Vitamins can be a useful supplement to a healthy diet.  One important fact to understand is that some vitamins require a fatty medium in order to be dissolved.  These so-called “fat-soluble” vitamins include Vitamin A, D, E and K.  I recommend my patients to take their multivitamin with breakfast or perhaps with fish oil capsules.  In addition, Vitamin D requires the additional step of sunlight to become active hence morning dosing would be more effective.

Please let your physician know about the vitamins you are taking as these can sometimes interfere with medications, such as vitamin K with Warfarin (Coumadin).

Traveling to another part of the world is often exciting, but sometimes complicated by jet lag.  Essentially, it is your body’s internal clock being out of sync with the daily rhythms of your location.  One of the best ways to prepare your body for this change is to alter your sleep cycle for about a week before.  For example, if you are traveling west, go to sleep a little later each night.  If you are traveling east, get up a little earlier each morning.

Be sure to avoid alcohol a few days before and on the flight, as alcohol can disrupt your brain’s normal functioning.  Though people often say alcohol helps them fall asleep, the quality of sleep under the influence of alcohol is not as restorative.  On the other hand, caffeine can be helpful for staying awake during the process of adjusting to the daytime hours.

After you reach your destination, try to adapt to the local time as best as possible.  Eat meals appropriate to the time of day.  I can’t stress enough the importance of drinking plenty of water, daily aerobic exercise, and exposure to natural sunlight.  Here are some tips on how to exercise while traveling.  If you are staying in a hotel, try to get a room that gets ample sunlight.   Limit computer use at nighttime.  The bright screen of a laptop can stimulate the eye and brain like an artificial sun.

Diet is often misconceived as a temporary solution to weight loss. I feel this has given the word “diet” the wrong connotation for most people. Diet should refer to good healthy eating throughout each day. I try not to make too many changes in my patient’s diets too quickly.

Humans are creatures of habit. We do not like drastic changes. I had a patient once who ate McDonald’s every day for lunch. When I told him his cholesterol was very high, he got scared. He asked me what he should eat. I told him whole grains, plenty of fruits and vegetables, less red meat, and absolutely no fast food. He missed his follow-up appointment and did not show up in my office until 6 months later. He recounted that he changed his diet completely for 2 weeks, eating nothing but oat meal, brown rice, steamed fish and vegetables. However, he went back to his “Big Mac” ways shortly after and said he felt like a failure. This is not healthy for both doctor and patient. The doctor gets frustrated that the patient didn’t adhere to the diet. The patient feels like he “failed” in his attempt. One can say there’s nothing wrong with unsuccessful attempts, but I disagree.

Take the example of the “slot jockey” at any casino. These men and women will play at a machine, putting in tons of quarters for hours on end. But if a machine does not pay out after 10 or 20 times, they will move on, perhaps mumbling, “it’s an unlucky machine.”  The same is true with diet, and smoking for that matter. If you fail multiple times, the chances of success on the next attempt are going to be much less. It becomes a self-fullfilling prophecy.

I often tell my patients to change one single item in their diet each week. For example, change the daily can of Coke to Diet Coke. That one small change will save you 140 calories per day. The next week, they can change the fried egg sandwich on a roll each morning to a fried egg sandwich with whole wheat toast. So this is a gradual, but more effective and lasting way of changing diet. It’s not feasible for someone to go from eating burgers and fries to eating something that looks like twigs, hay, and birdfood.

I once had a lovely Italian lady as a patient. I diagnosed her with type 2 diabetes. She didn’t mind taking medications but she was devastated about the dietary changes she would have to make, “How can I have my pasta?!” I taught her how to check her sugars and she was religious about checking before and after meals. She came back a few months later with a grin on her face. She said she “cheated” a few times and had lasagna and found the sugars to be high. However, a friend told her to try whole wheat pasta. After she had the same size portion, which she knew should be no bigger than a fist, she checked her sugars and found them to be good! Since then, she has been much happier. She learned on her own how to adapt her diet. As I mentioned previously, we humans don’t do well with drastic changes.

Remembering to take medications can be difficult, but there are some simple ways to make it easier. Find out if your medications need to be taken at a certain time of day. Be sure to ask your pharmacist or physician before you leave the store or office.

For medications that have to be taken at bedtime, keep the medication bottle next to your toothbrush. To remember morning doses, keep a bottle of water and the pill bottle next to your alarm clock. Pill organizers are very helpful as well. There is even one type that has a pocket for every day of the month (it’s about the size of a small monthly calendar). If you have an smartphone, there are alarms and apps where you can set reminders.

As we have learned from watching natural disasters in Haiti and Japan, you can never be overprepared. Always keep one week supply of medicines in a safe place, perhaps in a small resealable plastic bag with the date. If you need to evacuate, you will have at least one week of medication wtih you. Remember to change this supply every few months to make sure they do not become expired.