Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
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How community health screenings get more people of color vaccinated
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U.S. preventive health screening rates dropped drastically at the height of the COVID-19 pandemic. They have yet to go back to pre-pandemic levels, especially for Black and Latine communities.
Screenings, or routine medical checkups, are important ways to avoid and treat disease. They’re key to finding problems early on and can even help save people’s lives.
Community health workers say screenings are also a key to getting more people vaccinated. Screening fairs provide health workers the chance to build rapport and trust with the communities they serve, while giving their clients the chance to ask questions and get personalized recommendations according to their age, gender, and family history.
But systemic barriers to health care can often keep people from marginalized communities from accessing recommended screenings, exacerbating racial health disparities.
Public Good News spoke with Dr. Marie-Jose Francois, president and chief executive officer, and April Johnson, outreach coordinator, at the Center for Multicultural Wellness and Prevention (CMWP), in Central Florida, to learn how they promote the benefits of screening and leverage screenings for vaccination outreach among their diverse communities.
Here’s what they said.
[Editor’s note: This content has been edited for clarity and length.]
PGN: What is CMWP’s mission? How does vaccine outreach fit into the work you do in the communities you serve?
Dr. Marie-Jose Francois: Since 1995, our mission has been to enhance the health, wellness, and quality of life for diverse populations in Central Florida. At the beginning, our main focus was education, wellness, and screening for HIV/AIDS, and we continue to do case management for HIV screening and testing.
When the issue of COVID-19 came into the picture, we included COVID-19 information and education and stressed the importance of screening and receiving vaccinations during all of our outreach activities.
We try to meet the community where they are. Because there is so much misconception—and taboo—in regard to immunization.
April Johnson: So our job is to disperse accurate information. And how we do that is we go into rural communities. We build partnerships with local apartment complexes, hair salons, nail salons, laundromats, and provide a little community engagement, where people just hang out in different areas.
We build gatekeepers in those communities because you first have to get in there. You have to know that they trust you. Being in this field for about 30 years, I’ve [learned that] flexibility is key. Because sometimes you can’t get them from 9 to 5, or [from] Monday through Friday. So, you have to be very flexible in doing the outreach portion in order to get what you need.
I’ve built collaborations with senior citizen centers, community centers, schools, clinics, churches in Orlando and [in] different areas in Orange, Osceola, Seminole, and Lake counties. And we also partner with other community-based organizations to try to make it like a one-stop shop. So, partnership is a big thing.
PGN: How do you promote the importance of preventive screenings in the communities you serve?
M.F.: We try to make them view their health in a more comprehensive way, for them to understand the importance of screening. [That] self care is key, and for them to not be afraid.
We empower them to know what to ask when they go to the doctor. We ask them, ‘Do you know your status? Do you know your numbers?’
For example, if you go to the doctor, do you know your blood pressure? If you’re diabetic? Do you know your hemoglobin (A1C)? Do you know your cholesterol levels?
And now, [we also ask them]: ‘Have you received your flu shot for the year? Have you received all of your vaccine doses for COVID-19?’ We are even adding the mpox vaccine now, based on risk factors.
[We recommend they] ask their provider. For women, [we ask], ‘When do you need to have your mammogram?’ For the men, ‘You need to ask about your PSA and also about when and when to have your colonoscopy based on your age.’
We also try to explain to the community that the more they know their family history, the more they can engage in their own health. Because sometimes you have mom and dad who have a history of cancer. They have a history of diabetes or blood pressure—and they don’t talk to their children. So, we try to [recommend they] talk to their children. Your own family needs to know what’s going on so they can be proactive in their screenings.
PGN: What strategies or methods have you found most effective in getting people screened?
M.F.: Not everybody wants to be screened, not everybody wants to receive vaccines.
But with patience, just give them the facts. It goes right back to education, people have to be assured.
When you talk to them about COVID, or even HIV, you may hear them say, ‘Oh, I don’t see myself at risk for HIV.’ But we have to repeat to them that the more they get screened to make sure they’re OK, the better it is for them. ‘The more you use condoms, [the] safer it is for you.’
In Haitian culture, they listen to the radio. So we use the radio as a tool to educate and deliver information [to] get vaccinated, wash your hands. ‘If you’re coughing, cover your mouth. If you have a fever, wear your masks. Call your doctor.’
In our target population, we have people who have chronic conditions. We have people with HIV. So, we have to motivate them to receive the flu vaccine, to receive the COVID vaccine, to receive that RSV [vaccine], or to get the mpox vaccine. We have people with diabetes, high blood pressure, high cholesterol, depressed immune systems. We have people with lupus, we have people with sickle cell disease.
So, this is a way to [ensure that] whomever you’re talking to one-on-one understands the value of being safe.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Four Ways To Upgrade The Mediterranean Diet
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Four Ways To Upgrade The Mediterranean Diet
The Mediterranean Diet is considered by many to be the current “gold standard” of healthy eating, and with good reason. With 10,000+ studies underpinning it and counting, it has a pretty hefty weight of evidence.
(For contrast, the Ketogenic Diet for example has under 5,000 studies at time of writing, and many of those include mentioning the problems with it. That’s not to say the Keto is without its merits! It certainly can help achieve some short term goals, but that’s a topic for another day)
Wondering what the Mediterranean Diet consists of? We outlined it in a previous main feature, so here it is for your convenience 😎
To get us started today, we’ll quickly drop some links to a few of those Mediterranean Diet studies from the top:
- Definition of the Mediterranean Diet; a Literature Review
- Mediterranean Diet In Healthy Aging
- Cancer and Mediterranean Diet: A Review
- Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity
- Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies
- Adherence to Mediterranean diet and health status: meta-analysis
The short version is: it glows, in a good way.
The anti-inflammatory upgrade
One thing about the traditional Mediterranean Diet is… where are the spices?!
A diet focusing on fruits and non-starchy vegetables, healthy oils and minimal refined carbs, can be boosted by adding uses of spices such as chili, turmeric, cumin, fenugreek, and coriander:
The gut-healthy upgrade:
The Mediterranean Diet already gives for having a small amount of dairy, mostly in the form of cheeses, but this can be tweaked:
Mediterranean diet with extra dairy could be a gut gamechanger
The heart-healthy upgrade
The Mediterranean Diet is already highly recommended for heart health, and it offers different benefits to different parts of cardiovascular health:
The DASH (Dietary Approaches to Stop Hypertension) diet can boost it further, specifically in the category of, as the name suggests, lowering blood pressure.
It’s basically the Mediterranean Diet with a few tweaks. Most notably, red meat no longer features (the Mediterranean Diet allows for a small amount of red meat), and fish has gone up in the list:
Description of the DASH Eating Plan
The brain-healthy upgrade:
The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet combines several elements from the above, as the name suggests. It also adds extra portions of specific brain-foods, that already exist in the above diets, but get a more substantial weighting in this one:
MIND and Mediterranean diets linked to fewer signs of Alzheimer’s brain pathology
See also: The cognitive effects of the MIND diet
Enjoy!
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I’ve been given opioids after surgery to take at home. What do I need to know?
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Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.
These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.
However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.
Flystock/Shutterstock Which types of opioids are most common?
The most commonly prescribed opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).
In fact, about half of new oxycodone prescriptions in Australia occur after a recent hospital visit.
Most commonly, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.
Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.
Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.
Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.
Controlling your pain after surgery is important. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.
Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.
But there are also risks
As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.
Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.
But up to one in ten Australians still take them up to four months after surgery. One study found people didn’t know how to safely stop taking opioids.
Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.
Dependency and side effects are also more common with slow-release opioids than immediate-release opioids. This is because people are usually on slow-release opioids for longer.
Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed more than twice the amount they needed.
This results in unused opioids at home, which can be dangerous to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.
Don’t stockpile your leftover opioids in your medicine cupboard. Take them to your pharmacy for safe disposal. Archer Photo/Shutterstock How to mimimise the risks
Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).
These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.
Other techniques to manage pain include physiotherapy, exercise, heat packs or ice packs. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.
However, if you do need opioids, there are some ways to make sure you use them safely and effectively:
- ask for immediate-release rather than slow-release opioids to lower your risk of side effects
- do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing
- as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen
- before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.
A heat pack may help with pain relief, so you end up using fewer painkillers. New Africa/Shutterstock If you’re concerned about side effects
If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:
- constipation – your pharmacist will be able to give you lifestyle advice and recommend laxatives
- drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor
- weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.
If you’re having trouble stopping opioids
Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.
You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.
How about leftover opioids?
After you have finished using opioids, take any leftovers to your local pharmacy to dispose of them safely, free of charge.
Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.
For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has free online information about managing pain and opioid medicines.
Katelyn Jauregui, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, University of Sydney; Asad Patanwala, Professor, Sydney School of Pharmacy, University of Sydney; Jonathan Penm, Senior lecturer, School of Pharmacy, University of Sydney, and Shania Liu, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, University of Alberta
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Cold Truth About Respiratory Infections
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The Pathogens That Came In From The Cold
Yesterday, we asked you about your climate-themed policy for avoiding respiratory infections, and got the above-depicted, below-described, set of answers:
- About 46% of respondents said “Temperature has no bearing on infection risk”
- About 31% of respondents said “It’s important to get plenty of cold, fresh air, as this kills/inactivates pathogens”
- About 22% of respondents said “It’s important to stay warm to avoid getting colds, flu, etc”
Some gave rationales, including…
For “stay warm”:
❝Childhood lessons❞
For “get cold, fresh air”:
❝I just feel that it’s healthy to get fresh air daily. Whether it kills germs, I don’t know❞
For “temperature has no bearing”:
❝If climate issue affected respiratory infections, would people in the tropics suffer more than those in colder climates? Pollutants may affect respiratory infections, but I doubt just temperature would do so.❞
So, what does the science say?
It’s important to stay warm to avoid getting colds, flu, etc: True or False?
False, simply. Cold weather does increase the infection risk, but for reasons that a hat and scarf won’t protect you from. More on this later, but for now, let’s lay to rest the idea that bodily chilling will promote infection by cold, flu, etc.
In a small-ish but statistically significant study (n=180), it was found that…
❝There was no evidence that chilling caused any acute change in symptom scores❞
Read more: Acute cooling of the feet and the onset of common cold symptoms
Note: they do mention in their conclusion that chilling the feet “causes the onset of cold symptoms in about 10% of subjects who are chilled”, but the data does not support that conclusion, and the only clear indicator is that people who are more prone to colds generally, were more prone to getting a cold after a cold water footbath.
In other words, people who were more prone to colds remained more prone to colds, just the same.
It’s important to get plenty of cold, fresh air, as this kills/inactivates pathogens: True or False?
Broadly False, though most pathogens do have an optimal operating temperature that (for obvious reasons) is around normal human body temperature.
However, given that they don’t generally have to survive outside of a host body for long to get passed on, the fact that the pathogens may be a little sluggish in the great outdoors will not change the fact that they will be delighted by the climate in your respiratory tract as soon as you get back into the warm.
With regard to the cold air not being a reliable killer/inactivator of pathogens, we call to the witness stand…
Polar Bear Dies From Bird Flu As H5N1 Spreads Across Globe
(it was found near Utqiagvik, one of the northernmost communities in Alaska)
Because pathogens like human body temperature, raising the body temperature is a way to kill/inactivate them: True or False?
True! Unfortunately, it’s also a way to kill us. Because we, too, cannot survive for long above our normal body temperature.
So, for example, bundling up warmly and cranking up the heating won’t necessarily help, because:
- if the temperature is comfortable for you, it’s comfortable for the pathogen
- if the temperature is dangerous to the pathogen, it’s dangerous to you too
This is why the fever response evolved, and/but why many people with fevers die anyway. It’s the body’s way of playing chicken with the pathogen, challenging “guess which of us can survive this for longer!”
Temperature has no bearing on infection risk: True or False?
True and/or False, circumstantially. This one’s a little complex, but let’s break it down to the essentials.
- Temperature has no direct effect, for the reasons we outlined above
- Temperature is often related to humidity, which does have an effect
- Temperature does tend to influence human behavior (more time spent in open spaces with good ventilation vs more time spent in closed quarters with poor ventilation and/or recycled air), which has an obvious effect on transmission rates
The first one we covered, and the third one is self-evident, so let’s look at the second one:
Temperature is often related to humidity, which does have an effect
When the environmental temperature is warmer, water droplets in the air will tend to be bigger, and thus drop to the ground much more quickly.
When the environmental temperature is colder, water droplets in the air will tend to be smaller, and thus stay in the air for longer (along with any pathogens those water droplets may be carrying).
Some papers on the impact of this:
- Cold temperature and low humidity are associated with increased occurrence of respiratory tract infections
- A Decrease in Temperature and Humidity Precedes Human Rhinovirus Infections in a Cold Climate
So whatever temperature you like to keep your environment, humidity is a protective factor against respiratory infections, and dry air is a risk factor.
So, for example:
- If the weather doesn’t suit having good ventilation, a humidifier is a good option
- Being in an airplane is one of the worst places to be for this, outside of a hospital
Don’t have a humidifier? Here’s an example product on Amazon, but by all means shop around.
A crock pot with hot water in and the lid off is also a very workable workaround too
Take care!
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Body on Fire – by Dr. Monica Aggarwal and Dr. Jyothi Rao
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There are times when you do really need a doctor, not a dietician. But there are also times when a doctor will prescribe something for the symptom, leaving the underlying issue untouched. If only there were a way to have the best of both worlds!
That’s where Drs. Rao and Aggarwal come in. They’re both medical doctors… with a keen interest in nutrition and healthy lifestyle changes to make us less sick such that we have less need to go to the doctor at all.
Best of all, they understand—while some things are true for everyone—there’s not a one-size-fits all diet or exercise regime or even sleep setup.
So instead, they take us hand-in-hand (chapter by chapter!) through the various parts of our life (including our diet) that might need tweaking. Each of these changes, if taken up, promise a net improvement that becomes synergistic with the other changes. There’s a degree of biofeedback involved, and listening to your body, to be sure of what’s really best for you, not what merely should be best for you on paper.
The writing style is accessible while science-heavy. They don’t assume prior knowledge, and/but they sure deliver a lot. The book is more text than images, but there are plenty of medical diagrams, explanations, charts, and the like. You will feed like a medical student! And it’s very much worth studying.
Bottom line: highly recommendable even if you don’t have inflammation issues, and worth its weight in gold if you do.
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The Whole-Body Approach to Osteoporosis – by Keith McCormick
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You probably already know to get enough calcium and vitamin D, and do some resistance training. What does this book offer beyond that advice?
It’s pretty comprehensive, as it turns out. It covers the above, plus the wide range of medications available, what supplements help or harm or just don’t have enough evidence either way yet, things like that.
Amongst the most important offerings are the signs and symptoms that can help monitor your bone health (things you can do at home! Like examinations of your fingernails, hair, skin, tongue, and so forth, that will reveal information about your internal biochemical make-up), as well as what lab tests to ask for. Which is important, as osteoporosis is one of those things whereby we often don’t learn something is wrong until it’s too late.
The author is a chiropractor, which doesn’t always have a reputation as the most robustly science-based of physical therapy options, but he…
- doesn’t talk about chiropractic
- did confer with a flock of experts (osteopaths, nutritionists, etc) to inform/check his work
- does refer consistently to good science, and explains it well
- includes 16 pages of academic references, and yes, they are very reputable publications
Bottom line: this one really does give what the subtitle promises: a whole body approach to avoiding (or reversing) osteoporosis.
Click here to check out The Whole Body Approach To Osteoporosis; sooner is better than later!
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