Archive for January, 2019

One Elite Sperm Wins the Marathon: Understanding Semen Analysis

January 19, 2019

Andrew Siegel MD  1/19/2019

The journey of sperm from ejaculation to egg fertilization is an arduous process that is nothing short of a marathon, or perhaps more like a “tough mudder” race. The pilgrimage covers challenging and demanding terrain with abundant obstacles and impediments — the hills and valleys of the vaginal canal, the unwelcoming and entrapping cervical slime, and in the final leg, the extreme narrows and expanse of the fallopian tubes. The few mighty sperm that are capable of overcoming these formidable obstacles and stumbling blocks are not always able to cross the finish line and penetrate the egg, so there is often no winner in this marathon. In that case, these elite sperm perish, having been so close, but so far away.

Health Sport Marathon Team Athletics Run Runners

 Image above, Xenzo at English Wikipedia [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)%5D

A semen analysis is the best test to check a male’s fertility status and potential (or lack thereof when done following a vasectomy).  Although a specimen is easily obtained and analyzed, the results can be complex and nuanced.  Therein lies the utility of the marathon metaphor as an aide to help explain the complexities and meaning of the results.

Egg Sex Cell Sperm Winner Fertilization

Thank you, maxpixel for image above, https://www.maxpixel.net/Egg-Sex-Cell-Sperm-Winner-Fertilization-956481

How does one provide a specimen for a semen analysis?

Most men are highly skilled and experienced at this activity.  It requires a minor modification from the usual routine.  Instead of cleaning up with tissues, carefully deposit the specimen into the specimen cup provided, seal the top and place the cup into a paper bag and hustle it off to the lab with the accompanying prescription ASAP.  The semen will be placed on a slide and examined microscopically.  Note that it is important to abstain from ejaculating for at least 48 hours prior to providing the specimen in order for the volume of the reproductive juices to be optimized.

What information will be obtained from the semen analysis?

  1. Volume of semen (1.5 – 5 cc)
  2. Number of sperm (> 20 million/cc)
  3. Forward movement of sperm (> 50%)
  4. Appearance of sperm, a.k.a. morphology (> 30% normal forms)
  5. Clumping of sperm, a.k.a. agglutination (should be minimal)
  6. White blood cell presence in semen (should be minimal)
  7. Thickness of semen

Marathon metaphor

A marathon is a long-haul endurance race (26.2 miles) with many participants (sperm) and usually only a single winner who crosses the finish line (fertilizes the egg). A sufficient number of participants (sperm count) ensure a competitive race to the finish line with the more participants, the greatly likelihood of a quality finish.

There are about 30,000 runners in the Boston Marathon, but in the fertility marathon there are millions and millions of participants. A fertile male can easily have over 300 million sperm in his semen (that’s 10,000 times the number of participants in the Boston Marathon).  If only a minimal number of participants show up on race day (oligospermia), there may be no one capable of crossing the finish line or doing so on a timely enough basis.

The runners need to stay on course, pace themselves and run in a forward direction. If the participants have poor mobility and move erratically without attention to direction (asthenospermia), they doom themselves to losing the race.

A quality runner most commonly has the characteristic size and shape (morphology) of an endurance athlete, which for a long-distance runner is typically long and lean.  If one has a build that deviates (head and tail defects) from that of the elite runner, it is likely that they will not finish the race, or not finish on a timely basis.

Runners need to focus and make every effort to meet the challenge.  However, if they are not serious about racing and instead of doing business decide to hang out and socialize (clumping together—a.k.a., agglutination) instead of pursuing the task at hand, the outcome will not be favorable.

If marathon security lapses and uninvited stragglers (white blood cells in semen, a.k.a. pyospermia) cross the mechanical barriers and infiltrate the course, the dynamics of the race are altered and the uninvited guests can cause direct harm to the participants, interfering with their ability to complete the marathon.

The runners (sperm) can be affected by the environment (semen) in which they participate.  Although these endurance athletes can deal with a variety of weather conditions, if conditions are extreme enough, the pathway to the finish line will be impaired.  Severe humidity (semen too thick, a.k.a. hyperviscosity), can be a substantial impediment to a competitive race time. In a severely dry and arid environment (minimal semen volume, a.k.a. hypospermia), the sub-optimal race conditions can also impair the race to the finish line.  Similarly, in severe rainy weather (too much seminal volume, a.k.a. hyperspermia), the route can literally be flooded with the marathoners’ capacity for finishing the race compromised.

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Amazon author page with all books authored  including the following:

PROSTATE CANCER 20/20: A Practical Guide To Management Options For Patients And Their Families

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

MPF cover 9.54.08 AM

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor

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Why Is My Prostate Growing When Everything Else Is Shrinking?

January 12, 2019

Andrew Siegel MD  1/12/2019

The prostate is one of the few organs that gets bigger over time.  Meanwhile, there is  shrinkage, loss of tissue mass and recession going on elsewhere, e.g., bones, muscles, gums, hairlines, etc. 

Normal-vs-enlarged-prostate

Attribution of image above: Akcmdu9 [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)%5D, from Wikimedia Commons

The following paragraph from Gabriel Garcia Marquez’s Love in the Time of Cholera (an awesome read) colorfully sums up the aging prostate:

“He was the first man that Fermina Daza heard urinate. She heard him on their wedding night, while she lay prostrate with seasicknessin the stateroom on the ship that was carrying them to France, and the sound of his stallion’s stream seemed so potent, so replete with authority, that it increased her terror of the devastation to come. That memory often returned to her as the years weakened the stream, for she never could resign herself to his wetting the rim of the toilet bowl each time he used it. Dr. Urbino tried to convince her, with arguments readily understandable to anyone who wished to understand them, that the mishap was not repeated every day through carelessness on his part, as she insisted, but because of organic reasons: as a young man his stream was so defined and so direct that when he was at school he won contests for marksmanship in filling bottles, but with the ravages of age it was not only decreasing, it was also becoming oblique and scattered, and had at last turned into a fantastic fountain, impossible to control despite his many efforts to direct it. He would say: ‘The toilet must have been invented by someone who knew nothing about men.’ He contributed to domestic peace with a quotidian act that was more humiliating than humble: he wiped the rim of the bowl with toilet paper each time he used it. She knew, but never said anything as long as the ammoniac fumes were not too strong in the bathroom, and then she proclaimed, as if she had uncovered a crime: ‘This stinks like a rabbit hutch.’ On the eve of old age this physical difficulty inspired Dr. Urbino with the ultimate solution: he urinated sitting down, as she did, which kept the bowl clean and him in a state of grace.”

The prostate is a mysterious-to-many, deep-in-the-pelvis male reproductive organ that can be the source of trouble and angst.  It functions to produce a milky liquid that is a nutrient and energy vehicle for sperm. Similar to the breast in many respects, the prostate consists of numerous glands that produce this fluid and ducts that convey the fluid into the urethra (urinary channel that runs from the bladder to the tip of the penis). At the time of sexual climax, the muscle within the prostate squeezes the glandular fluid into the prostate ducts and then into the urethra, where it mixes with secretions from the other male reproductive organs to form semen.

The prostate completely envelops the urethra, enabling its many ducts to drain into the urethra. However, this necessary anatomical relationship between prostate and urethra can potentially be the source of many issues for the aging male. In young men the prostate gland is the size of a walnut.  Under the influence of three factors—aging, genetics, and the male hormone testosterone—the prostate gradually and insidiously enlarges.

Prostate enlargement is highly variable from man to man, depending upon the aforementioned factors.  As the prostate gland enlarges, it often—but not always—squeezes the section of the urethra that runs through it, making urination difficult and resulting in a number of annoying symptoms and disturbed sleep.  The effect of the enlarging prostate on urinary flow is similar to that of stepping on a garden hose, obstructing the flow. The resultant situation can be anything from a tolerable nuisance to one that has a huge impact on one’s daily activities and quality of life.

The condition of prostate enlargement is known as BPH—benign prostate hyperplasia—one of the most common plagues of aging men. Other processes that can mimic the symptoms of BPH include urinary infections, prostate cancer, urethral stricture (scar tissue causing obstruction), and impaired bladder contractility (a weak bladder muscle that does not squeeze adequately to empty the bladder).

Although larger prostates tend to cause more crimping of urine flow than smaller prostates, the relationship is imprecise and a small prostate can, in fact, cause more symptoms than a large prostate, much as a small hand squeezing a garden hose tightly may affect flow more than a larger hand squeezing gently. The factors of concern are the precise anatomical location of the prostate enlargement and the extent of the compression on the urethra. In other words, prostate enlargement in a location immediately adjacent to the urethra will cause more symptoms 
than prostate enlargement in a more peripheral location. Also, the prostate gland and the urethra contain a generous supply of muscle and, depending upon the muscle tone, variable symptoms may result.

Symptoms that develop as a result of BPH are commonly “obstructive” as the prostate becomes, in the words of one of my patients: “welded shut like a lug nut.”  These symptoms include a weak stream that is slow to start, a stopping and starting quality stream, prolonged time required to empty, and at times, a stream that is virtually a gravity drip with no force.  Another patient described the urinary intermittency as “peeing in chapters.”  Many men have to urinate a second or third time to try to empty completely, a task that is often impossible. Not only may the stream be slow to start, but also may continue after urination is thought to be completed, a condition known as post-void dribbling.  At times, one cannot urinate at all and ends up in the emergency room for relief of the problem by the placement of a catheter, a tube that goes in the penis to drain the bladder and bypass the blockage. BPH can be responsible for bleeding, infections, stone formation in the bladder, and on occasion, kidney failure.

The other type of symptoms that can develop with BPH are “irritative” as opposed to “obstructive” and may include the following: an urgency to urinate requiring hurrying to the bathroom, frequent daytime and nighttime urinating, and at times, urinary leakage before arriving to the bathroom.  As a result of these “irritative” symptoms, some men have to plan their routine based upon the availability of bathrooms, sit on an aisle seat on airplanes and avoid engaging in activities that provide no bathroom access.  One symptom in particular, sleep-time urination—a.k.a. nocturia—is particularly irksome because it is sleep-disruptive and the resultant fatigue can make for a very unpleasant existence.

Not all men with BPH need to be treated; in fact, many can be observed if the symptoms are tolerable. There are effective medications for BPH, and surgery is used when appropriate. There are three types of medications used to manage BPH: those that relax the prostate muscle tone; others that shrink the enlarged prostate; and Cialis that has been FDA approved to be used on a daily basis to treat both erectile dysfunction as well as BPH.  There are numerous surgical means of alleviating obstruction and currently the most popular procedure uses laser energy to vaporize a channel through the obstructed prostate gland.

In terms of the three factors that drive prostate growth: aging, genetics and testosterone– There is nothing much we can do about aging, which is quite a desirable state!  We cannot do a thing about inherited genes.  Having adequate levels of testosterone is a positive in terms of general health.

So what can be done to maintain prostate health? The short answer is that a healthy lifestyle can lessen one’s risk of BPH.  Regular exercising and maintaining a physically active existence results in increased blood flow to the pelvis, which is prostate-healthy as it reduces inflammation. Sympathetic nervous system tone tends to increase prostate smooth muscle tone, worsening the symptoms of BPH; this sympathetic tone can be reduced by exercise.  Maintaining a healthy weight and avoiding abdominal obesity, will minimize inflammatory chemicals that can worsen BPH.  Vegetables are highly anti-inflammatory and consumption of those that are high in lutein, including kale, spinach, broccoli and peas as well as those that are high in beta-carotene, including carrots, sweet potatoes and spinach, can lower the risk of BPH.

Bottom Line: BPH is a common problem as one ages, oftentimes negatively impacting quality of life.  There are medications as well as surgery that can help with this issue; however, a healthy lifestyle that includes exercise, avoidance of obesity, and a diet rich in vegetables can actually help lower the risk for developing bothersome prostate symptoms.

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

MPF cover 9.54.08 AM

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor

Seasonal Weight Gain, Pre-diabetes and E.D.: The Hard Facts

January 5, 2019

Andrew Siegel MD  1/5/2018   Happy New Year!

As reviewed in the last entry, many factors over the past few months have conspired to add inches to our waistlines…Halloween sweets, Thanksgiving treats, December feasts, New Years celebrations, etc., with ample opportunities for over-indulging.  Then there is the added element of the cold and dark season that make exercising outside challenging and fueling the desire for comfort foods.  Before you know it, our pants are snug and we discover that we have gained 10 pounds or so.  

Today’s entry is on the topic of how gaining weight—the possible beginning of the journey to diabetes—can affect one’s manhood and vitality. While optimal sexual function is based on many factors, it is important to recognize that diet and physical activity play a vital role. What we eat—or don’t—and how much we exercise—or don’t—impacts our health and sex lives significantly.  For many, 2019 is a time for New Year’s resolutions, which often involve weight loss and a healthier lifestyle. Yet another benefit of becoming leaner and fitter is improved sexual function.

fat belly

Image above: visceral obesity, often associated with pre-diabetes or diabetes and a disaster for health in general and function “down below”

 

A Canary in Your Trousers

The penis is a marvel of engineering, uniquely capable of increasing its blood flow by a factor of 40-50 times over baseline.  This surge happens within seconds and responsible for the remarkable physical transition of the penis from flaccid to erect. This healthy sexual response is a clear indication of robust blood flow to the genital and pelvic area and intact sexual function serves as an excellent marker of overall cardiovascular health.

Eating Yourself Limp

Weight gain and obesity steal one’s manhood. Men with large bellies are likely to have fatty plaque deposits that clog blood vessels–including the arteries to the penis–making it difficult to obtain and maintain good quality erections. Additionally, as one’s belly gets bigger, one’s penis appears smaller, lost in the protuberant roundness of the large midriff and the abundant pubic fat pad. Furthermore, abdominal fat contains the enzyme that converts the male hormone testosterone to the female hormone estrogen, accounting for low testosterone levels and man-boobs in obese men. The combination of a big belly, a small and poorly functional penis and the presence of man boobs translates to emasculation– essentially “eating oneself limp.”  The bottom line is that poor dietary choices with meals full of calorie-laden, nutritionally-empty selections (e.g., fast food, processed foods, excessive sugars or refined anything), puts one on the fast track to weight gain and obesity and clogged arteries that can make your sexual function as small as your belly is big.

Pre-diabetes and Diabetes

Glucose is the body’s main fuel source.  Diabetes is a disease in which blood glucose levels become elevated. Insulin, a hormone secreted by the pancreas, is responsible for moving glucose from the blood into the body’s cells so that life processes can be fueled. In diabetes, either there is no insulin, or alternatively, plenty of insulin, but the body cannot use it properly. Without functioning insulin, the glucose stays in the blood and not the cells that need it, resulting in potential harm to many organs.

Type 1 diabetes is an autoimmune condition in which the body’s immune system destroys insulin-producing cells, severely limiting or completely stopping all insulin production.  It is often inherited, is responsible for 5% of diabetes, and is managed by insulin injections or an insulin pump.

Type 2 diabetes is caused by overeating and sedentary living and is responsible for 95% of diabetes. This form of diabetes is caused by insulin resistance, a condition in which the body cannot process insulin and is resistant to its actions. Anybody with excessive abdominal fat is on the pathway from insulin resistance towards diabetes.  Type 2 diabetes is a classic example of an avoidable and “elective” chronic disease that occurs because of an unhealthy lifestyle.

Diabetes is the most common cause of erectile dysfunction (E.D.) in the U.S.A. Since Type 2 diabetes is often an evolving process, gradually progressing from a normal metabolic profile to pre-diabetic status to diabetes, it should be no surprise that pre-diabetic status can be associated with E.D. In fact, studies have shown that one in five men with new-onset E.D. have unrecognized pre-diabetes.

Pre-diabetes is characterized by elevated serum glucose levels (100-125 mg/dL) and hemoglobin A1c values of 5.7-6.4%.  Pre-diabetes is also associated with other metabolic abnormalities, including higher body mass index, elevated cholesterol and triglycerides, and lower testosterone.

Chances are that if you have a big abdomen (“visceral” obesity marked by internal fat) you are pre-diabetic. This leaves you with two pathways: the active pathway – cleaning up your diet, losing weight and getting serious about exercise, in which this potential problem can be nipped in the bud and the progression to diabetes can be reversed. However, if you take the passive pathway, you’ll likely end up with full-blown diabetes.

Healthy lifestyle choices are of paramount importance towards achieving an optimal quality and quantity of life. It should come as no surprise that the initial approach to managing pre-diabetes (and sexual issues) is to improve lifestyle choices. These include proper eating habits, weight loss and thereafter maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and minimizing stress.

Fueling up with wholesome, natural and real foods helps prevent weight gain and the build-up of harmful plaque deposits within blood vessels. Healthy fuel includes vegetables, fruits, legumes, nuts, whole grains and fish. Animal products—including lean meats and dairy—should be eaten in moderation. The Mediterranean-style diet is an excellent one for helping to reverse the non-inevitable course towards diabetes and E.D.

Bottom Line:  Diabetes progresses in a step-wise fashion from pre-diabetes and is considered to be an “elective” chronic disease caused by an unhealthy lifestyle.  Accompanying a myriad of potentially serious medical problems are sexual consequences that rob men of their manhood and masculinity.  The good news is that lifestyle modifications can reverse this situation.  

 Wishing you a healthy, peaceful, happy (and sexy) 2019,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health 

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

MPF cover 9.54.08 AM

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor

 

2019 Healthy Eating New Year’s Resolution

January 1, 2019

Andrew Siegel MD  1/1/2019  Happy New Year!

The last few months have been a difficult time of the year for staying fit and trim, with many factors conspiring to add inches to our waistlines. It starts off with Halloween sweets and shortly thereafter, the bounty of Thanksgiving. This segues into the December holidays, which provide ample and constant opportunities for over-indulging. The cold and dark season make it more challenging to exercise outside and fuel desire for comfort foods.  So, what to do?

No carb diet?Paleo diet?Keto diet?…really?  Are they sustainable?  Not a chance!

Today’s entry is about a healthy eating lifestyle—as opposed to a diet—that will help improve your shape and shed those excess pounds that crept on over the past few months. This is a style of eating that can be easily incorporated to replace calorie-rich, nutrient-poor diets that are overloaded with processed and refined junk and fast foods.  As opposed to many fad weight loss programs that are gimmicky, unbalanced, unhealthy, unsustainable and frankly ridiculous, this approach is a no-nonsense, intelligent one—clean, lean, with plenty of green—that will stave off hunger and hold caloric intake in balance with expenditure, making it effective and durable.

The keys are sensible and nutritious eating, substituting less caloric and healthier foods for more caloric and unhealthier alternatives as well as incorporating Michael Pollen’s philosophy, Mediterranean-style eating and an 80/20 strategy.

Substitutions

  • Seafood and lean poultry instead of red meat (when you do eat red meat, consume only the leanest cuts and grass-fed is preferable to corn-fed)
  • Lean turkey meat instead of beef for hamburgers, meatballs, chili, etc.
  • Vegetable protein sources (e.g. legumes—peas, soybeans and lentils) instead of animal protein sources
  • Avocados instead of cheese
  • Olive oil instead of butter
  • Real fruit (e.g. grapes, plums, apricots, figs) instead of dried fruit (raisins, prunes, dried apricots, dried figs) that are energy-dense
  • Real fruit (e.g. orange, grapefruit, apple, etc.) instead of fruit juice (OJ, grapefruit juice, apple juice, etc.) since real fruit has less calories, more fiber and phyto-nutrients and is more filling than the refined juice products
  • Whole grains (e.g. wheat, brown rice, quinoa, couscous, barley, buckwheat, oats, spelt, etc.) instead of refined grain products
  • Tomato sauces instead of cream sauces
  • Vegetable toppings (e.g. broccoli) on pizza instead of meat toppings (pepperoni)
  • Unshelled peanuts instead of processed peanuts (unshelled are usually unprocessed and are difficult to over-consume because of labor-intensity of shelling, the act of which keeps us busy and occupied)
  • Flavored seltzers or sparkling water instead of soda (liquid candy) with its empty calories
  • Baked, broiled, sautéed, steamed, poached or grilled instead of fried, breaded, gooey
  • Baked chips instead of fried
  • Bialys instead of bagels
  • Wild foods instead of farmed (e.g. salmon)
  • Plain Greek yogurt instead of sour cream on baked potatoes and instead of mayo in salad dressings and dips
  • Frozen yogurt bars, which make a delicious 100 calorie or so dessert instead of ice cream
  • Soy, rice, almond or other nut-based milks instead of dairy
  • Low-fat or non-fat dairy products instead of whole milk products

Michael Pollen’s philosophy can be summed up with his famous seven words: “Eat food, not too much, mostly plants.”  Food translates to real, natural, wholesome and unprocessed nourishment (as opposed to processed, refined, fast foods); not too much obviously means in reasonable quantities (as opposed to consuming massive quantities); and mostly plants emphasizes eating foods grown in the soil– whole grains, vegetables, fruits, legumes, seeds, nuts, etc. (with animal sources in moderation).

Mediterranean style eating is healthy, tasty, filling and enjoyable.  It incorporates an abundance of vegetables and fruits that are rich in phyto-chemicals (biologically active compounds such as anti-oxidants, vitamins, minerals and fiber), whole grains, legumes, nuts and seeds.  Seafood, legumes and poultry (in moderation) are the key sources of protein with red meat eaten on a limited basis. Healthy vegetable fats are derived from olives, nuts, seeds, avocado, etc., replacing animal fats (e.g. butter).  Herbs and spices are used to flavor food, rather than salt. Dairy products are eaten in moderation. The Mediterranean style drink of choice is red wine in moderation.

The other element is the 80/20 (or 85/15 or 90/10 or 95/5) strategy.  This means that 80-95% of the time you adhere to a healthy eating style, but 5-20% of the time you give yourself a break, temporarily jump off the wagon and indulge in limited amounts of whatever temptation indulgence you would like. This avoids deprivation and serves as “an inoculation to prevent the disease.”  On the limited list are sweets including cookies, cakes, donuts, candy, etc. and liquid carbohydrates such as sugary drinks including soda, ice tea, lemonade, sports drinks, fruit juices, etc.

Additional Valuable Nuggets of Advice

  • Pathway to a healthy weight is slow and steady, demanding patience and time
  • Cook healthy meals at home instead of dining out
  • Eat slowly, deliberately and mindfully
  • Eat as if you were dining with your cardiologist and dentist
  • Get sufficient quality and quantity of sleep to help keep the pounds off
  • Avoid late night meals and excessive snacking
  • Eat only when physically hungry with the goal of satiety and not fullness
  • Stay well hydrated as it is easy to confuse hunger with thirst
  • Exercise portion control, especially at restaurants where portions are often supersized
  • Order dressings and sauces on the side to avoid drowning salads and pasta meals in needless calories
  • Do not skip meals
  • Keep healthy foods accessible
  • Perishable food with a limited shelf life is much healthier than a non-perishable item that lasts indefinitely, as do many processed items
  • Read nutritional labels as carefully as if you were reading the label on a bottle of medicine
  • Avoid foods that contain unfamiliar, unpronounceable, or numerous ingredients
  • Avoid foods that make health claims, since real foods do not have to make claims as their wholesomeness is self-evident
  • Avoid food with preservatives, hormones, antibiotics, pesticides, artificial colors, etc.
  • Plants that are naturally colorful are usually extremely healthy
  • “Organic” does not imply healthy or low-calorie
  • Use small plates and bowls to create the illusion of having “more” on your plate
  • Let the last thing you eat before sleep be healthy, natural and wholesome (e.g., a piece of fruit)—you will feel good about yourself when you get into bed and even better in the morning

Wishing you the best of health and happiness in 2019,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.  He is the author of 5 books, including PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Promiscuous Eating