A new year has just begun!  Many people have a tradition of setting new year’s resolutions for themselves.  Unfortunately, many of us don’t keep them up for more than a month or so.  I recommend that instead of these resolutions, we find ways to make gradual changes.  One way is to set S.M.A.R.T. goals.  For example, rather than saying “I want to lose weight this year” you would set a goal to exercise at least 15 minutes 3 days a week.  This is one small step, but by making it easy and being able to accomplish it, you will fuel motivation for more changes.  Think about how someone achieves a long term goal such as finishing a college degree or learning how to play piano.  Are either of those achievable in a month or two?  I doubt it, unless you are a genius!  Losing weight, changing your eating habits, or getting into a regular exercise routine is similar in that they all need time and dedication, and incorporated gradually into your lifestyle.

Aside from setting S.M.A.R.T. goals, you can also start tracking your progress and reward yourself along the way.  Maybe you could take a calendar and mark a red X on the days when you accomplished your task.  For example, if you went to the gym, you would mark that day.  Another way is to put a large jar on your kitchen counter, each day you meet your goal, you put a $1 or $5 bill inside.  At the end of 3 or 6 months, use that money towards something that will bring you pleasure (but also healthy), such as a massage treatment/facial, or perhaps a weekend getaway.  I understand that this is not likely feasible to continue for many years, but by as a few months go by, you will have incorporated this habit into your life and you will likely be able to continue it.

Assess how you feel after adopting a healthier lifestyle.  Do you have more energy?  Are your moods turning more positive?  Do you feel motivated at work?  If so, keep going and continue on this path throughout the year.

Our feet take a lot of punishment each day.  It’s amazing that they can support our body weights with each step we take.  My mother always said that you can save money on clothes, but never try to save money on shoes.  A good pair of shoes can prevent you from foot pain, injuries, back pain, and knee pain. In my practice, I see that “flip flop” sandals are being worn in more places than the beach or around the pool.  They are being used for walking to work and strolling on city streets.  Not surprisingly, I am also seeing a number of injuries directly related to the wearing of these flimsy plastic sandals.  Here are some examples about why you should save them for beachwear only.

• They do not provide support for your feet.  This is particularly true for people with “flat feet”.  In fact, walking in flip flops can increase your chances of getting a condition called “plantar fasciitis” which causes severe pain on the bottom of the foot often lasting for months.  Because of the instability, you are also more liable to twist or sprain your ankle.
• They are usually poorly made.  Many of them have a small knob that is threaded through a hole in sole.  This can often pull through the soft rubber and cause you to trip and fall
• Having your toes exposed and low to the ground puts you at risk for getting cut by metal or glass that may be on the street.  The thin rubber in these sandals is also vulnerable to punctures from nails or tacks that may be in the street.  If you had a thick soled shoe, this would be much less likely.   I have pulled many small shards of glass from peoples feet in New York City.  Even worse, a lot of times cuts on the feet can easily get infected.  Think about all the grime, animal urine, and bacteria that fill the streets.  If you get cut with a piece of glass that’s been sitting on the street you can bet it will be dirty.
• You are more likely to be stepped on by others and have serious injuries to your heels, toes and toenails.  These areas are completely exposed and leave your feet vulnerable.

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.

Happy Healthy Heart Health Month!  To mark the occasion, we should all take some time to consider one of the most important organs, the heart.  Diseases affecting the cardiovascular system including myocardial ischemia (“heart attack”), strokes, and aortic aneurysms (ballooning of the large artery in the chest) account for the leading cause of death in the US.  Sadly, these deaths are largely avoidable through lifestyle changes and proper screening.  Are you at risk?  The American Heart Association has put together a wonderful self-assessment tool called Life’s Simple 7, that you can complete to find out.

In addition, here is my checklist of things you need to consider and discuss with your primary care provider:

• Know your numbers.  Blood pressure, cholesterol (including breakdown of LDL “bad” and HDL “good” types), blood sugar, heart rate, weight, height, and BMI are essential to an assessment of your fitness.  If you have any abnormalities in any of these, you should ask your primary care provider how you can improve them.
• If you have a blood pressure monitor at home (I believe everyone should have one of these, even if you don’t have high blood pressure.  They are inexpensive and can detect blood pressure issues early), check your blood pressure a few times a week and record these numbers.  Bring these readings with you when you see your provider.  Having multiple readings at different times can help your provider find out if you have a blood pressure issue.
• Do you have a family history of cardiovascular disease.  Ask your blood-relatives for their history.  It is important to find out about high cholesterol, diabetes and hypertension (high blood pressure) history since these are the main contributors to heart disease.  If you have any family members who have had a heart attack or stroke before the age of 50, this is a VERY significant piece of information as cardiovascular disease affecting younger people usually means there is a genetic component.
• What is your exercise capacity?  Has it changed recently?  The heart helps pump blood to muscles so that you can move around.  If you used to be able to climb three flights of stairs without getting short of breath, but now you climb just one and feel winded, something may be going wrong with your heart.
• Are you still smoking?  Smoking is the most significant risk factor for heart disease.  Quitting will reduce your heart disease risk significantly.
• Is your diet too high in saturated fats and sugars?  In general, most saturated fats are derived from meat.  However, there are also plant-based fats that are bad for you such as the “tropical oils” such as coconut oil or palm oil.  Reduce these in your diet as much as possible.  Sadly, many manufacturers of packaged goods will add these to make cookies and cakes taste better.  Be sure to read the labels of all the food you buy and if you see these oils, avoid buying those foods.  Sugar comes in many forms, some which are worse than others.  I would reduce intake of any corn-based sugars such as corn syrup as these have been shown to worsen blood sugar.  Honey or cane sugar, in moderation of course, would be better options.  Stevia, which is technically a spice that makes things taste sweet but doesn’t contain sugar and has no calories, would be the best option.
• What is your stress level?  More and more studies show that stress has a very negative impact on our health.  Stress induces our body to secrete hormones such as cortisol and epinephrine.  In small doses, these are great for helping us ‘weather the storm’ when we face challenges.  However, over time these can have deleterious effects on our body such as increasing blood sugar, weight gain, and raising blood pressure.  We all need to manage stress as much as possible.  Try meditation to help with stress, or start seeing a therapist to talk through your issues.

Be sure to get your annual physical exam, including bloodwork and possibly and EKG!

Recently, the New York Times reported the findngs of a Swedish research study in an article titled “Dog Owners Live Longer”  The article mentioned a study in Sweden which found that dog owners are 20% less likely to die of all-causes and 23% less likely to die from heart disease.  For comparison, statin medications such as Lipitor, Zocor, or Crestor are known to reduce heart disease death by 20%.  So could your “pooch” be making you healthier as much as medications?  It certainly seems that way!

There may be many reasons for these dramatic findings.

• Dog owners will likely be taking their dogs for daily walks.  We have learned that increasing the number of steps we take each day burns calories and keeps our heart in shape.
• When people play with dogs, their stress levels drop dramatically.  Stress is directly linked with inflammation and heart disease.
• Caring for a dog requires a lot of exercise.  Carrying large bags of dog food, refilling the water in dog dishes, bending over and cleaning up after a dog, and playing fetch are calorie-burning chores.
• Dogs can encourage social interaction among owners.  When you take a dog to a dog park, you will likely strike a conversation with other dog owners.  This can lead to friendships and more social involvement, both of which can improve people’s moods.
• Taking the dog to regular vet visits can remind the owner of his/her own need for medical checkups.
• Being responsible and caring for another living creature can induce feelings of compassion and understanding, ultimately reducing stress. There have been studies with elderly individuals who were given plants to take care of in nursing homes.  Many of them were found to have lower rates of dementia than those who did not.  They also noted that they had lower stress levels.

Dogs make great companions.  The fact that they can lower your risk of heart disease is one more added benefit to the unconditional love they provide to us.  I would advise that if you have the means and want to have a dog, it may prove beneficial to your health.  However, please do not buy a dog for someone else just because you feel it would benefit their health.  Not everyone has the capacity to do what is required and we don’t need any more dogs in shelters.

My Brother’s Beagles, Luke and Leia