Diabetes and Depression: Managing Both for Better Senior Health

It is a sad commentary on our current cultural worldview that sunlight is widely perceived to be harmful, a cancer-causing threat. But what does the research actually say? And does this research affect older adults differently than other people?Spectrum: For starters, we should understand that sunlight is a complex combination of photons, with different wavelengths and properties. The sun is the original full-spectrum illumination, while both incandescent and LED lights emit, as one might expect, mostly visible-spectrum light.Intensity: The other important variable is the intensity of light, measured in LUX units (a foot away from one candle): direct sun comes in at 100,000; a cloudy day at 1,000; a kitchen or office measures 500; and a living room only 50. Thats why you need to get outside.UV: At one extreme is ultraviolet light (UV), whose wavelength is slightly shorter than visible violet. With regard to our health, UV is a mixed bag.It does cause sunburns, damages DNA, and triggers the aging of skin. It is also statistically associated with malignant melanoma, although, curiously, not with increased deaths from melanoma (because these cancers are mostly treatable).On the other hand, there are numerous health benefits: UV lowers the risk of hypertension, diabetes, atherosclerosis (hardening of the arteries), blood inflammation, and COVID infections. UV also stimulates Vitamin D synthesis in the skin. A large-scale study of 500,000 Brits, with a 12-year follow-up, found that frequent UV exposure lowered all-cause mortality by 14%, with cardiovascular deaths down 21% and total cancer mortality decreased by 13%. It gives one pause to reconsider the vast sums spent on sunscreen lotions. Just wearing light summer clothing blocks 80% of UV.IR: UV radiation represents only about 3% of the sunlight that strikes the surface of the earth, while about 50% is infrared (IR), whose lightwaves are just beyond (longer) than visible reds. IR radiation is more predominant at the beginning and end of days, while UV is strongest when the sun is overhead. A thick cloud cover reduces IR significantly more than UV. In a recent superb Huberman Lab podcast, Dr. Roger Seheult touted the many benefits of IR radiation. Most severe and chronic diseases also involve mitochondrial dysfunction (mitochondria are the small organelles within a cell that produce the energy-generating chemical ATP). One aspect of aging is that we lose 70% of our mitochondrial functioning after age 40. Unlike UV, IR radiation passes through light clothing and the surface of the skin to penetrate deep into body tissues, where it significantly stimulates mitochondrial ATP synthesis.Effects: The effects of improved mitochondrial functioning are pervasive, correlated empirically with sun exposure. Dr. Seheult cited statistics demonstrating that the greatest number of all-cause mortality comes soon after the shortest day of the year, and the lowest number of deaths occurs close to the longest days.People who live far north or south of the equator where days are particularly short in winter have higher overall mortality rates, particularly in mid-winter. In a study of almost 30,000 Swedish women, avoidance of sun exposure carried the same risk of premature death, as did smoking.There is well-replicated rigorous research that moderate IR exposure lowers the risk of cancer, heart disease, diabetes, hypertension, and it reduces blood lipids and chronic inflammation. IR increases immune system response to infections, such as influenza, COVID and pre-cancerous cells.On a sunny day, just 15 minutes outside can make a big difference. If youre in a green space with lots of grasses, leaves, bushes, and trees, you can receive two to three times the IR dose because plants reflect much of the IR that strikes them (notice that most leaves dont get hot in the sun because of these reflective properties).Red Light Therapy: There are many red-light therapy devices now available if you are considering them, be sure to carefully research IR wavelengths, dosage, safety, and therapeutic benefit. One study, utilizing an IR desk unit shining only on face, neck, and hands, proved to be quite therapeutic.Forest Bathing? Dr. Seheult delighted in reminding us of the wisdom of the ancient beliefs that sunlight and fresh air promote convalescence. Forest bathing has become a thing the air around trees is infused with phytoncides that defend plants from bacteria, fungi, and insects. When inhaled by humans, they up- regulate immune functioning and lower stress levels, and reduce stress hormones. The beauty and serenity of such an environment further enhances these benefits, some of which are detectable by lab tests a month later. Furthermore, getting up with the sun (and out from behind the filtering effects of plate glass windows) helps to set your circadian rhythm, which can improve sleep patterns. Take home message: forests, parks and even golf courses soothe the soul, and the body. And early morning and late afternoon may be particularly beneficial.Sweat Benefits: Dr. Seheult is a pulmonologist who treats many respiratory infections he also reminded us about how previous generations treated patients with hot baths and hot packs, as if to sweat out infections. Its been recently discovered that body temperatures a little over 100 degrees Fahrenheit actually accelerate the production of interferon, a powerful anti-viral protein. Maybe weve been a little too quick to reduce our fevers with aspirin, Tylenol, and Advil. And maybe the saunas so favored by Scandinavians and Russians are more therapeutic than weve realized.Conclusion: As spring has sprung, we encourage everyone to get away from your screens, go outside and enjoy the benefits of the sunshine that so amply surrounds us. Residents at Kavod Senior Life have a myriad of ways to get outside, whether it be on the sunlit patio areas, in the resident gardens, on the nearby walking paths in Cherry Creek or on the many benches and sitting areas surrounding the campus. Come for a visit and see for yourself!Ben and Scott  https://theagingwiselyproject.com/

By Faith Protsman, MD, Regional Medical Director, VITAS HealthcareVietnam War veterans face unique obstacles throughout the twilight of advanced illness. For hospice care providers to tailor care to meet the needs of veterans who have served in this theater of war, they must consider the tribulations these patients face as they reach the end of their lives.The Vietnam War era was a very tumultuous time to be a soldier. The United States' prolonged involvement in a war of questionable motivation left society with disdain toward the government and its institutions, especially the military.Coupled with horrific images shown on television, constant controversy was a new reality and negative public opinion formed around this conflict, of which those serving the nation were not spared.Careful consideration is necessary when treating patients facing these traumas.Tours of duty proved to be traumatizing in many ways. Young soldiers, some having just turned 18, were drafted into a war that many of them did not believe in. They were not fighting for love of country and God; rather, they were fighting for survival and out of fear for their lives.Intimate battles in the dense jungle led many to be subjected to the horrors that come with fighting in a foreign land that was only familiar to the elusive guerilla enemy soldiers.Servicemembers did not receive a warm welcome when returning home from Vietnam, often being judged and labeled as cruel and even inhumane.Moral Injury Can Impair Mental HealthThis perfect storm of trauma led to lasting moral injury that plagues many veterans for their entire lives. Veterans returning from the war were marginalized and pushed into isolation, often turning to alcohol and substance abuse, which worsened their anxiety and exacerbated their strife.Questions like Ive never spoken about the war, can I now? Was the war moral or immoral? and Was I a good soldier? come bubbling to the surface later in life as their illnesses intensify and their defenses weaken.Careful consideration is necessary when treating patients facing these traumas.The restlessness that can result from post-traumatic stress disorder (PTSD) is often treated with benzodiazepines. In most cases, these medications can bring relief through calming the patient.Yet, there is a common trend amongst veterans who cope with trauma that results in the opposite effect.Benzodiazepines can lower the walls that Vietnam veterans have built up throughout a lifetime of suppressing trauma and negative memories. This class of medications can exacerbate the symptoms of PTSD as traumatic experiences and feelings of regret resurface. Benzodiazepine-induced inhibition of neurotransmission can even lead to agitated toxic psychosis, increased anxiety, hostility, and rage.1The Value of Compassion Along with Clinical CareRemaining considerate does not end with simply staying mindful during the planning of clinical solutions. Providing care for Vietnam veterans requires a high level of empathy.A key to an empathetic approach is taking the time to listen nonjudgmentally. Though seemingly simple, practicing nonjudgmental, open communication with patients facing trauma from war can help avoid the all-too typical responses of Its okay and You did what you had to do.These patients do not need sympathy, because they have been judged enough throughout their lives. When care teams approach them without judgment, they honor the sacrifices these heroes have made.VITAS hospice care provides compassionate care approaches that are tailored to meet the distinctive needs of Vietnam veterans. With the Veterans Administration (VA) offering hospice care as part of its medical package, VITAS team members can provide empathetic psychosocial support, while utilizing clinical solutions that help manage symptoms.The qualifications for veterans to receive hospice benefits include: A life-limiting illness Treatment goals that focus on comfort, rather than curative treatments A life expectancy of 6 months or less, if their illness runs its normal course Veterans also benefit from the option to receive concurrent care through the VA. The VA can provide curative treatments as the patient simultaneously receives symptom-managing comfort care administered by the hospice care provider of their choosing.Offering solace, while remaining compassionate when patients need it most, is too often overlooked in the busy practice of healthcare. Acknowledging the adversity that Vietnam War veterans have had to face throughout their lifetimes and adapting care approaches to meet their needs is the best way for healthcare providers to give back to those who have sacrificed so much for the preservation of freedom.1Paton, C. (2018, January 2). Benzodiazepines and disinhibition: A review: Psychiatric bulletin. Cambridge Core. Retrieved November 2, 2022, from https://www.cambridge.org/core/journals/psychiatric-bulletin/article/benzodiazepines-and-disinhibition-a-review/421AF197362B55EDF004700452BF3BC6

Diabetes is a chronic condition that affects millions of people worldwide, causing high levels of glucose (sugar) in the blood. Over time, this can lead to serious health complications, including heart disease, nerve damage, and kidney problems. While managing diabetes often requires medication, there are also natural ways to lower your blood sugar levels and improve your overall health. In this article, well explore the top strategies for regaining control over your blood sugar naturally. From dietary adjustments to lifestyle changes, well provide you with the knowledge and tools you need to take charge of your blood sugar and live a healthier, more vibrant life!Understanding the Importance of Blood Sugar ControlMaintaining healthy blood sugar levels is crucial for everyone, but especially those with diabetes or prediabetes. High blood sugar, also known as hyperglycemia, can cause a range of adverse effects on the body, including: Increased risk of heart disease and stroke Damage to blood vessels, leading to vision problems, nerve damage, and kidney issues Slower wound healing and increased susceptibility to infections Fatigue, increased thirst, and frequent urination By taking proactive steps to lower your blood sugar, you can significantly reduce the risk of these debilitating complications and improve your overall quality of life.Dietary Strategies for Blood Sugar ManagementOne of the most effective ways to control blood sugar is through the foods you consume. Here are some dietary strategies that can help:Focus on Fiber-Rich FoodsFiber is a crucial component in regulating blood sugar levels. Foods high in fiber, such as whole grains, vegetables, fruits, and legumes, slow the absorption of carbohydrates, preventing rapid spikes in blood sugar. Aim to incorporate a variety of fiber-rich foods into your meals and snacks.Prioritize Lean ProteinsProtein-rich foods like lean meats, poultry, fish, eggs, and tofu can help slow the digestion of carbohydrates, leading to a more gradual release of glucose into the bloodstream. Combining protein with carbohydrates at each meal can help maintain stable blood sugar levels.Choose Healthy FatsHealthy fats, such as those found in avocados, nuts, seeds, and olive oil, can also play a role in blood sugar management. These fats can help slow the absorption of carbohydrates and provide a sense of fullness, reducing the likelihood of overeating.Limit Added Sugars and Refined CarbohydratesFoods high in added sugars and refined carbohydrates, like white bread, pastries, and sweetened beverages, can cause rapid spikes in blood sugar. Limit your intake of these items and opt for complex carbohydrates, which are digested more slowly.Incorporate Chromium and Magnesium-Rich FoodsCertain minerals, such as chromium and magnesium, have been shown to help regulate blood sugar levels. Foods rich in these nutrients include leafy greens, nuts, seeds, and whole grains.Lifestyle Modifications for Blood Sugar ControlIn addition to dietary changes, adopting a healthy lifestyle can also contribute to better blood sugar management. Here are some key lifestyle modifications to consider:Regular ExerciseRegular physical activity can improve insulin sensitivity and help your body better utilize glucose. Aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, swimming, or cycling, most days of the week.Stress ManagementChronic stress can disrupt the bodys ability to regulate blood sugar levels. Practice stress-reducing techniques, such as meditation, yoga, or deep breathing exercises, to help keep your blood sugar in check.Adequate SleepLack of sleep can negatively impact blood sugar control. Aim for 7-9 hours of quality sleep each night to support your bodys natural blood sugar regulation.Maintaining a Healthy WeightExcess weight can contribute to insulin resistance and higher blood sugar levels. Achieving and maintaining a healthy weight through a balanced diet and regular exercise can have a significant impact on blood sugar management.Monitoring and Tracking Your ProgressEffective blood sugar control requires ongoing monitoring and tracking. Here are some strategies to help you stay on top of your progress:Regular Blood Glucose MonitoringUse a home blood glucose meter to check your levels regularly, especially before and after meals. This will help you identify patterns and trends in your blood sugar levels, allowing you to make informed dietary and lifestyle adjustments.Keeping a Food and Activity JournalDocumenting your food intake, physical activity, and blood sugar readings can provide valuable insights into how your body responds to different factors. This information can help you fine-tune your approach and identify any potential triggers for blood sugar spikes.Collaborating with Your Healthcare TeamWork closely with your healthcare provider, such as a registered dietitian or certified diabetes educator, to develop a personalized plan for managing your blood sugar. They can provide guidance, support, and recommendations based on your individual needs and health status. Regaining control over your blood sugar naturally is a journey, but its one that can have a profound impact on your overall health and well-being. By incorporating the strategies outlined in this guide, you can take proactive steps to manage your diabetes, reduce your risk of complications, and improve your quality of life. Remember, every small change you make can contribute to significant improvements in your blood sugar levels and overall health. Embrace the process, celebrate your successes, and dont hesitate to seek support from your healthcare team and loved ones along the way! Disclaimer: This article is for informational purposes only and does not provide medical advice. While we at Chefs for Seniors specialize in providing healthy, customizable meals, we are not medical professionals. Always consult with your healthcare provider for medical advice, diagnoses, and treatment plans to fit your specific needs.