Tips for Stress Management

I think most people are feeling a little stressed lately.  There are a few very practical things that you can do to stay calm when the world around you seems to be spinning out of control.
  

Here are some things that you can do to help you manage your stress.   

Breathe -
 

Controlled breathing can help to physiologically control your stress.  This is one part of your body over which you have significant control.  Take slow, even, deep breaths - 7 seconds in, hold for 1 second, then 7 seconds out.  Use your watch to time yourself.

Why does this work?  When you control your breathing at a slow pace, you actually slow the circulation of blood flowing through your lungs.  Slowing the circulation through your lungs will slow your overall circulation, leading to a slower heart rate.  Slowing your heart rate can help to make you feel more calm, and can help slow the racing thoughts in your brain.

Be Mindful -
 

When you have a lot going on, and your mind is thinking of all of the worst case scenarios, racing thoughts can take control and get away from you.  Make yourself stop and focus on being exactly where you are for just one or two minutes.  Do this by taking the time to notice:

• 5 things that you can see
• 4 things that you can feel
• 3 things that you can hear
• 2 things that you can smell
• 1 thing that you can taste

You may not be able to notice all of these things, but the idea is to reach out with your senses and notice the things around you.  Maybe you will notice how intense the lights are in the room, or the pressure of your body in the chair, or maybe the sound of a bird outside your window.  Be right here, right now.  Avoid going backward or forward in your mind.  Just be in the moment, in the exact place that you are.
  

Find a Good Distraction -
 

You don't want to be distracted all of the time, but when things seem overwhelming, it can be helpful to distract yourself for a bit.  It can protect your brain, lower your blood pressure, and give you a chance to live outside of the stress for a little while.  Give yourself permission to have a time out.  Watch a funny TV show, or read an engrossing story, or maybe try Duolingo to learn a new language!

Try to Keep Things in Perspective -
 

As bad as things might feel right now, they are likely to get better with time.  Take the time to think about the things that are good right now.  For instance, maybe you are getting to spend more time with your family than usual. 

Things Over Which You Can Have Control, Take Control -

• Try to get enough sleep.  This can definitely improve your stress level.
• Try to eat regularly and in a healthy way.  Try to avoid emotional eating and avoid eating a lot of junk foods.  This can be hard as we all tend to crave junk foods when we are stressed!
• Try to get some exercise on a daily basis.  Even if you are not able to do your usual exercise routine because you can't go to the gym, there are ways that you can exercise at home.  Maybe go for a walk a couple of times a day, even if it is just in your backyard, or around the inside of the house.  Do some jumping jacks or turn on some music and dance.  Maybe you could have a dance party with the kids, and you could all use up some energy!
• Try to get some time outdoors every day if you can.  Even though you may be stuck at home, most of us can get outside without being exposed to others.  If you are not able to get outside, try to get curtains open in every room to get plenty of light in the house.  Sun exposure can improve your mood.  
• Keep your living space clean; not just sanitized, but organized.  Organizing the space around you can give you a significant sense of control.

If you have any questions about managing stress, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

How to Boost Your Immune System

If you are like most people, you have probably been wondering if there is a way to boost your immune function to protect you against infection.  Unfortunately, there is also plenty of misinformation that can make it challenging to know what to do.  Let's talk about what you can do to strengthen your immune function.

Your immune system is a complex system that includes different types of cells, tissues, and organs that all work together in a complicated pathway.  Healthy immune function is dependent on many factors.  Those factors include your genetic make-up, the germs that you have been exposed to over your lifetime, and your lifestyle.  Lifestyle factors that impact your immune function include:

• Stress level
• Sleep pattern
• Dietary factors
•  Exercise

Here are some things that you can do to strengthen your immune system:
 

Exercise - We have talked about this in previous Health Tips, but it is worth repeating.  Depending on your level of exercise, it can be good or bad for your immune function.

• Maintaining a regular exercise routine, which consists of at least 30 minutes of moderate exercise a day, has been shown to improve your immune response and lead to significantly fewer respiratory infections.
• Excessive exercise, such as participating in high-intensity workouts for more than 90 minutes at a time on a regular basis, has been shown to be associated with significantly more respiratory infections than occur in people who perform moderate exercise.

Stress - Your immune system works better at fighting illness when your body is not under stress.  Several studies back this up.  In one series of studies from Carnegie Mellon University, people were given nose drops containing a cold virus.  The people who reported less stress in their lives were significantly less likely to develop cold symptoms even though they were exposed to the same amount of cold virus.

Worrying about the coronavirus, or the stock market doesn't help your stress level!  Learning techniques to help manage your stress can help your immune system to function better.  This would include things like meditation, controlled breathing exercises, or talking with a therapist.

Sleep - Improving your sleep habits is a good way to strengthen your immune system.  You should try to sleep 7-8 hours per night.  Try to get into a regular routine, with your bedtime and wake time not varying more than about 30-45 minutes each day.  Avoid excessive lighting in the evening, especially screen time late in the evening.  You need the dim light to trigger your natural melatonin release to help you get a better night's sleep.
 

Dietary factors - Several dietary factors can affect your immune function.

• Vitamin D - There is promising research to suggest that maintaining a normal vitamin D level could help your body fight off respiratory infections.  You might talk with your doctor about checking your vitamin D level, and taking vitamin D supplements if it is low.  There are no clinical recommendations for taking vitamin D supplements for immune function if you have a normal vitamin D level.
• Avoid excessive alcohol consumption - There have been many studies that show a link between excessive alcohol consumption and immune function.  Research indicates that people who drink alcohol in excess are more susceptible to respiratory infections and that they recover from infections and wounds more slowly.  There are several ways that excessive alcohol can decrease immune function.  This is true for binge drinking as well as chronic, daily excessive alcohol use.
• Maintain a balanced diet - A healthy, balanced diet, with plenty of fresh fruits and vegetables, and whole grains, with low levels of simple sugars, can improve the health of the microbiome of your gut.  You may be surprised to know that your gut microbiome has a huge effect on your immune function. 
• Don't waste your money on unproven supplements - Despite many claims to the contrary, there is no single food or natural remedy that has been proven to improve immune function.  You can read various claims about the immune-boosting properties of a number of foods, spices, and supplements, including ginger, turmeric, oregano oil, bone broth, zinc, and more.  According to Dr. Krystina Woods, hospital epidemiologist and medical director of infection prevention at Mount Sinai West, "There are people who anecdotally say 'I felt great after I took whatever.'  That may be true, but there's no science to support that."  There is no harm in eating foods that are touted as immune boosters as part of your balanced diet, especially if you enjoy them, but don't rely on supplements that are unproven instead of a balanced, healthy diet.

If you have any questions about boosting your immune system, please log into your account and send us your question. We are here to help.  And don't forget to keep up the handwashing, trying not to touch your face, and avoiding close contact with people who are sick.

Dr. Anita Bennett MD - Health Tip Content Editor

Debunking Myths about High Blood Pressure

High blood pressure is a common problem in our country.  Nearly half of all adults in the U.S. have high blood pressure, according to the American Heart Association (AHA).  Untreated high blood pressure significantly increases your risk for heart attack, stroke, kidney failure, and other serious health problems.  High blood pressure accounts for more deaths from cardiovascular disease than any other "modifiable" risk factor in the U.S.  It is second only to cigarette smoking as a preventable cause of death for any reason.  We all need to understand the dangers of high blood pressure.  Let's talk today about some common myths about high blood pressure and the dangers of believing them.

Myth - I feel fine, so my blood pressure must be normal.  

Truth - Research has shown that up to half of people with high blood pressure don't know they have it.  People who do know they have it usually know because they had their blood pressure checked, and not because they had symptoms.  High blood pressure often causes no symptoms at all.  It can sometimes cause symptoms when it is extremely high, but this is unusual.  Most of the time it is high enough to cause damage to your heart, arteries, kidneys, and other organs, without causing any symptoms at all.

Myth - No one in my family has high blood pressure, so I don't have to worry.
Truth - There are many factors that increase your risk of high blood pressure.  Your genetic make-up is only one of those factors.  Other factors that play a role in your risk for high blood pressure include smoking, being overweight, eating a poor diet, sedentary lifestyle/getting too little exercise, and drinking too much alcohol.

Myth - A blood pressure of 140/80 is considered normal.
Truth - New high blood pressure treatment guidelines were published in 2017.  A normal blood pressure is considered less than 120/80.  Elevated blood pressure, also called prehypertension, is 120-129 on top AND less than 80 on bottom.  Stage 1 high blood pressure is 130-139 on top OR 80-89 on bottom.  Stage 2 high blood pressure is at least 140 on top OR at least 90 on bottom.  Blood pressure in the Stage 1 range actually doubles your risk of cardiovascular complications, compared to people with blood pressure under 120/80.

Myth - All people with elevated blood pressure need medication.
Truth - People with "elevated" blood pressure, and most people with Stage 1 high blood pressure should be treated initially only with lifestyle changes, such as weight loss, increased exercise, and a heart-healthy, lower salt diet.  Medication is recommended, in addition to lifestyle changes, in people with Stage 1 high blood pressure who have already had a cardiovascular event, such as a heart attack, OR have a high risk of having a cardiovascular event based on other risk factors, or people with Stage 2 high blood pressure.  Some dietary changes have been shown to be as good as medication in treating the early stages of high blood pressure. 

Myth - I don't have to worry about salt because I don't add salt to my food at the table.
Truth - Most of the salt in the average U.S. diet is hidden in processed foods, such as sauces, salad dressings, soups, and prepared foods.  Be sure to look at food labels to see how many mg of sodium you are getting.  Although the recommended amount of sodium per day is 2300 mg, people over 50 and anyone who has high blood pressure should aim for less than 1500 mg per day.
   

What should you be doing to stay on top of high blood pressure and decrease your risk?

• Have your blood pressure checked once a year, or more often if you are at high risk.  If you are having it checked outside your doctor's office, be sure to see your doctor if it is elevated.
• Eat a heart-healthy diet, rich in fruits and vegetables, and low-fat dairy products, with reduced levels of saturated fat and cholesterol, and reduced salt intake.
• Maintain a routine exercise program with moderate exercise at least 150 minutes per week.
• If you are overweight, lose weight.  Research has shown that even just 9 pounds of weight loss can lower blood pressure by 5 points.  
• Don't smoke or use nicotine products.
• If you already have high blood pressure, follow your doctor's advice regarding treatment and routine follow up visits in order to keep it under good control and decrease your risk for complications.

If you have any questions about high blood pressure, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor