Operation You: Taking Personal Responsibility
There’s just no easy way to say this: your biggest problem is you. It’s not the weather, or the economy, or the government, or the alignment of the stars. It’s you. Phew! I’m glad we’ve sorted that out. Now, we can start getting you out of your own way. Prepare yourself for Operation: You. The Stuff That Happens TO You vs. BECAUSE of You In life, there’s stuff that happens to you and stuff that happens because of you. One you have control of, the other you don’t. The stuff that happens to you is often out of your control. Your boss is in a bad mood. Your football team got beaten in the playoffs. Your car won’t start. Many of these things you cannot control. Perhaps you can influence them. For example, servicing your car regularly means it probably will start, but largely that stuff just happens. If you put too much effort into worrying about it you’ll waste the energy you could actually use to effect some positive change in your life. The stuff that happens because of you and your actions is completely in your control. In understanding this, you put the power in your own hands and remove it from those around you. Meaning, no one else can prevent you from getting what you want. And that’s why I wrote earlier that you have to get out of your own way. Are You at the Cause or the Effect? Psychology students are taught about external and internal loci of control. An external locus of control is when you believe external factors control your situation. While an internal locus of control is when you believe you are in control. An internal locus of control sees you taking responsibility for what is happening in your life. The key is personal responsibility. When you take responsibility for what is happening in your life, then you put yourself in a position of power. You put yourself in a position from which you can achieve your dreams. NLP practitioners learn about cause and effect. When you are in control, you are at cause — you cause your results. When you are at effect, the external world affects your outcomes. Understanding the differences between these two positions is essential. Cause is a position of empowerment. Effect is disempowering. The position of effect allows you to explain away your poor outcomes. Cause doesn’t let you off the hook. If you want positive outcomes in your life, you have to be responsible and in control of your responses, actions, and outcomes.
Preet Kahlon
Nutrition: Tips to improve your health
Good nutrition is one of the keys to a healthy life. You can improve your health by keeping a balanced diet. You should eat foods that contain vitamins and minerals. This includes fruits, vegetables, whole grains, dairy, and a source of protein. Ask yourself the following questions. If you answer yes to any of them, talk to your doctor about your health. You may need to improve your eating habits for better nutrition. Do you have a health problem or risk factor, such as high blood pressure or high cholesterol? Did your doctor tell you that you can improve your condition with better nutrition? Do diabetes, cancer, heart disease, or osteoporosis run in your family? Are you overweight? Do you have questions about what foods you should eat or whether you should take vitamins? Do you think that you would benefit from seeing a registered dietitian or someone who specializes in nutrition counseling? Path to improved health It can be hard to change your eating habits. It helps if you focus on small changes. Making changes to your diet may also be beneficial if you have diseases that can be made worse by things you are eating or drinking. Symptoms from conditions such as kidney disease, lactose intolerance, and celiac disease can all benefit from changes in diet. Below are suggestions to improve your health. Be sure to stay in touch with your doctor so they know how you are doing. Find the strong and weak points in your current diet. Do you eat 4-5 cups of fruits and vegetables every day? Do you get enough calcium? Do you eat whole grain, high-fiber foods? If so, you’re on the right track! Keep it up. If not, add more of these foods to your daily diet. Keep track of your food intake by writing down what you eat and drink every day. This record will help you assess your diet. You’ll see if you need to eat more or less from certain food groups. Think about asking for help from a dietitian. They can help you follow a special diet, especially if you have a health issue. Almost everyone can benefit from cutting back on unhealthy fat. If you currently eat a lot of fat, commit to cutting back and changing your habits. Unhealthy fats include things such as: dark chicken meat; poultry skin; fatty cuts of pork, beef, and lamb; and high-fat dairy foods (whole milk, butter, cheeses). Ways to cut back on unhealthy fats include: Rather than frying meat, bake, grill, or broil it. Take off the skin before cooking chicken or turkey. Try eating fish at least once a week. Reduce any extra fat. This includes butter on bread, sour cream on baked potatoes, and salad dressings. Use low-fat or nonfat versions of these foods. Eat plenty of fruits and vegetables with your meals and as snacks. Read the nutrition labels on foods before you buy them. If you need help with the labels, ask your doctor or dietitian. When you eat out, be aware of hidden fats and larger portion sizes. Staying hydrated is important for good health. Drink zero- or low-calorie beverages, such as water or tea. Sweetened drinks add lots of sugar and calories to your diet. This includes fruit juice, soda, sports and energy drinks, sweetened or flavored milk, and sweetened iced tea. Things to consider Balanced nutrition and regular exercise are good for your health. These habits can help you lose or maintain weight. Try to set realistic goals. They could be making some of the small diet changes listed above or walking daily. Doctors and dietitians suggest making healthy eating habits a part of daily life rather than following fad diets. Nutrition tips and diets from different sources can be misleading. Keep in mind the advice below, and always check with your doctor first. Secret diets aren’t the answer. Fad or short-term diets may promise to help you lose weight fast. However, they are hard to keep up with and could be unhealthy. Good nutrition doesn’t come in a pill. Try eating a variety of foods instead. Your body benefits most from healthy whole foods. Only take vitamins that your doctor prescribes. Diet programs or products can confuse you with their claims. Most people in these ads get paid for their endorsements. They don’t talk about side effects, problems, or regained weight. Questions to ask your doctor How many servings should I eat from each food group? If I’m on a strict diet, such as vegetarian or vegan, how can I improve my health? Are there certain eating habits I should follow for my health condition?
A dust over India
s your plane descends upon New Delhi, a soft orange haze engulfs you, drawing you in. A cascade of shanty towns drift below, clogged arteries of traffic dividing the landscape into innumerable scattered shards of populace. If you land in the evening, the haze throbs over the country with a dull glow in the speckled city lights. If you land in the afternoon, then the haze is a giant mass of incomprehensible dust — some amalgamation of smog, smoke, dirt, and fog — and no matter how far away you go, or how far you get, you never completely escape it. I have been to 40 different countries. Yet India made the most indelible impression of any of them. And not for all of the right reasons. Frankly, it’s not a pleasant place to be. Anyone who tells you otherwise lacks perspective. India’s full of contradictions: horrors and delights, achievements and atrocities, often on the same city-block. And despite the immense history, the monuments, the spectacular sites of human ingenuity, one can’t help but ask themselves repeatedly what they’re doing there. The first thing that strikes you about India is how dirty it is. In a word, the place is disgusting. All of it. The entire country. Never before have I seen mountains of garbage the size of a small house stacked on the side of a road, in broad daylight, in the middle of a city, repeatedly. Dumpsters tipped over and overflowing. Mounds of trash — wrappers, cups, papers, napkins, strewn all about, mixed with sludge from the soda and urine and spit coagulated from thousands of daily passersby. Like the dust, the garbage never ceases. And along with the garbage, there is an unending stream of humanity. It is impossible to spend a full day in the middle of a major Indian city without lobotomizing yourself trying to figure out where the hell all of the people come from. I’ve been to Hong Kong. I’ve been to Manhattan and Beijing. I’ve been to Mexico City. And the swarm of humanity crawling through India’s cities is unparalleled. There’s no comparison. Many streets more closely resemble a bee hive than a functioning human society. When I flew into Mumbai, there were homeless people sleeping on the tarmac. Take a moment for that to sink in: the city is so crowded and disgusting that people decide they’d rather sleep on the airport runway. And that is the second thing to strike you about India. The poverty. It is legitimate, take-your-breath-away poverty. Like the kind you see on TV charity ads, but far worse. And far more real. Limbless men stewing about in their own feces. Emaciated children playing on piles of garbage. A man with his leg literally rotting off to the bone, maggots and all, laying on the curb. It’s everywhere. The amount of suffering is indescribable. And it is unceasing. After a couple days, I was excited to hire a driver to go to Agra because I figured I’d be able to see some countryside and escape the stench and horrors of the city. But no. The entire four hours between Delhi and Agra was an unending stream of people, garbage and cars, with billows of dust drafting in our wake the whole way down. My initial reaction the first few days was pure shock. But it quickly evolved into anger. How could a place like this be allowed to exist? How could normal people walk around with a clear conscience with so much shit and squalor festering about them? I felt indignant. Where was the social accountability? Where was the charity? Where the fuck was the government? I’m no expert. And god knows my own country has plenty of problems. I’ve been to plenty of developing countries and seen plenty of poverty. But this was something else entirely. The sheer magnitude, more than anything, wrought a deeply emotional response out of me. For the first time in my life, I finally grasped what inspires people to drop everything and move to a dirt hole in the middle of Africa and start feeding people. When confronted with that much suffering, it seems insane not to do it. People like Mother Teresa or Princess Diana or Bill Gates didn’t seem like such foreign actors anymore. I could feel what they must have felt, even if just for a moment. With my driver taking me on a full-day trip to Agra, I watched the endless poverty scroll by like a demented video game. I had an overwhelming urge to stop at an ATM and withdraw 25,000 Rupees and start handing money out to people at random. I started doing the math in my head. That’s roughly $500. I could hand out $25 to twenty people. $25 could probably feed these people for almost a month. How much of my monthly income would I be willing to give up to feed 20 people each month? At what number would I no longer be willing to do it? At what dollar amount did my morality begin and end? The numbers began to make my head swirl. I was calculating my personal morality. I felt pathetic. And powerless. Like Oscar Schindler at the end of Schindler’s List, sobbing that his gold ring could have saved one more Jew, self-pitying yet noble at the same time. That Big Mac I had in the airport could have saved one more Indian! Damn you, value meal! Things only got more surreal from there. At a security checkpoint, a kid brought up a real live cobra to my car window, scaring the living shit out of me and my fellow passengers. He then asked us for a rupee. We didn’t give him one. In another scenario, a Swedish girl in the car with us mentioned she should have given some starving boys her box of cookies. When we asked her why she didn’t, she calmly replied that little boys shouldn’t be eating cookies, that it’s bad for them. In a Pizza Hut, every table had its own waitress. When I ordered hot wings as an appetizer my waitress duly congratulated me on making such an excellent culinary decision. Seriously. That’s what she said. As I looked around the restaurant, I saw each table occupied with fat, well-dressed Indians. I was reminded of the line from Monty Python and the Holy Grail: “He must be a king.” “What makes you say that?” “He doesn’t have shit all over him.” In Pizza Hut, the Indian people did not have shit all over them, therefore I assumed they were kings. That and they all conspicuously had their Blackberry’s out for one seemingly nonchalant reason or another, silently bragging to one another across the restaurant between garlic sticks. Meanwhile, out the window in front of the restaurant, a homeless boy (covered in shit) was attempting to pry open a boarded-up hot dog stand, presumably to find some scraps of food left inside. Stray dogs licked their open sores nearby. Trash milled about, blown by dust. And we, the fat, rich kings of Pizza Hut had our appetizers congratulated by personal staff. The mind boggled. The contradictions mounted. My cognitive dissonance flared. When the manager came by to ask me how I was enjoying my meal, my first thought was “This is fucking Pizza Hut. What’s wrong with you?” But I didn’t. I smiled and said “Fine, thanks.” But the bizarro world of India didn’t always lead to anger. It could be charming as well. At the Taj Mahal, I was approached by an Indian guy my age who asked me to take a picture. I said sure and reached out to take his camera, assuming he wanted me to take a photo of him in front of the monument. But instead, he stepped away from me, pointed the camera at me, and as four of his friends surrounded me and draped their arms around me, snapped a photo. Minutes later, a small family of four requested the same. And then another family, but this time just me kneeling with their kids. Then a group of teenage boys who wanted a picture with my tattoo. As a tourist, I became part of the tourist attraction myself. Here we are at the Taj Mahal. And here we are with a white person. And here’s little Sandeep flexing his arm next to the big white man. Soon a crowd had gathered. Many of them hung around, nervously trying to speak English with me. Some of them simply stared for minutes on end. All of them beamed smiles of excitement. The dust pervades every city and town, some with a smoggy golden hue, others with a gentle grey haze. It cakes the cars, the streetlights and the dead stray animals. It scratches at your throat and turns your snot black. Indian culture itself is quite disorienting. The people can be incredibly warm and hospitable, or cold and rude depending on the context and how they know you. The conclusion I eventually came to is that if they already know you, or if they’re somehow benefiting from you, then they can be incredibly warm and open people. But if they don’t know you, or if they’re trying to get something out of you, then they are a prickly, conniving bunch. The local I got to know the best was Sanjay, the 20-something year old who ran a hostel I stayed in. He had studied in London and been all over Europe so he was fairly westernized. He and I would stay up late together drinking cheap vodka, regaling each other with our travel stories. There was little else to do after nightfall in India but get drunk. And little felt more appropriate. But what Sanjay told me about Indian people is bizarre but true. He said Indians will rarely, if ever, resort to violence. As a foreigner, you never have to worry about being robbed, or having a knife pulled on you, or getting beaten up by a gang of thugs and having your kidney carved out of you. And this is true. I’ve been to many shady parts of the world. But never did I once feel unsafe in India. Even late at night. But, Sanjay said, an Indian will lie to your face. He’ll say anything to get what he wants from you. And most of them don’t see it as immoral or wrong. So on the one hand, they won’t stick a gun in your face to take your wallet. But they’ll hand you fake business cards and offer to sell you something that they don’t actually have, so that you’ll voluntarily empty your wallet to them on your own accord. And I have to give them credit, they’re really convincing salespeople. In Agra, our driver brought us to a handcrafted rug shop. Inside the shop I immediately knew what was coming: a “tour” of the rug factory where we would be cornered (literally) and pitched to buy one. I had seen this before in other countries and here I saw it coming a mile away. Yet the man came across as so unassuming, so genteel, so incredibly polite, it was impossible to not be won over. He showed us the individual thread counts of the rugs, how the rugs are meticulously woven by hand. He showed us how they design the patterns on elaborate grids and then translate them to their wooden weaves. He then took us downstairs, gave us beverages and launched into one of the most impressive sales pitches I’ve ever heard in my life. The man should be selling luxury cars in the United States. By the end of it, I was busy deciding which rug my mother would like the best. After some gentle bargaining, and some friendly gestures, I made the purchase and arranged to have it shipped to her in the US. It was about an hour later in the car when I realized what had just happened. The elaborate setup. The way packages with American addresses had been set out just right for us to see. The pictures of “satisfied customers.” I knew what they were, and they were good. My stomach dropped. I’d been had. My mother would never see that rug. But with only a couple hundred dollars lost, I got away fairly unscathed. An 18-year-old Canadian kid staying in our hostel got taken for thousands of dollars. A couple of Indians stopped him on the street, and with perfect English convinced him they worked for a travel agency. They then led him to their “office,” where they handed him “brochures” and “planned” out over a month’s worth of traveling and lodging, telling him the entire time that they were getting him the best deals and that they would pre-arrange every relevant tour. By the end of the hour, he had spent close to $2,000 and felt good about it. By the time he got back to the hostel his face was white. He realized what happened. He asked Sanjay about it and Sanjay told him to immediately call his bank in Canada and cancel the card. Tell them it had been stolen. There was no trip. No lodging. No travel agency. Just two Indian guys with silver tongues. The travel scams aren’t limited to high-end tourist items either. Pirated DVD’s that don’t work. Taxis that let you off at the wrong place. Hotels that add suspicious “fees” at the last minute. You get harassed constantly on the streets: vendors following you for half a block trying to hock their useless shit to you. Luckily, I learned long ago the perfect remedy to street touts: iPod + sunglasses. Crank that shit up to 10 and just keep walking. What you can’t hear or see can’t bother you. Would-be harassers and hagglers bounce off you like flies. Image credit: t3rmin4t0r But, to be fair, many Indians will go out of their way to be honest with you. There were multiple times where I thought the guy had asked for 50 Rupees when he had actually said something else, and instead of taking the extra money, he gave it back. Or like the time a taxi driver offered to show me a famous Minaret for free, for no other reason than because he was Muslim and thought I should see it. Or the kid in Gaya who rode me all the way back to my hotel on the back of his bike, for no other reason than he was excited to practice English with me. Or Sanjay, who on our third night drinking together, surprised me with an entire home-cooked meal made especially for me. Or my tour driver, who after dutifully driving us around for over 13 hours straight, teared up and hugged me when I gave him a 50% tip. Like anywhere else, Indians aren’t all good or all bad. You simply get more of each social extreme. It’s unpredictable. Not to mention emotionally draining. The constant need to be on-guard is taxing on one’s psyche. In Bangalore, I snapped. My taxi driver from the airport “forgot” to turn on the meter. Realizing this, I watched his odometer and counted the 30 kilometers we traveled. When we arrived, he tried to charge me for 50 kilometers. A shouting match ensued. I threw the money for 30km at him, grabbed my bag and walked into my hotel. He followed. He began pleading to the hotel clerk that I had refused to pay and that his price was the appropriate price. Now, with four people watching, I pulled out my laptop, connected to the wireless network, loaded Google Maps, and showed him that it was, in fact 30 kilometers from the airport to the hotel. My hands were shaking with anger by the time it finished loading. Luckily, he took my money and sulked off. At the door he turned around and said, “But you need to sign the receipt.” I shouted back, “Go fuck yourself.” I moped into my room, frazzled and bitter. After almost three weeks of dealing with such nonsense, I was reaching my wit’s end. I would not be surprised if I ended up punching someone over something menial soon. I lost it with the taxi driver. And when I did the math in my head, it was just $4. I freaked out over $4. Luckily I was leaving soon, heading to Singapore in a few days, back to civilization. I laid out on my bed, took a deep breath and opened my laptop. In the inbox was an email from my mom: “Thanks for the rug, I love it!” In the northern foothills of the Himalayas, the dust morphs into an awkward haze. It sticks to the horizon. Trash still permeates the small villages, although in smaller heaps, many of them charred from their daily burnings. The beggars seem less down-trodden. Cows sprinkle the roadways in between tuk-tuks and overflowing caravans. For the most part, the crowds have dissipated. India attracts a wide variety of spiritual-seekers, lost western souls criss-crossing its geography in search of meaning or of themselves. India is the cradle to two of the oldest major religions in the world: Hinduism and Buddhism, both of which, unlike their western counterparts, focus predominantly on a first-person perspective of spiritual development. Having been interested in Buddhism for over a decade and having spent much of my college years meditating and attending retreats, my interest was piqued by the plethora of ashrams, gurus, and Dharma groups available. The reality was a let down. There’s no other way to describe the phenomenon other than what it is: spiritual tourism. Which is somewhat of an oxymoron, especially in Buddhism. And also disheartening as it falls victim to the same scam-inducing practices as India’s other tourist markets. Scattered around places like Bodhgaya and Goa, flyers are shoved in your face, street peddlers try to convince you that they can take you to the best ashram in town (as if there’s a “best” way to do yoga). Some even promise enlightenment… for 10,000 Rupees a week. Now, I’m sure there are legitimate and profound retreats and ashrams in India. But the whole process felt cheap and inauthentic. Children tried to sell marijuana around yoga retreat centers. And it was apparent why: the dreadlocked, tie-dyed, mid-life-crisis’ed Western clientele who streamed through enthusiastically buying from them told you all you needed to know about the scene. Two westerners I spoke to in Bodhgaya, where I considered sitting in on a retreat for a couple days, told me that they had never meditated before and were excited to learn it in India. When I mentioned that one could learn to meditate in 10 minutes at home to see if they actually liked it, they replied, “Yeah, but it’s so much cooler to do it in India.” My mind’s eye could just see The Buddha face-palming at that statement. One girl tried to brag to me that she had visions of Krishna in the northern mountains and that she thinks she may convert to Hinduism. When it came out that she had been smoking local hashish every day for weeks on end, I pointed out that these two things may not be a coincidence. She didn’t like hearing that. Perhaps it was my own arrogance, but it saddened me. My belief has always been that spirituality is something that is experienced personally, not measured, compared, or quantified. Meditating on a loud bus in Chicago can be just as profound as meditating under the Bodhi Tree itself. In a religion whose whole belief system revolves around impermanence, unattachment to the material world, and equanimity, making a 4,000 mile pilgrimage to a tree in the middle of Nowhere, India, for bragging rights seems, well… counterproductive. I can see the interest historically, and perhaps emotionally, but spiritually, there’s not a whole lot of difference. And so as I passed the flyers, and the hippies with their braids and skullcaps, it became harder and harder not to be a little bitter. I understand that pilgrimages and capitalizing on your most holy site are pretty standard for all of the world’s religions. But I guess in my mind I held out hope that Buddhism was different. And actually, Buddhism is different. It’s the followers who aren’t. (Or maybe I just don’t like hippies.) But I can’t help but feel that the volume of poverty in India is related to the solipsistic tendencies of the religions based there. I also can’t help but feel that foreigners regularly mistake being pushed so far out of their cultural comfort-zone as some sort of spiritual experience. When the human mind is presented with paradoxical conditions, it usually reacts with inexplicable feelings and often invents a supernatural explanation for them. And India is rife with paradoxical conditions. The most beneficial effect of traveling that I’ve found is that it forces you to become more confident and independent in a million, tiny, unnoticeable ways that add up to a great, noticeable whole. The more difficult and exotic the culture, the more it challenges you, the more it engages you on an emotional level, and the more you grow in intangible and personal ways. Perhaps there’s nothing inherently “spiritual” about the sub-continent, it’s just the most extreme cultural experience a westerner can subject themselves to and, as a result, grow from. Every country we go to, our natural inclination is to search for some kind of greater meaning. “China’s finally making the leap,” or “Latin culture is exceedingly passionate,” or “Corruption dominates Russia,” — all of these trite little platitudes that we bring home with us and spill amongst our friends and loved ones to show that we did something significant, that we learned something interesting. This is where I went. This is the meaning. All in one or two sentences. There’s no single sentence for India. The place is a fucking mess. And it’s the only country that I’ve ever been to where I left more confused than when I arrived. My search for meaning came up empty time and time again. One day in Bodhgaya, a small town of maybe a few thousand people, I ate at an outdoor restaurant in the town square. Beggars, shirtless children and cows littered the square, along with a few assorted street vendors. I had just returned from touring the temple built for the place The Buddha had become enlightened. Looking out over the town square from my large plate of curry, I watched the beggars stew about, completely ignored by the townspeople. By this time my search for meaning in this land had become frantic, and my emotions fried. I looked at the mound of food before me. It had cost $2.50 US dollars and could feed multiple people. I called the waiter over and ordered another one. The two nearest beggars were an old man and woman together, huddled on the ground, clothes tattered, white hair and beard matted and dirty. They looked up at me with their emaciated arms outstretched in cups, the same cupped hands one would use to drink from a river. Their eyes sank into their sockets. They seemed to look beyond me. I put the second plate of food down in front of them like a pair of dogs. They looked at it wide-eyed for a moment, and began shoveling the food into their faces as fast as they could. Curry dripped from the man’s beard. Rice mashed into his black fingernails. Bits of chicken spattered on the ground below them. I stood there watching for a few seconds, expecting something. What? I don’t know. But I wanted to feel something. I wanted to feel like there was some purpose to all of this. That I could walk away with something important from my whole experience. But instead I felt helpless. It was like I had just put a band-aid on the Titanic. He’s going to go digging through garbage again in a couple hours. He didn’t even look at me. What’s the point? Obviously, I’m no Mother Teresa. And it’s just as well; Mother Teresa couldn’t save this society from itself. Sometimes human systems become so large that they hurt people, not by design, but by inertia. And it’s beyond any of our ability to grasp, let alone control. The townspeople had seen what I had just done. And within seconds, a boy approaches me and asks me to buy him a soccer ball. I tell him no and begin to walk away. He follows. Then another man comes up wanting to sell me pirated Bollywood DVD’s. I also tell him no. He gets upset, “You give food to a beggar, but you won’t even buy a DVD from me? Why not?” He felt like I committed some terrible injustice against him. A crowd was beginning to form around me, looking for handouts. I quietly put on my headphones and sunglasses, turned my iPod up to full blast, and walked through the dust.
Healthy beverages guidelines
Introduction In the beginning there was water—abundant, refreshing, providing everything the body needs to replenish the fluids it loses. Humans relied on it as their only beverage for millions of years. Milk came next, with the advent of agriculture and the domestication of animals. Then beer and wine and coffee and tea, all drunk for taste and pleasure as much as for the fluids they provide. The newcomers—soft drinks, sports and energy drinks, and the like—offer hydration but with a hefty dose of unnecessary calories that the body may have a hard time regulating. With so many choices, all with different, sometimes unexpected effects on health, it’s easy to be confused about the “best” beverages for health. This prompted a group of nutrition experts from across the U.S. to form the independent Beverage Guidance Panel. These six researchers, including Dr. Walter C. Willett of the Harvard School of Public Health’s Department of Nutrition, reviewed the evidence on beverages and health and ranked categories of beverages into six levels, based on calories delivered, contribution to intake of energy and essential nutrients, and evidence for positive and negative effects on health. (1) The winner? Water. But that doesn’t mean that water is the only beverage that’s good for your health, or that everyone needs to drink eight glasses of water a day. Beverage Guidelines from the Experts The Beverage Guidance Panel distilled its advice into a six-level pitcher, much as food experts have done with the food pyramid. The group published its recommendations in the March 2006 issue of the American Journal of Clinical Nutrition. Here is a description of each level: Level 1: Water Water provides everything the body needs—pure H2O—to restore fluids lost through metabolism, breathing, sweating, and the removal of waste. It’s the perfect beverage for quenching thirst and rehydrating your system. When it comes from the tap, it costs a fraction of a penny per glass. Water should be the beverage you turn to most of the time. It’s impossible to set a single requirement for how much water the hypothetical average American needs each day. The amount you need depends on how much you eat, what the weather is, and how active you are. So instead of setting an estimated average requirement for water, as it has done for other nutrients, the Institute of Medicine has set an adequate intake of 125 ounces (about 15 cups) for men and 91 ounces for women (about 11 cups). (5) Note that this is not a daily target, but a general guide. In most people, about 80% of this comes from beverages; the rest comes from food. As for the oft-repeated nutrition advice to “drink eight glasses of water every day,” there’s little evidence to support it, but this would be one excellent way to fulfill most of a person’s fluid requirement. Level 2: Tea and Coffee After water, tea and coffee are the two most commonly consumed beverages on the planet. Drunk plain, they are calorie-free beverages brimming with antioxidants, flavonoids, and other biologically active substances that may be good for health. Up to three or four cups of coffee or tea a day appear to be fine. Green tea, especially the strong variety served in Japan, has received attention for its potential role in protecting against heart disease, while coffee may help protect against type 2 diabetes. (2, 3) More research on the health benefits of tea and coffee is needed, but one thing is for certain: The addition of cream, sugar, whipped cream, and flavorings can turn coffee or tea from a healthful beverage into a not-so-healthful one. For example, a 16-ounce Mint Mocha Chip Frappuccino with Chocolate Whipped Cream contains 470 calories. Tucked in this beverage (which is actually closer to a dessert) are 12 grams of saturated fat—nearly a day’s worth—and 71 grams of sugar, the equivalent of 17 teaspoons of sugar. (4) Keep in mind that for pregnant women, the jury is still out on whether high coffee or caffeine intakes increase the risk of miscarriage, but it seems prudent to limit caffeinated beverages to one cup per day. (For more information about coffee and chronic disease, see Ask the Expert: Coffee and Health.) Level 3: Low-Fat and Skim Milk and Soy Beverages For children, milk is a key source of calcium and vitamin D. Fortified soy milk is a good alternative source of calcium and vitamin D for those who prefer not to drink’s cow’s milk. Both are also good sources of protein and other essential micronutrients. Low-fat milk, sold as 1% or 1.5% milk, or skim milk, which is virtually fat-free, are the best choices because they contain much less saturated fat than reduced-fat milk or whole milk, which contain 2% and 4% milk fat, respectively. Even low-fat milk is high in calories, and high levels of consumption may increase the risk of prostate and ovarian cancer (see The Nutrition Source article Calcium and Milk: What’s Best for Your Bones and Health? for more information). So it’s best for adults to limit milk (and all dairy products) to a glass or two a day; less is fine, as long as you get enough calcium from other sources. For growing children, the ideal amount of milk and calcium is less clear, but not pushing beyond two glasses of milk per day appears to provide sufficient nutrition without being excessive. Level 4: Noncalorically Sweetened Beverages So-called diet sodas and other diet drinks are sweetened with calorie-free artificial sweeteners such as aspartame (Equal®, NutraSweet®, others), saccharin (Sweet’N Low®, Necta Sweet®, others), or sucralose (Splenda®); a new addition to the market are drinks sweetened with stevia, a calorie-free sweetener made from the leaves of a South and Central American shrub. These diet drinks are a better choice than sugar-sweetened soft drinks because they are lower in calories. But the possibility that they may contribute to weight gain suggests that they aren’t an innocuous alternative to water, and should be drunk as the occasional treat rather than as a daily beverage. For those who find it difficult to give up full-calorie soda, these may be useful in making the transition to healthier beverages, like a nicotine patch can do for smokers. Level 5: Caloric Beverages with Some Nutrients This category includes fruit juice, vegetable juice, whole milk, sports drinks, vitamin-enhanced waters, and alcoholic beverages. Each has its pluses and minuses. One-hundred-percent fruit juice has most of the nutrients of the fruit itself, but it usually delivers more energy. The Dietary Guidelines for Americans recommends no more than one serving (4 ounces) of 100% fruit juice as part of the daily fruit intake. Fruit smoothies are usually very high in calories, and so aren’t recommended as daily beverages. Vegetable juice is a lower calorie alternative to fruit juice, but may contain a lot of sodium. Whole milk is a good source of calcium and vitamin D, but has nearly twice the calories as skim milk. Whole milk is also a significant source of saturated fat, with 4.5 grams per glass. Sports drinks have fewer calories than soft drinks, and offer small amounts of sodium, chloride, and potassium. They aren’t needed by casual athletes or daily walkers. The only people who really need them are endurance athletes who exercise for more than an hour at a stretch and who sweat a lot. Vitamin-enhanced waters, meanwhile, are not necessary for anyone who takes a daily multivitamin, and adding vitamins to a sugary drink does not make it a healthy choice. Alcohol may have benefits for some but may be hazardous for others, and entire books have been written on the subject (see The Nutrition Source article Alcohol: Balancing Risks and Benefitsfor more information). Level 6: Calorically Sweetened Beverages The Beverage Guidance Panel gave its “least recommended” designation to beverages that are sweetened with sugar, high-fructose corn syrup, or other high-calorie sweeteners and that have few other nutrients. These include carbonated and noncarbonated soft drinks, fruit drinks, lemonade, and other “ades.” They get the thumbs down as a daily beverage because they provide so many calories and virtually no other nutrients. Routinely drinking these beverages can lead to weight gain and increase the risk of type 2 diabetes. Fruit smoothies, many flavored coffee and tea drinks, and some so-called energy drinks also fall into this category. (For a handy guide to the calories and sugar in popular beverages, see How Sweet Is It? on The Nutrition Source.) Putting It All Together: A Sample Beverage Plan Your body would be perfectly content if you drank nothing but water. You would get all the fluid you need, and you would get all of your nutrients from food. But with so many choices available, most people drink a variety of beverages. To give some perspective to choosing beverages, the Beverage Guidance Panel poured its recommendations into a pitcher (see our version above). The exact number of ounces isn’t what’s important—these are given for a typical person taking in 2,200 calories a day. What matters are the proportions. Here’s one way the Panel suggests getting less than 10 percent of daily calories from beverages: At least half of your daily fluid should come from water. For a person who needs 12 cups of fluid a day, that would mean six cups of water. More is fine—up to 100% of your daily beverage needs. About one-third (or about three to four cups) can come from unsweetened coffee or tea. If you flavor your coffee or tea with a lot of sugar, cream, or whole milk, then drinking less would help manage weight. If you take a pass on coffee or tea, choose water instead. Low-fat milk can make up another 20 percent, or about two 8-ounce glasses. Less is fine, just make sure you get your calcium from another source. A small glass (4 ounces) of 100% fruit juice, and no more than 1 to 2 alcoholic drinks for men or no more than 1 for women. Ideally, zero “diet” drinks made with artificial sweeteners, but up to 1 to 2 glasses (8 to 16 ounces) a day (this is adapted from the Beverage Guidance Panel’s original recommendation of up to 32 ounces per day). Ideally, zero drinks sweetened with sugar or high-fructose corn syrup, but up to a maximum of 8 ounces. *Suggested beverage consumption pattern for a person who requires 2,200 calories per day, providing 10 percent of calories from beverages. The values 50, 28, 16, and 4 fluid ounces are shown for illustrative purposes only; the total should sum to 98 fluid ounces, as shown at the top of the figure. The range listed at each level refers to the Beverage Guidance Panel’s suggested consumption range for each beverage. Caffeine is a limiting factor for coffee and tea consumption; up to 400 mg per day, or approximately 32 fluid ounces of coffee per day (can replace water). Noncalorically sweetened beverages can substitute for tea and coffee with the same limitations regarding caffeine, up to 16 fluid ounces per day (this is adapted from the Beverage Guidance Panel’s original recommendation of up to 32 fluid ounces per day). Adapted with permission from Am. J. Clin. Nutr. (2006; 83:529-542), © American Society for Nutrition.
3 steps to better asthmatic control
Effective asthma treatment requires routinely tracking symptoms and measuring how well your lungs are working. Taking an active role in managing your asthma treatment will help you maintain better long-term asthma control, prevent asthma attacks and avoid long-term problems. Create a written asthma action plan with your doctor. This written plan will serve as an asthma treatment guide tailored to your specific needs. It will help you follow these three important steps and keep a good record of your asthma treatment: 1. Track your symptoms Write down your symptoms in an asthma diary each day. Recording symptoms can help you recognize when you need to make treatment adjustments according to your asthma action plan. Use your asthma diary to record: Shortness of breath or whistling sounds when you exhale (wheezing). Disturbed sleep caused by shortness of breath, coughing or wheezing. Chest tightness or pain. Quick-relief (rescue) inhaler use — record when you need to use your quick-relief inhaler, such as albuterol (Proventil HFA, Ventolin HFA), and write down how many puffs you take. Disruptions to work, school, exercise or other day-to-day activities caused by asthma symptoms. Asthma symptoms during exercise. Changes in color of phlegm you cough up. Hay fever symptoms such as sneezing and runny nose. Anything that seems to trigger asthma flare-ups. 2. Record how well your lungs are working Your doctor may have you periodically record results of breathing tests (lung function tests). If your lungs aren't working as well as they should be, your asthma may not be under control. There are two main lung function tests: Peak flow. This test is done at home with a simple hand-held device called a peak flow meter. A peak expiratory flow measurement indicates how fast you can force air out of your lungs. Peak flow readings are sometimes gauged as a percentage of how your lungs work at their best. This is called your personal best peak flow. Spirometry. Spirometry tests can be done at your doctor's office with a machine called a spirometer. Some people use a hand-held spirometer to take measurements at home. Spirometry tests measure how much air your lungs can hold and how much air you can exhale in one second after you've taken a deep breath. This measurement is called forced expiratory volume (FEV). Your FEV measurement is compared with the typical FEV for people who don't have asthma. As with your peak flow reading, this comparison is often expressed as a percentage. 3. Adjust treatment according to your asthma action plan When your lungs aren't working as well as they should be, you may need to adjust your medications according to the plan you made with your doctor ahead of time. Your written asthma action plan will let you know exactly when and how to make adjustments. The chart below can help you determine if you're doing a good job of keeping your asthma under control. A similar system should be included in your asthma action plan. Depending on where your asthma control falls on the chart, you may need to make adjustments to your medications. Levels of asthma control in children older than 12 and adults Well-controlled GREEN ZONEPoorly controlled YELLOW ZONEVery poorly controlled RED ZONE Symptoms such as coughing, wheezing or shortness of breathTwo days a week or fewerMore than two days a weekDaily and throughout the night Nighttime awakeningsTwo times a month or fewerOne to three times a weekFour times a week or more Effect on daily activitiesNoneSome limitsExtremely limiting Quick-relief inhaler use to control symptomsTwo days a week or fewerMore than two days a weekSeveral times a day Lung test readingsMore than 80% of your predicted personal best60 to 80% of your predicted personal bestLess than 60% of your predicted personal best There are two main types of medications used to treat asthma: Long-term control medications such as inhaled corticosteroids are the most important medications used to keep asthma under control. These preventive medications treat the airway inflammation that leads to asthma symptoms. Used on a daily basis, these medications can reduce or eliminate asthma flare-ups. Quick-relief inhalers contain a fast-acting medication such as albuterol (Proventil HFA, Ventolin HFA). These medications are sometimes called rescue inhalers. They're used as needed to quickly open your airways and make breathing easier. Knowing when to use these medications can help prevent an impending asthma attack. Long-term control medications are the key to keeping your asthma controlled and in the green zone. If you frequently use a quick-relief inhaler to treat symptoms, your asthma isn't under control. See your doctor about making treatment changes. Make sure you know how to use your asthma medications properly. They will only keep your asthma under control if you use them correctly. Work with your doctor Asthma symptoms and severity are always changing. Following your plan will help you avoid asthma attacks and minimize the disruptions caused by asthma symptoms. Meet with your doctor regularly to review your treatment. Take your asthma diary and action plan with you so that you can review them with your doctor and make any needed changes to your treatment plan. Here are some reasons why you might need to adjust your medications: If you're still having bothersome symptoms even though you're following your plan, talk to your doctor about possibly increasing or changing your medications. If your asthma is well-controlled, you may be able to reduce the amount of medication you take. If you have seasonal allergy triggers, your asthma medication may need to be increased at certain times of the year.
Broken Bone analysis
What is a broken bone? A broken bone happens when one of your bones becomes cracked or broken into multiple pieces. It’s also known as a fracture. It can result from a sports injury, accident, or violent trauma. Broken bones usually aren’t life threatening, but they do require immediate medical care. Learn how to recognize the symptoms of a broken bone, provide first-aid treatment, and get professional help. What are the symptoms of a broken bone? A broken bone can cause one or more of the following signs and symptoms: intense pain in the injured area that gets worse when you move it numbness in the injured area bluish color, swelling, or visible deformity in the injured area bone protruding through the skin heavy bleeding at the injury site How can you provide first-aid care for a broken bone? If you suspect that someone has a broken bone, provide first-aid treatment and help them get professional care: Stop any bleeding: If they’re bleeding, elevate and apply pressure to the wound using a sterile bandage, a clean cloth, or a clean piece of clothing. Immobilize the injured area: If you suspect they’ve broken a bone in their neck or back, help them stay as still as possible. If you suspect they’ve broken a bone in one of their limbs, immobilize the area using a splint or sling. Apply cold to the area: Wrap an ice pack or bag of ice cubes in a piece of cloth and apply it to the injured area for up to 10 minutes at a time. Treat them for shock: Help them get into a comfortable position, encourage them to rest, and reassure them. Cover them with a blanket or clothing to keep them warm. Get professional help: Call 911 or help them get to the emergency department for professional care. If the person doesn’t appear to be breathing, is unconscious, or both, call 911 for medical help and begin CPR. You should also call 911 if: you suspect they’ve broken a bone in their head, neck, or back the fractured bone has pushed through their skin they’re bleeding heavily Otherwise, help them get to the emergency department by car or other means so a doctor can diagnose their condition and recommend appropriate treatment.