RLMI Blog

Lifestyle Medicine Week: Avoiding Toxic Substances

Welcome to Day 3 of Lifestyle Medicine Week.

Today we visit another Lifestyle Medicine pillar: avoidance of risky substances. While it may seem obvious, it is extremely important to acknowledge the harm that is caused by opioids, alcohol, tobacco, vaping, and other inhaled, injected, and ingested non-food substances.

If you are experiencing a substance addiction, please reach out to your medical provider or the national Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) 1-800-662-4357. You can also find a list of resources for individuals and families by clicking here.

Avoid toxic substances

While you may be among those fortunate enough not to be under the control of addiction, we all need to recognize that there are many toxic substances that we are exposed to in our environment and food supply that are not under our direct control. Let’s all consider what role we can play in helping to insure that there is clean air, clean water, and uncontaminated food for us and for future generations.

Stay well,

Ted D. Barnett, MD, FACLM
Partner, Borg and Ide Imaging
Board Member, American College of Lifestyle Medicine
Founder and CEO, Rochester Lifestyle Medicine Group
Founding President, Rochester Lifestyle Medicine Institute
Rochester Lifestyle Medicine Institute is proud to support the critical work of the American College of Lifestyle Medicine (ACLM). ACLM recognizes six pillars of Lifestyle Medicine: the use of a whole food, plant-predominant dietary lifestyle; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection. As you can see from our Wellness Wheel, we have added 3 pillars of our own: spending time outdoors, seeking purpose, and finding joy.

Lifestyle Medicine Week: Fostering Relationships

Welcome to Day 2 of Lifestyle Medicine Week!

Today, on Memorial Day, we come together to celebrate those who have dedicated and sacrificed their lives in the service of our country and the freedoms we cherish. We encourage you to please include in your celebrations someone who may be feeling left out, especially someone who has made sacrifices for the greater good.

We urge you to adapt to the new and creative ways of gathering together necessitated by the current pandemic. We humans are social creatures and relationships are central to our lives—we need connections to thrive and survive.

Our health depends on having others around us!

Yours in connectedness,

Ted D. Barnett, MD, FACLM
Partner, Borg and Ide Imaging
Board Member, American College of Lifestyle Medicine
Founder and CEO, Rochester Lifestyle Medicine Group
Founding President, Rochester Lifestyle Medicine Institute
Rochester Lifestyle Medicine Institute is proud to support the critical work of the American College of Lifestyle Medicine (ACLM). ACLM recognizes six pillars of Lifestyle Medicine: the use of a whole food, plant-predominant dietary lifestyle; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection. As you can see from our Wellness Wheel, we have added 3 pillars of our own: spending time outdoors, seeking purpose, and finding joy.

Happy Lifestyle Medicine Week!

Welcome to the first day of Lifestyle Medicine Week! Rochester Lifestyle Medicine Institute is proud to support the critical work of the American College of Lifestyle Medicine (ACLM)!

ACLM recognizes six pillars of Lifestyle Medicine: the use of a whole food, plant-predominant dietary lifestyle; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection.

Over the course of the next week, we will acknowledge each pillar separately. We will then explore the three additional pillars that have been added by RLMI: spending time outdoors, seeking purpose, and finding joy.

See you tomorrow!

Stay well,

Ted D. Barnett, MD, FACLM
Partner, Borg and Ide Imaging
Board Member, American College of Lifestyle Medicine
Founder and CEO, Rochester Lifestyle Medicine Group
Founding President, Rochester Lifestyle Medicine Institute

Plant-Based Shopping During Covid and Beyond!

The current crisis

We’ve all been asked to stay home except for essential jobs and shopping for essentials, which includes food. Most people can get their supermarket trips down to once a week with a little planning.

A harrowing experience?

That’s how a friend described food shopping at this time. It’s unsettling to feel that you are taking your life in your hands, just by going to the supermarket! Wearing masks, constant wipe-downs, the “supermarket swerve” when someone avoids you with her cart—these are not what we usually expect but we’ve accepted them. It’s serious business at the grocery store these days.

Focus on what’s essential

With restricted shopping during the epidemic, you need to stock up on foods that keep well in storage: rice and other grains, beans both dried and canned, pasta, and frozen vegetables. That’s right: the very foods that went missing off the shelves in the first couple weeks of the lockdown. I remember thinking: “Wow! These people are making pretty good choices!” There’s something about a crisis that brings out people’s survival skills.

A little heat is essential!

An image I’ll never forget, from one of my first post-epidemic supermarket trips, is a very satisfied-looking young man approaching the cashier, with one large bottle of Frank’s Hot Sauce in each hand. I wondered: Did he think Frank’s will protect him from the virus? Or is life just not worth living without it?

What’s the plan?

Eventually, even the abnormal becomes normalized, and you start to see food shopping during COVID for what it always has been: an adventure and an important mission. So how to approach it?

Plan. Sit down, looking at the calendar to see what days you have least and most time to cook, and choose recipes for dinner for the week. (Where to find recipes is “everywhere,” but also a topic for another day.) Draw up a list of ingredients to buy for those meals, noting when the recipe calls for a staple you already have (like soy sauce or balsamic vinegar). Review your staples while you are at it, to see if you are running out of any. Don’t forget breakfast and lunch needs, like oatmeal, bread, and peanut butter. Stretch out your produce purchases by choosing recipes that will allow you to use a large vegetable like a head of cauliflower in two different entrées during the week.

What should you buy?

Well, start out with those items that went missing in the first panicked weeks of the coronavirus. Those people knew what they were doing.

Rice, dry beans and dry pasta last indefinitely on pantry shelves in their original packages, or in carefully sealed containers once opened. Canned goods are a time-honored way of surviving a crisis: canned beans are great, and canned vegetables can be good in a pinch (rinse both to reduce sodium). Canned tomato products (crushed, diced, sauce, paste) are indispensable. Some other canned and jarred products add a gourmet touch to your cooking: jarred roasted red peppers, capers, canned artichoke hearts. Frozen vegetables are nutritionally equivalent to fresh, but choose varieties with no added sauces (which contain lots of sugar, salt, and oil).

Limiting factors

What sends a person to the grocery store when they run out of it? For most people, plant-based or no, it’s probably bread, milk, and lettuce. But bread can be stored in the freezer; and plant-based milk comes in aseptic (juicebox-type shelf-stable) packages that can stay on your pantry shelf till opened. That leaves lettuce. Shelf-stable and frozen items, along with long-lasting fresh produce, can stretch out the time between shopping trips, making salad greens the limiting factor for plant-based shopping.

Getting fresh

But salad greens aren’t the only fresh produce you want in your kitchen. Buy a variety of whatever fruits and veggies are your favorites, and don’t forget dark leafy greens like kale. [See follow-up entry, “Save Your Veggies,” for more specific advice.] But some vegetables have a special role during an extended emergency.

At a time when your trips to the grocery store are widely spaced and could be curtailed at any time by a new directive, stock up on vegetables that last for weeks in their preferred storage space: onions and garlic (on the counter), carrots and cabbage (in the fridge), and potatoes (in a dark pantry or drawer). These vegetables also happen to be economical, and versatile as building blocks for a variety of meals when you add canned tomatoes, beans, and ethnic herbs and spices. Put them in a curry or a stir-fry; add Mexican or Middle Eastern spices for a soup or stew. The possibilities are endless!

If you do run out of lettuce, you can shred or slice cabbage (red, green, or both) along with carrots for a delicious salad. With cabbage, alway pull away leaves from the outside rather than slicing into the head, to keep the rest of the head crisp and unspoiled. Don’t forget fruit. Oranges and apples are good keepers: store at room temperature, but refrigeration can lengthen their freshness if you have room.

In bad times and in good …

We can be well nourished even in a time of shortages and restrictions. And guidelines about what foods are good for us, and how to use them to the fullest, can serve us well even when this crisis has passed.

Bonus tips for COVID shopping

No, You Don’t Need To Disinfect Your Groceries. But Here’s How To Shop Safely.
An excellent article from NPR with advice from scientists:
Click here to learn how to shop safely!

Be well!

Save Your Veggies

“Food Network star has advice on storing, using quick to spoil vegetables”
by Jeanne Muchnick, Rockland/Westchester Journal News; published April 7, 2020, found at lohud.com.

[This article was picked up by USA Today and appeared in the Rochester Democrat and Chronicle on Friday, April 17, 2020 under the title “Save your veggies.”]

Food shopping during the coronavirus takes more plotting and planning — and buying in bulk — so what do you do with the 5 pounds of tomatoes or carrots you just bought to avoid having to return to the store? Storing and usage can be challenging when it comes to quick-to-spoil vegetables.

Pleasantville native Jessica Tom, a Food Network star, author and food influencer on Instagram, says that, “as crazy as it may sound,” it’s good to inventory what you have. That way, you won’t forget what you bought, which helps cut down on waste.

Her suggestion: Categorize your veggies into groups, i.e. Use now, Later and Latest. Put hardier ingredients towards the back of the fridge and your more fragile ingredients upfront.

A huge haul of veggies — good enough for a week — means greater management. “Each veggie has its own internal clock,” she said. “And it’s your job to eat them before it’s too late.”

Rather than being reactive to spoilage, be proactive and think about what you want to use first. Some rough guidelines follow.

Use me quickly: Use vegetables with high water content and delicate cellular structure ASAP.  That means cucumbers, mushrooms, string beans, snow/snap peas, lettuces and greens. One pointer: When the bag on your lettuce starts to inflate, the cells are degrading and giving off gas.

Monitor me: Most vegetables fall in this middle ground and their longevity will depend on the condition in which they were bought. Watch out for signs they’re about to go bad — wrinkling, browning, soft spots, and should it come to this, mold and sliminess. Items that fall in this category include romaine, eggplant, corn, grape and cherry tomatoes, zucchini, small radishes, fennel, broccoli, cauliflower, kale and bok choy.

Save me (in the fridge): Carrots, turnips, rutabaga, beets, cabbage, large radishes, leeks and kohlrabi are good for weeks.

Save me (in a cool dark place like a cellar or spare fridge): Potatoes, sweet potatoes, winter squashes, onions, shallots, garlic and ginger.

Worth noting: A little browning or mold is no big deal. Just cut that part out, along with any part that has softened or gone bad. If it smells off, just toss it [into the compost] and make sure you’ve learned your lesson.

Jeanne Muchnick covers food and dining. Click here for her most recent articles and follow her latest dining adventures on Instagram @lohud_food.

Being Joyful in Turbulent Times

“Expect the end of the world. Laugh. Laughter is immeasurable. Be joyful though you have considered all the facts.”
Wendell Berry, 1973 From “Manifesto: The Mad Farmer Liberation Front”

“Be joyful though you have considered all the facts!”  How is this possible in a world where so many of the facts we face seem to point us away from joy and toward fear and despair?

The Book of Joy is a beautiful account of a five-day conversation that took place in 2015 between Nobel Peace Prize Laureates the 14th Dalai Lama, Tenzin Gyatso and Bishop Desmond Tutu, on the occasion of the Dalai Lama’s 80th birthday at his home in Dharamshala, India.  The two looked back on their long lives to answer the question: How do we find joy in the face of life’s inevitable suffering?

I encourage you to read The Book of Joy, or listen to the audio version, in order to receive the full benefit of the authors’ profound thoughts on the subject.

“It does not matter whether one is a Buddhist like me, or a Christian like the Archbishop, or any other religion, or no religion at all. From the moment of birth, every human being wants to discover happiness and avoid suffering. No differences in our culture or our education or our religion affect this. From the very core of our being, we simply desire joy and contentment. But so often these feelings are fleeting and hard to find, like a butterfly that lands on us and then flutters away.”– Dalai Lama

The Eight Pillars of Joy

Pillars of the mind:

Perspective
Humility
Humor
Acceptance

Pillars of the Heart:

Forgiveness
Gratitude
Compassion
Generosity

Many of our most successful patients find that they are motivated to stick with their new healthy habits when they consider how the lifestyle changes we ask them to make will not just benefit their own health, but will also help heal our planet and even other people (by setting an example of healthy living). In this way, they are considering the big picture and thinking outside of themselves. Dr. Jane Goodall says, “What you do makes a difference, and you have to decide what kind of difference you want to make.”

Reflect on what you’re grateful to have been given. Allow your mind to step into the shoes of those in need and feel for them. Take pride in the small achievements on the path to your goals. Doing so will help ensure that every day you will have more to celebrate than to regret.

There is a reason that Joy figures so prominently on our Wellness Wheel. Finding joy is key to a well-lived life. With all of the challenges that we will be facing in the days and years to come, try to keep the Eight Pillars in mind whenever you can. I know they help me find joy. Perhaps they will help you too.

With gratitude,
Ted D. Barnett, MD, FACLM

 

Beans: Not Just Food For a Crisis!

Supermarkets in the Time of Coronavirus

On one of my widely-spaced forays to the supermarket since the coronavirus hammer came down, I was happy (and somewhat surprised) to see that people had made good decisions! They had stripped the shelves, or at least made major inroads, in some of my favorite sections of the supermarket, including the dried beans section. Who knew we had such survival skills?

A close up of food Description automatically generated

The New York Times agrees!

On 3/22/20, the Times reported that “amid all the panic shopping, the growing demand for beans has stood out as an especially potent symbol of the anxious and uncertain times. At supermarkets, shoppers are stocking up on canned beans from familiar brands like Goya Foods, as well as thick bags of dry beans that usually lie largely untouched on store shelves.”

Food for any crisis

Dried beans are the ultimate food for a crisis. They store indefinitely, virtually without any risk of being infested or losing nutritional quality, in a sealed or resealed bag or in a glass jar (where they can be quite beautiful on your kitchen counter or pantry shelf). All you need is water to soak them and a source of heat to cook them, to turn them into food.

What other kind of crisis is there?

Hmm. There are other crises brewing that have gone to the back burner now that we’re dealing with an epidemic. Beans help to deal with the planetary climate crisis because, like all plant foods, they are low on the food chain and use way fewer resources to grow than animal foods, and generate a fraction of the waste, too.

Beans help deal with our crisis of chronic disease and soaring medical expenditures, too, because they keep you so healthy.

The experts weigh in

Brenda Davis, RD, in Becoming Vegan (2014), p. 373 says “Eat at least three ½ cup servings of legumes per day. (New consumers should begin with smaller servings to allow the gut bacteria to adjust to the increased fiber intake.)” Michael Greger, MD (of nutritionfacts.org fame) in How Not To Die (2015), pp. 294-85 says one study shows that ½ cup a day of pinto beans for 2 months can reduce your cholesterol by 19 points; another study shows that each increment of 2 tbsp a day in bean consumption was associated with an 8% reduction in risk of premature death.

Nutritional benefits—just a few of many

 What are beans full of? Complex carbs with loads of fiber, both soluble and insoluble, to regulate your cholesterol, clean your gut, and foster a healthy microbiome. Just the right array of macronutrients to sustain a human, including the right amount of protein. Micronutrients galore, including vitamins and minerals like folate, iron, potassium and magnesium.

Not the stars of the show

Beans often get neglected.

When people start a plant-based diet, sometimes the hardest challenge is to get used to eating beans. Everyone knows they should eat lots of daily servings of fruits and vegetables (5! 7! 9!). And everyone loves grains for comfort food (and it’s not too hard to switch the emphasis to whole grains). But sometimes the only bean dishes people are familiar with are baked beans and hummus. Those dishes can be great, but they are just the beginning!

Okay, but how do I cook beans?

Dried beans

To cook beans from scratch:* Pour the beans into a pot and sort through to remove stones and shriveled beans. Cover with water 2-3 X the volume of the beans. Soak overnight to use them the next day, or at least 3-4 hours before you want to start cooking them. To cook soaked beans: pour off any remaining water; add fresh water 2X the volume of the soaked beans. Cook 45 min. to 1½ hrs, depending on the type of bean (check after 45 min. to see if done, and check frequently to see if you need to add water). Lentils don’t need to be soaked beforehand and cook in 45 min., or less for red lentils. VERY IMPORTANT: When cooking beans from scratch, do not add salt or anything acidic (such as tomatoes, citrus juice, or vinegar) to the beans until they are cooked to desired tenderness.

Here’s a recipe that uses dried beans that do not need to be soaked before you cook with them. When I last shopped, green split peas were the only dried beans left on the shelf.

SPLIT PEA OR LENTIL SOUP*

1 pkg. green or yellow split peas, or lentils
10 c water or vegetable broth, or more as needed
1 onion, diced
1 clove garlic, minced
1 or 2 stalks celery, sliced
1 or 2 carrots, sliced
1 t cumin or curry powder
1 t dried basil and/or other herbs
½ t salt
Dash of Liquid Smoke (optional)
2 potatoes, peeled and diced (optional)

Pour split peas or lentils into a large pot and sort through for stones. Add water, onion, garlic, celery, carrots, herbs and spices. Bring to a boil, lower heat, cover and simmer for about 30 min. Add potatoes about 15 minutes before the end of cooking time.

This is a wonderful hot lunch or dinner that is very economical. Serve with green salad and bread.

Canned beans are good too!

Best to rinse and drain them before using. Some people save the bean liquid and use it as an egg substitute (aquafaba) but that’s a whole other post!

Enjoy, and until next time!  —Carol Barnett

*The dried beans instruction and soup recipe are taken from the book for the plant-based nutrition course, which will be given again on six Thursdays starting on September 24th. Go to roclifemed.comfor info and to register.

A Lifestyle Medicine Approach to COVID-19

We at Rochester Lifestyle Medicine Institute share your concern about the ongoing COVID-19 epidemic. While physical distancing, frequent handwashing, and not touching your face are important for slowing the spread of the disease, we can further reduce risk by employing the pillars of Lifestyle Medicine.

Please feel free to share this message with anyone who might benefit.

Recommendations:

  • Nutrition – Move as far toward a whole-food, plant-based diet as you can.  In particular, eat lots of leafy greens, vegetables and fruits across a rainbow of colors, and eliminate animal products.  This will help develop a healthy microbiome, reduce inflammation, and give you a spectrum of micronutrients to maximize health.
  • Activity – Exercise daily, aiming for at least 30 minutes of moderate activity per day.  Make sure that you work up a sweat.  This virus has the highest impact on people’s hearts and lungs, so you want to make sure that they are in as good shape as possible if you get the virus.
  • Substances – Avoid smoking, vaping, or inhaling any substance, which can be toxic to the lungs.
  • Sleep – Sleep is critical for your immune system.  Aim to get 7-8 hours of sleep nightly, and to wake up rested.  Go to bed at a regular time.  Make sure your room is cool, dark, quiet, and comfortable.  Avoid screens at least 90 minutes before bedtime.  Develop a “wind down” ritual, like listening to soft music, writing in a journal, or reading a book.
  • Stress – This is a stressful time.  Managing stress is important to reduce cortisol levels and optimize your immune system.  Some things to consider in reducing stress:  talk with friends and family; practice mindfulness and meditation; do deep breathing exercises. If you find that your stress is becoming unmanageable, seek help sooner rather than later.
  • Relationships – This is an important time to support and be supported by the people you love.  Be kind; listen to each other; express your feelings and listen to the feelings of others.  Call friends.  Try to help neighbors or others who may need a hand.
  • Time outdoors – being outside is calming.  And you can walk with a friend and still maintain physical distancing! (Just stay 6 feet away.)  Try to get outside every day, especially during the middle of the day.
  • Meaning and purpose – This is a time for reflection, as well as a time for action.  Reach out to others, to see if there is a way you can help.  If you are religious, use the power of prayer.
  • Positive emotions / finding joy – There is a saying that “It’s better to light a single candle than to sit and curse the dark.”  Be that candle.  Find the moments of joy and light, even if they are few and far between.  Think about all the things you are grateful for.  Smile and laugh when you can.  Your immune system will thank you!

We look forward to seeing this through together! Thank you.

Best Regards,
Ted Barnett and Susan Friedman

Ted Barnett, MD, FACLM
Partner, Borg & Ide Imaging
Board Member, American College of Lifestyle Medicine
Founder and CEO, Rochester Lifestyle Medicine Group
Founding President, Rochester Lifestyle Medicine Institute

Susan Friedman, MD, MPH
Staff Physician, Highland Hospital
Professor of Geriatric Medicine, UR School of Medicine and Dentistry
Medical Director, Rochester Lifestyle Medicine Group
Director of Clinical Research, Rochester Lifestyle Medicine Institute