Archive for March 12th, 2009


Thursday, March 12th, 2009

As you grow older, you probably will begin to “look forward” to your later years so that you can enjoy the activities that you never had time for before. Then, suddenly you find yourself retired, and time begins to weigh heavily on your hands. If you are a homemaker, you may now find that the presence of your husband for many hours a day is difficult to tolerate. He, on the other hand, may find that less time is actually necessary to do the things he always wanted to do, and much of the day seems empty and purposeless. You should reach an agreement with your spouse and children as to how much time each of you can spend with the other comfortably.

Many programs and books are available to help you find an appropriate hobby or activity in which you can use your skills. Volunteer or other work can often be combined with hobbies, such as teaching others how to care for plants in a greenhouse club or to repair small appliances. You might renew your interest in reading and music, and many clubs in libraries, schools, and senior-citizen centers promote such involvement. Many universities and colleges welcome senior students, and teachers are invariably impressed with the dedication and capabilities of the older student. Going back to school in your later years can be an exciting experience. Your years of practical wisdom become an important asset to your new academic interests.

The retirement years are also a good time to get involved in collecting. Stamps, coins, magazines, antiques, old books, and innumerable other items can be collected. You will have time to search out interesting items, read about them, and learn their history and meaning. The items do not have to be valuable or even expensive. It is more important that you find something that maintains your interest. One retiree who had collected stamps for many years decided to focus on one era and country in his stamp collecting. He developed such a complete collection that a local museum asked to borrow it for a special exhibition.

Some older people decide to raise pets. There may now be time to breed them and even teach other people the skill, or to start a small business. Animals are a source of satisfaction and companionship. Many books are written on the subject, and you may be able to get some hints from local pet shops, veterinarians, and even the local zoological society or university.

Gardening is popular with many older people. Depending on where you live, it may be possible to raise plants outdoors, or you may have to develop a small greenhouse or restrict your skills to plants that can be grown indoors. Plants and flowers can give joy and satisfaction, especially if for some reason you must stay at home. You can learn how to grow them for your own pleasure, but you will probably find that many of your neighbors and friends will want to share in your expertise.

The older person who has recreational outlets is usually more productive and satisfied than one who just “sits out” the later years. Many community and senior-citizen centers have excellent programs, and they can be used effectively and positively not only for recreation but also for social activity and friendship. Visit them and give them a try. No doubt you will find fulfillment and satisfaction in whatever hobby or activity you choose.



Thursday, March 12th, 2009

One reason that people sometimes become physically and emotionally dependent in their later years is because they have left the work force after a long career. Self-esteem and independence are difficult to maintain when you no longer feel that you are making a contribution to society. In addition, families often become fragmented and are geographically separated. This means that you cannot even count on your role as a respected elder, which used to be the case when families remained together. Some professionals can pursue their vocations into their later years, and this allows them to continue being productive and dynamic. However, many people do not have the opportunity to continue working after age 65 or 70, although this is changing with the disappearance of age-based mandatory retirement. Even with the change in the law people will have to retire at some time, although the age may be higher for many individuals.

Some older people fare very well after they retire; many, however, find that time becomes their enemy. The inactivity that frequently follows retirement often leads to excessive preoccupation with the body and concerns about health. Those who find productive and creative outlets for their retirement years seem to have the best chance of maintaining their health and vigor.

Ideally, preparation for this stage of your life should be done long before your actual retirement. But if you have not prepared, new skills and interests can still be developed after you stop working. Hobbies can satisfactorily fill a good deal of your newfound time. In order to promote your continued involvement with other working and productive people, you can can even embark on a new career. Many businesses and stores might welcome your assistance in various tasks. The amount of money that you earn should not be a major consideration. It may even be possible for you to return to your previous place of work with an agreement that you earn a limited income for a limited amount of work. Many employers might welcome the experience and expertise that you can contribute to younger workers. A recent Time magazine article on aging in America describes a large insurance company that hires back retired workers instead of paying fees to temporary employment agencies. The director was quoted as saying, “We get better, more competent, dedicated and highly motivated people.”

Look into schools and recreational facilities. For example, you could teach children carpentry, cooking, sewing, bookkeeping, or other useful skills. Hospitals and nursing homes might welcome you as a volunteer to help patients and residents. Remuneration for these activities is less important than the satisfaction that is achieved from productive work and being in touch with others.

I know a woman who is almost 85 years old and who works every day as a volunteer in a home for the aged. She proudly shows off a pin that she was awarded after she had finished more than 10,000 hours of volunteer work. During the preceding ten years she worked as an assistant to nurses in helping disabled residents in the home with their meals. Whenever she sees me, she mentions how much she loves helping the “old folks.” Her strength and positive outlook have been reinforced by the knowledge that the residents rely on her for their welfare.

Professional people and executives can often find outlets for their skills and training more easily. Many volunteer programs allow skilled older people to act as advisers and instructors. Occasionally, this may require travel, but often positions can be found locally. Even a few days a week or a few hours a day provide incentive and satisfaction.

Some schools and other institutions use the expertise of retired professionals and crafts people to teach courses. One man I met, who was retiring from his position as a senior baker for a large baking firm, volunteered a few hours a week to teach skills to students of baking and nutrition. I le looked forward to his new role in life with great enthusiasm.



Thursday, March 12th, 2009

One widely accepted definition of health is that it is the absence of disease. Illness sometimes affects people for no apparent reason, but the more positive your view of life, the less likely you are to succumb to many of the problems that afflict the elderly. A combination of good health habits, sensible nutritional practices, and outlets for physical and emotional energies will go a long way in helping you enjoy healthy and satisfying senior years. And many older individuals seem to maintain the vigor and spirit to help overcome any physical disabilities. Although physicians may be able to guide you about many aspects of your health care, the principles of living the good life must be not only understood but also adopted.

To remain in the best possible state of health, you must be emotionally satisfied and socially secure. There are important interactions among your physical, psychological, and social well-being. Before examining the medical aspects of good health, I will discuss other factors that influence how successful your senior years will be.



Thursday, March 12th, 2009

Frequently you will hear the question, “What do you expect at your age?” But, in fact, aging is not a disease. There are, of course, many illnesses that are more common in older people, but whatever illness might affect you, there are many ways to deal with it. I will try to take some of the mystery out of medicine and suggest how you can help your physician take care of you. It is less frightening and more reassuring if you know what is going on, rather than being bewildered by symptoms that are frequently puzzling and treatments that are often confusing and alarming.

Just as changes occur in childhood and adolescence, the passage from middle age to your mature years is also associated with certain changes. But these should not be thought of as illness or disease. You can continue to function very well despite these natural alterations. Many organs of the body decrease their ability to carry out functions as efficiently as you age. This gradual process begins during the early adult years and continues throughout life. Although the capacity for the body to function may lessen with age, there is ample reserve for life to continue actively and productively for many years.

As more research is done on the process of aging, it is becoming clear that some of the decline is as much a consequence of poor body maintenance as of the aging process itself. A Rolls Royce will deteriorate if not properly serviced, and a Model T Ford can be kept running beautifully and efficiently if maintained with care. Although illness occurs at all ages, often without apparent reason, many of the diseases affecting older people are at least partially if not completely the result of poor health habits throughout a lifetime. Some of these processes can be halted or modified, if not reversed. It is in your power to make the best out of what you have. It is never too late to change, and a conversion to a more positive, active role in your own care can lead not only to better health but also to discovering more enjoyment and satisfaction in life.

There are two sides to every medical interaction: the giver and the receiver. After you have learned more about your body and the changes or illnesses that can occur, you should be able to approach your physician intelligently and assertively. You will learn that you should receive an explanation about your medical condition. And you will find out that, whatever the illness, the possibilities of diagnosis and treatment should not be automatically denied because of your years.

It is important for you to feel comfortable with your physician. The best relationships are those that have been built up over many years. However, this is not always possible, and, unfortunately, many older people are intimidated by physicians. If you are not happy with the way your physician relates to you, do not be afraid to tell him. Some people go from one physician to another because they are afraid to tell each one that they are unhappy with their health care. This practice often leads to the absolutely worst medical care, because it takes mutual trust between physician and patient for the health care process to succeed.

Your physician should respond to your knowledge and interest positively. You should tell him that you would like to play an active role in your own health care. You can assist by confirming your confidence in his abilities. At the same time, you must express your desire to be treated honestly and openly. If you can reach this agreement with your physician, you are already well on the road to receiving good medical care.



Thursday, March 12th, 2009

How many times have you been asked, “How old are you?” Perhaps it would make more sense to ask, “How old do you feel?” It is common to place everyone over the age of 60 or 65 in that community called “senior citizens.” But why was the age of 60 or 65 chosen so arbitrarily as the age for retirement? Perhaps the initial intentions behind the decision to remove older people from active participation in the work force were good ones. Unfortunately, in many cases retirement is emotionally and physically disastrous.

Older people are capable of contributing to the community, so each one of us is affected very deeply by society’s edict that we remain idle and, hence, useless.

As more and more people live into their seventies and eighties and nineties with good health, sharp minds, and productive capacities, society will perhaps eventually recognize the talents of the elderly. Andres Segovia at the age of 88 and Vladimir Horowitz at the age of 80 were still enthralling musical audiences. The great British philosopher Bertrand Russell was mentally active and productive until his death at the age of 98. Comedian George Burns fills movie theaters at the age of 93. Charles de Gaulle and Golda Meir were politically active and respected until their deaths. At the age of 88, the loss of Marshal Tito of Yugoslavia had international repercussions. And nobody would have thought of retiring Albert Einstein at the age of 65, which would have been eleven years before his death. Ronald Reagan managed the U.S. presidency at age 77. Like these famous people, there are hundreds of thousands of elderly people who are productive and active in their own ways, and, indeed, who very much want to remain so. In fact, the prospect of twenty or thirty years of inactivity may not be as conducive to good health as some of us would like to think.

The Western world has become progressively more youth oriented. With the introduction of a mandatory retirement age and the attitudes fostered by consumerism, the older person has been placed in a nonessential role in society. The abolition of age-based mandatory retirement in the 1980s in the United States may have a beneficial impact on the future of many older Americans and how they are viewed by the rest of society.

The nuclear family has disintegrated, and many younger people have little experience or contact with their older parents or grandparents. If one has not related to an older individual on a personal and intimate basis, it is easy to consider all older people as uninteresting and nonproductive. Many members of the medical and nursing profession who have their major interaction with older people in hospitals, institutions, and clinics naturally associate aging with illness.

The relative slowing down that often accompanies aging is frustrating to many younger people. It interferes with the pressure “to get things done.” You have only to watch people waiting in line at a bank or a ticket office when an older person is trying to carry out a transaction. The slower pace often exasperates the clerk and the younger customers waiting their turn. Have you ever noticed the impatience of many bus drivers when senior citizens get on or off a bus at a pace that is too slow for the pressure of schedules? Traffic lights give little time for older people to cross a street safely. Experiences like this can make it difficult for the older person to feel wanted and needed by the community, and it is not surprising that, once removed from an active role in the world of commerce and work, you are expected to grow old gracefully, deteriorate physically and mentally, and then pass away quietly.

It may be difficult for older people to change the attitudes of society but the change in retirement legislation indicates that changes can occur which will allow seniors to continue to be active regardless of age. With determination and knowledge, you can let those responsible for your health care know that you no longer accept aging as a sufficient explanation for your medical complaints. By being an informed and enlightened consumer of health care, you can direct the medical profession to respond to your needs.

The first step is to rid yourself of some of the myths about the process of aging. If you believe the myths yourself, you will find it difficult to convince your physicians and other health personnel to discard them. I will try to give you the information that will allow you to be a well-informed recipient of health care, because a good part of the responsibility must be yours. The great tendency for older people to assign responsibility for their health to their physicians puts seniors in a passive role about something that is crucial for positive and productive later years. After you learn to assume the responsibility for your own health and learn to see your physician as an adviser and consultant, you will no doubt benefit both mentally and physically.

Most people assume that the inevitable process of growing old is naturally linked to illness, and this is an assumption that is shared by many members of the medical profession and other health care professionals. It is presumed that as the body gets older, it begins to fall apart and become plagued by illness. But there is no specific age at which health deteriorates or illness occurs. To have reached your senior years, you may have survived many illnesses, or if you were extremely fortunate, perhaps you have never been ill.

That you are still here is a reflection of your strength. Your age is far less important than your ability and desire to participate in life.



Thursday, March 12th, 2009

Andy Warhol once said that his favorite meal was a peanut butter sandwich eaten while standing over the sink. Well, we’ve all done it, we’ve all gobbled up a lot of high-fat, high-sugar foods while standing there. (It’s almost as if we think it won’t count if we eat it fast enough!) Don’t fool yourself. The more relaxed you are, the more slowly you’ll eat, the more you’ll enjoy your food, the better your digestive system will perform, and most likely, the more nutritious your meal will be. In addition, I suspect that eating slowly will give the Chitosan in your stomach a better opportunity to attract the fat and carry it away.

Eat a variety of foods—Boredom is one of the primary reasons that many people abandon an eating program. They get tired of eating the same old things over and over again. Consequently, they switch to something else—which is usually a combination of pizza, doughnuts, and maybe a couple of beers! (I remember one diet that consisted of bacon, eggs, and grapefruit 3 times a day for as long as you could stand it. People did lose weight on this diet, probably because they just didn’t want to eat very much after the first few days. But, of course, they soon started eating something else and regained the lost weight in no time.) So, experiment: Try new dishes, new foods, new combinations. The more interesting you make your food, the more likely you are to feel satisfied by it and not switch to something that isn’t good for you. (Yes, it’s okay to splurge occasionally, but when you do, enjoy it—try not to waste your splurge on leftovers because you got bored with your main meal.)



Thursday, March 12th, 2009

This popular high-protein diet swept the country many years ago. Authored by Herman Tarnower, M.D., it was featured in the New York Times, Family Circle, and many other newspapers and magazines. The Scarsdale Diet encourages you to eat lots of meat and claims that you can lose up to a pound a day. The foods that may be eaten every day are carefully controlled, but portion sizes are pretty much up to the dieter. They are only warned that they should not eat so much that their stomachs become uncomfortably overloaded. I don’t believe that this will work with people who tend to overeat as a rule. Simply telling them not to stuff themselves until they can’t eat anymore is not exactly the cornerstone of a healthful, lifelong eating regimen. It might work for people who are already used to moderate portions, but many obese people are accustomed to eating quite a bit.

And not only are the parameters weak and poorly defined, the Scarsdale Diet is potentially dangerous. Like the Atkins Diet and many others, it works on the principle of inducing an

unnatural state—ketosis—into the body. Even Dr. Tarnower, who devised the diet, warns you not to stay on it for more than 2 weeks at a time because of the dangers of ketosis, which can include lethargy, weakness, coma, and even death. Dieters who follow this program may also become deficient in vitamin A, vitamin D, and calcium, while simultaneously overdosing on protein. We’ve been taught to believe that protein is good, and the more we eat the better. But the truth is that excess protein can lead to an increased risk of osteoporosis and kidney stones, while the high fat associated with high protein increases the risk of cardiovascular disease.



Thursday, March 12th, 2009

A phenomenally popular diet that swept the nation in the 1970s, the Atkins Diet is still being used today. That’s a shame, for in my opinion it is nutritionally unsound and potentially dangerous. Atkins claims that most overweight people suffer from metabolic imbalances cause by a carbohydrate intolerance. His solution is to eliminate carbohydrates altogether during the diet, then keep them cut way down permanently. Promising that you will not be hungry, Atkins encourages you to cut back on carbohydrates, not calories. You can eat to your heart’s content, he asserts, because when you eliminate carbohydrates from the diet, your desire for food is diminished.

Atkins and others who promote high-protein diets are simply trotting out an old idea devised by a Victorian-era doctor. According to the high-protein proponents, the high protein/low carbohydrate diet is supposed to force the body to rid itself of stored fats faster than usual. What really happens is that the poorly metabolized fatty acids (called ketones) that result from this diet cause you to urinate greater amounts of body water, along with magnesium, potassium, and other important minerals. It may seem like you’re losing weight, but that weight is quickly replaced when you take a drink. It’s all smoke and mirrors—you think you’re losing a lot of weight but you’re really not. And meanwhile, all those ketones in your bloodstream can harm your health.

Another dangerous aspect of the high-protein diets is bone loss (osteoporosis). Thinning of the bones, commonly caused by loss of calcium, is a common problem for seniors, especially

elderly women. Thinned bones are more likely to fracture under pressure. Even a very slight touch is all it takes to crack the bones of some osteoporosis victims. High-protein diets cause us to lose dangerously high amounts of calcium in the urine. Not only that, but the excess sulfur and nitrogen from the proteins can literally leach calcium right out of bones.

The diet promises that you can eat luxuriously—heavy cream, butter, mayonnaise, cheeses, meats, fish, fowl. A small amount of these foods can add flavor to the diet, as well as certain nutrients, but to base a diet on these high-protein, high-fat foods is folly. Even Dr. Atkins admits that his program is unbalanced. This diet revolution is, in the author’s own words, “deliberately unbalanced … to counteract the metabolic imbalances that cause people to get fat in the first place.” He’s right about the first part, the diet is unbalanced and filled with potentially dangerous amounts of fat. Eliminating carbohydrates from the diet and replacing them with protein and fat can only encourage heart disease, cancer, and a host of other ailments. As for the second part about metabolic imbalances causing obesity, well, relatively few of us are overweight because of metabolic imbalances. I tell my patients to read the Atkins and other high-protein diet books, if they want, then do the exact opposite. The best approach is to eat plenty of complex carbohydrates (found especially in fresh vegetables and whole grains) and reduce your fat intake by sensible eating coupled with Chitosan. That’s the basis for healthy weight loss and healthy living.



Thursday, March 12th, 2009

Our lives have become super fast paced in recent years. We often don’t have time to sit down as a family to a leisurely dinner. That’s a sad fact of modern life, and some of us may be suffering both physically and psychologically because of it. Of course, others may enjoy the challenge of the fast pace—but even so, they probably aren’t helping their physical well-being. For one thing, we all tend to eat more junk when we’re forced to grab something quickly. Still, it is possible to eat well, even when you are eating on the run:

♦ No matter how rushed you are, when it’s time to eat a meal, always try to stop what you’re

doing, even for a moment, to sit down and focus on what you’re eating. It really doesn’t take

that long to eat a meal, especially if you’re by yourself. You really can afford to take the time.

You owe it to yourself to take that time because if you let eating become just one more of the

10 things you’re doing at once, you’ll end up eating more and feeling less satisfied. So don’t

talk on the phone, drive, do paperwork, read, or stand in front of the refrigerator while eating.

Sit down and make every meal an occasion, even if for only 10 minutes.

In this respect, Chitosan can help because you have to think about it before you eat. How

much fat does the meal you are about to eat contain, and therefore how much Chitosan should

you be taking in advance of it? The very fact of such a decision will help remove the meal

from merely one of your many concurrent activities and make it slightly special.

♦ Brown-bag it as much as possible. Fresh fruit, raw vegetables, nonfat yogurt, whole wheat

bread, and nonfat cottage cheese are all easy to take along. They are also packed with

nutrients. When you’ve got these good foods handy, you won’t be forced to grab whatever is

available. Since you should already be making your Chitosan bag into a habit, the extra effort

of completing the meal may be something you can live with.

♦ If you do have to buy something to eat on the fly, consider dropping by the grocery store to

pick up fresh produce or other nutritious food. Convenience stores also have fruit, juice,

cutup vegetables, bagels (but don’t add globs of cream cheese.,), dairy products, and other

things that can keep you on the plan. Moreover, since nearly all such foods are now labeled

with their fat content, you will know precisely what amount of fat your Chitosan has to deal

with. Many fast-food restaurants have heart-healthy choices like grilled chicken sandwiches

or baked potatoes, plain or with low-fat toppings.



Thursday, March 12th, 2009

If the sort of exercise you are planning to do involves truly vigorous bursts of energy, you should spend 5-10 minutes warming up your muscles. The best warm-up exercises are gently aerobic: jumping jacks, jogging in place, bicycling, or anything else that gets your blood moving. Start slowly, easing your body into high gear. Just as you wouldn’t start a cold car, slam it into gear, and then roar down the street at 60 miles per hour, you don’t want to leap right into your exercise routine.

Also, as part of your warm-up, you should do some stretching exercises. Again, start gradually and work your way up to a full stretch.

To achieve maximum effectiveness (especially if you are seeking to become competitively fit) your total exercise session should last at least 30 minutes for maximum fat-burning and cardiovascular-strengthening effects. Obviously, if you are in training for a particular sport, you may need much more time than this. No one can compete in a marathon by training for only half an hour a day! But athletic training is not the subject of this book; I am talking merely about weight loss and healthy living. For that, you do need to exercise. As I have emphasized before, all increases in your exercise program are helpful if you are also eating a little less and taking Chitosan. However, for optimum fat burning, your exercise sessions should last for at least half an hour. Some patients ask me why 30 minutes is the magic number for burning fat. Why not 3 separate 10 minute

During times of intensive exercise involving a short burst of intense energy (for example, while dashing 100 yards or lifting a heavy weight), the muscles primarily use glucose for fuel. But if the exercise continues at a lower intensity for some time (as it does in swimming, walking, or jogging) the body eventually switches to fat as its primary fuel. Aerobic exercise encourages the switch because it provides the muscles with oxygen, which is essential in the fat-burning process. However, before the switch occurs there is a time gap while your body decides whether the exercise counts as a short burst or as an extended, fat-burning effort. Most experts today feel that this gap may be anywhere from 5 to 15 minutes. Thereafter, the body burns fat. I believe that 30 minutes is a reasonable minimum time for exercise to continue and for a meaningful amount of fat to be used up—although 45 minutes or even longer is better, provided you enjoy it enough to be able to work out that consistently.

However gradually you start increasing your exercise, your efforts will almost certainly gain momentum. As time passes and you decrease your food intake—partly by cutting down and partly by taking Chitosan—your energy level naturally rises and you become more active. And that makes longer and more vigorous aerobic effort both easier and more enjoyable. You slowly get hooked on one of the few addictions that is good for you.

But there is more good news to come. It is that once aerobic exercise has become a regular part of your life, its benefits just seem to snowball. The more aerobic exercise you do, the more efficiently your body will burn fat. (That’s because it becomes better at delivering oxygen to the muscles. The presence of oxygen makes it possible to use fat as a fuel source.) So, in effect, you can turn your body into a fat-burning machine just by exercising aerobically 3-4 times a week. And soon you won’t just be burning fat only during exercise sessions—you’ll be burning some fat all the time.

When you’ve completed your aerobic exercising, it’s important that you always do a short cool-down. You don’t want to get your heart going at its peak rate, then suddenly stop dead and go sit down. Instead, you should gradually bring your heart rate back down to its resting level. You can do a cool-down by performing a scaled-down version of your main exercise. (For example, if you’ve been jogging, jog very slowly in place.) Walking at a moderate pace is a good cool-down exercise. You’ll also find that the cool-down is an excellent time to stretch more

vigorously to help you stay limber all day (which, in turn, will make
you more likely to move around more—and so burn off more calories). Your muscles, now warm, will be much less likely to strain or tear.