The LILI Letter December 2023

December,

This month has so many layers to it. The Ancients wisely celebrated the winter solstice. The cold and darkness would eventually change to warmth and light! If only we could keep the spirit of this season going all year. It also packs a lot of expectations with it, which can make it anything but joyful. Let’s try to stay with the positive. Wishing all of you a calm and joyful winter solstice, Christmas, Hanukkah and Kwanzaa, sans the stress.

In good health,
Jennifer James

Success story

No one particular person for this month’s featured “Success Story”, but I do know of a way to lose weight that is quite simple and effective. For those of you who drink sugary beverages routinely (without artificial sweeteners) such as regular sodas, regular lemonade, sweet tea and so on, stopping these beverages can yield amazing results. Especially if you drink a lot of them.

An extended family member of mine stopped drinking Coke and the amount of weight this person lost is dramatic. Over 50 pounds! I have seen multiple people in our cardiac rehab program, outpatients and those who have taken the weight loss class stop drinking sodas and lose substantial amounts of weight. 

If you love sugary drinks, you may love losing weight more. I have seen the havoc these beverages can visit upon us. How does an increased risk of colon cancer, pancreatitis, kidney stones, increased triglycerides, elevated blood sugars and a fatty liver sound to you? Are any of those on your bucket list? My friends, if you change one thing about the way you live your lives, let nixing the sugary drinks be on the top of the list. Please. 

Do you really know…Carrots?

CPAP and weight

I had a conversation with a patient the other day regarding if a well-oxygenated body would encourage weight loss. My thinking was that fuel burns better with   oxygen. However, most of the research shows that wearing a CPAP (continuous positive airway pressure) and giving a person more oxygen during sleep actually increases weight. What gives?

It has been well-documented that consistently sleeping well does influence hormone levels that affect our weight. When we are sleep-deprived, ghrelin, a hormone secreted by the stomach that increases hunger, is elevated. Another hormone, leptin, secreted by our fat tissue that curbs hunger, is decreased. Therefore, when we don’t sleep well, we tend to eat more. 

Obesity increases our chances of having obstructive sleep apnea, or OSA. If we do not sleep well routinely, dragging our tired selves throughout our days is no fun.  The benefits of using a CPAP machine are legion: we are more alert, symptoms of anxiety and depression decrease, our risk of having a stroke decreases, blood pressure may decrease a bit, and the risk and severity of heart failure decreases. When my mother started using her CPAP machine, she grew more hair on her head! Surprise!

Untreated OSA may cause a person to use more energy to breathe during sleep. Waking up to breath burns more energy than sleeping soundly through the night. Research has shown that our metabolic rate drops with CPAP use. Some research shows an increase in waist size, other research does not. Overall, most of the research and the larger studies show an increase in weight. Smaller numbers show a decrease in weight. It’s messy. 

Should we stop using our CPAP machine to lose weight? Absolutely NOT. If we have sleep apnea due to a heftier weight, what is it about the rest of our lives that created the obesity in the first place? A junky diet? Lack of exercise? Medications? Stress? Making changes in those areas will certainly help. Wearing a CPAP is beneficial in a round-about-way for weight loss. We may feel less moody and have more energy for exercise and eating healthier. If we don’t nap as much we have more time for health-related pursuits. 

My initial thoughts about the benefits of using a CPAP for weight loss did not pan out. But, feeling well rested from using one certainly helps in many ways with weight loss. Don’t you dare stop using your CPAP if you need it! Work on losing weight in other ways. There. 

Gillette, Hope. (2023, May 26). CPAP machines and weight loss: it’s complicated. Healthline. Viewed at CPAP Machines and Weight Loss: Is There a Connection? (healthline.com)

Pleava, R. et al. (2020, August 30). Long-term effects of continuous positive airway pressure (CPAP) therapy on obesity and cardiovascular comorbidities in patients with obstructive sleep apnea and resistant hypertension. An observational study. Doi: 10.3390/jcm9092802.

Summer, Jay and Singh, Abhinav. (2022, October 27). Before and after CPAP machine effects: How your body changes. Sleep Foundation. Viewed at Before and After CPAP Machine Effects: How Your Body Changes | Sleep Foundation

The other side of food

As I was eating my delicious lunch from our hospital café the other day, it occurred to me that simply enjoying a good meal is often taken for granted. We are so focused on counting calories, carbs, etc. ad nauseum that we forget about the other side of food. Sometimes it is just nice to sit and fully enjoy a meal, healthy or not. 

I am acquainted with people who cannot eat and sustain themselves with real food, they are on tube feedings or intravenous (through the vein) feedings. They may be able to tolerate a little here and there, or just some clear liquids, but they cannot enjoy food like the rest of us. Rather than thinking about all the things we shouldn’t eat, or not eat too much, let’s appreciate the simple fact that we CAN eat. That our mouth can chew, our throat can swallow, our stomach empties like it should, our pancreas, liver and gallbladder work, that our small and large intestines function, and the fact that we have all of the parts that make a highly choreographed bodily function occur (and work as well as it does). 

Our cancer patients who receive radiation to parts of their mouth, throat or esophagus have a terrible time eating because it is so painful. If they receive chemotherapy they are often nauseated, develop mouth and esophageal ulcers, and thrush (a yeast infection in their mouths), all extremely painful, which nixes the ability to eat and enjoy food. This is critical. If they lose a significant amount of weight it impacts their ability to withstand the treatment, and possibly survive.

During this season of overindulgence, let’s take a moment each time we eat or drink to be very grateful that we CAN enjoy our food and drink. Because many others cannot. 

Managing holiday stressors

If you have ever uttered the words, “I hate Christmas”, this is for you. This season brings a load of expectations for many of us: gift giving, sending cards, cooking holiday meals, cleaning, being nice, spending too much money, attending church functions, and so on. It can be too much at times. Managing our stress during this time of year will make us much nicer to be around. It will help us relax, enjoy the season, stay out of debt, and even keep us out of the pokey. 

• When alone in our car, turn on the music to a loud volume, and scream as loud as we can. It is cathartic, I promise you. 
• Set boundaries. Say NO and mean it. If we resent doing something, then don’t do it! 
• Breathe. A lot. When we start feeling agitated, check in with the narrative we have rolling around in our heads and challenge it. Is it a fact?
• Go for a walk or go to the gym. Regularly. Exercise helps keep our stress level down. Yoga works well too. It forces us to slow down. 
• Practice gratitude. Daily. It helps to keep a list of five good things that happen every day. 
• Buy ourselves a present or treat ourselves to something nice, like a massage. Really. Something we actually want.  
• If we have no family in the area, volunteer during the holidays at a homeless shelter, food bank, or other community outreach organization. Host a holiday meal for the “orphans”, those without any family in the area. 

Spiced carrot soup

I had not made carrot soup until now. This was a compilation of internet recipes. This was very easy and actually quite tasty. I did not have cilantro on hand, but it would be a nice addition.  

1 Tbsp. canola or olive oil
1 small onion or shallot, sliced
1 medium garlic clove, minced
1 Tbsp. ground coriander
1/8 tsp. ground nutmeg
½ tsp. ground cumin
1 pound of carrots, trimmed and peeled, cut into small chunks 
1 quart low-sodium chicken or vegetable broth
¼ cup lite sour cream
Lime wedges
Cilantro, chopped

1. Heat in the oil in a soup pot until shimmering. Add the onion or shallot and the garlic. Cook over medium heat, or medium-low until they soften. Stir in the spices.
2. Add the water, broth paste and carrots. Bring to a boil, then turn down to a simmer, cover and cook for 25-30 minutes, or until the carrots are soft.
3. Using a stick blender, blend the soup until no solid pieces remain. Gently whisk in the sour cream until well blended.
4. Ladle into soup bowls. Top with a little cilantro and a spritz of lime juice.

Makes ~ 6 cups
1 cup ~90 calories, 152 mg sodium, and 90% of the Daily Value for vitamin A 

"Givers need to set limits because takers rarely do."
 -Unknown