Dr. Poonam Singh, MD

Dr. Amar Singh, MD

Harbin Clinic

Amar Singh, MD and Poonam Singh, MD 12/17/20 Amar Singh, MD and Poonam Singh, MD 12/17/20

Why should you take the COVID19 vaccine?

To understand how vaccines work, let’s review how the body’s immune system works to protect us against disease. Our immune system is a specialized network of organs, cells, and tissues that all work together to protect against infection. When a disease-causing microbe (for example, a virus or bacteria) enters the body, the immune system:

Recognizes the germ as being foreign (not belonging in the body).
Responds by making unique proteins (called antibodies) that help destroy the germ. Most of the time, the immune system can’t act fast enough to stop the microbe from making one sick. But by eliminating the microbe can usually help one get well again.
Remembers the germ that made one sick and how to destroy it. Upon future exposure to the same microbe, the immune system can quickly kill it before it has a chance to make one sick. This protection is called immunity.

Vaccines and immune system

Vaccines give immunity to a disease without one getting sick first. The main goal of a vaccine for a particular infectious agent, like a virus, is to teach the immune system what that agent looks like. Once educated, the immune system will vigorously attack the actual virus if it ever enters the body. Vaccines use killed or weakened versions of the disease-causing germ or parts of the microbe (called antigens). For some vaccines, genetic engineering helps make the antigens used in the vaccine. It’s much safer to get a vaccine than to get the disease it prevents.

What are viruses?

A virus is a small collection of genetic code, either DNA or RNA, surrounded by a protein coat. It is not alive and cannot replicate alone. Viruses must infect cells and use components of the host cell to make copies of themselves. Often, they kill the host cell in the process and cause damage to the host organism. The virus’s DNA or RNA genes make messenger RNA (mRNA); the mRNA then makes the proteins to make the protein coat. An mRNA of a specific structure makes a protein of a particular design.

Vaccines against viruses

Some traditional vaccines use a weakened virus, while others use just a critical piece of the virus’s protein coat. In the case of COVID-19, a part called the spike protein is the critical piece. Traditional vaccines are very effective. They have wiped off diseases like Polio and Smallpox from the face of this earth. Collectively, vaccines may have done more good for humanity than any other medical advance in history. But growing large amounts of a virus and then weakening the virus or extracting the critical piece takes a lot of time.

Dr. Amar Singh, MD and Dr. Poonam Singh, MD

The invention of mRNA vaccines

Three decades ago, scientists began exploring more straightforward ways to make vaccines. After discovering genetic codes, it became relatively easy to make mRNA in the laboratory in large amounts. The researchers keep looking for the mRNA’s exact structure (such as spike protein of SARS-CoV-2 virus) that made the critical piece of a virus’s protein coat. They wondered if you injected that mRNA into someone, and the mRNA then traveled through the bloodstream to be gobbled up by immune system cells, and then those cells started to make the spike protein? Would that educate the immune system?

Although this concept seemed simple, it took decades of intense research. Scientists learned how to modify mRNA so that it did not produce violent immune system reactions. Then they learned how to encourage immune system cells to gobble up the mRNA as it passed in the blood. After that, they learned how to coax those cells to make large amounts of the critical piece of protein. Finally, they learned how to enclose the mRNA inside microscopically small capsules to protect it from being destroyed by chemicals in our blood. Along the way, they also learned that, compared to traditional vaccines, mRNA vaccines could generate a robust type of immunity: they stimulate the immune system to make antibodies and immune system killer cells — a double strike at the virus. Several companies have been working painstakingly to bring mRNA vaccine technology to the actual working threshold. The companies had built platforms that, theoretically, could be used to create a vaccine for any infectious disease by merely inserting the right mRNA sequence for that disease.

Then along came COVID-19. Within weeks of identifying the responsible virus, scientists in China had determined the structure of all of its genes, including the genes that make the spike protein and published this information online. Within minutes, scientists 10,000 miles away began working on the design of an mRNA vaccine. Within weeks, they had made enough vaccines to test them in animals and then in people. Just 11 months after discovering the SARS-CoV-2 virus, regulators in the US and the United Kingdom confirmed that an mRNA vaccine for COVID-19 is effective and safely tolerated, paving the path to widespread immunization. No new vaccine has ever taken less than four years to make.

All of these discoveries depended on scientists’ willingness to persist in pursuing their longshot dreams — often despite enormous skepticism and even ridicule — and the willingness of society to invest in their research. Future mRNA vaccine technology may allow for one vaccine to protect multiple diseases, thus decreasing the number of shots needed for protection against common vaccine-preventable diseases. Beyond vaccines, cancer research has used mRNA to trigger the immune system to target specific cancer cells.

Facts about COVID-19 mRNA Vaccines

They cannot give someone COVID-19.mRNA vaccines do not use the live virus that causes COVID-19.

They do not affect or interact with our DNA in any way. mRNA never enters the cell’s nucleus, where our DNA (genetic material) is kept. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.
Corners were not cut in the clinical trials and approvals process. Vaccine trials take place in stages, starting with trials on animals. Three trials on people – Phase 1, Phase 2, and finally Phase 3.Regulatory agencies reviewed the data from Covid-19 vaccine trials more quickly than usual by looking at it on a rolling basis rather than only once the trials were complete. Still, they did not fundamentally change their rules. The process was faster than usual because researchers had already built an mRNA platform – a way of getting viral mRNA into the body – for cancer and other vaccines under trial. It meant this could be put into action as soon as the virus’s genomic sequence was shared. Companies and governments also took the risk of producing large numbers of vaccines even before the first stages of experimentation had been completed, which meant they were ready to begin large human trials as soon as the results were in.
The vaccine triggers an inflammatory response. The vaccine partly works by inducing local inflammatory reactions to activate the immune system. This means that it’s normal for many people to experience pain at the injection site and sometimes fever and discomfort for one or two days after the vaccine. One unwanted response to the Pfizer-BioNTech mRNA vaccine came to light during the first day of mass vaccination in the UK after two people with a history of significant allergies reacted to the injection. A history of a severe allergic reaction (e.g., anaphylaxis) to any other vaccine or injectable therapy (e.g., intramuscular, intravenous, or subcutaneous) is a precaution, not a contraindication to vaccination.

We received the Pfizer COVID-19 vaccine today and hope you also take it. The highest risk right now (especially for vulnerable people) is not to be vaccinated.

Clinical considerations for the use of Pfizer-BioNTech COVID-19 vaccine

Administration

2-dose series administered intramuscularly 3 weeks apart
Administration of 2nd dose within the 4-day grace period (e.g., day 17-21) considered valid
If >21 days since 1st dose, 2nd dose should be administered at the earliest opportunity (but no doses need to be repeated)
Both doses are necessary for protection; the efficacy of a single dose has not been systematically evaluated.

Interchangeability with other COVID19 vaccines

Pfizer-BioNTech COVID-19 vaccine is not interchangeable with other COVID-19 vaccines. The safety and efficacy of a mixed series have not been evaluated.
Persons initiating series with Pfizer-BioNTech COVID-19 vaccine should complete series with the same product.
If two doses of different mRNA COVID-19 vaccine products are inadvertently administered, no additional doses of either vaccine are recommended. Recommendations may be updated as further information becomes available or additional vaccine types authorized.

Coadministration with other vaccines

Pfizer-BioNTech COVID-19 vaccine should be administered alone with a minimum interval of 14 days before or after administration with any other vaccines.
If the Pfizer-BioNTech COVID-19 vaccine is inadvertently administered within 14 days of another vaccine, doses do not need to be repeated for either vaccine.

Persons with a history of SARS-CoV-2 infection

Vaccination should be offered to persons regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection.
Viral or serologic testing for acute or prior infection, respectively, is not recommended for vaccine decision-making.

Persons with known current SARS-CoV-2 infection

Vaccination should be deferred until recovery from acute illness (if the person had symptoms) and criteria have been met to discontinue isolation.
No minimal interval between infection and vaccination. However, current evidence suggests reinfection uncommon in the 90 days after the initial infection. Thus, persons with documented acute infection in the preceding 90 days may defer vaccination until the end of this period if desired.

Persons who previously received passive antibody therapy for COVID-19

Vaccination should be deferred for at least 90 days to avoid the treatment with vaccine-induced immune responses. Based on the estimated half-life of therapies and evidence suggesting reinfection is uncommon within 90 days of initial infection.

Will the vaccine work against new virus variants?

Researchers are scrambling to make sense of the new variants. The latest research suggests that Pfizer’s COVID-19 vaccine will be protective against a mutation found in the two more-contagious variants of the coronavirus that have erupted in Britain and South Africa. Other vaccines are being tested. Dr. Anthony Fauci said that the coronavirus variants don’t appear to block vaccine-induced antibodies but that testing needed to be sure is underway in the U.S. and elsewhere. Likewise, British scientists have said the variant found in the U.K. – which has become the dominant type in parts of England — still seems to be susceptible to vaccines.

Which vaccine is better?

The Pfizer/BioNTech vaccine is authorized for ages ≥16 years and Moderna’s for ≥18 years. Aside from this age difference, there is no target population better suited to one vaccine or the other. In these times of limited supply, we are advising our eligible patients to get the vaccine that’s made available to them. It has already become common for people to ask others about which vaccine they have received, but the efficacy and safety findings in trials of both vaccines were strikingly similar. However, once the vaccine series has started, it should be completed with the same vaccine on the recommended schedule. There are no safety or efficacy data on using one vaccine for the first dose and a different vaccine for the second.

Should a patient who is diagnosed with Covid-19 shortly after the first dose still receive the second scheduled dose?

The vaccine begins to generate protective immunity 10 to 14 days after the first shot. As a result, it is not surprising that some people have experienced Covid-19 shortly after their first immunization, and they naturally wonder whether they should proceed with the second shot as originally scheduled. The current recommendation is that people with current infection should wait until they have recovered from the acute illness and are eligible to discontinue isolation. These recommendations apply both to those who developed Covid-19 before their first injection and to those who developed it after starting the vaccine series. On the basis of this guidance, some people in the latter group may be able to proceed with their scheduled second shot and others will need to wait. Treatment of Covid-19 with either monoclonal antibodies or convalescent plasma should delay receipt of the vaccine by 90 days since these treatments could theoretically make the vaccine less effective.

References:

https://bit.ly/3mpwzpr

https://bit.ly/34wgyrE

https://bit.ly/2WxrEbf

updated on 12/23/20

updated on 1/8/2021

updated 1/18/2021

About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP, for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.

Amar Singh, MD and Poonam Singh, MD 12/11/20 Amar Singh, MD and Poonam Singh, MD 12/11/20

Can you smell a rose?

How do you smell?

A smell begins when a molecule -- say, from a flower -- stimulates the olfactory nerve cells, part of the olfactory cranial nerve, found high up in the nose. These nerve cells then send information to the brain, which identifies the specific smell.

Why you lose the sense of smell?

There are over 100 reasons why people can lose their sense of smell. However, most people lose it from sinusitis, after viral infections, traumas, or tumors. It can often be of idiopathic (unknown) origin. When you catch a severe cold, your nose stuffs up; you can't smell anything, and food tastes funny. Fortunately, most people regain their sense of smell once the cold runs its course. But for others, the complete (anosmia) or partial (hyposmia) loss of the sense of smell is permanent.

Cranial nerves control how things work in our head and neck -- such as the nerves that allow us to speak by using our vocal cords, control our facial motion, hear and smell. A variety of viruses can attack the cranial nerves related to smell or the mucosal tissue surrounding those nerves. Common coronavirus infections by rhinoviruses and influenza viruses lead to colds and upper respiratory illnesses. COVID-19 is one type of disease caused by a coronavirus (SARS-CoV2). They cause inflammation in and around the nerves, which cannot function properly. This leads to the loss or dysfunction of smell. It can happen to anyone: young and old, healthy, and sick.

Smell loss can be one of the earliest signs of a COVID-19 infection. It can sometimes be the only sign. Or it can present after other symptoms. Although it may not affect every patient with COVID-19, loss of smell and taste is associated with the disease. In some countries, including France, they've used this as a triage mechanism. People need to know that altered smell can be due to the COVID-19 disease process, so they aren't going about their lives like normal and spreading the virus.

The pandemic also might impact how we treat patients with olfactory dysfunction in general. When someone has a viral-induced inflammation of the nerve, they are sometimes treated with steroids to decrease the inflammation. But treating all COVID-19 patients with steroids might be a bad idea because of its effect on the inflammatory processes in their heart and lungs.

For those who lose the ability to smell after trauma, postviral infection, or when we don't know why it happened, olfactory training can be used, a straightforward protocol that patients can do at home. The patients smell several essential oils ( rose, eucalyptus, clove, and lemon) in a structured way twice a day, every day, over a long time. The oils stimulate different types of olfactory receptor cells in the nose. It is useful in 30 to 50 percent of patients. Researchers are trying to find out if both stem cells and neurostimulation can work. The olfactory nerve has an inherent ability to regenerate. Researchers are taking advantage of this fact and switch on those regenerative cells.

Bottomline

The treatment depends on the reason for the loss and may include surgery or medications.
If you lose your sense of smell and it isn't coming back after all the other symptoms have gone away, seek care as soon as possible. If you wait too long, your options dwindle. Interventions, including olfactory training and medications, are more effective when you get early treatment.
If you lose your sense of smell or taste during this pandemic and don't have any other symptoms, contact your doctor. The doctor can decide whether you require COVID-19 testing and self-isolation to avoid being a vector of the virus in your family or community.

Some interesting facts

Humans possess around 12 million olfactory receptor cells that can detect approximately 10,000 odors. Dogs, on the other hand, have anything from 100 to 200 million-plus receptor cells, depending on the breed. The bloodhound is thought to have more receptor cells than any other dog (as many as 300 million) and can detect 40,000 different odors! The higher concentration of an odor, the stronger the signal sent by the receptor cells to the olfactory bulb.

References:

https://bit.ly/37NIAQ5

Published 12/11/2020

About Us

Amar Singh, MD and Poonam Singh, MD 12/9/20 Amar Singh, MD and Poonam Singh, MD 12/9/20

Twelve things doctors wish patients knew about flu shots

During the 2019–2020 flu season, the flu (Influenza) caused an estimated 18 million medical visits in the United States. Getting a flu vaccine (Influenza vaccine) can help to reduce the burden on doctors and nurses as they fight COVID-19. Last season, flu vaccines prevented 3.7 million medical visits.

The vaccine doesn’t give you the flu

While the flu shot is made of pieces of the virus, the nasal spray is a whole virus, but it’s an inactivated form of the virus so that neither kind can give you the flu. It’s not uncommon for people to have a low-grade fever or feel a little run down for a couple of days after receiving their vaccine. That’s just their immune system responding to the vaccine and doing exactly what it is supposed to do. Patients will sometimes coincidentally come down with the flu shortly after receiving the vaccination, but that’s just a quirk of timing. It takes the vaccine a couple of weeks to generate a full immune response, so you don’t have your maximum protection until a couple of weeks after you get your shot.

Getting flu shot more critical than ever

People have not necessarily been getting their preventive medical services during the pandemic. We want to highlight the importance of continuing to get preventive services in general, and the flu vaccine is an excellent example of that. Every year, influenza causes hundreds of thousands of hospitalizations and tens of thousands of deaths in the United States. We're very concerned about it compounding the hospital capacity problems that we may see if we get more surges in the numbers of patients with COVID 19. Additionally, it is possible to get influenza and COVID 19 simultaneously, and then you have that double whammy in terms of two significant respiratory illnesses. The flu vaccine is really to get protection against that scenario.

Can reduce flu risk by up to 60%

We typically don't know the vaccine’s effectiveness until we get into flu season, and we can see what types of viruses end up circulating in the population. The flu vaccine is adjusted every year to align with what is predicted to be the most likely strains circulating. It typically falls somewhere between 40% and 60% effectiveness. In recent years, we have commonly seen them reporting closer to 60% for common flu strains, which is excellent. Some protection is better than none.

Get it as soon as possible

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices generally recommends getting the flu vaccine in September or October. Ideally, you can start to get your vaccine before the end of October, but if you don’t squeeze it in, get it any time ideally, before January is what’s best. But we’ll tell people throughout the flu season, if you haven’t gotten the vaccine yet, it’s still okay to get it, and you’re likely to benefit.

Everyone should get it, especially seniors

There are a couple of reasons why someone might not be able to get the flu vaccine—that’s relatively rare. A real allergy to it might be the most common reason, but generally speaking, you should definitely get the flu vaccine if you are older than six months. Our seniors, for sure, are a higher-risk population. They have slightly different vaccine options that are designed to protect them a little bit more. Because they are also clearly one of those high-risk populations for COVID 19, it is even more vital for them to defend themselves against the flu.

There are nasal sprays too

The sprays are only approved for ages 2 through 49. There are some medical conditions or reasons why you may not be able to get the spray, or it may not be the best choice for you, but most people can take that option if they are anxious about getting the shot. We will say If it means you end up getting a flu vaccine, and you'd instead choose a nasal spray, get that nasal spray. It is typically pretty comparable to the shot in terms of effectiveness.

Egg allergy is not an excuse

Despite the common notion, people with egg allergies can take age-appropriate flu vaccines.

Please do it for yourself and others

There are benefits to us as individuals: We're less likely to get the flu. Even if we do develop the flu, we're less likely to be hospitalized, and it tends to be less severe if you get the vaccine. It is also about protecting others—your family, friends, community members. With each day seeing tens of thousands of new coronavirus cases in the U.S., the impending flu season raises fears of a “twindemic” of COVID-19 and influenza that could sicken tens of millions of Americans and further strain the nation’s health system resources.

Save time

Getting a flu vaccine can prevent you from getting sick with the flu. People who get the flu are usually sick for about a week. Staying healthy means you can be there for your loved ones who depend on you, and you don’t miss work.

Reduce the severity of illness

You may still get the flu if you get a flu vaccine, but you won’t get as sick. Flu vaccines have been shown in several studies to reduce the severity of illness in people who get vaccinated but still get sick.

Protect people with diabetes and heart disease

People with certain chronic conditions are at high risk of getting very sick from the flu, including being hospitalized or dying. Getting a flu vaccine reduces the risk of giving the flu to people with asthma, diabetes, heart disease, cancer, HIV/AIDS, and sickle cell anemia.

Bottomline

Influenza vaccine is not optional; it is a lifesaver. Please get immunized.

References:

https://www.cdc.gov/

https://bit.ly/3lZa0Yj

Published 12/9/2020

About Us

Amar Singh, MD and Poonam Singh, MD 11/28/20 Amar Singh, MD and Poonam Singh, MD 11/28/20

How To Protect Your Vision From A Silent Enemy

Light is made up of electromagnetic particles that travel in waves, emit energy, and range in length and strength. The shorter the wavelength, the higher the energy. Different wavelength categories are - gamma rays, x-rays, ultraviolet rays, visible light, infrared light, and radio waves. Together these wavelengths make up the electromagnetic spectrum. However, the human eye is sensitive to only one part of this spectrum - visible light, that part of the electromagnetic spectrum seen as colors: violet, indigo, blue, green, yellow, orange, and red. Blue light has a very short wavelength, which produces a higher amount of energy. Studies suggest that, over time, exposure to the blue end of the light spectrum could cause significant long-term damage to your eyes.

What is blue light?

Blue light is everywhere. As sunlight travels through the atmosphere, the shorter, high-energy blue wavelengths collide with the air molecules causing blue light to scatter around, giving the sky its blue color. Exposure to blue light during daytime hours helps maintain a healthy circadian rhythm, the natural sleep-wake cycle. Dr. Charles Czeisler has demonstrated that daylight keeps a person's internal clock synchronized with the environment. Too much exposure to blue light late at night can disrupt the sleep-wake cycle, causing problems sleeping and daytime tiredness. However, under exposure to sunlight in children adversely affects eyes and vision’s growth and development. Few studies show a deficiency in blue light exposure could contribute to the recent increase in nearsightedness.

Blue light helps boost

alertness
memory and cognitive function
reaction times
elevate moods
the feeling of well being.

With the evolution in digital screen technology, devices use LED backlight technology to enhance screen brightness and clarity. These LEDs emit powerful blue light waves. Blue light waves are among the shortest, highest-energy wavelengths in the visible light spectrum. Because they are shorter, these "Blue" or High Energy Visible (HEV) wavelengths flicker more easily than longer, weaker wavelengths. Flickering creates a glare that can reduce visual contrast and affect sharpness and clarity. This flickering and glaring may be one reason for digital eye strain, headaches, physical and mental fatigue caused by many hours sitting in front of a computer screen or other electronic device.

Our eyes' natural filters do not entirely protect against blue light rays from the sun, let alone the blue light emanating from these devices or fluorescent-light tubes. Prolonged exposure to blue light may cause retinal damage and contribute to age-related macular degeneration, leading to loss of vision.

Some studies suggest a link between exposure to light at night, such as working the night shift, to diabetes, heart disease, and obesity. That's not proof that nighttime light exposure causes these conditions, nor is it clear why it could be bad for us. A Harvard study shed a little bit of light on the possible connection to diabetes and possibly obesity. The researchers put ten people on a schedule that gradually shifted the timing of their circadian rhythms. Their blood sugar levels increased, pushing them into a prediabetic state, and leptin levels (satiety hormone) went down.

Melatonin is a hormone that the brain produces in response to darkness, helping with circadian rhythms and sleep. Exposure to light, even dim light, suppresses the secretion of melatonin, disrupting sleep. Light at night is why so many people don't get enough sleep, and researchers have linked short sleep to increased risk for depression and diabetes, and cardiovascular problems. While the light of any kind can suppress melatonin secretion, blue light at night does so more powerfully. Harvard researchers and their colleagues experimented comparing the effects of 6.5 hours of exposure to blue light to exposure to green light of comparable brightness. The blue light suppresses melatonin for about twice as long as the green light and shifted circadian rhythms by twice as much (3 hours vs. 1.5 hours).

Protect yourself from blue light

There are a few ways to decrease exposure to blue light:

Use dim red lights for night lights. Swap out fluorescent/LED night lights in bedrooms and bathrooms for dim red lights, which have the least effect on melatonin and circadian rhythms.
Avoid looking at bright screens beginning two to three hours before bed.
If you work a night shift or use many electronic devices at night, consider wearing blue-blocking glasses or installing an app that filters the blue/green wavelength at night.
Expose yourself to lots of bright light during the day, which will boost your ability to sleep at night, as well as your mood and alertness during daylight.
Computer glasses with yellow-tinted lenses that block blue light can help ease computer digital eye strain by increasing contrast. Wear computer glasses while on a device for two or more hours.
Anti-reflective lenses reduce glare and increase contrast and block blue light from the sun and digital devices.
Clean Your Screen. A dust-free, smudge-free screen helps reduce glare.
Adjust screen brightness, change background color from bright white to cool gray.
Take frequent breaks and move away from the screen.
Those who smoke are up to 4 times more likely to go blind in old age. If you are a smoker, kick the habit to preserve your vision.
Remind yourself to blink more often. Staring at a digital screen can affect the number of times you blink, causing eyes to dry. Use artificial tears when your eyes feel dry.
Eliminate screens in bedrooms overnight. (You might need to buy an alarm clock).
Avoid device multi-tasking, especially while trying to learn or work from home. Jumping between screens and apps makes work take longer. Turn off notifications for all but the essential apps. Use your phone. Don’t let it use you.

60% of people spend more than 6 hours a day in front of a digital device. The ‘virtual’ life during the current pandemic can leave us with screen fatigue and craving human connection. I’ve realized with clarity in these dark, anxious times that so many of our problems with technology don’t emanate from digital screens. Instead, it is from the disruption and alienation that creeps into our relationships with ourselves and others as we allow our experiences and challenging emotions to be mediated, numbed out, blurred by digital media. The phone is like a fentanyl lollipop; yes, it’s possible to abuse, but our pain, and the massive pain of the world driving us to it, is arguably the real problem. The antidote is reconnecting to our bodies and our feelings, with the assistance of loved ones who make it safe to do that.

References:

https://pubmed.ncbi.nlm.nih.gov/21600300/

https://pubmed.ncbi.nlm.nih.gov/25535358/

Published 11/28/2020

About Us

Amar Singh, MD and Poonam Singh, MD 11/25/20 Amar Singh, MD and Poonam Singh, MD 11/25/20

Getting Back To Gratitude

Expressing thanks may be one of the simplest ways to feel better. Giving thanks can make you happier. It's time to give thanks for all that we have! Now that the final harvest has long passed, we settle into the cooler autumn weather, and slowly turn inward for a long winter ahead. But first we must celebrate our abundance and have gratitude for everything in our lives!

The Thanksgiving holiday began, as the name implied, when the colonists gave thanks for their survival and a good harvest. So perhaps November is an excellent time to review the mental health benefits of gratitude and consider some advice about cultivating this state of mind. Maybe the most straightforward and effortless habit for living a happier life is to take one or a few minutes every day to focus on what is already here and that you can be grateful for in your life.

Gratitude has been conceptualized as an emotion, an attitude, a moral virtue, a habit, a personality trait, or a coping response. The word gratitude is derived from the Latin word gratia, which means grace, graciousness, or gratefulness (depending on the context). In some ways, gratitude encompasses all of these meanings. Gratitude is a thankful appreciation for what an individual receives, whether tangible or intangible. With gratitude, people acknowledge the goodness in their lives. In the process, people usually recognize that the source of that goodness lies at least partially outside themselves. As a result, gratitude helps people connect to something larger than themselves as individuals — whether to other people, nature, or a higher power.

In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.

People feel and express gratitude in multiple ways. They can apply it to the past (retrieving positive memories and being thankful for elements of childhood or past blessings), the present (not taking good fortune for granted as it comes), and the future (maintaining a hopeful and optimistic attitude). Regardless of someone’s inherent or current level of gratitude, it's a quality that individuals can successfully cultivate further.

Research on gratitude

Dr. Robert A. Emmons of the University of California, Davis, and Dr. Michael E. McCullough of the University of Miami, have researched gratitude. In one study, they asked all participants to write a few sentences each week, focusing on particular topics. One group wrote about things they were grateful for that had occurred during the week. A second group wrote about daily irritations or something that had displeased them. The third wrote about events that had affected them (with no emphasis on them being positive or negative). After ten weeks, those who wrote about gratitude were more optimistic and felt better about their lives. Surprisingly, they also exercised more and had fewer visits to physicians than those who focused on sources of aggravation.

Dr. Martin E. P. Seligman, a psychologist at the University of Pennsylvania, tested the impact of various positive psychology interventions on 411 people, each compared with a control assignment of writing about early memories. When their week's task was to write and personally deliver a letter of gratitude to someone who had never been adequately thanked for their kindness, participants immediately exhibited a huge increase in happiness scores. This impact was more significant than that from any other intervention, with benefits lasting for a month.

Of course, studies such as this one cannot prove cause and effect. But most of the studies published on this topic support an association between gratitude and an individual's well-being.

Other studies have looked at how gratitude can improve relationships. For example, a study of couples found that individuals who took time to express gratitude for their partner felt more positive toward the other person and felt more comfortable expressing concerns about their relationship.

Managers who remember to say "thank you" to people who work for them may find that they feel motivated to work harder. Researchers at the Wharton School at the University of Pennsylvania randomly divided university fundraisers into two groups. One group made phone calls to solicit alumni donations in the same way they always had. The second group — assigned to work on a different day — received a pep talk from the director of annual giving, who told the fund-raisers she was grateful for their efforts. During the following week, the university employees who heard her gratitude message made 50% more fundraising calls than those who did not.

There are some notable exceptions to the generally positive results in research on gratitude. One study found that middle-aged divorced women who kept gratitude journals were no more satisfied with their lives than those who did not. Another study found that children and adolescents who wrote and delivered a thank-you letter to someone who made a difference in their lives may have made the other person happier — but did not improve their well-being. This finding suggests that gratitude is an attainment associated with emotional maturity.

Ways to cultivate gratitude

Gratitude is a way for people to appreciate what they have instead of always reaching for something new in the hopes it will make them happier or thinking they can't feel satisfied until every physical and material need is met. Gratitude helps people refocus on what they have instead of what they lack. And although it may feel contrived at first, this mental state grows stronger with use and practice.

Here are some ways to cultivate gratitude regularly

Write a thank-you note. You can make yourself happier and nurture your relationship with another person by writing a thank-you letter expressing your enjoyment and appreciation of that person's impact on your life. Send it, or better yet, deliver and read it in person if possible. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself.

Thank someone mentally. No time to write? It may help you think about someone who has done something nice for you and mentally thank the individual.

Keep a gratitude journal. Make it a habit to write down or share with a loved one thought about the gifts you've received each day.

Count your blessings. Pick a time every week to sit down and write about your blessings — reflecting on what went right or what you are grateful for. Sometimes it helps to pick a number — such as three to five things — that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you.

Pray. Religious people can use prayer to cultivate gratitude.

Meditate. Mindfulness meditation involves focusing on the present moment without judgment. Although people often focus on a word or phrase (such as "peace"), it is also possible to focus on what you're grateful for (the warmth of the sun, a pleasant sound, etc.).

Gratitude is when memory is stored in the heart and not in the mind. Let us be grateful to the people who make us happy; they are the charming gardeners who make our souls blossom.

Reflect on your present blessings, on which every man has many, not on your past misfortunes, of which all men have some.

—Charles Dickens (M. Dickens, 1897, p. 45)

References:

https://bit.ly/2UZMm2X

https://bit.ly/3m6eUn7

https://bit.ly/36614vx

https://bit.ly/3fwT2Pw

Published 11/25/2020

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Amar Singh, MD and Poonam Singh, MD 11/20/20 Amar Singh, MD and Poonam Singh, MD 11/20/20

Oil for Brain Health?

We are inundated with daily advice about ‘diets’ and ‘superfoods’ to improve our health. One dietary regime that has stood the test of time – and importantly, scientific scrutiny – is the Mediterranean diet. Once a year, various diets are scored by a panel of nationally recognized experts in diet and nutrition. Earlier this year, U.S. News and World Report named the Mediterranean diet as the best diet of 2020 for the third year in a row. In second place was another consistent high performer in the rankings, the DASH diet (dietary approaches to stop hypertension), which lowered blood pressure.

The common thread between the Mediterranean diet and the DASH diet is olive oil. Olive oil has been an essential part of Mediterranean cuisine for 5,000 years. Homer, the famed Greek poet, called it “liquid gold.” The ancient Greeks so valued olive oil that cutting down an olive tree was a crime punishable by death! Traditionally, whole olives are crushed into a paste, which is then pressed to extract the oil. The method of extracting oil from olives has not changed much in thousands of years, except the tools are now stainless steel instead of stone. Olive Oil, particularly the extra virgin kind (EVOO), made from pure cold-pressed olives, contains many antioxidants and has significant anti-inflammatory properties. These are the two most important properties of healthy foods.

EVOO is a superfood rich in cell-protecting antioxidants, known for its multiple health benefits, including helping put the brakes on diseases linked to aging, most notably cardiovascular disease. Boosting brain function is key to staving off the effects of aging. And if there was one thing every person should consider doing right now to keep their brain young, add EVOO to their diet, according to research by scientists at Temple University. Their study appeared in the journal Aging Cell. It addressed another aging-related disease, tauopathies characterized by the gradual buildup of an abnormal form of a protein called tau in the brain, leading to a decline in mental function and, eventually, dementia. Their findings are the first to suggest that EVOO can defend against a specific type of cognitive decline linked to tauopathy known as frontotemporal dementia. Alzheimer’s disease is itself one form of dementia that primarily affects the hippocampus, the brain’s memory storage center. Frontotemporal dementia affects the areas of the brain near the forehead and ears. Symptoms typically emerge between ages 40 and 65 and include changes in personality and behavior, difficulties with language and writing, and eventual deterioration of memory and ability to learn from prior experience. Their previous research on mice also showed that EVOO preserves memory and protects the brain against Alzheimer’s disease. This adds another piece of the puzzle in the story about EVOO’s ability to ward off cognitive decline and to protect the junctions (synapses) where neurons come together to exchange information.

In a study published in 2018, Spanish scientists demonstrated potent anti-inflammatory and antioxidant effects of olive oil. Administering olive oil to animals significantly reduced the number of harmful chemicals that can cause tissue injury and aging, particularly within the brain. Olive oil administration also increased the enzymes that protected against oxidative damage in the brain and reduced the harmful actions the lipopolysaccharide releases by bacteria in the gut, reducing inflammation in the brain. The gut microbiome (the genetic material of all the microbes - bacteria, fungi, protozoa, and viruses - that live on and inside the human body) changes drive the brain inflammation. This is the likely scenario: an imbalance in the gut bacteria leads to inflammation, chemical debris released from the bacteria migrate out of the gut into the blood and then into the brain. The most harmful of this bacterial debris is called lipopolysaccharide, and it can induce a robust inflammatory response inside the brain. Olive oil modifies how your gut microbiome communicates with your brain.

Olive oil’s beneficial effects on the human brain and body are likely related to the polyphenols’ hydroxytyrosol (HT) and Oleic acid (OA) presence. HT protects cells that are under oxidative stress. OA is a monounsaturated omega-9 fatty acid that is generally higher in olive oil than vegetable fats. It has beneficial effects on blood cholesterol levels.

Bottom-line

EVOO has been a part of the human diet for a very long time and has many benefits for health, for reasons that we do not yet fully understand. The realization that EVOO can protect the brain against different forms of dementia allows us to learn more about the mechanisms through which it acts to support brain health. Brain benefits a lot from adding olive oil to your diet, and these benefits originate in response to the changes that olive oil makes to your gut microbiome. Olive oil should become a big part of the diet for anyone with an aging brain.

Reference:

https://bit.ly/35AiCzF

https://bit.ly/2K4Toky

https://bit.ly/3pA7Npa

https://bit.ly/3lCpy50
Published 11/20/2020

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