How to Prevent Heart Disease — The Number One Cause of Death Worldwide

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Image by Bruno Glätsch from Pixabay

Heart disease is the number one killer, worldwide. Prevention is key. Although these ten points were written for healthcare professionals,  there are a few points that we can incorporate into our own lives. In the first point, we are to be encouraged to aim for a healthy lifestyle throughout life. It’s never too early or too late to start living a heart-healthy lifestyle.

It is also important to note points four and five — the heart-healthy diet and exercise recommendations. Making healthy choices 80% of the time is what we are aiming for. Knowledge is power.

 

Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

American Heart Association, 2019

1.  The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.

2.  A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions.

3.  Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning.

4.  All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.

5.  Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.

6.  For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist.

7.  All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.

8.  Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.

9.  Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10.  Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

Arnett et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000678

Age well, my friend.

Angela G. Gentile, MSW, RSW

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CBD Topical Remedies Update: Canna-Care

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Canna-Care Tincture Rollerball and Canna-Care Cream

Guest Post: Pharmacist Judy Lee-Wing, Consultant on Cannabis

A name for Judy’s topical CBD remedies has been selected! Thank you to all who entered. It was a difficult decision to make …


Gerald is the lucky winner, and the name chosen is Canna-Care!

(See original post)

Are you not sure if cannabis (marijuana) is safe to use, but you want to try it for your chronic back, wrist, shoulder, or knee pain? You are not alone. Many people are considering cannabis to relieve chronic pain, inflammation, and stiffness. (Note: Cannabis is legal for medical and recreational use in Canada.)

There are many ways to use cannabis, including smoking, vaping, and ingesting. Judy, a Pharmacist, specializes in topical CBD products which can be applied to the skin.

Testimonial

“This product has helped my son’s back so much. He has two herniated disks. He puts it on before bed & when he wakes he can actually get out of bed without using any assistance (a broom). He saw great relief after three days. Over the years, my husband’s shoulder had a lot of hockey injury issues. He started using it at night & the pain is gone by morning! Amazing product. Thank You, Judy!” – K. & G.

Judy is:

  • committed to promoting the safe and appropriate use of medications
  • dedicated to serving others by providing excellent pharmaceutical care
  • interested in collaborating with healthcare providers and others to promote health and wellness

What Judy Offers

For a reasonable consultation fee, Judy makes topical botanical tinctures, creams, and oils customized for you. Her service includes assessment, medication review, product sampling, and follow up. For a nominal fee, Judy can also safely and professionally incorporate your own CBD oil into an OTC base that is appropriate for you. This would also include follow-up. A portion of the proceeds will be used towards various acts of kindness.

As a pharmacist, Judy plays a much-needed role in working to ensure the safe and appropriate use of cannabis. Pharmacists work collaboratively with other healthcare providers to optimize health outcomes. By performing medication reviews and consults, pharmacists can help to identify possible drug-related problems, interactions, side effects, and adverse drug reactions which might occur in combination with existing medications.

Please discuss with your physician, veterinarian, or health care provider prior to use.

Canna-Care Tincture is highly effective in relieving pain, inflammation and muscle stiffness. She does not know all of the uses yet, and she is still discovering and eagerly listening to everyone’s amazing stories! The tincture has an alcohol smell which dissipates in less than one minute, leaving a mild, fresh scent. Customized for you, essential oils like lavender can be added as a fragrance and for a combined therapeutic effect. Judy recommends using a moisturizer as needed.

Canna-Care Cream is the botanical tincture (mentioned above) combined with a pharmaceutical over-the-counter (OTC) cream, customized for you. There is no need to reinvent the wheel as these products are highly regulated and have proven therapy. Customization promotes the safe and appropriate use of medications and enhances the optimal relief of pain, swelling, and stiffness. The medicinal ingredients work synergistically to enhance the effectiveness to relieve pain and inflammation.

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Canna-Care Rollerball

Testimonial

“I have had a really stiff and sore back the past few days and I used your CBD rollerball on it and WOW! Immediately the stiffness was gone and my back felt so much looser. Super impressed!!! It dries immediately, too. It’s just amazing!” – Happy Customer

Judy’s products have a natural sanitizer

Organic oils and creams, by nature, may contain ingredients which can degrade or go rancid. Additionally, organic oils and creams may be prone to bacterial and mold growth. In Canna-Care Tincture and Canna-Care Cream, the alcohol in the tincture is a natural sanitizer.

Testimonial

“Judy is awesome! She is very caring, friendly and knowledgeable. Her consult is worth every penny. The tincture works great for the pain in my wrist that has been bothering me for years. Thanks.” – Mike

Some additional points

  • Please consult with a physician prior to using topicals. If medical attention is required, please seek medical attention.
  • Ingesting, smoking, or vaping cannabis is not appropriate in people at risk of psychosis or schizophrenia, cannabis use disorder, or heart conditions.
  • Customized topical CBD remedies including Canna-Care Tincture and Canna-Care Cream works almost instantly in a lot of cases.
  • Ingesting oil or capsules may take up to 1.5 hours for effect. Your customized remedy works to relieve pain and inflammation before oral kicks in.

 

About Judy:

Judy Lee-Wing is a licensed Pharmacist Consultant in Winnipeg, Manitoba, with over 25 years of diverse pharmacy experience including management, caring for people in the community, long-term care, and in the hospital.

 

Resource information

1. Health Canada – Cannabis Education Resources.
2. Judy Lee-Wing attends cannabis workshops, conferences, webinars, continually researches the topic on the internet and very importantly, talks to people.

Questions? Please email Judy at judyleewing@gmail.com, phone or text (204) 488-0812 (Winnipeg, Manitoba, Canada).

Intermittent Fasting Information Session

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Please join me (Angela G. Gentile) at Village Chiropractic in Winnipeg (482 River Avenue) on Friday, April 26, 2019; 6:00 pm – 7:30 pm. I will be presenting an education session on “Intermittent Fasting for Health & Weight Management.” I’ve been practicing an IF lifestyle since December 26, 2018 and I haven’t looked back. I am excited to share what I have learned and I am looking forward to answering any questions you may have.

Please register soon – it’s FREE and spots are limited!

 

Angela G. Gentile, MSW, RSW

12 Tips for Making Healthy Nutrition Choices on an Intermittent Fasting Program

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Image courtesy of kerdkanno at FreeDigitalPhotos.net

Nutrition is an essential aspect of our overall health and well-being, no matter what our age. What we consume can make us gain weight, lose weight, or cause (or prevent) many health problems. I had lost 30 pounds during my cancer ordeal in 2017, and the weight started to creep back up. I realized that if I didn’t change my diet, I would probably gain the weight back and some. Scientific studies show a link between obesity and medical problems like cancer, high cholesterol, and diabetes. As I age, I want to be as healthy as I can and prevent any further medical problems – or recurrence of cancer.

After talking to my doctor about my concerns, I went to a dietician she had recommended. I told her I was following an intermittent fasting lifestyle, and the dietician was good with that as long as it’s working for me. In the hour I was with Marni, she listened to my concerns and gave me some great tips. She wants to help me make healthy choices during my “eating window.” She says my dietary habits need some “tweaking.”

Following are the words of advice that stand out for me. Keep in mind that each person’s situation will be different, and dietary recommendations given here are tailored to me, my situation and my overall goals. You may find some of these tidbits helpful, or you may want to see a dietician for your own personal advice.

#1. Consider the 80/20 Rule. For 80% of the make “healthy choices.” She said it’s okay sometimes (about 20% of the time) to eat or drink what we consider “fun foods.” We all need to satisfy our indulgences or treat ourselves once in a while. “Cheat days” are not encouraged. Instead, follow the 80/20 rule and you won’t feel guilty. FYI – 20% of equals 1½ days per week or about four meals in seven days. Read more about the 80-20 Rule.

#2. The 50/25/25 Plate. When filling up your plate, half should be vegetables, one-quarter protein, and one-quarter carbohydrates/starch. For some people, the carbohydrates can be reduced or eliminated. My doctor also told me to reduce the amount of carbs. For example, if I was having a piece of bread, cut it in half. Pasta, rice and other starches should also be consumed in smaller amounts. Here’s more info on the healthy portion plate. 

#3. Focus on Healthy Choices and Lifestyle (Not Weight Loss). Psychologists, dieticians, and obesity specialists are realising that they have to stop focusing less on weight loss as this does not help people keep weight off in the end. The focus has to be more on healthy choices and lifestyle. Also, the “set point” theory states our body is going to try and get to a certain weight, no matter what we do. If we weigh less than our set point, then our body is going to do whatever it can do to get to that weight. Case in point, on the TV sensation, “The Biggest Loser,” the contestants may have lost a lot, and I mean A LOT of weight. When some of these people were followed up six years later, they had gained most of the weight back, except for one contestant. This is a testament to the set point theory, and it is related to metabolism. All we can do is focus on healthy nutrition choices and lifestyle, and go by what our body is telling us. If it feels healthier with the choices we are making, then we can say that’s a win! The dietician told me, “Things have their way of coming together.” For example, if you are a runner, you may eat differently to fulfill your caloric needs.

#4. Know Your Why for Wanting to Lose Weight. I had to think about the reason why I wanted to lose weight. Was it because society tells me I “should” weigh less? Is it societal pressures on me as a woman? Is it because I want to “look” better? Or is it because I want to be healthier? For me, I know there are many reasons why. And what I do know for sure is that I don’t want to be overweight or obese.

#5. Keep Unhealthy Junk Food Temptations Out of the House. If you don’t have those unhealthy choices around you all the time, it’s a lot easier to avoid them. Instead of opening up the cupboard to find that unhealthy snack, you would have to drive to the store to get it. That little deterrent can help a lot. Having a supportive environment can help support healthy choice goals.

#6. Listen to Your Body – Eat When Hungry, Stop When Full. Some people don’t know what hunger feels like. If you are not hungry, don’t eat. When you do it, make sure you eat until you feel full. Eating more of the “healthy choices” will help prevent you from snacking and eating things you consider unhealthy — more quality AND quantity.

#7. Eat 1-3 Servings of Fruit a Day. Fruits are a good source of vitamins and minerals, and play a role in preventing vitamin C and A deficiencies. Read more about why fruit is so good for us. 

#8. Practice Mindful Eating. The first bite or sip of anything is the most satisfying and rewarding. We usually don’t need to eat much more than a bite or two to satisfy a craving. If what you desire is considered an unhealthy or “fun food” choice, try one or two bites, or a small amount. That’s probably all you need. We usually continue to eat something because we want that feeling to stay. But that’s usually not the case (e.g., potato chips and chocolate.)

#9. Follow the 2019 Canada Food Guide. There are lots of great tips and advice there. For example, water is recommended as the beverage of choice. Mindful eating is encouraged.

#10. Nuts and Legumes are Healthy Choices. These are considered good sources of protein and healthy fat.

#11. Dietary Fiber is Important. Beans, whole grains and brown rice are all good choices. Here’s the top 10 according to WebMD. 

#12. End Your Meal by Brushing Your Teeth. I like to end my meal with something sweet or fresh-tasting as I don’t like the food after-taste. I used to chew gum after, but in the evenings that cuts into my “fasting window” time. I was in the habit of eating chocolate or something else that was sweet (even marshmallows!). Options would be to brush my teeth, chew gum for a bit, or have a mint. A breath mint spray may also work.

The dietician was pleased that I have found something that works for me (intermittent fasting) and she is going to help me tweak it. She says regimens like WW (Weight Watchers) works for some people, and there are other programs that can help with making healthier choices. A good friend of mine has lost 20 pounds on WW! We are all different and it’s good to have choices on what works for us and complements our lifestyles. What works for one person may not work for the next.

I will consider all these tips and see what works for me. I know there are plenty more tips and you may want to add some of your own in the comments below. The dietician wants to see me again in April, and she has registered me for the Well 4 U exercise and education program. There is also a Fit 4 U program this fall that she recommends I attend.

By the way, she said I could have a little bit of dark chocolate every day! 1-2 squares daily is okay – even more if my body says I need it. But as it turns out, I gave up chocolate for Lent. No chocolate for me until Easter!

Angela G. Gentile, MSW, RSW

The ​Long Road to Recovery

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Anyone who has had or has cancer or any other chronic illness or disease knows there is a certain amount of time when they feel they are truly on the road to recovery, recovered, or have discovered their “new normal.” I am one of those people.

I was diagnosed with anal cancer in April 2017. I finished treatment in August 2017. One and a half years later, I can say I am starting to feel “recovered” for the most part – “still recovering” in other areas –– and have discovered my new normal.

My new normal includes ongoing and long-term physical rehabilitation as a result of pelvic radiation damage. I am not complaining (radiation saved my life!), I am just sharing that although some people look great after a big ordeal like cancer, there could be ongoing battles that you may know nothing about. Invisible wounds and scars are very common for people who have experienced cancer.

Recently I attended an art show, and I received a few compliments on my appearance (the picture above was taken at the end of a Hawaiian vacation last month). I know I am feeling much better physically, and my self-image is shaping up. My hair is almost all grown back and highlighted again; I am back to yoga once weekly, and I have started back on my elliptical and doing stretches and weights. I even started wearing my FitBit again. My modest goal of 6,000 steps daily is still a ways away, but at least I am working towards it.

I have also been enjoying my new “intermittent fasting” lifestyle and my relationship with food. I am feeling in control of my life and my body. It’s taken almost two years, but I finally feel like each day I feel better and better.

I am enjoying moderating and managing support groups on Facebook. The “Anal_Cancer Support” group on Facebook is doing amazingly well and has recently achieved the 10-year milestone and the 300th member. Having cancer has expanded my social network by leaps and bounds. A profound and harrowing experience can bring more people into your life – if you want it. You just have to open up and ask for it.

The “Dementia Caregiver Solutions Support Group” is also growing and the admin team recently expanded to include two new moderators who are actual caregivers. They join three professionals to moderate and keep things on track. I find comfort in knowing I have given caregivers this safe forum to share, vent, and get advice for such a difficult time in their lives.

I am also pursuing other volunteer opportunities to help me reach more people who may benefit from my experience, passion, and support. I seem to have an infinite amount of “help” to give, and I am looking for ways to do so –– in a way that will keep me balanced and not over-taxed.

I continue to write for a company called Trualta. I am enjoying my writing projects and look forward to writing for more companies and individuals as the opportunities present themselves.

I am also helping people get married, sort out their problems, write books, develop websites and more. I am starting to consider finishing up my book on aging well (this will be my fifth book!).  Where all this will take me? Who knows. The long road to recovery takes us places that we never dreamed of. I am looking forward to continuing on this journey.

Angela G. Gentile, MSW, RSW

 

My 72-Hour Fasting Experience, Part 3

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7:30 am. Half-way (36 hours) into my fast, I woke up after having a bad dream. I dreamed I was being chased by a large, vicious, hungry lion! I haven’t remembered my dreams that vividly for a long time. I was in some sort of building, a school perhaps, and I heard a loud rustling noise. My intuition told me danger was lurking. As the noise got closer, I saw the lion coming around the corner! I ran into a room and locked the door. That’s when I woke up. (Maybe it was all that thinking about hungry animals yesterday that brought it on!)

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I felt noticeably “lighter” this morning, so I stepped on the scale. I lost three pounds! Now going from 163 to 160 isn’t a lot when you look at the bigger picture, but wow, it’s interesting how lighter one can feel after not eating for 36 hours!

My energy is still good. I have a slight little nagging headache, but that will soon pass once I have my green tea and some Himalayan pink salts (I hope!). (See the screenshot above of the app I am using, it’s called LIFE.)

I will be working today so I will be kept busy.

Angela G. Gentile, MSW, RSW

 

 

Intermittent Fasting – A New Way of Eating for Health and Weight Loss

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Photo by Kaboompics .com on Pexels.com

A couple of months ago, I read an article in a newsletter written by an acquaintance about her five-day “fasting” experience. For health reasons, she drank only water for five days. I was both shocked by this news (how could any live for five days without food?!) and curious (she said she felt better and wants to try for seven days next time.) I tucked this knowledge away in my back pocket, with the intent of learning more.

Then a few weeks after that, I listened to an interview by D’vorah Lansky, bestselling author, who interviewed Gin Stephens who wrote the bestseller, “Delay, Don’t Deny.” D’vorah had adopted the “intermittent fasting” lifestyle and Gin was talking about this way of living and her book sales. This interview was so powerful, I hung on to every word Gin said about how the time-restricted feeding pattern freed her from years of dieting. She lost 80 pounds and has kept it off.

Intermittent fasting (IF) is when you choose to not eat anything for at least 12 hours and for as long as 24 hours. It can be done for religious or health reasons.

I purchased her book (ebook for Kindle) and read it in one day. I loved everything about this new way of eating (WOE) and vowed to myself that I would start on December 26, 2018. I was going to start by not eating after supper and skip breakfast, and only consume water and black tea during my 16-hour fast.

It was much easier than I thought! I felt in control. My hunger pains were short-lived and I soon realized that I was not only eating too much but TOO FREQUENTLY. We are a “well fed” society, and the more I learn about this, the more I understand why there is so much obesity and other related health problems (central abdomen obesity, high blood pressure, high bad cholesterol, low good cholesterol, and high blood sugar). Metabolic syndrome –– which includes three of the five previously-mentioned conditions –– causes an increased risk of cardiovascular disease (heart problems) and type 2 diabetes. Increasing age also causes us to have an increased risk in these areas. I realized in order to reduce my caloric intake, instead of “dieting,” I needed to give myself a “window” of time where it was okay to eat. I am learning how to delay my meals, instead of denying them.

As I write this I am on Day 12 of my new WOE. There is a lot of flexibility with intermittent fasting. For example, my usual pattern is 16 hours of fasting with an 8-hour window of feasting or eating. This is a good place for most people to start. I “close my window” at 8pm, and I don’t eat anything until noon the next day. This gives my body a good 16-hour break from eating. I can drink all the water or black tea (or coffee if I wanted) during the fast. I found I was closing my window earlier, so some of my days were 17 hours of fasting (or more).

Some people choose this 16:8, others choose 18:6 or 20:4 – or some other variation. There are also other patterns, and “extended fasting” which is what the lady did who I mentioned at the beginning of this article. (I’ve also read any fast over 72 hours is dangerous, so be mindful of that.)

For special occasions, where I know I will want to eat or drink outside of my regular window, I can switch up the fasting time. For example, I went for a 21.5-hour fast before new year’s eve so I could have champagne and snacks during the evening. This weekend, I knew I would be having two different family meals, so I did a 24-hour fast. This is also called “alternate day fasting” (ADF) which is another pattern of eating. There is also one-meal-a-day (OMAD) in which the eating window is very short, which could be anywhere between 2-4 hours. Each person finds their own “sweet spot” and you learn how to listen to your body. The Mediterranean diet is what I prefer, as it has the most research behind it for health and longevity. Oh, and my sugar addiction is being curbed as the fasts force me to abstain.

Many people find a lot of benefits associated with intermittent fasting (IF). Improved health and weight loss are the two biggest reasons why people try it. I belong to a few groups on Facebook, and the success stories and non-scale victories (NSV) are very inspiring and encouraging.

IF isn’t for everyone, however, and there isn’t a lot of research on it as it is quite new. I’ve read Gin Stephens’ books and I am also learning from Dr. Jason Fung and will be reading his books, too. Gin says IF is not for pregnant women or children. For those who have pre-existing medical conditions, they should talk to their doctor. In fact, I’ve heard of a few people now who say their doctor recommended IF for their health! It’s been known to reverse type 2 diabetes. If you are considering trying it, please speak to your doctor first.

I am enjoying this new WOE and I am already feeling less bloated and I am sleeping better. I lost 30 pounds a couple of years ago going through my cancer ordeal, and I put most of it back on. The way I lost it was not in a good way. This time I want to lose it in a way that is intentional and will benefit my well-being. I want to reap the benefits of a healthier body that is well fed –– not frequently fed. I also have my own group on Facebook for women who are 40 and better. If you’d like to join us, please drop me a line.

Age well, my friend.

Angela G. Gentile, MSW, RSW

 

Chair Exercises for Older Adults or those with Mobility Limitations

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Photo credit: jill111 – pixabay.com

I was approached by Joseph Jones at California Mobility to provide my recommendation on how to help an older adult with dementia stick to an exercise routine. My comments are in the article 21 Chair Exercises for Seniors: A Comprehensive Visual Guide.

This extensive guide on chair exercises for older adults (or anyone with mobility issues) includes easy-to-follow videos, helpful images, and lots of great tips on chair exercises. These exercises can be adapted for anyone! Please check out the article for helpful tips on keeping active, at any age.

Age well my friends!

Angela G. Gentile, MSW, RSW

 

 

 

“Improving Your Memory” –– A Great Handbook for Those Concerned About Memory Changes (Book Review)

What do you get when two clinical social workers who work in a geriatric centre write a handbook on how to improve your memory skills? A fine little guide for helping older people who are concerned about the changes in their memory!

Janet Fogler and Lynn Stern team up in “Improving Your Memory: How to Remember What You’re Starting to Forget” (2014) in this fourth edition. Originally published in 1988, these social workers have created the book that I have been looking for. In this fourth edition, they have included the smartphone and other technologies that are helpful to us as we manage our daily tasks and are challenged by our aging minds and bodies.

The paperback (168 pages) is medium-sized and is packed with real-life stories and examples to help the reader understand the concepts. There are also quizzes throughout to help the reader apply the knowledge learned (to help one remember!). It is divided into four parts:

  1. How memory works
  2. How memory changes as we age
  3. Factors that affect memory
  4. Techniques for improving your memory

I cracked open the book and dived into section four, as I was eager to see what techniques the authors were recommending. They offered some great ideas, and even ones I had not heard of before. One of them had to do with switching your ring or watch to your other hand or wrist, as an indicator that you had something to remember. It is much like the classic “tying a string around your finger” trick. I found some of the mental exercises fun and a little tricky, and I enjoyed trying out some new skills to help me remember things. The one example for myself that comes to mind is when I am attending an appointment and I have to park in a large parkade. I will use an “active observation” technique so I won’t forget where I left the car!

The first three parts of the book are very easy to understand and come with an illustration of “A Model For How Memory Works.” For us visual learners, these kinds of diagrams are helpful. Encoding (getting something to stick) and retrieval (being able to recall something) can become a little more difficult as we get older, for a variety of reasons. The authors explain, in simple language, why these things happen and how we can try to combat them. Whether our forgetfulness is due to stress, grief, depression, poor concentration, medications, or illness, memory problems can cause added stressors. The authors give some good advice in the appendix on Alzheimer’s Disease and Related Dementias; “What is good for your heart is also good for your brain, so monitoring heart disease, diabetes, stroke, high blood pressure, and high cholesterol is important” (page 142).

I was surprised to learn the book doesn’t talk about “mild cognitive impairment” and the prevalence rates of Alzheimer’s disease and other related dementias. Knowing that the risk of Alzheimer’s disease increases with age is important to know, but not knowing the level of risk does not allay any fears or concerns one may have. (The World Health Organization estimates, of those 60 and over, 5 to 8 people per 100 will develop dementia.)

I also noticed the absence of the terms “mindfulness” and “meditation,” as those two terms are used quite often in most of the current brain health literature I have been reading. Fogler and Stern mention how alcohol can negatively affect your memory, but they omitted any mention of drugs. Interestingly the nutrition section has no reference to supplements. I also observed God, higher power, and spirituality are not discussed.

Overall, a highly recommended guide and workbook for those who want to learn about: how the brain stores and retrieves information (in our “working” and “long-term” memory); what happens to the aging brain; what may cause memory problems; and tips and techniques on how to maximize your chances of remembering things. I’ll leave you with these two tips: “Much of what is called ‘forgetting’ is a lack of paying attention” (p. 137); and “Study after study shows that increased fitness levels result in improvement on cognitive tests” (p. 64).

Angela G. Gentile, MSW, RSW
Author/Specialist in Aging

www.AngelaGGentile.com

“Brain Rules for Aging Well” Misses the Mark – Book Review

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Dr. John Medina’s book, “Brain Rules for Aging Well: 10 Principles for Staying Vital, Happy, and Sharp” (2017), disappointed me. Perhaps I had high expectations as I was impressed with his first book “Brain Rules.” He has labeled himself the “grumpy neuroscientist” and his writing in this book shows. The hefty price of the hardcover ($36.99 CAD) made me believe that the information contained within must be good. As a specialist in aging, and someone who is very interested in the concept of “aging well,” I had to take a look.

I was encouraged by most of the reviews that this book was full of useful and helpful strategies to help one age well. As I dug in, I quickly realized that the book’s premise was inspired by the findings of an experiment from 1979 known as the “counterclockwise study” (Langer).  This was a very small study based on the experience of eight seventy-year-old men who were “stereotypically old.” For one week they were subjected to a time warp –– and lived as if it were 1959. After being immersed in the happy days of old, they came out seemingly younger –– happy with improved postures, hearing, and vision. Their hand grips strengthened and they moved with improved ease. As a woman in my fifties, I started to doubt how this book could adequately cover the topic of aging well – and my doubts were confirmed.

The book is divided into four sections, with the proposed “10 Brain Rules for Aging Well” which Medina starts and ends with as the guiding principles. Parts called Social Brain, Thinking Brain, Body and Brain, and Future Brain with a handy index at the end comprises the layout of the book. He refers to many scientific studies and other resources, and he directs us to “Extensive, notated citations at http://www.brainrules.net/references.” I found this style of referencing quite odd, and it was difficult to find what I was looking for. When I sit down to read a book, I don’t want to have to go to the internet to find the references. Also, the way the references are listed doesn’t make it easy to find what you are looking for.

I found myself bored with all the scientific jargon and his stories to help explain some of the complicated workings of the brain didn’t hit the mark. I ended up skim reading through quite a bit. Some of his aging well advice, such as engaging in friendly arguments and playing certain video games were quite surprising to me. I have yet to understand how a specialist in brain research would suggest arguing with people and playing video games as part of a good plan for overall brain health.

I liked the summaries at the end of each chapter. Medina’s advice about exercise, healthy diet, friendships and “say no to retirement” were well-taken. I found the discussion on the updated term “working memory” for the outdated term “short-term memory” interesting.  The personal stories he shares were endearing, especially the one about nostalgia, reminiscing and the “our song” syndrome he and his wife share.

The book was apparently well-proofed and edited (as Medina notes in his acknowledgments); however, I found two glaringly obvious errors. The first was on page 104, where Medina mistakenly tells us that reading from books 3.5 hours a DAY will help reduce our risk of dying by a certain age when compared to those who didn’t. In actuality, the research states it is a 30-minutes-a-day activity, which translates into 3.5 hours WEEKLY.

The second error, which I was astonished by (as an author and editor myself), was on page 164. Medina was talking about research on exercise done with people with limited mobility. He said that the participants were “assessed by a test called” and there was a blank space after that. The next paragraph started with a period. Perhaps that was the period that he deliberately omitted back in the introduction on page 7? I’d be pretty ticked if I were Medina, knowing this one slipped by all the reviewers.

I believe this was a good attempt by Medina to write a book on Aging Well; however, his dated references to works from 30-40 years ago (e.g., Hauri’s book No More Sleepless Nights, and the movie Cocoon) made me less confident in thinking he was using fresh and current research. This book was a good attempt at starting the conversation about brain health and aging well, but I think he has a lot more reading and researching to do on the subject. One last thought –– I wish he’d avoid using the term “elderly.” That’s a term we are getting away from in the aging well literature when discussing older adults. I believe mainstream media is also moving away from using that term.

Angela G. Gentile, MSW, RSW

www.AngelaGGentile.com