The YOU Docs Blog

• Post 18—Why skinny doesn't always equal healthy
• Post 17—The ultimate holiday health superfood
• Post 16—How to become someone who never gets sick
• Post 15—Make your workout last longer
• Post 14—How to prevent an out-of-the-blue heart attack
• Post 13—Are you too busy for 30 minutes of walking?
• Post 12—Nature's answers to sleep drugs
• Post 11—Was my checkup complete?
• Post 10—The skinny on getting rid of belly fat
• Post 9—Set off on the right foot
• Post 8—The guide to good fats
• Post 7—How short can your workout be?
• Post 6—The wonder vitamin you're missing out on
• Post 5—How to get more (and better) sleep
• Post 4—The effortless way to eat more veggies
• Post 3—Stop your sugar cravings
• Post 2—What to make of the latest vitamin news
• Post 1—Should a doc be able to turn you away?

For more from the YOU Docs, visit RealAge.com.

Being at your ideal weight is great—congrats! But it doesn't always mean you're in ideal health. Where you carry the little fat you have can make a big difference. If you have omental fat—that is, fat between your abdominal organs—you're at risk for cardiovascular disease and metabolic syndrome (hypertension, diabetes and a cluster of other conditions), even if your weight's ideal.

To figure out whether you're at risk, check your waist. When measured at your belly button while you suck in, it should be half your height or less in inches. The more fat you have bunched around your middle, the more proinflammatory cytokines you have racing around in your blood. These signal inflammation, and the more inflammation you have, the greater your health risks. Once the inflammation ball gets rolling, the danger of obesity, cardiovascular disease and metabolic syndrome go up.

The great news is that you and your body get a second chance. It doesn't take that long, and it isn't that difficult—if you know what to do. Lower your percentage of body fat with the triple threat:

• Walking 30 minutes each day (no excuses!)
• Weight training—not for bulk, for strength—three times a week
• And eating right

Start by having 70 calories of fat (six walnuts will do) 25 to 30 minutes before any meal. Then, avoid all saturated and trans fats, simple sugars and syrups and any grains that aren't 100 percent whole.

It's easier than you can imagine once you start. It's how both of us always eat (yes, always!). And the inches around your waist will roll off, as long as you keep walking and working out.

For more from the YOU Docs, visit RealAge.com.

The holiday superfood you can eat all year long.

What can be dished up tart or sweet and melds with turkey and trail mix as easily as bread and sauces? Cranberries. And they're so good for you, why limit them to holiday fare? Here are five reasons to eat them year-round:

They're antioxidant all-stars.
Cranberries have more of these disease-fighters than do apples, red grapes, strawberries, oranges, bananas, pears, grapefruit, pineapples and peaches! And the antioxidant roster includes powerful resveratrol, the heart protector in red wine, which is now being tested against breast, skin, prostate and liver cancer.

They keep your ticker, well, ticking.
Cranberries pack a triple whammy: They're chock-full of antioxidants, anti-inflammatories and anticlotting agents, a combo that helps prevent fats and cholesterol from sticking to artery walls and seems to lower bad LDL cholesterol and boost good HDL cholesterol.

They protect your pearly whites.
Compounds in cranberry juice appear to reduce decay-causing mouth bacteria and dissolve clusters of unhealthy germs. Just be sure to buy sugar-free juice or rinse well with water afterward. Do the same with any sweetened drink.

They ward off ulcers and upset tummies.
Cranberry compounds and bad bacteria loathe each other, which is a good thing. Scientists suspect that the berries keep ulcer-causing H. pylori bugs from hanging around the stomach and flush other harmful bacteria out of your digestive system.

They fight infections "down there."
Urinary tract infections (UTIs) are responsible for 8.3 million doctor visits each year. That's a lot of waiting-room discomfort. But drinking cranberry juice significantly cuts the rate of UTIs and may even cure those that are already under way. The antioxidants—in this case proanthocyanidins—keep the pesky bacteria at bay.

No wonder these merry berries have become must-adds for health-conscious, age-fighting home cooks. Getting the right amount of antioxidants through diet or supplements can make your RealAge as much as six years younger.

For more from the YOU Docs, visit RealAge.com.

Make yourself the kind of person doesn't get sick.

Q: Why is it that I catch every common cold virus or other sickness that someone around me has? I exercise, wash my hands frequently, eat plenty of fruits and vegetables, drink water and tea, take supplements and get enough sleep every night. Why can't I be one of those people who never get sick?

A: You can be one of those people! You're already doing many of the right things to keep germs from messing with you, especially washing your hands frequently (maybe someday you can share your secret for getting enough sleep!). But you can do more. Make sure you're getting these:

• Vitamin C, 500 mg twice a day, from supplements or foods such as oranges, tomatoes and bell peppers. This vitamin helps your immune system produce more bullets, so to speak, that kill invading germs.
• Yogurt that contains Lactobacillus acidophilus helps fight off fungus-related infections. You can get the same power from acidophilus supplements (20 mg twice a day) or with supplements containing Bacillus coagulans.
• Flavonoids found in plants—especially oats, apples, broccoli, strawberries, cranberries, red wine and nonherbal teas—allow your body to remember old foes longer, so it fights them off.
• Ginger and curcumin (a component of turmeric, a spice found in curries and some yellow mustards) help ward off infection.

While being out in the world will expose you to germs, cutting yourself off from it won't keep you healthy. Keeping your social life active and managing your stress level are just as important as nutrients when it comes to bolstering your immune system. And so is washing your hands before and after. Or, if you can't get to a sink, use an alcohol hand sanitizer.

Still feel a cold coming on? You can't stop it in its tracks, but you can reduce the symptoms. Eat chicken soup four times a day, take 500 mg of vitamin C four times a day, or take zinc lozenges every six hours, and drink lots of fluids to help flush your body of the infection.

For more from the YOU Docs, visit RealAge.com.

The key to a better workout? It's all in your head.

Want to take the shortcut home from your walk or ditch your spin class before it's done? Before you do, check where that "quit" signal is coming from, because new research suggests your mind might be checking out even when your body would be happy to continue.

In a small study, researchers looked at what happened when a group of people did a demanding mental task for 90 minutes or loafed around watching a documentary before a workout on a stationary bike. When people did the mental workout, they called it quits sooner on the bike and thought their workouts were harder—even when their response to exercise was the same (nothing about their bodies indicated that they had worked harder or were more fatigued). In other words, when they tired out their minds, they thought their bodies were wiped out too. The "why" is not clear, but we do know that the exhaustion isn't from the rational mind, it's from the emotional, reptilian one. (That reptilian one messes with your finances, too, but that's another tip.) In the meantime, it's proof of how persuasive the reptilian brain can be.

That doesn't mean you shouldn't work out after a tough day—in fact, that's when you may need a workout the most. But if you think you want to bail early, ask yourself which part of you is saying: "Hey, can we stop now? Pleeease?" Your legs, lungs or core might be fresher than you think. So use your rational mind to control your reptilian brain and to keep you working out—and keep you younger—longer.

For more from the YOU Docs, visit RealAge.com.

Prevent a sudden, out-of-the-blue heart attack.

And you thought your 401(k) statement was scary. How about the fact that more than half of all heart attacks strike people who seem perfectly healthy—no high LDL cholesterol, no high blood pressure? Don't cue up the menacing music yet: There are other known risk factors, and you can control them relatively easily.

One reason a heart attack happens to a seemingly healthy person like you is that there's a stalker in your arteries: inflammation. And now, the benefit of what we've been doing to combat it at NewYork–Presbyterian and the Cleveland Clinic has been confirmed by a Harvard Medical School study. The study found that if you have this inflammation villain but you're in good shape otherwise, taking a statin drug could slash your risk of a horror-story heart attack by 50 percent.

People in the study had fairly healthy levels of lousy LDL (under 130 mg/dL) but high levels of C-reactive protein (CRP), a sign of chronic inflammation. Those who got the statin drug saw their CRP counts fall 37 percent and their absolute risk of a heart attack drop by 50 percent. And when you control your risk of a heart attack, you also control your risk of stroke, impotence, kidney failure and even wrinkles. A major cause of all of these is arterial aging, and while arterial aging is typical, it is neither normal nor necessary.

Does this mean you need a statin, even if your cholesterol's not high? Maybe. But there's a better take-home message: Don't wait until you need a drug to get serious about inflammation. Here's how to keep it in check, with or without a statin:

Know Your CRP Score
Get a baseline test of your CRP levels in your 20s, again at 35 and annually after your 50th birthday. Get an hs-CRP (short for high-sensitivity) test, which detects CRP in low ranges (cost: $20 to $50). Regular CRP tests are fine for checking high inflammation levels in rheumatoid arthritis and serious infections, but they won't detect the low levels that can threaten your heart.

A CRP under 1.0 mg/L is considered low risk for cardiovascular disease, 1 to 3 is considered average, and over 3 is considered high risk. That's the conventional wisdom; people in the study got treated at levels as low as 2 mg/L.

If Your CRP Is 2 or Higher, Do Something About It
In addition to making inflammation-quenching lifestyle moves (more on those in a minute), talk with your doc about the pros and cons of statin therapy. By the way, the lower dose of statins that Dr. Mike usually prescribes seems to work just as well as the higher dose in the study. There's little doubt that a statin can lower your risk. But, like all drugs, statins can have side effects. If statins don't seem right...

Consider Aspirin
We recommend half of a regular aspirin or two low-dose aspirin (162 milligrams total) every day if you're a man over age 35 or a woman over 40 (drink half a glass of water before and after). It cuts the risk of a heart attack by 36 percent by lowering arterial inflammation and making platelets less likely to form heart-threatening clots. But talk to your doctor first. Aspirin can raise your odds for an ulcer or gastric bleeding, but those odds are reduced by more than 60 percent when you drink that half glass of water before and after.

Make Good Choices
Inflammation in your arteries is fueled by belly fat; inactivity; eating too much saturated fat; too few fruits, vegetables, whole grains and beans; and even by ongoing low-grade infections like sinusitis and gum disease. But you can control it with these steps:

• If you smoke, for heaven's sake quit!
• Move! Get at least 30 minutes of walking every day.
• Take vitamin D (1000 international units) and omega-3 DHA (600 milligrams of DHA). If you prefer fish oil, take 2 grams every day.
• Put colorful, high-fiber foods, including beans, blueberries and tomatoes, on your plate at every meal. A high-fiber diet can reduce CRP levels. So can the carotenoids in pumpkins and cantaloupes, the lutein in tomatoes, the natural oils in herbs like oregano, and something called oleocanthal in fresh-pressed extra-virgin olive oil.
• Skip Conan, Letterman and Jon Stewart and turn in early. Or just TiVo them or catch them on the Web the next day. In one recent study, sleep-deprived people—especially women—showed a marked increase in proteins associated with inflammation.
• Floss. Plaque buildup in your mouth may provoke inflammation.
• Battle belly fat, even if you're skinny. The higher your percentage of body fat—especially around your middle—the more proinflammatory cytokines are racing around in your blood. To lower your body fat, use the triple threat: aerobic exercise, weight training and a balanced diet.

For more from the YOU Docs, visit RealAge.com.

Find time to walk—even if you're too busy to remember!

Q: I leave for work too early in the morning and get home too late at night to walk for fitness. Are workout videos as effective as walking?
A: Having your feet hit the ground for 30 minutes every day is as important as making sure your car has tires. So, sure, videos that get you on your feet for 30 minutes are as good as walking. But don't wait until you get a video. Walking around your dining room table or chasing your spouse around the bedroom is effective too!

Q: In your books and columns, you are firm about getting 30 minutes of walking every day, which works out to 210 minutes a week. When I'm super busy, can I stagger days or cut back to 10 minutes, as long as I average 210 minutes a week?
A: Walking turns on genes that apparently require daily activity to stay on. Normally, we hate to give you absolutes when the data aren't perfectly clear—but this case is an exception. We believe that 30 minutes a day is necessary. However, when you're super busy (or just in the mood for quick, short walks), you can break up the time and walk in intervals as small as 10 minutes. Why a total of 30 minutes and intervals no smaller than 10 minutes are the magic numbers is as clear as a window during a snowstorm. We just don't know why, but those times appear to be what it takes to change the way certain genes function.

Q: In terms of burning calories, is 11 minutes of stair climbing equal to 36 minutes of walking?
A: Usually, 36 minutes of walking will burn about 200 calories, whereas 11 minutes of stairs will burn around 100. We say "usually" because the burn rate depends on how fast you walk or do stairs. If you have access to a gym, there's an easy way to find out: Mimic your pace on a treadmill and a stair-climbing machine, and see how many calories you burn in those time periods. While the calorie counters on machines aren't perfect, they'll give you a reasonably accurate idea that's better than guessing.

Q: I get lower back pain if I walk, so I'm biking daily. Is it doing me as much good as walking?
A: Most studies don't directly compare biking to walking, but our best estimate is that if you bike with resistance (as if you're going up hills), you will get most of the same benefits. The key exception: Biking won't make your bones stronger. Strengthening your bones (by laying down more calcium and other minerals into them) requires actual contact with the ground: lifting your foot up and then landing on it again. Your body, not your bike, has to support you for your bones to get the message.

Q: After fighting my weight for 35 years, I had gastric bypass surgery in 2006. I have maintained my current weight of 119 for two years, but I can't get motivated to exercise. I get up at 3:15 a.m. and work a full-time job at a hospital lab from 6 a.m. to 2:30 p.m. I'm 59. My husband is 66 and has cirrhosis and is on dialysis, so I am the caretaker. I work and keep my house up, and by the time my day is over, I am ready for bed. How can I fit exercise in?
A: You may already be getting the exercise you need. Find out by clipping on a pedometer and seeing how many steps you walk daily. If you are getting 10,000 steps a day doing your lab job, cleaning, making meals, taking care of your husband and doing all the little extras that life requires, fantastic. If not, but you're reasonably close—and we bet you are—park a little farther from the lab, or get off one bus stop earlier and go one bus stop farther at the end of the day, then walk the difference. Dr. Mike parks in the lot that's farthest from his office and walks about a mile each way just going to and from his car. Of course, Dr. Mike's a little crazy—he tries to do 12,000 steps a day, and if he doesn't, he gets on a treadmill before he goes to sleep. In fact, he just completed 50 minutes on the treadmill—so he's signing off for bed! And no, hip movement in bed doesn't count, and even he doesn't wear a pedometer to bed.

For more from the YOU Docs, visit RealAge.com.

The prescription for sleep—without medication.

And you don't have to solve the world's problems. All you need to do is stretch. When a group of women did a simple stretching routine every day, they fell asleep more easily than nonstretchers. Why isn't clear, but who cares if you're out like a light? A basic yoga routine's probably perfect, but just stretching out the day's knots slowly and soothingly should do the trick.

If stretching is too subtle for you—or if you're going to do something physical, you want to torch some calories while you're at it—consider moderately intense exercise. But do it in the morning. Women who did a.m. workouts for a total of at least three hours and 45 minutes a week (about half an hour a day) also joined the better-sleep club.

But shorter morning workouts didn't help much. And women who worked out that much at night didn't see sleep benefits, though that's no surprise: Exercising within two hours of bedtime can leave you wide-eyed.

Another candidate for natural Ambien: tai chi. People who did an hour of tai chi three times a week for six months fell asleep about 18 minutes faster and slept almost an hour longer than a control group.

There's a bonus to all this zzz time: Better sleep not only makes you feel good but also reduces overeating, arterial aging and heart attack risk. So get moving and go to bed.

For more from the YOU Docs, visit RealAge.com.

Did your doctor forget something? And, are generics just as good?

Q: I just got the results of the blood tests that my doctor did at my checkup, and there's nothing on there about my homocysteine level. I've heard that too much homocysteine increases your risk for heart disease and stroke. Shouldn't she have tested for it?

A: Not necessarily. If you are getting enough folate (400 micrograms), B6 (4 milligrams), and B12 (25 micrograms) from diet or vitamins, you would be very unlikely to have an elevated homocysteine level. Those nutrients bring homocysteine down, so you should focus on getting them, rather than the test.

There are, however, two times you should get the test. One, if you have a strong personal or family history of cardiovascular disease, but don't have any risk factors, such as high LDL cholesterol or high blood pressure. And two, if you're in an Executive Health Program like the Cleveland Clinic's, where risk/benefit—not cost—determines whether the test is ordered.

Why we worry about homocysteine: It's a normal byproduct of digesting protein, and most of us pee it out or reprocess it. But too high a level seems to cause homocysteine to act like glass shards or small crystals in your bloodstream, making microscopic nicks in your arteries, which leads to plaque and inflammation (and heart disease and stroke). Bottom line: Make sure you get your nutrients: It's as important as filling your tires with air.

Q. Are generic drugs really the same as brand-name products? I've started taking the generic drug for Effexor, but I think the brand-name pill worked much better.

A. Generics are mostly the same. The FDA requires them to contain the identical drug and have the same quality, purity and strength as the brand-name product.

But there is some wiggle room within these regulations that may affect how the drug works in you. For example, the amount of generic drug that gets into your blood after you take it—called bioavailability—must be within 20 percent of the branded drug. That means if 100 percent of a brand-name drug gets absorbed into your blood, maybe only 80 percent of the generic gets in. In addition, generics can contain up to 7 percent above or below the dose stated on the prescription (so instead of 100 milligrams, you might be getting only 93). Further, the inert ingredients and the formulation (meaning, what else is in there to make it into a pill or tablet) may change in the generic form, and this can alter your absorption of the drug too. Together, all these factors could add up and lower (or raise!) the drug's effect on you. But most don't.

That said, some generics do not perform as well in treating the symptoms of a disease as the branded drug does. Thyroid medication seems to be particularly prone to this not-as-good-as-brand-name effect. But for the vast majority of patients and drugs, generics are equally effective—and they're less expensive.

Q: My husband was recently diagnosed with cancer and is starting chemotherapy soon. What can I cook for him if he's feeling unwell? We generally eat a healthy diet.

A: First, it may seem cruel but don't deliver the food to him, because it's essential that he keeps walking—it usually turns on a gene that mutes several cancer growth factors. Next, while loss of appetite can be a big challenge before, during and after treatment, these strategies may make meals easier for both of you:

• Vary texture, temperature and taste. One day, a crunchy, cold mixed fruit salad may hit the spot. On another, something warm, bland and smooth is more comforting. Keep meals small, and offer them frequently. Freeze small servings of a variety of entrées so you have options, depending on how your husband is feeling. If friends ask what they can do—and they will—recommend that they make a healthy soup, casserole or pasta dish for freezing. Have healthy snacks—whole-grain crackers, nuts, avocados and both fresh and dried fruit—within reach.
• Steer clear of saturated fats. These turn on a family of genes that increase cancer growth rates. And we know we don't need to say it, but we can't resist: Avoid sweets and other foods made with anything but healthy fats as if they cause homicide—because they do, and you'll be arrested by the YOU Docs police (or should be).
• Avoid foods that can overwhelm. Go easy on the spices, especially hot ones, unless your husband has diminished taste. And take care not to overpower his senses with strong smells.
• Don't force it. If he doesn't feel like eating, that's okay. Sometimes the best you can do is offer a smoothie loaded with great fats and great taste. If a complete lack of appetite persists, ask your doctor about liquid meal replacements. Making sure your husband has at least something in his system can be as necessary as having at least a teaspoon of gas in your car's tank.

For more from the YOU Docs, visit RealAge.com.

6 things you don't know about your fat belly.

All fat is not alike.
Eat more calories than you burn, and the extras get packed away in one of two places—long-term storage depots beneath the skin (subcutaneous fat) or short-term bins deep in the abdomen (visceral fat). Visceral fat is what we call omental fat—that is, fat in your omentum, a piece of webbing that hangs off your stomach just beneath your ab muscles, sort of like a mesh apron.

The fat you don't see is the most dangerous.
The soft, superficial stuff that ripples your thighs and tummy may be a bikini spoiler, but if you can pinch it, it probably won't kill you. However, if you have a solid "beer belly"...well, you're likely headed for more trouble than a politician hooked up to a polygraph. That's because too much deep fat churns out supersize amounts of hormones and proteins, which can lead to big hazards. Among them: lousy LDL cholesterol and triglyceride levels; high blood sugar and blood pressure; insulin resistance; and widespread inflammation. All are instigators of many diseases—including dementia, cancer, heart disease and diabetes. But often you can get a "do over," and it doesn't take that long and isn't that hard, if you know what you're doing. So don't stop reading!

First, don't rely on your scale. As you start to reduce risky belly fat, your weight may temporarily go up. So ditch the scale in favor of the tape measure. If you're a woman, your waist should be 32 1/2 inches. If you're a man, 35 inches. Creep past 37 inches for women or 40 for men, and the health dangers increase.

Stress makes you fat.
Not only does stress lead you to eat ice cream straight from the carton, but it also triggers the release of cortisol, a stress hormone. When stress becomes unrelenting, the omentum attempts to control cortisol flow by sucking it out of the bloodstream. Nice try, but cortisol fights back once it's in the omentum and turbocharges fat there. That sets off other chemical reactions that leave you feeling hungry...and looking for the Häagen-Dazs again. Fortunately, any kind of stress reduction, especially exercise, will help short-circuit this stress/fat cycle. Feeling tense right now? Go for a walk the minute you finish this column.

The fat you eat affects the fat you get.
When monkeys munched on trans-fat laced diets for 6 years, they developed more deep-belly fat than those who went trans-fat-free, even though both ate the same number of calories. Physiologically, we're close enough to monkeys to extrapolate that trans fat doesn't do anything good for your waist or your arteries.

Blasting belly fat isn't hard.
If you're not overweight but still have an oversized waist, the fastest way to shrink your omentum is by walking. Taking a brisk 30-minute walk each day will keep those fat cells from expanding. Pick up the pace some, walk a little longer, and you can give your omentum a makeover, turning a flabby apron of omental fat into sheer mesh again. After 30 days of walking, start doing resistance exercises as well to add muscle and lose inches—otherwise you'll hit a plateau. No dumbbells? No gym? No problem. You can get an excellent workout in 20 minutes by using your own body as a weight to stretch and strengthen all of your major muscle groups.

Watch a Dr. Oz–approved "gear-free" workout

Whole grains scare away belly fat.
If you and a friend go on a diet but you eat whole grains (meaning brown rice, steel-cut oats and whole wheat pasta, not whole grain Pop Tarts) and your friend eats processed grains (anything made with white/enriched grains and flours, cupcakes to noodles), you both might lose the same amount of weight, but you'll shed more belly fat and lower your levels of C-reactive protein, a marker of damaging inflammation. And your food will taste better, and you'll feel full longer. AND you'll have a flat stomach!

For more from the YOU Docs, visit RealAge.com.

Meet your walking goals with a pedometer.

The best number to go for is 10,000. That's not that many more than you're probably already taking. Most people log between 3,500 and 5,000 steps daily just by looking for the remote, double-checking that they fed the dog and otherwise going about their days. Even if you take 5,000 steps throughout the day—about 2.5 miles—experts (and even we YOU docs) consider you to be less than minimally active, or what our research friends politely term sedentary. But the good news is that if you're doing that much without even trying, it's not going to be that hard to bump up to the amount that counts when it comes to making your RealAge younger.

Research shows that people who kept the 10,000-step goal in mind literally walked the extra mile, logging about 2,000 extra steps a day. Wear a pedometer and experiment. How close to your goal do you get by taking the long way to the cafeteria or the produce section of the grocery store? Dr. Mike parks his car in the indoor lot that's farthest from his office at the Cleveland Clinic.

Those extra milers also lost weight and improved their blood pressure. Do it and bring on other benefits: Walking lowers lousy LDL, raises healthy HDL and decreases inflammation. And our favorite: It makes you feel great.

For more from the YOU Docs, visit RealAge.com.

The skinny on good fats vs. bad fats.

Here's all you need to know:

• Embrace the "uns."
  There are two kinds of unsaturated fat: monounsaturated and polyunsaturated. The ones that help you stay healthy are omega-3 fats—polyunsaturated—found in canola oil, walnuts, walnut oil, avocados, flaxseeds and flaxseed oil. Many people believe other unsaturated fats, such as the omega-9s that are prominent in olive oil and other nuts, also help you avoid aging. Notice a theme in these good fats? Right: They all come from plants, and many plant-based fats are heart healthy.
• Watch the ratio.
  The subject of fat is very complex, but at the risk of stopping your reading because you think we're geeks, we'll go into it a little bit: Many docs believe you should avoid omega-6 fats from soybeans, safflower and corn. Many experts on fat believe that omega-6s do not help you stay young. This area is as controversial as how many decks of cards a gambling casino uses in blackjack. But there does seem to be an ideal, and that's an omega-3 to omega-6 ratio of at least 1 to 4. The typical American diet is 1 to 20. Translation: We eat way too many omega-6 fats.
• Shun the solids.
  Unhealthful saturated fats are found in products from four-legged animals—most red meats, luncheon meats, butter, full-fat cheese—and also in palm and coconut oils. A key way to spot these fats: They're generally solid at room temperature. Need something to spread on your sandwich? Skip the butter and try a moist flavor-booster such as mustard, hummus, avocado, tomato sauce or a crushed-olive tapenade.
• Turn your back on trans.
  Trans fats are fats that have been hydrogenated, a process designed to keep fats from spoiling and becoming rancid. While hydrogenating works—trans fats keep foods stable at room temperature, increasing a product's shelf life—these processed fats have turned out to be the unhealthiest of all. They raise lousy LDL cholesterol and lower healthy HDL. Exactly the opposite of what your body wants. Our bottom line: Omega-3s make your physical age younger than your calendar age, so include a handful of walnuts and maybe some other nuts in your daily diet. Cook with as little fat as possible, and use canola oil when you do. Include fish oils and avocados in your diet.

Most scientists—but not all—include olive oil in the healthy group. Saturated fats and trans fats definitely turn on some genes that make your body age, so avoid them in order to keep your RealAge as young as it can be. And omega-6 fats sneak into so many foods that it's worth trying to avoid oils rich in them (soybean, safflower, corn and vegetable blends).

Finally, all fats make you feel fuller longer—but you need only 70 calories' worth (six walnuts, for example) to release cholycystokinin (CCK), a hormone that works on the brain to decrease the desire for food. After you eat 70 calories of fat on an empty stomach, it takes about 25 to 30 minutes for CCK to kick in. Dr. Mike's favorite technique: Munch on a few walnuts or have a bit of avocado on a celery stalk, a glass of water, a glass of your favorite wine and a 30-minute walk prior to dinner.

And keep in mind that even healthful fats are high in calories, and calories still count. Enjoy, but not in excess.

For more from the YOU Docs, visit RealAge.com.

What's the least amount of exercise you need to do?

Why the different numbers? They're about different payoffs. The "30 minutes" guideline is the minimum that the Centers for Disease Control recommend for staving off chronic disease. The "55 minutes" number is from a new study in which people who did that much kept off 10 percent of their weight.

The fact is, staying at a healthy weight is part of staving off chronic disease. We think that workouts should do far more than one thing for you. They can fight aging, heart disease, osteoporosis, belly bulge, arthritis, memory loss, stress and more—so why not get them all? To keep your body from hitting its expiration date before you do, set these four goals. However, if you've been cozier with the couch than your walking shoes lately, do each one for 30 days before adding the next.

1. Take two different types of steps.
   Work up to walking 10,000 steps a day, every day. Do 30 minutes' worth—about 3,000 to 5,000 steps—as brisk walking that gets your heart rate up perceptibly. This is not a stroll, but it's not as high as you'd get while doing a stamina workout such as the elliptical trainer at the gym. Your heart rate should be at least 10 beats per minute higher than when you're strolling. This is "moderate" activity. Pressed for time? Three 10-minute walks are just as good. Even these small amounts can lower your blood pressure, lousy (LDL) cholesterol and inflammation level and raise healthy (HDL) cholesterol.
   
   The other 5,000 to 7,000 steps are the casual ones you accumulate while walking through the grocery store, to the bus, around the office and with the dog. These steps burn calories and help keep your weight down, but they're not enough on their own.
   
   Where does housework fit in? If vacuuming gets your heart pumping and takes longer than 10 minutes (few household chores do, believe it or not), then chalk it up as moderate activity. But chances are it's an exception, so count these steps in your "casual" total.
   
   
2. Heft some weights for 30 minutes a week.
   It only takes three 10-minute muscle workouts (time actually spent lifting the weights or using resistance bands) a week to get you strong enough to reverse some of the aging process. We're not talking about bench pressing monster truck tires. We mean using your body to push and pull against some kind of resistance, whether it's exercise bands, a weight machine, dumbbells or your own body weight (cheapest gym you'll ever join).
   
   Use proper form and never sacrifice form for weight (use the heaviest weight you can while maintaining perfect form). Developing flawless form usually involves instruction and periodic checks by a pro. This tiny amount of resistance training not only builds muscle but also helps keep bones strong and stokes your calorie-burning furnace—muscle burns more calories than fat. And it keeps your arteries young, your immune system fit, your risk of falls low and your body confidence high. 
   
   
3. Break a sweat for 20 minutes three times a week.
   We call these "stamina" workouts—they make you sweat in a cool room. You can bike, use the elliptical trainer, jog, swim, dance or even make vigorous love...if you can do it that long. Stamina workouts strengthen your heart (and maybe your blood vessels).
   
   If you want to get into the next Olympics or just run a 5K, you'll need to do more than 60 minutes a week. But if you want optimum health, it's all you need. Overachievers, take heed: Once you go over 60 minutes or so, there's no more benefit from a longevity standpoint. In fact, the extra wear and tear on your body could actually decrease your lifespan.
   
   
4. Stretch for five minutes five times a week.
   Simple yoga combinations and plain-vanilla stretching increase your flexibility. Hold a position for a minute or longer and you'll also get a meditative component, which can have spiritual and physical bonuses.
   
   Get Dr. Oz's simple, seven-minute morning yoga routine.

When it comes right down to it, working out is pretty simple: If it hurts, stop. If you dread your workout, change it. The pursuit of health should be a joy and a pleasure. Go out and love it.

For more from the YOU Docs, visit RealAge.com.

The wonder vitamin you're not getting enough of!

And if you're over 60, have dark skin or slather on sunscreen every time you step outside, put yourself in the 85 percent zone. That's bad news for your health. Not just because you need D to build strong bones, but because a steady stream of recent research suggests this familiar nutrient is responsible for more good deeds than a string of superheroes put together—including the biggie that it can even help you live longer. Several studies have found that if people take more vitamin D, they have 25 percent less cancer and heart disease.

If you don't? A just-released study found that people with the lowest levels of vitamin D in their blood are 26 percent more likely to die from any cause (heart disease, cancer, infection, you name it) than folks with respectable amounts.

That's just the beginning. Vitamin D is like the quiet kid in the back of the room who ends up developing the next Google. It's equally underestimated. New benefits of D are being discovered faster than you can say cholecalciferol (that's science-geek speak for the active form of vitamin D, also known as vitamin D3). Here's the latest on how it helps you stay young and healthy.

• It cuts your risk of breast and colon cancer.
  Many cells love to multiply faster than rabbits in the arugula patch. But out-of-control cell growth can lead to cancer. Enter vitamin D. It keeps a lid on the rate that cells reproduce, and it turns on your DNA spell checker, called the P53 gene. This gene checks your DNA for typos and kills cells—like cancer cells—that have errors. Experts now believe this is why women who live in sunny climates, and thus have plenty of D (your body makes it when sunlight hits your skin), are less likely to develop breast cancer. D has also been linked to lower chances of developing ovarian and lung cancers and better odds of beating colon cancer. Recent research found that colon cancer patients with the highest D levels are the most likely to survive.
  
• It deters diabetes and other serious diseases.
  When researchers looked at the link between sun exposure and type 1 diabetes in children, they found fewer cases of diabetes in kids who live closer to the sunny equator (and therefore make more D). And because D improves your ability to produce and use insulin, it may also help protect against type 2 diabetes. The vitamin, which is thought to be an immune system ally, may help prevent autoimmune diseases too, including multiple sclerosis and rheumatoid arthritis.
  
• It keeps your heart healthy.
  Vitamin D helps your ticker by controlling inflammation, moderating blood pressure and keeping your arteries young. That's probably why vitamin D-deficient men are twice as likely to have a heart attack as men with healthy levels—and twice as likely to die from it.

When it comes to getting enough of this high-test health booster, only a handful of foods supply it: primarily oily fish (salmon, herring, sardines) and D-fortified foods (many cereals, nonfat yogurt, skim milk, soymilk and OJ). But you have to eat a lot of them (like 10 glasses of orange juice a day) to get what you need.  True, you can get D from sunshine, but you need to be outside during peak sun hours for at least 10 minutes several days a week. And in the northern two-thirds of the country, that only works from spring through fall. Between October and mid-April, the sun doesn't have enough energy for your body to make D in its active form—even if you sit out in the sun all day.

That's why we recommend vitamin D3 supplements. Aim for 1,000 International Units (IU) daily; 1,200 IU if you're over 60—though check your multivitamin, which probably has around 400 IU of D, so you don't overdo. Limit your daily dose to a max of 2,000 IU. At the same time, don't become D-ficient. Get the best D-fense against cancer and heart disease—about 1,000 IU a day from a bottle.

For more from the YOU Docs, visit RealAge.com.

Strategies to get enough sleep.

Q: How do I choose between sleep and exercise when I'm short on time? I usually go for the sleep, but maybe extra exercise would do me more good.

A: Your health isn't a game of Let's Make a Deal, but there is an ideal minimum: at least 6.5 hours of sleep a night and 30 to 50 minutes of exercise a day. That may mean you have to end your relationship with late-night TV to hit the pillow a little earlier, but it's the only combo that will protect your health.

The optimal amount of sleep for men is 7 to 8 hours a night; for women, 6.5 to 7.5 hours. And those need to be solid hours: It takes 1.5 hours for sleep to become truly restorative. Plus, not getting enough sleep causes you to eat more and your arteries to age faster, which increases your risk of having a heart attack—not to mention of yawning in your boss's face.

Those 30 to 50 minutes of exercise aren't complicated. Every day, simply walk (or do any other aerobic exercise) for 30 minutes, no excuses. However, on crazy-busy days, you can break up the time into can-do segments. For instance, do three 10-minute sessions throughout the day. In addition, add 20 minutes of strength training three times a week. That's it.

Q: Do women have more trouble sleeping than men?

A: Yes and no. Part of the answer may depend on whether they're sleeping together or not. One recent study found that men tend to sleep better when they're next to a woman, while women tend to sleep worse when they share a bed with a man. Why? It isn't totally clear—though one observer suspects it may simply be that more men snore—loudly (which may explain why roughly 25 percent of couples sleep separately).

That said, in theory women ought to sleep better than men because estrogen benefits the brain's sleep center. This female sex hormone seems to help women stay asleep longer and wake up less often during the night. But in reality, many women miss out on great sleep. In fact, despite their hormonal edge, women are twice as likely to have insomnia as men are.

Modern life could be a factor. Stress and financial problems from high divorce rates and frequent job upheavals seem to disrupt women's sleep more than men's. Plus, estrogen plays a dual role. While it starts as a sleep ally, over time it becomes a sleep thief. Estrogen levels start falling in midlife and continue dropping until menopause is complete. The resulting hot flashes—also known as night sweats—can disturb a woman's sleep for years.

Q: Sometimes I wake up with dark circles under my eyes, but not always. Sometimes they're puffy too, but not always. And sometimes they're fine. Why is that?

A: If you don't usually have dark circles under your eyes, when you do, it may be because you've had an allergic reaction to something. When that happens, congestion settles in, swelling the veins around your eyes and nose. The veins become more visible through the thin skin under your eyes, making the area appear dark.

The puffiness could be related to the congestion, to not getting enough shut-eye or to retaining fluids—which can happen if you are menstrual or take in more salt than usual or you are dealing with a variety of health problems.

The short-term solution is to prop up your head for a few minutes and put something cold on your closed eyes (slices of cucumber from the fridge; a chilled, gel-filled eye mask; a bag of frozen peas wrapped in a dishtowel). Long-term, check with your doctor to figure out if you have an allergy, what is triggering it and whether a 1-micron pillow covering or an allergy medication will help. To avoid puffiness, try putting wood blocks or bricks under the head of your bed. It will help counter the gravity that encourages fluid to collect around your eyes while you're sleeping.

For more from the YOU Docs, visit RealAge.com.

The effortless way to eat more veggies.

Other ways to ensure you'll eat it:

• Sniff it first. If it doesn't smell fresh, don't purchase it.
• And look for the new "country of origin" stickers. (Yes, we prefer local food in season.)
• When you get it home, eat it quickly. Nutrient content drops over time, even when it's refrigerated...with the exception of dark plums, which might get a little antioxidant boost with short storage. Some fruits hold up better than others—black grapes, apples, oranges and tomatoes (yes, tomatoes are considered fruit)—but it's still best to eat them when they're fresh. And keep them in the crisper. Exposure to light can make some nutrients flee.

Know you won't be home much this week? Stock up on frozen fruits and vegetables. Some high-end chefs have even recently confessed to using frozen here and there (especially brussels sprouts, peas, corn and yellow and red bell pepper strips). And we low-end YOU Docs often use frozen fruit in our berry-blaster smoothies.

Since it's harvested at its peak, frozen produce may have more nutrients than fresh that has been picked early, then shipped and stored. So learn where your neighborhood fruit and vegetable parlor is, and remember the names of the produce masters. You'll find out from them what's fresh and enjoy their expertise in steering you to the best-tasting foods.

For more from the YOU Docs, visit RealAge.com.

Stop your sugar cravings!

• You say: Feed me now, or I'll kill you.
  This usually reflects low blood sugar. Eating sugar helps in the first few minutes but makes things worse in the long term.
  Break it:
  Sucking on a Tic Tac or two can be enough to stop the attack. After that, eat more protein and fewer sweets to keep your blood sugar stable. And eat those foods often: Multiple small meals instead of three big ones decrease cravings.
  
• You say: I'd really like a Twinkie.
  You generally feel okay but find yourself going through your cabinets looking for sweets.
  Break it:
  Holistic docs say—without great evidence, yet there have been some successful treatments—this could reflect yeast overgrowth in the gut and that treating it with probiotics (healthy bacteria) can help. We like probiotics made from bacillus coagulans, such as Digestive Aide or Sustenex.
  
• You say: It's my period, and I'm depressed.
  Low levels of serotonin—the "happiness molecule"—around your period can cause you to crave carbs.
  Break it:
  Eating dark chocolate (not a whole storeful; try an ounce or so) will supply a natural antidepressant called PEA, plus the carbs you crave. And any other time you think you might eat something when you're not really hungry, go for a walk or have some water. Much of the "I want to eat" feeling stems from lack of sleep (walking can help wake you up), lack of sex or lack of water.

For more from the YOU Docs, visit RealAge.com.

What the latest vitamin news means to you.

Does this have anything to do with your mainstream daily multivitamin/mineral, which contains a wide array of antioxidants as well as many other nutrients? No. Don't let the latest medical-study pingpong match scare you away from a multi...much less from the phytonutrients in fruits and vegetables.

Truth is, when news organizations highlighted the 191-page antioxidant report, important details got lost. Two examples:

1. Yes, beta carotene and vitamins A and E (all antioxidants) did raise the risk of death by 4 to 16 percent, but only in studies involving high doses—more than 15,000 international units (IU) of A and 7,500 IU of E. That's three to 300 times higher than recommended levels—not smart. For instance, we know too much vitamin A increases your risk of lung and liver cancers, and bone weakening too. (Choose a multi with fewer than 3,500 IU of A.)
2. Meanwhile, selenium didn't seem to affect the risk of dying, one way or the other. But as far as living well, selenium appears to lower some cancer risks and increase prostate health.

Also, while evidence against taking high-dose antioxidant supplements has been mounting, so has the support for eating lots of antioxidant-rich foods. One dramatic example: Taking supplements of vitamin A actually raises lung cancer risk in smokers. But new research has found that eating lots of strawberries, apples, beans, onions, brussels sprouts and green and black tea—all rich in antioxidants—cuts the risk of lung cancer in smokers.

The likely moral of this nutritional story: All of us (not just smokers) need the complex cornucopia of nutrients in real food to fight cell damage and disease.

But since it's easy to get too few antioxidants and other nutrients when you're eating breakfast in the car, lunch at your computer and dinner over the kitchen sink (we're not recommending this, by the way; we're just listening to what you tell us), we also believe it's a good idea to take a mainstream multi as an insurance policy against a less-than-perfect diet. It's also a good idea to divide it in two and take it twice a day—it makes it easier for your body to absorb all those nutrients.

As for proceeding with caution with some antioxidants, here are our basic guidelines:

• If you're taking cholesterol-lowering drugs, be careful with vitamins E and C.
  These can inhibit the anti-inflammatory component of cholesterol-clearing statins such as Mevacor, Lipitor, Crestor and Pravachol. While they'll still lower your cholesterol, 40 percent or more of their benefits are anti-inflammatory, and you'd be missing out on those. Avoid taking more than 100 IU of E daily or 100 milligrams of C twice a day. (This flags another problem with these studies, by the way: They often involved medications that interact with C and E but didn't limit the use of the two vitamins.)
• If you're facing cancer treatment, avoid antioxidant supplements entirely, unless your doc specifically tells you it is okay.
  They may help protect the cancer tissue, so they could make your treatment less effective.
• If you want to up your intake of phytonutrient-rich foods (of course you do!), shop for fruits and veggies by color.
  The brighter and deeper the color outside (including deep greens), the more the phytonutrients are waiting inside. All-stars (in alphabetical order) include apples, bananas, blueberries, broccoli, carrots, citrus, cranberries, dark-colored beans (like black and kidney beans), figs, peaches, red cabbage, red peppers, spinach, strawberries, sweet potatoes and tomatoes. Aim for at least nine servings of phytonutrient-rich fruits and veggies a day. A diet high in them can help your body combat cancer, heart disease, diabetes and needless aging.
• If you want a no-calorie way to boost your antioxidant supply, sip tea and coffee.
  Green and black tea, as well as coffee, are packed with antioxidants. We recommend more than 2 cups of each per day if you and your doc agree.

For more from the YOU Docs, visit RealAge.com.

Should doctors be able to refuse to heal you?

Basically, the Bush Administration issued this rule to protect healthcare workers who won't perform services that don't fit their personal beliefs. It also cuts off federal funding to entities that don't allow their healthcare employees to refuse to provide care. The rule takes effect before the current administration ends.

To us, this rule is the antithesis of the "serving master" concept that medical care is based on. As docs, we are supposed to serve you. We have studied hard and hold ourselves as masters (although we are not all-knowing, so we bring in colleagues to help). If we feel we cannot do what you need for our own religious reasons, we have an obligation to find you another qualified doc who can.

Our job is not to tell you to get lost or say that you've come to the wrong docs or that we won't honor your beliefs because ours trump yours. In our minds and practices, we are subservient to you.

Here's an example: Suppose you are a Jehovah's Witness and need your heart's mitral valve repaired. Any blood transfusion is against your religious beliefs. We believe that we need to inform you of the following options and their risks (we're simplifying them here):

• We can try to do it without transfusion. If we fail, let your God and you have peace, even if you die. (Let's make it a little less complicated and suppose no one is absolutely dependent on you for their survival.) We would describe when and where bleeding could occur during the operation and suggest medications and lifestyle changes to build your tolerance in advance of such blood loss.
• We can persuade you to accept blood transfusion alternatives as long as the blood doesn't lose contact with your body.
• If we feel these options are too risky, we can persuade you to bring in your religious elders and discuss accepting a transfusion this one time.
• We can find you another excellent team that will do the surgery according to your wishes.
  

We feel passionately that our task is to inform you of your options (using images as well as words). Once you've been fully informed, we follow your choice. But this new rule seems to abrogate the healthcare code that asserts that doctors serve you.

There's another side to this issue: emergencies. That's when the rubber hits the road. Emergencies are always exceptions. We believe no healthcare provider (not doctors, nurses, pharmacists, no one) has the right to refuse to perform a vital service (or refuse to dispense a time-critical drug) when there's no time to provide an alternative. It's our duty to serve you, even if we incur personal risk or a disruption of our belief systems. After all, we treat infectious diseases at our own peril, but that's the bargain we make with society and with you for the privilege of doing what we do.

We hope you believe that your docs and health professionals and institutions are "serving masters" to you—honoring your wishes after you have been informed of the alternatives. We've occasionally been persuaded that we were wrong (1988 was the last time, we think), so let us know your thoughts.

For more from the YOU Docs, visit RealAge.com.

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