Earth day is a time we acknowledge the state of our environment and what we can do to improve it, but it should also be a time that we think about our own health and well being.  These are mutually concepts as pollution in our environment has a direct impact on our health.  Here are some ways I recommend to mark this day.

1. Plant herbs.  This is so simple, buy some pots, soil and seeds.  I like planting basil or cilantro.  Any windowsill provides adequate sunlight.  By growing your own herbs without pesticides and fertilizer, you are helping the environment.  Fresh herbs are also great additions to your diet as they contain many nutrients and add a amazing flavors to your food.  If you have high blood pressure, herbs can be a replacement for excess salt.
2. Buy sustainable and locally grown produce.  Think this is expensive?  They are actually usually just as expensive, but often tastier since they do not need to be shipped from other countries and are picked from the fields when they are ripe.  Know what fruits and vegetables are in season.  Out of season fruits are almost always grown abroad.
3. Compost your waste.  Find out where you can drop off your coffee grounds, fruit peels, and other organic matter.  A simple Google search can help you.  Better yet, if you have the space, create a compost pile in your yard which will turn into free fertilizer for you garden!
4. Take mass transit or ride a bike.  Mass transit is often less expensive and has a smaller carbon footprint than driving a car.  As an added health benefit, you often will have to climb stairs and take more steps walking to the station.  You burn more calories!  It’s a win-win situation for you and the earth.
5. Avoid packaged or processed foods.  A box of cookies or a microwave dinner require a lot of plastic and paper which lead to destruction of the environment.  These food items also contain a lot of preservatives, processed sugars and chemicals that can be toxic to your body.  Make these items yourself or go to a local small business which makes food fresh and without carcinogens.  Trust me, a freshly baked cookie always tastes better than anything that comes out of a box that has been sitting on the grocery store shelf for six months!
6. Avoid wasting food.  Buy only what you need and freeze any leftovers.  Food wasted is not only costly for you, but also the environment.
7. Do not discard medications down the toilet.  There have been some studies that have found trace amounts of antidepressants and antibiotics in lakes and streams.  If you have any leftover pills, bring them to your pharmacist or your doctor’s office for safe disposal.
8. Use cleaning supplies that do not contain harmful chemicals.  Vinegar, baking soda, glycerin soap and plain water are often just as effective as the harsh chemicals we often use to clean, which can often cause chemical irritation to our noses and skin.  Don’t pollute your home!

At the Academy Awards this year, the wrong movie was announced as the Best Picture which created a very awkward situation.  After a full investigation, the cause of the embarrassment was a distracted staff member who was using social media while he should have been fully focused on his job.

I was not surprised that social media and cell phone use caused this debacle.  Many major train crashes and derailments in recent years have been attributed to conductors who were not paying attention because they were looking at their phones.  Don’t get me wrong, I think phones and social media are not inherently “evil”.  Heck, you may be reading this article on your phone right now!

My concern is that we are no longer living in the moment and experiencing life now.  Humans can not “multitask”.  We are not designed to deal with more than one task at once.  Meanwhile, while I’m writing this blog, I am drinking my morning cup of coffee and listening to music.  Isn’t that multitasking?  Yes, an observer may think that I am doing three things at once but I’m actually not.  I’m typing for a few seconds, then my attention goes to reach for the coffee mug, then it goes back to typing on the keyboard.  I am actually “toggling” between activities, albeit at a very fast pace.  I am not truly doing these three things at once.

If a task requires more concentration or I am doing more tasks at once, the “toggling” becomes more cumbersome and reaction/response time will increase.  My chance for error will also increase.  Hence, this is the root of the Oscar incident and many accidents.

While it is not entirely feasible to “disconnect” from our phones entirely in this digital age, I would recommend that we try to avoid the temptation to be staring at screens all the time.

Here are some tips to learn how to “live in the moment”.

• Create a dedicated “time out” from electronic devices each day.  I recommend putting the phone away when you are eating and at least one hour before bedtime.  Why?  Distracted eating can cause you to overeat.  Think about the last time you went to the movies and how much popcorn or candy you ate.  Looking at the news (especially nowadays!) and social media before bedtime can also lead to disrupted sleep.  Oftentimes when we sleep, we replay events or thoughts in our mind particularly things that occupied our minds just before falling asleep.
• Remove or hide “addictive” apps from the phone/tablet.  Games and shopping are great distractions and are not all bad.  They can sometimes give your mind a mini “mental coffee break”.  However, if you are finding they are taking up too much of your time, they can negatively impact your health.  That 20 minutes playing a “Candy” game could be better spent getting some fresh air outdoors or calling a friend you haven’t spoken to in a long time.
• Talk to people.  It’s amazing how little we talk to people even with our closest friends.  We text, instant message, snapchat, tweet, but we don’t talk to real people in real time as much as we should.  Pick up the phone and call someone today.
• Practice mindful eating or any other activity.  We need to experience things more completely.  Try this little experiment.  The next time you start to eat something, take one small bite of the food and close your eyes.  Take 2 full minutes to eat that piece of food.  Allow your taste buds and your mouth to fully sense the full texture, taste, and even sound produced.  You would be surprised how wildly complex and exciting one bite of food can be, but we don’t often realize it because we are eating too quickly and eating with distractions.  This often leads to overeating.  You can adapt this to any life experience.  I love to do this when I’m enjoying a beautiful sunset.
• Try an “Electronic Device Fast”.  Just like people stop eating food for certain religious holidays, I recommend a period of time where we live as we did 15 years ago.  Put away your tablets and/or phones for just one day or two.  Right now, most of us continue to check our electronic devices even while on vacation!  I am just as guilty of this myself.  However, on a recent trip to Cuba, where internet access is difficult, I was forced to disconnect for 3 days and it felt great.  When you first try the “fast”, you will notice that smartphones are like drugs, you will notice a sense of withdrawal.  However, after a while you will be much more mindful and focused on “real life” experiences rather than “screen” life.
• Meditate.  I can’t overemphasize how meditation is the best solution to counter the negative effects of information overload.  I think meditation is like the “reset” button for our brains, similar to pushing and holding the power button on the smartphone when you’ve opened too many apps and the phone freezes.

Per my gastroenterologist friends, “you can tell a lot about a person’s health by how they poop”.  I couldn’t agree more, but I often find patients are reluctant to discuss their bathroom habits or even to bring up issues such as hemorrhoids (enlarged veins in the anal area that often bleed or cause itching).  Our bowel movements are dictated by many different factors:  how much fiber we eat, how much water we drink, how much we exercise, and how long we sit on the toilet.  Here are some tips on how to improve your visits to the bathroom.

• Eat fiber and lots of it!  Fiber acts like a scrubber and removes cholesterol along your intestinal walls and pushes food forward.  It also causes the stool to clump up and come out in one piece.  Your bowel movement should look like a banana-  tapered at the front and back.  I recommend shooting for a goal of 25-35 grams per day.  Here is how to get there.
• Take probiotics found in foods.  Billions of bacteria live in our colon.  They serve to help us digest properly.  Yes, they sometimes do contribute to embarrassing gas, but overall they are the “good guys” and keep us healthy.
• Drink water.  Hard stools which lead to constipation, are often caused by inadequate hydration.
• Do not sit more than 2 minutes on the toilet.  There should be no email writing, reading of magazines, newspapers, or even novels on the toilet.  You should be practically running to the toilet to have a bowel movement.  If you sit for more than 2 minutes and nothing is happening, go do something.  Drink some water, or exercise to get your bowels moving.  Don’t worry, you WILL move your bowels at some point.
• Try a new way of sitting on the toilet.  A new product called Squatty Potty (which debuted on the TV show, Shark Tank) has been shown to improve hemorrhoids, straining, and reduce time on the toilet.  I have one and I absolutely swear by it!
• Exercise.  Yes, yet another reason to exercise.  Each time your body bounces up and down on a treadmill, exercise bike, or jumping rope your intestines also move food along.  Ultimately, this leads to the need to eliminate.
• Avoid or reduce medications which can cause constipation.  Narcotics (such as oxycodone, Percocet, codeine), antihistamines, and even calcium supplements or TUMS are well known culprits for causing constipation.  If you do take one of these, you may even want to take a laxative or increase your dietary fiber to avoid the resulting constipation which can sometimes be severe enough to require hospitalization!
• Keep track of your bowel movements.  We should all ideally be going to the toilet at least once every day or every two days.  If it gets more than that or your habits change suddenly, it may be time to check in with your primary care provider.  Colon cancer can manifest with sudden constipation.

When I see a person, I see not just one living organism but one giant ecosystem composed of billions of different species most of the time co-existing together, but sometimes an “evil” one takes over and wreaks havoc.  Doesn’t this sound like science fiction rather than medicine?  More and more we are learning the bacteria in our intestines, skin, stomach and even arachnids (mites which are relatives to spiders) that live in our eyebrows can influence our health.

Not surprisingly, the pharmaceutical industry is creating and selling an increasing number of products that are meant to restore or maintain the populations of beneficial bacteria in our body.  Scientists are not completely sure if this is the correct approach and the topic is debated hotly at conferences.  On one hand, many people who suffer from IBS (irritable bowel syndrome) have noticed dramatic improvement with taking probiotics.  However, many of the bacteria found in commercial probiotics are not actually common in humans.  Acidophilus is one of the most common species of bacteria in probiotics, but it is more ubiquitous in yogurt not the human colon.  So should we be populating our bodies with yogurt making bacteria?  Perhaps, if this bacteria prevents “evil” bacteria such as C. dificile (which is notorious for causing a life-threatening diarrheal disease after any antibiotic use), I could see the probiotic as being beneficial.  Ultimately, we don’t have a real answer.

Interestingly enough, if you look at foods around the world almost every single culture has a “probiotic” food.  I believe this is no simple coincidence.  When people eat foods that make them feel better, or anecdotally prevent or cure illness the knowledge gets passed along.  Ultimately, this knowledge becomes tradition.  Here are some probiotic foods from around the world.  I recommend eating them regularly, as they are also usually quite delicious!

• Greek Yogurt (Greece and Middle East)- great source of calcium and full of lactobacillus/acidophilus
• Kefir (Middle East)- a yogurt drink made from cow milk and grains, similar in probiotic profile to yogurt
• Miso Soup/Paste (Japan)- fermented soy beans create this umami-rich paste that is commonly made into a soup
• Sauerkraut (Germany)- fermented cabbage, great source of fiber as well
• Kim Chi (Korea)- spicy, preserved bok choy which can also inhibit growth of bad bacteria
• Dark Chocolate (South America)- while this may not actually contain bacteria, the good bacteria in our intestines thrive on dark chocolate and multiply faster.
• Kombucha (Japan)- this fermented tea is filled with Saccharomyces bacteria
• Gochujang (Korea)- a spicy condiment made from fermented chilis, rice and soybeans
• Natto (Japan)- fermented strongly flavored sticky soybeans, a very acquired taste!
• Cheese (Europe)- some cheeses are more probiotic than others, typically the more pungent ones such as gouda, parmesan, and blue cheese contain more beneficial bacteria.
• Fruit Chutney (India)- a staple condiment with most Indian dishes, chutneys add a touch of sweetness to your meal and many bacteria to your gut.
• Harissa (Africa)- a seasoning paste of mildly fermented chilis.
• Tempeh (Indonesia)- fermented soy product that is often used in place of meat, sometimes called “mock meat”, also rich in protein and fiber.
• Pickles (Europe/USA/Asia)- this picnic favorite should be a regular addition to your diet.  It has no fat, no carbs, can be stored for a long time in the fridge and tastes great.
• Sourdough Bread (USA)- the “yeasty” flavor is a sign that it contains plenty of healthy bacteria.
• Dosa (India)- a giant crepe-like pancake made from fermented rice and lentils often served with savory ingredients.
• Pickled Herring/Fish (Scandinavia)- an easy way to get protein, probiotics, healthy fish oils and vitamin D!
• Lassi (India)- a fermented dairy drink often incorporated into fruit shakes (e.g. mango lassi).
• Poi (Polynesia)- a purple root vegetable that is often pounded into a paste and allowed to ferment before eating
• Fish Sauce/Nuoc Mam (Asia)- made from fermented anchovies, adds a very distinct pungent flavor to any dish.

Mr. Jen Yin Chiu, Dr. Kao Mei Chiu, and a very young Dr. Edward Chiu

I find it amusing that many people are turning to the “Paleo” diet for improved health and longevity.  Ironically, the people who lived in the “Paleo” age died at the average age of 25!  Granted they also had to deal with infections, the elements and animals trying to eat them.

My grandfather lived to be 101 years old.  I think it is much more logical to model my diet on what he ate to be healthy!  Let me tell you a little about him.  Mr. Jen Yin Chiu worked as a farmer and painted oil paintings as a hobby.  He got up early in the morning, and went to bed early each night.  He drank at least 4 large mugfuls of oolong tea each day.  He did 10 minutes of stretching every morning when he woke up, kind of a mix between tai chi and yoga with deep breathing exercises.  Throughout his life, he rarely ate processed foods having grown up in a farming village where fresh vegetables and fruits were always plentiful.

When I am trying a new food, I think to myself “would my grandfather recognize this as food?”  If the answer is “no” I avoid it.  A good example is cereal that comes in multicolored ring shapes.  Sure, the ingredients list things like wheat and corn, but if my grandfather saw fluorescent colored donuts that stain the milk a rainbow color, he probably would think this is a bowl of plastic beads.  No good.  The same goes with soda.  He only drank tea and water.  In general, anything that is overly processed would be out.  Anything that grows on a farm with the fewest steps between the field and your plate would be ok.

I suggest that rather than “fad diets”, try to avoid packaged foods.  When shopping at the grocery store, shop around the perimeter of the store, which includes the meat section, dairy case, and vegetables.  Avoid the inner aisles where there are packaged and processed foods galore.  The only exception would be the aisle with beans and whole grains.  Read the ingredients on food labels.  If you can’t  pronounce words like “sodium caseinate, disodium inosinate, maltodextrin, disodium guanylate” which I recently saw on a bag of orange colored, triangular shaped corn chips, I recommend you don’t eat it!

My grandfather never stepped foot in a gym to do workouts, but he did get plenty of exercise daily.  Most people burned more calories in previous generations during their daily routine.  Why?  Well, when my grandfather wanted to write a letter to a friend, he would write the letter out by hand and walk it to the post office 20 minutes away.  Today, we could sit at the kitchen counter and click “send” and the email is sent.  When my grandmother washed clothes, she did them by hand.  I estimate she probably burned a good 200-300 calories washing clothes for every half hour of laundry by hand every few days.  Today, when I do laundry, I burn zero calories as I just throw them in the machine and press start.  I’m not saying we should all be doing our laundry by hand again, but this means we MUST get some form of exercise in our day and not just sit at our desks, in our cars or on the couch for over 12 hours a day (and that’s not an exaggeration!).

To make things worse for us, our food portions are getting way out of control.  We are easily consuming 2-3 times the amount of calories that our grandparents ate and the fat content of our food is higher than ever.  Not convinced?  Check out the size of your dinner plate.

Currently, we are on course to a looming health catastrophe.  Already we are seeing Type 2 Diabetes emerge in children (Type 2 Diabetes usually does not appear until adulthood and is associated with obesity).  We are eating more calories than ever and burning less calories because of technological advances.  Healthy eating and regular exercise should be incorporated into everyone’s daily life.  If you have children, you should teach them healthy habits from the start.  Get them off the sofa, perhaps exercise together as a family.