Happy Thanksgiving!

I hope that each of you have a safe, healthy and happy Holiday!  The smells of Fall are quickly turning to early winter, as everyone begins to bundle up and wait for the inevitable.

As I am getting older, I actually enjoy winter more.  It's not that I do anything special during the winter months, but rather, I feel that everyone slows down a bit.  In our fast-paced lives, times often seems a greater commodity than money!

With a greater time to focus on our daily lives, we can begin to make clearer and smarter decisions on what is really important to us.  This usually allows us to be more productive, both at work and home, with less effort.

A greater personal focus and intent actually helps us to be healthier, as I note in the first article of this newsletter.  A positive outlook is more than just, "I'm having a good day." A purposeful direction in life is about celebrating the small successes that continue to accumulate.  It is much easier to do than to describe!

This Thanksgiving Day, I am going to be thankful for each small win over the past year, even if that small success did not amount to more than knowing I did the right thing for the right reason.

I hope that each of you finds small wins to celebrate this Holiday Season, and that you can share those wins with your family and friends!

Happy Thanksgiving!

Dr. Frisch

"Thanksgiving is Overrated!"

I don't know if this is a fact, but I have certainly heard many people make that comment this year.  I wonder if they truly believe it or if they are simply saying that too much emphasis is being placed on a secular Holiday?  I hope that they were merely making early "bah, humbug" comments and that when the actual day draws near, each of them will rejoice a bit and be thankful for what they have received, earned and shared throughout this past year.  Unfortunately, not everyone is able to experience gratitude and thankfulness.

A study published in the Journal of Behavior Research and Therapy (2006)¹ investigated the inability of some persons to experience gratitude and thankfulness.  They used a population of Vietnam veterans suffering with Post-Traumatic Stress Disorder (PTSD) and compared them to an equal group of Vietnam veterans that did not suffer with PTSD.  They measured daily disposition and gratitude as it related to pleasurable day-to-day activities and functioning.  They also measured the ability of the test subjects to experience gratitude over a longer period of time.

The results, although not a complete surprise, were still disturbing.  It was determined that individuals suffering with PTSD exhibited significantly lower levels of dispositional gratitude, while no differences were found on daily gratitude. Dispositional gratitude predicts a more positive outlook and perception of experiences, as well as a degree of self-esteem.  Those veterans suffering with PTSD did not, overall, feel emotions of gratitude, joy or elation in situations when that would have seemed appropriate.  

I feel that this study really investigated how emotional and/or physical trauma upsets our brain and the internal environment of the body.  Physical and emotional trauma that is interpreted and learned within our nervous system and integrated into long-term learning centers by the brain, often changes who we are as humans.  With time, some people may regain their previous outlook on life, but if the learning was ingrained and supported for a longer period of time, his or her response to the world around them may be permanently impaired.  Traumatic events can and do happen in each of our lives, but it is our perceptions of those events and the actions taken, that will determine our outcome.

We as humans, however, do have a degree of control over our physical and psychological functioning.  A positive outlook on life has shown to be of benefit in staving off the progressive effects of age-related depression.  Considerable research has been performed in this area of mental health.  A study published  in the Journal of Affective Disorders² evaluated 464 men aged 64 to 84 years over a 15 year period of time, with evaluations every 5 years.  Things like age, self-reported health, heart disease, and physical activity were factored into the testing.  At the end of the 15-year study, those elderly men that were free of depressive behavior and had a disposition of optimism, remained free of any development of age-related depression.  

The findings of these two different and distinct studies are significant because they give us insight into what we can and what we may not be able to control as it relates to each of us in our life.  I would suggest that when we do suffer negative physical or emotional trauma, we seek the appropriate care to regain who we were prior to the trauma.  Some people may get lucky and bounce back without intervention, but others may never be 'who they were' without the care.  The brain is very good at self-preservation, but it is not always the easiest partner to live with.  

When we are able to consciously focus with a positive outlook on each day's events, we can lessen the likelihood of depression as we age and other negative psychophysiological disorders.  Developing a positive outlook on life may take a little practice for some and a lot of practice for others, but a general, positive outlook will allow each of us to feel more control of life each and every day.

As the Holiday season descends upon each of us, remember to be thankful for the small, daily successes you have had over the past year.  When you get tired of counting all of your little 'wins', I will bet you a drumstick, that you will have found something significant to feel good about and grateful! 

 

1. Kashdan, T.B., Uswatte, G., Julian, T. 2006. Gratitude and hedonic and eudaimonic well-being in Vietnam war veterans. Behavior Research Therapy. Feb;44(2):177-99.

2. Giltay, E.G., Zitman, F.G., Kromhout, D. 2006. Dispositional optimism and the risk of depressive symptoms during 15 years of follow-up: the Zutphen Elderly Study. Journal of Affective Disorders. Mar; 91(1): 45-52.

Eileen's Corner

"The mere mention of Brussel Sprouts sends many people running with an abandon that would make a 6-year old proud.  That's too bad because they are really good!

Roasting Brussel Sprouts makes them succulent and sweet.  These are 'Grown up' Brussel sprouts and you will love these!  These are a Holiday staple at our house!" 

Roasted Brussel Sprouts

 
1 1/2 pounds Brussel sprouts
 
3 tablespoons good olive oil
 
3/4 teaspoon kosher salt
 
1/2 teaspoon freshly ground black pepper
 
Preheat oven to 400 degrees F
 
Cut off the brown ends of the Brussels sprouts and pull off any yellow outer leaves.  Mix them in a bowl with the olive oil, salt and pepper.
 
Pour them on a sheet pan and roast for 35 to 40 minutes until crisp on the outside and tender on the inside.  Shake the pan from time to time to brown the sprouts evenly.  Sprinkle with more kosher salt and serve immediately.
 
 

Enjoy these tasty morsels and have a great Holiday!

Eileen

Hint:

 For an added treat, sprinkle grated parmesan cheese over the sprouts just before serving.  It adds another layer of flavor!

Drive with Awareness

Thanksgiving is the beginning of the 'Family-Related' Holiday Season.  Holidays like Thanksgiving, Christmas, New Years, and Easter, usually are centered around family, rather than friends or acquaintances.  Family Holidays, for this reason, often involve a greater amount of driving and time on the road.  Accident statistics are readily available and they do show a dangerous picture of travel during the Family-related Holidays.

In 2005, the Journal of Injury Prevention¹ published a report that cited the most dangerous times of the year for travel.  The investigation was performed by hour, day, week, month and season.  They were able to determine that, on average, there are 100 crash-related deaths per day in the United States with a low of 42 and a high of 252.  Most traffic-related deaths were in the Summer and Fall.  The Fourth of July had the greatest number of crash deaths, but Independence Day also had the greatest number of alcohol-related road deaths, which did skew the numbers a bit.  January 1st was second in line for crash-related deaths, but it  was also the greatest for pedestrian death!  This is likely due to driver exhaustion and not focusing on driving the vehicle, while also being aware what or who is around the vehicle.

Thanksgiving is the first real family-travel Holiday of the season.  Traffic will be heavy and it is also probably not the best time to let teenage drivers take over wheel duties.  Statistics continue to show that teen drivers do not have an awareness of the road, are unable to judge safe distances between vehicles and are unsure what to do in spontaneous traffic situations.  This is all because teen drivers do not have enough experience behind the wheel to be confident and safe drivers.  Distractions like talking on the phone, listening to IPods and talking while driving place everyone on the road at risk for injury and death, especially the teen driver.

A 2006 study published in the Journal of Pediatrics² found that when 16-year old drivers followed a State run graduated driving program, traffic deaths for teens dropped as much as 20%. The program included: a 3-month mandatory waiting period to drive after licensure, nighttime driving restrictions, more then 30 hours of supervised driving instruction and passenger restrictions.  If you are a teen, you probably want to shut the computer down right about now, but don't!  Gaining more experience behind the wheel now will make you a safer driver and save 20 out of 100 of your friends.  The study went on to report that by the time a driver reaches 24 years of age, no amount of training or restrictions would drop vehicle death rates.

This means that when someone chooses to be a 'bad driver' and does it for about 8 years, no amount of training or penalties/restrictions will change his or her behavior behind the wheel.  

(What a Shame!)

Studies like this may help to explain the behaviors that we see during rush hour traffic, but it does not make them any less palatable.  I treat accident-related trauma every day.  It is my privilege to help each patient that I see, but unfortunately, I also get to see the devastation that it causes in each life.  I have observed accident-related injuries result in people quitting or being 'let go' from their job, selling their home, and damaging relationships and marriages.  All this, because some driver was not paying attention behind the wheel or not experienced enough to know that they have to pay attention when driving.

With this first travel-holiday of the season, here are some simple rules:

1. Make sure that your car is serviced and safe to drive.

2. Be rested and not tired behind the wheel.

3. Wear your set belt.

4. Do not speed.  You don't save that much time anyway!

5. Give enough distance between you and the driver ahead of you.  Tailgating is not only moronic, it is completely disrespectful of another person's life! 

6. Count to 3 before accelerating on a green light.  People run red lights!

7. Use your turn signals.  Other drivers do not know what you are going to do until you tell them.

8. If you do something dumb in traffic (we all do) wave and say you are sorry.  The other driver usually nods and waves in acknowledgement. End of problem!

9. Accept the fact that most drivers on the road have never thought about the first 8 rules!!!!

1. Farmer, C.M., Williams, A.F. 2005. Temporal factors in motor vehicle crash deaths. Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention. Feb; 11(1): 18-23.

2. Chen, L.H., Baker, S.P., Li, G. 2006. Graduated driver licensing programs and fatal crashes of 16-year-old drivers: a national evaluation. Pediatrics. Jul; 118(1): 56-62.

It's Thanksgiving... So Eat Up!

Everyone is always so worried about putting on weight during the Holidays, but are they careful?  Do they watch what they eat?  Of coarse not!  At least, not until January, when we all start talking about just being big-boned.  We should not worry so much about eating during the Holidays, especially Thanksgiving, because Thanksgiving is all about the food.  Food is social. Food is family. Food is happy and most of all, food is good!  Why then do we fret so much about weight-gain?  We know that we are going to eat beyond what would be considered normal during any two days of the week.  We also know that we are going to keep eating until we can't eat any more, at least, until the second round.  Who thought that it would be a good idea to classify eating on Thanksgiving the same way we classify boxing matches.  Round one, round two.....you get the picture!  Both events do seem, however, to result in one objective, "How much abuse can I sustain and still stay on both feet?"  Well, enough small talk.  The burning question in everyone's mind since the pilgrims landed at Plymouth Rock is, "Can I make it through this Holiday and hold my weight?"  The answer is...Yes!

A 2006 study at the University of Oklahoma¹ attempted to determine if college kids would put on weight, while home for the Thanksgiving Day Holiday.  They tested 94 students for Body Weight (BW), Body mass (BMI), and whether they were an undergraduate or graduate student.  The first fasting test was given before they left for Holiday break and the second test was administered when they returned from vacation.  The results indicated that males gained (.6kg) more weight than did females (.4kg) and the graduate students gained more weight than did undergraduates (Hey, it was free food?).  When body mass indices were evaluated, 'normal weight' students gained less (.2kg) than did students who were classified as 'overweight/obese' to start with (1 kg).  The results showed that everyone put on weight, but heavier people tended to put on more weight then normal or thin people.  This becomes a concern if the weight gain is not reduced during the school year and before the next weight-challenging Holiday.

All is not lost, however, with Thanksgiving Day binging.  There is a word that keeps popping out in the literature....Conjugated Linoleic Acid (CLA).  You may be familiar with the Omega fatty acids and their health benefits, but you may not have heard about CLA.  CLA is a naturally occurring fatty acid that has shown the ability to lessen weight gain and decrease fat mass in animals.  In nature, CLA is found in meat and dairy products of ruminants like cows, sheep, bison, deer, and goats (A ruminant is any animal that digests its food in two steps, first by eating the raw material and regurgitating a semi-digested form known as cud, then eating (chewing) the cud, a process called ruminating. (Wikapedia)

A 2007 study published in the International Journal of Obesity² gives us hope for Holiday eating.  The researchers randomized a double-blinded, placebo-controlled study to evaluate 40 people during a 6-month period.  Four measures of weight were established during the baseline, and Body Weight was measured monthly during the Pre-Holiday (Aug-Oct), Holiday (Nov-Dec), and the Post-Holiday Seasons (Jan-Mar).  The CLA group was given 3.2 g/day of CLA, while the placebo group received nothing. 

The results were positive for the CLA group.  No weight gain was noted during the Holiday Season and over the 6 month period, the CLA group lost significant body fat and improved their body composition.  The placebo group was not so lucky.  They gained weight, altered insulin resistance, and affected blood lipids and liver function.

This means that, In addition to supplementing our diet with health Omega Fatty Acids 3-6-9, we may want to take a closer look at integrating into our diets the 'forgotten fatty acid'...Conjugated Linoleic Acid!  Most nutritional stores should be able to help you out in this regard.

Have a Great Thanksgiving Holiday!

Dr. Frisch

1. Hull, H.R., Radlev, D., Dinger, M.K., Fields, D.A. 2006. The effect of the Thanksgiving holiday on weight gain. Journal of Nutrition. Nov 21; 5:29.

2. Watras, A.C., Buchholz, A.C., Close, R.N., Zhang, Z., Schoeller, D.A. 2007. The role of conjugated linoleic acid in reducing body fat and preventing holiday weight gain. International Journal of Obesity. Mar; 31(3): 481-487.