included multiple years of follow-up, using chamomile tea as a self-management strategy for generalized anxiety disorder made a difference. It's also been used for its antioxidant, anti-inflammatory and in some cases (topically) even pain control capacity.

Q: So how can we get the most from this humble little tea as a micro-resolution?

A: Consider carving out 15 minutes per day to boil the water, steep the tea and mentally process your day.

There's no wrong way to inject a few minutes of calm, it can be done anytime, the key is being intentional about it. Rather than just consuming it, take the time to slow down and have that be the full focus of your time. If you really want to go all in, consider putting this in the time slot that is 30-60 minutes before bed as a reminder to cut back the bright lights/electronics/etc. - a really powerful way to ready the physiology for rest.

Next week I'll touch on a way to double up the habit with some techniques that are particularly good for those who may have a hard time getting to sleep.....but for now, just enjoy the tea.

We're +/- 30% through the winter - stay strong!

Have a great weekend,

Mike E.

Micro-habit 2: The Oatmeal Resolution

Jan 8

If you've read along for a while or sat through one of the presentations we've given you've probably heard us talk about the goldilocks know, the grading system for the perfect bowl of porridge.....not too hot, not too cold, just right. In mathematical terms this could be called "non-linear", that is a situation where more of a good thing doesn't necessarily produce better results (and less doesn't necessarily make things worse) which means there is a "just right" amount, a sweet-spot, which in the case of the Three Bears, was the temperature of baby-bear's morning hot-cereal.

There are so many aspects of life where this concept applies. Even things like water and Oxygen - definitely vital for us - can be problematic or even deadly in the wrong concentration. Certain kinds of Oxygen in fact ("reactive oxygen species") are markers of cellular stress which plays a role in aging and disease. This would generally be thought of as bad but, and this is where it can get really confusing, because even this too has a sweet-spot, short-term and resolving exposure can actually be good for our health such as in the case of exercise while constant or unresolving exposure such as in the case of regular e-cigarette use puts our nervous system on overdrive.

Q: So where does this leave us in terms of a New Year's micro-habit resolution?

A: Circling back to porridge......and oatmeal in particular.

Although oatmeal is not the ONLY type of hot cereal eaten for breakfast, the micro-habit resolution for this week centers on it because it is one of the most well studied. More than 100 years ago physicians started advocating for oatmeal as a way of reducing the impact of diabetes and there are countless other studies which have tested consumption of this whole grain and shown a positive impact on health. Of course it's important to remember that not all oatmeal is the healthy kind. Some pre packaged brands are very high in sugar and lower in fiber than the whole/cooked type, which may negate a lot of the benefit.

If you can make oatmeal for breakfast a 4 week habit you may be able to lower your inflammatory profile significantly as shown here.....but even if you don't get that far, this small study showed that a serving of oatmeal before even a single session of high-intensity exercise blunted the markers of cellular stress.....which means it likely has the same effect before a hard day's work.

We're 20 days into the Winter, which means we've got +/- 70 to go. Keep up the great start.

Have a great weekend,

Mike E.

Resolution Idea 1: Stair Snacks

Dec 31

Maybe it's a yearly tradition for you. Maybe you never do but somehow this year has been enough of wildcard that you're going to dust the old concept off. Maybe it'll be the start of something entirely new. Who knows where it could take you.

Yes, of course I'm talking about New Year's resolutions. Not whether they work for everyone (spoiler, even though change was 11 times more likely stick when a resolution was made, resolutions work less than 1/2 the time) but rather as a tip of the cap to those who are going to make an effort.....and to give a few ideas to those who are on the fence. After all, sometimes the hardest step is the first one.

Resolution 1: Take the stairs, 4 times in a row

In 2018 an interesting finding was reported by a cardiologist in Spain. In more than 12,000 individuals tested and followed, those who did not have the fitness capacity to walk up 3 flights of stairs "very fast" or 4 flights of stairs "fast without stopping" were approximately 3 times more likely to die of heart disease or cancer in the following 5 years when compared to those who could.

The elegance of this finding is in its simplicity. Stairs are not specialized fitness equipment. The whole thing can be done in a minute or so. The pay off, although not surprising since fitness capacity has been connected to MANY risks, is pretty huge.

The drawback (and some of the criticism at the time) however was in quantifying what "very fast" or "fast without stopping" meant. This left people wondering - was their version of fast, fast enough?

Well, now, almost exactly 2 years later, the findings have been refined in a smaller subset of patients. As it turns out, the ability to climb by walking (but not breaking into a run) four flights of stairs (approximately 60 stairs) in less than 1 minute was an important risk-lowering threshold for cardiac issues, with 45 seconds or less the lowest risk.

Health-geek-speak: I will achieve at least 8 METS of fitness capacity in 2021.

Resolution Translation: I will do at least 1 minute of stairs most days of the week, stopping for rest as needed, until I can do at least 60 stairs in under a minute without stopping.


Need some additional help making it stick? Here are some good tips on how to make the process work for you.

We'll bring you another one next week!

Happy New Year, have a great weekend,

Mike E.