The LILI Letter March 2023

March,

What a long, snowy winter this has been! I know we are all thankful for the much-needed moisture. I think March is a lot like our lives: unpredictable, inspiring, maddening and hopeful. Wishing us all a lion and lamb-like month, because we can't have one without the other. This month we observe the spring equinox, Saint Patrick's Day, Purim and the beginning of Ramadan. Happy Spring my friends!

In good health, 
Jennifer James

Success story

One of the former class attendees agreed to write about her Success Story this month. ”M”'s story is the other attachment to this email. Great job “M”!! You inspire us all.

Intermittent fasting, again

I am often asked for my opinion on intermittent fasting, even by other health care professionals. There is a lot of lab animal data, but not so much human data. Anything that restricts our food intake to reasonable amounts within a reasonable time frame seems reasonable to me.

A randomized, control trial with 137 firefighters, who worked 24-hour shifts, found that time-restricted eating to a 10-hour window resulted in improvements in their hemoglobin A1C, blood pressure and lipids (fat/cholesterol in the blood). It improved their quality of life as well when compared to the control group (no intervention). The study lasted for 12 weeks. Granted, it was not a long period of time, but there were some obvious advantages to not snacking throughout their 24-hour shift. Most of us do not work 24-hour shifts, but it could work for the average Joe, or Joanne.

I think a 10-hour window for eating is reasonable (breakfast at 7 am, lunch at noon and dinner at 5 pm). We will sleep better, have less heartburn and possibly lose a few pounds. What I don't like is limiting our eating to less than 8 hours per day. A coworker of mine tried it for a while, but just found that he ate more during the allotted time, which was only 6 hours. Along the same lines, many goals in the support group are to limit eating after a certain time, say 7 pm. What it did for some, was a push to eat more food at 6:55 pm! Even if we don't have to lose weight, limiting our food intake to a 10-12 hour window per day seems to work quite well on several levels.

Those who are dealing with wound healing, cancer treatment, gut issues, diabetes, hypoglycemia or pregnancy, may not do well with intermittent fasting. It really depends on an individual's situation. If you want to try a highly restrictive intermittent fasting plan, clear it with your PCP first.

Source: Feasibility of time-restricted eating and impacts on cardiometabolic health in 24-h shift workers: The Healthy Heroes randomized control trial — PubMed.

Grumpy & Co.

I've been feeling grumpy. Perhaps you have too.

We have a wide range of human emotions and to expect ourselves to be cheery 24/7 is a bit unrealistic. If we push our negative emotions away or sweep them under the rug — guess what? They will resurface, sometimes in destructive ways. The analogy I like to use about our emotions is a tree with the weather. Trees don't resist the rain, snow, wind or sun. They also don't hang onto them. The weather comes and goes, our emotions come and go. What is the message behind the emotion? Figure it out and let it go. My current grumpiness is due to fear of negotiating slick and snowy areas on a peg leg, my weary back from all the extra work it does, and the greater effort it takes just to get through the day. I miss Mother Nature terribly. So, I get grumpy.

But, I realized, it is OK to feel grumpy now and then. It is ok for you to feel grumpy too. Acknowledge that something is difficult, and we are doing our best. Self-compassion, gratitude, the realization that this too shall pass, and keeping it all in perspective are things that help.

Our issues pale in comparison to what the folks in Turkey, Syria and Ukraine are enduring. Helping others, such as donating to one of the global relief organizations, is an easy way to feel better instantly.

Living life as a human is tough, and it is ok to be grumpy about it sometimes. Just don't make it a lifestyle.

(Interestingly, just writing about this cheered me up).

Alcohol update

I read the Ghost Map written by Steven Johnson a few years ago. It was about a cholera epidemic in London in the 1800's. The author surmised that in the early days of human civilization, the ability to “hold one's liquor” was an advantage since alcohol was sterile and potable, where water supplies were often contaminated. Better to die of cirrhosis at age 40 than cholera at age 18. Now that our water supply is much safer, rethinking our alcohol habits is a wise thing to do, especially with the new research that is coming out.

The Canadian Center for Substance Abuse and Addiction released new guidance in January for Canadians. Their 22-member expert panel concluded that less alcohol is healthier than more, but did not preach abstinence. They reported that 1-2 drinks per week was considered low risk, but 3-6 drinks per week increased the risk of breast, colon and other types of cancers. Seven or more drinks a week increased the risk of heart attacks, strokes and other negative health outcomes.

Research out of Oxford University in England found detrimental changes to the brain at even low levels of alcohol. Over 25,000 people participated in the study by answering a questionnaire about their drinking habits, coupled with brain scans and cognitive testing. ANY alcohol was correlated with lower levels of grey matter and changes to the microstructure of white matter in the brain. The more one drank, the more damage there seemed to be. If the study participants had high blood pressure and/or a higher body mass index, this was correlated with more extensive damage. Grey matter processes information in the brain, white matter is involved in learning, problem solving, mood, focus and balance.

Just so we are on the same page here, one drink is a 12-ounce beer (~5% alcohol), 8-9 ounces of malt liquor (~7%), 5 ounces of wine (~12%), or 1.5 ounces of hard liquor (~40%). The researches did not recommend total abstinence, but that drinking less was better than drinking more. I discovered just one beer makes my surgical foot hurt. I realize we are not Canadians or Brits, but it's quite likely our DNA is very similar. Dear Reader, do what you will with this information. Don't shoot the messenger. Cheers!

Source: Farrell-Low, A. (2023, February 7). CISU Researches inform new Canadian alcohol guidance. University of Victoria, UVIC News.

Source: Topiwala, A. et al. (2021, May 12). No safe level of alcohol for brain health: Observational cohort study if 25,378 UK Biobank participants. MedRxiv preprint.

Coriander chicken

I have always liked the subtle flavor of ground coriander, and often add it to soups and other dishes. Pairing it with chicken seemed enticing, so I put a recipe together from ideas I found online. I cooked a bunch of asparagus in the same pan with a little water to pick up the flavors and tasty bits after I cooked the chicken. With whole grain rice, it made a healthy, tasty meal. Rather than sautéing the chicken, you can bake it in the oven if you prefer.

• 1.5 pounds, or 4 skinned, deboned chicken thighs, fat removed, cut into chunks
• 4 tsp. ground coriander
• ½ tsp. dried thyme
• ¼-½ tsp. garlic powder
• ¼ tsp. salt
• 8 grinds of black pepper
• 2 Tbsp. corn starch or flour
• Lemon wedges
• 1 Tbsp. oil

Toss the chicken with the dry ingredients in a Ziplock bag until lightly coated. Using a large non-stick skillet, heat the oil until it shimmers over medium heat. Add the chicken chunks to the skillet. You may have to do this in batches. Turn after several minutes, cook until firm but not dry, roughly 8-10 minutes total, or the internal temperature is 165 degrees. Transfer to paper towels.

Another option is to bake the chunks on a pan lined with parchment paper. Set the oven at 425 degrees, bake for 16-18 minutes, stirring once, until golden brown or it registers 165 degrees on a meat thermometer.

Spritz with a little lemon juice and enjoy!

Calories: 3 ounces cooked, or 1/6 of recipe ~215 
Sodium: 217 mg per serving 
(Subtract ~25 calories per serving if baked in the oven, no oil).

Mondays, 2:00pm — 3:00pm 
Heart Center Conference Room, Suite 200, ORMC Medical Plaza 
Free to LILI graduates

There is no longer a Thursday group 
There will not be a spring “Losing It & Loving It” class

"The idea that you have to be protected from any kind of uncomfortable emotion is absolutely what I do not subscribe to." — John Cleese