Are We Getting What we Pay For?

In today's Wall Street Journal, Deepak Chopra, MD and his colleagues wrote a very interesting opinion piece on the mainstreaming of alternative medicine. But I really thought the core message of the article was that, in the US, we are spending billions on health care, procedures, medication, and technology when much of what we are buying could be reversed with simple lifestyle change.

Instead of needing coronary stents or expensive cholesterol, diabetes or blood pressure medicine, patients really need to embrace smoking cessation, exercise, stress reduction, better nutrition, and having a more active and more supportive social life.

Physicians should be as excited about advocating healthy lifestyles (and providing guidance on how to do it) as they are in making complex diagnoses and prescribing procedures and medications.

Let me know what you think about this issue.

Younger Next Year

The book "Younger Next Year", by Chris Crowley and Henry S. (Harry) Lodge was recently recommended to me by a friend. He was a recently retired plastic surgeon, somewhat depressed and overweight. He said "this book is changing my life" which tends to get my attention! My wife bought the book and gave it to me that night and, over the next few days, I read it with great interest.

Harry's rules are:

1. Exercise six days a week for the rest of your life.
2. Do serious aerobic exercise four days a week for the rest of your life.
3. Do serious strength training, with weights, two days a week for the rest of your life.
4. Spend less than you make
5. Quit eating crap.
6. Care
7. Connect and commit

This book elaborates on these seven rules, which are a wonderfully simple approach to healthy aging. Although I am a fairly fit 58 year old, I can tell you I had some fine tuning to do after reading the book, and felt inspired to do it! Here is the tangible, near-term result of the book for me:

1. I am committing to trying some new things, such as a yoga class with my wife one or two days a week (I have been to three so far!)
2. Increasing my aerobic exercise duration to at least 45 minutes a day for at least 5 or 6 days a week.
3. Increasing the time and effort of my two times weekly weight workout.
4. Cutting out more fried foods from the diet.
5. Avoiding the temptation to have that third glass of wine at night.
6. Thinking concretely about connecting in my work and social interactions, rather than just going along for the ride.

I can enthusiastically recommend this approach to you if your life and your health is in a funk and needs a jump start. These guys are seasoned, realistic, optimistic and fun to relate to. They also have a web site http://www.youngernextyear.com.

Check it out. Comments always welcome.

Exercise Yourself to Sleep

Occasionally, after a vigorous workout you’ll hear someone say, “I’ll sleep well tonight”. Without a doubt, I have found that I don’t sleep as well on days that I am not able to exercise. But what does the literature have to say about this phenomenon of “exercising yourself to sleep”?

A study published in the Journal of the American Medical Association examined the impact of moderate exercise on sleep quality in older adults with moderate sleep-related complaints. In this study, 43 men and women between the ages of 50 and 76 were split into two groups. One group exercised moderately (30- to 40-minute aerobics classes four times a week) for 16 weeks, while the other group made no changes to their lifestyles. After 16 weeks, the exercisers showed improvement over the control group in general quality of sleep, quicker sleep-onset, longer sleep duration and feeling rested in the morning

Another study conducted at Tufts University took 32, “slightly to moderately depressed” elderly men and women and assigned them to an exercise group or a control group. The exercise group performed three strength training sessions each week. At the end of the 10 week study the exercise group reported not only significant improvement in sleep quality over the control group, but improvement in quality of life also.

Women who have gone through menopause are noted to be at higher risk for sleep problems. Researchers have found that postmenopausal women who performed moderate-intensity exercise for at least a half-hour every morning had fewer problems falling asleep compared to less active women.

Relatively few research studies have looked at the impact of exercise on insomnia. The ones that have support the premise that exercise improves sleep patterns, primarily by increasing total sleep time and decreasing sleep latency. To maximize the benefit of exercise, it appears that the duration of exercise is more important than its intensity. Also, it is preferable that exercise occur 5 to 6 hours (minimum of 3 hours) before bedtime.