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Photo: Jamie Findlay Photography

I have always been a cheerful person. I’m known for my smile and “Pollyanna” outlook on life. After giving birth to twin boys 10 months ago, I was over the moon in love with them. I have a 4-year-old son as well, and my boys mean the world to me. I was doing my best to juggle my career, three boys under 4, keep up with my yoga practice, all while healing my diastasis. I have to admit, I was getting pretty tapped out.

I hadn’t been sleeping much since the twins were born (one of my little guys is still up at least two to three times a night), and lack of sleep plus a lot of stress had caught up with me. I started feeling depressed, anxious, and short-fused. I surely didn’t want to let my emotions get the best of me but could also tell I wasn’t quite myself.

Dealing with out-of-whack hormones and postpartum depression.

Hormones can shift and change, especially after pregnancy, and all of a sudden you’re not sleeping or eating enough and trying to do waytoo many things. I could barely concentrate or focus, and some days I just wanted to cry. Postpartum depression can occur anytime after giving birth, not just in those first few weeks. As a matter of fact, some moms can experience postpartum depression months or even years after having a child.

I don’t know if I had true postpartum depression, but I do know that I wasn’t my usual self. I turned to all of the things that usually to make me happy: yoga, meditation, talking to my mom or a good friend, the list goes on. And yet, I was still a little down. I’m not the type to take medication, so I decided I would start seeing a therapist possibly when I returned from leading a yoga retreat in Montana.

Ahead of leaving for that trip, I was so nervous about leaving all of my boys for four days—but I was also excited for an adventure and to teach a group of lovely students and experience an incredible spa and resort. I thought that was just what the doctor ordered.

Taking on the aerial ropes course.

Photo: Kristin McGee

On the very first morning at the ranch before I even taught my first class, I signed up to take an aerial ropes course. I had never done anything like this in the past and thought, Why not? I was driven out to the course along with a lovely family from Utah. When I got to the course, I looked up at the 30-foot-high ropes and thought, No way. Yet I was embarrassed to show how nervous I was and especially when even the 6-year-old girl from the family was gearing up in her harness and ready to go.

The course was all spread out with intricate steps and rope walls, tires, uneven boards, and obstacle courses way up high. I took a deep breath and started my ascent on the first uneven rope ladder. I couldn’t think of anything but my breath and where to place my hands and feet next. I kept my core strong and my mind focused. I couldn’t multitask; I couldn’t think about all of the things I needed to do; I couldn’t give up on myself. Once I started my way across a huge course, I had to keep going and trust I could do it.

I stood up at the top looking out at the beautiful Montana skyline; breathing hard and feeling so alive, I realized there was nothing to be down about. I was uplifted. I had restored my faith in myself as a strong woman and a mother. Having children is tough as shit; you can read as many books as you want to, but nothing truly prepares you for it. You just have to dive in and go with the flow. Trust the process and breathe and let go, as you stay focused and strong.

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Choosing the outdoors.

My yoga practice has always been indoors, for the most part. But through this experience, I realized just how wonderful the fresh open air felt for my body, mind, and spirit. I knew I couldn’t take a huge aerial ropes course among a forest of trees in Montana back to New York with me, but I could make it a goal to get outside daily. To go for walks, breathe in the fresh air, get out of my own way, and choose to be happy amid the craziness in my life right now.

I made it out of my funk, and I make it a point to stay on top of my moods and not let myself fall into the blues. I still journal, meditate, and practice yoga daily, and whenever I get a chance, I play outside. I climb the jungle gyms or trees with my sons; I put my feet in the dirt or sandbox; I take us for walks and make it a point to breathe in the fresh open air. Changing my altitude changed my attitude, and whenever I feel stressed, depressed, or anxious, I remind myself of how high I climbed and how bravely I crossed crazy uneven bridges and ropes holding myself up the entire time.

https://www.mindbodygreen.com/articles/how-an-aerial-ropes-course-healed-my-post-partum-depression?utm_term=pos-4&utm_source=mbg&utm_medium=email&utm_campaign=171119

Photo: Nadine Greeff

Many of my patients don’t have time to cook, resorting instead to unhealthy takeout, prepackaged foods, or skipping dinner altogether.

You don’t need to turn dinner into a seven-course Martha Stewart–inspired affair, and you can certainly do just fine grabbing Whole Foods after work. But at the same time, preparing dinner needn’t feel like a herculean chore.

Ultimately, I encourage patients to forgo takeout and hot bars. Instead, I ask them to preplan a little and prep one of these three uncomplicated dinner recipes. My approach takes a simple but nutritionally comprehensive approach to dinner that takes the guesswork out of calorie-counting: Fill your plate with one-quarter protein and healthy fat, and for the other three-quarters, add a large salad or vegetable side dish.

Photo: Nataša Mandić

I also try to incorporate fermented and cultured foods to support the growth and proliferation of healthy gut bacteria. These include:

  • Cultured foods, such as coconut yogurt or goat milk kefir
  • Fermented foods, such as Japanese fermented vegetables, sauerkraut, or kimchi
  • Cultured beverages containing favorable live bacteria, such as kombucha

Eating the right foods, including cultured or fermented foods, keeps your gut healthy and prevents dysbiosis, an imbalance between favorable and unfavorable gut microorganisms that leads to leaky gut, small intestinal bacterial overgrowth (SIBO), and many other gut disturbances.

I’ve discovered a few other simple rules to follow to make every dinner gut-friendly and avoid overeating:

  • If you know dinner will be late and you’re getting hungry late afternoon at the office, have a healthy snack.
  • Take a moment to reflect on your day during dinner. As you strive to get a handle on your gut issues, I encourage you to keep a daily food and symptom diary. And in addition, keep a gratitude journal entry for each day.
  • Slow down and be mindful with your food. Some people confess to things like reading through social media, thumbing through their favorite magazine, or checking email while eating. These actions don’t let you be present in the relaxed state necessary for smooth and easy digestion.
  • If you suffer from gas, bloating, and other post-meal miseries, watch how much fluid you consume, drink less during meals to avoid diluting your digestive enzymes, and try a comprehensive digestive enzyme supplement about 15 minutes before meals. These three meals are designed to be easy on your digestive system, but symptoms can still occur if you don’t follow these rules.
  • Try to finish eating dinner no less than three hours before going to bed to reduce the chances of acid reflux from undigested food still sitting in your stomach pushing acid up into your esophagus.

Mahi-Mahi With Shallots, Lime, and Veggies in Parchment

Photo: @sag29

A versatile, easy-to-prepare meal with little to no cleanup! For your guest, it’s like a surprise in a pouch. Feel free to double or triple the recipe if you’re having guests over for dinner. This grain-free meal is easy on the digestion.

Serves 2

Ingredients

  • Two 6-ounce wild mahi-mahi fillets (about 1 inch thick)*
  • ½ teaspoon sea salt
  • ¼ teaspoon black pepper
  • 1 tablespoon coconut oil
  • 1 teaspoon grated lime zest
  • 1 tablespoon fresh lime juice
  • 1 tablespoon minced fresh parsley**
  • 1 tablespoon minced fresh thyme**
  • 1 shallot, minced**
  • ½ cup julienned carrots**
  • ½ cup julienned snow peas**
  • ½ cup julienned zucchini**
  • 4 thin slices lime

* You may substitute any firm-fleshed wild white fish fillet, such as halibut, cod, or haddock.

**You may also try different combinations of herbs and vegetables.

Method

  1. Preheat the oven to 400°F.
  2. Cut two 15-by-24-inch pieces of parchment paper. Fold in half crosswise. Draw half a large heart on each piece, with the fold of the paper along the center of the heart. Using scissors, cut out two heart-shaped pieces of parchment.
  3. Sprinkle the fish with the salt and pepper. Place one fillet near the fold of each parchment heart.
  4. Combine the coconut oil, lime zest, lime juice, parsley, and thyme in a bowl; stir until blended.
  5. Top each fillet with half of the coconut oil mixture. Evenly divide the shallot, carrots, snow peas, and zucchini between the two fillets, and top with 2 lime slices apiece.
  6. Starting at the top of the heart, fold one half of the heart over the other, fully covering the fish. Seal the edges with narrow folds. Twist the end tip to secure tightly.
  7. Place the parchment packets on a baking sheet. Bake for 15 minutes. Transfer to serving plates, cut open the parchment paper, and serve immediately.

Stir-Fried Veggies and Shrimp Over Rice Noodles

Photo: Jira Saki

A quick-and-easy weekday meal. This rich combination of shrimp, veggies, and gluten-free rice noodles really satisfies your palate. Made with ghee—rich in butyric acid, a source of butyrate, which is anti-inflammatory for the gut and keeps the cells that line the colon healthy—this dish is the right combination of gut-healing nutrients. Ginger, as a functional food, augments the inflammation-fighting properties of this recipe.

Serves 4

Ingredients

  • 8 ounces dry rice noodles
  • 1 pound large wild raw shrimp, peeled and deveined
  • 1¼ teaspoons sea salt, divided
  • ¼ teaspoon black pepper
  • 2 tablespoons ghee, divided*
  • 1 cup mushrooms, sliced**
  • 1 cup shredded carrots**
  • 1 cup pea pods**
  • 2 small scallions, thinly sliced**
  • 1 cup Homemade Vegetable Broth
  • 1 tablespoon apple cider vinegar
  • 2 teaspoons molasses
  • ½ teaspoon ground ginger
  • 1 tablespoon sesame oil
  • ¼ cup fresh basil, chopped
  • 1 tablespoon toasted sesame seeds

* If you don’t have ghee, avocado or coconut oil is a great substitute.

**Use any combination of vegetables in this dish.

Method

  1. Bring a pot of water to a boil. Add the rice noodles, remove from the heat, and let sit for 5 minutes until tender. Drain and rinse the noodles in cold water, and set aside.
  2. Sprinkle the shrimp with ½ teaspoon of the sea salt and ¼ teaspoon of the pepper.
  3. Heat 1 tablespoon of the ghee in a large skillet over medium-high heat. Sauté the shrimp in the skillet until firm and pink, 5 to 10 minutes. Transfer the shrimp to a platter.
  4. Reduce the heat to medium and add the remaining 1 tablespoon ghee. Add the mushrooms, carrots, pea pods, and scallions. Sauté until tender, 2 to 3 minutes.
  5. In a small bowl, whisk together the vegetable broth, vinegar, molasses, remaining ¾ teaspoon sea salt, ginger, and sesame oil. Add the sauce to the vegetables in the skillet. Stir in the rice noodles and shrimp, and continue to cook until heated through.
  6. Sprinkle with the basil and sesame seeds and serve hot or cold.

Chicken Piccata

Photo: Nadine Greeff

This flavorful, lemony chicken is perfect for any occasion and quick to prepare. The dish incorporates capers, which are rich in quercetin—a plant polyphenol that helps heal the mucus barrier of the gut by promoting the growth of Akkermansia muciniphila, a friendly gut microbe associated with improved glucose tolerance and lean body mass.

Serves 4

Ingredients

  • 1 pound free-range, antibiotic-free chicken tenderloins, cleaned*
  • ⅓ cup brown rice flour
  • ½ teaspoon salt
  • ¼ teaspoon black pepper
  • ¼ cup organic ghee**
  • 2 shallots, chopped
  • 3 tablespoons fresh lemon juice
  • 2 tablespoons capers
  • ¾ cup chicken broth
  • Lemon twists, to garnish (slice lemons into thin rounds, make a cut halfway through the round, and give it a twist)

* Turkey or pork cutlets also work well in place of the chicken tenderloins.

**Olive oil can be substituted for the ghee.

Method

  1. Place the chicken tenderloins in a single layer between two sheets of parchment paper and pound until about ¼ inch thick.
  2. Mix together the rice flour, salt, and pepper in a shallow bowl.
  3. Dip the chicken tenderloins into the flour mixture, coating each side evenly.
  4. Heat the ghee in a large skillet on medium heat for 2 to 3 minutes.
  5. Turn the heat to medium-high and add half the chicken pieces in a single layer; do not crowd. Cook for 4 to 5 minutes on each side, until the chicken is light brown; remove and set aside. Cook the remaining chicken pieces in the same manner; remove and set aside with the first batch.
  6. Add the shallots to the pan and sauté for 2 minutes.
  7. Add the lemon juice, capers, chicken broth, and chicken pieces to the same pan. Simmer for about 5 minutes until the sauce thickens.
  8. Transfer the chicken piccata to a serving dish, and garnish with the lemon twists. Serve.

https://www.mindbodygreen.com/articles/gut-healing-dinner-recipes

Working out isn’t all about losing weight. In addition to slimming your waistline, research suggest that regular exercise can help reduce your risk of cardiovascular disease and Type 2 diabetes. And staying active has also been linked to improved sleep, energy, and mood.

Sold.

I’m sure it comes as no surprise that what you eat before and after your workout is extremely important. Fueling your fitness with the proper nutrition will help to maximize the benefits of all your hard work at the gym. As a registered dietitian, here are the top tips I give my patients regarding eating right for your workout.

Courtesy of Jessica Jones

Pre-Workout:

1. Carbs are good.

Carbs = energy. When we eat them, they break down into glucose, enter our muscle cells, and give us fuel to exercise at our maximum capacity. If you’re strapped for glucose during your workout, you’ll likely feel weak, tired, and tempted to call it quits and take a nap. Before a workout, it’s good to eat simple carbohydrates, because they are digested fast and provide quick energy. Examples include: A granola bar, a piece of fruit, oatmeal, Greek yogurt (this contains carbs and protein), dried fruit, crackers, a rice cake, and a piece of toast.

2. And don’t forget about protein.

In addition to carbs, it’s a good idea to consume a little bit of protein before your workout—especially if you are doing weight training. When we exercise (i.e. lift weights), we create small tears in our muscle fibers. Protein helps those muscles heal and grow stronger, which ultimately is the goal. Examples of protein include: nuts, Greek yogurt, a slice of turkey, a hardboiled egg, and milk/soy milk.

3. Timing is everything.

The ideal time to eat is between 30 minutes to three hours before your workout. Having said that, this can be customized. You may have to experiment to see which timeframe does your body good. If you’re working out first thing in the morning, you probably won’t be able to eat a whole meal before you hit the gym. A small snack or mini-breakfast should suffice. I like to start sipping on this protein-packed green smoothie 30 minutes to an hour before I hit the gym, and finish the other half when I’m done. If you are exercising later in the day, I recommend having a 100- to 150-calorie snack 30 minutes to an hour before your workout, OR working out 2-3 hours after a well-balanced meal.

4. Drink up.

It’s best to get your body hydrated before you even think about heading to the gym. One way to determine your overall hydration status is to check out the color of your urine first thing in the morning. According to the Academy of Nutrition and Dietetics, lemonade-colored urine is a sign of appropriate hydration, while dark colored urine (think apple juice), indicates a deficit in H20. While there is no-one-size-fits-all method to determining fluid needs and exercise, a good place to start is drinking about 2 cups of water 2 to 3 hours before exercise and 1 cup of water 10 to 20 minutes before working out. The goal here is to minimize dehydration without overdoing it. You should try to also stay hydrated throughout your workout. Consider drinking 1 cup of water for every 15-30 minutes of intense physical activity, especially if you are sweating profusely or are training in a heated environment. Again, this may take a bit of experimentation until you find what works best for your body.

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Here are a few pre-workout snack and meal ideas I recommend:

  1. Snack: A smoothie with 1 cup of fruit and 2 cups of vegetables or this protein-packed green smoothie recipe (drink half before the workout and half after)
  2. Snack: An apple or pear with 1 tablespoon of nut butter
  3. Snack: ¾ cup of Greek yogurt with 1 tablespoon granola and ½ cup of berries
  4. Snack: 2 tablespoons of dried fruit and 1 tablespoon of raw, unsalted nuts
  5. Snack: 100-calorie granola bar
  6. Snack: 1-2 rice cakes topped with 1 tablespoon of nut butter
  7. Meal: Oatmeal with a tablespoon of peanut butter and ½ cup of fruit
  8. Meal: 4-ounces of baked salmon, ¾ cup of brown rice, with 1 cup of roasted veggies

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Post-Workout:

1. Make sure to eat something…soon.

You need to eat after a workout. Period. For one, it’s important to replenish the glycogen that has been depleted during your exercise. Secondly, eating protein after a workout is a must for a speedy muscle recovery (particularly after weight training). If you aren’t able to eat a full meal right away, have a snack within 20 minutes of your training, then a full meal 3 to 4 hours later. Your post-workout meal should be high in complex carbohydrates like quinoa and brown rice, and loaded with healthy protein, like tofu, beans, or fish.

2. Don’t overcompensate.

Here’s the thing, it’s really easy to overdo it with your post-workout snacks, and end up eating or drinking more calories than you actually burned. That’s fine if you are trying to gain weight, but for folks who want to lose, this is counterproductive. Skip the energy drinks, bars, sugary smoothies, and smoothie bowls at the gym juice bar. You don’t need ’em. Try to keep your post-workout snack under 150 calories and your post-workout meal under 500.

3. Athletes: Your protein needs may be increased.

For athletes doing intense weight training for long periods of time (45 to 90 minutes), you may require a little bit of extra protein (especially if your goal is to build muscle). You can customize your protein needs using this simple formula:

  1. Divide your weight by 2.2 to get kilograms
  2. Multiply that number multiplying by 0.4 and 0.5. to get a range of recommended protein intake

Okay so let’s do the math. If you weigh 130 pounds, divide that by 2.2 and you’ll get 59 kilograms. Then multiply that number by 0.4 and 0.5 to get a protein range. In this case, it’s 24 to 30 grams. Keep in mind that 4-ounces of chicken has 30 grams of protein, so these numbers aren’t that hard to achieve if you have a meal immediately after working out. Remember that these protein calculations are used determine protein needs for athletes doing intense resistance training for long periods of time. For those of us who do a cute (but equally tough!) 25 minutes on the treadmill and 20 minutes in the weight room, our protein needs may not be as high, and there’s nothing wrong with that.

4. Rehydrate ASAP.

Getting enough water after exercise depends on many factors, namely the length and intensity of the exercise, the environmental conditions, and your individual physiology. If you want to get all scientific about determining your fluid needs post-workout (trust me, I love to go there) you’ll need to bust out that smart-phone calculator. Start by weighing yourself before and after exercise and recording both numbers. After your workout, drink 16-ounces of fluid for every pound you’ve lost. Again, do what feels right for your body. And as mentioned above, use your pee as a guideline for your overall hydration status.

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And here are a few post-workout snack and meal ideas I recommend:

  1. Snack: 1 cup of chocolate milk
  2. Snack: 1 slice of whole wheat toast with 1 tablespoon of peanut butter and ½ sliced banana
  3. Snack: 2 graham crackers with a tablespoon of peanut butter
  4. Snack: 1 to 2 hardboiled eggs with a slice of whole wheat toast
  5. Meal: 1, 7-inch round whole wheat pita stuffed with grilled veggies and 2 tablespoons hummus
  6. Meal: A protein-rich green smoothie
  7. Meal: Veggie omelet with avocado and ½ cup of roasted potatoes
  8. Meal: 4-ounces of steamed trout with a baked sweet potato and sautéed spinach

And remember that these are only guidelines.

The beauty of it all is that everyone’s body is different and will have specific needs and preferences. I should also note that it’s probably not a good idea to experiment with any nutritional changes on a game or race day. Limit any diet tweaks to training. Happy training!

https://www.self.com/story/what-a-registered-dietitian-says-you-should-eat-before-and-after-a-workout

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Experts offer advice for making your workout work for you over the years.

Even the most youthful and dedicated athletes are not immune to exercise-related injuries. But any expert will quickly point out that the risks of not engaging in regular physical activity are far more dangerous to your health than doing nothing.

Proper technique, form and training all are keys to maximizing workout benefits and avoiding a pulled muscle, sprain or worse. As we age, education about our changing bodies also is critical to getting optimum benefits.

Here’s what experts say about mindfully navigating your way through the decades.

In Your 40s

“It’s easy at this age to feel like you should be able to do all of the things that your body was able to do in your 20s and 30s,” says Samantha Merchant, exercise physiologist and personal trainer at The Works Fitness Center in New Hampshire.

It’s an assumption that equals potential injury. Now more than ever, what you do before a workout has everything to do with your overall success.

“Warm up properly,” Merchant says. “This is especially important before high-intensity or high-impact routines like boot camps.”

An effective warm-up will:

  • Increase heart rate and core body temperature;
  • Prepare your body to handle quick decelerating movements;
  • Increase muscle length, and;
  • Activate your core.

A typical workout should last about an hour, says Caley Whitney, certified personal trainer. Select a variety of exercises, including:

  • Resistance;
  • Cardiovascular;
  • Relaxation, and;
  • Whole-body stretching.

“Each component of fitness does not need to be addressed every day,” Whitney says. “But some sort of workout should be done most days of the week.”

In Your 50s

By the time you are 50, you definitely will notice it takes fewer calories to maintain your body weight. Like it or not, that’s normal.

“Basal metabolic rate, or the minimum amount of energy your body must expend per day to keep all vital processes functioning properly, decreases with age,” says Kyle Coffey, a physical therapist and professor at UMass Lowell outside of Boston.

The good news is, “Regular activity is known to raise the resting metabolic rate,” Coffey says.

A few more perks of regular exercise in your 50s and beyond?

  • Better self-esteem;
  • Lower blood pressure;
  • Increased bone density, and;
  • Improved cholesterol.

In Your 60s

Recovery from workouts gets more difficult as we age. Suddenly, the body will not be able to “bounce back” like it used to, Merchant says.

“Avoid back-to-back days,” she advises. “This will allow the muscles and the joints to recover appropriately and limit the aches and pains you may feel from repeated bouts of impact.”

More best practices?

  • Add foam rolling, which improves posture, increases flexibility and reduces tension while boosting athletic performance;
  • Don’t work out through pain, and;
  • Consider focusing on increasingly moderate-level fitness activities to prevent injury.

In Your 70s and Beyond:

Older adults are disproportionately affected by chronic conditions such as arthritis, diabetes and heart disease, as well as disabilities caused by injuries from falling.

Get an annual health-risk assessment and tweak your workout routine. You’ll also get information on proper movement, nutrition and stress management skills.

Some best practices?

  • Swimming and other water exercises for cardiovascular training without putting pressure on joints;
  • Yoga classes to combat decreased range of motion and increase mindfulness, and;
  • Balancing exercises to reduce risk of falls.

“I have a client who just started working out at age 82. Her endurance has improved, and daily tasks have become easier,” Whitney says. “We work at her pace and stop when she says she is done.”

https://www.huffingtonpost.com/entry/how-to-adapt-your-workout-for-your-age_us_592f00c3e4b0540ffc83d4c0?utm_hp_ref=therapy

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Having a wealth of options can lead to poor decision-making, experts say.

Starbucks offers consumers up to 87,000 drink combinations. Comcast, the nation’s largest cable provider, offers up to 1,000 channels. Sirius offers 140 different satellite radio stations for your listening pleasure.

Americans have come to expect a wide array of choices, and most companies, be they car companies, clothiers or coffee shops, have been more than willing to pony up. But more choices do not always equate to happier consumers.

In fact, some studies show that having to make too many decisions can leave people tired, mentally drained and more dissatisfied with their purchases. It also leads people to make poorer choices — sometimes at a time when the choice really matters.

The notion that choice is always good for people — the more choices the better — seemed intuitively wrong to Kathleen Vohs, an associate professor of marketing at the University of Minnesota. “Clearly there are costs to having too much choice,” she says — and she set out to find what they were.

Vohs, who has studied the effect of choice on consumers for many years, found in a recent project that even making pleasant choices can deplete one’s mental resources, making a person less able to concentrate later.

Students in her study who were asked to make decisions later spent less time preparing for a test, gave up more quickly when trying to complete various tasks and performed worse on math problems than those not asked to make choices.

Vohs’ group also studied the “decision fatigue” that can occur at a shopping mall. They asked random shoppers at a Utah mall questions such as how many decisions they had made that day, the importance of those choices and the length of their deliberation. The researchers found that the more choices the shoppers had made, the worse they performed on simple math problems they were then asked to complete on the spot.

Making decisions takes work, says Barry Schwartz, a professor of psychology at Swarthmore College and author of the 2004 book, “The Paradox of Choice: Why More Is Less.”

“The mere act of thinking about whether you prefer A or B tires you out,” Schwartz says. “So if I give you something else that takes discipline, you can’t do it — you’ll quit faster. If I have lifted weights in a gym, later trying to lift a 30-pound weight is impossible.”

Schwartz says that one of three things is likely to occur when people have too many decisions to make — consumers end up making poor decisions, are more dissatisfied with their choices or become paralyzed and don’t choose at all.

And as the complexity of a decision increases, a person is more likely to look for ways — often erroneous — to simplify the choosing process. If there are 100 kinds of cereal, instead of looking at all of the characteristics, people will evaluate a product based on something familiar, such as brand name, or easy, such as price.

Even when we choose well, we are often less satisfied because, with so many choices, consumers are certain that somewhere out there was something better. “They think about attractive things they’ve passed up and missed opportunities,” Schwartz says.

Schwartz recently fell victim to this when purchasing a pair of jeans. He went to the Gap and tried on all the available styles. He walked out with jeans that fit well, but he was still not happy with his purchase, he says. With so many different varieties of pants, he was left thinking, “One of them should have been perfect — and none were.”

Most marketers are aware that consumers succumb to the idea that more options means we’re more likely to find the perfect product.

And most companies use this fact of human psychology to their advantage. Because creating a new brand of shampoo or laundry detergent is expensive, companies often save money by marketing products that differ only slightly from their competitors’ products or other brands of their own. Then they spend time convincing buyers that the products are, in fact, very different, says Sheena Iyengar, a professor at the Columbia University Graduate School of Business.

“How different are 400 types of bottle water?” Iyengar asks. (The answer to her rhetorical question: hardly at all.)

“More and more choice does not guarantee better options, just more of them,” Iyengar says. “If customers wise up to the idea that marketers and retailers are using tricks of differentiation, retailers will stop creating the fluffy options.”

The final problem with decision-making is that it can overwhelm people to the point of their making a default choice or no choice at all.

A 2000 study by Iyengar and colleagues in an upscale California grocery found that consumers were 10 times more likely to purchase jam when offered six kinds instead of 24. In other words, faced with too many choices, some threw up their hands and opted to buy no jam.

And in another study in 2007, employees who were offered a large variety of options for a 401(k) were more likely to allocate their savings into less complex money market or bond funds rather than select among the many stock mutual funds, which are more lucrative over the long run.

“This potentially is quite detrimental,” Schwartz says. “You are debilitating yourself making inconsequential decisions” — such as which jam to buy or which jeans to buy or what kind of coffee beverage you’ll have to drink that morning. “Then,” he says, “something important arises and that machinery is not working at optimal capacity because you wasted it doing all this choosing.”

Of course, you can always opt to purchase from a grocery store that offers fewer choices (Trader Joe’s and Fresh & Easy, for example). But there’s no getting away from the fact that a plethora of consumer choices is likely to remain around to tantalize and torture us. (See our tip box on a few ways to minimize decisions.)

“I don’t think we have the option to reduce choices so that we go to a world where we only have seven of everything,” Iyengar says. “As a society, we just need to be given better tools on how to choose.”

http://articles.latimes.com/2009/mar/16/health/he-choices16/2

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On any given day in her office, San Francisco-based therapist Tara Griffithhears millennials wonder aloud: Is this it? Am I failing at being an adult? How did my parents have it all figured out by this age?

“They’re dealing with reality versus expectations,” said Griffith, who heads up the team at Wellspace SF, a San Francisco community of licensed therapists, nutritionists and certified coaches.

“The messaging they’ve grown up with ― ‘Go to college and you’ll land yourself a great career,’ ‘You’ve always been a hard worker. Just do what you love and you’ll be successful,’ ― is at odds with their reality,” she said. “Feelings of disillusionment and being ‘stuck’ arise.”

Below, Griffith and other therapists share the most most common concerns they hear from patients in their 20s and 30s, and the advice they give them.

They may have gotten into top-tier colleges and landed decent-paying jobs at tech startups, but many millennials still doubt their self-worth and ability to make a decision. When it comes time to make the next big move in their life ― leaving their job for a new one one or taking a relationship to the next level, for instance ― they struggle to make the call, Griffith told HuffPost.

“They have an abundance of options,” Griffith said. “You might ask, ‘What’s wrong with that?’ but research points to the fact that being presented with too many options can lead to paralysis. Having too many choices exhausts us, can keep us stuck and contribute to greater dissatisfaction.”

Griffith and her team tell their clients that there’s no one formula for success ― no “A + B = a happy life” equation to latch on to for guidance.

“As much as we want to know which decisions will make us the most happy, fulfilled and confident in life, we can only do our best to tune into what it is that we want and go after our passions,” she said.

Thanks in part to their helicopter parents, many millennials are overeager to impress and feel a deep sense of guilt when they say no.

“While hovering, these parents also have high expectations for their children, which has led them to become adults who do not want to disappointment anyone,” said Deborah Duley, a social worker and the clinical director of Empowered Connections, a therapy practice based in Maryland.

Duley tells her clients that it’s all about taking small baby steps to saying “no.”

“Use cheat phrases, such as ‘I don’t know if I can commit to this, but I’ll let you know next week,’” she said. “It’s a small way to begin asserting yourself and becoming more comfortable with saying no. Practice makes perfect.”

No, millennials aren’t blowing their cash on avocado toast and trendy restaurants. Instead, they’re freaking out and wondering if they’ll ever really feel financially secure, said Liz Higgins, a couples therapist in Dallas.

This is, after all, the generation that’s been hit hardest by the 2008 recession and student debt, and the reality is that internships and freelancing may be the only way to pay the bills for a while.

“This financial reality has led to a greater percentage of individuals who continue to live with their parents, which leads to issues in other areas of life, often including dating,” Higgins said. “I see many clients experience anxiety about entering a relationship due to their own financial status or due to their potential partner’s debt or financial status.”

When they find love, Higgins encourages clients to talk transparently with their partner about their financial expectations, values and differences.

“Many times, millennials just want to feel validated by their partner and want to establish clear communication and direction regarding their finances,” she said. “Plus, many millennials feel ‘owned’ by their financial situations, so my work with clients often focuses around empowering themselves to have difficult conversations and trusting what feels right when it comes to money boundaries.”

Many millennials feel overwhelmed by the onslaught of terrible news in the headlines, said Rachel Kazez, a Chicago therapist and founder of All Along, a program that helps people understand mental health and find therapy. They’re especially concerned about inequality and the state of the environment, she said.

“Their efforts to spread opportunity and rights have been successful, but inconsistently,” she said. “My advice to millennials feeling demoralized is to notice positive progress and to use their actions, words, influence and financial resources to support causes they believe in. As I tell them, if you genuinely feel you’re doing as much as you can about the causes you’re concerned about, additional anxiety won’t help the problem be solved faster.”

Millennials have grown up in a comparison culture and endlessly wonder if their real lives ― the ones lived off social media ― stack up to others, said Jess Hopkins, a certified life coach.

“The incessant stream of social media updates and humble-brags makes it practically impossible to stay in your own lane and go your own speed,” she said. “Instead, many millennials feel compelled to one-up their peers and turn every moment into an opportunity to prove their worthiness to the world. This hustle for worthiness provides temporary confidence at best and perpetuates deep insecurities at worst.”

Hopkins tries to stress to her clients that they are enough, without the positive reinforcement of “likes” on Instagram. She also recommends a bit of reading.

“For millennials struggling with self-consciousness, and by extension self-worth, I strongly recommend reading The Gifts of Imperfection by Brené Brown to begin a journey towards wholehearted living,” she said.

According to the American Psychological Association, millennials experience more stress and are less able to manage it than any other generation before them.

“Their overexposure to everything happening in the world, 24 hours a day, seven days a week ― literally their whole lives ― is contributing to millennials’ inability to turn things off, including their thoughts,” Duley said.

The first thing Duley does with clients struggling with anxiety is help them get a good grasp on their negative thoughts. Millennials need to know they’re more than capable of working through those thoughts and coming out stronger, she said.

“We begin helping them gain control of their worries by reframing the problem. Anxiety is the physical manifestation of fear and worry, and millennials have zero to little experience managing all that’s coming at them from every angle,” she said. “In therapy, I remind them they can get through it.”

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ANAHEIM, Calif. — The bar for what’s considered “high blood pressure” just got lowered, meaning millions more Americans will now be classified as having the condition, according to new guidelines from several leading groups of heart doctors.

The guidelines, from the American Heart Association (AHA) and the American College of Cardiology (ACC), now define high blood pressure as 130 mm Hg or higher for the systolic blood pressure measurement, or 80 mm Hg or higher for the diastolic blood pressure measurement. (Systolic is the top number, and diastolic is the bottom number, in a blood pressure reading.) Previously, high blood pressure was defined as 140 mm Hg or higher for the systolic measurement and 90 or higher for the diastolic measurement.

The findings mean that an additional 14 percent of U.S. adults, or about 30 million people, will now be diagnosed as having high blood pressure, compared with the number diagnosed before the new guidelines. This will bring the total percentage of U.S. adults with high blood pressure to 46 percent, up from 32 percent previously. [9 New Ways to Keep Your Heart Healthy]

However, the guidelines stress that, for most of the newly classified patients, the recommended treatment will be lifestyle modifications, such as weight loss and changes in diet and exercise levels, as opposed to medications. Only a small increase in the percentage of U.S. adults receiving blood pressure medications — about 2 percent — is expected, the authors said.

A chart summarizing new guidelines on the definition of high blood pressure.
A chart summarizing new guidelines on the definition of high blood pressure.

Credit: copyright American Heart Associtation

“There is a growing body of evidence that lower blood pressure is better for your health,” Dr. Steven Houser, the immediate past president of the American Heart Association, said here today (Nov. 13) at a news conference announcing the new guidelines.

The guidelines “[reflect] this new information and should help people prevent, diagnose and treat high blood pressure sooner,” Houser said. “We saw the needs to update these guidelines to reflect the real threats of high blood pressure.”

The new guidelines are based on a rigorous review of nearly 1,000 studies on the subject, which took the authors three years to complete.

The new guidelines now classify people’s blood pressure measurements into the following categories:

  • Normal: Less than 120 mm Hg for systolic and 80 mm Hg for diastolic.
  • Elevated: Between 120-129 for systolic, and less than 80 for diastolic.
  • Stage 1 hypertension: Between 130-139 for systolic or between 80-89 for diastolic.
  • Stage 2 hypertension: At least 140 for systolic or at least 90 mm Hg for diastolic.

(The new guidelines eliminate an older category of “prehypertension,” which was used for people with systolic blood pressure between 120-139 mm Hg or diastolic blood pressure between 80-89 mm Hg.)

The findings touch on an issue that has been under debate in the medical community: Exactly how low should patients aim to go when reducing blood pressure levels. Several recent studies suggest that lower blood pressure targets — even lower than previously recognized — had substantial health benefits for patients.

For example, a 2015 study known as the SPRINT trial found that patients who lowered their systolic blood pressure to around 120 mm Hg were 27 percent less likely to die during the study period, compared with those whose treatment target was to lower their blood pressure to less than 140 mm Hg. (The SPRINT study made headlines in 2015 when the trial was abruptly cut short because the findings were so significant.)

Researchers also now know that people with a blood pressure between 130-139/80-89 mm Hg have double the risk of cardiovascular complications, compared with those with normal blood pressure, said Dr. Paul Whelton, a professor of global public health at Tulane University and lead author of the guidelines.

“We want to be straight with people — if you already have a doubling of risk, you need to know about it,” Whelton said in a statement. “It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure.”

The new guidelines recommend that doctors only prescribe blood pressure medication for patients with stage I hypertension if they have already had a cardiovascular “event” such as a heart attack or stroke; or if they are at high risk for a heart attack or stroke based on other factors, such as the presence of diabetes, the authors said.

People with stage 1 hypertension who don’t meet these criteria should be treated with lifestyle modifications. These include: starting the “DASH” diet, which is high in fruit, vegetables and fiber and low in saturated fat and sodium (less than 1,500 mg per day); exercising for at least 30 minutes a day, three times a week; and restricting alcohol intake to less than two drinks a day for men and one drink a day for women, said vice chairman of the new guidelines, Dr. Robert Carey, a professor of medicine and dean emeritus at the University of Virginia Health System School of Medicine. [6 Healthy Habits Dramatically Reduce Heart Disease Risk in Women]

Carey hopes the new guidelines will “cause our society and our physician community to pay attention much more to lifestyle recommendations.”

Stage 2 hypertension should be treated with a combination of lifestyle modifications and blood pressure medications.

Some people may ask why doctors are lowering the threshold for high blood pressure, when it was already difficult for many patients to achieve the previous blood pressure targets of below 140 mm Hg/90 mm Hg, said Dr. Pamela B. Morris, a preventive cardiologist and chairwoman of the ACC’s Prevention of Cardiovascular Disease Leadership Council. However, Morris said that the guidelines were changed because “we now have more precise estimates of the risk of [high] blood pressures,” and these new guidelines really communicate that risk to patients. So, just because it’s going to be difficult for people to achieve, “I don’t think it’s a reason not to communicate the risk to patients, and to empower them to make appropriate lifestyle modifications,” Morris told Live Science.

Dr. Rachel Bond, associate director of the Women’s Heart Health Program at Lenox Hill Hospital in New York City, who was not involved with the guidelines, said she agreed with the new updates. “I believe this will allow for earlier detection [of high blood pressure], and allow for more lifestyle modification to prevent the long-term detrimental effects of untreated high blood pressure,” Bond said.

The guidelines also say that a patient’s blood pressure levels should be based on an average of two to three readings on at least two different occasions. It’s also reasonable for doctors to screen for “white-coat hypertension,” which occurs when blood pressure is elevated in a medical setting but not in everyday life, the authors said. This can be done by having patients measure their blood pressure at home.

Bond said she also agreed with these guidelines, and noted that she has worked to educate her medical staff on the proper methods for obtaining blood pressure “rather than hastily checking a number which has a huge impact on our patients’ medical care.”

Dr. Ragavendra Baliga, a professor of internal medicine at The Ohio State University Wexner Medical Center, called the new guidelines a “tour-de-force.”

“Given there is more up-to-date data on the impact and significance of hypertension…this ACC/AHA guideline is timely and comprehensive,” said Baliga, who was not involved with the guidelines. Baliga added that he thought the new targets should be achievable with a combination of lifestyle modifications and medications.

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