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"Roizen, Michael F"
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What to eat when : a strategic plan to improve your health & life through food
\"This guide reveals how to use food to enhance our personal and professional lives--and increase longevity to boot\"-- Provided by publisher.
Book
A Web-Based Mindfulness Stress Management Program in a Corporate Call Center
OBJECTIVE:The objective of this study is to determine the effectiveness of an 8-week web-based, mindfulness stress management program (WSM) in a corporate call center and added benefit of group support.
METHODS:One hundred sixty-one participants were randomized to WSM, WSM with group support, WSM with group and expert clinical support, or wait-list control. Perceived stress, burnout, emotional and psychological well-being, mindfulness, and productivity were measured at baseline, weeks 8 and 16, and 1 year.
RESULTS:Online usage was low with participants favoring CD use and group practice. All active groups demonstrated significant reductions in perceived stress and increases in emotional and psychological well-being compared with control. Group support improved participation, engagement, and outcomes.
CONCLUSION:A self-directed mindfulness program with group practice and support can provide an affordable, effective, and scalable workplace stress management solution. Engagement may also benefit from combining web-based and traditional CD delivery.
Journal Article
Mitigating preventable chronic disease: Progress report of the Cleveland Clinic's Lifestyle 180 program
Background
Poor lifestyle choices are key in development and progression of preventable chronic diseases. The purpose of the study was to design and test a program to mitigate the physical and fiscal consequences of chronic diseases.
Methods
Here we report the outcomes for 429 participants with one or more chronic conditions, including obesity, hypertension, hyperlipidemia and diabetes mellitus, many of whom had failed traditional disease management programs, who enrolled into a comprehensive lifestyle intervention. The Lifestyle 180 program integrates nutrition, physical activity and stress management interventions and was conducted at the Wellness Institute of the Cleveland Clinic, United States. An intensive 6 week immersion course, with 8 hours of group instruction per week, was followed by 3 follow-up, 4 hour-long sessions over the course of 6 months.
Results
Changes in biometric (weight, height, waist circumference, resting heart rate and blood pressure) and laboratory variables (fasting lipid panel, blood glucose, insulin, hemoglobin A1c, ultra sensitive C-reactive protein) at 6 months were compared with baseline (pre-post analysis). At week 30, biometric and laboratory data were available for 244 (57%) and 299 (70%) participants, respectively. These had a mean ± SD reduction in weight (6.8 ± 6.9 kg, P < 0.001), waist circumference (6.1 ± 7.3 cm, P < 0.001), glucose (4.5 ± 29.6 mg/dL or 0.25 ± 1.64 mmol/L, P = 0.009), triglycerides (26.4 ± 58.5 mg/dL or 0.30 ± 0.66 mmol/L, P < 0.001), low-density lipoprotein cholesterol (LDL) (7.9 ± 25.1 mg/dL or 0.2 ± 0.65 mmol/L, P < 0.001), hemoglobin A1c (HgbA1c) (0.20 ± 0.64%, P = 0.001), insulin (3.8 ± 11 microU/ml or 26.6 ± 76.4 ρmol, P < 0.001) and ultra sensitive C-reactive protein (US - CRP) (0.9 ± 4.8 mg/dL or 7.3 ± 40.2 nmol/L, P = 0.012), an increase in mean high-density lipoprotein cholesterol (HDL) (3.7 ± 8.4 mg/dL or 0.1 ± 0.22, P < 0.001), and decreased use of medications.
Conclusion
Implementation of a comprehensive lifestyle modification program among adults with common chronic conditions results in significant and clinically meaningful improvements in biometric and laboratory outcomes after 6 months.
Journal Article
Boost your brain : the new art and science behind enhanced brain performance
An internationally recognized neurologist presents a revolutionary brain-optimization program that, despite research to the contrary, proves that as humans get older, they can actually get smarter and increase their brain speed.
Book
“Living Well with Chronic Pain”: Integrative Pain Management via Shared Medical Appointments
Abstract
Objective
To evaluate the effectiveness of a multidisciplinary, nonpharmacological, integrative approach that uses shared medical appointments to improve health-related quality of life and reduce opioid medication use in patients with chronic pain.
Design
This is a retrospective, pre–post review of “Living Well with Chronic Pain” shared medical appointments (August 2016 through May 2018).
Setting
The appointments included eight 3-hour-long visits held once per week at an outpatient wellness facility.
Subjects
Patients with chronic, non–cancer-related pain.
Methods
Patients received evaluation and evidence-based therapies from a team of integrative and lifestyle medicine professionals, as well as education about nonpharmacological therapeutic approaches, the etiology of pain, and the relationship of pain to lifestyle factors. Experiential elements focused on the relaxation techniques of meditation, yoga, breathing, and hypnotherapy, while patients also received acupuncture, acupressure, massage, cognitive behavioral therapy, and chiropractic education. Patients self-reported data via the Patient-Reported Outcomes Measurement Information System (PROMIS-57) standardized questionnaire. Use of opioid medications was evaluated in morphine milligram equivalents.
Results
A total of 178 participants completed the PROMIS-57 questionnaire at the first and the last visits. Statistically significant improvements in all domains (Physical Functioning, Anxiety, Depression, Fatigue, Social Roles, Pain Interference, and Sleep Disturbance) were observed (P < 0.001) between the pre-intervention (visit 1) and post-intervention (visit 8) scores. Average opioid use decreased nonsignificantly over the 8-week intervention, but the lower rate of opioid use was not sustained at 6 and 12 months’ follow-up.
Conclusions
Patients suffering from chronic pain who participated in a multidisciplinary, nonpharmacological treatment approach delivered via shared medical appointments experienced reduced pain and improved measures of physical, mental, and social health without increased use of opioid pain medications.
Journal Article
How I do it: the patient who asks about lifestyle choices to prevent heart disease
Most do not realize that looking old (having wrinkles), stroke, impotence, most memory loss, and heart attacks are part of the same process: arterial aging.1 So no matter how motivated my typical patient seems by the phrasing of the questions, I review with each patient the five steps of arterial aging (with a heart attack video, whether I am speaking with one person or to a group of 14 000): injury, immediate repair with a fatty streak, chronic inflammation, acute inflammation and rupture, and clot formation. Just 6 months ago (December 4, 2012 to be specific), an international study indicated those individuals (more than 31 000 men and women of average age 66 in this study) who chose whole grains, fruits, veggies, nuts, and fish over meat, eggs, and simple carbs, had a 35% reduction in cardiac death rates over 5 years.6 That is a 35% reduction in addition to the decrease from surgery and optimal medical management. Since four factors control over 50% of heart disease,1,7 we start with these: KISS YOUR BUTT GOODBYE No, we are not talking about weight, but about tobacco, which is still the leading cause of heart disease and strokes (not to mention cancer).
Journal Article
Use of the BIS Monitor to Detect Onset of Naturally Occurring Sleep
Inadvertent sleep episodes are a recognized complication of sleep deprivation. Although such events can be life threatening, no system currently exists to detect and prevent sleep onset. Because sleep shares electroencephalographic similarities with the anesthetized state, we hypothesized that the BIS monitor, a currently available EEG-based monitor of anesthetic depth, would detect the onset of physiologic sleep. To test our hypothesis, we monitored volunteers during the transition from waking to sleep.
Non-medicated volunteers were asked to lie down in a dark room for 30-minutes and fall asleep while attached to a BIS monitor located outside the room. A laptop computer was used to generate an audio tone inside the room. Speaker volume was adjusted to the lowest level detectable by the awake subject. Testing was begun by activating a computer to play a tone at random intervals. The subject was instructed to click a mouse connected to the computer upon hearing the tone to verify wakefulness. The session was terminated upon loss of response to three consecutive tones or after 30 minutes. Subjects were questioned afterwards regarding their perceptions of sleep during testing.
11 out of 28 self-described good sleepers could not sleep under testing conditions. BIS values for the remaining 17 fell from 96.4 +/- 2.1 to 86.5 +/- 0.79 (p < 0.01) upon sleep onset. All subjects responded to audio stimuli at BIS values >90, and were asleep either by subjective or objective report at BIS values <80. Three subjects retained the mouse-click response despite low BIS scores and subjective descriptions of sleep.
Although variability in the BIS value marking sleep onset was noted, the BIS monitor detected all episodes of sleep onset in our testing regimen. We conclude that a threshold BIS value can be defined to allow the BIS monitor to detect sleep onset.
Journal Article