The words “vegetarian” and “vegan” for some people brings to mind food that “is missing something” or “not filling” or even “bad tasting”.  Other people have told me they could never imagine themselves not eating meat in any one meal, or that they couldn’t stand the taste of tofu, which they believe to be the basis of all vegan/vegetarian diets.  I think many of us have also been influenced by media and even the notorious “food pyramid” we were taught as kids, remember those giant chicken legs and steaks pictured in the middle of the pyramid?  (BTW, the pyramid is no longer promoted and has evolved into a food plate which does not require animal protein!)  In addition, we all have the memory of that one vegetarian/vegan friend who during dinner is forced to eat the green garnishes on the meat-filled plate or has to dig out the veggies from the chicken stir fry.  Sure, they look sad and miserable, but that’s because their selections are limited.  In the past, we have not made it friendly for people with food preferences different from our own, but as you read further, this is changing fast.

First, let’s define these terms.  Vegan is the stricter diet which leaves out all forms of animal protein including eggs and dairy.  However, some vegetarian diets can incorporate one or both of these exceptions.  There is also another type called pescatarian (which allows fish and seafood to be eaten).  For the purposes of this post, I will use vegetarian as it is more encompassing.

In my own life, while I am not completely a vegetarian/vegan, many of my meals during the week do fall into this category.  This has happened very gradually over many years, mainly because I just feel better afterwards.  It is a misconception that you must be “vegetarian/vegan all the time”.  Some people even feel intimidated walking into a vegetarian restaurant because they feel they would be vilified for being a meat eater, like in some Hollywood thriller movie scene where there are a group of cult members who find out that there is an imposter in the group and attacks that person.  Trust me, the vegetarian community is generally very open and accepting!  While many Eastern religions follow plant based diets, vegan/vegetarian does not equal religious cult (another common misconception).

Are there health benefits?  I would say, even a few plant-based meals can improve your health.  Many studies have shown that reducing animal protein can lower LDL (bad type) cholesterol.  I think part of this comes from “cost-avoidance”.  For every vegetarian meal you are eating, you are not eating cholesterol-saturated fat-laden meats.  Also, we often prepare meats with extra salt and fats.  Eating more vegetables is also a main component of the DASH diet, which has been shown to lower blood pressure.

I have compiled some ways that you can adopt some elements of a non-animal diet into your life and pointers.

• Remove preconceptions of what meals should taste like.  Ever wonder why we think that cereal, toast, eggs, milk and juice make us think of breakfast?  Mostly it’s the influence of culture and advertising.  In other cultures, such as Japan, breakfast is rice, pickles, and soup!  When we’ve been eating a certain way for a long time (e.g. meat and potatoes) it can be difficult to imagine eating something different.  We should be open to change and trying new things.  Unfortunately, the lucrative meat industry has literally “force-fed” the concept that you must have meat to have a complete meal.  Remember the beef commercials, “Beef, it’s what’s for dinner”?  Sadly, there was never a similar push by the carrot or mushroom industry!
• Remove your past experiences with vegetarian meals from memory.  Having lived in New York City my whole life, I have seen the plant based food scene literally blossom.  Twenty years ago, you couldn’t really find really high quality vegetarian food restaurants.  Most of them would be small diner-type restaurants with modest selections of salads and noodle dishes.  I think for some people who shudder at the word “vegetarian”, they had tried these in the past and have allowed those memories to cloud their view on the vegetarian food scene ever since.  These days, there are a wide array of amazing vegetarian restaurants some decorated with white table cloths, good wine selections, locally-sourced fresh organic produce and sometimes, prices to match.  If you live in the New York City area, here are some restaurants that I recommend:  XYST, Red Bamboo, Terri, Village Natural, Peacefood Cafe, Blossom, and Dirt Candy.  You will certainly realize how tasty plant-based food can be!
• You will not be suddenly anemic (low blood levels of iron) or have low protein levels by reducing your meat intake moderately.  A good example is the country of India.  In some parts of India, over 70% of the residents have eaten completely vegetarian for thousands of years and most of them are not and could not possibly be anemic.  I’m not one for conspiracy theories, but I think we have been ingrained at an early age with the thought that eating meat equates with proper nutrition.
• You will not be hungry.  Vegetarian food is both filling and nourishing.  Plants contain fiber which helps you to feel full.  Many times, I actually felt more full eating a vegetarian meal than a meat based meal!
• If you like desserts, try vegan desserts.  By not having eggs/milk/butter, they are often much healthier (fewer calories) for you and can be great for people with lactose intolerance.  Moderation is the key as they still contain sugar.
• Try vegetarian for lunch.  Since we often eat less during the mid-day meal, this could be a good opportunity.  Here is my recipe for a savory healthy veggie wrap.
• Because the focus is not on meat, which is generally more expensive, vegetarian/vegan establishments will invest money on higher quality ingredients.  For example, instead of mass produced mushrooms, they may use local, organic, and pesticide-free mushrooms.  In general, these will taste far better.  Also, since most vegetarians are health conscious, they will use healthier ingredients such as canola or olive oil instead of corn oil.
• You may save money eating vegetarian.  Generally, vegetarian options are less expensive, but no less tasty.  I’ve been to many top restaurants (that serve meat) with very high quality vegetarian dishes.
• Be selective with vegetarian food.  I often tell people that vegetarian food doesn’t always equal healthy, just as meat is not always bad.  For example, french fries with ketchup would be considered vegetarian technically, but of course are not healthy. Some vegetarian food will have extra salt added to enhance their flavors.  I find that certain Indian vegetarian dishes will use clarified butter, called ghee, which can cause increase in cholesterol.
• Vegetarian food is not just tofu.  Beans, mushrooms, root vegetables, and whole grains are often used to complete meals and are quite filling.  Some places will use “mock meat” which is soy protein that is seasoned and textured.  While some people have an issue with this as they believe it is trying to pander to the concept that we must eat meat, I find it helpful for people who want to transition.  I have not eating beef for over six years for health reasons and every so often I miss classic beef dishes such as stir-fried beef with broccoli.  I am often amazed at how amazingly similar it tastes with the meat substitute!
• If you enjoy cooking, use internet searches to find recipes.  I love using Google to find vegetarian versions of foods I love.  Try Googling your favorite foods and put the word “vegetarian” or “vegan”.  For example, “vegetarian meatloaf”.  You will be surprised how delicious they can be!  Try my Tofu Caprese Salad.
• As in all my blogposts, my recommendation is to be open to trying new things and to make changes gradually.  Ask yourself, how do I feel after I eat this food, how do I feel after I exercise, how do I feel after I meditate.  If your answer is “I feel great”, keep going!  Every little bit counts.  Good health is a marathon, not a sprint!

The New York Times published an article by Nicholas Bakalar titled, “Boxers or briefs, It may depend on your fertility goals” which reported that men who wore looser fitting underwear produced more sperm and better quality swimmers than those men who wore tight briefs.  I think this makes complete sense, as the whole reason why nature has designed men’s genitalia to extend outside of the body is because sperm cannot survive in high temperatures, whereas ova (eggs) in woman can tolerate higher temperatures.

Here are some additional advice for men considering becoming fathers:

• Eat organic foods, especially when with fruits and vegetables that you will be eating the skin, have broad leaves or those that grow underground.  Typically organic produce is grown without pesticides.  If you think about it, pesticides are meant to kill small, rapidly growing insects and worms.  Guess what?  Sperm have very similar qualities.  Ingesting high amounts of pesticides could certainly reduce sperm reproduction.  Fruits and vegetables where you have to peel a thick skin (bananas, oranges, grapefruit, pineapple, pumpkin, etc.) may not always need to be organic as the thick rinds make it less likely for the pesticides to penetrate inside.
• Avoid crossing your legs.  For the same reason that tight underwear reduces sperm count by raising the temperature of the testicles, crossing your legs achieves a similar result.
• Avoid uninterrupted sitting.  Have you ever sat in a chair for a long time and started feeling warm in the pelvis?  Sitting in chairs, particularly in upholstery that doesn’t breathe such as leather, plastic, or vinyl can increase the temperature of male genitalia.  Stand up and stretch every so often.  Change your office chair to a mesh chair.  You can also purchase a small fan to place under your desk to promote air circulation.
• Avoid sitting in hot tubs or steam rooms.  These are known sperm killers as the temperatures can be as high as 110 degrees Fahrenheit, far too high for sperm to survive at long periods of time.
• If you smoke, stop smoking!  There are so many reasons to not smoke!
• If you drink alcohol regularly, drink in moderation.  This means no more than 2 drinks in 24 hours for men. (1 drink= 1 shot of liquor OR 1 bottle of beer OR 1 glass of wine)
• Increase your water intake.  Dehydration is not good for any organs in the body.
• Get regular exercise.  When you exercise, your heart pumps blood to all parts of the body including your legs, brain, and your reproductive organs.  In particular, I recommend “male Kegel exercises” which are designed specifically to strengthen the muscles down there.  Imagine exercise as a way to “flush out” old blood and bringing oxygen to those areas.
• Reduce stress.  Try meditating even 10 minutes a day. Don’t know how?  Here is a post on how to do it.
• Get adequate and proper sleep.  While we are asleep, our body repairs itself and relaxes.
• Eat shellfish or take a multivitamin.  Sperm need certain trace minerals to survive and grow.  One of these is zinc, which is naturally found in shellfish.  I believe the old wive’s tale that oysters stimulate libido is likely stemmed from this.  Be careful that the seafood you eat doesn’t contain too much mercury.  Find out more about seafood and mercury here.

I’m seeing many people are suffering from gas pains.  We are eating way too quickly (often inhaling food), not drinking enough fluids with our food, and drinking gassy liquids such as sodas and seltzers.  These can all cause gas to be trapped in our stomachs and intestines.  When this happens, we can feel uncomfortable abdominal or even chest pains!   The intestines and stomach are adjacent to our diaphragm and are very close to the heart and lungs.  Many times a week, someone will come into my office thinking they are having a heart attack, but after taking antacids and gas-relieving medications they feel immediately better.  I think part of the problem is that we are afraid to let go of our gas as it is not usually socially acceptable to pass gas from below or burp/belch in public.  As a result, we keep it all inside and it build until we have severe pain or discomfort.

Here are some tips I recommend to help you prevent/release gas:

• Eat more slowly- when we eat fast, we will swallow extra air with our food, eating slowly allows for less air.
• Avoid fizzy beverages- sodas, beer, seltzers, and champagne are extremely bloating.
• Avoid drinking beverages with a straw- drinking with a straw makes us ingest more gas than drinking from a glass
• Lie down and pull your knees up to your chest and hold them with your hands.  You can also rock from side to side on your back while in this position.  Ever wonder why many people pass gas in a yoga class?
• Take Gas-X tablets with your meals.  This is a pretty harmless medication (which never gets absorbed into your bloodstream, stays only in your intestines) which will effectively reduce gas.  I find this medication very helpful when I’m drinking/eating foods which I know will be gas forming such as beans, cauliflower, broccoli, and beer.
• Go to the bathroom when you feel gas is building and burp/pass gas from below.  I usually go into a stall and sit on the toilet (not to have a bowel movement).
• Identify foods which cause you to produce more gas.  Many are have been well-studied and called FODMAP foods.
• Avoid artificial sweeteners (in coffee, sugar free gum, sodas, etc.)- while they may make your food taste sweeter, they are notorious for causing gas and bloating and even diarrhea in large amounts!
• Drink plenty of water when you  eat.  Water helps you to digest food and pass food along your digestive tract.  I always tell people to take a sip of water in between every few bites of food.

There are several foods that you can easily overeat.  I recommend that if you do indulge in them, to be mindful of your portion size.  I recommend sharing them with friends, putting them in smaller size containers, or just avoiding them completely.  While I am not a proponent of wasting food, given some of the giant portions that food sometimes comes in, it may be a better solution than to ingest calories you may find it difficult to burn off (or may never burn off).

• Movie popcorn- these often come in ridiculously huge tubs and we unconsciously shovel handfuls into our mouths since we are distracted by watching the movie.  It’s very easy to consume 500+ calories in one sitting (one whole day’s worth of calories for the average person should be no more than 2000 calories).  Get the smallest size, share with a friend, or ask for an empty drink cup so you can pour the popcorn into a smaller container.  Another option at some theaters is kid’s size popcorn bags.
• Watermelon- it’s so delicious especially during the summer.  However, each slice can have in excess of 100 calories.  Try to limit it to one slice.  Watermelon is one of a few fruits that can be very high in sugar and calories.
• Nuts- they are a part of the Mediterranean Diet and are great for raising your HDL (good cholesterol), however, they often come in tubs which make it too easy to grab many handfuls.  Nuts are extremely high in calories.  A proper portion size of nuts is one palmful or approximately 12 nuts.  If you do buy nuts, scoop them out into small dishes.  I have a set of sauce dishes approximately 2 inches in diameter which almost always yields 12 nuts, and I do not refill the dish after I finish them.  Another option is to eat pistachios or peanuts in the shell as it takes much longer to eat.
• Chips- we often reach into the bag unconsciously until it is empty!  I would really try to avoid all chips, personally, I find carrots and hummus (or fat free salad dressing) to be much more satisfying.  As an alternative, I recommend purchasing small “snack bags” and portioning them out into single servings.
• High calorie beverages- these include juices, sodas, and alcoholic drinks.  Because they are liquids, we can ingest many of them in a short amount of time.  Much of the current obesity epidemic is from these sugary, high calorie drinks.  If you must have juice, dilute it with seltzer water or water (about 50/50).  You will still get the taste but half the calories. Try making your own fruit-infused water.
• Unwrapped chocolates- you get to a party and there is a bowl of brightly colored candy coated chocolates, you find yourself grabbing handfuls at a time and shoveling them into you mouth.  Sound familiar?  Opt instead for chocolates that are individually wrapped in “small sizes” instead.
• Peanut butter- this is a very high calorie food.  Many times, when medical missions go to countries where people are starving, they will often bring peanut butter to help people gain weight and provide sustenance.  Limit your intake of this high fat food by spreading a very thin layer on your food.  Oddly enough, jelly or fruit jam is less in calories and fat and would be a better choice for your sandwich or bagel topping.
• Giant coffee drinks- the ubiquitous coffee chain (whose symbol is a mermaid) sells sugary creamy coffee drinks laden with sugars and fat.  They come in HUGE sizes which can ruin your diet in an instant.  If you must get one of these, get the smallest size and ask for a separate cup so you can share it with a friend.
• Dried fruits- every try to eat 10 fresh plums in 2 minutes?  It would pretty much be impossible unless you were a champion food competition eater.  However, could you eat 10 dried prunes in that same time?  Most likely so.  They have the same calories!  Prunes are essentially plums that are dehydrated (water is removed).  I always recommend fresh fruits as opposed to dried fruits whenever possible.  I do like dried fruits when I’m traveling and may not have access to fresh fruits or if they would be too heavy to carry (while hiking), but I portion them out into small plastic snack bags. When eating dried fruits, try to drink extra water to allow them to rehydrate in your stomach, making it easier to digest.

Summer is a great time to enjoy the outdoors!  However, extreme heat can be very dangerous to your health.  This is especially true for the very young, very old, and people with chronic medical issues such as high blood pressure and diabetes.  Here are some tips to beat the heat this summer.

• Stay hydrated!  Be sure to drink plenty of water.  By the time most of us are thirsty, we are already slightly dehydrated.  As people get older, the thirst center of the brain becomes less sensitive.  Elderly people may not think they are dehydrated until it is too late.  How do you know you are well hydrated?  You should be urinating at least every hour and the urine should be clear, not cloudy or dark colored.  If this is not the case, your body is likely trying to hold onto water.  I would recommend that you start drinking water until you feel the urge to urinate.
• Eat plenty of fruits and vegetables.  Most of these contain over 80% water and can provide more hydration along with electrolytes such as potassium, which is essential to prevent muscle cramps.
• Stay cool, especially when the temperature is over 85 degrees Fahrenheit.  Stay indoors or in the shade particularly between the hours of 12-3 when the sun is very intense.  Drinking cold, non-alcoholic beverages can also keep your body temperature down.  If you feel like you are overheating, jump into a pool or ocean to cool your body temperature down.
• Keep you body covered.  Wear wide brimmed hats or use an umbrella if the you must be outdoors for long periods of time in the sun.  Clothing such as linen can cover up skin, while keeping it cool.
• Avoid excessive exertion.  Save the yard work for a cooler day.  Go running or exercise indoors with air conditioning. Hot, humid, pollen-filled air can trigger respiratory problems in people with asthma or allergies.
• Eat cool foods such as frozen juice pops, salads and cold soups such as gazpacho.  Avoid heavy, greasy, hot-temperature foods.  These can raise our body temperature and can make digestion more difficult.  Avoid grilling as the heat from the grill can also raise your body temperature.
• Check in with people around you, especially the elderly and the young.  Some signs of health issues with heat include:  mental confusion, racing heartbeat (usually over 100 beats per minute), dizziness upon standing, feeling tired/lethargic, shallow and rapid breathing, blurry vision, inability to urinate, nausea, and loss of appetite.