self defense manual

1

2014, David Schwartzman, MD 412-647-9145

[email protected]

Self-Defense A Manual for Personal Wellness

2


[email protected]

DISCLAIMER The information provided in this document comes from me alone. These are my personal beliefs (and practices), and are based upon experience and my own interpretation of the relevant science as it exists today. The opinions of any one person should never be taken as gospel - please approach this document keeping that in mind. INTRODUCTION If you are reading this, it is likely that you or someone you know has been diagnosed with a disease of the heart or blood vessels. Examples of such diseases include high blood pressure, atrial fibrillation, coronary artery disease, heart attack, stroke, dementia, diabetes, sleep apnea, gout, kidney insufficiency, and erectile dysfunction. Such diseases are important to know about and require treatment. It is equally, if not more, important to recognize that these diseases have likely occurred in part due to problems with one or more lifestyle elements. These elements should be looked upon as the foundation for your health, on which management of any disease should be based. Just as a house built on a poor foundation is destined to collapse, so too your health if you do not address these elements. This is why the development of one disease often predicts that more diseases are coming. More importantly, you must understand that life quality erodes even in the absence of known disease. This can be difficult to define, even personally, in part because it can be gradual. I like to think of it as a shrinking of the canvas upon which your life is painted. Typical examples include declining desire to explore new things, to interact with friends and family, and diminishing joy or contentment with day to day living. The erosion process, which I call progression of frailty, is built into our genes to take place as we age, for reasons which are not well understood and which current medical science is unable to prevent. It is true that your genes do, to a certain degree, dictate the pace of your progression of frailty so feel free to (continue to) blame mom and dad. However, for most of us, the impact of genes is small compared to the impact of foundation: in any individual, the progression of frailty will be accelerated by a weak foundation. The good news is that you are empowered to dictate the quality of your own foundation in effect, to defend yourself. This manual has been created to make you aware of the individual foundational elements, and to provide a primer on each. I have provided additional information and references where relevant. I am also available to discuss any of these items my contact information is provided at the bottom of each page. FOUNDATIONAL ELEMENTS

1. Vaccinations These are a gift from heaven, and youll be placing yourself at unnecessary risk if you miss them without a good reason. These include flu, tetanus/diphtheria/pertussis, varicella,

3


[email protected]

zoster, measles/mumps/rubella (if born after 1957), pneumococcus, and hepatitis. Please query your primary care physician as to your status. You might also find the following web link useful: http://www.cdc.gov/vaccines/schedules/hcp/adult.html.

2. Regular use of seatbelts A no-brainer, but important to include on the self-defense list. Motor vehicle accidents kill or maim a large number of people each year, and seat belts have been shown to protect. You might find the following web link interesting: http://www.nsc.org/safety_road/DriverSafety/Pages/SeatBelts.aspx.

3. Use of a cell phone while driving We are all aware of the perils of texting or emailing while driving, but it is clear that any use of a mobile phone while operating a vehicle places you at risk for accident due to the limited ability of your brain to multitask. Multitasking of this sort also places considerable stress on your heart and blood vessels. You might find the following web link interesting: http://www.textinganddrivingsafety.com/texting-and-driving-stats/.

4. Tobacco and nicotine These kill or maim, plain and simple. This is true whether you encounter them first or second hand. You must avoid them completely. There are many ways to achieve this. Among others, UPMC maintains an effective quit smoking program which balances education with techniques and technologies to help you. Please let me know if you would like more information.

5. Cancer screening There are several types of cancer which, depending on your age, gender and family history, may be worth detecting early. These include colon, breast, cervix, and prostate. It is important that you discuss the pros and cons of any screening test with your primary care physician. You might also find the following web link helpful: http://www.cancer.gov/cancertopics/screening.

6. Exercise I believe that regular exercise is a crucial element of self-defense. Ill define exercise as any activity during which you are moving constantly. Examples include walking, treadmill, elliptical machine, bicycle, swimming, and rowing. I want you to shoot for a daily regimen (does not need to be the same thing each day), in which the activity lasts for 30 minutes or longer. Intensity matters less than duration. There should be no pain, you should not exercise in

4


[email protected]

environments at temperature extremes, and you should not expose yourself to unnecessary injury (for example, slipping on icy or wet pavement). Although exercise is a key, do not depend on it alone to lose weight or trim your waistline. I frequently meet with frustrated patients who have markedly increased their exercise habit, only to see little effect on weight and waistline. This is because the body will make adjustments as to maintain the status quo, unless you convince it otherwise. That is no small thing, as our bodies have evolved to be expert in keeping things stable. It is going to require a focus on the food, the subject of the next section.

7. Food Tell me what you eat, and I will tell you what you are Anthelme Brillat-Savarin The Physiology of Taste (1825) Food is undoubtedly the most important of all the foundational elements, because the quality of your food determines in no small part the quality of the tissues comprising your body. To emphasize this, I have included a number of appendices which you may find helpful in relation to food and eating. In Appendix 1, I provide a primer on nutrition, which will help you to speak the language as you learn more (I hope) about food and nutrition. In Appendix 2, I have created a list which separates food into those you should and those you should not eat. You may find it helpful to take this to the grocery store with you. In Appendix 3, I provide a primer on how to read a food label. You would do well to become familiar with this, so as to become an educated eater. In Appendix 4, I include a list of terms meaning sugar which you may see on a food label. I want you to avoid all foods to which sugar is added by the manufacturer (unless the manufacturer is god). In Appendix 5, I provide a primer on a whole food, plant-based (WFPB) way of eating, which uses only some of the foods from the list in Appendix 1. Many of my patients ask about my personal way of eating. It is WFPB, because I believe that it is the best way for me to delay my own aging process and minimize the likelihood that I will develop any given disease (including cancer, heart attack, stroke, dementia, joint replacement, kidney failure, and erectile dysfunction) along the way. Finally, in Appendix 6, I include some thoughts on eating outside of your home.

8. Sleep It might surprise you to learn that, as best we can tell, all animals sleep. This truth is indicative of the importance of the activity. During sleep, your body conducts processes which

5


[email protected]

can be thought of as repair and maintenance. When sleep is disordered, these processes are incomplete, and this can have a damaging effect. The damage tends to be cumulative. People vary in regard to how much sleep they need on a daily basis on average 7 to 8 hours. Some tips to promote healthy sleep include: A. go to bed approximately the same time every night; B. do not eat for at least 2 hours prior to bedtime; C. exercise every day; D. the sleep space should be cool, dark, and quiet. Some people have disordered sleep which requires professional evaluation and management. A common term used for disorders of this type is apnea. Warning signs of sleep apnea include loud snoring, daytime fatigue or sleepiness, and a partner who tells you that you stop breathing for periods of time while you are sleeping. Apnea is more common among people who are obese (see http://www.cdc.gov/obesity/adult/defining.html), have abnormally high waist circumference (more than 35 inches in women or 40 inches in men), or have abnormally high neck circumference (more than 14 inches in women and 18 inches in men).

9. Seek contentment, happiness, pleasure This might seem obvious, but in our crazy world they are commonly swept under the rug. What we have become aware of is the detrimental effect that your brain can have on your body if these things are forsaken. Elements here are highly personal, and include family, friends, intimacy, sex, faith, hobbies and work only you can define this. As a general strategy, consider setting aside a period of time each day to pursue this, as well as doing what you can to move your life in an overall positive direction. Some people may also find benefit from professional counseling.

ON SELF-MONITORING It is very important to monitor yourself over your lifetime, as nobody can do a better job. There are four things I would recommend: 1. Weight: weigh yourself on your home scale, stark naked. Do this weekly, and keep a record of the date and the weight. If this measurement is going up over time, this is almost always a bad thing. Bring this record with you to your doctor visits. 2. Waist circumference: to measure your waist circumference, use a tape measure. Start the top of your hip bone, then bring the tape measure all the way around, level with your belly button. Make sure the tape measure is straight and not tight. Do not hold your breath while doing this. Do this monthly, and keep a record of the weight and circumference. If this measurement is going up over time, this is almost always a bad thing. Bring this record with you to your doctor visits. 3. Blood pressure: you may do this with a system which you can purchase for the home, or at a department store or pharmacy. Measure only when you are at rest. Less important than any

6


[email protected]

one measurement is the pattern of measurements over time. As a generality, less than 135 on the high number (systolic pressure) and less than 85 on the low number (diastolic pressure) should be the goal. However, due to personal variations, age, gender, and medical conditions, certain people will be better served by different goals. It is important to discuss your goal with your physician. Measure your blood pressure weekly, and keep a record of both pressures alongside the date. Bring this record with you to your doctor visits. 4. Exercise: keep a record of the duration of exercise and the date. You do not need to make any measurements of intensity, such as heart rate (or calories burned if you have an exercise machine which provides such information). Simply put down the number of minutes in any given session in which you were moving constantly. ON PRESCRIPTION MEDICINES It is crucial that you understand each and every one of your prescription medicines. Among the questions you should be able to answer (and be comfortable with that answer) are:

1. What does this medicine do? 2. Is it used to protect me in some way, or is it being prescribed solely to make

me feel better? 3. Do I absolutely need to be taking it? Why? 4. Is there a cheaper version of the equivalent or similar medicine available?

You should be aggressive in seeking answers to these questions. In addition to your doctor, you should speak to the pharmacist where you have your prescriptions filled. You may also find http://www.drugs.com to be helpful. FREQUENTLY ASKED QUESTIONS

1. What about caffeine? Caffeine is a drug which we consider a stimulant. It is commonly found in coffee, tea, and soft drinks, but elsewhere as well (check the label). As a generality, it is not considered a danger. You should discuss your situation with your doctor.

2. What about sex? As noted before, sexual activity is an important element of life quality for many people, and if so should be encouraged. If you are exercising regularly, it is rare that sexual activity would be inadvisable. Men or women may experience problems when it comes to sexual activity, including lack of desire, inability to perform, or pain. It is important to recognize that these are not normal, and may be associated with foundational elements, disease processes, or prescription

7


[email protected]

medications. You should not be shy in discussing your situation with your doctor.

3. What about alcohol? As a generality, as little as possible is best. You should stay away from spirits, and not exceed 1-2 glasses of wine or beer per day. Keep in mind that alcoholic beverages contain calories of a type that the body likes to turn into fat. You may find this web site informative: https://www.drinkaware.co.uk.

4. What about dietary supplements? These include vitamins, minerals, herbs, probiotics, oils, powders and other assorted potions, all of which you can buy in stores or over the internet and without a prescription. It is important to understand that these substances are largely unregulated by the government, which give manufacturers broad scope as to what they put in the bottle, can, or bag. For example, recent reports have demonstrated that certain supplements contain things other than those on the label. In addition, the vast majority of supplements have never been tested scientifically as to whether they may do harm or whether they have any benefit. Finally, we are increasingly aware of harmful interactions between prescription medicines and supplements but again, our current awareness is likely only the tip of the iceberg. For these reasons, as a generality I do not recommend supplements. However, you should understand that there are certain circumstances in which a particular supplement will be safe and useful in protecting your health. You should be sure that you bring the containers of any supplements you are taking with you to all of your physician visits, and be prepared to discuss the pros and cons of each. If you are considering a new supplement, discuss this with your physician in advance. You may also find the following web site helpful: http://www.dsld.nlm.nih.gov/dsld/.

5. What about artificial sweeteners? Since I am telling you to eliminate any foods to which sugar is added, this is an important question. These are considered to be substitutes for sugar, and include acesulfame potassium (Sunett, Sweet One), aspartame (Equal, NutraSweet), saccharin (SugarTwin, Sweet N Low, NectaSweet), sucralose (Splenda), stevia extracts (PureVia, Truvia), and tagatose (Naturlose). Their attractiveness is based on the fact that they add few calories, and because they are many times sweeter than sugar, you need only a fraction of the amount to get your sweetness fix. I remain suspicious of these chemicals, for three reasons: A. They are often used in foods which have been processed to taste good, but in addition to the artificial sweeteners contain known to be harmful items (including processed carbohydrates, sugars trans fats, and salt). Thus, as often as not, artificial sweeteners are a marker

8


[email protected]

for foods that youd do well to avoid. B. Although most have been generally recognized as safe by the government, this definition is typically murky and poorly defined, and so buyer beware. C. I am concerned that, despite the lack of calories, these chemicals cause the body (including the brain, which is the central player in how you metabolize foods) to respond in a way similar to as if you had eaten sugar. The science here not clear and so should be considered a work in progress, but my feeling is that when it comes to chemicals (food or otherwise) which are not found in nature (and therefore unfamiliar to our bodies), they are guilty of causing harm until proven innocent.

6. What about salt (sodium)? As a generality, our diets contain more salt (sodium) than is healthy. Sodium is the active ingredient in salt that you need to be concerned about. Most of this comes from processed foods. In addition to avoiding such foods (see appendices), I would recommend that you do not add salt to your food. Instead, try experimenting with flavorful herbs and spices, including garlic/garlic powder, lemon juice, flavored vinegar, salt-free herb blends, cumin, nutmeg, cinnamon, fresh ground pepper, tarragon, and oregano. Salt substitutes should, in general, be avoided. If you are going to use a salt substitute, check with your doctor first. You should become adept at reading food labels (see Appendix 4) to see how much sodium is in the product you are considering. You should assume that any food that is prepared for you contains too much salt, which is one reason to limit your eating out frequency (see Appendix 5).

7. Ive been told that I cannot eat certain foods if I am taking a blood thinner. Is this true? This is simply not true, regardless of the blood thinner. As is detailed above and in the appendices, proper eating is a key to your self-defense strategy. Therefore, any drug, including blood thinners, must take a back seat to the food. However, and in particular if you are making a change in the way you eat, you should discuss this with the physician who is prescribing the blood thinner, so that s/he can anticipate changes in the amount you will need.

9


[email protected]

APPENDIX 1 A Primer on Nutrition

Eating is one of the great joys of life, as it should be. It is also required, as food (under which I will also include drink) can be thought of as fuel or energy which your body requires to function. In addition to energy, food contains compounds or chemicals which the body needs (cannot make them from scratch). Between energy and materials derived from your food, your body does the following:

1. maintains your tissues. 2. regulates body processes, including circulation, consciousness, breathing and digestion. 3. allows your muscles to work. 4. maintains your body temperature.

When food is digested and absorbed from your gut, the materials are made available for the bodys use. Food can be grouped into 6 large classes: 1. water; 2. carbohydrates; 3. fats; 4. proteins; 5. vitamins; 6. minerals. Ill provide a brief description of each: 1. water: except for air, water is the most essential element for life. We can live for weeks without food, but only a few days without water. All of the chemical reactions in the body which use food to create energy and new tissue require water. It is in every cell of your body. About two-thirds of your body weight is water. Your body loses water on a daily basis, to get rid of wastes (urine) and to maintain body temperature (sweat). Water is replaced primarily by food (solid or liquid). Just like you, most foods are mostly water. 2. carbohydrates: these are commonly known as starches or sugars. Also included would be fiber, (also known as roughage) but this is a type of carbohydrate which we are not able to digest, and so passes through our gut. The main function of carbohydrates is to provide energy. 3. fats: these are commonly known as lipids. Also included are oils. Fats may be called saturated (usually derived from animals, including beef, pork, lamb, milk, cheese and eggs. They are solid at room temperature), unsaturated or polyunsaturated (usually derived from vegetables or fish. We call them oils because they are liquid at room temperature), and trans (these are not natural rather, they are created by chemists. They have a number of advantages to food manufacturers, including taste, texture, and shelf life, but they are not good for you and should always be avoided). Check the label of your food package (see also Appendix 3). If you see the terms partially hydrogenated or hydrogenated vegetable oil or vegetable shortening or shortening, you can assume that the product contains trans fats. Fats have many functions in our bodies, in addition to providing energy. Included are tissue repair, body temperature regulation, protecting internal organs from damage, storing energy for later use, keeping skin healthy, and as a vehicle for vitamins (see below).

10


[email protected]

4. proteins: these are compounds which, unlike carbohydrates and fats, are not generally used to supply energy. Rather, they are generally used as building blocks to maintain the structure and function of your tissues. Contrary to what you may believe, protein is found in abundance in vegetables and grains. 5. vitamins: these are naturally occurring chemicals found in foods, and are necessary in very small quantities for normal body function. There are about 15 different vitamins. You need only a very small amount of each, and not necessarily on a daily basis. More than what your body needs provides no added benefit, and is often gotten rid of quickly. Some are not, and so too much can do harm. Most foods contain a variety of vitamins, but no one food has all of them. If your diet contains a variety of foods, it would be rare that all of your vitamin needs will not be met. 6. minerals: these are also naturally occurring chemicals found in foods, and like vitamins are needed in small quantities for normal body function. Although more than 15 different minerals are required, all together they make up less than 5% of your body weight. As for certain vitamins, taking in too much of certain minerals can be harmful. If your diet contains a variety of foods, it would be rare that all of your mineral needs will not be met. Note that some medications will cause your body to lose certain minerals, which cannot be replaced completely by food. In these cases your doctor may prescribe a supplement (examples include potassium and magnesium).

11


[email protected]

APPENDIX 2 Grocery Store Shopping List

1. Good: most, if not all, of your food/drink should come from this section. CHECK THE LABEL - avoid if any term for added sugar appears see also Appendices 3 and 4): A. Breads: - coarse wheat kernel - cracked wheat (bulgur) - coarse barley kernel - coarse rye kernel (pumpernickle) - whole grain pumpernickel - oat bran - Healthy Choice 7 grain - buckwheat - whole wheat matzo B. Cereals: - steel cut (Irish) oats - rolled oats - All Bran - Muesli - Kashi C. Rice: - brown rice - wild rice D. Pasta: - whole wheat - semolina - rye E. Grains: - bulgur wheat - teff - quinoa (really a seed, but well leave it here)

12


[email protected]

- kaniwa - farro - freekeh - millet - barley - wheat berries - buckwheat F. Meats/meat substitutes - fish - lamb - turkey - chicken - lean ground beef - veggie/garden burger - Boca burger - tofu - tempeh - seitan (whole wheat flour only) G. Nuts (no more than one half cup per day) - almonds - walnuts - pecans - brazil nuts - cedar nuts H. Seeds (raw or roasted; no added sugar or salt) - flax - hemp - sesame - sunflower - pumpkin - chia

13


[email protected]

I. Dairy: - plain yogurt (low fat) - string cheese - cottage cheese (low fat) - farmers cheese - mozzarella cheese - queso fresco J. Beans: - black - garbanzo (chickpeas) - lentil - kidney - black-eyed peas - edamame - cannellini K. Fruits (fresh, frozen or canned; if canned, no syrup): - apple - avocado - banana - cantaloupe - watermelon - honey dew - strawberry - raspberry - blueberry - cherry - apricot - guava - grape - kiwi - mango - mandarin - orange - papaya

14


[email protected]

- peach - pear - pineapple - plum - star fruit - dried apricot - raisin - fig - date - dried apple L. Vegetables: - artichoke - asparagus - bean sprout - beet - beet green - celery - parsley - chicory - chinese cabbage - chives - collard green - endive - jicama - mustard green - cabbage - kohlrabi - brussels sprout - dandelion green - green bean - pea - escarole - fennel - edimame - pepper (red, green, orange, yellow, hot)

15


[email protected]

- bok choi - carrot - lettuce (romaine, red leaf, green leaf) - cauliflower - tomato - cucumber - eggplant - mushroom (any kind) - onion - radish - squash - spinach - turnip - zucchini M. Eggs - organic - free range - pastured N. Beverages: - cows milk (reduced fat) - rice milk - soy milk - almond milk - coconut milk - water - sparkling water - club soda - coffee (black) - tea (herbal) - wine - sugar-free flavored waters O. Spreads: - hummus

16


[email protected]

- salsa - spreadable whole fruits P. Condiments: - soy - sweet and sour - cocktail - teriyaki - barbecue - ketchup Q. Oils: - olive - canola 2. Bad: these items should be avoided: A. Breads: - bagel - white - corn - potato - rice - doughnut - hamburger bun - hot dog bun - croissant - roll - English muffin - Italian - baguette - pita - tortilla B. Cereals: anything not listed in section 1

17


[email protected]

C. Rice: - basmati - white - jasmine - Arborio (risotto) - long grain D. Pasta: - white - noodles - canned E. Grains/baked goods: - pop tart - cake - brownie - chip (any) - cracker (any) - pizza (crust) - rice cake - instant oatmeal - waffle - pancake - cookie F. Meat/meat substitutes: - bacon - chorizo - sausage - hot dog - lunch meats (any) - turkey bacon - steak - hamburger - turkey dog

18


[email protected]

G. Nuts: - candied - roasted - glazed H. Dairy: - yogurt (except plain) - cheddar cheese - jack cheese - American cheese - Colby cheese - cream cheese - ice cream I. Fruits: canned in syrup J. Vegetables: - French fries - tater tots - onion rings - baked beans - popcorn K. Beverages: - soda - sports drinks (Gatorade, Powerade, Propel, G2, etc) - diet anything - slurpie - smoothie - juice - flavored milk - whole milk - cocoa - designer coffees (frappucino, macchiato, mocha, latte, etc) - beer

19


[email protected]

L. Spreads - jam - jelly - honey - peanut butter - guacamole - margarine - butter M. Condiments: - lard - sugar - cream cheese - sour cream - mayonnaise - salt - salad dressing (except oil and vinegar) - honey N. Oils: - coconut - vegetable shortening

20


[email protected]

APPENDIX 3 How to Read a Food Label

Packaged foods are required by the government to have labels which tell you about what they contain. These are entitled Nutrition Facts. An example is shown below. Here are the keys to reading these labels: 1. Serving size: usually given as a volume (the cup measure is commonly used) and/or weight. Understanding serving size is crucial, because people commonly assume that the label summarizes all that is contained in the package. This is usually not true. It is important, because the information as to what is inside will be per serving. So, for example, if you eat double the serving size listed, you must double everything on the list below (calories included). 2. Calories: this is a term for energy contained per serving. The minimum number of calories you need per day to maintain health varies based on a number of factors, including age, gender, and body size, but if you are 50 years or older is approximately 1600 for women and 1800 for men. On the label will also be a term entitled calories from fat, which I want you to ignore. As is discussed elsewhere in this manual, the calorie issue is a tough one. First, it is difficult to count calories accurately, and even if you could you probably dont want to be doing this for the rest of your life. Second, it is difficult to restrict calories adequately over the course of time. I favor a different approach: ignore calories. My thinking is that, assuming you choose only the right foods, you can eat as much as you want, not count calories and not gain (and lose if you are overweight) weight. 3. Fat: usually given as total and, underneath this, different types including saturated, monounsaturated, polyunsaturated, and trans (see Appendix 1). For each is given a weight (grams or g) as well as a percentage (%) daily value. The latter term has to do with what the government believes is reasonable, based on a diet which contains a total of 2000 or 2500 calories. I want you to ignore the weight and percentage of total, saturated, monounsaturated and polyunsaturated fat in the product. What I do not want you to ignore is the presence of trans fats. If you see the term trans, I would recommend that you do not use this product. 4. Cholesterol: this is a type of fat. The amount is usually given as a weight (milligrams or mg) and % daily value. I want you to ignore this. 5. Sodium: this is a type of mineral (see Appendix 1). The amount is usually given as a weight and % daily value. It is very commonly added to foods, because we like the taste and because it prolongs shelf life. As a generality, we eat too much of it, and this may do harm. I would recommend that you aim to eat no more than 2,000 milligrams per day. In addition to paying attention to labels, this means that you should get rid of the salt shaker and not add salt to foods when cooking. As is discussed elsewhere in this manual, there are excellent substitutes for salt from which you can choose.

21


[email protected]

6. Carbohydrate: given as total and, underneath this, different types (eg. fiber, sugars). For each is given a weight (grams or g) as well as a percentage (%) daily value. I do not want you to pay attention to the total carbohydrate data. However, I do want you to pay attention to the different types. First, look at the fiber. Fiber is a material which only comes from plants (fruits, vegetables, grains, nuts, seeds) and which cannot be digested by the body. Despite the fact that it is not digested, it is a crucial element of health. When it comes to fiber, more is better. I want you to aim for a total of at least 40 grams of fiber per day, every day. If you are eating fruits, vegetables, and (some) nuts and seeds, there will be no label, so I have provided a table below which gives you a sense of the amount of fiber in some of these items. Next, look at the sugars. Unfortunately, the current government mandated food label does not tell you whether the sugar is natural (contained within the food) or added by the chemists who create the final product which is sold. You will have to also look at the ingredient list (below). If you see on this list any term for sugar (see Appendix 4), it means it was added and thus I want you to try to avoid this product. 7. Protein: given as a weight (grams or g) as well as a percentage (%) daily value. I want you to ignore this. 8. Vitamins and minerals: these are listed in the section below protein. On the sample label shown below, they include vitamin A, vitamin C, calcium, iron, thiamin, vitamin B6, and phosphorus. Next to each is provide a % daily value. I do not want you to worry about these. 9. At the bottom of the label is a chart which provides government recommendations for amounts of different items from the sections above. I want you to ignore this. 10. Ingredients: either next to (as in the sample label below) or elsewhere on the package, you will find the list of all ingredients in the product. As a generality, if there are more than 3 ingredients in this section, the product should be considered as suspicious. There are a couple of specific ingredients that I want you to look for, and if you see them I would recommend that you avoid using the product: A. added sugar. In addition to sugar, look for one or more of the terms listed in Appendix 4. Avoid these foods. B. trans fats: If you see the terms partially hydrogenated or hydrogenated vegetable oil or vegetable shortening or shortening, you can assume that the product contains trans fats. Avoid these foods.

22


[email protected]

23


[email protected]

TABLE. Fiber content in Fruits, Vegetables and Nuts Food Amount Fiber Content (grams) Alfalfa sprout 1 cup 0.6 Almond (slivered) 1 tablespoon 0.6 Almond (sliced) 1 cup 9.5 Apple (raw, with skin) 1 3-5 Apricot (raw) 1 0.8 Artichoke (cooked) 1 10.3 Artichoke (canned heart) 1 1.0 Asparagus 1 cup 3.5 Avocado 1 2.8 Banana 1 3.0 Bean (black) 1 cup 19.4 Bean (great northern) 1 cup 16.0 Bean (kidney) 1 cup 19.0 Bean (lima) 1 cup 12.0 Bean (pinto) 1 cup 18.8 Bean (white) 1 cup 16.0 Beet (sliced) 1 cup 5.0 Blackberries 1 cup 8.8 Blueberry 1 cup 3.6 Bok Choi 1 cup 1.7 Brazil nuts 1 1.7 Bread (white) 1 slice 0.8 Bread (whole wheat) 1 slice 3.0 Bread (rye; whole grain) 1 slice 3.0 Bread (seven grain) 1 slice 3.3 Broccoli 1 cup 8.0 Brussel sprout 1 cup 4.0 Bulgur wheat 1 cup 9.6 Cabbage (white or red) 1 cup 3.0 Cantaloupe 1 4.0 Carrots 1 cup 4.6 Cashew 1 cup 2.7 Cauliflower 1 cup 3.0 Celery 1 cup 6.0

24


[email protected]

Cherry 10 1.2 Chestnut 1 0.8 Chickpeas (garbanzos) 1 cup 12.0 Coconut 1 tablespoon 3.4 Corn (cob) 1 ear 5.0 Corn (kernels) 1 cup 10.0 Cranberry 1 cup 8.0 Cucumber (with skin) 10 thin slices 1.0 Dates (pitted) 2 1.2 Eggplant 1 cup 2.5 Endive 10 leaves 1.0 Figs 1 2.0 Flax seed 1 tablespoon 2.8 Grapefruit 1 1.6 Grape (any) 20 1.0 Green (snap) pea 1 cup 4.2 Swiss chard 1 cup 8.0 Honeydew melon 3 inch slice 1.5 Kale 1 cup 2.6 Lentil (brown) 1 cup 18.0 Lentil (red) 1 cup 20.0 Lettuce 1 cup 0.8 Mushroom (whole) 5 small 1.4 Mushroom (sliced) 1 cup 8.0 Nectarine 1 cup 2.4 Okra 1 cup 3.2 Olives 6 1.2 Onion 1 cup 3.0 Orange 1 2.4 Peach 1 2.3 Pea (green) 1 cup 18.2 Pea (black eyed) 1 cup 16.0 Pecan 1 cup 2.7 Peppers 1 cup 2.4 Pineapple 1 cup 1.6 Plum 1 cup 2.3

25


[email protected]

Pomegranite 1 11.3 Potatoe (boiled, with skin) 1 3.5 Potatoe (mashed) 1 cup 6.0 Prune 1 0.6 Raisins 1 cup 2.4 Raspberry 1 cup 9.2 Rutabega 1 cup 6.4 Sesame seed 1 tablespoon 1.1 Spinach 1 cup 7.0 Squash 1 cup 5.0 Sunflower seed 1 tablespoon 3.1 Sweet potatoe 1 3.8 Zucchini 1 cup 6.0 Strawberry 1 cup 3.0 Sunflower seed 1 tablespoon 0.5 Swiss chard 1 cup 3.7 Tomatoe 1 2.0 Turnip 1 cup 4.8 Walnut 1 1.1 Watermelon 1 thick slice 2.8

26


[email protected]

APPENDIX 4 Other Names for Sugar

Agave nectar Barley malt Beet sugar Brown sugar Buttered syrup Cane juice Cane juice crystals Cane sugar Caramel Carob Carob syrup Confectioners sugar Corn syrup Corn syrup solids Date sugar Dextran Dextrose Diatase Diastatic malt Erythritol Ethyl maltol Fructose Fruit juice Fruit juice concentrate Galactose Glucose Glucose solids Golden sugar Golden syrup Granulated sugar Grape sugar High fructose corn syrup (HFCS) Honey

27


[email protected]

Hydrogenated starch hydrolysate Invert sugar Isomalt Lactitol Lactose Malt Malt syrup Maltitol Maltodextrin Maltose Mannitol Maple syrup Molasses Raw sugar Refiners syrup Sorbitol Sorghum Sorghum syrup Sucrose Turbinado sugar Xylitol Yellow sugar

28


[email protected]

APPENDIX 5 A Whole Food, Plant-Based Way of Eating

NOTE Any substantial change in how you eat requires careful consideration and planning. In addition the understanding the reason to change, the goals, and the types and quantities of food items on the menu, it is important to consider your environment. This includes family, with whom you should discuss this in detail before embarking, as well as friends and other people from whom you receive social support. Many people have told me that partnering with one or more family or friends makes the transition easier. You should be aware that you body is quite complex when it comes to how it perceives and acts upon food. Therefore, although a given way of eating might be better for most people, there are some for whom it will not work or even potentially cause harm. You must have patience. In embarking on any way of eating with a particular goal, for example changing your weight or waistline, you must understand that you are going up against millions of years of evolution. If nothing else, our bodies have evolved to hold the line, presumably because we evolved in environments (unlike today which were very unpredictable when it came to essential elements, such as food and water. Thus, your body will fight back hard against any force you place on it which threatens the status quo. A change in your way of eating may be just such a force. You should be aware of the fact that a change in way of eating may well change your prescription medicine requirements. Reducing the number of medicines you need is an excellent incentive for adopting a better way of eating. However, whether and how this takes places will vary, and thus it is very important to keep your doctors aware of what you are up to, as to make changes safely over time. INTRODUCTION I know this may be difficult to understand, given that if you are like me, youve been brought up to believe in the concept of calories in, calories out when it comes to weight. Therefore, our understanding of the word diet has been an endeavor in which you limit calories. In addition to the torture of constantly trying to figure out how many calories are in this, that, or the other thing which can suck the joy out of eating calorie restriction will inevitably leave you hungry. This is doomed to fail in the long term. And it is the long term we are interested in, because if you lose weight for only a brief period of time say 6 months or a year then you do not significantly change your health path. So, sustainability is the key. This is why I call this a way of eating rather than a diet, because the word

29


[email protected]

diet makes you think this: Ill do this for a while, get my weight where I want it to be, then go back to what I was doing before. This is also doomed to fail, or worse, because if you reintroduce old foods to your body after a period of dieting, the weight and waistline will come back with a vengeance, often exceeding where you started. This phenomenon, which some call yo-yo, is very common, and it is demoralizing. Changes in weight and waistline must be sustained over your remaining lifetime in order for you to receive the full health benefit. There are several different ways to eat which will induce weight loss, and it is important to understand that the science in this area is as yet immature. This is why you have and will continue to see pieces on television and in print about outcomes with certain diets. Conflicting information may leave you confused and frustrated, thinking that the medical or scientific communities do not know what they are talking about (sometimes true). For what it is worth, based on my personal evaluation of the science it is my firm belief that the whole food, plant-based (WFPB) makes the most sense, given what is known in 2014, for a number of reasons:

1. It will not leave you hungry. Hunger competes with pain to be the most terrible of sensations, and it is simply not sustainable for a person who has access to food. Assuming that you stick to the menu (below), you can eat more, certainly enough for you to feel full and not subjected to constant cravings and food thoughts or fantasies, while losing weight and waistline. The emerging truth is that the body perceives certain types of food differently than others effectively, a calories is not a calorie. There are good calories and bad calories. The bad calories will tend to make you fat, even if you restrict them. It is therefore best to avoid them.

2. You will not have to count calories. If you stay true to the food choices, you can literally eat as much as you want.

3. You will be well nourished. Although losing weight, maintaining a healthy weight, and minimizing your waistline circumference are very important goals, they are not the only goals. In addition to energy, food contains thousands of compounds which your body tissues use to maintain themselves. It is my belief that in 2014 these compounds are best provided by a WFPB diet.

4. You will be able to afford it. Many ways of eating, in particular those attached to commercial products (eg. Weight Watchers, Jenny Craig , Nutrisystem), may sell packaged products which can be very expensive. This is not necessary in WFPB. Be aware however that WFPB is becoming big business, and some promoters are also selling branded foodstuffs (examples: Fuhrman, McDougal). Purchasing such products is NOT recommended, as they add unnecessary cost. In my experience, these elements give you the best chance of adopting this way of eating for the rest of your life. Note that The nutrient composition in WFPB is approximately 75% carbohydrate, 15% fat, and 10% protein.

30


[email protected]

MYTHS DEBUNKED 1. Not enough protein: incorrect there is plenty of protein in plants. As discussed above, variation in what you eat is important so that your body gets all different types of protein. 2. Arent carbohydrates bad for you? They can be, which is why the specific choices are crucial. See the menu below. 3. Ive heard that WFPB leaves you with vitamin deficiencies? This is possible, and should be monitored by your physician, who may prescribe selected supplements including vitamins B12, K2, and D3, iodine, and a chemical called docosahexaenoic acid (also known as DHA). CHANGING YOUR FOOD ENVIRONMENT One of the keys to WFPB is stocking your pantry and refrigerator with the right stuff, and getting rid of the wrong stuff. It is a given that a WFPB pantry will turn over faster than a typical pantry, so you will need to plan. If you know throughout the week that your ingredients are waiting for you at home, and that they will not keep, youll be less likely to pick up restaurant food. When shopping, come with a list and become adept at reading labels (Appendix 3). Although early on the supermarket will seem like a brave new world, once you have a sense of what you enjoy eating and can prepare in the context of the rest of your day, it will be quick. You cannot control your food environment outside of your home, and this is a real problem. So many convenience foods are available and within eyeshot, and that can be very tempting if you are hungry. You will need to plan ahead and take your pantry with you. For example, prepare a bag with apples, strawberries, raisins, carrots, or almonds. Hummus travels well, and can be used in lieu of dressing on just about any vegetable. When eating out, you will be challenged. Restaurants make money by serving food, and it is their nature to seek foodstuffs that have extended shelf lives (which imply processing and the inclusion of sugar and salt). WHATS ON THE MENU?

1. All fruits (see Appendix 1) 2. Leafy or cruciferous vegetables, including lettuce, collard greens, kale, broccoli. Whether

you go for organic or conventional produce, eat an array of colors. Different colors imply different sets of nutrients, so you want to be all over the board. You can eat these raw, of course, but youll also want to experiment with mixing things up, such as with grilling, baking, or sauting. See also Appendix 1.

3. Tubers and starchy vegetables, including potatoes, yams , yucca, winter squash, corn and green peas (see Appendix 1)

4. Grains: whole grains have not been refined through a manufacturing process which removes the bran and germ portions of the plant (these are the most important). You can find

31


[email protected]

whole-grain versions of all kinds of foods, including bread, rice, and pasta. Look carefully at the label (Appendix 3): dont just look for the word whole; also read the ingredients to be sure that whole grain is first or second on the list. Also, there should be no more than one or two ingredients after that, nothing that says refined or enriched, and NO added sugar (Appendix 4). Examples include rolled oats, brown rice, wild rice, whole wheat, buckwheat, millet, and bulgur. See Appendix 1.

5. Tofu 6. Tempeh 7. Seitan (whole wheat flour only) 8. Legumes: all kinds, including black beans, kidney beans, pinto beans, navy beans, garbanzo

beans (chickpeas), lentils, edamame, and cannellini beans. 9. Hummus 10. Salsa (no added sugar) 11. Nuts (no more than a handful per day): almonds, walnuts, brazil nuts, cedar nuts, and pecans.

Raw or roasted 12. Seeds: flax, hemp, sesame, sunflower, pumpkin, chia and quinoa. Raw or roasted 13. Oils: olive, canola 14. Beverages: water, sparkling water, club soda, soy milk (no added sugar), almond milk (no

added sugar), coffee (black or with almond/soy milk; no added sugar); tea (no added sugar), wine.

REFERENCES There are an almost unlimited number of resources which will help you adapt to a WFPB way of eating. I list a few representative sites below. You will need to teach yourself this is time well spent.

1. Books: The Complete Idiots Guide to Plant-Based Nutrition (Julieanna Hever) Eat to Live (Joel Fuhrman) Eat more, weigh less (Dean Ornish) The Forks over Knives (Gene Stone) The Prevent and Reverse Heart Disease Cookbook (Ann Crile Esselstyn) The Whole Foods Plant Based Diet A Beginners Guide (Gary Roles)

2. Web sites: http://myplantbasedfamily.com http://www.forksoverknives.com http://plantpoweredkitchen.com

32


[email protected]

APPENDIX 6

Tips for Eating Outside the Home

1. Eat out as infrequently as you can. In general, restaurant food contains bad stuff, in particular sugar and salt, because these things improve the taste and prolong shelf life both are good things if you are a restaurant owner. You will likely never know what is in the food, and you should not assume that your server has any clue. If you are going to eat out and have the opportunity to plan, research the menu first to get a sense of whether there are decent options.

2. NEVER eat at or get delivery from a fast food restaurant, including: Arbies, Baskin-Robbins, Blimpies, Buffalo Wild Wings, Burger King, Cals Jr., Chick-fil-A, Dairy Queen, Dunkin Donuts, Hardees, Jimmy Johns, Krispy Kreme, Kentucky Fried Chicken, McDonalds, Pizza (any), Popeyes, Roy Rodgers, Sonic, Steak n Shake, Taco Bell, Wendys, White Castle, Wingstreet.

3. Sit-down restaurants with very limited healthy choices include: Applebees, Bob Evans, Chilis, Cracker Barrel, Dennys, Eat n Park, Five Guys, Golden Corral, IHOP, Olive Garden, Pizza Hut, Red Lobster, TGI Fridays.

4. When in restaurants: A. drink a full glass of water first. NO soda or juice. Limit wine or beer to 2 glasses. B. do not eat bread from basket - ask to have it not delivered or taken away. C. order a large salad as an appetizer; dressing on the side (use it to dip), no croutons. D. do not be afraid to negotiate with the server for things not exactly on the menu. Many restaurants which make food to order are willing to make alterations, such as switching sauces or side dishes E. try to say NO to dessert.

self defense manual

Documents

impact of foundation

david schwartzman

progression of frailty

poor foundation

weak foundation

lifestyle elements

impact of genes

coronary artery disease