Blog Archives

what's the latest on high blood pressure?

May 13

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

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

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

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

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

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

Get Out There and Eat Better

Apr 29

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

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

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

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

Have a great weekend,

Mike E.

Was Dr. Evans Right?

May 6

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

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

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

In short: Yes and No.

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

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

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

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

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

Have a great weekend,

Mike E.

Cancer Stopping Blood

Apr 22

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

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

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

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

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

Have a great weekend,

Mike E.

A Faulty Flow Sensor?

Apr 15

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

Pump Up Your Recover

Apr 8

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

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

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

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

Have a great weekend,

Mike E.

The Eyes Have It: A Connection Between Daylight and Diabetes?

Apr 1

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

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

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

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

The "eyes" have it.

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

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

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

Have a great weekend,

Mike E.

So How'd We Do This Year?

March 25

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

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

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

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

Here are three critical points:

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

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

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

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

Have a great weekend,

Mike E.

Inside the Mind of the Happy Doers

March 18

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

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

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

It starts with mindset.

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

The Pursuit of Happiness

March 11

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

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

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

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

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

Statistically Speaking: When Will U Be Happiest?

Mar 4

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

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

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

So what do we do about it?

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

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

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

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

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

Have a great weekend,

Mike E.

Functional Fat and Layers of Fitness

Feb 25

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

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

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

Winning the Long Game and How They Did It

Feb 18

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

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

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

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

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

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

The Need For Speed

Feb 11

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

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

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

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

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

Have a great weekend,

Mike E.

Move + Recover = Achieve More

Feb 4

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

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

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

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

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

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

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

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

MOVE + RECOVER = Achieve More.

Have a great weekend,

Mike E.

Foods That Reverse Age

Jan 28

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

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

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

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

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

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

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

Have a great weekend,

Mike E.

Is Timing "Everything"?

Jan 21

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

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

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

They uncovered two particularly key points worth knowing about:

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

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

What does this mean for us?

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

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

Have a great weekend,

Mike E.

Defining Cold

Jan 14

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

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

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

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

Have a great weekend,

Mike E.

Improved Health in 4 Minutes (Resolution Part 2)

Jan 7

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

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

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

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

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

3. Get started, MOVE.

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

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

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

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

There's more to come on this'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.