Finding New Ways

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Thanks to everyone who wished me a happy birthday by replying to Paula’s Memo or on social media. I appreciate the sentiments and the kind words; it’s great to have you along for the ride as we all try to be healthier.

After a long, drawn-out process, my email has been whitelisted again by the powers that be in that arena. If you’ve missed some Memos in the past couple of months, check your spam folder. They may be there, or you can just visit the website and look through the Memos section.

New Ways

Whether you’re in your 20s, your 70s, or any place in-between, our bodies change over time. The things we used to do with ease, even something as simple as walking, can become challenging.

I heard a quote that went something like this: “I can’t do things the normal way. I have to do things a different way.”

We can relate that to anything we used to do with ease but may now limit us. I’ve noticed a subtle change in my balance—not one that has resulted in falling, but just enough that I notice it. I definitely have noticed a change in my strength. Those are physical attributes.

Our brains change as does just about every system in the body. There may be changes in the digestive system. If there is one thing I’ve learned over the years is that pretty much everyone dislikes any change in their bathroom habits. What was once your normal may not be normal more for you.

That realization is a critical junction. You can begin to limit what you do, or you find a different way to do it. It may require a change in the type of exercise or even beginning to exercise at all. Or maybe a more diverse diet, weight loss, or better dental care. And on and on.

As our bodies change, our normal way of doing things may change. You can decide to shrink your world, or you can decide to do things a different way. It all depends on what you want your world to be.

What are you prepared to do today?

        Dr. Chet

Happy Birthday, Dr. Chet!

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Hi, Gang—Paula here. Today is Chet’s birthday, and he’s letting me take over; that photo above is a few years old, but it’s one of my faves. I’ve done a lot of thinking about what to get him for his birthday, and I decided the best gift would be something you can help me give him: more readers.

In his mission to help people be healthier, it’s important to reach as many people as possible. Here’s the ask:

If you know people who are interested in improving their health, please invite them to subscribe to Dr. Chet’s Health Memo.

For example, you might choose whichever recent Memo has been your favorite and forward it to those people. Almost everyone knows people with lower back pain, so the July 12 Memo on “Walking and Lower Back Pain” might be a good candidate; so would last Saturday’s Memo on “Artificial Intelligence? Focus on Artificial” because we’re all being bombarded with competing (and sometimes ridiculous) health claims. Or you can just include this link to the Memo page and let your friends browse: https://www.drchet.com/memos/. His bio page has all the info on his background and qualifications if they’re curious. Every page has a subscribe button at the bottom to make it easy (and it’s equally easy to unsubscribe). Did you know new subscribers get a free MP3 of Dr. Chet’s Top Ten Tips—Small Changes for a Healthier Life, in English or Spanish?

Most of all, I want to say thank you for joining Chet and me as we make one more trip around the sun. You’re the reason for what we do, and we’re eternally grateful.

Dr. Chet Paula

Artificial Intelligence? Focus on Artificial

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Recently, I researched a topic on PubMed, the government database of published scientific research. There was a posting on the home page that the National Center for Biotechnological Information would be down for usual maintenance. That’s something we’ve come to expect from just about any database-based website.

But it made me pause for a few minutes. When I use AI to research a topic, I’m not really interested in what it says; I’m interested in the research the AI used to formulate its answer. For topics I search for, the research has to include scientific research from PubMed and other science databases. I ignore comments based on information from other websites that are based on interpretation of research rather than the research itself.

What occurred to me were these questions:

  • What if studies on some topics were intentionally left out of the database? That means that we would not be getting the full research on important health conditions and treatments.
  • What if some studies that were not peer-reviewed were added to the database? If that were to happen, a researcher with enough familiarity with prior research might be able to understand that something isn’t right, but people looking for answers for their own health and disease might accept what AI produced.

If you use AI to search for answers related to health and disease, check the references the AI provides. Here is my ranking of references you can use as a guideline by degrees of importance:

First degree
The actual research paper(s). You can read the abstract if nothing else.

Second degree
The press release hitting the highlights about the research, typically from the laboratory or agency that did the research.

Third degree
A credentialed health expert’s evaluation of the actual research, although this is subject to bias.

Fourth degree
A comment on the press release by just about anyone with a website or a podcast? Forget it. Use it to find clues to the original research, but don’t base any life changes on it.

As I said, I use the research papers only to verify that AI searched for and found papers related to the topic. Once past that level, there can always be some form of bias in the references.

I’ll leave you with two thoughts:

  • First, AI is only as good as the databases it’s allowed to search to find answers. By disallowing certain sources of research, it’s easy to influence the direction of the response.
  • Second, artificial means just that. AI can search, prioritize, and use algorithms to perform the search, and it will do it fast. But at the end of the day, it’s artificial—it’s a computer—with no ability to interpret what it’s sending you.

For more perspective, I’ll assign you a movie: watch Terminator again and think about Skynet.

What are you prepared to do today?

        Dr. Chet

Lift Five Kilos to Live Better

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Anybody up for knocking out 25 pushups? How about 10? How about just one? Let’s make it more practical: pick up your largest cast iron frypan or Dutch oven. Or pick up a 10-pound sack of flour or sugar and lift it over your head. Can you do it? Who cares? Maybe you should, and here’s why.

Researchers examined data collected between 2013 and 2020 from the Survey of Health, Ageing, and Retirement in Europe (commonly called SHARE). This includes 16 countries and has over 51,000 participants over the age of 50 who have joined the study. The participants were tracked for over four years. The participants provided medical histories, health habits, and included some physical testing at baseline and then twice afterward including handgrip strength. Key question was, “Can you lift five kilos (11 pounds)?”

After analyzing the data, researchers found that those subjects who could not lift five kilos had higher risks for developing a low quality of life, depression, low handgrip strength, and osteoarthritis. In addition, they were also at risk for rheumatoid arthritis, heart attack, type 2 diabetes, hypertension, Alzheimer’s disease, stroke, or hip fracture. Nothing good on that list for sure.

This was an observational study, so cause and effect cannot be established. But the genius of the study was using objects used in everyday life that weighed about five kilos. That demonstrates that age-related sarcopenia, the loss of muscle, really can impact life, and the risk increases the older that we get. You don’t have to have Hulk-sized muscle, but you still need to maintain a practical amount muscle strength as you get older. Time to hit the weight room or yoga or exercise tubes!

Insiders Call Is Tomorrow

For all those who’ve let me know about their vegetable and fruit intake over the 4th, I’ll send out the log-in information Wednesday morning so you can participate in tomorrow’s Insider call. Main topic is a look at some of the products such as drinks and patches that seem to be highly promoted these days; fact or fiction? You’ll find out tomorrow and find out what being an Insider is like.

What are you prepared to do today?

        Dr. Chet

Reference: Nature. Scientific Reports. 2025. https://doi.org/10.1038/s41598-025-03128-y

Walking and Lower Back Pain

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At some point, most of us experience lower back pain. Many people use walking as their mode of exercise—could walking contribute to the development of lower back pain? A recent study examined the rate of lower back pain and walking.

Researchers tracked over 11,000 participants in the Norwegian HUNT study. To qualify, the subjects could not have had any back pain prior to being included in the study. The initial testing period included wearing an accelerometer during each test period as well as a questionnaire related to lower back pain. The tests were repeated and the subjects were tracked for just over four years, and 1,659 subjects developed lower back pain.

The subjects were grouped into quartiles by number of minutes walked per day for the analysis, and there was an inverse relationship between the risk of lower back pain and both walking intensity and minutes walked. Simply stated, the more a person walked, the lower the rate of lower back pain. The more energy expended by walking faster, the risk of back pain was lower.

The lesson for people 20 and older? If you don’t have any orthopedic obstacles, the more time spent walking as well as the higher the speed of the walking, the lower your risk of developing lower back pain. Just like the vegetable and fruit challenge, which I hope got more people to eat more plant products, walking 30–45 minutes per day most days a week can get you fitter as well as reduce the risk of back pain. The path to better health may just be a simple walk a day, and the great thing is that it’s a multigenerational activity. Walking as a family sets an example for the kids that exercise is something everybody does, and you’ll be setting them up for a healthier life.

If you’re new to walking, remember the talk test. If you have to take deeper breaths but can still carry on a conversation, that’s just about right. If you’re sucking wind so much that you’re gasping for air, that’s too much exertion for beginners. However, if you can sing, that’s not hard enough.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA Network Open. 2025;8(6):e2515592. doi:10.1001/jamanetworkopen.2025.15592

Better to Wear Out

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How did you do on the vegetable and fruit challenge? Paula and I averaged over five per day for the holiday weekend; cutting up vegetables to use in a dip always helps the average. Remember—just send me an email saying, “I did it!” to get an invitation to the Insiders Conference Call next Wednesday evening.

While recumbent biking Sunday morning, I was listening to a podcast about hot dog joints, of all things. One owner asked an 84-year-old guy who was financially secure why he was still working in the restaurant part-time. He told the owner, “It’s better to wear out than rust out—and don’t you ever forget it.”

I believe there’s a lot of wisdom in those words. I would add one more part to it: “on your own terms.” There is a difference between approaching 84 living an immobile life with many self-inflicted conditions. It’s entirely another when you’re sharp enough and fit enough to still enjoy looking forward to another day. Genetics, environment, and prior body abuse aside, you can still work at being as independent as possible every day. Eating enough vegetables and fruit are a part of that process. If you did it for a challenge, that’s a start. You can do it for life.

Wear out, don’t rust out, on your own terms. It all comes down to one thing: What are you prepared to do today?

        Dr. Chet

Reference: Podcast. The Sporkful. “This Hot Dog Tastes Like Home” 07/04/2025

The Holiday Challenge III

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If you do something more than once, it can become a tradition. I decided to do the Holiday Challenge again with a slight twist. If you remember, the challenge last year was to see who could eat the most servings of vegetables and fruit over the 4th of July weekend. I’m still interested in volume: I want more of you to do the challenge, wherever you are in the world. But instead of eating the most number, the goal is to eat at least five servings of fresh or frozen vegetables and fruits every day—Friday through Sunday.

What’s the incentive? Everyone who eats five fruits and veggies per day can participate in the next Insider conference call on July 16th. It’s been a long time since I opened it up to non-Insiders, and you can earn your way to an invitation by reaching the five veggies and fruits per day for the weekend. Just respond to this email saying “I did it!” and I’ll put you on the guest list. If you have trouble figuring out what qualifies, check out last year’s Memo from July 2nd.

One more thing: a cooking tip. If you’re cooking this weekend and you want to enhance the flavor to make it more salty and umami, try fish sauce. It is made by fermenting fish for a couple of years, so if you’re allergic to seafood, don’t use it. But I add it to just about everything I cook as an entrée or sauce, including BBQ sauce; I can’t explain it, but it’s almost magical. I think you’ll find the additional flavor is excellent but watch the amount. A dash will do the trick. If you don’t find it at your regular grocery, you’ll definitely find it at any Asian market.

If you’re traveling by car this holiday weekend, you can binge listen to my podcast Straight Talk on Health that I do for the local public radio station. Click the link or find it on Spotify, Apple Podcast, and other podcast sites.

Have a safe weekend and I’m looking forward to your responses next week.

What are you prepared to do today?

        Dr. Chet

Just Breathe

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As I was lying there before my colonoscopy, waiting for the drugs to kick in to put me in la-la land during the procedures, I used a form of the technique used in this study of dealing with stress: rhythmic beathing. First, the paper.

Researchers recruited 27 graduate students to participate in a clinical trial to test two types of deep breathing in stressful situations. The only issue they cite was that they had no male volunteers, so the results may apply only to women (but probably not, in my opinion). They tested heart rate via electrocardiogram (EKG), electroencephalogram (EEG), as well as verbal responses. The EEG gave the researchers the chance to see the responses in specific areas of the brain. While complex in interpretation, they were able to identify areas associated with stress and relaxation.

They used two different breathing techniques. The fast response was a quick 1 second in and 1 second out. The slow technique was 3 seconds in and 3 seconds out. The key to both was belly breathing where you expand your belly as you breathe in. The slow technique reduced heart rate more than the quick breath technique.

Why would slow belly breathing impact heart rate and brain activity? It may be the impact on the vagus nerve, which slows down both breathing and heart rate. No matter how, slow rhythmic breathing in stressful situations works.

The specific technique I use is sometimes called box breathing: 4 seconds in, a 4-second hold, 4 seconds out, and another 4-second hold. There are many permutations taught in everything from yoga classes to mental coaching programs; when you’re not in a critical stress situation, it can help you focus your thoughts.

Whichever method you prefer, slow breathing techniques can help relieve stress and anxiety.

One More Thing

It would be irresponsible of me not to tell you about the classic way to deal with the physical and mental response to stress: regular aerobic exercise. Exercise trains the autonomic nervous system (ANS) that controls hormone release as well as resets the tone of the ANS. Briefly, your heart rate is controlled by both the sympathetic and parasympathetic nervous system; the sympathetic wants to speed things up while the parasympathetic says to relax. The balance between them is called tone. Exercise sets the tone lower so when you’re exposed to stress and anxiety, your body can deal with it better. Your body can be trained to deal with stress by moving more—and that’s in addition to all the other benefits.

What are you prepared to do today?

        Dr. Chet

Reference: Nature. Scientific Reports. (2025) 15:841

Living with Stress and Anxiety

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“May you live in interesting times.” —Ancient Chinese Curse

Paula got that message in a fortune cookie many years ago, and she thinks it has proven to be true. Interesting is one thing, but with all that goes on in our lives, it can be downright stressful; I got stressed just trying to find out who actually said that quote. There are several theories, but no one really knows for sure.

I just had an endoscopy/colonoscopy last week. The most difficult part? It wasn’t the prep, which stresses out many people—it was the potential results that stressed me out. I had three polyps last time and was diagnosed with Barrett’s esophagus. Were things better or had they progressed? The results turned out fine with a couple of polyps removed, but that didn’t reduce the anxiety of waiting.

We live in stressful times. The price of food—heck, the price of everything. Proposed healthcare cuts: you find out that your healthcare plan just increased your annual contribution before insurance kicks in just when you need a new roof or car repairs. And then there’s the whole issue of politics and most likely hundreds of other scenarios in our lives. You can just feel your heart rate and blood pressure rise. Who knows what else is going on that may be damaging your body, from your brain to your kidneys? We try to shield our kids, but they have their own stressors, as well as picking up on adult anxiety.

A recent study tested a theory of how to deal with this stress and anxiety. I’ll cover that on Saturday. Hang in there until then.

What are you prepared to do today?

        Dr. Chet

Creatine: Does Size Matter?

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The researchers in Tuesday’s study demonstrated that the use of creatine did not increase muscle size after considering the increase in fluid levels. The major problem is the limited scope of the study: looking only at changes in lean body mass. While the researchers should be given credit for the approach using DEXA, there are several issues with the study.

Age: The researchers used both men and women in the study—no problem if you have enough of each gender. The problem was that they included subjects between 18 and 50 years old; research has shown that muscle loss due to age can begin as early as 40. With only 63 subjects, ideally it would mean 15 men and 15 women in each group. Dividing those few subjects into under 40 and over 40 means as few as six or seven subjects in each group. That’s just not enough subjects to prove their point; it’s sufficient for a pilot study, but not enough to determine health recommendations.

SEM: SEM stands for Standard Error of Measurement. The DEXA scan has limitations in determining the lean body mass with precision. The differences in lean body mass fell within the standard error of the measurement; the measuring tool wasn’t precise enough to measure actual differences.

Strength: Where was the strength data comparing differences in gains between the creatine and experimental group? Looking at lean body mass is looking at a combination of factors, but strength is strength: the amount of weight can you lift in several lifts like the dead lift, the squat, and the bench press. You can’t do such an intensive study and not measure the simplest variable. I’ve emailed the corresponding author, but he’s on a break in Australia. If I get a response, I’ll share it with you.

The Bottom Line

Creatine is a natural substance that may be beneficial for a variety of issues besides muscle growth. I use it every day because I lift to increase strength, but also because it benefits energy levels, skin, muscles, and other organs as well. I think everyone over 40 can probably benefit from taking five grams of creatine monohydrate every day.

Check with your doctor to find out your limitations on exercise intensity and get after it. Weight training should be a part of your regular routine, and creatine is a natural way of making more energy to increase muscular strength.

What are you prepared to do today?

        Dr. Chet

Reference:  https://doi.org/10.3390/nu17061081