A Lifestyle Medicine Approach to COVID-19

We share your concern about the ongoing COVID-19 epidemic. It is important during this challenging time to practice self-care. Be informed, but balanced. It is important to limit over-exposure to the non-stop news cycle to prevent worry and overwhelm. Stress and anxiety about current events can lead to physical tension that builds up in the body and can trigger a host of health problems. Totally eliminating worry can be impossible but it’s important to explore ways to lessen the worry habit. Pause several times throughout the day to take a few calming breaths. The practice of mindfulness can help us to recognize thought patterns that lead to distress. Sit quietly and observe your thoughts without engaging them as you focus on your breath. Over time you will be able to detach from your reactions as you observe your thoughts. Find ways to invite more calm and relaxation into every day through yoga, deep breathing, reading, walking in nature, etc.

Self-care is not selfish care. During these trying times it is important to support others in our communities by sharing available resources and helping our neighbors.   

While social distancing, frequent hand washing, and not touching your face are important for slowing the spread of the disease, we can further reduce risk by employing the pillars of Lifestyle Medicine. We share these tips from our friends at Rochester Lifestyle Medicine Institute.


  • Nutrition – Move as far toward a whole-food, plant-based diet as you can.  In particular, eat lots of leafy greens, vegetables and fruits across a rainbow of colors, and eliminate animal products. This will help develop a healthy microbiome, reduce inflammation, and give you a spectrum of micronutrients to maximize health.
  • Activity – Exercise daily, aiming for at least 30 minutes of moderate activity per day.  Make sure that you work up a sweat.  This virus has the highest impact on people’s hearts and lungs, so you want to make sure that they are in as good shape as possible if you get the virus.
  • Substances – Avoid smoking, vaping, or inhaling any substance, which can be toxic to the lungs.
  • Sleep – Sleep is critical for your immune system.  Aim to get 7-8 hours of sleep nightly, and to wake up rested.  Go to bed at a regular time.  Make sure your room is cool, dark, quiet, and comfortable.  Avoid screens at least 90 minutes before bedtime.  Develop a “wind down” ritual, like listening to soft music, writing in a journal, or reading a book.
  • Stress – This is a stressful time.  Managing stress is important to reduce cortisol levels and optimize your immune system.  Some things to consider in reducing stress:  talk with friends and family; practice mindfulness and meditation; do deep breathing exercises. If you find that your stress is becoming unmanageable, seek help sooner rather than later.
  • Relationships – This is an important time to support and be supported by the people you love. Be kind; listen to each other; express your feelings and listen to the feelings of others.  Call friends. Try to help neighbors or others who may need a hand.
  • Time outdoors – being outside is calming.  And you can walk with a friend and still maintain social distancing! (Just stay 6 feet away.) Try to get outside every day, especially during the middle of the day.
  • Meaning and purpose – This is a time for reflection, as well as a time for action.  Reach out to others, to see if there is a way you can help.  If you are religious, use the power of prayer.
  • Positive emotions / finding joy – There is a saying that “It’s better to light a single candle than to sit and curse the dark.”  Be that candle.  Find the moments of joy and light, even if they are few and far between.  Think about all the things you are grateful for.  Smile and laugh when you can. Your immune system will thank you!

We look forward to seeing this through together! Thank you.

Ted Barnett, MD, FACLM
Partner, Borg & Ide Imaging
Board Member, American College of Lifestyle Medicine
Founder and CEO, Rochester Lifestyle Medicine Group
Founding President, Rochester Lifestyle Medicine Institute

Susan Friedman, MD, MPH
Staff Physician, Highland Hospital
Professor of Geriatric Medicine, UR School of Medicine and Dentistry
Medical Director, Rochester Lifestyle Medicine Group
Director of Clinical Research, Rochester Lifestyle Medicine Institute

GERD (Chronic Acid Reflux) – Finding Relief

Gastroesophageal reflux disease, or GERD, is a common gastrointestinal disorder where the contents of the stomach backwash into the esophagus. This occurs when the sphincter that closes the stomach off from the esophagus relaxes or weakens and opens up inappropriately. In normal digestion, this sphincter opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. The continual backwash of stomach acid irritates the lining of the esophagus and can cause it to become inflamed.


Anyone can develop GERD, some for unknown reasons. You can be more likely to have GERD if you are pregnant, taking certain medications or a smoker. According to the National Institutes of Health GERD affects about 20 percent of the U.S. population. It is believed that our modern, highly processed western diet and high rates of obesity are contributing factors.

Common Symptoms

The most common symptoms of GERD are heartburn or acid regurgitation. GERD symptoms most often occur after eating and in many cases adopting a healthy diet and lifestyle can lessen symptoms. In more severe cases medication or more chronic therapy may be warranted. GERD may increase your chance of developing Barrett’s esophagus which affects the lining of your esophagus and is precancerous. It is important to follow the direction of your gastroenterologist (a doctor who specializes in the digestive system).

Symptoms include:

  • Chest pain, painful burning sensations in the throat or chest
  • Difficulty in swallowing or a sensation of a lump in your throat
  • Persistent dry cough, hoarseness or sore throat
  • Regurgitation of food or sour liquid (acid reflux)

Finding Relief

  • Anything that relaxes the sphincter can worsen symptoms therefore avoidance is helpful to prevent these symptoms. Foods to avoid include fatty foods (fried foods and fatty meats), soda (carbonated drinks), alcoholic beverages, cheese (red wine and cheese), excessive coffee (caffeine), chocolate, citrus foods and peppermint. Also avoid cigarette smoking.
  • Nutrition: It is important to eat small, frequent meals and slow down when you eat or drink. Choose whole foods and avoid processed foods such as processed meats and refined grain products, including packaged snacks such as cookies and chips. Focus on nutrient rich plant-based foods with a lower fat content, lean protein and complex carbohydrates. Choose healthy fats such as olive oil, avocado and nuts and seeds. Include probiotic foods such as fermented vegetables, yogurt or kefir. Ensure adequate daily water intake. Aim for one-half your ideal body weight in ounces.
  • Lying down too close to eating time can worsen symptoms for some people. Have a small dinner and try to have your last meal several hours before going to bed for the night.
  • Get regular exercise and maintain a healthy weight. Exercise benefits digestive health, helps with managing stress, improving sleep quality and lowering inflammation.
  • Speak with your doctor about whether any medications you currently take may be making your symptoms worse. It is important to follow your doctor’s recommendations. In the short-term, antacids and acid blockers can be helpful toward healing but long-term treatment with these medications is not usually encouraged. They can impact proper digestion as well as impede proper absorption of vitamins and minerals such as B12, Calcium and Vitamin D.
  • It is important to manage stress because stress can greatly interfere with digestion and can worsen symptoms because it opens our esophageal sphincter. Techniques that help calm stress and anxiety may help reduce symptoms of GERD. Incorporate relaxation techniques such as progressive muscle relaxation, deep breathing, prayer, or guided imagery. We can also manage stress through using anti-anxiety essential oils such as lavender and frankincense, exercising, practicing yoga or tai chi, and getting more rest.  
  • Incorporate good sleep hygiene habits and aim for 7 to 9 hours of quality sleep per night. In addition, it may help to elevate the head of your bed about 6 – 12 inches when sleeping.

By working with your doctor and understanding the causes and proper treatment for GERD, most people can find relief.

-Diane Duvall, Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Atlantis FL 33462.  Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook: Dr. Geni Abraham

Brain health rests on heart health: Guidelines for lifestyle changes

Right now the world is experiencing an epidemic that is projected to get much, much worse. It’s an epidemic of dementia, affecting 50 million people and millions more of their caregivers — staggering numbers that are projected to triple by 2050.

The dementia crisis is such a massive worldwide issue that the World Health Organization (WHO) announced a strategic public health action plan, including compiling an organized database of quality dementia research and creating guidelines for the prevention of dementia. The guidelines have just been published, a 96-page document that is summarized here, as well as in this post.

Dementia is a progressive, heartbreaking deterioration of brain functioning associated with aging. While there are different causes, the most common — Alzheimer’s and vascular dementias — are now thought to be closely related to, and greatly impacted by, the same diet and lifestyle factors.

Your diet and lifestyle can lower your risk of dementia

Several key protective health habits are highly recommended:

Regular physical activity — any activity, for at least 150 minutes per week, is number one on the list of evidence-based actions you can take. Exercise clearly lowers the risk of dementia, even Alzheimer’s. Studies show that people who exercise more are less likely to develop dementia of any kind, and this stands even for adults with mild cognitive impairment.

Eating a plant-based diet is crucial. There is substantial research evidence showing that eating a diet high in fruits, vegetables, whole grains, healthy fats, and seafood is associated with a significantly lower risk of cognitive decline and dementia. This approach to eating is often referred to as the Mediterranean-style diet, but it can be adapted to any culture or cuisine.

The WHO also recommends avoiding toxic, inflammatory foods like processed grains (white flour, white rice), added sugar, sodium, and saturated fats like butter and fatty meat. It’s important to note that the WHO does not recommend taking any vitamins or supplements for brain health, because there is no solid evidence showing that these have any effect whatsoever. Just eat a healthy plant-based diet and avoid unhealthy foods as much as possible.

The WHO also issues strong recommendations to avoid or quit smoking and to minimize alcohol use, especially in those who already have cognitive concerns.

They mention additional lifestyle factors that have less evidence but may also help: getting enough good sleep, positive relationships, and social engagement have been shown to protect cognition.

What’s fascinating about these dementia prevention guidelines is how similar they are to those for heart disease prevention.

How is heart health related to cognitive health?

We have long known that the diseases and conditions that clog the arteries of the heart also clog the arteries of the rest of the body, including the brain. It all boils down to damage of the arteries, the blood vessels that are critical for blood flow and oxygen delivery to the organs. Arterial damage leads to arterial blockages, which lead to heart disease and heart attacks, strokes, peripheral vascular disease, and vascular dementia.

Meanwhile, Alzheimer’s disease used to be thought of as a different process, because the brains of people with Alzheimer’s seemed to be full of tangled tube-shaped proteins (neurofibrillary tangles). However, more and more research is linking Alzheimer’s dementia to the same risk factors that cause heart disease, strokes, peripheral vascular disease, and vascular dementias: obesity, high blood pressure, high cholesterol, and diabetes.

The evidence is substantial: studies show that people with these risk factors are significantly more likely to develop Alzheimer’s disease. Meanwhile, studies also show that people with Alzheimer’s disease have significantly reduced brain blood flow, and autopsy studies show that brains affected by Alzheimer’s can also have significant vascular damage.

Researchers are now focusing on why this is — what is the connection? It appears that good brain blood flow is key for clearing those tubular proteins that can accumulate and become tangled in the brains of Alzheimer’s patients, and so one solid hypothesis is that anything that reduces brain blood flow can increase the risk for Alzheimer’s, and conversely, anything that increases blood flow can reduce the risk for Alzheimer’s.

What’s the take-home message?

Even if someone has a family history of dementia, particularly Alzheimer’s dementia, and even if they already have mild cognitive impairment (forgetfulness, confusion), they can still reduce their risk of developing dementia by simply living a heart-healthy lifestyle. That means a minimum of 150 minutes per week of activity, a plant-based diet aiming for at least five servings of fruits and vegetables daily, avoiding toxic foods like processed grains, added sugars, sodium, and saturated fats, avoiding or quitting smoking, and curbing alcohol use as much as possible.

Selected resources

WHO Dementia Prevention Guidelines Executive Summary

AHA/ACC Guideline on the Prevention of Cardiovascular Disease

Association of obesity, diabetes, and hypertension with cognitive impairment in older ageClinical Epidemiology, July 25, 2018.

Vascular and metabolic factors in Alzheimer’s diseases and related dementiasCellular and Molecular Neurobiology, March 2016.

Defining the relationship between hypertension, cognitive decline, and dementia: a reviewCurrent Hypertension Reports, March 2017.

Mediterranean diet, cognitive function, and dementia: A systematic review of the evidenceAdvances in Nutrition, September 2016.

POSTED JUNE 12, 2019, 10:30 AM

Monique Tello, MD, MPH

Monique Tello, MD, MPH
Contributing Editor Harvard Health Blog

Doing these five things could decrease your risk of Alzheimer’s by 60 percent, new study says

Here’s a to-do list for preventing dementia, new research suggests: Ditch red meat, take a brisk walk to the grocery store, do the Sunday crossword and stick to one glass of wine at dinner.

A study presented Sunday at the Alzheimer’s Association International Conference in Los Angeles found that combining five lifestyle habits — including eating healthier, exercising regularly and refraining from smoking — can reduce the risk of Alzheimer’s by 60 percent. A separate study showed that lifestyle choices can lower risk even for those who are genetically prelifestyle disposed to the disease.

The first report, compiled by the Rush University Medical Center in Chicago, tracked 2,765 individuals over about a decade. All participants were older adults enrolled in either the Chicago Health and Aging Project (CHAP) or the Rush Memory and Aging Project (MAP), both federally funded, long-term observational studies that examine mental decline among aging Chicago residents.

Over the past decade, studies have increasingly pointed to controllable lifestyle factors as critical components to reducing the risk of cognitive decline. Researchers say that, as with heart disease, combating dementia will probably require a “cocktail” approach combining drugs and lifestyle changes. And as recent efforts to develop a cure or more effective drug treatments for dementia have proved disappointing, the fact that people can exert some control in preventing the disease through their own choices is encouraging news, they say.

While the new study’s authors expected to see that leading a healthier life decreases the chance of dementia, they were floored by the “magnitude of the effect,” said Klodian Dhana, a Rush University professor and co-author.

“This demonstrates the potential of lifestyle behaviors to reduce risk as we age,” said Heather Snyder, senior director of medical and scientific operations at the Alzheimer’s Association. “The fact that four or five lifestyle habits put together can have that kind of benefit for your brain is in­cred­ibly powerful.”

[Healthier living could reduce worldwide dementia by a third, report says]

The Rush team assessed study participants’ lifestyles on five metrics: their diet, their exercise regimen, whether they smoked, their alcohol consumption and their “engagement in cognitive stimulation activities,” Dhana said. The researchers then scored each factor, assigning participants a ‘1’ if their behavior was healthy in that category and a ‘0’ if it was unhealthy.

Individuals who ate a “high-quality diet” of mostly vegetables, nuts, berries, beans, whole grains, seafood, poultry and olive oil — while avoiding red meats, butter, cheese, pastries, sweets and fried food — earned 1s. This was also true for anyone who exercised at least 150 minutes a week, whether by biking, walking, swimming, gardening or doing yard work.

People who did not smoke, limited themselves to one glass of wine a day, and regularly — two or three times a week — engaged in mentally stimulating activities such as reading the newspaper, visiting the library or playing games such as chess and checkers also earned 1s.

After crunching the numbers, Dhana and his colleagues found that individuals with a score of 4 or 5 — meaning they pursued four or five healthy behaviors over the period studied — were 60 percent less likely to develop Alzheimer’s compared with participants who scored 0 or 1. The results did not vary by race or gender, Dhana said.Researchers designed a fitness test to predict longevity. Could you pass it?The sitting-rising test might measure some important factors for longevity — but it’s not easy for everyone. (Video: Allie Caren/Photo: Kolin Pope/The Washington Post)

The average age of participants in the CHAP cohort was 73 and in the MAP cohort, 81. The population studied included both men and women and blacks and non-Hispanic whites.

Around 50 million people have dementia worldwide, and that number is expected to triple by 2050, according to the 2018 World Alzheimer Report. The global cost of dementia in 2018 was roughly $1 trillion, a figure projected to double by 2030.ADVERTISING

[Why it’s important to say something if a relative exhibits signs of Alzheimer’s]

If you cannot adopt all four or five healthy lifestyle habits studied, aim for one or two — whatever you can do, Dhana said. Anything will help: The Rush team found that making just one more healthy choice, no matter how many participants had already made, decreased their chance of Alzheimer’s by an additional 27 percent.

And, if you’re trying to decide which habits to adopt, Dhana has his favorites.

“My biggest takeaway is I encourage older people to consume more leafy green vegetables, replace red meat with poultry, and avoid as much as possible fried food,” he said. “Also, walk to the grocery store and read books!”

Another study, also presented Sunday and published online in the Journal of the American Medical Association, found that lifestyle choices may even counteract genetic predisposition for Alzheimer’s. That research, led by a team at the University of Exeter Medical School in England, showed that people with a high genetic risk of Alzheimer’s were less likely to develop the disease if they pursued a healthy lifestyle.

Synder said she expects to see more studies examinining the role of lifestyle choices going forward.

“I think we will see people honing in on, ‘What are the specific aspects of these behaviors that are already identified?’ ” she said. “But I also think we’ll see people asking, ‘What are other behaviors?’ ”

Snyder said she would not be surprised if the number of recommended lifestyle choices eventually rose as high as 10 or 12.


Why Should You Work with a Health Coach?

Living a healthy life can be challenging at times. A state of optimal health and well-being means more than just the absence of disease.  To pursue good health we need to make individual lifestyle choices that support our physical, mental, spiritual and emotional well-being. Lifestyle habits in the area of diet, physical activity, sleep and stress management can greatly impact the quality of our life and ultimately impact our long-term health.

A Need for Change

Over 75% of chronic disease is preventable. We know that most chronic disease can be prevented by eating well, being physically active, and avoiding tobacco and excessive alcohol consumption.  According to the World Health Organization chronic diseases including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide.

Most of us want the benefits of being healthy. We want to avoid disease and have energy and stamina to thrive in our lives. Many people know that getting proper exercise, eating well and managing stress are healthy behaviors but do not practice these things. Many people have tried to improve their fitness levels, manage their weight, improve their sleep or reduce the negative effects of stress… only to find that behavior change is hard. Whether you have failed to make your health a priority, have found it difficult to implement long-term change, or you are not sure where to begin, a health coach may be able to help you on your journey to well-being.     

A health coach is a supportive mentor and wellness authority that can help you create personalized, lasting mental and physical changes. Your doctor may have advised you on healthy changes you need to make. A health coach can act as your partner to support you and help you in developing the skills needed to embrace new behaviors.

Doctors and Coaches Working Together

In her internal medicine practice, Dr. Geni Abraham recognized that patients weren’t feeling better just because she gave them medications and treatment protocols. So, she explored what else she could do. In that process her office transformed into a wellness focused office and she added a health coach. As her health coach, I help patients develop healthy nutritional habits with a “food is medicine” focus, encourage exercise that they enjoy, and work on stress management and sleep hygiene.  It turns out that these measures are going to promote health and wellness and prevent disease.  This integrated approach helps patients feel healthier, more energetic and they are able to meet the challenges of today’s stressful society.  It is also what is going to reduce our overall healthcare costs in the future.

We offer lifestyle and stress management programs to our patients and members of our community.  I spend a lot of time with each person, often regularly scheduled 30 or 60-minute appointments to help them stay motivated and accountable as they make positive changes to reach their health goals.

How will a health coach help you to make lasting lifestyle changes, from weight management to overall wellness?

  • Goal Setting: Your coach will challenge you to focus on your ultimate outcome. What is your long-term wellness vision? Perhaps you want to change your diet and lifestyle to have more energy and vitality, and to make sure you can be around for your children or grandchildren. This long-term vision will help you to break through the obstacles you may face when embarking on behavioral changes such as a new way of eating or exercising. With an understanding of your personal interests and your readiness to change your coach will help you to establish SMART goals which are: specific, measurable, actionable, realistic and timely.  You will establish both short and long-term goals that you will continually revisit as you transform them into reality.
  • Maintaining a Positive Focus: You can retrain the way you think and establish positive self-talk. A health coach can help you shift to a more accurate and positive way of thinking. The focus will be on your strengths rather than your weaknesses to make behavior changes. Do you feel that you’re not motivated enough? Do you feel you lack time or discipline? Does the weather, an injury or financial constraints hold you back? A health coach can help you break down and overcome these barriers so that you can get back on the path to better overall health.
  • Implementing Small Changes: Have you found that making drastic changes all at once were unsustainable and didn’t last in the long-term? Have you discovered a lot of contradictory advice in the overwhelming amount of information on the internet and in the media? A health coach can help you implement small changes at a pace that is comfortable for you so that you can meet all of your health goals.
  • Creating New Habits: To find success in realizing your health goals it is important to develop healthy habits and stick with them. These new habits will turn into automatic behaviors. Start by committing to something easy and practice this new habit regularly.  It is not hard to form a new habit when you relate it to an important goal. Your health coach can support you in forming new healthy habits and reversing unhealthy ones.

Working with a personal health coach could change your life. Take the next step on your health journey and let a health coach provide you with the guidance, expertise and support you need on your path to achieve optimal wellness.

-Diane Duvall, CLC, CHHC, CPT     Diane Duvall is a Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.   We offer health coaching sessions to help you reach your personal goals.

Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462.  Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook           

Taking Care of Your Heart

February is American Heart Month. This is a great time to focus on steps we can take to keep our heart healthy and prevent heart disease. Heart disease is the leading cause of death in the United States, but a heart-healthy lifestyle can go a long way to prevent heart disease. Medical conditions such as high blood pressure, high cholesterol and diabetes can increase your risk of heart disease. Make sure you are working with your doctor and incorporating healthy lifestyle practices to treat these conditions.  Our day to day lifestyle choices directly impact our heart’s health. Research shows that making healthy lifestyle changes, even later in life, may stop and actually reverse heart damage.

A healthy diet is one of the best weapons you have to fight heart disease.  The food you eat (and the amount) can affect other risk factors such as cholesterol, blood pressure, diabetes and being overweight. Choose nutrient-rich foods instead of nutrient-poor foods. The Mediterranean diet is a heart-healthy eating plan that is high in fresh fruits and vegetables (variety of color), lean protein, healthy oils (Extra virgin olive oil), whole grains, beans, nuts and seeds.  Research has shown that the traditional Mediterranean diet reduces the risk of heart disease.

This healthy diet includes:

  • Eating fish and poultry at least twice per week and limiting red meat to no more than a few times per month.
  • Using herbs and spices instead of salt to flavor foods.
  • Avoiding hydrogenated oils (trans fats) which are found in fried foods and processed foods such as pies, cookies, pastries, donuts and frozen food.
  • Limiting refined sugars and carbohydrates such as white bread and white rice.
  • Sticking with water as your beverage of choice is best, as there is no benefit to adding sugary drinks.
  • Focusing on whole, natural foods and eating lots of vegetables.
  • For dessert, eating fresh fruit and saving sweets for a special treat or celebration.
  • Taking time to savor your food and enjoy your meals with family and friends.  

Regular exercise is one of the most effective tools to strengthen the heart muscle and reduce the risk of heart disease. Your heart will get stronger and healthier if you lead an active life. Regular exercise has many benefits including: burning calories, lowering blood pressure, reducing “bad” cholesterol and boosting “good” cholesterol. Aim to do aerobic exercise (“cardio”) for thirty minutes, five to six times per week.  Some examples include walking, jogging, biking, swimming or dancing. To check your intensity and make sure you are not pushing too hard, you should be able to talk but you shouldn’t be able to sing a full song. Find activities that you enjoy and start small. You can even break up your exercise sessions into 10-minute intervals. In addition, you should include strength training twice per week to build muscle and reduce body fat. To maintain flexibility, be sure to include stretching exercises (such as yoga) weekly as well. For ongoing encouragement, use an app on your phone or a wrist band that provides input on how many daily steps you have taken. Talk with your doctor before making any changes to your current exercise routine.

Focus on rest and relaxation. The effects of stress can have a direct impact on your body and can harm your heart. It’s important to have healthy habits in place to help in preventing and managing stress. When we feel stressed, we often reach for unhealthy habits to find relief, such as drinking alcohol, smoking cigarettes or overeating. These unhealthy habits lead to other factors that may contribute to damaging your heart by increasing blood pressure, cholesterol, triglycerides and blood sugar.  Find hobbies and activities you enjoy, stay social and engage with friends and family. Stay positive and ponder uplifting thoughts about the future, as optimism is good for your heart. Dedicate a certain time each day to focus on your body and relaxing. Practice stress reduction techniques and exercises such as deep breathing, meditation, yoga and tai chi. Getting a good night’s sleep is important for a healthy heart. Aim for seven to nine hours of quality sleep per night. Create a nightly routine to unwind and relax before bed and stick with the same sleep schedule, even on the weekends.

Working with your doctor is essential to managing your health effectively. Staying proactive with your lifestyle choices will have a positive impact on your heart and overall health.

-Diane Duvall, CLC, CHHC, CPT

Diane Duvall is a Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine to prevent chronic disease and promote health and wellness. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462.  Phone: (561) 432-8935 Visit DrGeniAbraham.com and Follow us on Facebook

5 Tools to Transform Your Life Through Goal Setting

How do you achieve the life of your dreams? The first step is to create a vision that will guide you on your path to what you desire. Without a clear vision we can lose our focus and allow circumstances to distract us from our course. It is very important to create goals and design action plans to achieve those goals. If goals are done properly and specifically they can transform your life. It is important to lay out goals for every area of your life: personal, emotional, spiritual, physical/health, financial.
If your goal is to lose 40 pounds, for example, you would include action plans such as going to the gym three days per week. What is the vision that will inspire you to continue the action steps necessary to achieve this goal? Perhaps it is seeing yourself feeling vibrant in a body you love and being proud of your accomplishments. You now see yourself feeling emotionally powerful, having better relationships, filled with more energy and exuding confidence.
Setting goals is a fundamental key to all lifelong success plans. Use these five tools to help you reach your goals.

Design Your Goal
Determine a crystal-clear goal and focus on the result that you really want. Without goals our energy is scattered, and we will be less effective. You must write down your goals. Just the action of writing something down sets the wheels in motion. It makes ideas more concrete and will hold you accountable for working toward your goals. Use positive language and make sure your goals align with your vision. We often get caught up in what we think we should be doing instead of going after what we are truly passionate about. It is helpful to set goals that are SMART. Specific: Set a desired outcome as explicitly as possible. Measurable: identify the ways in which you will track your progress. Action-oriented: outline the specific steps that will enable you to complete the goal. Realistic: Create a goal that you are willing and able to accomplish. Timely: Set a deadline or time for achieving your goal to help keep you motivated.

Create Goals from a Place of Gratitude
Our state of mind is very important in setting and achieving goals. When we come from a place of scarcity, lack or disappointment we will hinder our progress toward our desired goal. We need to line up with the feelings of abundance and gratitude to be in alignment with those things we truly desire. Take a few deep breaths and spend at least ten minutes writing down or thoughtfully pondering those things for which you are most grateful. Focus on those things that bring you joy until you fill up with that feeling of appreciation and gratitude. This is the energy that will break through any resistance to the creation and achievement of our goals.

Focus on What You Desire
Whatever we focus on consistently we will experience in our life. Your brain is a supercomputer and your self-talk runs the program. If you tell yourself that you can never lose weight, you may be self-sabotaging your weight loss efforts without even realizing it. Don’t limit your future based on past experiences. Focus instead on how you love being active, energetic and fit, and your brain will supply the means to get you there. Think of the kind of person you want to be in the future. For example, if you are trying to quit smoking, don’t just focus on the will power required to resist cigarettes. Focus on becoming a non-smoker and the freedom that comes with that. How your immune system will be stronger, your skin will look healthier, and your breathing and exercising will become easier. Think in terms of end results with a clear vision of what you desire. Maintain a laser focus on your goals. Wake up and go to sleep focusing on your goals. Get in that state of certainty – how will you feel when you achieve your goal?

Celebrate Small Wins
Big goals are great, and they inspire us to keep going and keep growing. But our big goals are not going to happen overnight. A goal may be too big to swallow in one bite and will need to be broken down into yearly goals, monthly goals, weekly goals and daily goals to get us there. We need to focus on the small and significant steps we take along the path to the big goal. By celebrating the small wins, we will stay motivated and have the strength to stay on our path. New Year’s Resolutions often fail because we are trying to accomplish everything all at once. Whether we have an intention to quit something such as smoking or drinking or to start something such as an exercise plan, we need to pick a date of completion and slowly build to the outcome we desire.

Visualize Your Goals as Achieved
Visualization is a powerful tool to help you reach your goals. It is the process of creating what you want through crystal clear pictures in your mind. Start to imagine what you will feel like, what your world will look like once you’ve achieved your goal. Creating a vision board can be a powerful, fun activity. Make a collage filled with pictures of your future goals. By surrounding yourself with images of the goal that you want to achieve, you make sure that you’re always keeping your goal in mind. This means that your brain will be working on how to achieve your goal on a subconscious level around the clock, and you will be inspired with ideas on how to move toward your goal.
The ultimate reward of goal setting is not necessarily the attainment of the desired outcome but who we become on our path toward our desired achievements.


Diane Duvall, CLC, CHHC, CPT
Diane Duvall is a Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine. Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine to prevent chronic disease and promote health and wellness.
Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462. Phone: (561) 432-8935 Visit DrGeniAbraham.com and Follow us on Facebook

Five Daily Habits for a Healthy Heart

Take care of your heart.  Your heart affects every part of your body.  Your heart does the most physical work of any muscle during your lifetime.  It beats about 100,000 times a day, and with this faithful steady beat you have the gift of life. You control your heart health through your diet, lifestyle, and managing your stress.  Your emotional and physical well-being are both important for maintaining a healthy heart.

Start today to develop some daily heart-healthy habits to protect this vital organ.  Habits are the small decisions you make and actions you take each day. What we repeatedly do and focus on forms the person that we are.  The sum of your daily habits ultimately forms the current status of your emotional and physical health.

Find 30 minutes a day to exercise. The American Heart Association recommends 30 minutes of moderate exercise at least five days per week.  For people who would benefit from lowering their blood pressure or cholesterol, they recommend 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week.

You can break this out into 15 minute intervals twice per day. On days you can’t make the 30-minute time goal start with at least ten or fifteen minutes. Don’t let the “all or nothing” goal stop you from making health gains today. Just start walking. Every step you take you are on your way to better health. You can build up to a 30-minute brisk power walk. Find a sport, fitness class or activity that you enjoy. Consider activities such as swimming, bicycling, tennis or dancing. When you get your body moving and your blood pumping your heart will benefit. And don’t forget to include strength training twice per week. Lifting weights and using whole body movements will raise your heart rate, strengthen your muscles and help manage stress.

Enjoy colorful, wholesome foods. Choose nutrient-rich foods every day that will benefit your heart and your health. Eat a variety of colorful fresh fruits and vegetables at each meal and snack.   Choose fiber-rich whole grains, beans, nuts and seeds. Include lean protein and healthy oils such as olive oil and flaxseed oil. Don’t forget to include fish at least once a week and fresh herbs and spices daily.  Focus on what you should eat. Instead of focusing on what you can’t have, focus on all the healthy choices and you will be too full to eat junk food.

Make sure to get seven to eight hours of sleep.  The better night’s sleep you get the healthier your heart will be. Several recent studies show links between shortened sleep duration, defined as less than six hours of sleep, and increased risk of heart disease.  The key to making sure you have time for quality sleep is to schedule it. Keep a consistent schedule for the time that you sleep and awake each day. Make this a habit and it will become part of your daily routine. Support this schedule by creating a bedtime routine that helps you relax with hot baths, journaling, soothing music or good books.

Practice deep breathing at least 15 minutes.  Deep breathing is one of the best ways to lower stress in the body. Increased heart rate, fast breathing and high blood pressure, which all happen when you are stressed; all decrease as you breathe deeply to relax.  Your brain receives the message to calm down and relax and sends this message to your body.  Breathe long, slow and deep in a mindful-state as often as possible.  As a powerful daily practice, deep breathing will advance your health and well-being.

Cultivate gratitude and acknowledge the good things in life. Some research suggests that by cultivating gratitude we cultivate well-being.  The simple act of writing down what you are grateful for can increase well-being and gratitude.  Taking time to meditate with appreciation and praying more often has been found to help people be more grateful.  Simply ask yourself each day, “What am I grateful for?”  This question will open up a wider outlook on life and can bring awareness and appreciation to the positive aspects within you and around you. A grateful heart is a healthier heart.

If you desire better or lasting health, it all starts with better habits. When you learn to transform your habits you can transform your life.

Why is Magnesium so Important?

Magnesium is important in your daily diet because your body requires it for so many different functions. We can quickly become deficient in this important mineral if we are not consuming enough high magnesium foods. Magnesium plays a role in over 300 enzymatic reactions within the body, including the metabolism of food. Magnesium is also required in fat synthesis, protein synthesis, and the transmission of nerve impulses. Magnesium is necessary for muscle relaxation and energy production.  In the adult body, bones contain approximately 60% of all magnesium, and most of the remainder is contained in muscles and soft tissues.

At least half of the US population is not getting enough magnesium in their daily diet and inadequate magnesium intake is associated with increased diabetes risk.  The typical American diet is low in vegetables and whole grains, resulting in reduced magnesium intake.  The Recommended Daily Allowance (RDA) for magnesium is 310-320 mg/day for adult women and 400-420 mg/day for adult men.  Recent research (The Nurses’ Health Study (NHS), NHS2 and Health Professionals’ Follow-Up Study), reveals that higher magnesium intake is associated with lower risk of type 2 diabetes, particularly in diets with poor carbohydrate quality.

A deficiency of magnesium may be involved in many conditions, including:


Cardiovascular disease

Type 2 Diabetes



High blood pressure


Insulin Resistance



Premenstrual syndrome


Magnesium can help you with:

Relieving constipation

Calming nerves and anxiety

Relaxing muscles

Easing insomnia

Improving insulin sensitivity

Bone health

Increasing energy

Relieving migraine headaches

Where will you find Magnesium? Green leafy vegetables, unrefined whole grains, and nuts and seeds are richest in magnesium.  Meats, yogurt and milk also contain a moderate amount. Refined foods, like carbohydrates, are poor sources of magnesium.  There are various websites including The U.S. Department of Agriculture’s, which list the nutrient content of many foods and provide comprehensive lists of foods containing magnesium arranged by nutrient content and by food name.

Should you supplement with Magnesium?  Magnesium supplements are available, but it is best to obtain any vitamin or mineral through food, because nutrients work better when synergistically combined with other nutrients. Check with your doctor before taking any supplements.