“Song for Autumn” by Mary Oliver

In the deep fall
don’t you imagine the leaves think how
comfortable it will be to touch
the earth instead of the
nothingness of air and the endless
freshets of wind? And don’t you think
the trees themselves, especially those with mossy,
warm caves, begin to think
of the birds that will come — six, a dozen — to sleep
inside their bodies? And don’t you hear
the goldenrod whispering goodbye,
the everlasting being crowned with the first
tuffets of snow? The pond
vanishes, and the white field over which
the fox runs so quickly brings out
its blue shadows. And the wind pumps its
bellows. And at evening especially,
the piled firewood shifts a little,
longing to be on its way.

Heat Stroke Deaths & Emergency Room Visits at Record Levels: 13 Tips for Preventing Heat Illness, Heat Stroke & First Aid

This article appeared in The Huffington Post

Unprecedented heat waves across the United States have significantly increased heat stroke deaths and heat illness emergency room visits significantly over previous years.

I’ll never forget volunteering at the Marine Corps Marathon’s Finish Line Emergency Tent. The experience was horrifying and exhilarating at the same time.

I spoke at the marathon’s scientific conference the day before, and the other speakers — dedicated medical specialists who came from around the world — were amazing. Their expertise and dedication saved many lives at the marathon.

But what is seared in my brain forever are the exhausted runners stumbling into the emergency tent on the verge of death: Forced into ice-water baths, several doctors surrounding each tub struggling to get IVs into the runners to save their lives.  It was heat stroke.

The runners were frighteningly disoriented: delicate young women and huge, strong men were screaming, cursing, defecating (the room reeked); they couldn’t remember their own names, let alone birth dates. After some time in the painful icy water with IVs injecting life saving fluids, once their body temperatures were lowered, they were whisked off in waiting ambulances to nearby hospitals. Everyone survived that day.

The most essential nutrient: water

Nutrients don’t only come in the form of food; water is the most important, and often most forgotten, nutrient. You can last for some time without food, but only days without water. Your lean body mass contains about 70 percent to 75 percent water, with fat containing much less: about 10 percent to 40 percent water. Because of increased muscle mass, men’s and athletes’ bodies contain more water than bodies with proportionately lower muscle and higher fat, such as non-athletic women, people who are overweight and people who are older.

Water is:

– The solvent for important biochemical reactions, supplying nutrients and removing waste.

– Essential for maintaining blood circulation throughout your body.

– The maintainer of body temperature. As you exercise, your metabolism and your internal body temperature increase.

Water carries heat away from your internal organs before serious damage occurs, which can lead to heat stroke, and even death. The heat travels through your bloodstream to your skin, causing you to sweat. As the sweat evaporates, this allows you to cool off and maintain a safe body temperature, optimal functioning and health.

Daily water intake must be balanced with losses to maintain total body water. Losing body water can adversely affect your functioning and health. Once you start feeling thirsty, you’ve probably lost about 1 percent of your body water and are dehydrated. With a 2 percent water loss, you could experience serious fatigue and cardiovascular impairments. It’s important to note that individual fluid needs differ depending on your sweat rate, the environmental temperature, your clothing, humidity and other factors.

Heat Illness First Aid

Hydration Tips For Preventing Heat Stroke

As summer temperatures hit, here are a number of important tips.

– Drink enough water to prevent thirst.

– Monitor fluid loss by checking the color of your urine. It should be pale yellow and not dark yellow, too smelly or cloudy.

– For short-duration (less than 60 minutes), low-to-moderate-intensity activity, water is a good choice to drink before, during and after exercise.

– Any time you exercise in extreme heat or for more than one hour, supplement water with a sports drink that contains electrolytes and 6 percent to 8 percent carbohydrates. This prevents “hyponatremia” (low blood sodium), which dilutes your blood and could also lead to serious impairment and death.

– Begin exercise well-hydrated. Drink plenty of fluids the day before and within the hour before, during and after your exercise session.

– Avoid alcohol the day before or the day of a long exercise bout, and avoid exercising with a hangover.

– Consider all fluids, including tea, coffee, juices, milk and soups (though excluding alcohol, which is extremely dehydrating). The amount of caffeine in tea and coffee does not discount the fluid in them, even if they have a slight diuretic effect, according to the most recent report by the National Research Council’s Food and Nutrition Board.

– Eat at least five cups of fruits and vegetables per day for optimum health, as they all contain various levels of water and the all-important nutrient potassium.

– During exercise, for those who experience high sodium losses, eat salty foods in a pre-exercise meal or add an appropriate amount of salt to sports drinks consumed during exercise. Orange juice is high in potassium. Dilute juices, such as V-8 or orange juice, 50/50 with water so that the drinks are 6 percent carbohydrate solutions (the same as sports drinks), which will empty from your stomach quicker than 100 percent juice (juices are naturally 12 percent solutions), allowing the electrolytes and water to quickly reach your heart and organs.

– Following strenuous exercise, you need more protein to build muscle, carbohydrates to refuel muscle, electrolytes to replenish what’s lost in sweat, and fluids to help rehydrate the body. For two hours or less exercise, yogurt and water are excellent choices. For strenuous or long distance exercise of more than two hours, low-fat chocolate milk is a perfect, and natural replacement that fills those requirements.

– You can also replace fluid and sodium losses with watery foods that contain salt and potassium, such as soup and vegetable juices.

– For long hikes, when you’ll need food, dried fruit and nut mixtures contain high amounts of potassium, sodium, protein, carbs and calories — though continue to drink plenty of water.

– To determine your individualized need for fluid replacement: During heavy exercise, weigh yourself immediately before and after exercise. If you see an immediate loss of weight, you’ve lost valuable water. Drink 3 cups of fluid for every pound lost; use this figure to determine the amount of water (or sports drink) you’ll need to drink before and during your next exercise session to prevent weight/water loss in the future.

Warning! Losing Muscle is Dangerous: Muscle Loss Starts in Your 30s, and While Using Ozempic: Gain Muscle With 7 Easy Steps

Muscle Loss is a new and dangerous side effect of using Ozempic, but it can easily be prevented. It’s not just about aesthetics! Muscle loss can ruin your quality of life, devastate your health, and increase your risk of early death. It is linked with chronic inflammation, a compromised immune system, an increased incidence of infections, diabetes, cancer, heart failure, respiratory failure, renal failure, and sepsis (blood poisoning). It leads to aging, and becoming frail prematurely. You’re more likely to fall, become hospitalized, and unable to perform activities of daily living.

In other words: Don’t lose muscle!

STRATEGIES

1)Vitamin D increases muscle mass, strength, power, and velocity, while lowering body fat. It’s important, though, to take the right amount. And that’s where your doctor comes in. The only way to determine what amount of Vitamin D supplement you need is to get regular blood tests. Everyone’s requirements are different, and should be individualized. Studies show blood levels of 50 to 70 are necessary for good health. I recommend you take 1,000 to no more than 4,000 IU daily.

2)Collagen peptide supplements have been shown to boost muscles and lower body fat. It has other benefits, too. For decades, it’s been established that collagen supplementation increases bone strength, density, and mass; improves joint stiffness/mobility, and functionality, while reducing pain. These aspects are associated with bone loss due to aging, and damage caused by strenuous physical activity. It also enhances your skin. This review of studies to date has found collagen lessens skin aging by minimizing wrinkles, lowering skin roughness, boosting moisture, strengthening skin, its layers, and building up skin collagen. More good news is that studies show taking oral collagen has no side effects. So you have nothing to lose, and everything to gain (except body fat) by supplementing your eating with collagen.

4) Yogurt daily, with its essential probiotics, burns fat, reduces insulin resistance, and increases muscle. Eat any kind of lowfat yogurt every day. The more, the better, if you’re eating fat free or low fat versions (the whole milk yogurts will increase your cholesterol levels). Greek yogurt contains very high protein levels for very few calories.

5)Protein is essential your entire life, but especially when you’re over 30, or when you’re losing weight quickly – an inevitable situation for most people taking Ozempic. Eating enough high protein foods is essential because losing muscle not only endangers your health, you become a thinner flabbier self! Internationally recognized professional organizations recommend protein intakes that are double the current Recommended Dietary Allowances (RDAs). In fact, joint recommendation by the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine are that we eat 1.2 to 2.0 grams of protein per kg of body weight each day (that’s 0.54 grams per lb. of body weight each day – to – 0.9 grams of protein per lb. each day).
The practical: One way to figure out if you’re getting the right amount of protein is looking at the Nutrition Facts Panel of foods that you buy and adding up the grams of protein in a meal and in a day. But since you’re not going to always eat food with labels, another measure is that one ounce of animal protein, and one egg, contains 7 grams of protein. Whole grains have about 2 grams per ounce (1 slice of bread or 1 ounce of cereal). 1/2 cup of legumes contain about 8 grams of protein.
High Protein Foods versus Protein Supplements: Protein supplements significantly increase blood glucose after exercise, when compared with high protein food. Both conditions increase blood insulin after exercise, which helps convert glucose to energy you can use. High protein foods are digested slower than protein drinks. That means your body is able to absorb more protein from one meal, according to this study in the Journal of The International Society of Sports Nutrition. Established research suggests that your body cannot absorb over 25 to 35 grams per meal, or eating occasion, depending on the person. Hint: Eat yogurt through the day to fill these requirement.
Timing: To be absorbed and to increase muscle effectively, eat high protein foods 3 to 4 times a day. Also, eat a protein-containing meal immediately before, or immediately after exercise. Eating your meal before or after exercise can depend on your personal preference, your schedule or how the meal makes you feel. For instance, does eating the meal before exercise make you feel too full and hamper your efforts? If so, try a smaller meal, or switch to eating the meal after exercise, instead of before. I recommend eating nonfat or fat free Greek yogurt as snacks between meals so your body can absorb more through the day.
Meal composition: In order for protein to be absorbed and to get the desired muscle increase and fat decrease, your meal must be mixed with a carbohydrate containing food. Yogurt is perfect. It’s a mix of carbohydrate and protein, with Greek yogurt being higher in protein than traditional European styles, plus your daily probiotic requirement. Its low calorie content, as long as it is low fat, means you can eat it throughout the day to satisfy the timing requirements.

6)Weight training is critical for gaining muscle. That doesn’t mean you need a complicated regimen, or to go to the gym. A simple weight training routine is all you need. All it takes is a few minutes of your time, and about five different exercises to gain muscle in your major muscle groups. The Mayo Clinic has guidelines you may find helpful. Weight training doesn’t have to be hard. You can search for routines you can do in your own home, that don’t require any equipment, and only take up the amount of time you’re comfortable with. Look up Women’sHealth Magazine’s “28 best bodyweight workout videos to try now, from 5-50 minutes – without equipment.” There are many easy exercise routines on YouTube, too, including this 5 minute routine.

7)Cardio: Cardio burns body fat, while weight training doesn’t. Losing body fat is just as important as gaining muscle. Both cardio and strength training are important, but have separate benefits. Cardio burns body fat, it lowers blood cholesterol, pressure, glucose, and reduces the risk for cancer. There are many reasons why I strongly recommend walking over anything else for your daily cardio. a) Walking is just as effective as running or anything vigorous, b)Virtually everyone knows how to walk, c) You are less likely to injure yourself while walking as opposed to running, or anything else that’s more vigorous, d) You can walk anywhere, whether you’re shopping, in a museum, at the zoo, in your neighborhood, or on a beautiful path in nature, e) You get to enjoy the outdoors, fresh air, and sunshine, f) Chores are a necessity of life, and they usually require walking more than usual. Plus you get more gold stars for doing your chores, g) You can actually get somewhere with your feet, an under-appreciated body part. Studies show that walking for a purpose, like getting somewhere or doing chores, is more likely to be sustained.

Another of Katherine’s strong recommendations is to wear a pedometer to track yourself. More than a decade of studies show monitoring your steps motivates you to walk more (of course, I knew this fact in the 1990s and was recommending pedometers way way back then!). Simply put: the more you walk, the more fat you burn.
How to begin a walking routine? The key here is to prevent excessive soreness and injuries. With that in mind, do not walk more than usual immediately. Get a baseline number of steps first. Once you’ve established your baseline – the average steps you’re already taking – use your highest step day – and walk that amount daily until you’re comfortable consistently. Once you’ve experienced no soreness with that level of walking, start increasing slowly. Try adding just 1,000 steps (about half a mile), and keep that up for a few days or more, until it gets too easy. Then I recommend you increase by 1,000 steps every few days to a week. Don’t worry. You’ll have plenty of time to achieve your steps goal.

There is no need to spend more than $50 on a pedometer. The clip-ons are better and more accurate than ones you wear on your wrist. Clip-ons actually measure steps, while the bracelets and watches measure your wrist movements. One of my clients got 10,000 steps a day … by knitting! 30 years ago, I recommended an Omron pedometer, and I still do today. You can find them on many websites