Great Health is Not a Mystery…It’s a Puzzle

puzzleMalcolm Gladwell, the best-selling author, has written about the differences between a mystery and a puzzle.  Solving a mystery requires gathering clues that often are hard to come by and sometimes impossible to find.  

Puzzles are totally different.  Think of a jigsaw puzzle.  Once you open the box and spill all the pieces on the table, you don’t need to find any clues…they are all right in front of you.  In order to solve the puzzle, you just need to figure out a way to put all of the pieces together.

Attaining great health is not a mystery, it’s really a pretty simple puzzle.  Despite that fact many individuals invest significant time and money trying to find a missing clue, or “the magic bullet.” The solutions are staring us right in the face…and, as you probably suspect, you already know what they are.

Genetics, (i.e. your mom and dad), are responsible for about 20-30% of your health.  The balance, which is obviously substantial, is completely up to you.  The majority of your overall health is about personal habits (what you do, or don’t do, on a regular, often daily, basis) and your environment.  These are both things you can control.

There are all sorts of habits that can significantly impact your health, either positively or negatively.  The Big Three are nutrition (what and how much you choose to put in your mouth), physical activity and sleep.  Of these, nutrition and sleep are essential for life while physical activity is optional.  Obviously, you can live without physical activity…however, you can’t live well.  

On a scale of 1 to 10, I encourage you to rate yourself on the categories of nutrition, physical activity, and sleep…1 being terrible and 10 being terrific.  Now add up the three numbers.  If your total is 27 or higher, congratulations!  If not, no worries. The good news is, it’s never too late to improve your health and the solutions are not complicated.  

Spoiler alert! I don’t consider what follows to be “breaking news!” It also does not qualify as “fake news.”


I like to separate the topic of nutrition into two buckets, weight and health.  While the two often overlap, I believe it’s helpful to differentiate in order to clarify your game plan.  If you are interested in losing weight, then you must develop new skills to help moderate your caloric intake.  Many Americans are awful at portion control.  Believe it or not, it’s not what you eat, but when and how you eat that will help you lose weight and, more importantly, keep the weight off.  Learning the difference between appetite and hunger and slowing down your eating experience are two of the most critical skills that lead to permanent weight loss.

From a health perspective, the quality of what you put in your mouth is important.  The research is clear that the Mediterranean Diet (which is not a diet, but a lifestyle) is a fantastic way to improve your health and lower your risk of disease.  Whole grains, along with plenty of green leafy vegetables, fruit, seeds, beans, nuts and berries, should be staples if you are interested in maximizing your health.

Physical Activity

To many, “exercise” is a four-letter word, but make no mistake, incorporating regular physical activity into your routine is one of the best ways to improve both the quality and quantity of your life.  Time is always the most popular excuse as to why individuals don’t exercise, but I don’t buy it.  We all have 168 hours in a week and we know, if you embrace HIIT (high-intensity interval training), you can get all you need with about 30 minutes a week…total.  Please understand, I am not promoting a “something for nothing” strategy as it relates to physical activity…the science here is solid.  I will admit you have to be in pretty good shape to reap the rewards of HIIT, but if you’re avoiding exercise because you are just “too busy,” then it’s time for you to come up with a better excuse.  

Note to overachievers… (guys, this means you).  If you are currently deconditioned from a lack of regular exercise, please don’t try to jump off the high dive, boil the ocean or go from zero-to-60 immediately.  You didn’t get out of shape overnight, so you are not going to recapture your fitness overnight either.  Start where you are and be sure to check with your primary care doc if you have any concerns about your capacity for exertion.  A great place to start is to walk the dog…even if you don’t have one!  


When it comes to optimal health, I call sleep the “third leg of the stool.”  We’ve heard the “diet and exercise” drumbeat for years, but statistically many Americans are trying to get by on too little shut-eye.  Don’t fool yourself.  Without adequate sleep, you will never hit on all cylinders.  

Adults need at least seven hours of sleep per night, but the research shows that 71% of us are either moderately or severely sleep deprived.  The benefits of a good night’s sleep are substantial…more energy, lower blood pressure, better glucose metabolism, improved memory, enhanced mood, a stronger desire to exercise, greater immunity, less stress, longer life and maybe most importantly, a better sense of humor.

Having a consistent sleep routine seems to be the key.  This is known as “sleep hygiene.”  Try to be consistent with when you go to bed and when you get up, even on weekends.  Keep your bedroom like a cave…dark, cool and quiet.  

Try winding down at least an hour before you want to get to sleep.  It’s helpful to avoid one last check of your email, texts, Twitter or Instagram before turning out the lights.   Preparing your brain for sleep is important, so avoid violent television shows or Stephen King novels right before bedtime.  If you have trouble falling asleep, try a hot shower or bath just before sliding under the cool, crisp sheets.  The quick reduction in your core temperature will facilitate relaxation and help set the table for an excellent night of rest which can be the difference between an “average” or “excellent” tomorrow.

There are plenty of other pieces to the “health puzzle,” but the three mentioned above are a great place to start.  One critical point to remember is you can’t outsource your health.  Improving your odds of living a long and healthy life is absolutely possible, you just need to put the puzzle together.

Stay well!


Henny_pennyWhen it comes to the health of our country, Chicken Little was right…the sky IS falling!

While healthcare and the Affordable Care Act dominate the headlines it seems that actual health gets very little attention. In June the American Diabetes Association released new statistics regarding the rate of diabetes in the United States. 12.3% of American adults (29.1 million) are now diabetic. More troubling is that 37% (86 million) are pre-diabetic…and nine out of 10 of those don’t know it.

That means that 49.3% of us are now diabetic or pre-diabetic!

The A.D.A. also pointed out the cost to treat diabetes has increased 41% between 2007 and 2012.

Then, two months later (August 12, 2014), the Centers for Disease Control and Prevention announced that forty percent of Americans born between 2000 and 2011 will develop diabetes…double the risk of those born just a decade earlier. The numbers are even more ominous for minorities. More than half of all Hispanics and non-Hispanic black women born between 2000 and 2011 will develop diabetes in their lifetime. For black men the lifetime risk is 45%.

Just to top it off, on September 17th, the Journal of the American Medical Association published a study indicating that 54% of American adults, both men and women, had waist circumferences that were too large. “Abdominal obesity” is defined as a waistline of more than 35 inches in a woman and more than 40 inches in a man. This fat, also known as visceral adiposity or belly fat, is different than the fat we carry in our hips, thighs and buttocks. It’s been described as “angry fat” and dramatically increases our risk for a number of conditions including heart disease, stroke and diabetes. That 54% total is up from 46% reported in 1999-2000.

If these trends and predictions hold true, and there’s no reason to think they won’t, then the dialog about who is going to pay for healthcare becomes irrelevant. Why?…because no one has a checkbook big enough to pay for what’s coming!

Diabetes dramatically increases the risk of heart disease, stroke, blindness, neuropathy, amputation, kidney disease, and liver failure. Besides the tragic impact on quality of life all of these conditions cost a great deal to treat.

Here’s the real tragedy…and it has nothing to do with economics. The vast majority of diabetes is preventable. Type 2 diabetes, which accounts for well over 90% of diabetes, is considered a lifestyle disease. It’s primarily a result of obesity and inactivity.

Americans are eating more and moving less than ever in our history. Processed food laden with added fat, sugar and salt dramatically increases what the Big Food companies define as “craveability.” According to a May 2011 study by Dr. Tim Church and colleagues (PlosONE) at least eight out of 10 Americans now sit for a living compared to just five out of 10 in 1960. The majority of us are now classified as “thought workers.” That means the average woman today is burning 120 fewer calories per day at work and men 140 less calories per day than we were 50 years ago. These numbers correlate perfectly with the obesity epidemic where right now well over a third of American adults have a body mass index (BMI) above 30 (a ballpark of at least 30 or more pounds above ideal).

What’s the solution? Great question! It’s clear this is not a result of bad genes. It’s a result of habits and environment. We now live in an obesigenic world where a wide variety of factors are producing a society that struggles to move, sleep, connect, and enjoy the phenomenal gifts we’ve been given.

One thing is clear. We can’t outsource our health. Of the over seven billion people in the world no one can move for us, sleep for us, or eat for us. We need to all start taking personal responsibility and then decide what we can do to make a difference in our homes, schools, churches, companies, and communities. The solutions are available. We need to start by getting off the couch.

Otherwise, Chicken Little’s prediction will come true.

Stay Well,


That’s Just Nuts!

thats-just-nutsOne of my favorite expressions is that Food is Fuel.  Just like a car needs gasoline in order to run, humans need food in order to live.  Not just to breathe but to flourish. The quantity, or amount, of food is obviously important but so is the quality.  I believe many of us overlook the importance of the quality of our diet.

In terms of quantity, we measure gasoline in gallons and we measure food in calories.  We require a certain amount of calories every day just to satisfy our basic needs such as keeping our heart, lungs and brain operating.  That’s known as our Resting Metabolic Rate (RMR).  You can calculate your estimated RMR with the worksheet on page XX (This is fairly accurate estimate.  You can more accurately measure your RMR with a simple breath test which many dieticians offer for around $100.00).

Our caloric needs go up as we increase our physical activity levels (just as your car requires more gasoline to drive from Dallas to Houston than it does driving from Dallas to Ft. Worth).

When the topic of weight loss is discussed you often hear that “a calorie is a calorie,” whether it comes from a soft drink or from a lentil.  Basically that’s true.  If you eat more calories than you burn then you gain weight.  If you burn more calories than you eat then you lose weight.

As it turns out though, not all calories are created equal.  Some calories last longer than others.  In essence, they provide better mileage.

Take for instance nuts.  Even though nuts are relatively high in calories they are very healthy and they make you feel full longer.  Nuts are high in fat (heart healthy unsaturated fat), protein, and fiber which increase satiety.  If you are looking to lose or maintain weight then satiety is crucial.  If you feel “full” or “not hungry” then you are generally not motivated to eat.  Certain foods, like nuts, increase satiety while others tend to decrease it.

The New England Journal of Medicine published a big study in 2011 which followed over 120,000 men and women for between 12 and 20 years.  The primary goal was to determine the rate at which people were gaining weight.  The study showed that, on average, folks were gaining 3.35 lbs. every four years, or 16.8 lbs. every 20 years.  That certainly corresponds to the increase in the rates of obesity in the United States since the early 80s.

However, what was interesting is that there seemed to be certain foods that promoted weight gain while other foods seemed to help with weight maintenance.  The foods that promoted weight gain, in order, were French Fries, potato chips, potatoes (see a trend here?), soft drinks and red meat.  The foods that appeared to help with weight maintenance were yogurt, nuts, fruit, whole grains, and vegetables.

So maybe not all calories are created equal after all.

In 2003 the FDA issued a qualified health claim regarding nuts: Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.

Nuts that are eligible include almonds, hazelnuts, peanuts (although they are technically legumes), pecans, some pine nuts, pistachio nuts, and walnuts.  Nuts also provide many important minerals including magnesium, manganese, zinc, and phosphorus.

The National Heart, Lung, and Blood Institute, as part of their famous DASH (Dietary Approaches to Stop Hypertension) diet, recommends 4 to 5 servings per week from the nuts, seeds and legumes (peanuts, dry beans, lentils, and peas) category.  That may help lower blood pressure and reduce the risk of stroke.  A “serving” of nuts equals 1.5 ounces (42 grams) or about a third of a cup.

The real key though is not to eat too many nuts and that’s sometimes pretty challenging, especially if they are salted.  Nuts are naturally low in salt but since food providers know that salt increases “craveability” they often will add it (salt also increases thirst which is why many bars often provide salted nuts as snacks).  When shopping look for “unsalted” or “lightly salted” nuts.

Obviously, with nuts there is a great deal of variety from a calorie, taste, and nutrition standpoint.  Almonds, cashews, pine nuts, and pistachios are the lowest in calories (about 240 calories per serving, 1.5 ounces).  Pecans, macadamias, and walnuts are on the higher side (about 300 calories per serving).  If you are watching your weight then be sure to factor these totals into your food log.

I like to think of nuts as a terrific “bridge” to help get me from breakfast to lunch or from lunch to dinner.  I get a container of “unsalted, mixed nuts” and keep it in my desk at work.  If, in between meals, I get a little hungry then I’ll have just a few nuts and that usually is all I need to get me to the next meal.  When traveling, I put about a third of cup of mixed nuts in one of those small, resealable snack bags.  I then toss in five or six peanut M&M’s and that usually gives me all I need in the airport or on the plane.  My main goal is to avoid getting so hungry that I’m forced to select from the limited options provided at many airports or in the air.  I like to make sure that I’m in charge of my fuel, not the environment, and nuts are a great way for me to do that.

Eat more fruits and vegetables.

Strive to add at least one serving of a fruit or vegetable per meal.  Notice I said at least one…  One half of a cup is considered a “serving”. A piece of fruit (i.e. small banana, apple, pear, etc.) is also considered a serving. Fried does NOT count, nor do corn, peas, or potatoes (except sweet potatoes). Think colorful and leafy green vegetables like broccoli, carrots, spinach, cabbage, kale, tomatoes, green beans, bell peppers, etc.