At Lifestyle 180, we have found that a positive outlook, and a good mood, are integral parts of helping you stay committed to a healthier you.   So, what is one of our tasty little secrets?   Dark chocolate.

For our participants, this is big news.  Dark chocolate, with at least 70% cacao (make sure you read those labels), consumed in a moderate way, has been shown to be good for your mood and for heart health.  When it comes to heart health, we call this “cardio-protective”, and the US Preventive Services Task Force has indicated the importance of “cardio-protection” for preventing chronic disease.

So, why dark chocolate?  Scientists believe it may have to do with these great agents, called “anti-oxidants”, especially “flavonoids”.  The mood part…well, you don’t need scientists to tell you that a little chocolate is good for a brighter disposition!

Now remember, dark chocolate is still high in calories and saturated fats, so small amounts are important.  Think of it as a well deserved reward for getting through the day, achieving your 10,000 steps, and eating a balanced diet of fruits, vegetables, and whole grains.

 Dr. Elizabeth Ricanati is the former director of The Cleveland Clinic's LifeStyle 180 program and a regular columnist for ShareWIK.com

For more Dr. Elizabeth Ricanati articles, click here.


©ShareWIK Media Group, LLC 2010


Current national guidelines recommend that I exercise at least thirty minutes a day, five days a week.  But how am I supposed to fit that in on top of everything else that I do?  And does it really matter, anyway?
The answer is, yes, it really does matter.  And yes, you and I can find time, each and every day, to be physically active.  Physical activity is great for our heart health, our brain health, and our overall mental health.  Not to mention, of course, things like our bones.  Since it's February, and American Heart Month, let's focus on our hearts.  Research has shown that physical activity correlates with health.  The less activity you do, the more unhealthy you are.  
The most recent physical activity guidelines for Americans, issued by US Department of Health and Human Services in 2008, recommend 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity weekly.  That's hard for most of us to do.  But it doesn't have to be.  You can break it up, for example, into 10 minute increments.  You can jog in place while you read the mail.  You can walk around your dining room table while you talk to your children.  You can march in place while standing in line at the grocery store. 

You can do it.
And you should do it.  Why?  Your heart-health improves with regular physical activity: you'll reduce your risk of dying from heart disease; you'll reduce your risk of having a stroke; you'll reduce your risk of developing high blood pressure (and reduce your blood pressure if you've already been diagnosed with high blood pressure).  Have I given you enough reasons yet?
So go on, lace up those sneakers, and I promise, it will make you feel good.

Dr. Elizabeth Ricanati is the former director of The Cleveland Clinic's LifeStyle 180 program and a regular columnist for ShareWIK.com


For more Dr. Elizabeth Ricanati articles, click here.

©ShareWIK Media Group, LLC 2010

Did you go outside today? Or at least want to go outside today?


If so, don't forget the sunscreen! Summer is nearly upon us…and so is the potential for sunburn! While sun exposure can boost your body’s level of Vitamin D, its ultraviolet rays can also damage your skin. Sun exposure can prematurely age your skin as well as cause wrinkles and make your skin look tough and leathery.  Years of severe sunburn and/or sun exposure has been linked to the development of melanoma, a deadly skin cancer.


On the bright side (pun intended!), here are a few ways to maximize the sun’s benefits while reducing your risk for sun damage, sunburn and skin cancer.


·      Try and avoid the sun between 10 a.m. and 3 p.m. when the sun’s ultraviolet rays are at their strongest.

·      When you do go outdoors – especially for long periods during the middle of the day – protect exposed skin by wearing long sleeves, a wide-brimmed hat and sunglasses that filter ultraviolet light.

·      Most importantly, always wear sunscreen.


Ah yes, sunscreen. Walk into any drugstore today and you'll be confronted with enough products for an army.  So, which sunscreen should you choose? And how often to apply? And at what SPF level? And which one is really the best – waterproof, long acting, etc.?


Let's start with SPF. This number refers to Sun Protection Factor, the sunscreen's ability to block harmful ultraviolet rays that can cause you to burn and put you at risk for developing skin cancer. SPF ranges from 15 to 55….and even as high as 100! But higher SPF doesn't necessarily mean better protection. You could use an SPF 30 just as well as a SPF 100...what matters is that you use it! And often – especially on the face, neck, and other exposed parts of the body. Use at least a capful, and re-apply at least every two hours.


It’s important to remember that no sunscreen offers 100% protection against the sun’s harmful rays. So, no matter how high the SPF – or claims of “long lasting,” “all day,” or “waterproof” – continue to apply sunscreen throughout the day. This is especially true if you’re outside for long periods of time, perspiring heavily, and/or in the water. Doing so will ensure sunny days ahead for your skin.


Dr. Elizabeth Ricanati is the mother of three children and director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com


More Dr. Elizabeth Ricanati articles, click here.

 ©ShareWIK Media Group, LLC 2010

Can you believe it? Summer is finally here…and, if you’re like many Americans, it’s a hectic time filled with barbeques, sporting events, children’s activities and vacations.   Even though your schedule might be jam-packed from May through August, be sure to take time out for you - to breathe, to relax, to enjoy a walk, to watch a baseball game or a sunset. In spite of all the summer fun and frolic, you can still find time to stay healthy through nutrition, exercise and stress management.


  • Nutrition.  Going to a cookout?  Plan ahead and bring a healthy side dish or appetizer.  Take advantage of local Farmers markets, pick-your-own fruit stands, or maybe even a garden of your own.  Fresh fruits and vegetables are a great way to get the necessary nutrients that you need to stay healthy:  for example, tomatoes are loaded with lycopene, carrots with vitamin c, and dark leafy green veggies have lots of folic acid. Add fruit and vegetables to your kebobs instead of steak…choose guacamole or salsa over creamy dips…enjoy a black bean or wild salmon burger over traditional ground hamburgers.


  • Exercise.  If you live in a cold-weather climate like Cleveland, take advantage of the sun and warm weather! Take up an outdoor sport - running, biking, walking, golf or tennis to name a few. All provide great cardiovascular benefits and can help tone muscles. If you like being in or around the water, choose swimming, kayaking or boating.  Whatever you choose to do, try to be moderately active for at least thirty minutes daily (this will keep you right on target with the current guidelines for physical activity in the U.S.).  If you have children, include them in your activity as well. This will help teach them the importance of exercise and set them on a path of better health for the rest of their lives.  Don't forgot to wear sunscreen (and now there are so many different types of clothing with built-in sun-protection), a hat if necessary and carry a water bottle with you.


  • Stress management.  Aah, it's light later.  You can be outside more.  These simple nature adjustments can make you feel more energized and productive. Be sure to take advantage of the beauty and light of summer to help manage your   stress levels. Consider spending some time alone outdoors stretching…or locate an outdoor yoga class.  If you live near the water, take a walk by the beach or the shore, and time your breathing to the movement of the waves. Clear your mind of your troubles and concerns and just be. Summer is a great time to take stock, re-evaluate your goals for yourself, and make sure that you have the necessary strategies in place to meet those goals.



Dr. Elizabeth Ricanati is the mother of three children and founding Medical Director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com


More Dr. Elizabeth Ricanati articles, click here.

 ©ShareWIK Media Group, LLC 2010

On May 9, 2010 – Mother’s Day – the pill celebrated its 50th anniversary. Debuting in 1960, oral contraceptives proved both revolutionary and controversial. Women alternately were praised and condemned for taking control of their sexual health, and the decision when – or even, if – to bear children. Since that time, women have seen their annual incomes and opportunities – both in an outside the home – escalate and expand.  So, too, have their birth control options.
Oral contraception is still the number one form of birth control in the U.S.  However, new formulations include injections, skin patches, and vaginal administration are gaining popularity as women look to take even more control over their sexual health and well-being. All are equal in terms of effectiveness and chemical composition as each contains a combo of estrogen and progesterone that prevent your ovaries from releasing eggs. It’s the method of delivery and convenience that differentiates one type from another.
If you know you won’t remember to take a pill every day, you can now wear a patch, get a quarterly injection or insert a vaginal ring. It’s important to consider your lifestyle when choosing a method of birth control. You want to be sure you can be compliant with the method you choose so you can prevent unwanted pregnancies.  And don’t forget a few very important things: 1) any type of hormonal contraception puts you at risk for some very serious health problems including blood clots, stroke, and heart attacks. This risk is increased if you smoke cigarettes and are over the age of 35; 2) if you are planning on using hormonal birth control, you are strongly encouraged not to smoke; and 3) none of the hormonal forms of birth control protect against sexually transmitted diseases, so make sure your partner uses a condom as well.
As we celebrate this landmark accomplishment in women’s health, know that there are many more medical breakthroughs on the horizon. Who knows what sort of medical breakthroughs our daughters and granddaughters will be celebrating in 50 years? Happy Anniversary to the pill!
Dr. Elizabeth Ricanati is the mother of three children and founding Medical Director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com
More Dr. Elizabeth Ricanati articles, click here.
 ©ShareWIK Media Group, LLC 2010

You may have noticed more products at the grocery store labeled “gluten-free” or “wheat-free”; some stores have entire sections devoted to these products. But what are they? Gluten-free foods are great options for individuals with celiac disease, a gastrointestinal autoimmune disorder. Children and adults with celiac disease cannot digest gluten, a type of protein found in grains such as breads, pastas and cereals. When a person has celiac disease, his/her body's intestines cannot digest gluten properly which leads to inflammation in the lining of the small intestine and a decrease in absorption of nutrients – including vitamins and key minerals. This “malabsorption” can lead to other health problems. For example, celiac disease can affect iron absorption and lead to anemia; or it can affect bone health and lead to osteoporosis.


Celiac disease is unique in that its treatment is not medication but rather total dietary modification. The good news is that once individuals with celiac disease remove gluten from their diet, their symptoms improve and they feel better. But changing to a gluten-free diet can be challenging in our world of pre-packaged processed food and fast food restaurants. Luckily, as awareness of this disease increases, more grocery stores, bakeries and restaurants offer gluten-free alternatives to popular food choices.


Celiac disease affects one in every 133 people worldwide, and can be diagnosed at any age. Symptoms of celiac disease include weakness and fatigue, and gastrointestinal symptoms such as diarrhea and cramps. Celiac disease is often confused with Irritable Bowel Syndrome (IBS). 


Be sure to talk to your physician if you have family members with celiac disease, or vague gastrointestinal symptoms, fatigue or weight loss or any other symptoms that concern you.


Dr. Elizabeth Ricanati is the mother of three children and founding Medical Director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com


More Dr. Elizabeth Ricanati articles, click here.


 ©ShareWIK Media Group, LLC 2010

Sugar isn’t only harmful to your teeth – it’s harmful to your body as well. The edible crystalline carbohydrate occurs naturally as sucrose, yet most of us ingest sugar in its manufactured forms of glucose, fructose, and high fructose corn syrup. It’s these manufactured forms – most commonly found in US industrial food preparation – that can contribute to disease development.
Here’s how: too much sugar in our bodies can lead to something called insulin resistance.  (You may have heard of this, especially if you or someone you know has diabetes.)  Insulin resistance occurs when the body produces, but cannot properly use, insulin, a hormone required to process glucose (your body’s main source of energy). This insulin resistance can lead to inflammation.  Too much inflammation in our bodies can cause disease.  Depending on where the inflammation is will depend on the type of disease that develops.  For example, inflammation can lead to heart disease (a major cause of disease for women, especially as we get older).  Diets high in refined carbohydrates (think white rice, white bread, simple sugars) and low in protein and omega-3s (think salmon, nuts and lean meat) can increase your susceptibility to insulin resistance and various inflammatory diseases.
So what can you do?  
Pay attention to the ingredients in the food you’re eating. When you're in the grocery store, make sure to read the back of the food item you're putting in your cart.  Ignore whatever health claims are on the front of the item (think “low-fat,” “good source of whole grains”) – they don’t always tell the truth!  Turn the box or the can over and look in two places.  First, look for the amount of sugar. Ideally, whatever you are purchasing should contain less than 4 grams of sugar per serving.  Second, look in the actual list of ingredients.  The first five are the most important as they comprise the bulk of what is in that particular item.  Look for any words that end in -ose...that's code for sugar.  Look for enriched flours or white flour...another code for sugar.  If any of those is in the first five ingredients, put the item back on the shelf. It's that simple --- by paying attention to the food you feed yourself and your family today; you can cut your risk of developing insulin resistance, inflammation and disease in the future.
Now that’s a sweet ending.  
Dr. Elizabeth Ricanati is the mother of three children and the former founding Medical Director of The Cleveland Clinic's LifeStyle 180 program.  
More Dr. Elizabeth Ricanati articles, click here.
©ShareWIK Media Group, LLC 2010 

Where did the summer go?  The end of August looms ahead bringing with it the words kids dread to hear: school is back in session! As you pack your child’s backpack with all the tools she needs to succeed - notebooks, folders, pens and pencils – don’t forget to pack the most important item. Lunch.


Packing your child’s lunch can help establish healthy eating habits that can benefit your child long after she’s finished with school. Kids who eat packed lunches generally eat healthier than those who choose their lunch from a cafeteria (burger and fries, anyone?).  But even the most well-meaning parents can pack foods that are less than healthy in their little one’s lunches. It’s easy to do – food marketers are very savvy at showcasing the good ingredients and hiding the not-so-good ingredients in packaged foods.


So what’s a parent to do? Don’t be discouraged! The great news is that packing lunches can be quick and easy for you, and healthy (and edible!) for your children.  One of the easiest places to start, and one I often forget, is to simply involve your child in the process.  Packing lunches that they won't eat doesn't help anyone (and makes for a long afternoon at school!).   

First of all, know what your child absolutely will and will not eat. It’s important to be realistic. Once you have a sense of what is going to fly, shop appropriately, aiming to find the healthiest options available. If your child loves cheese, choose a low-fat string cheese to accompany a sandwich made with 100% real peanut butter (the ingredients should be peanuts and salt only).


Does your child love those fruit cups packed in syrup? Try sending your child to school with fruit kebobs or apple slices spritzed with lemon juice. Or pack carrot sticks with a healthy ranch dressing (kids love to dip their foods!). Kids also like foods in snack-size portion because lunch time is more for socializing with friends than it is for eating! Cut their sandwiches in small, bite-sized portions and pack fruits such as sliced peaches or grapes that can be eaten easily and with less mess than whole fruits. A handful of heart-healthy nuts (like walnuts or almonds) and 100% whole wheat pretzels can round-out a tasty – and healthy – lunch!



Dr. Elizabeth Ricanati is the mother of three children and founding Medical Director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com


More Dr. Elizabeth Ricanati articles, click here.


 ©ShareWIK Media Group, LLC 2010

Sep 26

On President's Day 2010, my family and I set out to go on a few mile cross-country ski adventure at one of our Cleveland Metroparks locations. Unfortunately, I quickly learned I would not be a participating member of our group. I was a fat, out-of-shape, 42-year-old diabetic man whose body would not and could not keep up with his beautiful, healthy family. Having been told the year before by a doctor in Breckenridge, Colorado that, due to contracting high elevation pulmonary edema (HAPE), I needed to cut short another family trip and immediately head back to Cleveland's lower elevation, this was my last straw.


Several days later I began a program that dramatically affected my quality of life and changed my entire outlook on how diabetes and obesity can be controlled.
The Lifestyle 180 team at Cleveland Clinic has given me my life back and changed the entire dynamics of my family. Within three weeks of beginning to work with the team, I dropped more than 16 pounds, was taken off of
ALL of my diabetes medicines, and found I was beginning to learn how to recognize and release tension. My health was beginning to return. Even though I had seen multiple dietitians and nutritionists, and been taught for many years how to count carbs and read labels, I had not been able to get control of my disease. The simple and repeated messagea of Wellness Center’s chef Jim Perko and registered dietitian Kristin Kirkpatrick of eating nothing with more than two legs (I thought – “No red meat, you've got to be kidding? I'll starve"); no food where sugar is listed in the first five ingredients (I had to throw out most of what was in my refrigerator and cupboards); and eating only whole grains is very easy to follow.
Over the course of the summer, I have gone from a waist of 126.5 cm. to 103cm. In addition, I was part of the Cleveland Clinic Pan-Ohio Hope Ride team and rode my bike from Cleveland to Cincinnati (another truly amazing life journey) I also ran in the Chagrin Falls Blossom Time Festival with my family as well as Race for the Cure.


This weekend, I will compete in my first ever triathlon at Portage Lakes. Every where I go, people will stop and ask me what I have done to change my life, and how it has impacted me and my family. Cleveland Clinic’s Lifestyle 180 program has been a gift from God guided by some extremely talented professionals who care about you and your health.


I am now once again an athlete who fits the image of his profession as a financial advisor and auxiliary police officer. I no longer ask myself, “Will I be around to see my son and daughter grow up?”  But rather, I ask, “How can I encourage others to take the small steps that will give them a whole new outlook on the world?” 


Jim M. lives outside of Cleveland.


©2010 ShareWIK Media Group, LLC

Have you ever tried to reframe a problem?  Taken a bad situation and decided to think of it as an opportunity instead?  You may have done this with a situation at work. Perhaps you did not receive the promotion you wanted but rather than become upset, you decide instead to be grateful for the work you have and how your work load allows you to be home when your children are finished with school.


We do this a lot with children, too. When your son or daughter is not chosen for the school sports team or theatrical performance, you probably console them - and also point out all the other opportunities available such as local city sports teams, community theatre, and dance and vocal classes. But did you know that these same reframing techniques can be applied quite successfully to a divorce?  


Before you call me crazy, keep reading. For many, a divorce is the most stressful situation ever. It affects careers, friends, family, children – and even your health and well-being. It’s easy to see why. When you get married, you usually assume it's forever. And often it is.  But not always. In the U.S., approximately 50 percent of marriages end in divorce, which makes it a very real possibility for many of us. If you’re ever faced with a divorce, it's important to make sure that you continue to take care of yourself and implement lifestyle modification skills that can keep your stress level in check.


Even though you may feel as if your world is falling apart, do your best to continue to eat lots of fruits and vegetables, get enough rest, and attempt to reach those 10,000 steps a day.  These things may seem unimportant at the time, but they are all integral in keeping yourself healthy – physically, emotionally, and psychologically.


Lifestyle modification also includes stress management. If there was ever a time for stress management, it's during a divorce! This can take many forms – yoga, meditation, deep breathing, mind/body coaching or seeing a mental health professional. Talk with your physician about what technique is best for you.


Stress management can also include keeping the divorce amicable. Every divorce situation is different and, if an amicable divorce is an option, I recommend it. Amicable divorces can be easier on your health and well-being, which is important for you and, if you have children, for them and their health as well.


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com


More Dr. Elizabeth Ricanati articles, click here.


 ©ShareWIK Media Group, LLC 2010

It may seem too good to be true, but I think there is a benefit to Halloween candy.  That benefit is called portion-control!  The great thing about Halloween candy is that it is prepackaged into manageable portions.  

Instead of eating more than 40 grams of sugar in a regular-sized bar of your favorite candy, you will find that these small packages usually have less than 10 grams of sugar.  Not ideal, to be sure, but if you're going for moderation - and not elimination - to handle the holiday stress, then consider raiding your child's Halloween candy stash instead of working your way through a king-size candy bar. 

Before you mindlessly choose a few “fun sized” candy bars for yourself, consider giving yourself the best. The best chocolate, that is. 

Dark chocolate is the best chocolate for your body – it’s loaded with antioxidants! Look for candy bars with 72% or higher cacao content. And when unwrap that piece of dark chocolate, savor it. Take a moment to breathe in the rich scent and enjoy the sensation of the chocolate on your tongue. If you remember to be in the moment while you’re indulging, you’re less likely to overeat. 

For many of us, Halloween marks the beginning of a holiday season filled with tempting foods that are not always good for our bodies. Keep these small tips in mind so you can enjoy the tastes of the season while maintaining your health. 

Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 

More Dr. Elizabeth Ricanati articles, click here

 ©ShareWIK Media Group, LLC 2010


What's available to you 24/7, anytime, anyplace?  Your breath.  

Why is that important, you ask? Well, we’re about to embark on one of the most stressful times of the year – the winter holidays. Thanksgiving, Hanukkah, Christmas, Kwanza, New Year’s – no matter which combination of holidays you observe, they are bound to cause stress. Shopping for gifts, party planning, holiday baking, and family gatherings are all bound to have you feeling overwhelmed and stressed. But there is good news (and no, I am not about to advocate an extra glass of egg nog or piece of pie). By simply remembering to breathe, however, you can reduce your stress level, decrease your frustration or anxiety, and increase your ability to experience (and spread) holiday cheer.


Here’s how. The moment you notice yourself feeling stressed, overwhelmed or just plain tired, stop yourself. It doesn’t matter if you’re home alone or in a crowded shopping mall on Black Friday. 

Be aware of your feelings and take a breath. 

Begin by inhale deeply through your nose, taking the time to feel the breath across the back of your throat. Hold it for a second. When you think you can breathe in no more, exhale through your nose. Repeat as often as necessary to slow your heart rate down, decrease the tension in your head, neck, and shoulders, and reduce your feelings of anxiety.  Ahh, feel better yet? (C’mon, I know you are practicing while reading this blog!)


Yogis have been doing breath work for centuries, and it's about time you took advantage of this simple technique to feeling great, too.  Remember, you can do this anytime, anywhere, and nobody need be the wiser but you.  Breath work has been shown to improve our concentration, our mood, and maybe even our memory.  So perhaps you will remember all those gifts you have to buy this year!


Make a resolution for yourself this holiday season - stop and take a breath. I guarantee you will feel better, and that in itself is a reason to celebrate.



Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©ShareWIK Media Group, LLC 2010

So the holiday season is upon us, and it's already begun -- you're eating too much, not exercising enough, and starting to get those winter blues.  I know, I know – you said that you were absolutely not going to feel this way this year. But don’t worry; this holiday season can still be different for you - no five pound weight gain, holiday blues, or stressed-induced illnesses for you!  


Here’s how. Start by making a plan for each of the following areas: nutrition, exercise, and stress management. Doing so will make it easier for you to face those holiday cookies at work, your children's classroom parties, your in-laws and all the other stresses related to holidays!  


I will help you start your plan.


(1)  First up, nutrition. Be sure to eat breakfast every day and get that metabolism going! It will provide you with the fuel you need to get through the day. Are you spending most evenings at a holiday gathering?  Before you go, have a healthy snack such as a handful of almonds or an apple. This will help in curbing your urge to fill up on creamy dips and desserts at the holiday buffet. If you must eat out, remember to create a colorful plate of food (more color usually equals more nutrients). Think red pepper slices, sweet potatoes, oranges and cranberries. Don’t be afraid to fill your plate – it’s better than grazing all night!


(2)  Now that we’ve covered food, on to exercise. Although it might be easier to just order all your gifts online, try to venture out and go shopping (or at least window shopping). Walking around a shopping mall is a great way to get a lot of steps in!  Remember, we’re aiming for 10,000 steps per day. Taking 10 minutes several times a day is a great way to keep moving and feel good.  If you're traveling over the holidays, keep in mind that airports and train stations are all great places to pick up steps easily.  


(3)  Managing stress.  It goes without saying that the holidays can be very stressful.  And stress can easily take the cheer out of us. Fortunately, you have your breath with you 24/7.  It's free, easy and always accessible.  Don't forget to use it whenever you feel your frustration and anxiety levels start to rise. Stop, take a deep breath through your nose then exhale deeply.  Try to remember to do this several times a day, and certainly when dealing with long lines at toy stores, pesky relatives and when faced with yet another round of holiday cookies.


(4)  And, lastly, don’t forget to take a moment to feel grateful for all you have. Gratitude can easily lift your mood and make all those holiday stresses seem, well, not quite so stressful.


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©ShareWIK Media Group, LLC 2010


The holiday season is here and, whether you celebrate Hanukah, Kwanzaa or Christmas, you most likely have been bombarded with all the stresses that come with the season. It’s easy to turn cookies, eggnog, or wine to help make those family gatherings, office parties and gift-giving more tolerable. While the sugar rush may make you feel better in the short-term, these coping mechanisms are not good for your physical or emotional health in the long-term.


Excessive and uncontrollable consumption of food, alcohol or drugs can lead to an addiction which can have devastating effects on the individual and his/her family and friends. Many of us are not addicts, but willingly admit to consuming an extra piece of pie or holiday alcoholic beverage to help ease stresses or cope with an awkward situation. The pie – while delicious – will spike your blood sugar levels causing a “feel good” feelings before those levels crash leaving you irritable and hungry. Holiday alcoholic beverages are often chock-full of added sugar and syrups, and can often have more calories than your meal! They can also dehydrate you which causes headaches and fatigue that can last much longer than the time it takes to consume the drink.


I challenge you this holiday season to be mindful of your food and beverage choices. Be sure to fill up on protein and vegetables before sampling a (small) piece of dessert. And if you want to enjoy a holiday beverage, be sure to limit the quantity and drink plenty of water before and after to avoid dehydration. Try to avoid eating and drinking mindlessly as well – take three deep breaths before consuming food or drink to ensure that you really need what you are about to put into your body.


You can also take this one step further - try a new addiction. I am speaking of that addictive feeling of gratitude that comes with giving.  This is the time of year when some people need an extra coat, a thoughtful gift or a warm meal. These simple things can mean everything to a person or a family in need. Go out of your way to give a little more, even if you are overwhelmed with the holidays, too. In doing so, you'll be pleasantly reminded how addicting it can be!


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©ShareWIK Media Group, LLC 2010

Persimmons, Asian pears, pomegranates and clementines…the turn of the New Year is a terrific time to introduce into your diet new and yummy foods that are good for you.  Enough with too many holiday cookies, glasses of eggnog and fruit cakes! Make eating healthier part of your new year’s resolution – doing so can help you shed unwanted winter weight and can provide vital nutrients your body needs to ward off colds and flu.


Rather than sticking with your standard fruit and vegetable routine, how about trying something new? Winter fruits and vegetables are so beautiful and chock full of wonderful nutrients that are the perfect antidote to the overindulgence of the holidays. 

Pomegranate skins are brilliant shades of reds and pinks; persimmons are varying shades of orange; and dates are a rich velvety brown. Using these in your winter dishes can add color and texture to your food – along with vitamins and fiber. Pomegranates and persimmons are loaded with antioxidants, vitamin C and fiber, all ingredients that are needed to ward off the pesky colds going around this winter. Dates are fat-free and cholesterol free, and are rich in non-heme iron (the kind of iron found in plants, not animals), potassium, fiber and B vitamins.


There are countless lush, beautiful fruits and vegetables that I could discuss, but instead, I encourage you to break out of your comfort zone and try at least one new fruit or vegetable per week. Spend some time wandering through the produce department of a grocery store and pick something whose color or texture speaks to you. Maybe it’s a bunch of dark green kale, a box of bright clementines, or rich yellow-gold Asian pear.  If your grocery store is limited in its produce offerings, search out a local farmers market. Many cities host farmers markets in the winter months and their offerings can be more varied than a traditional supermarket.

So, if possible, try to incorporate some of these delicious and colorful foods into your diet as part of your overall New Year's strategy. 

Your body will thank you.


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©ShareWIK Media Group, LLC 2010

Have you read a good book lately?  Have you taken any time for yourself at all? Be honest.  I won’t be surprised if the answer is “no.”


Somehow, despite the best intentions each year, the time between Thanksgiving and New Year's Day just gets away from us. The holidays. They can get us every year. Between the actual obligations we have and the pressure we put on ourselves to do it all at this time of year -- it's enough to completely stress one out!  


After New Year’s Day, “real” life starts again and we often find that we accomplished less over the holidays than we wanted. Or, than we thought. And all those little things we planned to do for ourselves most likely never got done. Am I right? I have a suggestion for you. Before getting yourself back into the daily grind this New Year, stop.  That’s right, stop. Take a moment today.  Just for you.  What do you want to do? Read a book? See a movie? Start a scrapbook? Meet a friend for coffee? Do it.


It's like what the airlines always say before takeoff: put your oxygen mask on yourself first before assisting another.  If you aren't taking care of yourself, then it is awfully hard to take care of anyone else. In order to keep going, you need to take some time for yourself.  


So, how to do that?  


If the idea of taking 30 or 60 minutes away from your responsibilities overwhelms you, start small. Maybe it's five to 10 minutes.  Maybe it's a walk to the post office to mail the holiday thank-you notes. Maybe it's doing an extra load of dishes so you can be alone for a few minutes later.  Maybe it's shoveling the front path so you can get out of the house and have a moment to think.  Regardless of what it is, stop today and do it. You owe it to yourself.


Once you have mastered taking a few minutes for yourself, start adding to it every week. Pretty soon, you will relish the time you have for yourself, and can work up seeing that movie or meeting a special friend for coffee. Others will notice, too. The good that you do for yourself will spill over into the new year.  


Happy New Year!  It's going to be a wonderful one!


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©ShareWIK Media Group, LLC 2010

Sometimes life throws us curve balls.  We often hear,“When life throws you lemons, make lemonade.”  Or, “Everything happens for a reason.”


Sound familiar?  We all have heard these various pithy statements at times of stress or difficulty. Sometimes they're comforting, sometimes not. And, sometimes we feel that there’s really nothing anyone can say to ease feelings of anxiety, grief, sadness, or depression. I realized this weekend that, in my times of difficulty, there is a reason for believing in these statements.  


A friend of mine unexpectedly passed away last week. She was a mother, a daughter, and a ray of sunshine to so many.  As I struggled to understand why this happened, I went through a range of emotions and thoughts.  I remembered all of the wonderful times we spent together, and how she touched so many lives.  And I was sad.  She was too young. 


Then a wonderful thing happened this morning:  I woke up. I took a few really deep breaths, I watched the sun rise over the ocean (all those brilliant colors), and I was filled with gratitude. My friend was an artist - among other things - and I imagined her painting that brilliant sunrise, and I felt grateful.  Grateful to have had her in my life, for however long. Grateful to be able to be awake today to remember her, to speak about her.


Everything happens for a reason.


Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com 


More Dr. Elizabeth Ricanati articles, click here


 ©2011 ShareWIK Media Group, LLC 

Phew, we made it. Springtime is in the air. Well, for some of us anyway (my apologies to those still experiencing winter!) Here in Los Angeles, the cherry blossoms and magnolias are beginning to bloom already. Sneeze. Runny nose. Sneeze. Yes, with all these beautiful blooms come seasonal allergies.

Just about everyone is familiar with the symptoms of seasonal allergies (also known as hay fever) – the itching, sneezing and runny nose caused by whatever pollen is currently floating in the air. What most people don’t know is that hay fever is one manifestation of a more basic condition known as allergic rhinitis.

This condition affects approximately 10% of the U.S. population (roughly 30 million people) and is the most common allergic disorder in the country. No one knows why some people suffer from allergies and others do not. Some evidence suggests that allergies could be a hereditary trait. Other evidence links allergic rhinitis to asthma and eczema. People who suffer from these diseases are more likely to develop allergic rhinitis, too.

Seasonal rhinitis comes and goes with the reproductive cycles of plants and fungi. At certain times of the year specific to their species and geographic region, plants release pollen into the air, and fungi release spores. Those people who are allergic to one or more kinds of these allergens will develop allergic rhinitis.

No matter where or how your symptoms originate, there are steps you can take to ensure you continue to feel well everyday. To target multiple symptoms, consider over-the-counter, all-purpose antihistamine medications like loratadine or cetirizine. If nasal congestion is one of your symptoms and you do not have high blood pressure, purchase an antihistamine with a decongestant (like pseudoephedrine or phenylpropanolamine). If those aren’t strong enough to relieve your symptoms, talk to your doctor about prescription options.

If you prefer just to target a specific symptom (like itchy eyes or a runny nose), talk to your doctor about prescription nasal sprays or eye drops. Don't want traditional medications? Not a problem! Saline nasal sprays and neti pots can work wonders for congestion and dry mucus membranes. Lubricating eye drops can help dry, itchy eyes. And don't forget behavioral changes too! If you’re highly sensitive to flowers, keep artificial flowers inside your home instead of real ones. Turn on the air conditioning instead of opening the windows on days where the pollen count is high.

Try not to let your allergic rhinitis symptoms derail you. Know what environmental triggers increase your symptoms, and take precautions before going outdoors. If you do spend time outdoors, be sure to wash your hands when you come inside to get the pollen and other potential allergens off your skin.

Dr. Elizabeth Ricanati is the mother of three children and founding medical director of The Cleveland Clinic's LifeStyle 180 program.  She is a regular columnist for ShareWIK.com  


More Dr. Elizabeth Ricanati articles, click here


©2011 ShareWIK Media Group, LLC


Jul 18

I had just injured my left ankle while moving into our new home, when I noticed an increased amount of pain and inability to walk that seemed out of character for the injury.  I was seen and treated in the local emergency room for what they thought was plantar faciitis, inflammation of the tissue surrounding the bottom surface of the heel bone. I was given a flat boot and sent home with my left foot wrapped in an ACE bandage.  After about two or three days, I noticed an increased amount of pain and swelling, and I was unable to bear weight on my foot. 

I discussed my situation with my physician and mentioned to her that I was concerned about a possible blood clot – also know as deep vein thrombosis (DVT).  In addition to the injury and my sedentary condition due to experiencing pain for three days, I was also taking birth control for endometriosis (I am a non-smoker).  Because of my medical background, I knew birth control pills can increase your risk of developing blood clots. I requested my physician order an ultrasound of my left leg and calf and, during this process, two DVTs were found in my lower extremity.  I was immediately taken to the emergency department where they initiated treatment with Lovenox®, an injectable medication that alters the blood’s ability to clot, and consulted with Vascular Medicine.  After several days of treatment, I did well and the pain subsided. 

As part of my treatment, it was important that I maintain my INR levels with a steady, healthy diet and monitor my Coumdin® doses weekly.  INR is a way to measure the clotting tendency of your blood, and Coumadin® is a medication that helps normalize INR levels. I did well and was taken off the Coumadin® at the end of the third month. 

Dr. Marcelo Gomes, a vascular medicine physician, continued follow-up with me at the six- and 12-month intervals.  Other than occasional muscle spasms and aches, I have done well.  Actually, my symptoms have mostly resolved completely with no more aches or nighttime pain in my left leg.  I have continued with elastic compression stockings at 30-40mmHg daily since the day I was diagnosed and will continue with them for "life" per Dr. Gomes. These stockings help with blood flow, and aid in the prevention of future blood clots.

One of my objectives now is to lose weight and reduce my risk of the blood clots returning.  I have been tested for clotting disorders and have only tested positive for MTHFR, a genetic defect that only affects my ability to conceive/miscarry.  This isn't an issue at this time due to infertility which I diagnosed eight years ago.  I am no longer on any estrogen therapy (birth control) since the day of DVT diagnosis.  I have the option to pursue progesterone therapy should my endometriosis become unbearable or become a concern for my gynecologist.

I will continue to see Dr. Gomes yearly and will wear my compression stockings daily to help prevent the re-occurrence of the DVTs.  

My suggestion is that no matter what age - whether a smoker or non-smoker - you should use caution with possible side effects of estrogen therapy.  It has not been determined that the estrogen was a contributing factor in the development of the DVTs, but combined with my injury and bed rest for several days, it may have predisposed me to the incidence of blood clots. Otherwise, I suggest that you follow-up when an injury (especially to an extremity) does not resolve as anticipated, or if it worsens, to assure there are not further complications such as blood clots.

©2011 ShareWIK Media Group

Tis the season for colds and flues but luckily we have ways in which we can boost our immune systems to ward off illness! Acupuncture is oftentimes thought of as a pain-relieving treatment, but did you know it could also help to naturally boost your immune system?


Acupuncture is a branch of Traditional Chinese Medicine (TCM) with a rich history and lineage dating back thousands of years to ancient China. Acupuncture is truly a medical art, as each clinician uses various approaches, techniques and styles to address your ailment; no two patients are treated the same.  Acupuncturists insert hair-thin needles into the body to promote immune-boosting effects.


Conventional medicine has begun paying closer attention to acupuncture as there have been numerous clinical studies explaining the complex mechanism of action.  For example, we now know acupuncture works quite extensively in the body influencing the nervous system to release endogenous opioid endorphins, which are the body’s natural pain relieving chemicals.  


Most recently, scientists have been able to determine the role acupuncture plays in boosting the body’s immune system by enhancing the production of natural killer cells, which is the primary defense mechanism against organisms that make us sick.  It also acts on a complex immune building system that regulates white blood cells directly linked to the fight against infections, allergic reactions and even autoimmune disorders. 

Your initial appointment with an acupuncturist will usually be the longest as your acupuncturist will go through a lengthy and detailed assessment of your present and past medical history from which an appropriate treatment plan is developed. Acupuncturists have a unique and keen ability to address the patient as a whole. We take a tremendous amount of time assembling a complex jigsaw puzzle; each piece of the puzzle comprises details such as stress levels, bowel movements, response to changes in season, aversion or preference to cold or hot temperatures, menstrual cycle, etc.  Additionally, standard TCM diagnostic techniques will also include looking at your tongue and feeling your pulse on both wrists.  Our main goal is to treat the root cause of a patient’s condition. Our treatment will be specific to help boost your body’s immune system, but you may also begin noticing side benefits, such as improvement in sleep, mood, mental clarity, and overall improvement in quality of life.   


Once the assessment is complete, the acupuncture treatment will begin with you changing into a gown after which you will be asked to lay on a massage table. You will lie on your back or on your stomach, as the exact areas of the body to be needled will depend on the TCM diagnosis that is determined by your acupuncturist.  The acupuncturist will then begin inserting fine hair-thin needles into specifics “acupoints” on the body.  These points, when needled, will act to boost the body’s immune system.  Approximately 6 to 20 needles may be inserted in the body and left in place for 30 minutes.  

Throughout the duration of the treatment, patients lie quietly in a soothing, dimly-lit room.  Oftentimes calming music is played to help facilitate the relaxation response and many people end up falling asleep. 

Rest assured throughout your treatment, the acupuncturist will take great care to keep you completely comfortable. Under no circumstances should an acupuncture treatment be painful, but you may feel a sensation of “Qi” (pronounced “chee”), or life energy, that is oftentimes felt as warmth, electricity or a deep throb. When the treatment is over, the needles are quietly and carefully removed, and all questions answered.  A typical course of treatment is about 5-8 treatments total, and then the patient is re-evaluated for therapeutic effect. Acupuncture has a cumulative effect, so consistent treatment is best for optimal results.  The sooner you can begin treatment, the better your chances will be to ward off illness.


Acupuncture is now available in many US hospitals and private practices.  


For patients who are seeking to boost their immune system to protect them from getting sick, oftentimes a multidisciplinary approach is optimal.  Acupuncture can easily be incorporated into your conventional treatment plan, working in tandem with your physician.  If you are interested in a natural way to boost your immune system, speak with your provider about integrative treatment options like acupuncture, and you may just find relief!



Kim et al; Autonomic Neuroscience: Basic and Clinical 157 (2010) 38–41

Johnston et al; Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 481625, 14 pages

Jamie Starkey is Lead Acupuncturist, Center for Integrative Medicine at The Cleveland Clinic and offers Acupuncture with a focus on women’s health, oncology, acute/chronic pain management, stress-related disorders and acupuncture clinical research. She says she takes great pride in being a clinician of Traditional Chinese Medicine and strives to help patients discover the ability their body has to heal itself when properly supported and brought back into a balanced state of health and wellness.

©2011 ShareWIK Media Group, LLC

©2011 ShareWIK Media Group, LLC. All rights reserved. ShareWIK does not provide medical advice, diagnosis or treatment. For more information, please read our Additional Information, Terms of Use and Privacy Policy.

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