Accountability Improves Outcomes

It is a simple fact. Whether it is a boss, a partner, some silly app, or a crazy doctor, we do the right thing more consistently when we have someone or something holding us accountable. I beat this drum relentlessly with my patients that want to get healthier--particularly individuals who want to lose weight. In my experience, when patients take the time to consistently keep a detailed log of what they eat, they are about four times as likely to lose weight and keep it off. If a patient is "too busy" or "can't remember" to keep a food log, he or she is not committing to the process. Anyone CAN do it, but many of us simply won't. Believe me, I get it. It is inconvenient. It is tedious. It is boring. How badly do you want to feel great in your body and strong and energized? I love this article for its simple, no nonsense message of Rachel's weight loss!

15,000 Steps a Day

A recent piece in the New York Times discussed the improved health metrics of Scottish mail carriers that walk 15,000 steps a day. This seems like a no-brainer that walking about seven miles a day will improve your health. However, the take away message is not that you should take a two hour walk each evening. The goal is to live an active life; one which does not compartmentalize physical activity. Get up and move. Often. Constantly. Go out and walk at the beginning and end of the day. If you have a desk job, take a 5 minute walk break each hour. Take the stairs. You will be more productive, have less back pain and inspire others around you. Walk, run, play, laugh and love. Happy Monday! 

This Stuff is Seriously Delicious!!!

Good Culture was started in Irvine, CA by a couple of guys looking to make better cottage cheese. The product is all organic and the milk is from grass-fed, free roaming cows on sustainable family farms. As long as you don't follow a vegan diet, the nutritional content is ideal for getting in some lean protein. Did I mention that it is really, really tasty? Even if you despise cottage cheese, give this a try!


Updated Food Labels

The FDA is finally updating how packaged foods are labeled with nutritional information. Labels will soon have to list both per serving and per package information, as well as adapting serving size to more closely reflect the amount that is typically consumed. Would you think twice about finishing a pint of ice cream if the nutritional facts claimed the full 1120 calories?

What do I eat?

Patients and friends sometimes ask me what I actually eat when no one else is around. I have never hidden my affinity for cookies or the fact that I love food. My advice is to be as balanced as possible and eat all of the foods you love, in reasonable amounts. This is a breakfast I prepare for myself on those rare lazy Sundays when I'm only cooking for myself. My breakfast preferences have always trended towards anything that can be doused with hot sauce! 

Breakfast Scramble

1 organic egg and 2 additional egg whites, 1/4 cup shredded organic cheddar, 1/3 of an avocado, 1 plum tomato, 1 T diced onion, 2 T fresh cilantro, a wedge of lime and hot sauce, of course. 

This is one of my favorite simple meals. It has about 300 calories, 20 grams of protein and 7 grams of fiber. If you are watching calories you can use low fat cheese and egg whites only to cut the calories to about 240. Keep the avocado for healthy fats and lots of fiber. 

Influenza on the Rise

The CDC released its update on the 2015-2016 season. Many of my patients have mixed feelings about the flu vaccine. Young, healthy individuals have far less morbidity and mortality from influenza. However, if you travel frequently or spend time with babies or elderly people, I recommend the vaccine to avoid spreading the flu to more compromised individuals. I do order the FluMist nasal for the office each year. It is a live attenuated, preservative-free vaccine, approved for patients age 2 through 49.

The 2015–16 influenza vaccine is 59% effective so far — comparable to past seasons with good matches between vaccine and circulating virus strains — according to data presented at the CDC's Advisory Committee on Immunization Practices (ACIP) meeting on Wednesday.

When broken down by virus type, the estimated effectiveness is 51% against the H1N1 viruses causing most influenza this season, 76% against all influenza B viruses, and 79% percent against the B/Yamagata lineage of B viruses.

Flu activity started slowly this year, not becoming elevated until mid-January. Activity has remained elevated since then and "is still on the upswing and expected to continue for several weeks," said Dr. Joseph Bresee, chief of the CDC's Epidemiology and Prevention Branch.

Also at the meeting, ACIP updated its flu vaccine recommendations to note that patients with egg allergy may now receive live attenuated vaccine. (A 2015 study in The BMJ demonstrated its safety in egg-allergic children;)

Rave Reviews

One of the blessings of having a large family is that each child brings unique perspective, individual talents and their own energy into the household. While each child adds to the liveliness of family meals, each also willingly contributes his or her opinions, preferences and aversions. My motto is "Eat it and like it." Not because I am mean (although I am) but because I am busy. So, unless you are going to have an anaphylactic reaction or projectile vomit, you eat what I serve. However, there are the rare occasions when I make something that every member of my tribe enjoys. I use the term "enjoy" to mean everything from raving about how delicious it is to simply not whining and making gagging noises while swallowing. This was one such meal. Orange tarragon chicken, bruschetta and chopped salad with oranges and shaved fennel. Tarragon and fennel have strongly distinctive flavors so use the tarragon sparingly and shave the fennel thin. 

Salad- Throw together shaved fennel, romaine lettuce, sliced plum tomatos, peeled and halved small seedless orange sections, shaved romano cheese and toasted pine nuts. For the dressing, I mixed a small amount of fresh squeezed orange juice with red wine vinegar and tossed it just before serving. To keep it light, I just used about 2 T of each for the entire salad.

Marinade-Throw all of this stuff together in a mini food processor and then marinate a pound of chicken breasts in it for an hour or overnight. Grill the chicken right before serving.

  • 1 whole seedless clementine or small orange (unpeeled)
  • 1/2 yellow onion
  • 2 cloves garlic
  • Some fresh tarragon (I use the leaves from 3 or 4 sprigs
  • 1 T olive oil and salt and pepper to taste


Every time that I jog to the beach to watch the sunrise, I vow to make it part of my daily routine. Packing lunches, blow drying my hair, oversleeping and needing to get to the office early are just a few of the things that plow over my best intentions on a regular basis. Last night I was up past midnight reading The Outsiders because I want to discuss it with Ainsley as she reads it for school. With less than six hours of sleep, I was tired this morning. Rather than going for a run, I jogged down and stretched while the sun was rising. I didn't even work up a sweat on the way there or back. Not all motion needs to be exercise. I spent that 15 minutes feeling my body and mind wake up. Focusing on how grateful I am for all of the beauty in my life set this day in motion far better than an extra few minutes of sleep. Take a few minutes today to revel in the joyful parts of your world.