Tuesday, April 25, 2017

Blue Zones - Where People Live Longer and Better

By Emma Stafford, RN, APN-C, ACHPN, APHN-BC
Nurse Practitioner
Meridian Integrative Health & Medicine

I have just re-read the book The Blue Zones and highly recommend it to those who want to live longer and better. Our bodies are meant to live to a healthy 90 years old…in reality we are living to age 78, most with many chronic diseases. Some of us believe longevity and overall health is determined by our genes, but science is proving that environment and lifestyle are responsible for 80% of our health. The “Blue Zones” are areas in the world where a higher percentage of the population live longer. Residents of these areas are able to retain health and vitality well into their 80’s, 90’s and even into their 100’s. Brothers Dan and Tony Buettner identified these areas as Ikaria, Greece; Sardinia, Italy; Okinawa, Japan; Loma Linda, California, and the Nicoya Peninsula in Costa Rica. Their book, The Blue Zones outlines nine lessons that are associated with health and longevity:

1) Move naturally - Be active without thinking about it. Walk, bike, garden. Do not sit for more than 20 minutes. 
2) “Hara Hacha Bu” - In Okinawa, you will hear them chant this before meals. It is a reminder to stop eating when your stomach is 80% full. 
3) Plant Slant - Avoid meat and processed foods. Eat a plant-based diet with beans and meat in small and limited portions. Strict Adventists in Loma Linda, California take their dietary cues from the Bible. Genesis 1:29 “Then God said, Behold, I have given you every plant yielding seed that is on the surface of all the earth, and every tree which has fruit yielding seed: it shall be food for you.”
4) Grapes of Life - Drink red wine in moderation and always with friends or family. Three quarters of a glass for women and two glasses for men daily (no saving up for the weekend binge ).
5) Purpose Now - Take time to see the big picture. Have a strong sense of purpose and be able to articulate it – it is why you wake up in the morning. This helps reduce stress and reduces the chance of suffering from Alzheimer’s disease, arthritis, and stroke. 
6) Down Shift - Take time to relieve stress. Inflammation is the body’s reaction to stress and chronic inflammation promotes age related chronic diseases. Adopt a daily stress management program and be amazed at the changes it will make in your life.
7) Belong - Participate in a spiritual community. Studies have shown that attending religious services—even as infrequently as once a month—may make a difference in how long a person lives. 
8) Loved Ones First - Make family a priority. Invest time and energy in your children, your spouse, and your parents. Play with your children, nurture your marriage, and honor your parents in whatever way you can. 
9) Right Tribe - Be surrounded by those who share Blue Zone values. 

Small changes can make a big difference in your health—the choice is ours. Commit to changing one health behavior as outlined above and start your journey toward a longer life.

Thursday, April 20, 2017

The Most Effective Way to Prevent Heart Disease

By: Vivian A. Kominos, M.D., FACC
Integrative Physician

A study recently published in the prestigious medical journal, The Lancet, found that the Tsimane have the healthiest arteries. The Tsimane are a group of people in a remote corner of the Bolivian Jungle who farm and forage for food. Anthropologists who have studied this population for many years report that they have very few risk factors for cardiovascular disease. In a research project, over 700 Tsimane traveled for days to get CT scans of their hearts. These scans showed that most had no calcium in their arteries. Calcium is a marker for blockages in the arteries: the more calcium, the greater the risk for heart disease. The researchers found that the average 80 year old Tsimane had the arteries of a 50 year old American!

Scientists have asked the question, why are they the healthiest people on earth? Is it possible that the answer can be found by looking at their lifestyle? While processed foods make up more than half of the standard American diet, the Tsimane eat mainly wild game, fish, maize, fruits and nuts. Their diet is very low in saturated fat and most of their calories are from plants. And while the typical American walks 6,000 steps, the Tsimane walk 17,000 steps. They have to walk for their food: they hunt, fish, and farm. They live in a connected culture where they have large families and strong community connections.

Cardiologists agree that up to 80% of premature heart attacks and strokes can be prevented by living a healthy lifestyle. Maybe we can take lessons from the Tsimane. Besides diet and social connectedness, the amount of physical activity differs greatly from Americans. The Tsimane walk 8 miles a day just to live their normal every day existence while the average American walks 2.8 miles. We live in a sedentary culture where food is delivered to our doors, meetings take place over the computer, and the TV connects us to the rest of the world. More and more evidence has revealed that sitting time is dangerous. Those who sit and watch TV more than 4 hours a day have 50% greater risk of death and 125% greater risk of heart disease when compared to those that watch TV less than 2 hours a day.

I am not advocating that we give up our modern conveniences. But it is obvious that we need to move more. The current recommendations from the American College of Sports Medicine recommend that we get at least 150 minutes a week of moderate physical activity and 2 sessions of some form of resistance training that work our major muscle groups. Examples of moderate physical activity include walking 30 minutes, five times a week at a brisk 3-4 minute mile pace, riding a bike at 5-9 miles per hour, ballroom dancing, or playing doubles tennis. But suppose you cannot exercise this much? I tell all my patients that ANY exercise is better than no exercise and simply to become more active.

There are many ways to build activity into your day. Park at the farthest space in the lot rather than the closest to the store. Stand when you are on the phone. Walk to colleagues’ offices when you need to talk to them instead of texting or emailing. Create multiple work stations at work and at home so that you do not sit in the same position for extended periods. And if you do have a sedentary job, see if you can get a standing desk. And if you have to sit for long periods, get up every 20 minutes and walk for a couple minutes. When you go to concerts or games, don’t bring a chair but stand and pace. Cook your own food and go for a brief walk after eating.

I have been physically active my entire life. I started running at the age of 38 and completed 5 marathons. I no longer run long distances but run for fun, health and fitness, 15 to 20 miles a week. I hike and kayak. I practice yoga for resistance training and for the peace it creates. I would love to help you achieve a more active life and achieve more fitness and strength. Join me at one of my 2-hour “Creating an Active Life” workshops. You will not only learn about the benefits of exercise, but we will exercise together. Visit www.MeridianIntegrativeMedicine.com for more information or call 1-800-DOCTORS to register.

Tuesday, April 18, 2017

An Integrative Approach to Clean Eating - Part 3

By Nicole Cerillo, RD, LDN
Integrative Medicine Nutritionist 

The last few nutrition posts have been all about clean eating and making the commitment and New Year’s resolution to eat clean for 21 days. If you missed any of these posts you can find them here - An Integrative Approach to Clean Eating - Part 2 and Committing to Clean Eating.

Now that you have read through the introduction and the guidelines, I am sure you are thinking something like, "this sounds great—but what do I eat!?"

To keep it super simple, just eat FOOD! A whole lot of real food! Eat fresh and organic vegetables, fruits, nuts, seeds, wild fish, dairy, meats, oils, and whole (unprocessed) grains…that’s it! Let’s look into each group in more detail.

Non-Starchy Vegetables
Vegetables are your main source of nutrient dense vitamins, minerals, and fiber. Shoot for 6 cups of non-starchy vegetables each day. Non-starchy vegetables include mushrooms, tomatoes, zucchini, carrots, onions, kale, spinach, lettuce, broccoli, cauliflower, asparagus, green beans, cucumbers, etc.

Starchy Vegetables & Legumes
Starchy vegetables are also nutrient dense and are high in fiber. Include 1 or 2 servings per day (1 serving = 1/2 cup) of starchy vegetables such as pumpkin, summer and winter squash, red or white potatoes, sweet potatoes, corn, peas, beans, and lentils, which also count as a starch.

Fruits contain a high amount of antioxidants due to their bright colors and deep pigments which scavenge free radicals and can prevent against many types of cancer. Aim for 1 to 2 servings of fruits per day (1 serving = 1/2 cup berries, 1 medium apple or orange, half a grapefruit, 1 kiwi, 1 small banana, etc.)

Limit any processed dairy and switch to grass-fed butter, ghee, and unsweetened nut and seed milks (such as almond, cashew, hemp, flax, coconut, and hazelnut).

Enjoy grass-fed, organic, sustainable raised lamb, beef, bison, venison, organic chicken, duck, turkey, and pasture-raised eggs.

Fish & Seafood
Eat wild fatty fish such as sardines, mackerel, herring, black cod, and wild salmon. Shellfish, including clams, oysters, mussels, wild shrimp and scallops, and crab should be enjoyed in moderation. Avoid farm raised fish and fish high in mercury.

Nuts & Seeds
Include nuts such as almonds, macadamia, cashews, walnuts, coconut, pecans, and Brazil nuts. Include seeds such as hemp, chia, pumpkin, sesame, and flax. Nut and seed butters are also great options as long as they don’t contain added sugars or refined vegetable oils. Include 2 to 3 servings of nuts and seeds per day (1 servings = ¼ cup seeds, 1 ounce or about 22 almonds or walnuts, and 1 TBSP nut butter).

Whole Grains
Whole grains are complex carbohydrates that have abundant fiber and nutrients. Include gluten-free whole grains in moderation such as organic jasmine rice, buckwheat, quinoa, millet, arrowroot, and oats in their pure and unprocessed form.

Good Fats & Oils
Include healthy fats such as avocado, pure 85% organic dark chocolate, and olives. Increase consumption of healthy oils such as organic virgin cold-pressed unrefined coconut oil, organic extra-virgin cold-pressed olive oil, MCT oil, organic flax seed oil, organic expeller-pressed refined avocado oil, walnut oil, pumpkin seed oil, pistachio oil, and hemp oil. Aim for 1 to 2 servings per meal of healthy fats (1 serving = 1 TBSP oil, ¼ avocado, 1 ounce or 1 small square dark chocolate, and 8-10 olives).
*Portion and serving sizes may vary depending on specific body composition, energy needs, and your goals. If you have specific health goals, please make an appointment for optimal results.

Tuesday, April 11, 2017

Can Stress Be Beneficial?

By Sara Scheller, BSN, RN, CPN, CCRN
Integrative Health Coach

Does the word “stress” alone make you feel...stressed? Do you know that not all stress is bad? What if I were to tell you that how you view stress may have a greater impact on your health than the stress alone?

Stress serves an important purpose in humans. When a person experiences a real or perceived threat, the body prepares to act. Our heart rate increases, our blood vessels constrict, our mouth may feel dry, our muscles may feel tense and our pupils dilate. This stress response called “fight or flight” happens rather quickly - we may not be aware it even occurs - and takes time for our body to return to a normal resting state. When the fight or flight switch is turned on and stays on for long periods of time, inflammation occurs, our immune system response is decreased, and we may experience digestive issues which may lead to preventable chronic diseases like heart disease and obesity. So, should we try to avoid stress all together? Not necessarily!

Research has found that how we think about stress actually matters, as Kelly McGonigal has noted in her book, The Upside of Stress (2015). In fact, one study found a 43% increased risk of dying not from stress, but the, “belief that stress is actually bad for you.” The good news is that we have a built in mechanism for stress resilience called human connection. As our body secretes cortisol, it also secretes another stress hormone called oxytocin, known as the “cuddle hormone.” Ever notice that if something gets you fired up, you start talking about it? That is because the oxytocin motivates us to seek support. This hormone naturally protects us from the harmful effects of cortisol and helps us to recover faster.

As a health coach, we work together to develop tools to improve your relationship with stress. In our sessions, we practice these to initiate a relaxation response so that you can recover from the harmful effects of stress. If we can find ways to see your stress as something that is helpful, giving you a greater sense of purpose, or setting you up with better ways to handle difficult situations, we can actually change how your body reacts to stress and improve your stress resilience. We can improve your ability to bounce back so that you can handle challenges in a new found, healthy way.

Tuesday, April 4, 2017

Let Food Be Thy Medicine and Medicine Be Thy Food

By Lori Knutson, RN, BSN, HNB-BC
Administrative Director
Meridian Integrative Health & Medicine

“Let food be thy medicine and medicine be thy food.” - Hippocrates

Food is the body’s information. You could think of it this way, if your car is fueled by unleaded gas, you would not dream of putting leaded gas in the tank and expect your car to run. Well, that’s essentially true of how food sustains our body and mind. Food provides the chemical basis, the fuel, for our physical body to run properly. Hippocrates, the father of modern medicine, said, “Let food be thy medicine and medicine be thy food.” Could you imagine your physician giving you a prescription to be filled at the ‘FARMacy’ where you would be given the required fresh vegetables and fruits to address your current health situation?

Physicians, unfortunately, receive little to no education and training in food science and its relationship to health, illness, and disease. But that is beginning to change. Harvard’s T.S. Chan School of Public Health and The Culinary Institute of America have partnered to create a program for healthcare professionals with an emphasis on training physicians. This program is titled Healthy Kitchens, Healthy Lives.

Recently, Hackensack Meridian Integrative Health & Medicine, through the generosity of the Women’s Heart Fund, sponsored 12 healthcare professional to attend the Healthy Kitchens, Healthy Lives training at The Culinary Institute of America in Napa Valley, California. Included were eight physicians representing cardiology, oncology, surgery, primary care, psychiatry, physical medicine & rehabilitation, internal medicine, and integrative medicine. The training provided lectures on the science of food by some of the leading scientists in the field such as Walter C. Willett, M.D., Dr. P.H., Professor of Epidemiology and Nutrition at Harvard T.H. Chan School of Public Health and Professor of Medicine at Harvard Medical School. Attendees also participated in hands-on cooking skills with The Culinary Institute of America’s award winning chefs. 

As one of the physician attendee’s exclaimed, “This changes everything about my practice!” Maybe we will see a new specialty sprout, Culinary Medicine! Bon App├ętit!

The Hackensack Meridian Integrative Health & Medicine team and several Hackensack Meridian Health physicians had a great time at the Healthy Kitchens, Healthy Lives Conference in Napa Valley last month.
Pictured here: David Eisenberg, M.D., Director of Culinary Nutrition and Adjunct Associate Professor, Department of Nutrition, Harvard T.H. Chan School of Public Health; Lori Knutson, RN, BSN, HNB-BC, Administrative Director; Aviad Haramati, Ph.D., Professor in the Department of Physiology and Biophysics at Georgetown University, who spoke about #mindfulness and #mindful #nutrition at the conference; Jennifer DiNapoli; Nicole Cerillo, RD, LDN; David Leopold, M.D.; Vivian Kominos, M.D.; Elizabeth Maiorana; Ronald Matteotti, M.D.; Sylvia Takvorian, M.D. and Jorge Corzo, M.D. (Not pictured - Mark Krasna, M.D. and Nina Regevick, M.D.)

Tuesday, March 28, 2017


By Lisa Sussman, Psy.D.
Health Psychologist

"Yesterday is history. Tomorrow is a mystery, but today is a gift. That’s why it’s called the 'present.'" This quote about being in the present moment is from Kung Fu Panda, one of my favorite family movies. 

The ability to choose and control our focus of attention is something worth cultivating. Mindfulness is being fully present in our moment-to-moment experiences without being judgmental of the thoughts, sensations, or feelings we are experiencing. Often, our mind chatter, worries about what is going to happen in the future, thoughts about what we should have or could have done in the past, and judgments about ourselves and others, interfere with our ability to be in the here and now. We get stuck and then miss out on present opportunities. Benefits of mindfulness include increased acceptance, gratitude, and life satisfaction. Mindfulness also allows for increased options and choice in any given situation. When we can step back, observe, and accept our emotions, thoughts and sensations for what they are (just emotions, thoughts and sensations), we free ourselves, allowing for less reactivity and more choices/increased flexibility. Just because we have a thought (and researchers state we have between 50,000-70,000 thoughts per day), it doesn’t mean that thought is true, or that we have to attend to it. In other words, when we are mindful, we are less caught up in the past or worried about our future, and we feel more grounded and able to deal with our stressors. Other health benefits of mindfulness include a decrease in stress, anxiety, depression, blood pressure, chronic pain, and insomnia, as well as an improvement in relationships. 

Mindfulness doesn’t come easy. However, it is a skill that can improve with increased awareness and practice. One way to improve your mindfulness skills is to fully attend to a routine task. Take folding the laundry as an example. Tune into how each article of clothing feels as you fold it. See the shapes and colors. Smell the fabric. Feel the weight of the fabric. If your mind starts to wander, just notice that and bring your attention back to the sensations of folding laundry. Do not judge yourself for "getting off track." Re-attending is part of the process and can happen many times in a single mindfulness practice. You can try this with other routine “automatic pilot” tasks such as washing dishes, showering, eating, and driving. You can even exercise in a mindful way, focusing on an aspect of your workout such as how your muscles feel, your breath, the music, or the scenery. Using all of your senses will help you in your practice.

Another mindfulness exercise I like and want to introduce is called the "5-5-5." When you find yourself feeling overwhelmed emotionally or your mind is racing, first make an observation that this is happening. Then, gently allow yourself to notice and focus on 5 things you can feel/touch, 5 things you can hear, and 5 things you can see. This simple grounding exercise will help you and become less reactive and more open and creative. 

Have fun experimenting with mindfulness. J 

Register for our upcoming mindfulness classes by calling 1-800-DOCTORS. Fee: $30 per class
April 6, 2017 4:00 p.m. to 5:30 p.m. Meridian Health Village at Jackson
May 4, 2017 6:00 p.m. to 7:30 p.m. Riverview Medical Center, Red Bank
June 15, 2017 10:00 a.m. to 11:30 a.m. Meridian Health Village at Jackson

For more information, visit www.MeridianIntegrativeMedicine.com

Tuesday, March 21, 2017

Do You Know Your Own Strength?

By Suzannah Sabin, RN, BSN, NC-BC
Integrative Health Coach

If you are like most people who come to a health coach, your primary thought is on what you would like to change about your health. Naturally, this is most often the case, because the role of the health coach is to facilitate and partner with you to create positive change.

But it is important to take some time to uncover the strengths that you already possess, and find out how to apply them to the achievement of your health goal. 

I have found over and over, that many people don’t know their own strengths. When asked, many clients have a difficult time identifying their innate strengths, capacities and positive qualities. Finding these is important because these developed traits can be an important key to creating change.

Being in touch with what we do well underpins the readiness to change,” says David Cooperrider, the co-founder of Appreciative Inquiry. This means that focusing on our already developed character strengths can be empowering and transformative. We can learn to apply the strengths that have served us well, to the new area to be developed.

Here are some ways to begin to identify your strengths:

1. Take stock of your past successes and make a list of your personal attributes that contributed to the success. Some examples may be: Persistence, Courage, Detail-oriented.

2. Ask friends or family members to share the ‘stand-out’ traits that they see in you.

3. Explore the VIA Institute: www.viacharacter.org, an organization dedicated to helping you find your character strengths.

When we proceed from what we already have, our specific strengths, and align our actions with the deliberate changes we want to make, the results are sure to follow!