nutrition Archives - Page 25 of 31

Our Aging World

Tammy Petersen/7 May 2018/ All MFN blog/

We are aging—not just as individuals or communities but as a world. In 2006, almost 500 million people worldwide were 65 and older. By 2030, that total is projected to increase to 1 billion—1 in every 8 of the earth’s inhabitants. Significantly, the most rapid increases in the 65-and-older population are occurring in developing countries, which will see a jump of 140 percent by 2030.

People are living longer and, in some parts of the world, healthier lives. This represents one of the crowning achievements of the last century but also a significant challenge. Longer lives must be paid for. Societal aging may affect economic growth and many other issues, including the sustainability of families, the ability of states and communities to provide resources for older citizens, and international relations. The Global Burden of Disease, a study conducted by the World Health Organization and the World Bank, with partial support from the U.S. National Institute on Aging, predicts a very large increase in disability caused by increases in age-related chronic disease in all regions of the world. In a few decades, the loss of health and life worldwide will be greater from noncommunicable or chronic diseases (e.g., cardiovascular disease, dementia and Alzheimer’s disease, cancer, arthritis, and diabetes) than from infectious diseases, childhood diseases, and accidents.

Since the beginning of recorded human history, young children have outnumbered older people. Very soon this will change. For the first time in history, people age 65 and over will outnumber children under age 5. This trend is emerging around the globe. Today almost 500 million people are age 65 and over, accounting for 8 percent of the world’s population.

By 2030 the world is likely to have 1 billion older people, accounting for 13 percent of the total population. While today’s proportions of older people typically are highest in more developed countries, the most rapid increases in older populations are occurring in the less developed world. Between 2006 and 2030, the number of older people in less developed countries is projected to increase by 140 percent as compared to an increase of 51 percent in more developed countries.

Population aging is driven by declines in fertility and improvements in health and longevity. In more developed countries, declines in fertility that began in the early 1900s have resulted in current fertility levels below the population replacement rate of two live births per woman. Perhaps the most surprising demographic development of the past 20 years has been the pace of fertility decline in many less developed countries. In 2006, for example, the total fertility rate was at or below the replacement rate in 44 less developed countries.

Increasing Life Expectancy

Some nations experienced more than a doubling of average life expectancy during the 20th century. Life expectancy at birth in Japan now approaches 82 years, the highest level among the world’s more developed countries, and life expectancy is at least 79 years in several other more developed countries.

Less developed regions of the world have experienced a steady increase in life expectancy since World War II, with some exceptions in Latin America and more recently in Africa, the latter due to the impact of the HIV/AIDS epidemic. The most dramatic gains have occurred in East Asia, where life expectancy at birth increased from less than 45 years in 1950 to more than 72 years today.

Changes in life expectancy reflect a health transition occurring around the globe at different rates and along different paths. This transition is characterized by a broad set of changes that includes:

A shift from high to low fertility;
A steady increase in life expectancy at birth and at older ages; and
A shift from the predominance of infectious and parasitic diseases to the growing impact of noncommunicable diseases and chronic conditions.

The health transition shifts the human survival curve so that the chances of surviving another year are higher at every age. In early nonindustrial societies, the risk of death was high at every age, and only a small proportion of people reached old age. In modern survival curves for industrialized societies, most people live past middle age, and deaths are highly concentrated at older ages.

Increases in the probability of survival raise questions about limits to life expectancy and the potential for human lifespan. Despite assertions that life expectancy must be approaching a limit, data on female life expectancies from 1840 to 2000 show a steady increase of 3 months per year. The country with the highest average life expectancy has varied over time—in 1840 it was Sweden, and today it is Japan.

Recent research raises other questions about the future of life. Researchers have been able to experimentally increase lifespan in insects and animals through gene insertion, caloric restriction, and diet. It remains to be seen whether similar increases can be replicated in humans.

Rising Numbers of the Oldest Old

An important feature of population aging is the progressive aging of the older population itself. Over time, more older people survive to even more advanced ages. For research and policy purposes, it is useful to distinguish between the old and the oldest old, often defined as people age 85 and over. Because of chronic disease, the oldest old have the highest population levels of disability that require long-term care. They consume public resources disproportionately as well.

The growth of the oldest old has a number of implications:

Pensions and retirement income will need to cover a longer period of life.
Health care costs will rise even if disability rates decline somewhat.
Intergenerational relationships will take on an added dimension as the number of grandparents and great-grandparents increase.
The number of centenarians will grow significantly for the first time in history. This will likely yield clues about individual and societal aging that redefine the concept of oldest old.

The oldest old constitute 7 percent of the world’s 65-and-over population: 10 percent in more developed countries and 5 percent in less developed countries. More than half of the world’s oldest old live in six countries: China, the United States, India, Japan, Germany, and Russia. In many countries, the oldest old are now the fastest growing portion of the total population. On a global level, the 85-and-over population is projected to increase 151 percent between 2005 and 2030, compared to a 104-percent increase for the population age 65 and over and a 21-percent increase for the population under age 65. Past population projections often underestimated decreases in mortality rates among the oldest old; therefore, the number of tomorrow’s oldest old may be significantly higher than anticipated.

The percentage of oldest old will vary considerably from country to country. In the United States, for example, the oldest old accounted for 14 percent of all older people in 2005. By 2030, this percentage is unlikely to change because the aging baby boom generation will continue to enter the ranks of the 65-and-over population. In Europe, some countries will experience a sustained rise in their share of oldest old while others will see an increase during the next two decades and then a subsequent decline. The most striking increase will occur in Japan: By 2030, nearly 24 percent of all older Japanese are expected to be at least 85 years old. Most less developed countries should experience modest long-term increases in their 85-and-over population.

As life expectancy increases and the oldest old increase in number, four-generation families become more common. The aging of the baby boom generation, for example, is likely to produce a great-grandparent boom. As a result, some working adults will feel the financial and emotional pressures of supporting both their children and older parents and possibly grandparents simultaneously.

While people of extreme old age—that is, centenarians—constitute a small portion of the total population in most countries, their numbers are growing. The estimated number of people age 100 and over has doubled each decade since 1950 in more developed countries. In addition, the global number of centenarians is projected to more than quintuple between 2005 and 2030. Some researchers estimate that, over the course of human history, the odds of living from birth to age 100 may have risen from 1 in 20 million to 1 in 50 for females in low-mortality nations such as Japan and Sweden.

PROJECTED INCREASE IN GLOBAL POPULATION BETWEEN 2005 AND 2030, BY AGE
Age	Increase
0-64	21%
65+	104%
85+	151%
100+	400+%

Source: United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects.

Growing Burden of Noncommunicable Diseases

In the near future, the loss of health and life in every region of the world, including Africa, will be greater from noncommunicable or chronic diseases, such as heart disease, cancer, and diabetes, than from infectious and parasitic diseases. This represents a shift in disease epidemiology that has become the focus of increasing attention in light of global aging.

There is extensive debate about the relationship between increased life expectancy and disability status. The central question is: Are we living healthier as well as longer lives, or are our additional years spent in poor health? Some researchers posit a “compression of morbidity”—a decrease in the prevalence of disability as life expectancy increases. Others contend an “expansion of morbidity”—an increase in the prevalence of disability as life expectancy increases. Yet others argue that, as advances in medicine slow the progression from chronic disease to disability, there is a decrease in the prevalence of severe disability but an increase in milder chronic diseases.

A Host of Challenges

While global aging represents a triumph of medical, social, and economic advances over disease, it also presents tremendous challenges. Population aging strains social insurance and pension systems and challenges existing models of social support. It affects economic growth, trade, migration, disease patterns and prevalence, and fundamental assumptions about growing older.

Using data from the United Nations, U.S. Census Bureau, and Statistical Office of the European Communities as well as regional surveys and scientific journals, the U.S. National Institute on Aging (NIA), with input from demographers, economists, and experts on aging, identified nine emerging trends in global aging. Together, these trends present a snapshot of challenges and opportunities that clearly show why population aging matters.

The overall population is aging. For the first time in history, and probably for the rest of human history, people age 65 and over will outnumber children under age 5.
Life expectancy is increasing. Most countries, including developing countries, show a steady increase in longevity over time, which raises the question of how much further life expectancy will increase.
The number of oldest old is rising. People age 85 and over are now the fastest growing portion of many national populations.
Noncommunicable diseases are becoming a growing burden. Chronic noncommunicable diseases are now the major cause of death among older people in both more developed and less developed countries.
Some populations will shrink in the next few decades. While world population is aging at an unprecedented rate, the total population in some countries is simultaneously declining.
Family structures are changing. As people live longer and have fewer children, family structures are transformed, leaving older people with fewer options for care.
Patterns of work and retirement are shifting. Shrinking ratios of workers to pensioners and people spending a larger portion of their lives in retirement increasingly strain existing health and pension systems.
Social insurance systems are evolving. As social insurance expenditures escalate, an increasing number of countries are evaluating the sustainability of these systems.
New economic challenges are emerging. Population aging will have dramatic effects on social entitlement programs, labor supply, trade, and savings around the globe and may demand new fiscal approaches to accommodate a changing world.

A Window of Opportunity

Global aging is a success story. People today are living longer and generally healthier lives. This represents the triumph of public health, medical advancement, and economic development over disease and injury, which have constrained human life expectancy for thousands of years. But sustained growth of the world’s older population also presents challenges. Population aging now affects economic growth, formal and informal social support systems, and the ability of states and communities to provide resources for older citizens. We can think about preparing for older age on both an individual and societal level. On an individual level, people need to focus on preventive health and financial preparedness.

Since the mid-19th century, the life span in the US has nearly doubled. Most of the increase in life expectancy is due to declines in death from infectious disease. Unfortunately, the number of deaths from infectious disease has been replaced by the number of deaths from degenerative or “lifestyle” diseases. Most people would agree that living a long life without health and independence is not desirable. So, when we consider that an increasing number of people are living longer, we must also consider the problems that are created when the quality of these extended years is poor.

Morbidity is defined as the absence of health. All too often it is a state in which many frail elderly live for a long time prior to death. The major chronic diseases that contribute greatly to morbidity are arteriosclerosis, cancer, osteoarthritis, diabetes, and emphysema. These diseases usually begin early in life, progress throughout the lifespan, and worsen each decade until finally becoming terminal. An example is diabetes. It could begin with obesity at age 20, progress to glucose intolerance at age 30, develop into elevated blood glucose at age 40, be indicated by sugar in the urine at age 50, require medication at age 60, and lead to blindness and amputation at age 70. This is not a pretty picture.

The social consequences of an unhealthy older population are huge. Sickly elderly individuals become more and more unproductive which makes them and the family members caring for them miserable. All of this imposes a huge financial burden on society overall.

It has been estimated that by the year 2040 the average life expectancy of older people could increase by 20 years. By the middle of the 21st century there could be 16 million people in the US over the age of 85. It is also estimated that the average 65-year-old will spend 7½ years of this remaining 17 years living with some functional disability. If the present rate at which people are being added to the category of those experiencing morbidity is projected to the future, a 600% increase in healthcare costs will occur. Still expecting Medicare to take care of us all? Social and medical programs are directly linked to the size and health status of the elderly population in a society. The quality of life of our elderly – and in fact for all of us – will be affected not only by the number of years our seniors live, but also by how comfortably they spend those remaining years.

The emphasis in gerontological research has begun to shift from lengthening life to increasing years of health. The new goal is to shorten the period of time that people live in an unhealthy, dependent state. If scientific advances allow us to live 15 or 20 years longer, and if these 15-20 years consist mainly of pain, suffering, and dependence on others, what have we accomplished?

Because chronic diseases begin early in life and develop gradually, a healthy lifestyle can greatly postpone or even prevent the start of some of these chronic diseases like diabetes, emphysema, and heart disease. The longer the diseases are prevented, the less time an individual will experience morbidity in later years. As a matter of fact, individuals who practice sound health habits and prevent the onset of chronic disease for many years might NEVER experience morbidity.

While it is important for health professionals to develop and enhance life-extending strategies, we also must provide strategies that enable people to live as well as they can. There needs to be a balance between quantity and quality.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. If you are interested in working with older adults, it is important to have the knowledge base to safely and effectively train them. A good overall program to consider is the SrFit Mature Fitness Program, which is recognized for continuing education by many certification organizations including ACSM, BOC, NASM, NSCA, YMCA and others. You can check it out by going to www.aahf.info.

The medical community is good at diagnosing chronic lifestyle diseases, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases you will have more knowledge in this area than the physician who has been trained in tertiary, not preventative, medicine. Most MD’s know very little about diet and exercise since they are not taught this in medical school. Often all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. Be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.

Originally published on American Academy of Health and Fitness. Reprinted with permission from Tammy Petersen.

Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

Source

Much of the information provided here was taken from a report prepared by the U.S. State Department in collaboration with the National Institute on Aging.

NIH Pub ID: 07-6134

CIMS Pub ID: BK025

The National Institute on Aging (NIA), part of the National Institutes of Health, was established to improve the health and well-being of older people through research. As part of its mission, the NIA investigates ways to support healthy aging and prevent or delay the onset of diseases disproportionately affecting older adults. NIA’s research program covers a broad range of areas, from the study of basic cellular changes with age to the examination of the biomedical, social, and behavioral aspects of age-related conditions. Although the main purpose of this research is to increase “active life expectancy” — the number of years free of disability — it may also promote longevity.

Sports Supplements: Buyer Beware?

Nancy Clark, RD/23 April 2018/ All MFN blog/

Definition of Sports supplement: A food, food component, nutrient, or non-food compound that is purposefully ingested in addition to the habitually consumed diet with the aim of achieving a specific health and/or performance benefit.

The global sports nutrition supplement market (including sports foods, drinks and supplements) accounted for $28+ billion in 2016 and, with the help of rigorous advertising, is expected to almost double by 2022. How many of the products are moneymaking ploys marketed to uninformed athletes? Unfortunately, too many.

Due to the plethora of products that have infiltrated gyms, fitness centers and professional sports teams alike, I get questioned by fitness exercisers and aspiring Olympians: Which of these supplements are actually effective?? Hands down, the most effective way to enhance sports performance is via your day-to-day sports diet, coordinated with a consistent training program. Eating the right foods at the right times creates the essential foundation to your success as an athlete.

That said, specific sports supplements could make a minor contribution to small performance improvements for certain elite athletes. If you wonder if the grass is greener on the other side of your sports diet’s fence, here are some facts from the 2018 IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete (1).

Supplement use varies across sports. It increases with the athletes’ training level and age, is higher in men than women and is strongly influenced by perceived cultural norms. (For example, “Everyone” on my team takes creatine, so I do, too.)
Before making any decisions regarding sports supplements, you want to get a nutritional assessment to be sure your diet supports your performance goals. No amount of supplements will compensate for a lousy diet. To find a local sports dietitian who is a Certified Specialist in Sports Dietetics (CSSD), use the referral network at www.SCANdpg.org.
Despite the ads you see for a zillion sports supplements, very few have strong proof of directly enhancing performance. These include caffeine, creatine, specific buffering agents, and nitrate. Period.
Very little research with supplements offers definitive evidence, in part because the research is rarely done with elite athletes under real life conditions. Real life includes 1) multi-day tournaments, competitions or events, 2) “stacking” supplements (such as mixing caffeine and nitrates) and 3) determining if an elite athlete responds the same way to a supplement as does a Division-3 collegiate athlete. Real life also includes your unique microbiome (the bacteria in your gut that influence your overall health and well-being). We do not yet know how much a microbiome, which varies 80% to 90% between individuals, influences the effectiveness of a sports supplement and contributes to different responses.

Supplements are used for many different reasons. Here’s a breakdown of supplements by categories.

Supplements used to prevent/treat nutrient deficiency. Nutrients of concern for athletes include iron (to prevent anemia), calcium and vitamin D (for bone health), as well as iodine, folate and B-12 for specific sub-groups of athletes, including vegans and women who might become pregnant. The basic supplement question is: If you are deficient, what led to that deficiency and what dietary changes will you make to resolve the issue so that it doesn’t happen again?
Supplements used to provide energy. Sports drinks, energy drinks, gels, electrolyte replacements, protein supplements, energy bars, and liquid meals are commonly used to help meet energy needs before, during and after exercise. They are a convenient, albeit more expensive alternative to common foods. They aren’t magical or superior to natural food. They are just easy to carry, standardized and eliminate decisions about which foods would offer, let’s say, the “recommended ratio” of carbs, protein and fat.
Supplements that directly improve performance. Caffeine, creatine monohydrate, nitrate, sodium bicarbonate, and possibly beta-alanine are the very few performance enhancing supplements that have adequate support to suggest they may offer a marginal performance gain. If you choose to use them, be sure to test them thoroughly during hard training that mimics the competitive event. Choose a brand that is NSF Certified for Sport to minimize the risk of inadvertent doping due to contamination. Every year, athletes get suspended for failing a drug test after they unknowingly took a supplement with an illegal ingredient…
Supplements that indirectly improve performance. Some supplements claim to enhance performance indirectly by supporting the athlete’s health and limiting illness. “Immune support” supplements that have moderate research to support their health claims include probiotics, vitamin D, and vitamin C. Supplements that lack strong support for their immune-enhancing claims include zinc, glutamine, Echinacea, vitamin E, and fish oil. Tart cherry juice and curcumin show promise

A supplement with strong evidence to indirectly improve performance by helping build muscle is creatine monohydrate. Questionable supplements without strong evidence for athletes include gelatin and HMB.

Adverse Effects

If some supplements are good, would more be better? No, supplements can cause harm. Too much iron can lead to iron overload. Too much caffeine increases anxiety. Supplements are linked to liver toxicity, heart problems and seizures. In the USA in 2015, dietary supplements contributed to about 23,000 emergency department visits. Manufacturers are not required to show safety or assure quality of a supplement. Athletes beware— and try eating better to perform better?

Nancy Clark, MS, RD, CSSD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathon-ers, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

References

Maughan R, Burke L, Dvorak J et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete Intl J Sports Nutr Exerc Metab 2018, 28: 104-125.

https://globenewswire.com/news-release/2017/01/10/904591/0/en/Global-Sports-Nutrition-Market-will-reach-45-27-Billion-by-2022-Zion-Market-Research.html

Disabled Man with family practicing yoga outside.

Patient Activation Network Interview with Alene Brennan

Matt Cavallo/6 April 2018/ All MFN blog/

Matt Cavallo, MPH, patient advocate, author and speaker, interviews Alene Brennan, a Nutrition Coach, Yoga Instructor, Personal Trainer and Natural Food Chef. Alene overcame debilitating migraine headaches through diet and lifestyle and is now once again using a “Less Pharm, More Table” approach is managing her diagnosis of Multiple Sclerosis.

Since receiving her MS diagnosis and seeing first-hand the power of using diet and lifestyle to create a healing environment in the body, she dedicated her virtual nutrition coaching practice to helping people with MS and autoimmune take back control of their health. She connects with clients around the world via phone and video chat to help them transition to a healing diet and lifestyle and manage the symptoms of chronic illness.

Listen to the podcast from Patient Activation Network:

Our health is truly the only thing that connects us. Whatever your age, gender or background, health is the great equalizer. The Patient Activation Network was created by patients for patients to accomplish real change in healthcare. Visit patientactivationnetwork.com for more podcasts.

Matt Cavallo, MPH is a patient experience speaker, author, and podcaster who motivates audiences worldwide with his personal patient experience and genuine storytelling style. At age twenty-eight, Matt was diagnosed with Multiple Sclerosis. Seemingly overnight he went from a fully-functioning, healthy man to someone who was numb from the waist down and unable to walk. As a result of his diagnosis, Matt has dedicated his life to improving the patient experience. Matt is the founder of PatientActivation Network.

Breakfast is for Champions

Nancy Clark, RD/3 April 2018/ All MFN blog/

I don’t have time, I’m not hungry in the morning and I’m on a diet are three common excuses for missing breakfast. Unfortunately, athletes who skip breakfast generally suffer needless fatigue. They tend to have trouble concentrating later in the morning, and they work or study less efficiently. They can easily overeat at night and gain undesired body fat. Clearly, breakfast is a very important meal of the day!

If you are a breakfast skipper and routinely miss this energizing meal, try this experiment: Eat breakfast for three consecutive days and observe the benefits: more energy, less hunger, better nutrition. You’ll quickly discover breakfast is a key meal for champions!

Here are solutions to some breakfast barriers:

I don’t have time

You really do have time to do what you want to do. If you can make time to exercise, you can also make time to enhance your exercise program by appropriately fueling your muscles. You’ll discover:

you can think, work, and recover better if you eat breakfast within an hour of your morning workout.
you’ll have much more energy during an afternoon workout if you have eaten a substantial breakfast.

If you won’t eat breakfast at home, then simply eat breakfast on the run: a bagful of raisins and granola at the bus stop, a bagel with peanut butter on the way to school, or a yogurt and almonds at work. You don’t have to eat breakfast immediately upon getting out of bed. Your morning break can be more than just coffee!

I’m not hungry in the morning

Most often, athletes who lack a morning appetite ate their breakfast at bedtime, the night before. Too many evening snacks can easily ruin your morning appetite and also contribute to weight gain (if you overeat), dietary deficiencies (if you displace healthful breakfasts with “junk food” for snacks) and muscle fatigue (if you eat high-fat evening snacks—such as chips, chicken wings, ice cream—that inadequately refuel your muscles). Plan to rearrange your meal pattern so you eat a heartier breakfast, fewer evening snacks—and wake up hungry.

I’m on a diet

The most successful diets start with a substantial breakfast and end with a lighter dinner. A wholesome, carb-protein breakfast both fuels and builds your muscles and also prevents you from getting too hungry. When too hungry, you are less likely to care about what you eat and more likely to indulge in sweets and treats. Research suggests athletes who under-eat during the day have more body fat than those who eat adequately during their waking hours. Remember: You are going to eat the calories eventually; you might as well enjoy them in the morning in the form of quality food that keeps you feeling well-fed.

What’s best to eat?

Any breakfast is better than no breakfast, but some choices are better than others for your sports diet. You can easily boost your energy with some of these breakfast foods that fuel your muscles and your brain: oatmeal, whole grain cereal, whole-grain waffles, French toast, bagel, English muffin, banana bread, grits, fruit, juice, or whatever carbohydrate-based foods that might be readily available. Add some protein to build and repair muscles: eggs, cottage cheese, yogurt, cheese, nuts, and peanut butter.

One quick and easy “breakfast of champions” is iron-enriched cereal with lowfat milk, banana, and orange juice. This simple meal provides important nutrients that support your athletic program:

Carbohydrates: the best source of muscle fuel. Carbs should be the foundation of every sports-meal. A breakfast with whole-grain cereal, milk, fruit, and juice is an easy way to help meet that goal!
Iron: a mineral important for carrying oxygen from the lungs to your working muscles. An iron-rich diet reduces your risk of becoming anemic and experiencing needless fatigue during exercise. By enjoying orange juice along with iron-enriched cereals, you can absorb more iron. Note: the “all natural” cereals such as granola or Kashi, have no additives, hence no iron added. Combine them with enriched brands.
Calcium: from milk or yogurt eaten with the cereal. Calcium is important for strong bones, as well as for helping muscles contract properly.
Potassium: a mineral (electrolyte) lost in sweat. Bananas, OJ, whole grain cereals are potassium-rich.
Fiber: to promote regular bowel movements and reduce the risk of unwanted pit stops during exercise. If plagued by constipation, select raisin bran, bran flakes, All-Bran, or any type of bran cereal. If diarrhea is a problem, reduce fiber intake!

Summary

A carbohydrate-based breakfast that also includes some protein is a critical energy booster that helps athletes fuel and repair their muscles. Without this morning meal, you are likely to run on fumes, perform less effectively, and reduce your intake of nutrients that contribute to health and top performance. Try these meals for a high energy day:

Bran cereal, banana, chopped almonds, and lowfat milk.
Whole wheat bagel with peanut butter, and a latte.
French toast, ham, orange juice, and Greek yogurt.
Greek yogurt with granola, almonds, and berries.

Reprinted with permission from Nancy Clark.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

Fast Food Genocide

Dr. Joel Fuhrman/2 April 2018/ All MFN blog/

In his latest book, Fast Food Genocide, Dr. Fuhrman details the shocking role diet has played in derailing the American dream for large segments of our population. He explains how these foods destroy not only our physical health, leading to cancer, diabetes, obesity, and heart disease — he also explores the previously overlooked association of diet’s influence on behavior, emotional health and intellect. The fast and processed food industries keep people hooked on their unhealthy, highly addictive products and that has led to a national health crisis. This tragic and far-reaching epidemic of inferior nutrition can be turned around, and Dr. Fuhrman offers hope, explaining the powerful way a Nutritarian Diet can solve what has become a national health crisis. It is an eye-opening book all of us need to read and share with our friends. Below, Dr. Fuhrman answers what motivated him to write this book and some of the questions surrounding it.

How Can Fast Food Be Genocide?

Genocide — the deliberate destruction of a population — is the most accurate way to describe fast food’s devastating effects on our society. Processed, nutrient-barren products are designed by the food industry to be highly addictive, cheap to produce, and highly profitable. These products do not contain the nutrients humans need to thrive, and in those using them as a primary food source, it has created an explosion of disease, much suffering and death. Fast food and processed foods also damage our genes, which we pass on to our children and grandchildren, and we are seeing dangerous increases in autism, learning disabilities, allergies, autoimmune disease and childhood cancer. This must be stopped.

Which Foods Are The Most Dangerous?

I define fast food in two ways: First, it is the food served at commercial chain restaurants, where processed meats, pizza, burgers, French fries, pretzels, soft drinks, and rich desserts are made in an assembly-line process, with commercial ingredients that are duplicated and dispersed all over the world. Second, it is any commercially-made convenience food that includes artificial ingredients, processed grains, sweeteners, salt, and oil, all with high-caloric concentration and minimal nutrient content. These foods have now become the majority of calories consumed in America.

Why Are These Foods So Damaging to Our Health?

A person who eats fast food, fried food and processed food has an increased risk of cancer, obesity, diabetes, autoimmune disease, depression, and mental illness. Even moderate use of fast food is dangerous. For example, one serving of commercial French fries per week is linked to an over 25 percent increase in risk of developing breast cancer. The World Health Organization has declared that processed meats are a class 1 carcinogen in humans, which places them in the same category as asbestos and cigarette smoking. Fake food produces cancer-promoting signals, damages blood vessel and builds plaque. The food is most often high in calories and fattening. Weight gain has its own dangerous consequences. Body fat produces pro-inflammatory signals, raises blood pressure, drives insulin resistance and secretes growth signals that promote cancer.

How Does Fast Food Contribute to Depression and Mental Illness?

The scope of the effects of fast food on the brain is not yet known, but based on what we know so far, we greatly underestimate these effects, especially the effects on the brains of children. A single episode of elevated blood sugar has been shown to have negative effects on attention and memory. Eating commercial baked goods and fast food is primary causative factor in mental illness and major depression, and brain imaging studies have suggested that elevated blood sugar impairs the brain’s ability to process emotion. For young children, fast food, candy and soda consumption are linked to behavior and attention problems, and depression and suicide in teens. Mental illness now affects one in five in America, and our poor diet is at the foundation of this epidemic.

Why Isn’t This Information More Widely Known?

Some reasons why we are ignoring the devastating health crisis that is right before our eyes is that; we believe food industry propaganda and easily misled by conflicting information; we develop a desire for become addicted to these toxic foods; and we believe in the heavily promoted dogma that modern medical care can save us from nutritional-induced tragedies.

Food companies have discovered how to feed the most people in the most efficient and cost-effective manner to maximize profits. While the marketing spin promotes moderate consumption as safe, and encouraged by social norms. Scientific studies demonstrate otherwise.

**REGISTER for Dr. Fuhrman’s upcoming webinar on this topic, Fast Food Genocide: How Processed Food Are Killing Us and What We Can Do About It. Watch live or recorded! Register now >**

Joel Fuhrman, M.D.Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease. Visit him at DrFuhrman.com

Eating for Endurance

Nancy Clark, RD/26 March 2018/ All MFN blog/

What’s the best way to fuel for the Boston Marathon?

Should I eat a high fat diet to train my body to burn more fat and less glucose?

What percent of calories should come from carbohydrate? protein? fat?

When it comes to eating for endurance, today’s athletes are confronted with two opposing views:

Eat a traditional carbohydrate-based sports diet, or
Eat a fat-based diet that severely limits carbohydrate intake.

What should an eager marathoner, Ironman triathlete, or other endurance athlete eat to perform better? Here’s what you want to know about eating for endurance, based on the Joint Position Statement on Nutrition for Athletic Performance from the American College of Sports Medicine, the Academy of Nutrition and Dietietics, and Dietitians of Canada.

1. Eat enough calories.

Most athletes need ~21 calories per pound (45 cal/kg) of lean body mass (LBM). That means, if you weigh 150 pounds and have 10% body fat, your LBM is 135 pounds and you require about 2,800 calories a day. That said, energy needs vary from person to person, depending on how fidgety you are, how much you sit in front of a computer, how much muscle you have, etc.. Hence, your body is actually your best calorie counter—more accurate than any formula or app!

If you are eat intuitively—that is, you eat when you feel hunger and stop when feel content, you are likely eating enough. If you find yourself stopping eating just because you think you should, if you are feeling hungry all the time and are losing weight, you want to eat larger portions. Underfueling is a needless way to hurt your performance.

If you can’t tell when enough food is enough, wait 10 to 20 minutes after eating and then, mindfully ask yourself “Does my body need more fuel?” Athletes who routinely stop eating just because they have finished their packet of oatmeal (or other pre-portioned allotment) can easily be under-fueled. Even dieting athletes want to surround their workouts with fuel. Their plan should be to eat enough during the day to fuel-up and refule from workouts, and then eat just a little bit less at the end of the day, to lose weight when they are sleeping.

2. Eat enough carbohydrates.

According to the Position Statement on Nutrition for Athletic Performance, the optimal amount of carbohydrate on a day with one hour of training is 5 to 7 grams carb/kg. On high volume days, you need about 6 to 12 g carb/kg body weight. For a 150-pound (68 kg) athlete, this comes to about 350 to 800 grams carb a day—the equivalent of about one to two (1-lb) boxes of uncooked pasta (1,400 to 3,200 calories). That’s more than many of today’s (carb-phobic) athletes consume. You want to make grains the foundation of each meal : choose more oatmeal for breakfast; more sandwiches at lunch; and more rice at dinner to get three times more calories from carbs than from protein. Otherwise, you set the stage for needless fatigue.

3. Eat adequate—but not excess—protein.

Protein needs for athletes range from 1.4 g/kg (for mature athletes) to 2.0 g protein/kg (for athletes building muscle or dieting to lose fat). For a 150-pound (68 kg) athlete, protein needs come to about 95 to 135 grams protein per day, or 25 to 35 grams protein four times a day. That means 3 eggs at breakfast (with the bowl of oatmeal), a hearty sandwich at lunch, portion of lean meat/fish/chicken at dinner, and cottage cheese (with fruit) for an afternoon or bedtime snack.

For vegetarians, generous servings of beans, hummus, nuts and tofu at every meal can do the job; a light sprinkling of beans on a lunchtime salad will not. By consuming protein every 3 to 5 hours, you will optimize muscle building and deter muscle breakdown.

4. Fill in the calorie-gap with fat.

Include in each meal and snack some health-promoting, anti-inflammatory fat: nuts, salmon, peanut butter, avocado, olive oil, etc.. Fat adds flavor, offers satiety, and is a source of fuel for endurance exercise. Training your muscles to burn more fat for fuel happens when you do long, steady “fat burning” exercise. By burning more fat, you burn less of the limited carbohydrate (muscle glycogen, blood glucose) stores. You will have greater endurance and avoid or delay hitting the wall.

A (tougher) way to train your body to burn more fat is to severely limit your carbohydrate intake and push your fat intake to 70% of your calories. That could be 1,800 calories (185 g) of fat per day. This very high fat diet produces ketones and forces the body to burn ketones for fuel. Keto-athletes endure a tough, 3 to 4 week adaptation period as their bodies transition to burning fat, not glucose, for fuel. While some keto-athletes rave about how great they feel when in ketosis, the sports nutrition literature, to date, reports little or no performance benefits from a ketogenic sports diet. It might nix sugar binges, but it’s unlikely to make you a better athlete.

5. Drink enough fluids.

A simple way to determine if you are drinking enough fluid is to monitor your urine. You should be voiding dilute, light colored urine every 2 to 4 hours. (Exception: athletes who take vitamin supplements tend to have dark colored urine.) You want to learn your sweat rate, so you can strategize how to prevent dehydration. Weigh yourself nude before and after one hour of race-pace exercise, during which you drink nothing. A one-pound drop pre- to post-exercise equates to 16 ounces of sweat loss. Losing two pounds of sweat in an hour equates to 32 ounces (1 quart). To prevent that loss, you should target drinking 8 ounces of water or sports drink every 15 minutes. Athletes who pre-plan their fluid intake tend to hydrate better than those who “wing it.”

**6. Consume enough calories during extended exercise.**

If you will be exercising for longer than 60 to 90 minutes, you want to target 40 to 80 calories (10 to 20 g) of carbohydrate every 20 minutes (120 to 240 calories per hour), starting after the first hour (which gets fueled by your pre-exercise food). If you are an Ironman triathlete, long distance cyclist or ultra-athlete who exercises for more than three hours, you want to target up to 360 calories per hour. The key is to practice event-day fueling during the months that lead up to the event. By training your gut to tolerate the fuel, you’ll be able to enjoy the event without fretting about running out of energy.

The bottom line:

If you are going to train, you might as well get the most out of your workouts. Performance improves with a good fueling plan. Eat wisely and enjoy your high energy!

Reference:

Thomas, T at el. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada and the American College of Sports Medicine: Nutrition and Athletic Performance. J Academy of Nutri and Dietetics. 2016; 116 (3):501-28

How To Gain Weight Healthfully

Nancy Clark, RD/1 March 2018/ All MFN blog/

“No matter what I eat, I can’t seem to gain weight…”

“What about those weight gain powders … do they work?”

“How much more protein should I eat to help me bulk up?”

Although two-thirds of Americans are overweight or obese, a handful of skinny people—including many athletes—feel very frustrated by their seeming inability to gain weight. Their struggle to bulk up is on par with that of over-fat folks who work hard to lose weight. Add in rigorous training for a marathon, soccer team, or other sport, and scrawny athletes can feel at a disadvantage, fearing that no matter how much they eat, they’ll get even skinnier.

Clearly, genetics plays a powerful role in why some athletes have so much trouble not only gaining weight, but also maintaining any weight they manage to add. “Hard gainers” tend to be fidgety. They rarely sit, to say nothing of sit still. They are constantly puttering around, or when sitting, they are tapping their fingers, swinging their legs, twirling their hair, and shifting around in the chair. All of these activities burn calories that commonly end up in the midriff of calmer people who can sit motionless for hours.

If you are a hard gainer, you might have been told that consuming an extra 500 to 1,000 calories per day will lead to gaining 1 to 2 pounds per week. Unfortunately, Nature often confounds this mathematical approach. For example, in a weight gain study where the subjects were overfed by 1,000 calories per day for 100 days, some subjects gained only 9 pounds, whereas others gained 29 pounds (1).

How could that be? The answer likely relates to Non-Exercise Activity Thermogenesis (N.E.A.T.), the technical term for spontaneous movements that naturally occur in fidgety people. When you overfeed a fidgety person, they can become even more active, as if Nature wants them to burn off those calories.

Seven Tips to Gain Weight Healthfully

Fret not; even very lean people can gain some weight when they systematically enhance their diet. Although they cannot change their genetics and their tendency to fidget, they can boost their calorie intake. If you are a scrawny athlete, have a teenage eating-machine who wants to weigh more, or are trying to bulk up for football, here are some tips to help you gain weight healthfully.

1. Eat consistently. Do NOT skip meals; doing so means you’ll miss out on important calories needed to reach your goal. Every day, enjoy a breakfast, an early lunch, a later lunch, dinner, and a bedtime meal. This might mean breakfast at 7:00, lunch at 11:00, second lunch at 3:00, dinner at 7:00, and a protein-rich bedtime snack at 10:00.

2. Eat larger than normal portions. Instead of having one sandwich for lunch, have two. Enjoy a taller glass of milk, bigger bowl of cereal, and larger piece of fruit.

3. Select higher calorie foods. Read food labels to discover which wholesome foods offer more calories. For example, cranapple juice has more calories than orange juice (170 vs. 110 calories per 8 ounces); granola has more calories than Cheerios (500 vs. 100 calories per cup); corn more calories than green beans (140 vs. 40 calories per cup).

4. Drink lots of 100% fruit juice and low-fat (chocolate) milk. Instead of quenching your thirst with water, choose calorie-containing fluids. By having milk with each meal, you can easily add 300 to 600 wholesome calories a day. One high school soccer player gained 13 pounds over the summer by simply quenching his thirst with six glasses of cranapple juice instead of water (1,000 vs. 0 calories). He consumed the fluid he needed (juice is 98% water) and bonus of more carbohydrates to refuel his depleted muscles, plus a good dose of vitamin C to enhance healing.

5. Enjoy peanut butter, nuts, avocado, and olive oil. These foods are high in (health-promoting) fats. They’re a positive addition to your sports diet; they help knock down inflammation. Their high fat content means they’re calorie-dense. To boost good fats, add almonds to cereal & salads, spread extra peanut butter on the PB&J sandwich, dive into the guacamole with baked chips, and add extra olive oil dressing to your salads. That’s an easy extra 500+ calories/day.

6. Do strengthening exercise as well as some cardio. Weight lifting and push-ups stimulate muscle growth so that you bulk-up instead of fatten up. Plus, exercise stimulates your appetite and, sooner or later, you’ll want to eat more. Exercise also increases thirst, so you will want to drink extra juices and caloric fluids.

Take note: You will not build bigger muscles by eating extra protein. While you want to target a protein-rich food with 20-30 grams protein at each meal (and 10-15/snack), having more will not build bigger muscles. Resistance exercise builds muscles. To have the energy to do the muscle-building training, you need extra carbs. That’s where drinking more 100% fruit juice and chocolate milk offer benefits; you’ll be better-fueled & better able to lift heavier weights.

7. Don’t bother to buy expensive weight gain drinks. A hefty PB&J with a tall glass of chocolate milk adds about 1,000 calories for about $2.00. You would spend at least $10 get-ting those calories from Muscle Milk.

Conclusion: By following these tips, you should see progress, but honor your genetics. Most people do gain weight with age as they become less active, more mellow, and have more time to eat. Granted, that information doesn’t help you today, but it offers optimism (or a warning) for your future physique!

References:

1) Bouchard, C. 1990. Heredity and the path to overweight and obesity. Med Sci Sports Exerc 23(3):285-291.

Why Is Today’s Society So Unhealthy?

Connie Stoltz-McDonald/7 February 2018/ All MFN blog/

As we look back, our ancestors never worried about their thyroid, gut, heart disease, cancer or any of the issues that are top of mind today. So why are they popping up everywhere? It all comes down to they simply ate real food. Seasonal fruits & vegetables, grains, eggs and dairy. They avoided fake foods, such as crackers, cookies and frosted cereals.

In reality, half of Americans are over indulging and the other half are on a diet. So, why are we not taking care of ourselves? Why are we overweight, ill and struggling every day? The news changes our health regimen daily. One day, we’re told to cut out carbohydrates, then the next, cut out fat or reduce the amount of daily protein. I can see why, as a society, we are confused and just let go. Our lives are busy and the average consumer doesn’t have time to research what’s good and bad for them. Looking back, our ancestors got their nutrition through killing large mammals and picking fruits and nuts. Studies have shown that our body is better acquainted with consuming meat and natural sugars and has a hard time digesting fiber. Therefore, not obtaining the protein, fats, carbohydrates, fiber or any other nutrients that we need to maintain our bodies at optimal levels.

We are no longer growing our own food, but obtaining our meals through the drive-thru because of convenience and time. Let’s put it this way: our bodies can’t breakdown large amounts of vegetable oil and our bodies were not meant to sit all day. I remember growing up thinking, “when do we actually get a break?” When you live a life of a farmer, there is no downtime. It seemed from the moment I got off the bus until it was time to go to bed, I was on my feet. We didn’t have computer games, smart phones and only had a couple channels to watch on TV — which seemed like all there was to watch was news or cooking shows!

So, what is the root of such a growing concern? It’s simply poor lifestyle choices…. We overindulge, choose the wrong foods, we’re less active, and let stress and anxiety take over our lives. What can we do today to take action on our health?

Tips to Maintain a Simple Healthy Action Plan

ABM – Always be moving. Keep physically active, whether it’s getting away from the office chair for a walk downstairs or going outside during lunch to gain some much needed sunlight. Just doing stretches can get the blood flowing and revive that inner energy to regain focus. Strive for 30 minutes of exercise 3-5 days a week. Find an exercise you enjoy so you’ll maintain a regimen

Get cooking. Be creative in the kitchen and make your own meals at home. This way you incorporate the ingredients and you stay healthier. Plus it’s fun, gets you on your feet and a great family activity.

Choosing the right foods. Always shop around the outside perimeter of the store, as this is where you’ll find the wholesome goodness of fruits, vegetables, meats, dairy and unprocessed, preservative-free foods. Keep in mind that dietary guidelines have changed to where half our plate should be filled with fruit and vegetables. Plus, you never have a label to investigate prior to purchasing as there is only one ingredient. Keep in mind, to benefit from satiety, wait 20 minutes after your meal to cue into your hunger levels.

All in moderation. Keep a balance in your daily regimen. There will be days when life happens and you can’t maintain the My Plate routine along with the daily exercise plan. That’s OK. Keep yourself in check knowing you’ll get back on the wagon tomorrow. Life is all about things coming at you when you least expect it. That’s why you have a backup plan to slide the goal to the next day and never overwhelm yourself with anything, especially something that is out of your hands. This will, in turn, help alleviate the stress and anxiety that you get if you’re a perfectionist. I’m one to always have everything in check, but I’m realistic and know there will be surprises, so let yourself go if everything doesn’t fall into place.

Live a simple life. Sometimes going off the grid isn’t a bad thing. One thing I’ve learned is to not let social media rule our lives. It can consume our time, lead to insecurity, stress and anxiety. Limit your time on electronics and spend quality time with family and friends. Take time to eat at the dinner table while discussing how the day went or what’s new in your lives. It seems we get so wrapped up in what others are doing, thinking, feeling and finding out what’s going on with our family and friends through a Facebook post. Remember, you’re not living their life and they aren’t living yours, so take care of yourself first! Otherwise, you can’t be there to help others.

Meditation. It may seem silly at first, or make you feel out of place, but studies have proven the effectiveness of certain breathing methods and poses that will relax you and alleviate some of that stress from your day. Try sitting by yourself for 10 minutes and just take a breath in. Breathe through your nose to let go of all the chaos that may have happened throughout the day. You can also incorporate yoga, which aids in the meditation process.

Let’s not forget sleep! Strive for 6-8 hours. Remember, your body is like a machine, you need to keep it oiled and in tip-top shape for it to run at it’s best. If you’re not getting enough sleep, you’re causing oxidative damage, which causes your cells and DNA to build up, reducing our longevity.

Laugh. Amazingly enough. if you laugh for 10-15 minutes per day, you can burn up to 40 calories! So why aren’t you laughing?! It helps release endorphins to help you feel relaxed. Spend time with family and friends to gain the much needed benefit of humor and in-person social interaction.

In summary, living longer depends on how we react, what we choose to do, and how we live. Revive yourself from the inside with wiser food choices, letting go of the things beyond your control, and finding ways to alleviate stress in our lives. All you have to do is remind yourself of the simple life that our grandparents lived and how much of a difference it made in longevity and happiness.

As always consult your health professional. I hope this article finds you in good health.

Connie Stoltz-McDonald is an Integrative Nutrition-Certified Health Coach, CPT, Wellness Educator, Blogger and Author. From her passion for writing, she is excited to announce her first book release titled “Healthy Lifestyle- The inside secrets to transforming your body and health.” If you’d like to get a copy, you can connect with her at her website, www.lifestylehealthmentor.com, Facebook, Twitter, LinkedIn, or Instagram.

Sources:
www.scientificamerican.com
www.offthegridnews.com
www.mindbodygreen.com

Living a Happy Life with Fibromyalgia or Chronic Pain

Henry Moore/1 February 2018/ All MFN blog/

A chronic pain diagnosis can sneak up from nowhere, throwing our lives into a whirlwind. You might feel overwhelmed, depressed or even terrified. Perhaps you’re uncertain of where to turn for help coping with your symptoms.

If this sounds familiar, you’re not alone. Hundreds of millions of people live with chronic pain. In the United States alone, tens of millions of individuals suffer from fibromyalgia – just one of many conditions which can cause long-term pain. If you have fibromyalgia, chronic pain or any associated conditions, keep reading for some ideas for how to improve your quality of life.

Maintaining a healthy diet is one of the simplest – yet quickest – ways to manage chronic pain and other troubling symptoms of fibromyalgia. Simply put, when you feed your body wholesome, nutritious foods, you’re giving it the fuel it needs for healthy organ function, fighting off illness, and even healing. Enhancing your diet with a few select superfoods can help with fibromyalgia pain, and you probably already have many of them in your kitchen! Red grapes have a compound called resveratrol that helps keep muscle tissue strong, ginger and cherries have natural pain-fighting properties, and fish rich in omega-3s gives your brain the boost it needs to send relief to tender spots when they send pain signals. Similarly, there are lots of foods that have anti-inflammatory properties – like whole grains, leafy greens, tomatoes and olive oil – which should replace all or most of the processed foods consumed by fibromyalgia sufferers. That’s because the additives in processed foods may increase pain sensitivity, making physical discomfort feel even worse. If you’re enduring chronic pain, it’s critical that you take a look at your diet, and choose nutritious, natural foods over unhealthy, high-processed foods as often as you can.

Despite our best efforts to take care of ourselves, when your health starts to feel out of control, you might find yourself frustrated with your physical body and your life. During these difficult times, experts say it can be helpful to refocus your mind.

Author and transformational coach Sean Meshorer recommends redefining the things that make us happy. Meshorer can speak to the power of the bliss method from his own personal experiences living with chronic pain. This allowed him to develop “the bliss method” which completely focuses on finding happiness, contentment and peace – all without depending upon external factors.

By refocusing our minds to search for happiness within ourselves, we can better cope with our chronic pain. These techniques also help ease the depression, anxiety and fear that can come with our diagnosis, and help keep us from practicing harmful coping methods – like turning to our prescription pain pills – for comfort. In fact, you may be able to ease up some of your pain naturally via vitamins B, C, and D. If you aren’t already taking a vitamin supplement, it is worth looking into. There are several trusted brands, such as Ceregumil Vitamix Plus, which are great for joint pain.

Dr. Joseph Christiano, ND, CNC, agrees. “Refocusing the brain, using mental imagery, and practicing [breathwork],” he says, “are a few of the many techniques used for managing chronic pain in order to thrive while moving closer to pain-free living.”

Once you begin shifting your attention to the positive aspects of your life, you’ll find it easier to tap into your own potential for happiness. This is a skill that can be learned. Start by getting a piece of paper and a pencil, and creating a list of all the enjoyable things you can still do despite your chronic pain diagnosis.

Your personal reasons to stay positive might include having a warm, loving relationship or finding creative, new ways to serve humanity. Write down your favorite show to binge on Netflix. Be sure to include relaxing in bed with high thread count sheets, if that’s your ideal day. Whatever it is that brings you joy, write it down – and don’t be afraid to get creative. These are the things that will give you hope each day.

Many people also find a sense of calm, purpose and well-being by helping others. For some of us, that could mean blogging about our illness, with the underlying hope that others with chronic pain will realize they’re not alone. If you’re not a writer, you can still help others by donating to your favorite charity or finding other ways to help those in need.

Why are these techniques so powerful? The answer might have something to do with cortisol, the stress hormone. Many doctors now screen chronic pain patients for cortisol levels. Cortisol levels can be naturally reduced through lowering environmental stress factors. Activities such as yoga, meditation and massage also help by stimulating a calming neurotransmitter in the brain.

As you can see, there are various ways to cultivate hope and happiness, even with a chronic pain diagnosis. From yoga to bodywork, from acupuncture to meditation, try a variety of practices until you find something that works for you. As always, check with your doctor before trying any new activity or holistic treatment method. You’ll want to make sure it is safe for your personal condition, and that it won’t contribute to further pain or illness.

If you have a chronic pain diagnosis, you can still live a blissful life. Don’t give up; use the tips above to train your brain. Keep searching for things that bring you joy. Your body and mind will thank you for it.

Henry Moore is the co-creator of FitWellTraveler. The site blends two of his favorite subjects (travel and health) to provide readers with information about how to get the most out of both.