by Deepak Chopra, M.D.

In a world plagued by food shortage that are reaching crisis level, carbohydrates are the easiest salvation and yet the greatest temptation to abuse. Ironically, the same is true in prosperous countries but for opposite reasons. Where food is desperately needed, vast portions of the ecosystem are obliterated to make way for a small handful of crops, particularly rice and wheat, that can provide abundant, cheap calories to a mass population. In well-fed societies where food can be channeled for diversion rather than raw fuel, refiners mangle natural carbohydrates to produce refined sugar and flour.

Either way, it has taken thousands of years to move from the first farmers, who paved the way for civilization by cultivating wild grains, to our present situation. Most of the world cannot survive without more grains and vegetables – our primary source of carbohydrates – while a small portion of the world faces an epidemic of obesity and diabetes linked to over consumption of sugar and fat. What will give us a balanced use of the body’s main source of energy without falling into gross misuse?

When Our Mind Rules Our Eating
Since the reader is almost certain to belong to a prosperous society, balance begins with two steps: refusing to join the processed food glut and putting sugar and starch back in place where they naturally belong. The issue isn’t really how much fat, protein, and carbohydrate to ingest every day. It’s more important to stop abusing your body’s great gift of adaptability. Because human beings can adapt to almost any diet, you are in a situation no other living creature faces: our minds rule our diet.

Some people are naturally sensitive to bodily sensations. When they say, “My body is telling me” or “I need to eat such-and-such,” there’s a real basis for the statement. The rest of us, the vast majority, eat out of our heads. We are susceptible to advertising, suggestive selling in restaurants (“Did anybody save room for our delicious chocolate cheesecake?”) diet fads, diet scares, and endless “breakthroughs” over how to lose those extra pounds. In the massive food industry, the cheapest calories for sale are processed sugar, which leads to the disturbing fact that the average American consumes 156 pounds of added sugar per year. “Added” is the word that should shock you. As people consume 31 five-pound bags of processed sugar a year, much of it in processed corn syrup and white cane sugar, even more comes to them in fruits and vegetables.

Scare tactics haven’t altered this picture, which has been the same for decades. A recent study showed that adult males who regularly consume sodas are 20% more likely to suffer a heart attack. That seems like a strange finding, since a typical can of pop, although it contains from 12 to 18 teaspoons of sugar, is still free of fat, the molecule that eventually can clog coronary arteries. But soda is most often met in fast-food chains combined with high-fat burgers and fries. Lured by the three addictive tastes of sweet, sour, and salty, we think we are making choices with our minds when in fact the persistent message from our taste buds – along with mass media – have made the American diet mindless for millions of people.

Satisfy Your Desire for a Better Life
Your goal should be to bring your mind back in control of your diet. This step is more important than any fad or crusade. Forget food groups and remember yourself. You are here to satisfy your desire for a better life, and that means reaching in a state of well-being. As with protein and fat, carbohydrates fall in line with well-being if you ask a few basic questions:

• How much junk food am I eating for junk satisfaction?
• What does it take to stop taste addiction?
• Which foods make me feel good for the rest of my day?
• What’s the best way to meet my emotional needs?

The glut of sugar we consume is tied to how you answer these questions, because sugar can be abused so easily that it leads to junk satisfaction (a brief sugar high), taste addiction (craving sugary foods even when you are not hungry), broken connection to bodily signals (not knowing when your stomach is empty or full), and reaching for emotional surrogates (eating in order not to feel bad). None of this abuse is part of sugar itself. None of it relates to what your body actually needs as fuel. The best nutrition a=advice in the world is pointless until your relationship to food has been straightened out.

That’s a major process that reaches far beyond three meals a day. Carbs are only a sliver of the solutions, but since they play a big role in the problem, let’s arm ourselves with some basic knowledge.

What Are Carbohydrates?
To your body, carbohydrates are the most readily digested fuel. They are converted into energy, which everyone needs not only for physical activity but for basic metabolic functions. Every cell needs fats and proteins as well, but carbs provide quick, easily accessible fuel. Once metabolized by enzymes in the digestive system, most carbohydrates break down into simple sugars, which permeate the intestinal wall and then course through the bloodstream to deliver a caloric payload to your cells.

There are three main categories of carbohydrates:

• Simple sugars (simple carbohydrates), such as those responsible for the sweetness in fruit (fructose) and table sugar (sucrose).
• Starch, the most common complex carbohydrate in our diet.
• Fiber, another complex carbohydrate. Fiber can’t be broken down and passes through the system essentially undigested.

Most people naturally associate sugar and sweetness. But in scientific terms, sugars are not identified by flavor but by their chemical makeup. All sugars are based on a simple union of carbon, hydrogen, and oxygen molecules (C, H, and O). The sweetness of sugars will vary depending on how many molecules each of C, H, and O are in the sugar’s chemical formula.

Carbs have long been neatly grouped into two categories that also make diet choice more clear cut: simple carbohydrates and complex carbohydrates. You’ve heard many times that we should be eating complex carbohydrates and shunning simple carbohydrates. It would be convenient if one group represents “good” carbs and the other “bad” carbs. However, the health implications are not quite so neat and tidy.

Simple carbohydrates are so named because they are built on just one or two molecules. The structure of other sugars is termed “complex” because they have a molecular structure that is constructed of two or more joined molecules. (There are more complicated ways that sugars combine in nature, but we don’t need to go into those.) In this case, simple doesn’t equate with bad. Only the smallest molecules of sugar can pass through the intestinal walls and into the bloodstream. That’s why foods ingested as simple carbohydrates (single- and double-molecule sugars) can be used immediately. Complex carbohydrates (three or more molecules) require more time and action to break down and be absorbed.

Some simple sugars occur naturally in vegetables, milk, honey, and other unprocessed foods. Synthetic sweeteners such as corn syrup and high fructose are simple sugars as well. The problem with all of them arises because simple carbs cause a rapid rise and fall in glucose, or blood sugar, leaving you feeling hungry faster. Like pieces of wood going into a chipper, simple carbs resemble narrow branches and leaves that are quickly shredded. Complex or “long chain” carbs are bigger pieces, like thick branches and tree trunks that have to be fed slowly through the chipper to be broken down. Due to their bulkier, compound structure, complex carbs remain in the system for a longer time, providing slow-burning energy and longer durations of satiety, or feeling full. (Athletes who “carb up” begin the night before, taking advantage of the body’s ability to use long-term fuel sources.)

The threshold for a normal fasting glucose level in healthy people is 99 mg/dL; that is, 99 milligrams of glucose per 1/10th liter of blood. Lower than normal levels are characterized as hypoglycemia, indicating around 70 mg/dL and lower. This condition can be traced to three causes. The body may be using up the available blood sugar, or the glucose ingested may be released into the bloodstream too slowly. It’s also possible that too much insulin is being released.

Higher than normal levels of blood sugar are an indication of the opposite state, hyperglycemia. It exists as a threshold condition known as prediabetes (between 100 and 125 mg/dL) and further on clinical diabetes (126 mg/dL and higher). Elevated blood sugar is caused either by too little insulin being released by the pancreas or the body’s inability to use insulin properly. After you eat and sugars pass from the small intestine into the bloodstream, the pancreas detects this increase in blood sugar and secretes insulin in response. Most cells of the body have insulin receptors, which bind to the insulin molecule. The cell can then turn on other receptors that absorb glucose through the cell wall. Once absorbed, glucose may be used for energy or stored for the future.

Understanding Glycemic Ratings
The glycemic index (GI) ranks hundreds of foods on a scale of 0-100 according to their impact on blood sugar. The GI indicates how intensely and rapidly a food will influence glucose and insulin levels.Glucose, being the sugar that cells can immediately use as food, is the GI’s measuring stick and tops the index at a rating of 100. Foods in the lower range, which include many complex carbohydrates, are absorbed into the blood slowly. With a gradual and prolonged effect on blood sugar and insulin, low GI foods have a proven health benefit. The conviction of GI proponents—which include the World Health Organization, the National Institutes of Health, the Harvard School of Public Health, and others—is that diet should be based on low GI foods to prevent and even treat diseases that are in epidemic proportions in the Western world; namely, diabetes, obesity, and cardiovascular disease.

Instead of fretting over recommended allowances and food pyramids, it’s simpler to eat within a “calorie budget.” As your basic expenditure, you need to cover the essentials—vegetables and fruits, and possibly whole grains and dairy products—before the budget can afford to spend calories on foods that offer minimal nutritive value. Luxury isn’t bad – every life should have a sense of abundance – but wasteful spending is different. You don’t have to forbid yourself a treat here and there, but consider how it fits into your dietary budget.

Tune into Your Own Individual Needs
Yet every road leads back to holistic well-being. You can eat too much and harm your body. You can eat the wrong foods for what your cells actually need. You can eat all the “right’ foods but neglect to exercise, and exercise fanatics can forget to be relaxed and content simply with being. As nutrition becomes more scientific, it becomes more reductionist. Remember that no one ever became healthy by memorizing calorie charts and the government’s RDA of vitamins.

Millions of Americans make the numbers their enemy, as we are inundated with data. The scariest and probably the most useless data concerns food and dieting. Facts won’t make you achieve the ideal figure, a healthy heart, or freedom from aging and disease. Life isn’t a puzzle with many pieces that need to fit where they belong. Life is an unfolding process, and it’s your choice to make that process into one of continuous evolution.

About the Author

Deepak Chopra, M.D.

Deepak Chopra, M.D. is a best-selling author and founder of the Chopra Center for Wellbeing in Carlsbad, California. Along with co-founder Dr. David Simon, Deepak created many of the Chopra Center’s signature programs and workshops, including Journey into Healing mind-body workshop and the Perfect Health program, combining authentic Ayurvedic treatments, a medical staff trained in both Western and Eastern medicine, and instruction in yoga, meditation, and Ayurveda. To learn more about the Chopra Center’s programs, workshops, and retreats, please visit www.chopra.com/programs or call 888.736.6895.

At one time or another the misery of lower back pain is felt by everyone, which is no surprise. Our upright spine is as unique to being human as having an opposable thumb. But where anyone can see that using our hands involves every aspect of life, we don’t say the same about our backs. But it’s just as true. You can read a great deal standing behind someone, reading victory or defeat, success and failure, pride or shame, and every degree of self-esteem. More hidden are the stresses that shape the back. On the day that you feel that first twinge of back pain, an entire personal history has already unfolded.

Can we use that history to treat lower back pain?

The factors to consider are as varied as each person is, but the most salient include:

• Physical stress to the lower back
• Sedentary jobs
• Lack of exercise
• Untended psychological issues
• Depression, anxiety
• Sudden changes in physical routine
• Bad sleep
• Coping mechanisms, how you deal with stress
• Aging
• Old traumas such as car accidents and sports injuries
• Unknown predispositions

That’s a lot to consider. As you can see, saying “My back went out” or “I must have hurt my back” falls short of an adequate explanation. Everything on the list needs to be considered as a contributing factor. It’s important to distinguish between acute pain and chronic pain. Acute pain is intense and lasts from a few days to several weeks. Acute back pain is generally due to sprains or strains and usually gets better in a few weeks. Chronic pain lasts longer than three months. Chronic back pain is more complicated in terms of its causes and its treatment.

What We Already Know About Back Pain
We can start with a very general picture. Medicine knows a lot already about this chronic problem. About 1 in 6 Americans suffered from back pain continually for every day of the last month; a quarter of the population reports that they have had back pain in the last three months. Back pain is the number two reason people visit their doctor (number one is colds and flu).

And back pain is on the rise. The percentage of people getting care for spine problems increased from 10.8% of the US population in 1997 to 13.5% in 2006. The healthcare costs of back pain are up, too — way up. Expenditures for opioid medications for spinal problems increased an incredible 660% during that same period of time, and health expenditures for spine problems rose from about $19 billion to $35 billion, an increase of 82%.

These dramatic increases go hand-in-hand with the rise in back pain surgery. Almost one million spinal surgeries are performed in the US each year. About a quarter of them are spinal fusions, costing an average of $60,000 each. Most of these surgeries, besides being notoriously unpredictable in their success rate, are unnecessary, and a great many of the unsuccessful ones require re-operation. Surgery often leaves patients in pain, unable to return to work and dependent on opiate medications. We need to realize, on the positive side, that most back pain will respond to conservative treatment that leaves the patient able to return to work and free of the need for opiates.

The Most Common Causes of Back Pain
The complex architecture of the human spine makes us susceptible to accidental sprains and strains of the back muscles and ligaments. These passing incidents are by far the most common cause of lower back pain. Sprains occur when ligaments are overstretched or torn from their attachments. Strains happen when muscles are ripped or torn. The injury generally happens when you fall, lift something improperly, carry a heavy object, or make a sudden movement. Just having poor posture can cause sprains and strains, too. Other, nonspinal causes of back pain include fibromyalgia and depression (often accompanied by anxiety). Fibromyalgia is thought to be an inflammation of the connective tissue (including the muscles) of the body. Depression and anxiety often manifest with physical symptoms.

The good news is that most of the factors that put you at risk for back pain can be changed or modified: look carefully at stress, depression and anxiety, heavy backpacks, poor posture, being overweight, not getting enough exercise, smoking, unhealthy diet, certain medications, and job hazards. Risk factors you can’t do as much about may include aging, family history of back pain, and having had a previous back injury. Still, there are people with healthy backs who have such risk factors but overcome them.

In about 85% of back pain patients, no clear cause is ever identified. In order to diagnose back pain, a number of imaging technologies are now regularly employed — X-rays, CT scans, and MRI scans are the most common. But it is still very difficult to find out why someone is experiencing chronic back pain. Quite frequently imaging tests reveal abnormalities of the spine, such as spondylolisthesis and herniated discs, and it’s tempting to immediately ascribe back pain to these abnormalities. But bear in mind that these conditions are often found in people who have no symptoms of back pain at all. These abnormalities might have absolutely nothing to do with the pain you feel.

Surgery Rarely Required, Rarely Helpful
The majority of back pain heals without any significant medical intervention. Only a very small minority of back conditions require surgery. Worse still, about a third of spinal surgeries fail to relieve back pain, often requiring re-operation. This happens so often there’s even an acronym for it: failed back surgery syndrome (FBSS).

Fusion surgery is an increasingly popular type of back operation in which two or more vertebrae are fused together. Fusion surgery may be useful for slipped vertebrae or some types of fractures. But it is often prescribed for herniated discs, degenerated discs, or nerve problems. One large-scale study of almost 1,500 people with back pain found that after 2 years, only a quarter of people who had fusion surgery had returned to work, while two thirds of people who hadn’t had the surgery were back on the job. There was also a 41% increase in the use of opiate painkillers by the surgery patients compared with those who hadn’t had surgery.

Other studies have found that people who have fusion surgery for degenerative disc disease have worse outcomes than people with the same condition who choose not to have surgery. In spite of these startling numbers, fusion surgery for degenerated discs is the fastest-growing type of spinal operation. Spinal surgery should be reserved for cases where spinal nerves are compressed and are causing the loss of bladder or bowel control, or creating weakness or numbness in the legs. Only under these conditions, or when someone has chronic, debilitating back pain and has given all conservative, nonsurgical methods a fair trial, is it time to consider back surgery.

There are many nonsurgical measures for treating back pain, and they are generally most effective if used in combination with one another. If you have acute back pain, the first line of defense is “fire and ice”— hot pads and cold packs for easing pain and inflammation. After a few days of rest, you should start to become more physically active and gradually begin to do gentle exercise. Consult with a physical therapist to determine when you’re ready for stretching and strengthening exercises. NSAID medications or spinal injections of steroids or anesthetics can provide enough pain relief to allow physical therapy. Massage helps stimulate circulation to the back tissues and aids flexibility. Chronic back pain may be helped by psychological therapy as well.

The Role of Complementary Medicine

Complementary therapies can be helpful. Many people swear by acupuncture and chiropractic manipulation. Trigger-point therapy treats muscle pain by injecting anesthetics or steroids into painful areas of muscle. If you want to prevent lower back pain, the single most important measure you can take is to stretch and strengthen your core muscles through regular exercise. Yoga and Pilates are ideal for this. Aerobic exercise is helpful because it strengthens your cardiovascular system, increasing circulation to the tissues of your back. Be aware of your posture: avoid slouching, which places a great deal of strain on your back.

Being overweight strains your back as well, so lose weight if you need to. If you smoke, quit — smoking literally starves your vertebral discs of oxygen and nutrition. Eat high-nutrition, whole foods to keep your bones and back tissues healthy. Finally, find ways to relax if you’re stressed out, because tension alone can create back pain.

We have a national disposition to rely on drugs and surgery that is not abating. Our lifestyles are not going to become less sedentary; our lack of exercise and reluctance to treat stress are endemic. So lower back pain waits in the wings to test if each of us can take advantage of the knowledge that exists about this problem, and then to turn it into practice in our only day-to-day habits.

Asthma is one of the most common diseases in the world, with as many as 300 million sufferers. We’ve all seen what an asthma attack looks like, the typical symptoms being shortness of breath, wheezing, coughing, and tightness in the chest.  Because natural breathing is something most of us take for granted, asthma is a distressing disruption. Each day you breathe a huge volume of air, from 2,100 to 2,400 gallons. Even for people who manage it well through medication and avoiding risks, there is a major psychological component. Attacks are dreaded, and a silent threat lurks with every breath.

The psychological aspect of asthma is undeniable – even to witness a severe attack makes your own breath alter – but the causal link hasn’t been proved. Ask experts and sufferers alike if high stress and emotional upset contribute to asthma, and almost everyone will say yes without being able to prove it.

The fact that relief can come from practicing yoga, doing daily meditation, or training oneself in conscious breathing techniques (known as pranayama or yogic breathing) is not disputed. Some sufferers stand by acupuncture treatments as well, even though no studies have proven its efficacy.

The Baffling Increase in Asthma
The picture that emerges, then, is of a disorder that mysteriously links mind and body. There is no proven cause for asthma, a fact that is underlined by the unexplained increase in cases that has occurred since 1970. Our lungs are sensitive to pollutants, yet asthma is 8-10 times more common in developed countries than in the developing world. As with the sharp rise in allergies, which is also more common in the developed world, the situation is baffling – air quality and pollutants are worse in those countries that are not affected, or less affected, by the rise in disease. (In the US, about 7% of adults and 9% of children have asthma.)

Every Cell Is Connected to Our Breath

No disease can be fully understood without a cause. However, every cell in your body is intimately connected to your breath, and therefore a whole complex of factors seems to be involved. Completely healthy athletes, including 15% of those participating in the 1996 Summer Olympics in Atlanta, are diagnosed with asthma in numbers two to four times higher than the general population. Yet exercise is good for increasing your lung capacity and strengthening the muscles you use to breathe.

Let’s look at the basics of the disorder, most of which are physical at this stage of medical understanding.

Asthma is a chronic inflammation of the airways in your lungs, tiny pockets called alveoli where oxygen and carbon dioxide are exchanged as you breathe; there are a vast number of alveoli, about 500 million. The state of inflammation exists invisibly even when there is no visible attack. In simplest terms, when lung tissue is inflamed, oxygen can’t enter the bloodstream as easily and carbon dioxide cannot be expelled. Patients are test for lung capacity through a simple test where the amount of exhaled air is measured. The condition will be diagnosed as mild to severe in a range where the FEV (forced expiratory volume) is no worse than 80% of normal to less than 60%. In acute attacks, however, the patient may be completely unable to breathe, even with an inhaler, and death can result.

The Role of Inflammation in Asthma
As soon as the word “inflammation” is used, medicine faces a larger mystery. Inflammation is the immune system’s healing response to injury, a normal and necessary process. Once the pathogen has been disposed of – meaning an invasive danger to the body like a virus or bacteria – or the injury has healed, inflammation subsides. It isn’t needed anymore. But in asthma, the inflammatory response becomes self-perpetuating. Airway tissue becomes filled with immune system cells, which actively recruit other immune cells to the site. Blood flow to the affected airways increases. Mucus is released, airway tissue becomes filled with fluid and swells.

It is indisputable that this kind of inflammation represents a breakdown of the healing process. What is supposed to help the body starts to harm it. In some way, the body’s innate intelligence has made a mistake and keeps making it. The same can be said of allergies, where your immune system attacks harmless dust, pollen, and animal dander as if protecting you from a threat. My long-held position – seconded by a wide range of physicians, both mainstream and alternative – is that we must learn what causes such drastic mistakes to be made.

Unfortunately, every event in the mind-body system is connected with the body’s intelligence, and since doctors are trained to be focused only on one aspect, the physical, research results in asthma remain largely confined to physical findings. Here is what we know about the triggers and risk factors of asthma.

Triggers of Asthma

• Indoor air pollution and allergens such as tobacco smoke, animal dander, dust mites, and mold and mildew
• Irritants and allergens such as pollen, dust, air pollution, pesticides and fertilizers, and car fumes
• Cold air, nonsteroidal anti-inflammatory drugs (NSAIDs), and viral respiratory infections

About half of asthma sufferers have allergies. Avoiding such triggers becomes a major part of managing the disorder once you develop asthma.

Risk Factors of Asthma

There are many risk factors for asthma. Some can be controlled while others can’t.

Risk factors that can be modified include:

• Obesity.  The greater a person’s body mass index (BMI) and waist circumference, the greater their risk of asthma.
• Smoking
• Secondhand smoke exposure
• Exposure to environmental pollutants and irritants (for instance, household cleaners, industrial chemicals, dust mites, pollen, and animal dander)
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen, and naproxen

Risk factors that can’t be modified include:

• Gender. Before adolescence asthma is more common in boys, but when asthma occurs in adulthood it is more common in women.
• Genetics. A tendency to develop asthma can be inherited, but environmental factors are just as important.
• Having allergies
• Mother smoking during pregnancy, which leads to impaired lung function in the baby
• Premature birth

The symptoms of asthma vary from person to person. The four major symptoms are:

1. Coughing spells, usually worsening after exposure to cold air
2. Shortness of breath that gets worse with exercise or at night
3. Wheezing, especially when exhaling
4. Feelings of tightness or pain in the chest

Asthma attacks are a worsening of existing symptoms. Exposure to a trigger makes the ongoing inflammation in the lungs worse. The bands of muscle surrounding the bronchioles normally constrict in the presence of an irritant or allergen, but then they release. In asthma, they stay constricted. Edema (swelling) increases. Excessive amounts of mucus are released by the airway lining. The airways become swollen, constricted, and clogged by mucus, and both inhaling and exhaling become more difficult.

But what is considered an attack varies widely between individuals. For people who have no symptoms of asthma most of the time, an occasional coughing spell might be considered an attack. For someone with chronic symptoms, however, such as coughing and wheezing, an attack might include those symptoms along with new ones, like chest pain and shortness of breath.

A very severe asthma attack can come on over a period of hours or become serious in only a matter of minutes. These attacks are very dangerous because very little air moves in and out of the lungs, and the airways don’t open in response to bronchodilators. Emergency treatment is required.

Controlling Asthma

Asthma control has made considerable advances, which is why, even though incurable, asthma is successfully controlled in various ways.

Medications. There are two main types of asthma medication: quick-relief medications (bronchodilators), used before exercise or when you are having an attack, and maintenance medications, used even when symptoms are not present in order to keep inflammation under control.

Monitoring. By monitoring symptoms and keeping track of when they occur, you can understand what triggers your attacks. Using a peak flow meter, you can find out when your lung function is getting worse and take action.

Trigger avoidance. Once you’ve found out what triggers attacks, you can take steps to avoid or eliminate the triggers. For instance, if you are allergic to dust mites, you can encase your pillows in mite-proof covers. If pollen is a trigger, you may want to avoid exercising outside when levels are high.

Exercise. Some people with asthma avoid exercising because they fear exercise-induced asthma (EIA), but this is a mistake. Exercise strengthens your breathing muscles and increases your lung capacity, as we discussed.

To minimize the risk of exercise-induced asthma:

• Take maintenance medications regularly if they have been prescribed for you
• Use bronchodilators before exercising
• Warm up before you begin exercising and cool down afterwards
• Wear a scarf or mask over your face if you exercise outdoors in cold weather

A Call to Expand Our Knowledge of the  Body’s Innate Intelligence
So far, no treatment for asthma without medication has proved successful. Complementary treatments like meditation, stress management, and yoga are used in addition to your regular medication – they are not alternatives.  Even so, I feel that the conquest of asthma, along with associated disorders where the immune system makes drastic, sometimes lethal mistakes, depends on understanding the innate intelligence in every cell. Intelligence has physical markers that everyone agrees upon, such as the brain, but we now know that no part of the body lacks a kind of supreme intelligence. Right now medicine is only beginning to comprehend what this intelligence is and how we control it – or it controls us. When we put much more effort into expanding our knowledge, I’m confident that the breakdown of the body’s intelligence will be repaired by that same intelligence.

Deepak Chopra, M.D.

The whole issue of fat in the diet should be simple, as it once was. Doctors followed the dictum of “fat puts on fat,” assigning blame for overweight on a fatty diet. Of the three major sources of calories – fats, proteins, and carbohydrates – the one with the most calories per gram (8) is fat. It only makes sense that cutting back on this component should lead to weight loss. But to say so is like time traveling back to 1950, before the great cholesterol revolution.

America was in the midst of an epidemic of heart attacks back then. Lacking any effective drug treatment for prevention – indeed, lacking any real model for risk factors – and without the emergency room trauma care that we now take for granted, medicine scrambled to find answers to the sudden upsurge in heart attacks and strokes. A consensus built around cholesterol as the primary villain, and so a vast public campaign went forth that hasn’t subsided ever since.

Cholesterol: The Real Story

The problem with the cholesterol story is that it complicated matters far more than it clarified them. To begin with, high cholesterol in the diet was never a strong correlation with premature heart attacks. The strongest correlation had to do with psychological factors, in fact, but these were considered too “soft” to present to the public. Cholesterol was simpler and easy to communicate. But there was another major problem. The cholesterol you eat isn’t the same as the cholesterol that winds up in your bloodstream, so-called serum cholesterol. In between eating a fatty food and raising your serum cholesterol, there’s the process of digestion. In particular, fats are processed in the liver, and it’s the liver ability to select various fats that determines how high or low your serum cholesterol is.

In their zeal to deliver a simple story, however, heart experts demonized basic foods like eggs and milk when there was no evidence that either leads to increased heart attacks. Fifty years on, the anti-cholesterol campaign has become a billion-dollar juggernaut, thanks to the involvement of drugs that are supposed to correct imbalance in blood fats. We’ve been indoctrinated to think in terms of LDLs, HDLs, and triglycerides, yet the actual cause of heart disease is unknown. In addition, the simple formula that the “good” HDLs will rise as a drug lowers the “bad” LDLs has been proven wrong.

As with all disorders, the story of heart disease involves all the messages being sent to and from every cell in your body. Invisible factors like stress are just as important, if not more so, than the fats you eat, along with psychological factors like the difference between tense, perfectionist Type A personalities and relaxed, easy-going Type Bs. The only natural way that is proven to reduce the risk of heart attack combines meditation, exercise, and a low-fat diet.

Wellness Principles for Fat in Your Diet

To really know what causes heart attacks and strokes, we would have to discover why the tiny cracks develop inside the smooth, slick lining of blood vessels. An answer to that mystery is far from clear. So for the time being wellness in terms of the fat you eat encompasses some basic principles, as follows:

- Eliminate the hydrogenated fats or trans fats and reduce saturated fats in our diet, preferring fats like vegetable oil, omega-3 oils in fish, and olive oil.
- Whatever fat you eat, don’t demonize it. Fear isn’t part of wellness.
- Don’t rely on drugs to change your serum cholesterol until you have given prevention a chance.
- Forget so-called diet foods and processed foods with reduced fats. You don’t need the added chemicals. In addition, it has never been shown that eating diet foods helps reduce obesity.
- If you are overweight, make it a top priority to get your weight back in control. Reducing total calories is more important than fine-tuning the kind of fat you eat.
- Body fat appears to be more active in a harmful way than we used to think. To offset the hormonal effect of body fat, the easiest counter is regular, moderate exercise.

I’ve deliberately avoided going into detail about the war over dietary fat, because singling out one factor misses the holistic point: wellness is never about one villain who needs to be vanquished. It’s about changing the entire mind-body picture. There will always be fads and controversy swirling around America’s weight problem. One year the magic bullet is a high-protein, high-fat diet, while the next year it’s gluten allergies or switching to a vegan lifestyle. For healthy adults, these fads are harmless. In the end, they offer short-term benefits to almost everyone who flirts with them and long-term benefits to a very small minority. There is no replacement for holistic wellness.

For readers who want to hear about the technical details, however, here’s a brief rundown about the physiological nature of fats.

Not All Fats Are Equal

From bananas to bacon, there is fat in virtually every food, differing in amount and type. And whether we eat a burger, a sardine, or an avocado, we are eating a mixture of fats, both “good” and “bad.” According to the USDA, a stick of butter, for example, contains 51% saturated fat, 21% monounsaturated fat, 3% polyunsaturated fat. Olive oil has 14% saturated fat, 73% monounsaturated fat, and 11% polyunsaturated fat.

How much fat should you eat? The Institute of Medicine says fats should be 30-40% of total daily calories for children ages 1-3, and 20-35% of total daily calories for older kids and adults.

“Good” Fats

Dietary fats can be classified into two categories: unsaturated (the “good” fats) and saturated (the “bad” fats). Unsaturated fats come in two types: monounsaturated and polyunsaturated. Replacing saturated fats in the diet with unsaturated fats lowers blood cholesterol and the risk of cardiovascular disease. Desirable sources of these fats are healthy oils, nuts, seeds, fish and avocados.

Saturated fats are risky because they raise LDL (“bad” cholesterol) levels. As we touched upon, elevated LDL levels contribute to arterial plaque and increase the risk of diabetes, heart attacks, and stroke. Among the most common dietary sources of saturated fats are fatty meats and dairy products. The US population currently gets 11-12% of its energy from saturated fats and that hasn’t changed much over 15 years. It is generally recommended that saturated fat not exceed 10% of the daily fat intake, but some experts suggest getting it down to 5% would be healthier target.

The roles and benefits of omega-3 and omega-6 fatty acids are controversial and confusing. Both are essential fatty acids, which must come from our diet because our bodies cannot make them. They play key roles in every system in the body and are important in the regulation of many physiological processes and are crucial for the health of cell membranes and the neurological development.

There is growing evidence that most Western diets have too little omega-3 and this may affect immune system function and cause inflammation. Some scientists believe that the natural ratio of omega-3 to omega-6 fatty acids in the human diet is 1:1. In the typical modern Western diet, however, the ratio is about 1:16. That’s a big difference. Good sources of omega-3s include fatty fish, flaxseed oil, walnuts, and walnut oil.

Trans fats, artificially modified vegetable oils widely used in fried and processed foods, are undeniably bad guys. Trans fats are considered more harmful to your health—and especially your heart—than saturated fats. They have been shown to raise LDL-cholesterol, lower HDL-cholesterol (the “good” cholesterol), increase triglycerides, and contribute to inflammation, heart disease, stroke, and diabetes. Even a small amount—say 5 g, about the amount found in a serving of fast-food French fries—is enough to increase inflammation.

Body fat is complex
Body fat is getting more complicated. It was once thought of as basically inert; fat cells were like microscopic oil tankers that took on a small or expanding load of fat. Now we realize that fat is a very sophisticated and complex tissue. Fat in fact functions as an organ. Rather than just a passive or inert storage depot, fat is metabolically active and constantly communicating with other organs, including the brain, through a variety of hormones and chemical messengers.

The brain is the fattiest organ in the body. More than 50% of the dry weight of the human brain is fat. It is structural fat contained in the membranes of neural cells and a key component of the synapses, or connections, between neural cells.

Reading Your Fats Is Not So Tough
According to the American Heart Association, everyone over 20 years of age, regardless of their previous high cholesterol history, should have a blood cholesterol test at least every 5 years. If you’ve been diagnosed with high cholesterol, and are controlling it with diet, you should be tested every year. People who take prescription medications to control cholesterol levels, like statin drugs, may need to get their cholesterol tested at least twice a year to not only check cholesterol levels, but to also check liver function.

Today, many people know their cholesterol and triglyceride levels, just as they know their blood pressure. The theory is that the more thoroughly you understand these numbers and are able to put them to use, the more you’ll be able to maintain cardiovascular health. Frankly, ruling your life by the numbers makes for a miserable existence. Keeping vigilance over yourself tends to be a combination of prison guard and prisoner at the same time. No one reaches wellness by being statistically perfect. True wellness is beyond statistics, and even if medical markers are helpful, as of course they can be, the core of wellness lies elsewhere.

Question

It has been more than 15 years that I suffer from polycystic ovary syndrome (PCOS). The traditional treatment was with birth control pills. That seemed to work for a while but then again the same problem appeared. I stopped them in August 2011 and am now trying a progesterone cream. As a result I have a menstrual cycle but the cysts are still there. I am not obese, rather slim (48 kg and 158 tall), I do yoga and dance 3-4 times a week.

They tell me that due to lack of ovulation it will be very difficult to have children if not stimulated with hormone fertility medications.
Is this the only way to restore hormonal balance?

Thank you for your advice.

Eva

Dr. Patel’s Response:

Sheila Patel, M.D.

Dear Eva,

As you have been coping with PCOS for quite some time, you’re no doubt aware that while medical research has not yet been able to find the definitive cause of this disorder, many doctors believe that PCOS itself is a symptom of an underlying hormonal imbalance.  From the perspective of mind-body  medicine, there are many possible factors that can contribute to hormonal imbalance,  including elevated insulin, emotional stress, and low-grade inflammation.

The healing system of Ayurveda would also look at underlying imbalances in the mind-body energies, known as doshas, as well as other lifestyle influences on health, including your daily routine and sleep patterns. Based on your individual balance and imbalances, Ayurveda would prescribe a multi-dimensional treatment with the goal of restoring balance to the entire mind-body physiology.

From an Ayurvedic perspective, an imbalance in the reproductive tissue layer is the end result of imbalances at multiple levels and therefore likely requires a multi-dimensional approach to the treatment.  A thorough history, physical exam, and lifestyle evaluation would need to be done to give specific recommendations.

I recommend that you find a health care provider in your area who has a holistic approach to health for further guidance. Here are also a few general guidelines that may help you create greater balance.

Meditation.  Meditation is one of the most powerful healing practices we know of for restoring balance in all the tissues of the body.  It helps reduce stress and the production of “stress hormones” such as cortisol and adrenalin and has many other beneficial effects for physical and emotional health.  You may want to consider learning meditation with a Chopra Center certified instructor.  You can see if there is one in your area by clicking here.  Another good way to establish a meditation practice is to complete the Chopra Center’s 21-Day Meditation Challenge, which offers guided audio meditations and instruction. Learn more here.

Cleanse or gentle detox.  You may want to consider a cleanse that is designed to bring you back into balance.  This will address imbalances at all tissue levels and help restore balance to the doshas.  You can find further guidance in  a previous article I wrote on seasonal detoxification. Read the article here. You may want to  consider a gentle oral herbal cleanse, such as Purify to optimize the function of the vital organs and tissues.

Exercise.  From your question, you sound like you are active and at a healthy weight. That is excellent!  Keep up your activity and be sure that it includes aerobic activity in which you  work at an elevated heart rate and break a sweat for 20-30  minutes at least several times a week

Supplements.  There are certain herbs that may help as well, when included in a holistic plan of action.  The specific herbs that are right for you will depend on your individual health – please ask your health care provider for further guidance.

Emotional clearing.  It is important to explore any unresolved emotional issues, which will affect your hormonal functioning.  There are many powerful emotional release techniques, including the process developed by Chopra Center co-founder David Simon, M.D.  His book Free to Love, Free to Heal is a guidebook that you can use on your own to identify and release toxic emotions.  If you’re coping with a particularly deep issue and want to be guided in the process, you may also want to consider attending the Chopra Center’s Healing the Heart workshop.

I wish you the best on your healing journey.

Dr. Sheila Patel

Send Us Your Questions

If you have a question you would like to ask the Chopra Center medical staff, please email askthedoctors@chopra.com. Due to the volume of questions we receive,  the doctors are not able to respond personally to every query. If your question is selected, it will be posted with our response on the Healing Wisdom blog.

*Note: The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health program.

April is National Stress Awareness Month, yet many people would say that they  feel all  too aware of the stress  in their lives.

If you were to eavesdrop on the conversations taking place around you, stress would likely be one of the most common words you would hear. People  talk about feeling stressed about their work, the economy, global politics, deadlines, their relationships, and just about everything else. Many suffer from the emotional and physical consequences of chronic stress, which include accelerated aging and increased rates of heart disease, anxiety, cancer, depression, migraine headaches, and other serious disorders.

While stress is considered an epidemic problem, I’ve never believed that it exists in the environment or in external situations. At the Chopra Center, we define stress as our response to what is happening. It’s not the overdue payment, traffic jam, or fight with our spouse that causes stress – it’s our thoughts and the story we tell ourselves about an event or circumstance that create the emotional upset, racing heart rate, shallow breathing, surging adrenalin,  and other symptoms of the stress response.

The analogy of a surfer is useful here: If you’re a skillful surfer, every wave is an exhilarating adventure or at least an opportunity to learn something new. If you’ve never learned how to surf, on the other hand, every wave is a terrifying potential disaster.

Surfing the Waves of Change

Fortunately, learning how to deal effectively with stress doesn’t require any athletic ability – it’s a skill that anyone can learn. With a little practice, instead of continually being triggered into a stress response by outside situations and thoughts in your mind, you can learn to spend more  time in your own natural state of well-being.

Here are a few of the most effective tools we teach at the Chopra Center for navigating life’s ongoing waves of change.

1.)  Meditate

Meditation is a simple yet powerful tool that takes us to a state of profound relaxation that dissolves fatigue and the accumulated stress that accelerates the aging process. During meditation, our breathing slows, our blood pressure and heart rate decrease, and stress hormone levels fall. By its very nature, meditation calms the mind, and when the mind is in a state of restful awareness, the body relaxes too. Research shows that people who meditate regularly develop less hypertension, heart disease, insomnia, anxiety, and other stress-related illnesses.

How Does Meditation Work?
We are all engaged in a continuous internal dialogue in which the meaning and emotional associations of one thought trigger the next, usually without our being consciously aware of the process. Buddhist psychology describes this process as samskaras, which can be seen as grooves in the mind that makes flow thoughts in the same direction. Your personal samskaras are created from the memories of your past and can force you to react in the same limited way over and over again. Most people build up their identity on the basis of samskara without even realizing they are doing this.

In meditation we disrupt the unconscious progression of thoughts and emotions by focusing on a new object of attention. In the practice of Primordial Sound Meditation taught at the Chopra Center, the “object of attention” is a mantra that you repeat silently to yourself. A mantra is pure sound, with no meaning or emotional charge to trigger associations. It allows the mind to detach from its usual preoccupations and experience the spaciousness and calm within.

The more you practice meditation, the more you are able to experience expanded states of pure awareness. In the silence of awareness, the mind lets go of old patterns of thinking and feeling and learns to heal itself. If you’re interested in learning Primordial Sound Meditation, I encourage you to visit www.chopra.com to find a certified teacher in your area.

2.) Resolve the Stressful Situation If Possible

You may not have much control over many of the sources of stress in your life, but if there is action you can take to resolve a stressful situation, do it! Talk to friends about what you can do to change a situation or gain a new perspective on it. Consider getting help from a conflict resolution expert if necessary.

Conscious Communication
One skill that is extremely helpful in preventing and eliminating stress is conscious communication, also known as nonviolent communication. It’s a way to clearly communicate your needs in a way that improves the likelihood that they will be met.  With practice, you can learn to express your needs, ask for what you want, and create more fulfilling, stress-free relationships. At the Chopra Center, conscious communication is part of the core curriculum for our staff members and is also taught at several of the workshops and programs we offer. To learn more, the book Nonviolent Communication by Marshall Rosenberg, is an excellent place to start.

3.) Practice Mindful Awareness of Your Body

While the mind is constantly flitting to thoughts of the future and memories of the past, the body lives in the only moment that truly exists: the present. One of the best ways to relieve stress is to tune into your body.  Your first and most reliable guide to balance, harmony, and happiness is your body. When choosing a certain behavior, ask your body, “How do you feel about this?” If your body sends a signal of physical or emotional distress, watch out. If your body sends a signal of comfort and eagerness, proceed.

What can you do to start listening to your body? The most basic elements are as follows:

Feel what you feel. Don’t talk yourself into denial.

Accept what you feel. Don’t judge what’s actually there.

Be open to your body. It’s always speaking. Be willing to listen.

Trust your body. Every cell is on your side, which means you have hundreds of billions of allies.

Value spontaneity. Emotions change, cells change, the brain changes. Don’t be the policeman who stops the river of change by blocking it with frozen, fixed beliefs.

Enjoy what your body wants to do.Bodies like to rest, but they also like to be active. Bodies like different kinds of food that are eaten with enjoyment. Bodies like pleasure in general.

One of the most basic ways to be aware is by grounding yourself in the body. There is no mystery to it. Simply feel your body whenever you’ve been distracted. Let’s say you’re driving a car, and somebody cuts you off. Your normal reaction is to be agitated or angry; you jump out of the calm, relaxed focus that connects you to the mind-body field. Instead of being overshadowed by this disruption, just go within and feel the sensations of your body. Take a deep breath, since that is an easy way to come back to body awareness.

Keep your attention on these sensations until they disappear. What you’ve done is cut off the stimulus response with a gap. A gap is an interval of non-reaction. It stops the reaction from fueling itself. It reminds the body of its natural state of harmonious, coordinated self-regulation.

4.)  Understand Your Unique Stress Response

Your mind-body constitution (known as your dosha in Ayurveda) plays a great role in how stress affects you. Ayurveda offers specific recommendations for each mind-body type, including the most effective ways to cope with stress.

Here are the stress patterns of the three  doshas:

Vata: Those with predominantly Vata constitutions have the greatest tendency toward anxiety and worry. Normally creative and enthusiastic, in the face of stress, Vatas tend to blame themselves for their problems and become extremely nervous and scattered.

Pitta:  Pitta types are usually warm and loving, but if they’re out of balance, typically react to stress by finding fault with other people and becoming angry.

Kapha: The most even-tempered dosha is Kapha. Those whose mind-body type is predominantly Kapha are usually easygoing and gentle, but when faced with overwhelming conflict or stress, they may withdraw and refuse to deal with the situation.

If you don’t know your dosha, you can take the Chopra Center’s online Dosha Quiz to identify your mind-body type and get more information about how to stay in balance and manage stress.

5.)  Get Plenty of Sleep

Restful sleep is an essential key to staying healthy and vital. When you’re well-rested, you can approach stressful situations more calmly, yet sleep is so often neglected or underemphasized. There is even a tendency for people to boast about how little sleep they can get by on. In reality, a lack of restful sleep disrupts the body’s innate balance, weakens our immune system, and speeds up the aging process.

Human beings generally need between six and eight hours of restful sleep each night. Restful sleep means that you’re not using pharmaceuticals or alcohol to get to sleep but that you’re drifting off easily once you turn off the light and are sleeping soundly through the night.
You can get the highest quality sleep by keeping your sleep cycles in tune with the rhythms of the universe, known as circadian rhythms. Ayurveda teaches that the optimal sleep routine is to rise with the sun and go to sleep when it’s dark out, or at least by 10 p.m.

Ideally, eat only a light meal in the evening, before 7:30 if possible, and then go for a leisurely walk. The body’s digestive powers are strongest between the hours governed by the Pitta dosha (10 p.m. to 2 a.m. and 10 a.m. to 2 p.m.). By eating a light dinner, instead of focusing all its energy on digesting a heavy meal, your body can use the Pitta cycle to detoxify the body and get the deep rest it needs.  You can go for a leisurely walk after dinner and then be in bed by 10 p.m.
It’s also very helpful to download your thoughts from the day in a journal before going to bed so that your mind doesn’t keep you awake.

6.)  Practice Yoga

Yoga is another timeless healing practice for releasing stress and the damaging effects of the fight-or-flight response. Not only is yoga an excellent physical exercise that increases your flexibility and strength, but it also balances the mind and body, calming the nervous system, increasing the production of stress-relieving hormones, and releasing stored toxins.

You don’t need a lot of expensive equipment or to be in tiptop shape to start practicing yoga. All it takes is loose clothing, a mat (some classes will provide mats) and the desire to learn.

There are many different styles of yoga. Most use a series of postures designed to stretch and strengthen muscles and also use focused breathing to quiet the mind. One of the most popular styles in the U.S. is hatha yoga, a relatively slow-moving, gentle style. Other styles such as Ashtanga and power yoga are more vigorous. The Chopra Center teaches a unique style of yoga known as the Seven Spiritual Laws of Yoga, which focuses on body-centered restful awareness.

The intention of the Seven Spiritual Laws of Yoga is to integrate and balance all the layers of our life so that our body, mind, heart, intellect, and spirit flow in harmony. As we expand our awareness through the practice of yoga, we become more capable of perceiving the richness that life offers.

Getting Started with Yoga
Find out about the different kinds of yoga that are offered at classes in your area. Choose the style that fits your goals and level of fitness. You can also get started by using a good instructional book or DVD at home, although it’s usually better for beginners to start with a class.

Whichever style of yoga you choose, take it slowly at first. Don’t try to force yourself into difficult poses at the beginning. After a while, you will develop more flexibility, strength and stamina. Your teacher shouldn’t push you to do poses that aren’t comfortable. If your teacher is going too fast, talk to him or her, or look for a class that is a better fit.

With a regular practice, you will begin to experience a sense of calm and wellbeing that extends beyond the yoga mat into your daily life.

  7.)  Do Activities You Enjoy

Part of being stressed out is feeling that you never have enough time, so adding more activities to your schedule might seem like the last thing you need. But if you make even a little bit of time for an activity you really enjoy, the payoff can be huge: You feel calmer and happier and can deal with work and other demands better. Whether it’s playing music, doing a craft, or working on your car, do something that absorbs and relaxes you.

The goal in all of these practices isn’t to try to control the flow of life so that you’ll never experience stress or frustration again; the secret is to be patient and offer yourself compassion as you learn to respond to challenges from a place of peace and calm.

__________________________________________________________________________
Deepak Chopra, M.D. is a best-selling author and founder of the Chopra Center for Wellbeing in Carlsbad, California. Along with co-founder Dr. David Simon, Deepak developed the Perfect Health program, combining authentic Ayurvedic treatments and therapies, a medical staff (M.D.s) trained in both Western and Eastern medicine, and instruction in yoga, meditation, and Ayurveda. To learn more about Perfect Health and the Chopra Center’s other programs, workshops, and retreats, please visit www.chopra.com or call 888.736.6895.

Deepak Chopra

by Deepak Chopra, M.D., F.A.C.P.

A basic outline for prevention has existed for more than thirty years, but wellness has had a hard time making real headway. Old habits are hard to break. Our society has a magic bullet fixation, waiting for the next miracle drug to cure us of every ill. Doctors receive no economic benefit from pushing prevention over drugs and surgery. For all these reasons, compliance with prevention falls far below what is needed for maximum wellness.

Rather than feeling gloomy, my focus has been on getting the individual to take charge of their own wellness. This can be a considerable challenge, since we are each unique in our bodies but also unique in our pattern of bad habits and poor lifestyle choices. More than 40 percent of American adults make a resolution to live a better life each year, and fewer than half keep their promise to themselves for longer than six months. Conditioning is hard to break, but the key is that the power to break a habit belongs to the same person who made it – the turnaround amounts to giving up unconscious behavior and adopting conscious new patterns.

Creating New Patterns in Your Brain

Once your mind begins to pay attention, your brain can build new neural pathways to reinforce what you learn. Much is made of the brain’s ability to change and adapt – the general term is neuroplasticity – but I think science has been slow to catch up with wise experience. It has always been true that applying awareness in any form, through such things as resolve, discipline, good intentions, and mindfulness, has the power to create change. Breaking the process into manageable steps will you create a lifestyle that supports health, happiness, and genuine fulfillment.

Step 1: Set Goals by Baselining Your Health

The first step in taking control of your well-being is to set goals, and a sensible way to do this is to “baseline” your health. Gather some basic facts that realistically inform you about your body: weight, height, family history, exercise habits, general diet, and a self-assessment of your stress levels at work and in your home life.

Some experts would add medical measures that only a doctor can fully determine, such as blood pressure, cholesterol and other lipids levels, and bone density. My difficulty with these tests is that they encourage worry. Being in an anxious state is a bad motivator for most people. It can motivate you for as long as you remember to be afraid, but after that, people tend to give in to impulses, make erratic choices, and increase their own stress levels. With that in mind, I go against the grain of standard medical advice, at least partially, by saying that heeding these medical markers should come second, after you have already set yourself on a good wellness program for at least six months. Give consciousness a chance before you undermine it with potential anxiety.

How do you actually set your goals? Start thinking about the big picture. Changing poor lifestyle habits is rarely easy, especially if they comfort you, as smoking or overeating do for many people. You need a strong vision of what you want to achieve in order to succeed. I’d say the strongest vision comes from knowing about a simple trend: the latest research shows that more and more disorders, including most cancers, are preventable through a good wellness program. The benefits are increasing with every new study.

Step 2: Set Priorities

Making lists of your hot spots and your sweet spots will help you to set your personal priorities. The hot spots are weaknesses, the sweet spots strengths that crop up during an ordinary day. You can’t attack every bad pattern all at once; it’s good to achieve a series of small victories at first.

Hot spots: List the times you feel unhappy or most agitated—fighting a futile battle to get a good night’s sleep, perhaps, or recriminating yourself for ordering dessert when you were already full. Identify with clear sights your biggest challenges, such as getting to bed on time, reducing food portions, resisting sweets, choosing the couch over the treadmill, and so on. Doing this will help your mission take shape and direction.

Sweet spots: List the things that give you joy and satisfaction, for instance, spending time with your family or enjoying a favorite hobby. Recapture in your mind what it feels like to resist ordering dessert or to spend half an hour walking outdoors. Appreciating the sweet spots in your life is a source of strength as you embark on your habit-changing mission.

Step 3: Identify Harmful Patterns

To change your negative habits, you have to know what they are. Some bad habits, like smoking and excessive drinking, are obvious, but others may be less so. Sitting all day is damaging to your health, even if you get half an hour of exercise or more before or after work. Depriving yourself of eight hours’ sleep for even a short period is also hard on the body in ways that sleep researchers are just beginning to fully recognize.

Forming a new habit takes repetition and focus, and if your attention is elsewhere you may have a harder time adjusting to new behaviors. For this reason, some experts advise against planning big changes if you are going through a particularly stressful period. I think that reasoning is wrong. Although it’s true that you are likely to have more setbacks at such times, it’s just as true that people change as a result of meeting challenges and crises: “Aha” moments occur quite often when somebody hits bottom.

Visualizing your desired outcome is a useful tool in your journey. “Seeing” yourself as you wish to be has helped smokers quit, obese people lose weight, and sports champions achieve their goals. In order to change the printout of the body, you must learn to rewrite the software of the mind. This truism is reinforced by brain scans that show a decrease in certain higher functions (making good decisions, following reason over impulse, resisting temptation) when a person falls into a pattern of giving in to a wide range of lower impulses, such as fear, anger, or simply physical hunger. You need to implement a healing regimen that encourages and rewards your good choices if you want brain pathways to follow suit.

Step 4: Make Steady Changes

Even though you are working on the big picture, for psychological reasons a series of small victories is desirable. In essence, you are training your brain to succeed. Most of us, having been defeated by old conditioning, take the course of least resistance, not realizing that we are training our brains into pathways that rob us of free will over time.

So begin with a victory you can define and which means something to you. Skip red meat for a week. Take the stairs, not the elevator. If you’re very out of shape, walk ten minutes every day and gradually build up your time. Put down your fork halfway through your meal, take a few deep breaths, and ask yourself if you’re still hungry. If you work at a desk, make it a rule to always stand or pace when you’re on the phone. Over time, what seem like baby steps produce new physiological changes in every cell of the body. Trillions of cells are eavesdropping on your every thought and action. Instead of pretending that your body doesn’t know what you’re doing, make yourself the gift of delivering good news to your cells.

In my view, the most important victories occur in awareness, however. If you tend to procrastinate, be aware of the reasons you do it. We get comfortable in our warm, fuzzy old routines, and making changes, even small ones, feels threatening psychologically, as if even a positive change is a risk. Predict when you will procrastinate and invent a strategy to outmaneuver your future self. For example, if you know you’ll be tempted to hit the snooze button instead of getting up for an early morning jog, put your exercise clothes across the room from your bed—with your alarm clock on top.

Step 5: Reinforce Good Decisions

Sometimes brain research underlines the obvious, but it is a breakthrough to observe MRI scans and see for yourself that good decisions “light up the brain in ways that are different from bad decisions. In the larger scheme, when you undertake a wellness program, you will be faced every day with the choice to stay the course or abandon your mission. How does your brain make choices, then?

Executive control, which means choosing a thought or action to meet an internal goal, is managed by the brain’s prefrontal cortex. The orbitofrontal cortex and amygdala play roles in regulating decision-making based on the memory of feelings. Regions of the midbrain in which the neurotransmitter dopamine is predominant also influence decision-making. Some of the choices that trigger dopamine’s release: eating sweet foods, taking drugs, having sex.

We may overindulge in chocolate cake because we tend to value the short-term outcome we know (deliciousness) over the long-term outcome we have never experienced (weight loss and increased energy from better nutrition). One way to break that cycle is to reward ourselves in a different way. Instead of eating cake, we can go play a game or listen to music. Making the good-for-you decision gets easier with repetition.

____________________________________________________________________________________________________________________________________

Deepak Chopra, M.D. is an international best-selling author, mind-body healing expert, and co-founder of the Chopra Center for Wellbeing in Carlsbad, California. To learn more about the Chopra Center’s upcoming meditation retreats, teacher trainings, mind-body healing programs, and integrative health care workshops, please visit www.chopra.com or call 888.736.6895.

Question
I have taken the Chopra Center’s online Ayurvedic Dosha Quiz, and my scores tell me that I have a Pitta body and a Vata mind. Which lifestyle and diet do I need to follow?

Answer
It’s important to keep in mind that each of us has the elements of Vata, Pitta, and Kapha in our mind-body system, for all three doshas are necessary to maintain life. Since it is common for one dosha to predominate in the body, while another predominates in the mind, it is useful to consider how the information we take in through the five senses affects the body and mind.

According to Ayurveda, the body is DNA woven with food and, therefore, the most direct way to affect the body is through what we take in through our mouth. Since your body is predominantly Pitta, you will want to focus on Pitta-balancing foods, spices, and teas.

Of course, whatever we take into our body also affects our mind. In Ayurveda  food is divided into three categories: The most gross level becomes the products of elimination. The middle level of food nourishes the body. The most subtle level nourishes the mind.

For most people, the mind is most strongly influenced by sound and sensations. We  recommend that you engage in regular meditation to calm your Vata mind, and immerse yourself in the soothing sounds of music and nature to soothe your inner physiology. Give yourself a daily self-massage using Vata-pacifying oils such as sesame or almond (preferably before bed), and employ Vata-pacifying aromas such as lavender, vanilla, and sandalwood.Find instructions for an Ayurvedic self-massage here.

Following the above steps will help bring peace to the mental agitation to which the Vata mind is prone.

Send Us Your Questions

If you have a question you would like to ask the Chopra Center medical staff, please email askthedoctors@chopra.com. Due to the volume of questions we receive,  the doctors are not able to respond personally to every query. If your question is selected, it will be posted with our response on the Healing Wisdom blog.

*Note: The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health program.

By Deepak Chopra, M.D.

A basic outline for prevention has existed for more than thirty years, but wellness has had a hard time making real headway. Old habits are hard to break. Our society has a magic bullet fixation, waiting for the next miracle drug to cure us of every ill. Doctors receive no economic benefit from pushing prevention over drugs and surgery. For all these reasons, compliance with prevention falls far below what is needed for maximum wellness.

Rather than feeling gloomy, my focus has been on getting the individual to take charge of their own wellness. This can be a considerable challenge, since we are each unique in our bodies but also unique in our pattern of bad habits and poor lifestyle choices. More than 40% of American adults make a resolution to live a better life each year, and fewer than half keep their promise to themselves for longer than 6 months. Conditioning is hard to break, but the key is that the power to break a habit belongs to the same person who made it – the turnaround amounts to giving up unconscious behavior and adopting conscious new patterns.

Once your mind begins to pay attention, your brain can build new neural pathways to reinforce what you learn. Much is made of the brain’s ability to change and adapt – the general term is neuroplasticity – but I think science has been slow to catch up with wise experience. It has always been true that applying awareness in any form, through such things as resolve, discipline, good intentions, and mindfulness, has the power to create change. The practical dilemma is how to use your strengths and motivation to help yourself remain committed to wellness as a lifetime pattern.

Step 1: Set Goals by Baselining Your Health

The first step in taking control of your well-being is to set goals, and a sensible way to do this is to “baseline” your health. Gather some basic facts that realistically inform you about your body: weight, height, family history, exercise habits, general diet, and a self-assessment of your stress levels at work and in your home life.

Some experts would add medical measures that only a doctor can fully determine, such as blood pressure, cholesterol and other lipids levels, and bone density. My difficulty with these tests is that they encourage worry. Being in an anxious state is a bad motivator for most people. It can motivate you for as long as you remember to be afraid, but after that, people tend to give in to impulses, make erratic choices, and increase their own stress levels. With that in mind, I go against the grain of standard medical advice, at least partially, by saying that heeding these medical markers should come second, after you have already set yourself on a good wellness program for at least six months. Give consciousness a chance before you undermine it with potential anxiety.

How do you actually set your goals? Start thinking about the big picture. Changing poor lifestyle habits is rarely easy, especially if they comfort you, as smoking or overeating do for many people. You need a strong vision of what you want to achieve in order to succeed. I’d say the strongest vision comes from knowing about a simple trend: the latest research shows that more and more disorders, including most cancers, are preventable through a good wellness program. The benefits are increasing with every new study.

Step 2: Set Priorities

Making lists of your hot spots and your sweet spots will help you to set your personal priorities. The hot spots are weaknesses, the sweet spots strengths that crop up during an ordinary day. You can’t attack every bad pattern all at once; it’s good to achieve a series of small victories at first.

Hot spots: List the times you feel unhappy or most agitated—fighting a futile battle to get a good night’s sleep, perhaps, or recriminating yourself for ordering dessert when you were already full. Identify with clear sights your biggest challenges, such as getting to bed on time, reducing food portions, resisting sweets, choosing the couch over the treadmill, and so on. Doing this will help your mission take shape and direction.

Sweet spots: List the things that give you joy and satisfaction, for instance, spending time with your family or enjoying a favorite hobby. Recapture in your mind what it feels like to resist ordering dessert or to spend half an hour walking outdoors. Appreciating the sweet spots in your life is a source of strength as you embark on your habit-changing mission.

Step 3: Identify Harmful Patterns

To change your negative habits, you have to know what they are. Some bad habits, like smoking and excessive drinking, are obvious, but others may be less so. Sitting all day is damaging to your health, even if you get half an hour of exercise or more before or after work. Depriving yourself of eight hours’ sleep for even a short period is also hard on the body in ways that sleep researchers are just beginning to fully recognize.

Forming a new habit takes repetition and focus, and if your attention is elsewhere you may have a harder time adjusting to new behaviors. For that reason, some experts advise against planning big changes if you are going through a particularly stressful period. I think that reasoning is wrong. Although it’s true that you are likely to have more setbacks at such times, it’s just as true that people change as a result of meeting challenges and crises: “Aha” moments occur quite often when somebody hits bottom.

Visualizing your desired outcome is a useful tool in your journey. “Seeing” yourself as you wish to be has helped smokers quit, obese people lose weight, and sports champions achieve their goals. In order to change the printout of the body, you must learn to rewrite the software of the mind. This truism is reinforced by brain scans that show a decrease in certain higher functions (making good decisions, following reason over impulse, resisting temptation) when a person falls into a pattern of giving in to a wide range of lower impulses, such as fear, anger, or simply physical hunger. You need to implement a healing regimen that encourages and rewards your good choices if you want brain pathways to follow suit.

 Step 4: Make Steady Changes

Even though you are working on the big picture, for psychological reasons a series of small victories is desirable. In essence, you are training your brain to succeed. Most of us, having been defeated by old conditioning, take the course of least resistance, not realizing that we are training our brains into pathways that rob us of free will over time.

So begin with a victory you can define and which means something to you. Skip red meat for a week. Take the stairs, not the elevator. If you’re very out of shape, walk 10 minutes every day and gradually build up your time. Put down your fork halfway through your meal, take a few deep breaths, and ask yourself if you’re still hungry. If you work at a desk, make it a rule to always stand or pace when you’re on the phone. Over time, what seem like baby steps produce new physiological changes in every cell of the body. Trillions of cells are eavesdropping on your every thought and action. Instead of pretending that your body doesn’t know what you’re doing, make yourself the gift of delivering good news to your cells.

In my view, the most important victories occur in awareness, however. If you tend to procrastinate, be aware of the reasons you do it. We get comfortable in our warm, fuzzy old routines, and making changes, even small ones, feels threatening psychologically, as if even a positive change is a risk. Predict when you will procrastinate and invent a strategy to outmaneuver your future self. For example, if you know you’ll be tempted to hit the snooze button instead of getting up for an early morning jog, put your exercise clothes across the room from your bed—with your alarm clock on top.

Step 5: Reinforce Good Decisions

Sometimes brain research underlines the obvious, but it is a breakthrough to observe MRI scans and see for yourself that good decisions “light up the brain in ways that are different from bad decisions. In the larger scheme, when you undertake a wellness program, you will be faced every day with the choice to stay the course or abandon your mission. How does your brain make choices, then?

Executive control, which means choosing a thought or action to meet an internal goal, is managed by the brain’s prefrontal cortex. The orbitofrontal cortex and amygdala play roles in regulating decision-making based on the memory of feelings. Regions of the midbrain in which the neurotransmitter dopamine is predominant also influence decision-making. Some of the choices that trigger dopamine’s release: eating sweet foods, taking drugs, having sex.

We may overindulge in chocolate cake because we tend to value the short-term outcome we know (deliciousness) over the long-term outcome we have never experienced (weight loss and increased energy from better nutrition). One way to break that cycle is to reward ourselves in a different way. Instead of eating cake, we can go play a game or listen to music.

How long does it take to form a new habit? An average of 66 days, according to a 2009 study from University College, London. Repetition and giving yourself time to adjust are the main factors in forming a new behavior pattern.

________________________________________________________________________

Deepak Chopra, M.D. is a mind-body healing pioneer, the co-founder of the Chopra Center for Wellbeing, and the author of more than sixty-five books, including his most recent New York Timesbestseller, War of the Worldviews: Science vs. Spirituality.  He and colleague Dr. David Simon developed the Perfect Health healing immersion offered most weeks at the Chopra Center.  If you are coping with sleep apnea, stress, hypertension, or other chronic health issues – or you want to prevent health problems – join us for our 6- or 10-day Perfect Health program.  Learn more about Perfect Health here.

________________________________________________________________________

Note: The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health program.

Question:
I am a 24-year-old female  who has suffered from GERD (acid reflux) for four and a half years now. I have been on medication since then that decreases the amount of acid my stomach releases. However, I still have been experiencing problems and do not want to be on medication for the rest of my life. I also fear developing esophageal cancer. What are some natural remedies and approaches I can take to help alleviate my condition?

Thank you,
Natalie

Dr. Patel’s Response:

Dr. Sheila Patel

Hi Natalie,

I am sorry to hear about your health issue.  From an Ayurvedic perspective, GERD is usually an imbalance of the Pitta dosha (the heat element) and cooling herbs can help alleviate symptoms without interfering with digestion.  You could try pure aloe vera juice — try ¼ cup daily; or drink  coconut milk with water daily to soothe the heat.  That being said, the most important thing to do is to address the underlying issue of why this got started.  Pitta imbalances may be provoked by “over-doing”  (such as having  too many things on your plate — too much work, too much activity, etc.).  There is also often an underlying emotional issue that is unresolved, such as anger, resentment, guilt, and so on.

Without addressing the underlying issue, even using natural remedies may not solve the problem.  I recommend reading Deepak Chopra’s book Perfect Health or David Simon’s Wisdom of Healing  for a good holistic understanding of what is going on.  Diet is likely playing a role ,and you most likely require a Pitta-pacifying diet.  There is information in these books and on our website. You can learn more about Pitta and the other doshas — and how to balance them —  in our online library.

In addition, anything that calms the body will be helpful in returning to balance; therefore, daily meditation, yoga and other mind-body practices are a must. You might want to begin by joining us for our free 21-Day Meditation Challenge™, which begins next week, on February 20.  Perfect timing!  You can learn more and register here.

Best wishes,
Dr. Patel

Do you want to deepen your understanding of Ayurveda and Mind-Body Health?

Join us for the Journey into Healing workshop, led by Deepak Chopra and a team of guest experts and Chopra Center master educators. Our next Journey into Healing  takes place this March 7-11 at La Costa Resort & Spa in Carlsbad, California.

Continuing education credits are available for health care providers. Learn more here.

Send Us Your Questions

If you have a question you would like to ask the Chopra Center medical staff, please email askthedoctors@chopra.com. Due to the volume of questions we receive,  the doctors are not able to respond personally to every query. If your question is selected, it will be posted with our response on the Healing Wisdom blog.

*Note: The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition and before undertaking any diet, fitness, or other health program.