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Exercises, Aging and Your Brain

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Exercises, Aging and Your Brain

It was long believed that the brain you got was the one that you had to live with. Once you reached adulthood and full brain development had occurred it was assumed there would be no further neuron development. If you unfortunately lost some aspect of your brain due to aging, stroke, disease etc. it was believed you were left with a limited capacity that at best would hopefully lead to no further deterioration. What we now know is the brain is capable of having neuroplasticity, meaning that it is has the ability to generate new neurons. Gratefully it turns out aerobic exercise is one way this can be achieved! This occurs because aerobic exercise increases the production of a protein called BDNF (brain-derived neurotrophic factor), which increases the size and connectivity in the hippocampus. This occurs when stem cells, which are essentially a blank slate, are developed in to new nascent neurons, which in turn create new brain cells.

There are many ways to increase neuroplasticity but one thing we now know is that exercise has a significant impact on the development of new neurons particularly in the part of the brain called the hippocampus and the neo-cortex. This is important because these are the regions of the brain that degenerate as aging occurs. Further research has revealed that the most effective way to achieve this is to add some form of cognitive challenge during exercising. This includes things such as having to process spatial awareness, making choices and processing stimulus input while exercising. Adding this cognitive component has the greatest impact on neuron development. So what this means in real time is that getting on the bike at the gym and turning on the TV where your only cognitive input is staring idly at the TV is not nearly as beneficial as riding a bike outside, dealing with spatial awareness, traffic, pedestrians and while still needing to be cognizant of the direction you are travelling. The increase utilization of cognitive function while doing any aerobic exercise is the most efficient and effective way to increase BDNF.

While exercise has many effects on all parts of our body if you are approaching middle age you may want to seriously consider the way that you exercise to help prevent atrophy of the hippocampus and the neo-cortex. By simply adding a cognitive component to any aerobic exercise you are already doing you will increase the development of new neural cells. Any advantage that we can utilize to increase brain cell development will help diminish the effects of dementia and Alzheimer’s.

There have been many studies done to assess how much exercise is necessary to receive the neurogenic benefits and cellular development. The U.S. Department of Health and Human Services recommends that you should engage in aerobic exercise of moderate intensity for at least 150 minutes per week or 75 minutes a week for intense exercise or an equivalent combination of the two. More clinical trials are still being done to find the best way to target, physiological pathways to link the brain and the body to exploit our brain’s ability of exercised induces plasticity as we age but for now simply adding a cognitive component to your exercises will help tremendously.

A new year is upon us and is the case for many an opportunity to create new habits to increase our health and the joy we create in out life. As we begin this New Year consider not only exercising but also exercising in a way that helps protect the aging brain. I wish you and your family excellent health and many blessings as we begin this new decade.

With Gratitude,
Pat

Are You In The Blue Zone?

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Are You in The Blue Zone?

Before you even think of going there this is not an article on political discourse and has nothing to do with politics. Through out the world there are specific regions where the majority of the population experience exceedingly long healthy lives and many live to be well over a hundred. These regions are called the “Blue Zones” and extensive studies have been done in an effort to understand what the common denominators are that lend themselves to such a healthy long positive life. Some of the reasons will make perfect sense but some of the most important may surprise you.

The five blue zones where researchers have discovered where people live the longest are: 1.Sardinia, Italy, 2. Ikaria, Greece, 3. Okinawa, Japan, 4. Nicoya, Costa Rica and lastly right here in the U.S. in Loma Linda, California (primary home to the seventh-day Adventist). Researchers have determined that there are seven essential considerations that create these environments. These first five won’t surprise you. They include:

  1. Utilize whole foods especially plants in your diet- consistently most of the diets in these regions favored the Mediterranean type
  2. Avoid Processed foods: a no brainer. Processed foods are filled with chemicals that, accelerates aging and are toxic to your tissues and chemical balance.
  3. Create a healthy living environment. This includes things such as buying the right foods, planning ahead, eating, living and working in a peaceful environment and developing a good sleep pattern.
  4. Maintain a good body weight for your height and size, which, they found, was directly correlated to the amount of sleep you get. A good eight plus hours was necessary to maintain good hormonal balance. There is a saying that “hormones are stronger than diet”. It doesn’t matter how little you eat or how much you exercise, if your hormones are out of balance it is very difficult to maintain a healthy body weight so make sleep a priority. Create a comfortable dark inviting, peaceful space that is free of TV’s and screens.
  5. Exercise: They found that most of the centenarians exercises frequently but not in a gym. They walked everywhere they went, used their hands instead of machines to do work, and for more traditional exercise they did yoga, Tai Chi and played games with their friends instead of going to the gym. Many of these people also had physical jobs such as farming which is very different than the way most of us work. In addition most were found to have gardens of their own. Movement reduces inflammation and improves heart, bone and muscular health and for this to be beneficial you have to move everyday.

All of these findings make perfect sense and are fairly obvious but these last two results were found to play an even more significant role than the first five reported.

  1. A Strong healthy support system– According to researchers this was the most important and powerful thing you can do to increase your chances for longevity. For the blue zone residents this was a natural way of life and is built into the culture. People in the blue zones have strong systems of support and are much more willing to engage and help each other. We however spend significant part of our lives with our heads down and focused on a phone, iPad or computer. This has become such a problem that we now have neck injuries related to posture changes from this behavior! To derive this benefit we have to be willing to look up, connect with those around you and engage. Studies have shown that loneliness can decrease your longevity significantly. Sadly, many people in our country don’t even know the people they live next to. Blue Zone studies have shown that it doesn’t necessarily have to be intimate connectedness. Just being connected and knowing someone is aware of you has been shown to increase your chances for longevity.
  2. Spend time outdoors with friends and family: Not surprisingly many recent studies have extolled the value of being out in nature. In fact many physicians have begun prescribing it as a treatment regimen for depression. For the people in the blue zones this is a way of life. Staying connected to family and others is the single most important thing to them. The other benefit that being out in nature provides is that they are usually getting exercise at the same time. Additionally there are no “old folks” homes in the blue zone because they don’t need them and older people are cared for by family.

Living a healthy long life is obviously correlated to how committed you are to eating and sleeping well. Most importantly however is how willing are you to lift up your head, smile and connect to the people around you, step a way from the technology and head outdoors. No matter what gene pool you swim in making these choices greatly increase your chances of living a healthy long life. What will you choose?

With Gratitude,
Pat

Gratitude and Your Brain

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Gratitude and Your Brain

Turns out that the practice of gratitude does more than just make us feel better in the moment. Practicing gratitude actually changes your brain. It has long been established yet not a stretch to understand that gratitude will make you feel better but there have been many studies that support and outline the ways in which the brain changes. The Mindfulness Awareness Research Center at UCLA conducted studies that show that when you regularly express gratitude it literally changes the molecular structure of the brain, keeping the gray matter functioning at a higher level and as a result makes us feel happier and healthier. It turns out that when you are happy it affects your central nervous system enabling you to feel more peaceful, less reactive and less resistant.

There are many ways in which people practice gratitude. One is the ever-popular nighttime gratitude journal in which you jot down 5 or more things you are grateful for before going to bed. I think this practice has great merit because it puts the emphasis on the positive before you go to bed and is more likely to produce a good nights sleep. It is also a good review of the day. If you are someone who finds writing before bed more of a chore than helpful I recommend that when you first close your eyes just start saying silently to yourself al the things you are grateful for. I find this method very effective not only from a gratitude perspective but it also slows my brain down and puts me in a positive space to start dreaming.

Another gratitiude practice is to make it a habit of telling one person a day something that you are grateful for or appreciate about them. This simple act makes the both of you feel happier and as a result affects the way we interact with all of those around us. People feel better when they know they are appreciated and valued.

So what about those particularly hard days when you are having difficulty finding gratitude in anything? For those days I recommend that you start simple by being grateful for the basics such as having running water, a toilet or being grateful that we don’t live in a bombed out city. When we need to be grateful the most we often loose sight of the fact that despite all of the issues that we have in our country we are still free and that is something to be cherished and extremely grateful for.

Lastly, make it a practice to tell your self one thing each day that you are grateful about yourself. It can be anything from something you have done well or something you like about yourself. Studies have shown that a regular practice of gratitude are associated with better sleep and lower levels of anxiety and depression which are compelling reasons to have a regular practice of gratitude.

No matter what methods you chose to express your gratitude I encourage you to begin to make it a daily habit. It literally can positively change the lens in which you view your life from. On a personal note I am extremely grateful to all of you for taking the time to read my newsletters.

With Gratitude,
Pat

Is Sitting The New Smoking?

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Is Sitting The New Smoking?

We are a nation of sitters. Whether we are at work, commuting in our cars, sitting in class or working in front of a computer we sit. Not to minimize the exercising we do but an hour of exercise does not balance out the 8 plus hours of sitting we often are required to do in a day.

Recently you may have seen the research on the demerits of sitting for long periods of the day. It is not a stretch in imagination to understand the truth in this but there are other concerns related to sitting aside from cardiovascular consequences.

One of the most important muscle effecting sitting is the psoas muscle also known as the hip flexor. It is significant for both its position within the body and the action it produces. Additionally it is one of those muscles that can be tight but weak at the same time. Structurally it is attached to the front of the last five vertebrae in your low back and traverses through your abdomen attaching to the top of your femur or leg bone. During sitting this muscle shortens and the fibers come closer together and tighten up. When you rise from the seated position this muscle is sometimes slow to release and you may find you walk in a flexed or bent forward position for several steps. For those of you who are constantly being reminded to stand up straight and have a tendency to walk in a slightly bent forward position tightness in this muscle is often the culprit.

Keeping the psoas as lose as possible will significantly reduce low back stress and increase proper posture while strengthening will aid in keeping the core strong reducing back pain and minimizing the risk of injury.

To Stretch: There are several ways to stretch this muscle and I will review two of them for you here.

  1. Start with one leg in the kneeling position at a 90’ degree angle with the other knee on the ground. From this position slide your pelvis forward while leaning your torso backwards. Hold for 20 seconds and then repeat on the other side.
  2. Lay on the side of your bed or a bench with one leg hanging over the side but not letting your foot touches the floor. Hold this position for 20 seconds and then repeat on the other side.

Even though you may feel that one side is tighter than the other it is important that both sides are stretched to create a good balance.

To Strengthen: Again there are several ways to strengthen this muscle but I will give you two different ways to try this.

  1. Start in a standing position with either an ankle weight or theraband (available at the office or online) attached to the ankle area. Support yourself by holding onto what ever is available such as a counter or chair. Slowly lift you leg to a 90 degrees angle. Lower it slowly and repeat 10 times. Work your way up to 3 sets of ten resting in between. When you are able to do three sets of ten increase the weight and start back with one set of ten continuing to work up to three sets of ten again.
  2. If you are someone who belongs to a gym there are machines that you can use to strengthen your psoas. Due to the variability in machines you will need to ask a trainer which one in your gym will address this muscle.

In total it may take you five to ten minutes to address this muscle but I can assure you it will be well worth your effort in the long run. You will have less back pain, have better balance and stand straighter.

With Gratitude,
Pat

Does Your Body Need A Vacation?

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Does Your Body Need A Vacation?

Yet another year has come to a close and if you are like many of us there is a high probability that you have over indulged in an abundance of sugar, alcohol, rich foods and all the other goodies that go with the holidays. Now that it’s over if you are anything like me you can almost feel your body requesting a much needed break.

Consider starting off the New Year by giving you body a rest and remove the sugar, breads, pastas, coffee and alcohol from your diet for a short period of time. As a general rule I prefer to cleanse my body twice a year. Generally I do one cleanse at the beginning of the year and another sometime mid summer and I always feel great. The longer you are willing to remove these foods the better but whether it is three days, a week or a month you will give your organs a much needed rest and rid your body of excess toxins. I find a three week cleanse is highly effective and comprehensive but if you are unable to commit to that consider doing a week. There are many ways to approach this “cleanse” and I encourage you to find the best method that fits your life style, caloric needs and any medical issues you may have. Even if you haven’t overly indulged during the holiday just living in a city exposes us to a multitude of toxins that we ingest, inhale or absorb on a daily basis.

Our body gets rid of these toxins through our urine, fecal material, sweat and breath. Enabling these mechanisms to function efficiently will provide many benefits such as increased energy, increased mental acuity and clarity, deeper more restful sleep, clearer skin and overall more effective and efficient organ function.

Here are a few considerations that will make this adventure more effective and help insure your success:

  1. Plan ahead and have healthy snacks readily available. If you are hungry and don’t have anything to eat you will inevitably reach for whatever is available and it often will contain sugar.
  2. Drink water!!! As you detox your body will begin to release toxins from your body and water is essential to carry the toxins out of the body as a waste product. Not drinking an adequate amount of water will put a load on your system as opposed to cleansing it because as you release these toxins they need to be effectively carried out of the body. Generally half your body weight in fluid ounces daily is a good rough estimate for the amount necessary for adequate cleansing. Green tea is also helpful and replaces the coffee ritual.
  3. If you have access to a sauna at your gym, work or fitness facility consider getting in two times a week to further detoxify your system. The sweating further flushes the toxins from your skin and you will have the added benefit of muscle relaxation as well.
  4. Fill your diet with a variety of different vegetables, nut and legumes and get rid of the breads, pasta and meat. Try getting creative with different foods and food combinations. You will enjoy it more, have greater success and are more likely to carry these new habit into your life as you reintroduce foods back into your diet. Consider also adding fermented foods such as yogurt, kimchi, kefir or fermented vegetables. These provide bacteria, which will support digestion and further aid in the detoxification process.
  5. There are many products/kits on the market that are available to assist you in your cleanse. If you decided to enlist the help of one of these products please make sure they come from a reputable source. Here at the office we have some excellent products if you are interested.
  6. Move your body! It doesn’t matter what you do even if it is simply taking a walk. The activity helps to pump the lymphatic system and move the toxins more effectively through your system aiding in elimination.
  7. I encourage you to consider cleaning up the temple you live in. It’s easy, healthy, and you will definitely feel better. I can’t guarantee it but you also just may loose a little weight. Although a cleanse is good for just about everyone if you have any medical issues always check with your physician before starting a program to make sure it will be beneficial for you. My wish for each of you is a year filled with joy, health, love and success. Happy New Year!

    With Gratitude,
    Pat

Are You Hydrating Enough?

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Are You Hydrating Enough?

August is fully upon us and with it the blistering hot, dog days of summer are here. With rising temperatures and intense humidity we also see an increase in issues related to dehydration. The dangerous thing about dehydration is it has a way of sneaking up on you and you will feel its effects before you realize it. Generally people are thoughtful and remember to hydrate if they are going to play a sport or mow the lawn but most are not nearly as diligent in their day-to-day hydration practices.

More often than not people rely on thirst as their indication that they are dehydrated and as a result do not consume an adequate amount of water. The problem is that thirst is a poor indicator for the body’s need for water because by the time you are thirsty you are already significantly dehydrated.

Obviously dry mouth and increased thirst are signs that you are dehydrated but so is fatigue, dry eyes or blurred vision, lack of sweating, dizziness, cramping, dark urine and light headedness. In severe cases rapid heartbeat, rapid breathing, fainting, confusion and anger can all be indicative of dehydration.

So how much water do you need? The amount depends on your weight, heat exposure and medications you may take. There is considerable debate as to whether you should drink approximately ½ your body weight or by multiplying your body weight by 2/3. Personally I think that if you are somewhere in between and add a dose of common sense you’ll be fine. In addition add 12 ounces for every 30 minutes of a work out. If you take a dehydrating medication add an additional 12 ounces. Equally important is to not over hydrate. When you drink too much water you will dilute the sodium and electrolytes in your body, which can create a whole of other problems.

Everyone needs to be concerned with dehydration but children, older adults and people with chronic illnesses are especially vulnerable. Older adults naturally have a lower volume of water in their bodies and are more likely to take medications and have conditions that result in dehydration. Young children become dehydrated very easily especially with vomiting and diarrhea.

So, if you are on the dry side of hydrating I encourage you to take a look at where you can do better to wet your whistle. It is a simple critical component of self-care that is easily remedied and immediately effective.

Drink up!

With Gratitude,
Pat

What’s The Matter with Me?

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What’s The Matter with Me?

Check out the list of the following symptoms to asses if any apply to you. While all of the symptoms are related to many disorders they are also associated with low levels of vitamin B12. In order to accurately discern whether your B12 levels are low or you are suffer from some other issue a simple blood test is in order and your doctor can easily do this for you.

Low levels of B12 can lead to:

  1. Weakness, tired, lightheaded
  2. Heart palpitations/shortness of breath
  3. Constipation/diarrhea/loss of appetite/excessive gas
  4. Tingling in hands and feet/difficulty walking with ease
  5. Vision Loss
  6. Pale skin/smooth tongue
  7. Depression/ memory loss or behavioral changes

Low levels of B12 can be cause by a variety of issues but it is often the inability of our body to absorb the vitamin that is generally the root cause. Those individuals who are susceptible to any gastrointestinal disorders or have had gastrointestinal surgery are at a higher risk, as are older individuals, vegetarians, pregnant and lactating woman as well as those who suffer from pernicious anemia. Pernicious anemia is an autoimmune disease that affects the gastric mucosa resulting in atrophy, which in turn through a series of steps inhibits normal B12 absorption. Tingling in the hands and feet is a hallmark symptom of Pernicious anemia.

From a dietary standpoint the best sources of B12 include eggs, cheese, milk and milk products, meat, fish, fortified breakfast cereals, shellfish, poultry and some soy based products. B12 is a water-soluble vitamin so it is hard to overdose on it because what ever is not needed is generally excreted in your urine. Some of the side effects from taking B12 can include headaches, itching, anxiety or nervousness and in severe case uncontrolled movements.

I’m often asked if it is better to use the injectable form or take the oral supplements. This is entirely dependent on the state of your gastrointestinal system. In the case of pernicious anemia taking an oral supplement would be of little value because the atrophy of the stomach wall does not allow it to be absorbed therefore an injection is the best option. If you are able to digest and absorb properly then an oral supplement is fine. If you have assessed a need for B12 it’s important that you let your physician know before you begin to take it to ensure there are no issues with any other medication you are taking.

As with any medication, vitamin or supplement be certain that you have a need for it before beginning and if you do so taking it regularly will give you the best results.

With Gratitude,
Pat

Pickleball? Seriously?

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Pickleball? Seriously?

Yes despite it’s ridiculous name it is sweeping the country and the fastest growing sport in the world. I play and as a result people frequently ask me about my experience of playing. This prompted me to use the opportunity in this month’s newsletter to expose those of you who are curious about the game and want to know more. Pickle ball is the fastest growing sport in the world for many reasons but the biggest is it is just flat out fun. Many of you may have heard of this new craze but have no idea what it is and many of you are already avid devotees. For those of you who are curious this will remove some of the mystery.

Pickleball is a combination of three sports-tennis, badminton and ping-pong. It is played indoors or outside on a court similar to a tennis court that is about two feet shorter on the ends but the same width. The paddle is flat and approximately the same size as a racquetball racquet. The ball is the size of a whiffle ball on steroids or about the size of a baseball. Tennis serving boxes are in the front while the pickball serving boxes are in the back close to the server. It can be played with two, three or four players.

Some additional information that makes pickleball an attractive exercise option include:

  1. It won’t break the bank. Most places available for play are either free or have a nominal fee of $3-$5. Paddles can be purchased from $28 to $198 at pickleballcentral.com and amazon (of course). Some facilities have extra paddles available for your use.
  2. You don’t have to coordinate everyone’s busy schedules. You simply show up any time during the predetermined time and play for as little or as long as you want.
  3. Most everyone can play. If you have a previous history of playing any of the sports involved you will pick it up in just a few minutes. For those of you with little to no racquet experience you can also learn very quickly however may take a little more practice to become proficient.
  4. You can play virtually anywhere. Whenever I travel I usually do an Internet search for local pickleball locations and simply show up at the appointed time. People are always welcoming to outsiders. For example if I travel to St. Simons Island I will do an Internet search for pickleball St. Simons and it let’s me know the details of where and when games will be played.
  5. It’s a very social game. Everybody is generally welcoming and gracious. Over time you get to know an entire new group of friends and competition can range from very competitive to social but either way you will get a good workout and get your body moving. The limited size of the court is also a big advantage for those with knee or foot issues.
  6. Games generally don’t last a long time. You play to 11 however if there are a number of people waiting games are often shortened to 7 to allow more playing time for everyone.
  7. It’s great exercise and you can get a good workout but you generally are just having fun so you don’t notice the effort it takes.

For more information check out this video on how to play. What is Pickleball? – USAPA Pickleball

If you are interested in seeing some high level play watch the championship from last year by clicking this link. Pickleball Channel – YouTube

No matter what part of the country you live in consider checking out your local pickle ball centers and give it a try. I think you’ll have fun and be glad you did.

With Gratitude,
Pat

A Gift To Yourself

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A Gift To Yourself

So here we are once again at the beginning of a new year with all the promise it holds for the upcoming year. Whether you write down goals with specific intentions, unconsciously think them through, or ignore them all together the truth is statistically 92% of us won’t win our battle.

When most of us set goals or intentions for the year they are often unrealistic and lack self-compassion. This lends itself to a fairly high probability of limited success. I am sure it comes as no surprise when you hear some one say “It’s the same every year. I want to loose weight, exercise more and sleep better. I just never seem to quite get there”. There is a reason it’s the same thing every year.

We have all made mistakes, tried and failed, done and said things that we weren’t proud of and at the end of the day usually don’t let ourselves off the hook easily. When we make a mistake or things don’t go the way we planned or in the time we allotted we often give ourselves negative messages such as I’ll never be able to do it, I don’t know why I bother, I have no will power, I’m such a looser and soon you just stop trying.

When we continually come up short in our endeavors we are usually left feeling defeated. Creating unrealistic goals such as working out 5 days a week, changing your diet and committing to sleeping at least 8 hours a night is an overwhelming amount of change. While the enthusiasm is to be admired, a total revamp of your life all at once is the perfect recipe for failure. Consider take incremental steps at whatever level of comfort seems right for you. Stretch yourself but with considerate mindfulness. It is equally important to acknowledge yourself for whatever steps you do take no matter how large or small.

Make friends with self-compassion as a companion in your desire to create something new in this year. Whether you want to loose weight, start a relationship, getting a new job, being a better parent or partner or whatever else you may want to change recognize that inherent in that will be opportunity for growth and inevitably some amount of discomfort and struggle. However, it doesn’t need to be a battle.

Supporting ourselves by reminding and equally acknowledging what we did well instead of tearing ourselves down with what we didn’t do is what self -compassion looks like. In all likelihood most of us will not make changes perfectly but that doesn’t mean we stop doing it. Assess what is working and give yourself a hand and carry on. For the things that aren’t going quite as planned have some patience and compassion for yourself and start again. You are much more likely to have success in whatever changes you are trying to make.

As you journey on the path to the newer year I ask you to consciously consider acknowledging as many things as you can that you are doing well. Consider grace and self-compassion as a gift to yourself.

With Gratitude,
Pat

Take A Mini-Vacation Every Day

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Take A Mini-Vacation Every Day

Despite the continued warm temperatures the summer is beginning to wind down, students are slowly making their way back to the classrooms and others will be heading back to college soon. There is a different kind of energy in the summer that lends itself to a more relaxed atmosphere. Traffic is lighter, schedules are a little freer, kids stay up later but underlying that the continual stresses of life remain the same.

With any luck you have had an opportunity to take a break from work and go away on a vacation somewhere or have had some time off to have a “staycation” at home. Typically vacations involve a lot of time and energy to plan, sometimes we create expectations, the day finally comes, we get there, have a great time, come back relaxed and rejuvenated and then its effects vanish by the second or third day back at work.

We all have some kind of stress but how we manage the stress is the critical difference that determines whether stress is in control of us or we are in control of it. Vacations are wonderful but whatever positive effects we receive rarely lasts long so developing a way to incorporate consistent daily down time is critical. To help with this I often recommend that people intentionally create time to take a mini-vacation everyday. Developing a pattern of taking a daily mini-vacation is a choice we make and a gift we give ourselves and essential to creating balance in our life.

So what does a daily vacation look like? Consider the following:

  • Take a walk at lunch
  • Shut your door, shut your eyes and just breath for five minutes
  • Take a bath
  • Take an hour break from all electronics
  • Read or listen to a book
  • Download a meditation app and plug your headphones in an meditate for 10 or 15 minutes
  • Sit on a bench or at a coffee shop and people watch
  • Spend ten minutes actively relaxing you body starting with your feet and working up. (Don’t forget to relax your eyes)

It doesn’t matter what activity you choose and I encourage you to mix it up and be creative in finding ways that work best for you. This can sometimes be difficult especially for those who feel guilty “wasting time”. The only requirement is that it works as a time out for you. Taking time out for your self every day is critical. Not just a week or two out of the year but everyday. It has been shown to be a significant factor in increasing creativity, deeper sleep, increased immunity, lower blood pressure and increased presence and clarity just to name a few.

I encourage you to give it a try in whatever way works for you. I am confident you won’t be disappointed.

With Gratitude,
Pat