Healthy Living

Eating the Mediterranean diet may lead to a longer life

Who knew! Great read below. I’m off to Panini Grill!
— Dr. Dale

(CNN) -- Eating a Mediterranean diet may be your key to living longer. That's according to a new study led by Immaculata De Vivo, associate professor at Brigham and Women's Hospital in Boston and Harvard Medical School.

The diet involves eating items off a menu that is rich in vegetables, fruits, nuts, beans and peas, unrefined grains, olive oil and fish. It keeps dairy, meat and saturated fats to a minimum. And you can have a glass of red wine with dinner without cheating.

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The diet has been consistently linked with health benefits that includes helping you manage your weight, and it can lower your risk for chronic issues such as cardiovascular disease.

This new research looks at data from 4,676 healthy middle-aged women involved in the Nurses' Health Study, an ongoing study tracking the health of more than 120,000 U.S. nurses since 1976.

It found women who ate a Mediterranean diet had longer telomeres.

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Telomeres are part of your chromosomes, the thread-like structures that house your DNA. At the end of these chromosomes are telomeres, a kind of protective "cap" that keeps the structure from unraveling. It thereby protects your genetic information.

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Even in healthy people, telomeres shorten with age. Shorter telomeres are associated with aging, lower life expectancy and age-related diseases such asartherosclerosis, certain cancers and liver disease.

Scientists have noticed some lifestyle choices such as smoking, being overweight or obese and drinking a lot ofsugar sweetened drinks can prematurely shorten a person's telomeres.

Scientists believe oxidative stress and inflammation can also shorten them.

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Fruits, vegetables, olive oils and nuts -- the key components of a Mediterranean diet -- have well-known antioxidant and anti-inflammatory effects. The team of U.S. researchers led by De Vivo therefore wanted to see whether the women who stuck with this diet had longer telomeres.

"This is the largest population-based study addressing the association between Mediterranean diet adherence and telomere length in healthy, middle aged women," they write. The study included completed detailed food questionnaires and blood tests to measure telomere length.

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Each participant had a calculated diet score ranging from 0 to 9 points; a higher score signifies a closer resemblance to the Mediterranean diet. Each one point change in diet score corresponded an average of 1.5 years of telomere aging.

Telomere shortening is irreversible but healthy "lifestyle choices can help prevent accelerated shortening," says De Vivo.

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This study's results provide "some insight into the underlying physiologic mechanism behind this association," indicating that greater adherence to this diet is significantly associated with longer telomeres, she says. Because of the antioxidant and anti-inflammatory effects of the Mediterranean diet, following this diet "could balance out the 'bad effects' of smoking and obesity," De Vivo says.

These findings further support "the health benefits of greater adherence to the Mediterranean diet for reduction of overall mortality, increased longevity and reduced incidence of chronic diseases, especially major cardiovascular diseases."

None of the individual dietary components was associated with telomere length. Researchers suggest that means the whole diet is an important element, rather than one item being a kind of superfood.

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Dr. Peter Nilsson, a professor of Clinical Cardiovascular Research at Lund University in Sweden, who wrote an accompanying editorial, suggests that the variation in telomere length and dietary patterns may also be because of genetic background factors.

While promising, Nilsson believes that future studies "should take into account the possibility of interactions between genes, diet and sex."

With these results, De Vivo and her research team hope in the future to figure out which components of the Mediterranean diet may be having a bigger impact on telomere length.

Next they also hope to study the same thing in men.



Celiac Disease Showing Up in Many Forms and at All Ages

It’s nice to see more emphasis and greater study put toward celiac research.
— Dr. Dale
By Janice Neumann

(Reuters Health) - A classical set of celiac disease symptoms no longer reflects the profile of most newly-diagnosed patients, according to a new study from Italy.

Instead, doctors should take other symptoms into account and consider the possibility of celiac disease, even when patients don't fit the old image of the condition, researchers say.

"It's been a gradual phenomenon since the 1970s that fewer people are presenting with the classical diarrhea and more with non-classical or silent presentation, both in adults and children," said Dr. Peter Green, who wasn't involved in the study.

"We don't actually know why one person has diarrhea and another presents with abdominal pain or osteoporosis," said Green, director of the Celiac Disease Center at Columbia University in New York.

Dr. Umberto Volta and his coauthors wrote November 18 online in the journal BMC Gastroenterology that just 15 years ago, celiac disease was still thought of mainly as a rare pediatric food intolerance, whose most common signs were diarrhea and intestinal damage.

Volta, a professor of medicine at the University of Bologna in Italy and vice president of the Ethical Committee at St. Orsola-Malpighi University Hospital, and colleauges looked at the celiac patients diagnosed over the course of 15 years at that hospital.

The study involved 770 patients, 599 of them female, diagnosed between 1998 and 2007. Nearly half were diagnosed during the first 10 years of the study period and the rest in the last five years, indicating a steep rise in rates of diagnosis.

Among all the patients, 610 people, or 79%, had symptoms when they were diagnosed. But most of their problems were not the typical diarrhea and weight loss, but rather "non-classical" issues like bloating, osteoporosis and anemia. Diarrhea was a symptom in just 27%.

Indeed, classical symptoms became less common over the years, decreasing from 47% of patients during the first 10 years to 13% in the last five. Meanwhile, other problems, as well as a lack of any significant related illness, increased by more than 86%.

"The most striking change in clinical presentation of celiac disease over time has been the decrease of diarrhea as the leading symptom and the progressive increase of other non-classical gastrointestinal symptoms (such as constipation, bloating and alternate bowel habits as well as gastro-esophageal reflux, nausea, vomiting and dyspepsia)," Volta said in an e-mail to Reuters Health.

"A high proportion of celiac disease patients did not show any gastrointestinal symptom, but they displayed extra-intestinal manifestations such as iron-deficiency anemia, unexplained osteoporosis, abnormalities of liver-function tests and recurrent miscarriages," he said.

The most common illness associated with celiac was thyroid disease. Only half the patients had severe intestinal damage.

In later years, more patients were diagnosed with blood tests. That may be one factor accounting for the changing pattern of typical symptoms, Volta said, because the patients were diagnosed earlier.

"The effects of gluten weren't as severe yet," Volta said. "The story of celiac disease has been radically changed by the discovery celiac disease-related antibodies, which identify plenty of unsuspected cases."

Green agreed that testing has vastly improved diagnosis of the disease. He said that in the UK, anyone with iron deficiency or migraine is tested for celiac disease.

While most celiac specialists understand the varied symptoms, other physicians might not, he said. Green pointed out that in the United States, only 17% of people with the disease are actually diagnosed.

"Anyone can have celiac disease, it's common and underdiagnosed," said Green. "The message we want to get out is if you think you've got celiac disease, don't just go on a gluten-free diet, test for it."

Volta said he hoped the study reminded doctors about the many problems that can signal celiac disease.

"I hope doctors keep in mind that celiac disease is a very frequent food intolerance, which should be investigated not only in patients with diarrhea and overt malabsorption, but also in people (with other symptoms)," Volta said.

"The treatment by gluten-free diet improves the quality of life in symptomatic patients and prevents complications in all celiac disease patients including those without symptoms," he said.


BMC Gastroenterol 2014.

Hate being alone?

Check out this article by Alena Hall via the Huffington Post.  Very interesting! -- Dr. Dale


Why You Can't Stand To Be Alone -- And How To Learn To Love It

For many of us, the idea of being alone conjures up a sense of dread. Maybe it’s the sense of boredom, or the feelings of isolation, or being forced to confront our own thoughts. In fact, a recent study in the journal Science showed that people would rather give themselves electric shocks than be alone with their thoughts for just 15 minutes.

But turns out, there’s a difference between being alone and feeling lonely. Even though we may use the phrases interchangeably in conversation, psychotherapist and HuffPost blogger Ross Rosenberg, who also authored The Human Magnet Syndrome: Why We Love People Who Hurt Us, explains that they’re actually two distinct concepts.

The main distinguisher: Being alone is a physical description (meaning when we are alone, we are just not with people), while loneliness is a feeling that often is experienced as negative and painful. “You can be alone and happy, you can be alone and lonely,” Rosenberg explains. “The idea of being alone is what you make of it."

Many people who struggle with feelings of loneliness can link their struggles to deeper roots. According to Rosenberg, loneliness is a feeling fueled by trauma, loss and grief, a lack of self-esteem, and insecurity. Those who lead healthy, balanced lives are better equipped to face these negative experiences because they have both internal and external resources that help guide them through the process -- from a sense of community to a strong and positive self-concept.

"Loneliness is a normal part of the human existence," Rosenberg says. “We all feel lonely, but chronic, pathological loneliness is a deeply embedded pattern that is self-reinforcing. It’s a self-fulfilling prophecy. Healthy, resilient people respond to normal loneliness by resolving it. Unhealthy people become overwhelmed by it."

Personality type is also a big factor when it comes to who experiences discomfort from being alone. Introverts -- who lose energy from being around others -- may find alone time more desirable than extroverts, who instead gain energy from the company of others.

“If you’re an extrovert, you are comfortable and feel compelled to be around other people. It is just the way you are genetically set up. If you’re an extrovert and you’re not around people, you feel uncomfortable and if you’re psychologically healthy, you use internal and external resources to be around people,” Rosenberg explains. “If you’re an introvert and you like being alone, that’s also completely psychologically healthy. You can be very secure and self-confident and still be very nervous around crowds of people, but you have friends and loved ones, and those are the resources that make an introvert feel just fine when they’re alone."

At the end of the day, whether you're an introvert or an extrovert, all humans experience feelings of loneliness. And many do so during the times they are physically alone. But it doesn't have to be that way. Here are seven ways people who struggle with "me" time can learn to like it, and maybe even love it.

Consider the root causes.

Take the time to ask yourself where the discomfort of solitude comes from. Is it true feelings of loneliness or something else? If it's the former, explore what that means for you and come to the realization that loneliness usually can be traced back to an unpleasant experience or past memory. To truly understand what makes being alone so painful, you must recognize that it comes from a deeper situation -- no matter how uncomfortable it may be to do so, Rosenberg says.

Just do it.

With any uncomfortable situation, sometimes you have to push past the negative thoughts and hesitations and just take the plunge. The same goes for being alone. More often than not, the result will be far more positive than you anticipated.

"It’s like jumping in the pool when you know it’s cold," Rosenberg says. "Everyone knows that once you jump in the pool and get past the coldness, you’re going to have a blast and not even notice it’s cold anymore. You have to tell yourself that that shock to the system is only fleeting and that you're going to enjoy yourself."

It's all about addressing what are called "cognitive distortions," or things that tell us that the pain is not going to be worth it. "We have to actually tell ourselves the opposite," Rosenberg says. "We have to do reverse self-talk."

Explore new hobbies.

Some people who find that they don't like spending time alone are simply bored when they do so. By spending the majority of their time entertaining others, they haven't learned how to entertain themselves. To remedy this, you must retrain the mind by developing habits and hobbies that can consume your attention, inspire your creativity and spark your imagination, Rosenberg says. It may not come naturally at first, and it will likely require experimentation with different activities, but you get that much closer by taking the first step.

Deepen your relationships.

It might sound counterintuitive, but the strength of your relationships can speak bounds to how secure you feel when spending time alone. A lack of depth and connection can make you feel less heard, understood, appreciated or secure in the fact that you do have someone to call should you need to.

"To solve that problem, deepen your relationships, take risks," Rosenberg advises. "Knowing that there are people out there that love you whom you can call will solve your feelings in one of two ways: You’ll actually call them, or you'll just know that you can call them and that will make you feel better. It makes you feel less lonely in your world, and paradoxically, you don’t need to call them because you know they’re out there."

Opt for a change of scenery.

If you hate being alone because you feel stir crazy at home, a change in location could do the trick. Rosenberg suggests doing something new like visiting a museum.

"Do something you’ve never done," he advises. "Step out of your comfort zone physically. At the very least, it will make time pass quicker, and you might find that you actually enjoy yourself."

Think back to your childhood.

A critical component of feeling comfortable spending time alone is the ability to self-soothe, a coping technique learned at a very young age. According to Rosenberg, people with the ability to self-soothe mostly likely had a healthy early childhood, where their parents met their needs unconditionally and in a timely way. And unfortunately, people without this kind of upbringing may struggle more with self-soothing because it isn't something that can often be learned after adolescence.

"If the world around you feels trustworthy, you experience the world as safe. But if you have an early childhood experience when your parent could not or did not meet your nurturing and safety needs, you don’t feel secure in your world -- and as an adult you have to keep trying to bring people into your world to soothe that feeling," he explains.

Ask for help.

Through this self-exploration process, if you find you experience less the physical discomfort of of being alone and more the consistent feelings of loneliness, don't hesitate to reach out for help. According to Rosenberg, psychotherapy is one of the best ways to address chronic loneliness that is debilitating and self-perpetuating. Talking through the parts of life that engender those feelings is critical to discovering the many mindful benefits that solitude can offer.

Is 7 Hours of Sleep Ideal?

Very interesting.  Give it a shot!  Let me know how it works. Thanks Dr. Michael J. Breus!

-- Dr. Dale


Is 7 Hours of Sleep Ideal?

Eight hours. That's the nightly sleep recommendation you hear most frequently, the gold standard for a healthy sleep routine. But what if it isn't? I read this article in the Wall Street Journal with great interest, for it points to recent research that suggests the eight-hour model may not be the ideal one for most healthy adults.

Although eight hours is the number most often associated with a full night's sleep, sleep experts know that there is some degree of variation when it comes to individual sleep needs. Most often, the recommendation for sleep times comes in a range of seven to nine hours, depending on the individual. The National Sleep Foundation currently recommends this seven- to nine-hour range as ideal for healthy adults.

But there is a growing body of research that suggests the ideal amount of sleep may in fact be at the very low end of that range. A number of studies indicate that seven hours -- not eight -- may be the most healthful amount of nightly sleep. There's no broad consensus about this among sleep experts -- but there's an increasingly compelling case that's being made by studies that for many people, eight hours may be more sleep than they need, or than that's healthy for them.

We hear a lot more about the dangers of too little sleep, but sleeping too much can be hazardous to your health as well. Both too little sleep and too much sleep are associated with greater mortality risks. So understanding as much as we can about the overall "best" amount of sleep has real importance.

The National Sleep Foundation is currently at work examining and analyzing sleep data in preparation to release new guidelines for sleep. And the Centers for Disease Control has funded a panel to explore all manner of issues related to sleep, including updated recommendations for healthy sleep amounts. Both are expected to release their recommendations in 2015.

Those guidelines are important, for medical professionals and the general public. But the right amount of sleep is always going to be a personal and individual determination. The most important information in determining your sleep needs is what your body and mind tell you. Pay attention to how much (and how well) you're sleeping at night, and also pay attention to how you feel during the day. A sufficient night of sleep should leave you feeling alert and energized throughout the bulk of the day, and ready for bed at roughly the same time every night.

In order to read your body's need for sleep, it's important to practice good sleep hygiene. That includes consistent bed times and wake times, a dark, cool, and comfortable bedtime, and quiet time away from bright light and electronics in the hour before bed. Give yourself ample time for sleep, and create a sleep-friendly environment and routine, and your body can tell you a great deal about how much sleep you need.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor

Stressed? Think again.

This is a really great article about stress management.  Something we all should read. -- Dr. Dale


Stress-Free Is As Near to You As Your Own Thoughts

If you take a close look at stress over the course of a busy week, you're likely to discover that stress is happening in you far more than to you. It has more to do with the anxious way you relate to people and events than with the events themselves.

"We humans generate all sorts of stressful events purely in our heads ... linked to mere thoughts," states Robert Sapolsky, one of the world's leading stress researchers.

It's the way worried, pessimistic, stress-provoking thoughts ignite upsetting emotions that generate a sense of threat, when a real threat isn't verifiably present.

It's called psychological stress and it can flood your system with adrenaline and cortisol, sending your mind and body into an uproar. If these kinds of stress reactions become chronic, it will gradually wear out your body, depress your mood and could contribute to killing you. And it all begins with the stress provoking thoughts we think.

Recall the last time an email caused your mind to race with anxious thoughts, painting you mentally into a tight corner. This tight corner makes the world appear threatening, and we believe the threat our mind imagines is real. But it isn't real; it's the mind making up emergencies that the primitive brain assumes must be happening simply because you imagined it. The primitive brain possesses the intelligence of a two-year old, and when it senses any kind of danger, real or imagined, it sets off a fight, flight, or freeze reaction.

For the last 500 years, we've been quoting the great French statesman Michel de Montaigne, who said, "My life has been full of terrible misfortunes, most of which never happened." There's now a study to back up Montaigne. This study found that 85 percent of what we worry about never happens, and that the 15 percent that does happen turns out better than we expect. We laugh at Montaigne's comment because we see ourselves in it, but we often miss the message.

So here's the message: most of our stress is a form of mental suffering we inflict on ourselves by believing thoughts that aren't even true.

I knew a lawyer who was in litigation over a dispute between two large corporations. There was a lot at stake and this lawyer, who I'll call William, thought he was losing the case. He blamed it on the opposing litigator, who he described as unscrupulous and crooked. William was stressed about the case and he was becoming increasingly difficult for his legal team to work with. He was taking the case home at night. He thought about it incessantly, lost sleep over it, and as his stress level increased, he began to lose his edge and make bad decisions. By the time I ran into him he was exhausted.

Biologically, where there's stress, there's fear, so I asked William, "What are you afraid of?"

"Losing the case, of course," he said glaring at me as if I'd asked a stupid question.

"And if you lose the case, what are you afraid of?" I asked.

"Looking like a fool," he said nervously.

"And what's the fear of looking like a fool?" I asked.

"I'll lose my reputation," he said, and I could see terror flash in his eyes.

"So what's the fear of losing your reputation?"

"Well ... I'll lose my clients ... and my job ... and my livelihood." All at once, he looked like a deer caught in headlights. When I asked him what he was feeling, he said, "I see myself pushing a shopping cart down Main Street."

You can see in his last statement how far the mind can travel when we are afraid and really stressed. This was the story running in the back of William's mind, and the more stressed he became the more he believed the story.

So, I asked William, "Have you lost the case yet?"

"No," he said, "it's still on-going."

"Any chance you might turn things around and win?" I asked.

"Well, yes," he said. "I suppose there's an outside chance. You never know what a jury might do."

Next I asked, "Do you really think people see you as a fool?"

"No," he said somewhat self-consciously. "People respect me."

"If you lose this case will you really be in jeopardy of losing your clients?"

"No, it's not very likely," he said. "Everyone knows you win some, you lose some." He began to breathe easier and the lines on his forehead began to relax.

"Will you really be asked to leave the firm if you lose the case?"

"No," he laughed. "They're making me a partner." It was the first he'd smiled in some time.

"So," I said, "It's safe to say that you won't be pushing a shopping cart down Main Street any time soon, right?"

"Right," he laughed.

So I asked William: "Who would you be without these fearful thoughts?"

"I'd be calm," he said. "My mind would be clear. I'd sleep better. My decision-making would be a lot smarter. And I'd be nicer to my team."

This had a happy ending: When William went back to work on the case, he was at the top of his game. He wasn't undermining himself with stress-provoking thoughts.

A better life is as near to us as our own thoughts. In the last twenty years, biology has established that the vast biochemical environment that constitutes our brain and body is shaped by our mental state. So, become keenly aware of stress-provoking thoughts and tell yourself, these thoughts are in me, not in reality. Then choose not to believe them. If you don't believe a stressful thought, it doesn't turn into stress and anxiety. The ticket to the health, wealth, and love we seek is cultivating a mental state that every day brings a little more peace into our experience, a little more empathy into our heart, and a little more gratitude into our attitude. This is how the door swings open to a better life.

Best time to go to bed? Hmm.

Thank you Markham Heid for this interesting article.  I'm all about learning about sleep these days. -- Dr. Dale


You Asked: What’s the Best Bedtime?

The earlier the better? 11 PM? Sundown? Sleep experts say it’s not that simple. But there is a time range you should shoot for if you’re questing for a perfect night’s sleep

Every hour of sleep before midnight is worth two after midnight. Your grandparents (and great grandparents) probably adhered to that creaky adage. “The mythology is unfortunate, because there’s no pumpkin-like magic that occurs,” says Dr. Matt Walker, head of the Sleep and Neuroimaging Lab at the University of California, Berkeley. And while nothing special happens to you or the quality of your sleep at the stroke of midnight, many do wonder: What’s the best time to go to bed?

Walker says your sleep quality does change as the night wears on. “The time of night when you sleep makes a significant difference in terms of the structure and quality of your sleep,” he explains. Your slumber is composed of a series of 90-minute cycles during which your brain moves from deep, non-rapid eye movement (non-REM) sleep to REM sleep. “That 90-minute cycle is fairly stable throughout the night,” Walker explains. “But the ratio of non-REM to REM sleep changes.”

He says that non-REM sleep tends to dominate your slumber cycles in the early part of the night. But as the clock creeps toward daybreak, REM sleep muscles in. That’s significant, because some research has suggested that non-REM sleep is deeper and more restorative than lighter, dream-infused REM sleep—though Walker says both offer important benefits.

What does this have to do with the perfect bedtime? The shift from non-REM to REM sleep happens at certain times of the night regardless of when you go to bed, Walker says. So if you hit the sack very late—at, say, 3 AM—your sleep will tilt toward lighter, REM-heavy sleep. And that reduction in deep, restorative sleep may leave you groggy and blunt-minded the next day.

That’s unfortunate news for nightshift workers, bartenders, and others with unconventional sleep-wake routines, because they can’t sleep efficiently at odd hours of the day or night, Walker says. “The idea that you can learn to work at night and sleep during the day—you just can’t do that and be at your best.” Your brain and body’s circadian rhythms—which regulate everything from your sleeping patterns to your energy and hunger levels—tell your brain what kind of slumber to crave. And no matter how hard you try to reset or reschedule your circadian rhythms when it comes to bedtime, there’s just not much wiggle room. “These cycles have been established for hundreds of thousands of years,” Walker explains. “Thirty or 40 years of professional life aren’t going to change them.”

When it comes to bedtime, he says there’s a window of a several hours—roughly between 8 PM and 12 AM—during which your brain and body have the opportunity to get all the non-REM and REM shuteye they need to function optimally. And, believe it or not, your genetic makeup dictates whether you’re more comfortable going to bed earlier or later within that rough 8-to-midnight window, says Dr. Allison Siebern, associate director of the Insomnia & Behavioral Sleep Medicine Program at Stanford University.

“For people who are night owls, going to bed very early goes against their physiology,” Siebern explains. The same is true for “morning larks” who try to stay up late. For either type of person—as well as for the vast majority of sleepers who fall somewhere in between—the best bedtime is the hour of the evening when they feel most sleepy.

That means night owls shouldn’t try to force themselves to bed at 9 or 10 if they’re not tired. Of course, your work schedule or family life may dictate when you have to get up in the morning. But if you can find a way to match your sleep schedule to your biology—and get a full eight hours of Z’s—you’ll be better off, she adds.

Both she and Walker say your ideal bedtime will also change as you age. While small children tend to be most tired early in the evening, the opposite is true for college-aged adults who may be more comfortable going to bed around or after midnight. Beyond college, your best bedtime will likely creep earlier and earlier as you age, Walker says. And again, all of this is set by your biology.

Siebern suggests experimenting with different bedtimes and using sleepiness as your barometer for a best fit. Just make sure you’re rising at roughly the same time every morning—weekdays or weekends. It’s fine to sleep an extra hour on your days off. But if you’re getting up at 6:30 during the workweek and sleeping until 10 on weekends, you’re going to throw off your sleep rhythms and make bedtime more challenging, she says.


Robin Williams

Patients, friends, family: The news of Robin Williams' death yesterday has me in awe.  As a doctor I see many patients who have depression, and through medication and other means we are able to help them.

Please don't every be afraid to talk to me about feeling depressed.  We can work together to find the right solution to make you feel better.

Rest in peace, Robin.  You were a gift to the world.

-- Dr. Dale. 


12 Foods To Keep You Fuller, Longer

This is great!  Perfect for summer and losing the undesired weight. -- Dr. Dale


By Carey Rossi

When you're trying to lose weight, cutting back on the amount you eat is a given -- but feeling hungry all the time is one of the major reasons why most diets fail within a week. Still, you can silence your grumbling stomach without consuming extra calories. In fact, eating certain foods sends a signal to your brain that you're done eating and quiets your appetite. Shut out the ice cream pint that's calling your name by eating these healthy and satisfying foods.

  1. Apples
    Chomp on an apple approximately a half hour before a meal -- the fiber and water from the apple will fill you up, so you'll eat less, says Debra Wein, RD, president of Wellness Workdays, a leading provider of worksite wellness programs.
  2. Avocados
    Eating half of an avocado with your lunch may help you feel full for the rest of the afternoon, according to a study published in Nutrition Journal. Women who did that felt 22 percent more satisfied and had a 24 percent lower desire to snack three hours later than on days they ate a calorically equivalent lunch without the avocado.
  3. Beans, Chickpeas & Lentils
    Dietary pulses such as chickpeas, lentils, beans and peas are protein-rich superfoods that also pack in fiber, antioxidants, B vitamins and iron. Eating more of them may also help you control your appetite. A recent meta-analysis published in the journal Obesity found that people were 31 percent more satisfied after a meal when it included pulses.
  4. Soup
    In a Penn State study, people who slurped a bowl of low-calorie, broth-based soup before their lunch entrées reduced their total calorie intake at the meal by 20 percent. "Soups can take the edge of your appetite since they take up a lot of volume in your stomach, but with very few calories," says Beth Saltz, RD, owner of
  5. Pickles
    Pickles, sauerkraut, kimchi and other fermented foods have short-chain fatty acids (SCFAs), and recent research in the Annals of The New York Academy of Sciencesfound that they help strengthen the bond between the gut and the brain. SCFAs stimulate production of hormones that cross the blood-brain barrier and improve appetite signaling. Fermented foods also boast probiotics, the healthy bacteria that help digestion. Some experts believe probiotics may reduce appetite and aid weight loss, though research is inconclusive.
  6. Chili Powder
    You may already know that capsaicin, the compound in chilis that gives them their kick, fires up your metabolism. Recent research from Maastricht University in the Netherlands shows that adding heat to your meal may also control your appetite. The study, which was published in the journal Appetite, found that adding 1/4 teaspoon of chili pepper to each meal increased satiety and fullness. What's more, some participants were only allowed to consume 75 percent of their recommended daily calorie intake, but didn't feel any more desire to continue eating after dinner than those who were given 100 percent of their daily calories.
  7. Dark Chocolate
    When you're craving something sweet, reach for dark chocolate. Research suggests dark chocolate can help reduce blood pressure and protect the heart and brain. It's also more filling than milk chocolate and may help curb cravings for both sweet and salty foods, according to a study in the journal Nutrition & Diabetes. In fact, participants consumed 17 percent fewer calories at a meal following a dose of dark chocolate.
  8. Eggs
    Starting your day with eggs will leave you satisfied until lunch. The power's in the protein: research from the University of Missouri at Columbia suggests that eating a 300-calorie breakfast made up of 30 to 39 grams of protein (think: eggs and sausage) reduces hunger pangs and increases fullness during the time between breakfast and lunch. What's more, the research revealed that high-protein breakfast eaters consume fewer calories throughout the day.
  9. Nuts
    Nuts are another filling food that may help you eat less. In a British Journal of Nutrition study, obese women who paired either 1.5 ounces of peanuts or 3 tablespoons of peanut butter with Cream of Wheat cereal and orange juice felt fuller for up to 12 hours after finishing breakfast than those who didn't eat the peanut products. "Nuts are essentially designed by nature to control appetite because they're rich in healthy unsaturated fat, along with bonus protein and fiber," says Cynthia Sass, MPH, RD, Health magazine contributing nutrition editor. Together, the three nutrients slow digestion and regulate blood sugar when combined with carbs like fruit, oatmeal or brown rice.
  10. Oatmeal
    Consider ditching cereal for warm, gooey oatmeal. Oatmeal will keep you feeling fuller longer, suggests a study in the Journal of the American College of Nutrition. Participants were served 250 calories of cereal or oatmeal with 113 calories of milk. The oatmeal-eaters were satiated longer, and they also experienced a greater reduction in hunger and a decreased desire to eat compared to ready-to-eat cereal eaters. Why the difference? Oatmeal is higher in fiber and protein and also has higher amounts of beta-glucan -- the sugars that give oatmeal its heart-healthy properties, hydration and molecular weight compared to ready-to-eat cereals.
  11. Water
    Being low on H2O can trick you into believing you're hungry. Why? The symptoms of hunger are similar to those of being dehydrated: low energy, reduced cognitive function, and poor mood. So next time you're craving an afternoon snack, drink a tall glass of water and wait 10 minutes. Chances are, your hunger pangs will pass, and you'll have saved hundreds of calories.
  12. Whey Protein
    Dairy whey -- one of the two proteins that make up milk products -- may be the most filling type of protein. According to a study published in the journal Appetite, people who drank whey protein ate 18 percent less two hours later than those who had consumed a carbohydrate drink. Use whey protein powder to give smoothies a protein punch.

10 Ways To Get More Sleep

Well, we all know everyone can use this advice! -- Dr. Dale


By Rebecca Scritchfield for U.S. News Health

It's 1 a.m. on a Tuesday, and you're awake, sluggishly trying to finish every last item on your jam-packed to-do list. Sound familiar? You're not alone. Sixty-three percent of adults report that getting enough sleep is extremely or very important to them, but only 30 percent say they are doing a very good job achieving this goal,according to an American Psychological Association survey. In fact, and on average, American adults get only 6.7 hours of sleep per night.

These statistics are exactly why I created a 30-Day Sleep Challenge for the month of June. I'm challenging you to improve the quantity and quality of your rest, so you can be your best, healthiest self.

Sleep is often neglected in favor of getting more done, which almost always backfires. When you're sleep-deprived, you're less productive, more irritable and you often have too little energy for healthy eating and exercise that day.

If you habitually get too little sleep, your health could be in real trouble. Sleep is the time when your body recuperates and rebuilds from the day's stress. Imagine how much happier and healthier you could be with an additional 60 to 90 minutes of sleep each night.

What's keeping so many people up at night? Stress. It's the No. 1 reason people don't get enough sleep, according to the APA survey. Forty-three percent of people report lying awake at night because they feel stressed. We have too much to do and not enough time to do it, and instead of respecting the boundaries of our rest time, we take precious minutes (and even hours) from our sleep to worry about what didn't get done.

If you're stuck counting sheep, unable to fall asleep, try these healthy remedies: Make a list. If your mind is racing with all the things you have to do the next day, get them down on paper. This can help you move on and get your much-needed rest.

Drink a cup of warm milk, chamomile tea or tart cherry juice -– each can positively influence your sleep patterns.

Eat magnesium-rich foods like almonds, and calcium-rich foods such as cheese and crackers, which help your body use tryptophan and serotonin to get sleepy. You can also learn more about sleep producing foods by visiting my blog.

Leave your phone and other screens turned off. The glow can interfere with your body's production of melatonin, which is a hormone that makes us feel sleepy.

Don't lie awake staring at the ceiling for too long. If you’ve been awake for more than 30 minutes, get up and either get a glass of water, walk around the room or gently stretch. Doing so can help interrupt the "I can't sleep" pattern.

Hide your clock. The last thing you need to do is count every passing minute that you're awake. If you need an alarm clock to get up in the morning, just turn it around so you can't see the clock face at night.

One of the best things you can do for your health is create a better sleep routine. These are tips to help establish a healthy, long-term sleep pattern: Set sleep boundaries and stick to them. Allot at least eight hours for sleep every night. Don't stay up late or set your alarm extra early just to knock out a few extra to-do items. The more rest you get, the more productive you'll be during waking hours.

Give yourself a bedtime, and go to bed at that time every night. Our bodies become accustomed to the routine, and eventually you'll fall asleep faster.

Don’t workwatch TV, email, text or look at social media from bed. Your bed should be for two things only: sleep and sex.

Keep screens out of the bedroom, or at least away from the bed.

For my #30daysleepchallenge, I encourage you to improve your sleep habits so you can be ready for whatever life throws at you on a daily basis –- physically, mentally and emotionally. I'm posting tons of tips and information on my blog, Twitter, Facebook and Pinterest to help you get better sleep. We've already been going for a while, but you can join in at any time! Be sure to share your thoughts, and I'll be responding to your questions every day.

How Bad Sitting Posture at Work Leads to Bad Standing Posture All the Time

Amen to this!!!  I recommend something like this for your desk: click here - Dr. Dale



Looks like your mother was right when she told you to sit up straight.

There's growing evidence that good posture contributes to a range of health benefits, from reducing back and joint pain to boosting mood. Health-care practitioners from physical therapists to surgeons to psychologists increasingly take posture into account when evaluating patients, and offer tips and tools for improvement.

Good posture doesn't just mean standing with the shoulders thrown back. More important is maintaining good alignment, with ears over the shoulders, shoulders over hips, and hips over the knees and ankles. Body weight should be distributed evenly between the feet.

Seated posture, especially while using a computer, is critically important and deserves more attention, experts say, in part because it can affect a person's posture while standing and walking. Experts say it is essential to think about posture while walking, getting up out of a chair or using a cellphone or tablet.

The hunched-over position of the typical electronic-device user is of particular concern, and is sparking new back- and neck-pain problems in teenagers. A study of 6,000 Finnish adolescents found frequent use of computers, mobile phones, videogame players and television was associated with greater rates of neck and lower-back pain, according to a 2006 paper in the European Journal of Public Health.

Posture is "probably the 800-pound gorilla when it comes to health and wellness," says Allston Stubbs, an orthopedic surgeon at Wake Forest Baptist Medical Center, in Winston-Salem, N.C., who treats patients with back or joint pain. "We see the spine and overall skeletal structure being critical to a patient's functionality and their satisfaction with their life and health care."

Evan Johnson, of the New York Presbyterian-Columbia University Medical Center Spine Center, helps a patient, Josh Gordon, work on alignment. Cassandra Giraldo for The Wall Street Journal

Because poor posture can often be caused by obesity or weak muscle tone, correcting it isn't a quick fix for many patients. Even for people in good shape, bad posture habits can be so ingrained that it takes constant vigilance to improve them.

Evan Johnson, head of physical therapy at the Spine Center, a back-pain treatment facility at New York-Presbyterian Hospital and Columbia University Medical Center, starts scrutinizing patients' posture as soon as they walk through the door. "I will go get the patient from the waiting room and escort them back. As they're walking, you're evaluating," he says.

On a recent morning Dr. Johnson sat his patient on a bench. "Roll your chest up and forward. Sit tall through the top of the head," he said, gently pulling the patient's hair upward. "Bring your navel in." The patient, a man recovering from back-pain surgery who declined to be named, slowly straightened up.

Dr. Johnson then put a wooden stick down the back of the patient's shirt and asked him to stand. The stick was meant to remind him to keep his spine straight and bend at the hips as he got up. "Many patients, when they go from sitting to standing, they lose their posture. They slouch," Dr. Johnson said.

Dr. Johnson shows how an annotated map, right, can help locate the neutral spine position. Cassandra Giraldo for The Wall Street Journal

He peppered the patient with questions. "Remind me again, do you commute to work? Do you have a bucket seat in the car?" Dr. Johnson asked. "When you have a bucket seat, your butt is way down," which can cause back pain, he said. He brandished a wedge-shaped cushion and asked the patient to sit on it, with the thick edge in back. "It takes the bucket out," Dr. Johnson said, so that "your behind is above your knees."

One of the most common posture problems, called kyphosis, is a direct result of spending too much time in front of a computer, experts say. The shoulders hunch forward, the pectoral muscles in the chest tighten, the neck and head extend toward the computer screen, and the spine is no longer vertically aligned.

Many deskbound office workers have started standing and walking in this position, too, says Andrea Cheville, a rehabilitation physician at the Mayo Clinic in Rochester, Minn.

To counteract kyphosis, it is important to stretch the pectoral muscles and strengthen the trapezius muscles in the upper back, which hold the shoulder blades back, Dr. Cheville said. Remembering to keep the ears and head over the shoulders, and not jutting forward, is also important.

Another common problem is lordosis, or swayback, where the lower spine curves inward, toward the front of the body, and the butt is thrust backward. Overweight people often display this posture, as do women wearing high heels, Dr. Cheville said. Losing weight, strengthening the so-called core muscles around the trunk and pelvis and wearing flat shoes can help reverse it.

New research is also demonstrating links between body position and mood. It has long been known that depression can lead to a slumped posture. But new evidence suggests the reverse is also true—that slouching can spark negative emotions and thoughts.

In one recent study, 30 people receiving inpatient treatment for major depression disorder in Germany were divided into two groups, and asked to sit in either a slumped or upright position. Participants were shown 16 positive words, such as "beauty" and "enjoyable," on a computer screen, and then 16 negative words, such as "exhaustion" and "dejected."

After each word, they were asked to imagine themselves in a scene connected with the word, such as a time when they'd felt depressed or beautiful.

The participants were then distracted with other tasks for five minutes, and afterward asked to recall as many of the words as they could. Patients in the slumped position recalled more negative than positive words, while those in the upright position showed more balanced recall, according to the study results, which were published this year in the journal Clinical Psychology and Psychotherapy.

The study's main author, Johannes Michalak, a clinical psychologist at Germany's University of Hildesheim, said he became interested in the link between posture and mood after practicing qigong, a traditional Chinese movement exercise that he says helped boost his sense of well-being.

In a study published in the journal Biofeedback in 2012, researchers in California and Taiwan asked 110 university students to rate their energy levels, then walk in either a slouched position or in a skipping pattern. The students reported a decrease in energy levels after the slouched walk and an increase after skipping, the researchers reported.