Kick Bad Habits In Four Simple Steps Monday, Feb 24 2014 

by Charles Duhigg as appeared in Bottom Line Health, Bottom Line Health


Want to kick a bad habit—just about anybad habit? There’s a proven system that has helped millions of people give up damaging habits and establish new, healthful ones in their place. You can simplify that system to help yourself do the same. The secret: Drawing upon four key components of 12-step programs.

The first and most famous 12-step program is Alcoholics Anonymous (AA), and there are dozens of similar programs based on the same basic principles. These principles can help you, too, whether your goal is to cut back on junk food, quit being a couch potato, give up cigarettes, spend less, stop biting your nails or whatever.

The reason: What makes AA and other 12-step programs so effective for so many people is that they provide a powerful methodology for changing bad habits, according to Charles Duhigg, a Pulitzer prize–winning journalist and author of the best-selling The Power of Habit: Why We Do What We Do in Life and Business.

Members of AA often attest to the necessity of doing all 12 steps to deal with the life-threatening problem of alcoholism and achieve lasting sobriety. However, for the purposes of overcoming less grave bad habits and replacing them with good habits, you can think in terms of the following four key ideas…

Identify your primary commitment. People who come to AA typically have many problems—with family, friends, money, job, health, etc. All of those problems matter, and abstinence will help address them, but none of them are the main focus. Instead, people come to AA for one primary purpose—to get and stay sober.
Try this: In considering what habit of yours you’d like to change, commit to one specific goal (or one at a time, at least). For instance, instead of vowing to “get healthier” by overhauling your lifestyle (how complicated is that?!), focus on the single most important goal—say, no longer being a couch potato. Once you’ve established a routine of regular physical activity—for instance, taking a daily 20-minute walk—and have this new habit firmly embedded into your life, then you can start addressing other bad habits.

Take a self-inventory. AA encourages members to do an inventory, examining their feelings and behaviors and the “rewards” they get from drinking. This helps members to understand why they are drawn to drink and to recognize the specific triggers that spark cravings for alcohol. For example, a person may come to see that she drinks to numb feelings of fear or resentment or to feel more at ease in social situations…and that she is triggered by certain people or places, such as a longtime drinking buddy or a favorite bar.
Try this: Examine your own rewards and triggers. For instance, if you continually break your own promise to stop snacking on chips or sweets, what’s the reason? It’s probably not real hunger—instead, you may habitually reach for junk food when stressed or bored. To break his own afternoon cookie habit, Duhigg had to realize that it wasn’t the actual cookies he was so attached to, but rather the enjoyable routine of taking a break—getting up from his desk, walking to the cafeteria, chatting with coworkers. Once he understood this, he was able to come up with alternatives that provided the same rewards, such as walking around the block with a colleague or buying an apple instead of a cookie from the cafeteria.

Replace a bad habit with a good one—and practice the new habit every day. In AA, new members often are advised to “pick up the phone instead of a drink”…in other words, to take some positive new action (phoning a fellow alcoholic) whenever the urge strikes to indulge in the old habitual action (drinking). New members also are urged to attend 90 meetings in 90 days so that not a single day goes by without reinforcing the new habit of staying sober. Even if you are battling something far less serious than alcoholism, it takes at least several weeks for a healthful new habit to replace the old one—and consistency is key, Duhigg noted.
Try this: Suppose your goal is to get more sleep, so you’ve committed to going to bed by 11 pm every evening instead of habitually staying up past midnight. Do not undermine yourself by staying up late “only on Tuesdays” to watch a favorite TV show or by abandoning your new sleep routine on the weekends—at least for now. Once your new sleep habits are well formed, you may be able to make occasional exceptions without reverting to old bad habits (except in cases where complete abstinence is key to success, such as with an addiction).

Make use of a support network. In AA, selection of a “sponsor” (an AA mentor) plus contacts made at meetings provide a ready-made support system for each participant.
Try this: No matter what behavior you want to change, ask your friends and family members to support your efforts to establish your healthier new habit. It’s well proven, Duhigg said, that change is easier when you have someone who holds you accountable and applauds your progress. If you can find a buddy who has the same goal and the two of you can work together—or if you can find a mentor who has already achieved what you’re striving for (such as giving up smoking)—so much the better. Having the encouragement, advice and support of someone who truly understands what you’re going through will make it far easier to break old bad habits and create a healthier lifestyle for yourself.
These four steps could add up to one huge step for you!

Source: Charles Duhigg, Pulitzer prize–winning staff writer at The New York Times, and author of the best-seller The Power of Habit: Why We Do What We Do in Life and Business. (Random House).


The Healthiest Chocolates of All Wednesday, Feb 12 2014 

by Carole Jackson>, Bottom Line Health


It seemed too good to be true when studies began to tell us, seven or so years ago, that dark chocolate actually is healthy… but since then additional research has made the claims sweeter yet. Cacao beans, the base of chocolate, contain flavonoids (antioxidant-containing plant pigments) that make the antioxidants in dark chocolate nearly eight times as abundant as those in strawberries, which are themselves considered an excellent source. And then we learned that cacao beans help lower blood pressure and LDL (bad) cholesterol and that they can increase levels of serotonin, a natural antidepressant, as well.

With all that going for chocolate, it’s not surprising that there’s now a wide array of “healthy” chocolates for sale pretty much everywhere, from bustling national supermarkets to tiny, Zen-like health-food stores. Soon you will even be able to buy camel-milk chocolate, said (of course) to have health benefits unique to its unusual source. But what makes the difference between a healthful piece of chocolate and just a fattening indulgence? I called über nutritionist and weight-loss expert Joy Bauer, MS, RD, CDN, regular contributor to the “Today” show and author of several books, including her newest, Your Inner Skinny, to ask the question.

Healthy Chocolate

Bauer says the only way to be sure you are getting a reasonable amount of flavonoids in chocolate is to select those containing at least 70% cacao, noting that the health value escalates the higher that percentage climbs. She said that milk chocolate — including the camel-milk variety — can’t compete in the healthy sweepstakes, since the added milk reduces the body’s ability to absorb the antioxidants in cacao. Bauer gave a thumbs down to the heart-shaped boxes of Valentine’s chocolates that have those creamy or caramel centers — these are very heavy on sugar and should definitely be left in the box, she says. On the other hand, “mix-ins” made of nuts and berries are good. As for white chocolate — it isn’t a true chocolate and, not surprisingly, contains almost no flavonoids.

If you are looking for a healthy dark chocolate, Bauer says you don’t have to pay up for a premium brand. While upscale brands use very high-quality cacao beans and are “incredibly delicious,” she says that the health benefit is about the same no matter the price, noting this is true of mass-produced brands, such as Hershey’s and Dove (which is owned by M&M/Mars), and mid-priced brands, such as Lindt or Ghirardelli. And it must be said… all chocolate contains lots of calories along with the flavonoids — averaging 150 calories per ounce, says Bauer — so it is important to enjoy it in moderation.

Source: Joy Bauer, MS, RD, CDNToday show contributor, and author of several books, including her newest, Your Inner Skinny (William Morrow Cookbooks).

The 7 Best Energy Boosters Thursday, Jan 2 2014 

by Carole Jackson>, Bottom Line Health


Are you tired all the time? You have plenty of company. About 10 million doctor visits each year are attributed to fatigue. And all of those bottomless cups of strong coffee won’t help. Too much caffeine actually saps energy and makes fatigue worse.

The only way to beat fatigue is to create the conditions that bring more energy into your days and remove the obstacles that drain it away.

Most people know that exercise is energizing. It increases blood flow and circulates oxygen to the brain and other tissues. It also increases brain-derived neurotrophic factor (BDNF), a protein that improves alertness and focus, along with physical energy.

Other energy-boosters that really work…

1. Green drinks. We are always being told to eat more greens, but ­drinking them can be a much better choice when your energy flags during the day.

What to do: Take advantage of the liquid greens in health-food stores. Juices made from wheatgrass, barley and other vegetable extracts are alkalizing. They increase pH and shift the body’s balance to a less acid state. Too much acidity—a consequence of all the meat and grains in the American diet—­impairs energy as well as health.

The grasses used in green drinks contain chlorophyll and related substances that remove energy-­depleting toxins from the body. The drinks typically have little or no added sugar, so they won’t cause the spike and drop in blood sugar that you get from sweetened soft drinks or fruit juices. Green drinks are not delicious. They have a slightly grassy taste that takes some getting used to. My favorite is Barlean’s Greens, which is readily available online and in health-food stores and tastes surprisingly good.

2. Whole eggs. You need plenty of protein to satisfy your appetite, keep your energy humming and prevent the postmeal slump that occurs when you eat too much.

For years, people thought that egg-white omelets were the perfect high-protein meal. Not true. Whole eggs are better because the yolks are high in choline, a B vitamin that reduces inflammation—and the fatigue that accompanies it.

Don’t worry about the saturated fat in egg yolks. It’s not the enemy that people once thought. When researchers from Harvard and other institutions analyzed 21 previous studies that looked at the relationship between saturated fat and heart disease, they found that ­saturated fat did not cause an increase in heart disease or stroke.

What to do: Include a source of protein with every meal. It could be eggs, nuts, fish, grass-fed meat, beans or tofu.

3. Coenzyme Q10 (CoQ10). This is probably the most important ­energy-producing nutrient that most people don’t get enough of.

CoQ10 increases the activity of mitochondria, the energy-producing structures within cells. The body naturally produces CoQ10, but it’s a complicated process that involves at least seven vitamins. Since many people don’t get enough of these nutrients—including vitamin C and a variety of B vitamins—levels of CoQ10 tend to be too low to boost energy.

What to do: Supplement with 100 milligrams (mg) of CoQ10 daily if you’re generally healthy. If you have been ­diagnosed with a heart condition or are taking a cholesterol-lowering statin, increase the daily dose to 200 mg. Statins deplete CoQ10 from the body. It’s particularly important for heart patients to get enough because the heart requires CoQ10 to beat efficiently.

4. High-glycemic foods occasionally. You probably have heard that the best carbohydrates for long-term energy have a low-glycemic load. Fiber-filled foods such as lentils, peanuts, carrots and chickpeas are absorbed slowly into the intestine. They keep blood sugar and insulin at steady levels—not too low or too high.

There’s one possible exception. If you’re trying to lose weight and still keep your energy high, you might want to have occasional servings of high-glycemic foods. There’s some evidence that people who mainly eat low-glycemic carbs but allow themselves a high-glycemic meal every four to seven days help the body to overcome its tendency to burn fewer calories during a weight-loss diet.

My advice: Suppose that you eat mainly low-glycemic carbs but still want to lose a few pounds. Once or twice a week, have one meal that includes ­faster-burning carbohydrates, such as pasta, white potatoes or white rice. Scientists speculate that the jump in insulin overcomes the slowing of your metabolism that comes along with ­dieting.

5. Replenish your bacteria. You might not think that digestion has much to do with energy, but the action inside your intestines greatly affects how you feel.

A study published in Journal of Psychiatric Research found that probiotics (live, beneficial bacteria) may have antidepressant effects. The same organisms improve immunity and make it easier to fight off the fatiguing effects of viruses and bacteria.

My advice: Eat one or more daily servings of live-culture yogurt. Look for the letters LAC (Live and Active Cultures) on the label. It means that the yogurt contains at least 100 million live organisms per gram.

6. Lights out. Nothing saps your energy more than a poor night’s sleep. And what people don’t realize is that even very dim lights—such as the small LED indicators on computers, cell phones and bedside clocks—can make it difficult to get a decent night’s rest. Sleep scientists have found that even trace amounts of ambient light inhibit the production of melatonin, a sleep-promoting hormone.

My advice: Minimize the amount of light. Turn your digital clock so that it faces away from the bed, for example, or drape something over the computer to cover up the “on” light.

If you don’t get enough sleep, take a nap. Napping improves memory, lowers stress and improves all-day ­energy. Studies done by NASA have found that a short 26-minute nap can increase performance by 34% and alertness by 54%. Limit your naps to 26 minutes or less, preferably late in the morning or early in the afternoon.

7. Breathe deeply and well. You would think that nothing is more natural than breathing, but many people don’t breathe the way that nature ­intended.

Reason: We live in a very fast-paced world…and we spend a lot of time hunched over desks, staring at computer screens. Both stress and poor posture tighten muscles in the upper body and make it harder for the lungs to expand. We have become shallow breathers, which decreases oxygen and causes mental and physical fatigue.

My advice: Every few hours, take a breathing break. While sitting or ­lying down, place one hand on your abdomen and one hand on your chest. Slowly breathe in through your nose, then exhale just as deeply through your mouth. Make sure that the hand on your belly rises and falls while the hand on your chest barely moves.

During the day, if you notice that you’re breathing shallowly or more quickly than usual, remind yourself to relax and breathe in more fully.

Source: Jonny Bowden, PhD, CNS, a nutritionist and weight-loss expert based in Los Angeles. He is board-certified by the American College of Nutrition and is a member of the American Society for Nutrition. He is author of The Most Effective Ways on Earth to Boost Your Energy and coauthor with Stephen Sinatra, MD, of The Great Cholesterol Myth (both by Fair Winds).

“Sell By” Dates and Other Misleading Labels Cause Terrible Food Waste Monday, Dec 30 2013 

by Carole Jackson>, Bottom Line Health


Open your refrigerator or pantry, and pick up a few random jars, bottles, cans or cartons of food—peanut butter, orange juice, cereal, soup or whatever. Most of them probably are stamped with a date that says something like “sell by” or “enjoy by.” And if you’re like many people, you throw out the food once that date has passed—because you assume that it’s no longer safe to consume.

But are those assumptions correct? Typically not. In fact, in many cases those dates are arbitrary and meaningless! This makes it all the more aggravating that “date label confusion” is a significant contributor to the staggering amount of food waste that occurs in this country.

Food waste is bad for our wallets, costing the average American family of four $1,365 to $2,275 per year. What’s more, we’re suffering a lot of needless anxiety, worrying that what we eat is going to make us sick. A new report from the Harvard Food Law and Policy Clinic explains the problem and offers some solutions…


In the US, we waste an appalling 160 billion pounds of food per year. If only one-third of what’s thrown away somehow could be distributed to the 15% of Americans who don’t have enough food, no one would go hungry.

Much of that waste occurs when food is tossed unnecessarily by consumers who are confused by the food date labeling system. Yet it’s no wonder they’re confused—because terms such as “sell by” and “best before” have no official, standardized definitions. Is the food no longer fit to eat…or do manufacturers just want you to throw out stuff that’s been in your pantry for a while so that you’ll buy more of their products? Though people often assume that the food cannot be safely consumed after the stamped date, most food label dates indicate only peak freshness and optimal flavor,not an end to any safe window of opportunity for consumption.

The inconsistency problem: Although the FDA and the USDA have the authority to regulate various types of food labeling, they generally do not regulate date-labeling practices, instead leaving this to food manufacturers, states or even local governments. The result is wild inconsistency. For instance, a carton of eggs sold in South Carolina can be stamped with a date that’s up to 45 days after the carton is packed, while a carton of eggs sold in Alaska is marked with a date that’s not more than 24 days after packing.

The authors of the new Harvard report point out that it is impossible to provide actual definitions for all the date label terms currently in use because meanings are not legally defined. They vary by state, and there is no consensus about how to apply them to different categories of food products. However, the terms generally can loosely be interpreted as…

• “Production” or “pack” date—the date on which the food product was manufactured or placed in its final packaging.

• “Sell by” date or “expiration date”—information to retailers for stock control, leaving a reasonable amount of shelf life for the consumer after purchase.

• “Best if used by” date—typically an estimate of a date after which food will no longer be at its highest quality.

• “Use by” date—also typically a manufacturer’s indication of the last date recommended for the use of the product while at peak quality.

• “Freeze by” date—a reminder that quality can be maintained much longer by freezing a product.

• “Enjoy by” date—essentially useless to consumers.

Is there any term being used that indicates when a product is no longer safe to consume? No! And that’s the whole point of the report.

The authors had several recommendations for the food industry that could help cut back on needless waste, including standardizing the labeling system and improving the use of safe-handling instructions so consumers know which foods should be refrigerated or frozen and how long foods last in different conditions.

But until such industry changes are made, consumers can use common sense to waste not, want not. Obviously, you shouldn’t eat or drink anything that looks, smells or tastes like it has gone bad. For instance, toss anything with visible mold or discoloration, an “off” odor, changes in texture or flavor or marred packaging (such as a broken seal on a bottle or a misshapen or corroded lid on a can). Other than that, though…

• Remember that the “sell by” date is purely for grocers’ inventory-management systems. If you’re in the store and want to compare dates to select the freshest items for your cart, that’s fine, as is opting not to buy foods that are past the “sell by” date. But once a food is in your home, don’t misinterpret the “sell by” date as an “eat or throw away by” date.

• With nonperishable items (canned goods, spices, honey) and packaged foods (cereals, crackers), safety isn’t really an issue, the researchers said. However, these foods may taste less flavorful after a long time in storage.

• Perishable foods—such as unfrozen shellfish, fish, meat or poultry, and eggs and dairy products—can spoil and make you ill. However, there’s so much variability from food to food that it’s impossible to give a blanket number of days after the “use by” date within which all products should be consumed. For more information on particular types of foods, check a reputable resource such as

• Be sure to store each food as the label directs—for instance, by refrigerating after opening, if so instructed. That’s the best way to avoid food waste.

Source: Emily Broad Leib, JD, director, Food Law and Policy Division, Harvard Law School, Boston. She is coauthor of a report titled “The Dating Game: How Confusing Food Date Labels Lead to Food Waste in America,” copublished with The Natural Resources Defense Council, an international nonprofit environmental group.

More on Food-Labeling Problems

Yoga for Men: The Secret to a Flat Stomach, Healthy Heart and Better Sex Monday, Apr 22 2013 

by Carole Jackson>, Bottom Line Health


About 16 million Americans regularly practice yoga for health and healing—but four out of five of them are women.

What few people realize: Despite its reputation as a “soft” exercise that’s more suited to women, yoga can provide special health benefits for men—even helping to slow the growth of prostate cancer.

What all men need to know…*


Hundreds of scientific studies on yoga have shown that it can improve health conditions ranging from sleep problems and sinusitis to high blood pressure and schizophrenia. Many of these benefits are particularly relevant for men. For example, yoga has been shown to…

Slow prostate cancer. In a study published in The Journal of Urology, some men with prostate cancer did 60 minutes daily of gentle yoga (stretching, breathing, meditation, guided imagery and relaxation) for one year while others did not. Those who didn’t do yoga had eight times more growth of cancer cells than those who performed yoga daily.

Reduce abdominal fat. Stress is behind many “spare tires,” because it triggers high levels of the hormone cortisol, which stimulates appetite and overeating and then plays a key role in turning extra calories into extra belly fat. For unknown reasons, visceral fat, which releases disease-causing inflammatory chemicals, is more prevalent in men than in women.

Good news: Yoga reduces cortisol, which helps control abdominal fat.

Help prevent a heart attack. Each year more than 900,000 Americans have heart attacks, and the majority of them are men.

New research: Yoga can reduce many of the heart attack risk factors in people who have heart disease, including high blood pressure, elevated total and LDL “bad” cholesterol and high triglycerides.

Improve sexual performance and satisfaction. In a study of 65 men reported in The Journal of Sexual Medicine, practicing yoga an hour a day for three months improved every dimension of sexual functioning—libido…erections…ejaculatory control…satisfaction with performance, intercourse and orgasm…and sexual confidence.


Many middle-aged men make the mistake of thinking that because yoga looks easy, it is easy. While there are some easy versions that anyone can do, faster, more vigorous yoga styles require a fair degree of fitness and strength to even start. Even though yoga is generally safe for most people of all ages, if you’re middle-aged or older and have never practiced yoga, it’s best to start with a slower, less vigorous style. My advice…

Start with a yoga class, not with a book or DVD. Taking a class led by a skilled yoga teacher is invaluable because the teacher can look at you, review what you’re doing and guide you to the best injury-free experience. Expert instruction, mindfulness and not pushing too hard during practice can prevent most injuries, such as muscle spasms and ligament strains.

Helpful: If you do use a book or DVD to learn yoga, have a skilled yoga teacher look over your routine now and then to help you correct any mistakes.

Find a good class for men. Ask a male family member, friend or colleague who practices yoga for his recommendation. If you don’t know any men who practice yoga, ask a woman, or visit the Web site of the International Association of Yoga Therapists,

Don’t rush results. Men are often achievement-oriented and want fast results. That’s a mistake. Yoga is not about performance or competition—it’s about how the poses help you.

Just do it! This is the secret to success with yoga—simply doing a yoga routine, 15 to 20 minutes a day, every day.

For overall fitness, yoga is a good complement to cardio exercise and strength training. But remember, yoga also provides stress reduction, flexibility and mental focus.


Misconceptions about yoga can keep some men from trying it. Yoga is not…

A religion. It is practiced by Christians, Jews, Muslims and atheists.

Just stretching. Yoga includes stretching poses (asanas), as well as many other techniques, such as breathing exercises and meditation.

A single style of exercise. There are many styles of yoga, from slow and gentle (such as Ananda or Kripalu) to fast and vigorous (such as Power Yoga or Vinyasa Flow).

*Before starting yoga, check with your doctor if you have severe osteoporosis, problems with your spine or artificial joints—you may be at greater risk for injury. Also consult your doctor if you have any chronic health conditions or recent injuries. If you develop pain, dizziness or other symptoms while doing yoga, stop the pose and tell your teacher immediately.

Source: Timothy McCall, MD, a board-certified internist, medical editor of Yoga Journaland the author of Yoga as Medicine (Bantam). His articles have appeared in dozens of publications, including The New England Journal of Medicine and The Journal of the American Medical Association. He teaches workshops on yoga as medicine that are open to health-care professionals, yoga teachers and anyone seeking help with a specific medical condition.

The Case for Drinking as Much Coffee as You Like Wednesday, Feb 27 2013 

The Atlantic Magazine


What I tell patients is, if you like coffee, go ahead and drink as much as you want and can,” says Dr. Peter Martin, director of the Institute for Coffee Studies at Vanderbilt University. He’s even developed a metric for monitoring your dosage: If you are having trouble sleeping, cut back on your last cup of the day. From there, he says, “If you drink that much, it’s not going to do you any harm, and it might actually help you. A lot.”

Officially, the American Medical Association recommends conservatively that “moderate tea or coffee drinking likely has no negative effect on health, as long as you live an otherwise healthy lifestyle.” That is a lackluster endorsement in light of so much recent glowing research. Not only have most of coffee’s purported ill effects been disproven — the most recent review fails to link it the development of hypertension — but we have so, so much information about its benefits. We believe they extend from preventing Alzheimer’s disease to protecting the liver. What we know goes beyond small-scale studies or limited observations. The past couple of years have seen findings, that, taken together, suggest that we should embrace coffee for reasons beyond the benefits of caffeine, and that we might go so far as to consider it a nutrient.


The most recent findings that support coffee as a panacea will make their premiere this December in the American Journal of Clinical Nutrition. Coffee, researchers found, appears to reduce the risk of type 2 diabetes.

“There have been many metabolic studies that have shown that caffeine, in the short term, increases your blood glucose levels and increases insulin resistance,” Shilpa Bhupathiraju, a research fellow at the Harvard School of Public Health’s Department of Nutrition and the study’s lead author, told me. But “those findings really didn’t translate into an increased risk for diabetes long-term.” During the over 20 years of follow-up, and controlling for all major lifestyle and dietary risk factors, coffee consumption, regardless of caffeine content, was associated with an 8 percent decrease in the risk of type 2 diabetes in women. In men, the reduction was 4 percent for regular coffee and 7 percent for decaf.

The findings were arrived at rigorously, relying on data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, two prospective studies that followed almost 80,000 women and over 40,000 men from the 1980s through 2008. Although self-reported, the data is believed to be extremely reliable because it comes from individuals who know more about health and disease than the average American (the downside, of course, is that results won’t always apply to the general population — but in this case, Bhupathuraju explained that there’s no reason to believe that the biological effects seen in health professionals wouldn’t be seen in everyone else).

That there were no major differences in risk reduction between regular and decaf coffee suggests there’s something in it, aside from its caffeine content, that could be contributing to these observed benefits. It also demonstrates that caffeine was in no way mitigating coffee’s therapeutic effects. Of course, what we choose to add to coffee can just as easily negate the benefits — various sugar-sweetened beverages were all significantly associated with an increased risk of diabetes. A learned taste for cream and sugar (made all the more enticing when they’re designed to smell like seasonal celebrations) is likely one of the reasons why we associate coffee more with decadence than prudence.

“Coffee and caffeine have been inexorably intertwined in our thinking, but truth is coffee contains a whole lot of other stuff with biological benefits,” said Martin. And most concerns about caffeine’s negative effects on the heart have been dispelled. In June, a meta-analysis of ten years of research went so far as to find an inverse association between habitual, moderate consumption and risk of heart failure. The association peaked at four cups per day, and coffee didn’t stop being beneficial until subjects had increased their daily consumption to beyond ten cups.

Caffeine might also function as a pain reliever. A study from September suggested as much when its authors stumbled across caffeinated coffee as a possible confounding variable in its study of the back, neck, and shoulder pains plaguing office drones: Those who reported drinking coffee before the experiment experienced less intense pain.

The data is even more intriguing — and more convincing — for caffeine’s effects as a salve against more existential pains. While a small study this month found that concentrated amounts of caffeine can increase positivity in the moment, last September the nurses’ cohort demonstrated a neat reduction in depression rates among women that became stronger with increased consumption of caffeinated coffee.

But that caffeine is only mechanism behind coffee’s health effects is supported by a small study of 554 Japanese adults from October that looked at coffee and green tea drinking habits in relation to the bundle of risk factors for coronary artery disease, stroke, and type 2 diabetes known together as metabolic syndrome. Only coffee — not tea — was associated with reduced risk, mostly because of dramatic reductions observed in serum triglyceride levels.

So aside from caffeine, just what are you getting in a cup, or two, or six? Thousands of mostly understudied chemicals that contribute to flavor and aroma, including plant phenols, chlorogenic acids, and quinides, all of which function as antioxidants. Diterpenoids in unfiltered coffee may raise good cholesterol and lower bad cholesterol. And, okay, there’s also ash which, to be fair, is no more healthful than you would think — though it certainly isn’t bad for you.



Some of the chemicals in coffee are known carcinogens, though as far as we know that’s only been seen in rodents, not in the small levels we encounter in everyday consumption. Findings, on the other hand, have been supporting that coffee can protect against some cancers. When the Harvard School of Public Health visited the Health Professionals Follow-Up cohort in May 2011, it found that coffee’s protective effects extend only to some types of prostate cancer (the most aggressive types, actually). In a separate study of the same population from this past July, they also found a reduced risk of basal cell carcinoma with increased caffeine intake.

The association was strongest for those who drank six or more cups per day.

That same high dosage is also effective in fighting against colorectal cancer, according to a prospective study from June of almost 500,000  adults conducted by the American Society for Nutrition. While the association was greatest for caffeinated varieties, decaf made a small but significant showing. A meta-analysis of 16 independent studies this past January added endometrial cancer to the group of cancers whose relative risk decreases with increased “dosage” of coffee. And in 2011, a large population of post-menopausal women in Sweden saw a “modest” reduction in breast cancer risk with immoderate consumption of 5 or more daily cups.

Taking the benefits of coffee any further requires being patient-specific, but findings apply to a broad range of populations and conditions:

If you have fatty liver disease, a study from last December found that unspecified amounts can reduce your risk of fibrosis.

If you’re on a road trip, you may respond like the 24 volunteers for an experiment from February who were subjected to two hours of simulated “monotonous highway driving,” given a short break, then sent back out for two more hours. Those given a cup of coffee during the break weaved less, and showed reductions in driving speed, mental effort, and subjective sleepiness. If you’re on a weight-training regimen, it can provide a mild (and legal) doping effect.

If you’re trying to enhance your workout, the results of one experiment from October found that drinks containing caffeine enhances performance. And then another one from Dr. Martin in 2008: He coauthored a study of people enrolled in Alcoholics Anonymous in which there appeared to be an association between upping coffee intake and staying sober.

Nothing can be all good, and there is still information working against coffee — in October, TheAtlantic reported on a study from the health professionals cohort that suggested a link between excessive coffee consumption and glaucoma. “The current recommendation is that if somebody’s not drinking coffee, you don’t tell them to start,” said Bhupathiraju.

But she agrees that drinking coffee, and more of it, does appear to be beneficial. The evidence remains overwhelmingly in coffee’s favor. Yes, it was observational, but the study published in May in the New England Journal of Medicine looked at hundreds of thousands of men and women and found this bottom line result: people who drank coffee lived longer than those who didn’t.

And the more they drank, the longer they lived. If you’re into that sort of thing.

Plates That Help Your Weight Monday, Feb 25 2013 

by Carole Jackson>, Bottom Line Health


There’s a reason why stop signs are red. Not only is it the most noticeable color, but study after study has found that, because stop signs have been red for such a long time, the color itself has come to automatically signal “danger”…“don’t go here”… and, yes, “stop.” And now new research shows that this color even might help us stop drinking fattening beverages and eating too much food.

We have known for a long time that colors can influence our moods and even our behaviors, but it was Leonie Reutner, MSc, a doctoral student and lecturer at the University of Basel in Switzerland, who coauthored a study published online inAppetite this past January to see if color could actually be used as a tool for weight loss. The answer? Yes. But how?


Knowing how the color red signals “danger” in most people’s minds, Reutner and her colleagues wanted to see whether using red-colored plates and red-labeled glasses would make people eat less of a salty snack and drink less of a sugar-sweetened beverage. So they set up two experiments to find out…

The beverage study: Researchers approached 41 college students and invited them to take part in an “evaluation of three sweet drinks.” Since their pretest had found that female students took only tiny sips of the drinks, the researchers invited only male students to participate. Each participant was asked to rate three drinks matched for color (slightly yellowish) in clear plastic cups. An adhesive label with a large A, B or C printed in white on it was attached to each cup. The backgrounds behind the letters on each label were, randomly, blue or red. The drinks were not identified to the study participants, but they were lemon-flavored, white tea-flavored and green tea-flavored. Researchers weighed each cup before and after the drink test and found that—you guessed it—regardless of which drink was being tasted, participants drank significantly less (about 41% less, on average) from the red-labeled cups than from the blue-labeled cups.

The red-plate study: This time, 109 males and females, ranging in age from 13 to 75, were asked to assist in a study related to “various areas of psychology.” Each was given a questionnaire to complete, was seated at a table in front of either a white, red or blue paper plate containing exactly 10 pretzels, and was told, “Feel free to snack on the pretzels while completing the questionnaire.” After the participants left, researchers counted the pretzels that were left on each plate. And, sure enough, participants ate 48% fewer pretzels from red plates than from the blue and white plates.


Before anyone goes out and buys red plates and cups, Reutner said, it’s important to consider two points. The first is that the participants in the experiments didn’t know ahead of time that red might help them eat or drink less, but now that you know it, the red might not have the same effect on you. The second is that the participants were distracted during the experiment. They were focused on either rating a beverage or filling out a questionnaire as opposed to being focused on what they were eating…so again, your results might vary.

I applaud Reutner for being academically rigorous in pointing out these differences between her study and real life—but on the other hand, the red had such a huge effect in the study that it’s hard to imagine that it wouldn’t have some effect on our dinner tables.

So if you want to lose weight or if you want to help a loved one lose weight, why not try it? Get some red plates and give it some time—maybe a month—for the novelty to wear off, and then judge whether they are helping you. And while you’re at it, get smaller plates—size has also been shown to matter when it comes to quantity of food eaten.

Source: Leonie Reutner, MSc, researcher and lecturer, department of social and economic psychology, University of Basel, Basel, Switzerland.

Easy Way to Relieve Pain Saturday, Feb 23 2013 

by Carole Jackson, Bottom Line Health



If you suffer from some type of chronic pain and tend to get anxious about it (or if you tend to be an anxious person in general), you’ve probably been told umpteen times by well-meaning friends, “Just try to not think about the pain”…and of course, that’s easier said than done!

But I do have good news for you today—scientists at the Pain Research Center at the University of Utah in Salt Lake City have learned something new about a way that people can stop thinking about their pain…interestingly, this strategy works best for people who tend to be anxious or nervous!

To find out more about this intriguing discovery, I called David H. Bradshaw, PhD, who works in the department of anesthesiology at the center. His study was published in the December 2011 issue of The Journal of Pain.


For his study, Dr. Bradshaw gathered 143 men and women, ages 18 to 55, who were healthy and free of chronic pain. Participants were given questionnaires that assessed how much general anxiety they had. Then they went through three phases of the experiment. During one phase, they sat still while, at random times, they were given fingertip shocks to produce pain. Researchers chose to shock the participants rather than study people with chronic pain, because it made the data easier to measure and control. During another phase, participants got the random shocks while individually performing an “easy” task. The easy task was listening to a familiar melody (for instance, Twinkle, Twinkle, Little Star) and shouting “bad” when they heard a wrong note. During a third phase, they got the random shocks while individually performing a “hard” task. The hard task was similar to the easy task—but the researchers made the wrong notes more subtle and therefore more difficult to detect. How much each participant was “aroused” (or bothered) by the painful shocks was assessed by measuring changes in pupil dilation, palm sweatiness and electrical activity in the brain. Here’s what the researchers found…

Finding #1: This first discovery was not incredibly surprising. As you would expect, the more difficult the task that the participants were engaged in, the less they felt the pain.

Finding #2: The second discovery was much more interesting. Participants who had shown themselves to be anxious types on the general anxiety questionnaire and who performed the tasks well (signaling greater engagement) experienced the least amount of pain during the experiment—less pain, even, than participants who tended to have relaxed, worry-free personalities and performed the task well.

That’s the opposite of what was expected. And that’s why this study is so remarkable—it suggests that by becoming fully engaged in a task, some of the people who need pain relief the most can finally get it.


Of course, the type of task that the study participants performed isn’t something that you can easily replicate at home, but Dr. Bradshaw said there are other, similar ways that you can intensely engage your mind to relieve your pain. For example, if you want to make it less likely that your sore neck or bad back is going to bother you, forget passive activities such as watching TV. Even reading a book, while it isn’t passive mentally, is usually not very challenging—so most books aren’t likely to provide the kind of immersion that will really beat your pain.

More likely to help, Dr. Bradshaw said, are virtual-reality video games (the kind where you take on the role of a character onscreen, navigate your way through different virtual environments and make decisions along the way). In fact, research has shown that even burn patients have less pain when they play such games. Or if you’re listening to music, Dr. Bradshaw said, you can engage with it by singing or tapping along with your foot—because it forces you to pay closer attention to the rhythm, melody and lyrics. Another strategy you could try anywhere—even at work, where you can’t exactly sing along to music or play video games—is to breathe deeply, said Dr. Bradshaw. Inhale for 10 seconds, exhale for 10 seconds, and repeat this for at least a few minutes, focusing your mind on your breath and nothing else.

It is interesting to realize that the mind has so much power over our pain. Any pain reduction due to distraction is likely to be only temporary…but even brief relief is better than no relief. So when you are in pain, before you pop a pill, see if getting immersed in something doesn’t take the edge off—and if you are a worrywart, try this technique with confidence!

Source: David H. Bradshaw, PhD, research assistant professor, department of anesthesiology, Pain Research Center, University of Utah, Salt Lake City.

The Biggest Health Mistake Kids Make Thursday, Feb 21 2013 

by Carole Jackson>, Bottom Line Health


We all know that we should encourage our kids and grandkids to exercise because it boosts both their physical and mental health, but new research reveals that there’s a certain age at which the amount of physical activity that kids do tends to drop off the most.

And at that particular time in their lives, a few extra reminders wouldn’t hurt.

To learn more about exactly when—and why—this drop-off appears, I called study author Matthew Kwan, PhD, a postdoctoral fellow at McMaster University in Ontario, Canada, whose report was published in January 2012 in American Journal of Preventive Medicine.


In one study, starting at ages 12 to 15, 683 Canadian teens were followed over 12 years and interviewed every two years. Each time, Dr. Kwan and his colleagues assessed how much physical activity the teens had done over the previous three months. Physical activity was defined as any mild, moderate or vigorous leisure activities—from bowling to soccer to marathon running—but did not account for activities such as walking to school.

The results: Over the course of the 12-year period, the amount of physical activity among girls declined, on average, by 17%, while physical activity among boys declined by 30% on average. Dr. Kwan said that it’s important to note that boys were more active to begin with at around ages 12 to 15, so that might explain why their decline was steeper.

Another study of Dr. Kwan’s looked at when the steepest declines within that time period tend to occur. He looked at boys and girls, both those who went to college and those who didn’t. He found that in three of the four groups, the steepest decline took place around the age of 18, as the girls and boys were finishing high school. Among girls who went to college, there was a decline in their exercise around that age, but it wasn’t quite as steep as that of the other groups—probably because they had had another steep decline in middle school.


So what’s so special about the age of 18? I have to admit that I was surprised by the results, since many college kids have so much free time! I would have guessed that the largest drop would have been seen right after college, when young adults enter the workforce, often in sedentary jobs, and start to take on many more of life’s responsibilities. But the results seemed more logical when Dr. Kwan shared the following insights…

The transition from high school to college usually means a big drop-off in the number of organized sports that students participate in. Even great high school athletes can’t always compete at the college level—either because they aren’t quite good enough or can’t take on the greater time commitment. Less glamorous “club sports” in college may not seem that appealing… so it’s all too easy for physical laziness to set in and for kids to say “I’m done with the sport.”

There are more distractions at college…and there is much more freedom to participate in unwholesome activities. For example, besides tracking physical activity, the researchers also asked the kids about how often they smoked and drank alcohol—and it’s no shock that those behaviors tended to peak during the college years. And if smoking and drinking aren’t anti-exercises, I don’t know what is!


Is it all hopeless, or can we help our kids and grandkids keep up their health by keeping up their exercise? Well, Dr. Kwan said, if you have a bit of money to spend on this, indulge your older kid’s interest in, say, martial arts or dance by offering to spring for classes after he or she graduates high school. In many cases, that could be the best replacement for secondary-school sports. But spending isn’t the only answer, and not even the best answer. “There’s a lot of evidence that the more active parents are, the more likely their kids will be active,” Dr. Kwan told me. So, yes, if you really care about this, you should be a positive role model. Stay active yourself…make sure your kid knows that you are…and when your college kid is home on break, grab those hiking boots or tennis racquets and head out there together.

Source: Matthew Kwan, PhD, postdoctoral fellow, department of family medicine, Michael G. DeGroote School of Medicine, McMaster University, Ontario, Canada.

Have More Fun in Bed! All It Takes Is Some Sexual Intelligence… Tuesday, Feb 19 2013 

by Carole Jackson, Bottom Line Health


Are you sexually satisfied? For so many people, sex is more a source of anxiety than pleasure. Instead of bringing them closer to their partners, sex often makes them feel inadequate, perhaps due to concerns about their aging bodies. They look back nostalgically to a time when sex was satisfying and give a sigh, thinking that it’s just something else you lose as the years pass.

But things could be very different. What really helps is a bit of intelligence—sexual intelligence.

Here’s what that means…


On TV and the Internet and in magazines and movies, we are surrounded by youthful, sexy people. Sex is portrayed as mind-blowing, athletic and amazing. We’re conditioned to think that’s the way all sex is supposed to be.

But as we grow older, our bodies—and our lives—change. Also, factors such as medication use, chronic pain, familiarity with your partner and accumulated resentments can reduce libido during this phase of life.

So it makes sense that sex will be different during middle age and beyond. It may be difficult to adjust expectations, but the way to change your sex life is to change your ideasabout sex.


It’s a given that most people want pleasure and closeness from sex. But many focus on other things altogether…

How am I doing? It is very easy to equate sex with performance. This can mean constant self-evaluation. Is my erection as firm as it should be? Will it last? Am I attractive or skillful enough?

Is this normal? People may think, I like this, but is it morally acceptable? Unlike most activities they do for enjoyment, they may worry that their tastes in sex show them to be bad or wrong.

With all these anxieties, how much pleasure and closeness are people likely to experience when having sex?


To have satisfying sexual experiences, you don’t need to be a hotshot in bed. You need a combination of emotional skills and physical awareness, both of which are essential to sexual intelligence.

Partners must be patient and sensitive to each other’s feelings and keep any disappointment in perspective.

Physical awareness includes understanding how your own body and your partner’s body have changed over time. What are your bodies still capable of doing, and what can’t they do anymore? It means knowing what makes you and your partner feel good—where you both like to be touched, how you both enjoy being kissed, what aids are preferred. Sexual intelligence means accommodating these preferences, whenever possible, with good humor.

Important: Remember that emotional skills and physical awareness typically are more central to good sex than sexual technique.


Many people get into the habit of having sex while thinking about something else entirely. This undermines pleasure and intimacy.

Much better: Focus on the physical sensations. What specifically are you feeling in your arms, legs, genitals, fingertips? What do you smell and taste?

Soak up the emotional experience, too. Feel the pleasure, relaxation, excitement and fun. Also feel the closeness to your partner. If you’re anxious, worried or rushed, notice that, too, but don’t judge or analyze the feeling then. Set it aside to think about or talk about later. Bringing your attention back to the moment is helpful when you start to worry about your performance or appearance or what your partner is thinking. More self-acceptance and less self-criticism often enhances libido.


For better communication, you must view the person you have sex with as a partnerrather than as a critic or judge. Since this person is your partner, you shouldn’t feel reluctant to ask for what you would like in bed. Even better: Show your partner how you would like to be touched. And if something feels good, say so (and do it with a whisper—it’s sexier).

Take time to discuss your sexual relationship. It may feel awkward at first, but talking about performance anxiety is the best way to get past it. Also, this is the time to discuss with your partner anything new that you would like to try. And, if there is anything that you definitely don’t want to do again, make this clear. During this discussion, work out details, such as preferred time for sex (some people like the morning, others the night), place and even room temperature. Since initiating sex is a problem for many couples, discuss signals to use when one of you could be in the mood.


Most people consider “sex” to be intercourse. This thinking is unfortunate. There are drawbacks to intercourse that can make it inconvenient, ill-advised or even impossible. It requires an erect penis and lubricated vagina…it’s difficult for people with various physical problems…chronic pain can make it uncomfortable…and it’s not an effective way to have an orgasm for many women.

Speaking of orgasms—they probably get a good deal more attention than they merit. An orgasm is quite pleasant, but it lasts maybe five seconds during a sexual encounter that might be 20 minutes or more.

Consider that sex can be satisfying without intercourse and without orgasm. A broader range of physically and emotionally gratifying activities—oral sex, manual stimulation of body parts you may have ignored, watching each other masturbate, etc.—are all options.


In fact, you can think of sex in the same way you would think of other things you do with your partner. Was it enjoyable? Did you feel close to each other? How can you make it even better next time? In this spirit, you’re less likely to worry about success or failure and more likely to appreciate the rich range of experiences sex has to offer.

A couple should consider seeing a sex therapist if either or both have trouble discussing a sexual issue. To find a sex therapist, check with your doctor or consult the American Association of Sexuality Educators, Counselors and Therapists,

Source: Marty Klein, PhD, a licensed marriage and family therapist and certified sex therapist in Palo Alto, California. He is the author of seven books, including most recently Sexual Intelligence: What We Really Want from Sex and How to Get It(HarperOne).

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