Chocolate-covered mindfulness

fter celebrating love by indulging in creamy, dreamy chocolate over Valentine’s Day, many will struggle to tame their sweet tooth.  Those few divine pieces of chocolate left in the red heart-shaped box are hard to resist and leave you wanting more long after they’re gone.   Here’s some great news: You can have your chocolate and eat it too! In fact, it’s entirely possible to have less chocolate while enjoying it even more.  This is where the art of mindfulness come in.  Mindful eating is about slowing down and fully engaging your senses for a transcendent experience that derives maximum pleasure from food.  Here are three tips to heighten your chocolate satisfaction while cultivating mindfulness:

You Deserve the Best

High-quality chocolate will reward you with the richest and most complex flavors to revel in.  A smooth, shiny surface, even coloring and a clean break with no crumbling when the chocolate is snapped are just a few qualities of premium chocolate.  As with wine, the geographical origin of the cocoa beans used to make the chocolate will influence the flavors.  Commercial chocolates are highly processed and usually made with subpar ingredients, including corn syrup and artificial flavors, making them a less healthful choice.  While premium chocolate may cost a little more, treating yourself to it is a splurge you deserve! 

Dark chocolate contains flavonoids, powerful antioxidants that can help lower blood pressure, protect the… Click To Tweet

Delight In Dark Chocolate

Stirring the souls of chocolate lovers is cutting-edge research demonstrating the health benefits of chocolate.  Dark chocolate contains flavonoids, powerful antioxidants that can help lower blood pressure, protect the brain and increase blood circulation.  The darker the chocolate, the more flavonoids, therefore milk chocolate has minimal antioxidant activity and white chocolate has none.  Choose dark chocolate with at least 70% cacao or cocoa solids for the most antioxidant power and note that high-quality dark chocolate will contain only one type of fat, cocoa butter.  Chocolate with a higher cacao content has less sugar, making it easier to be satisfied with less as added sugar in chocolate can mask other flavors and leave you craving more.

Choose dark chocolate with at least 70% cacao or cocoa solids for the most antioxidant power! Click To Tweet

Slowly Savor

Quickly biting into chocolate and swallowing without fully experiencing its pleasures is a disservice to your senses. The essence of mindfulness is exploring details such as the aroma of the chocolate cupped in your hand and the smooth, sheen appearance.  Allow the chocolate to slowly melt on your tongue and swirl it around in your mouth to bathe all of your taste buds.  Note the texture as it may be silky, velvety or creamy.  The longer you allow the chocolate to melt, the more flavor notes will emerge.  Just like a fine wine, premium chocolate has different flavor stages including a beginning, middle and a finish.  Enjoy becoming a chocolate connoisseur and remember that no matter what you’re eating, the mindfulness skills you build will carry over! 

5 tips for returning to exercise after pregnancy

We all know how important exercise is to our health. I can attest to the endorphin rush from a good workout, and crave that post-run euphoria. Or at least I used to.

When I got pregnant two years ago my doctor advised me to keep my heart rate below 140, which meant a dramatic shift in my exercise regime. And since having my son I’ve hit the sidewalks sporadically, but not with any consistency. The net effect is that I can feel the difference in both my physical and mental well being, and it’s not a good difference.

The good news is that each day gives me a new opportunity to make the right choices. I’m registering to run a 10k at the end of February, and using the Couch to 5k app to track progress for the first eight weeks.

I recently spoke with Jace Duke, manager for Houston Methodist Orthopedics & Sports Medicine Athletic Training Services, about returning to exercise after pregnancy. He offered these five tips.

Talk to your doctor before starting any new exercise program. Tell him or her why you want to exercise, and what activities you had in mind. Do you want to improve cardiovascular health? Lose weight? Gain strength and flexibility? Your doctor will help make sure you are in good enough shape to start exercising, and then you can design a program to meet those goals.


Progress gradually. Make sure your exercise plan increases the strain on your body incrementally. Also, take note of your environment. You might not look forward to your second workout if your first run is at noon on July 4th.

Wear the right shoes. You don’t need to spend $150 on high-tech shoes, but you do need to have shoes that are appropriate for your exercise, and they need to be replaced whenever you can see wear.

Your body is a machine that depends on fuel, and that includes hydration. Just don’t make the fatal calculation that a 30 minute jog is license to eat anything you want for the rest of the weekend – espeically if weight loss is one of your exercise goals!

Listen to your body. You will probably be sore the day after a workout. You might be even more sore the second day. This does not necessarily mean you are injured or sidelined. Jace has a helpful way to identify injury from soreness. “God gave us two of most of our body parts. If you are experiencing symmetrical pain, you are probably just SORE. If you are experiencing asymmetrical pain (your right calf feels strained but your left calf feels just fine) you might be injured.”

Even if you are injured, though, you never have to stop exercising entirely. You might need to modify your activity. You might be sidelined from running, but you can walk, or bike, or swim. The key is to always stay active.

The health benefits of laughter

Everyone loves to laugh. The aching pain of your abs working way harder than they usually do, the accidental leakage you just couldn’t hold in anymore, the tears, ah yes, the sweet, salty liquid of a good, hard laugh. If you don’t enjoy laughing, you should.

Some of my best memories of traveling when I was little were of my sister and I’s laughing fits. There were times I couldn’t even look at her without giggling furiously for hours; much to my parent’s discontent, I’d assume. 

Laughing doesn’t just remind us of the old times or connect us; it can also be beneficial to our overall health. Laughing is good for our bodies. It boosts your heart rate, stretches the muscles in your face and body, and makes you breathe faster (although sometimes you may feel like you’re gasping for air) which sends more oxygen to your muscles. It can also lower cortisol levels (the stress hormone), increase dopamine (the feel-good hormone), protect against heart attack and laughing –no joke– burns calories.

When we laugh, it’s not just physiological; it’s mental. Laughing acts as a mood-boosting, spirit-uplifting, stress reducer that can make any bad day better. It just makes us feel better. It can also combat fear and depression.


Let’s recap. Laughing makes you feel good, burns calories, lowers stress and lifts your spirit. As you can see, the benefits of laughter are numerous. Charlie Chapman once said, “A day without laughter is a day wasted.” So, now that you know why you should do it, the only thing left to do now is, well, laugh.

And as always, we’re here to help. Here are some of my favorite funny videos. Laugh, share and repeat, because laughter is better shared.

Laughing makes you feel good, burns calories, lowers stress and lifts your spirit Click To Tweet

Want a workout and laugh? Are you in the mood for something scary? Do you like awkward family photos? Are you a fan of dogs and babies? Are you a fan of ventriloquists?

Need a laugh? Check out our Medical Humor Pinterest board:

Follow Houston Methodist’s board Medical Humor on Pinterest.

How to effectively treat postpartum depression

Pregnant women have a lot to think about when it comes to health. Every decision we make for ourselves directly impacts the health of our developing babies. One medical condition that every woman should be prepared for, regardless of her health history, is postpartum depression or PPD.

Mental illness is a medical condition, no different from any other, with serious symptoms. And like other medical conditions, mental illness can and should be treated.

Am I at risk?

If you are a woman who is pregnant, you are at risk for experiencing PPD. According to the CDC, 8 to 19% of women report having postpartum depression symptoms, and as many as 80% of women will experience the “baby blues.” By comparison, 5-8% of adults in the United States experience depression in a given year. There are a few factors that increase a woman’s risk for developing depression during pregnancy or postpartum. These include:

  • A history of depression or other mood disorders outside of pregnancy (if you have been depressed in the past you are three times more likely than the average woman to experience postpartum depression)
  • A history of postpartum depression specifically (this increases your risk by 70%).
As many as 80% of women will experience the “baby blues” Click To Tweet

What can I do about it?

As in many other areas of life, the best defense is a good offense. In this time of your life when all eyes are on your expanding belly and brand new bundle of joy, make sure you are keeping yourself and your own health a priority.

I know the last thing any pregnant woman wants to think about is yet another doctor’s appointment, but if you are at an elevated risk for PPD, you owe it to yourself to establish a relationship with a mental health professional before you have your baby.


If you’re not currently experiencing depression, you’ll likely only need to meet with a doctor two or three times during your pregnancy. These preventative appointments can help your doctor establish a baseline for your mental health.

Your doctor will also meet with you and your partner toward the end of your pregnancy, to ensure someone at home understands the warning signs of PPD, and the importance of prompt treatment. You’ll meet with your doctor again 4-6 weeks postpartum, to confirm you are still hanging in there.

There are psychiatrists who specialize in treating women during pregnancy and postpartum. Ask your OB for a referral if you need one.

What about treatment?

There are options that are safe for you and your baby, including psychotherapy, bright light therapy, and alternative medical treatments like acupuncture or supplements, as well as antidepressants.

Women are generally concerned about the safety of antidepressants during pregnancy, but it is important to remember that depression is a medical condition that sometimes requires medication. The risk of taking any medication must be weighed against the risk of not taking it, whether it’s for treating high blood pressure or depression.

The risk to a child from living with a depressed mother is just as real as the risk of taking an antidepressant. Do not ignore the warning signs and outward symptoms of depression because you are afraid of labeling and treatment.

Making sense of health certifications

As if the world of nutrition wasn’t confusing enough, throw in the terms registered dietitian (RD), registered dietitian nutritionist (RDN), and nutritionist and you may need some help figuring out where to begin when it comes to health certifications.

Whether you have prediabetes, you’re thinking of having or have had a gastric bypass surgery or you have digestive problems, going to the right person can make all the difference. So, what is the difference and whom should you go to for expert nutrition advice?

The term nutritionist is unregulated, and is a self-designated term anyone, regardless of education, training, background or credentials can use. While some nutritionists have an undergraduate degree in nutrition, others have completed a quick online program and many simply just have a personal passion for food and weight loss. Be careful!

The term nutritionist is unregulated and can be used by anyone Click To Tweet

What about a registered dietitian compared to a registered dietitian nutritionist? They’re exactly the same. In 2013, the Academy of Nutrition and Dietetics added the term and is giving each RD/RDN the option of deciding which title to use.

Be careful who you consult with about diet. While nutritionists may be able to assist, the term is unregulated and self-designated. A healthier option is to work with a dietitian or certified health and wellness coach.

A dietitian is the only credentialed, licensed nutrition professional. They have a minimum undergraduate degree in nutrition from an accredited institution, have completed a supervised practice through an accredited internship, and passed a national board exam. Every step of their training is overseen by the Commission on Dietetic Registration and once becoming an RD/RDN, dietitians are required to undergo continuing education and work to renew their registration every five years.

What about other health and wellness areas? You always want to look for someone who has training and credentialing from a reputable organization. For example, does your personal trainer have a certification? Likely, but it isn’t required depending on where they work. The American College of Sports Medicine (ACSM) is considered the top personal training certificate, while other reputable organizations include ACE, AFFA, and NASM.

In the health coaching arena, anyone can call themselves a wellness coach, but where did that title come from? Houston Methodist Wellness Services has certified health and wellness coaches (CHWC) that undergo training through Wellcoaches, a program accredited by the International Coach Federation and requires certain undergraduate degrees, classroom instruction, practical experience and exams before credentials are earned. Certified health and wellness coaches, like dietitians and certified personal trainers, are also required to do continuing education to maintain their credentials.

So, before you trust your health and wellness to just anyone, be sure to ask about his or her background so you can proceed confidently. At Houston Methodist, we have certified and licensed massage therapists and acupuncturists, registered dietitians, ACSM-certified personal trainers and certified health and wellness coaches ready to help you achieve your goals.

Just a flesh wound: movies vs reality

It doesn’t look good for our hero. He’s out of ammunition and the bad guy is drawing a bead on him. He decides to risk it all on one last, desperate attack. He springs into action but as he does the bad guy gets off a shot.

Luckily, the bullet hits our hero in the shoulder. Ha, no problem. In a second he has disarmed and disabled the bad guy, wounded shoulder and all.

Flip over to another channel, and Forrest Gump is in the war. Even though the movie is only five commercials deep, he gets shot. He is wounded in the, ah, BUTT-tocks. He recuperates by lying on his stomach, wearing a man-diaper and eating ice cream.

We sought out Dr. Jeff Kalina, co-director of the Houston Methodist Hospital Emergency Department, and asked: what’s the best kind of flesh wound to get in real life?

“A bullet striking the human body anywhere can cause an incredible amount of damage,” he says, “but it’s not always fatal.”

He’s seen the movies where someone is shot in the shoulder and fights even harder. “It’s more likely that a bullet hitting someone in the shoulder is going to cause some major damage to the bones and the joint in there,” Kalina says. “It may not kill you, but it will pretty much stop a lot of movement on that side of the body.”

And what about Forrest Gump? Getting shot in the rear end is pretty much always played for laughs in the movies but Kalina says it’s not so funny in real life. “Pelvic veins run all through that part of the body, like a spider web,” he explains. “There’s a real good chance a bullet going in back there is going to hit something important.”

So let’s ask Kalina to tell us where one can be shot and still have the best chance of survival. “Anywhere below the knee or in the calf … it might hurt, but you won’t die. On the outside part of the upper leg, either side of the upper body,” he says. “(In 1981) President (Ronald) Reagan took a bullet through the lung and he recovered completely.”

In fact, the 70-year-old President didn’t immediately realize he had been shot. Reagan thought he had broken a rib when a Secret Service agent pushed him into a car. But Reagan took a bullet in the chest, lodging in his left lung just an inch away from his heart.

What saved the President was the fact that the bullet ricocheted off an armored limousine before striking him, probably reducing much of the projectile’s lethal velocity. And the fact that Reagan received almost immediate medical care certainly helped in his recovery.

White House Press Secretary James Brady was shot in the head, permanently disabling him. When Brady died earlier this year, his death was ruled a homicide – caused by the gunshot wound he received nearly 33 years ago.

It’s tough to predict what can happen when a bullet enters the human body. “A bullet never travels in a straight line inside the body,” says Kalina. “It can be deflected by bone or large, thick muscle mass. It can cause a little damage, or a lot.”

A bullet never travels in a straight line inside the body. It can cause a little damage, or a lot Click To Tweet

Kalina once saw a patient who had been shot in the side of the head. Instead of going straight through, the bullet was deflected by the man’s skull and traveled over the curve of the skull under the skin and exited the other side. He lived.

“There are literally thousands of stories like that,” Kalina says. “But more often than not, bullets do serious, permanent injury and kill people. Movie fantasy is fun; getting shot in real life is not.”

Does high-intensity interval training live up to the hype?

When it comes to exercise, people usually subscribe to the notion that “more is better.” Many health organizations recommend at least two hours of moderate exercise a week, claiming that ramping up to five hours or more confers even more health benefits.

What if the key to getting the most out of exercise wasn’t the amount, but the intensity? What if you could get as many (if not more) benefits from as little as a couple minutes of exercise a week as opposed to several hours?

It may sound like I’m a television fitness guru that’s trying to sell you a series of DVDs, but I’m not. What I’m talking about is high-intensity interval training or HIIT. The time commitment is low and the benefits are real.

The time commitment is low and the benefits are real for high-intensity interval training (HIIT) Click To Tweet

How do HIIT and traditional exercise differ?

Exercises such as jogging, walking or cycling are usually given shorthand names like steady-state cardio or aerobic exercise. Their key features are that the intensity is low to moderate and the time commitment is usually 30 minutes or more a session.

In contrast, HIIT is characterized by extremely short periods of all-out intensity (such as sprinting) followed by timed rest periods. Watch this clip from an episode of BBC’s Horizons series. It shows how short, but intense HIIT can be:


Why you may want to cut back on long-term steady-state cardio

Doing things like going for a short, daily walk or participating in a yoga class is great for your health. Research reviews continually show that regular physical activity is helpful in managing and preventing chronic diseases like diabetes and high blood pressure.

However, when people commit large portions of time to steady-state cardio activities (think Iron Man participants and endurance athletes), the health benefits start to taper off and negatives can be the unfortunate result.

While lots of cardio may seem healthy, consistently overdoing it may result in negative health effects Click To Tweet

Studies from the Mayo Clinic, Journal of Applied Physiology, Medicine and Science in Sports and Exercise and the European Heart Journal have found endurance athletes show abnormal thickening of heart valves, a potential sign of heart failure.

That same population has been found to have highly-elevated levels of cortisol (a stress-response hormone), increased C-reactive protein (a sign of inflammation) and exhibit symptoms like immune system deficits, sleep difficulties and mood disturbances.

What are the benefits of HIIT?

Whereas too much long-term steady-state cardio can have negative effects on an individual’s heart, low volumes of HIIT (around three sessions a week) can improve heart artery stiffness and cardiovascular functions.

Studies have shown HIIT to have many other benefits such as:

How do you perform a HIIT session?

Some online guides complicate HIIT, calling for things like mixing free weights with bodyweight squats. An effective HIIT session really can be as simple as the video clip above from BBC Horizons.

If you’re just starting and/or want to keep things simple, stick with one form of cardio, such as sprinting or cycling on a stationary bike. Then follow a template such as this up to three times a week:

How to perform a HIIT session

How does color blindness affect one’s life?

While recently visiting my son at college, I immediately noticed something was a bit off. “What, is your hair pink?” I asked. “No, it’s blue,” he said.

For many years I have had this problem, and it’s not my son’s hair color. I’m color blind. No need for a pity party though, because I’m not alone. An estimated 32 million Americans – 8 percent of men and less than 1 percent of women – have some degree of color blindness.

This is not a handicap by any stretch of the imagination. People who are color blind see colors; they just don’t see them as normal-sighted people do.

“Instead of calling it color blindness,’ you could call it color confusion,” says Dr. Andrew Lee, chairman of the department of ophthalmology at Houston Methodist Hospital and a professor of ophthalmology, neurology and neurosurgery at Weill Cornell Medical College. “Sure, it can be a drawback in a few aspects of life but for the most part, color blind people rarely notice the difference.”

Color blind people don’t see life like a black and white TV show. Recognizing pure, deep color is no problem but color blindness tends to smear those millions of in-between shades into a spectrum of just a handful. A color blind person sees about 1 percent of the colors that everyone else can see. The color blind viewer can confuse colors, and some colors may appear washed out.

Do you see a number in each circle? The Ishihara color blindness test is the most well known color vision deficiency test. Click the image to take the test.

To me apples are red, summer leaves are green and the sky is blue. But I probably wouldn’t be much fun on a drive to see fall foliage, or a trip to the paint store. Rainbows? Forget it.

“In most people color blindness is caused by a congenital defect in photoreceptors in the retina of the eye,” explains Lee. “There are other, rarer forms of acquired color blindness that can be caused by injury, illness or a reaction to medications. Any disease of the optic nerve or retina, or rarely even a brain tumor, can bring on acquired color blindness.”

Color blind people figure out simple workarounds to help them function in a multi-colored world. And it helps to have a sympathetic family who corrects the settings on the TV or hangs a matching tie with a freshly pressed shirt.

A color blind person sees about 1% of the colors that everyone else can see Click To Tweet

Color blindness can close some jobs to affected people. Pilots and air traffic controllers must be able to read color-coded instruments or recognize colors that represent different altitudes on a radar screen. Railroad engineers are guided by signal lights of different colors, and laboratory technicians read colors for litmus tests and specimen slides.

Some companies sell corrective glasses or contact lenses to brighten those troublesome colors and a few video game manufacturers are building in modes to substitute icons and shapes for colors. And there are few phone apps that are advertised as filters to show what a color is supposed to look like.

On the medical side, Lee says there really is no medical or surgical correction that can cure congenital color blindness. “Most people adjust, and move on with their lives,” he says. “The human brain has a remarkable capacity to compensate for a deficiency and people often make very clever adjustments to get around color blindness.”

Because the genetic condition most likely began centuries ago, Lee believes humans have dealt with color blindness throughout history. “Humans managed to survive all these thousands of years, so good news – it’s not a serious disadvantage,” he says.

Now, blue hair? That’s a serious disadvantage. Anyway, the joke’s on my son: other people looking at a photo agree his hair looks more green than blue.

New year, new resolutions

he holiday parties have ended, decorations are coming down and the Thanksgiving-to-New Year’s food fest has come to a screeching halt. The start of 2015 is here and with that means an opportunity for many to start fresh. 

Most of us make New Year’s resolutions but can’t seem to make them stick. In fact, according to Forbes, 90 percent of Americans make a New Year’s resolution every year and only 8 percent follow through. 90% of Americans make a New Year’s resolution but only 8% follow through Click To Tweet

I asked several of my colleagues at Houston Methodist Hospital what their New Year’s resolutions were. Here’s what they said.

  • I want to beat last year’s FitBit total. – Dr. Marc Boom, president and CEO of Houston Methodist


  • Take advantage of the bike trail in my neighborhood and use it at least 30 times in 2015. – Dr. Angel Rodriguez, breast medical oncologist
  • Run at least 1,000 miles this year. – Dr. Mauro Ferrari, president and CEO of Houston Methodist Research Institute 
  • Take all my allotted vacation days and advance the field of telementoring in the OR. – Dr. Brian Dunkin, endoscopic surgeon and medical director of MITIE
  • Have less “electronic” time and more family time with my fiancé, Lisa and my two dogs, Cinny and Toti. – Dr. Joshua Harris, orthopedic surgeon
  • Strengthen my spirituality, strive to be a better person and participate in triathlons, injury-free so I can competitively participate in 2016. – Dr. Gavin Britz, chairman of the department of neurosurgery at Houston Methodist Hospital
  • I would like to spend more time brainstorming with my postdocs, reviewing their data, troubleshooting protocols and critiquing their scientific communications. I also intend to learn a dozen new BBQ recipes.– Dr. John Cooke, director of the center for cardiovascular regeneration and chair, department of cardiovascular sciences

Don’t forget to check back with us next year to see who kept up their resolutions throughout 2015.

Don’t be fooled by fat-free foods

It’s been said that the best things in life are free. Many people think when they see fat-free foods that they have hit the jackpot. They can eat as much as they want because the item contains no fat.

Unfortunately, foods labeled fat free, reduced fat, low fat or sugar free do not equate with calorie-free and contain additives like salt, sugar and chemical fillers that make them less than healthy.

If you want to keep off unwanted pounds, you need to look beyond the claims on the front of the package and take a critical eye to the nutrition label and ingredients. Labeling a food item fat free is a classic bait-and-switch marketing strategy the food industry uses to try and get consumers to forget about the calories.

Labeling a food as fat free is a tactic companies use to get consumers to forget about calories Click To Tweet

Kari Kooi, RD, LD, with Houston Methodist Wellness Services, says reduced-fat products often contain the exact number of calories per serving as full-fat versions.

Reduced-fat foods have a perceived healthy image that researchers have dubbed a “health halo.” Studies have shown that people tend to eat twice as much or more of these foods.

Nutrition facts
Don’t just look at fat content. You need to also pay attention to serving size and other macronutrients such as carbohydrates.

Manufacturers often set the serving size for packaged foods to be unrealistically small (a serving size of Oreos is three cookies, ha!), so it’s important to look at the number of servings per container.

For example, chips and drinks offered at the checkout lane in the grocery store appear to have one serving, but often times have two or more.

Instead of looking for products with health claims such a low fat, Kooi suggests concentrating on eating healthy fats from whole foods such as nuts, olive oil and avocados. Monounsaturated fats found in these foods have been shown to lower LDL or bad cholesterol and boost HDL or good cholesterol in the blood.

Omega-3 fats in oily fish such as salmon and anchovies also have been shown to lower LDL. She says that fat plays a strong role in feeling satisfied after eating, thereby helping with appetite control and should make up at least 30% of our daily calories.

She also recommends avoiding trans fats as much as possible as it promotes inflammation in the body. Products that contain partially hydrogenated oil in the ingredients list have trans fat.

When it comes to sugar free, it’s extremely important for people with diabetes to be smart label readers. Sugar is a carbohydrate and foods such as sugar-free cookies or candy are not free of carbohydrates. A person with diabetes may be unintentionally consuming large amounts of carbohydrates, which could lead to increased blood glucose levels.

The best way for all of us to avoid being fooled by reduced fat and sugar-free labels and putting on those unwanted pounds is to shop for nutrient-dense foods that don’t come in a package and therefore require no labeling.