Don’t Take Your Legs for Granted: How Hurricane Sandy Reminds Us to Stay Light on Our Feet

On wednesday – day two of the Sandy Black out – I walked from my apartment at 9th and Broadway up to 44th and 6th to find an open Radio Shack, in order to bring my 80-something year old neighbor back an FM/AM tape-deck and headphones. Mrs. H hadn’t had any way to contact the outside world since Monday night and cannot walk down six flights of stairs with her walker. 

Our doormen had been checking in on her daily, which is lucky, but they couldn’t leave their post to get her things. That morning when we knocked and asked if she needed anything she said if we came across a radio she would be so grateful -she felt like she was losing her mind trapped in her apartment without any news or contact. We only knew she was there because we asked the doorman if there were elderly on our floor. I had never met her before. 

The message I posted on Facebook was this: As you – our friends with young legs- freely escape your dark buildings downtown remember that behind all those anonymous hallway doors there may be people who could use a hand, especially as the fray lasts longer than we thought. 
…Now it is Friday and the lights are still out. I am thinking of Mrs. H often because I haven’t been home since I left her the radio and I don’t know how she is. 
I’m also weary of always being on the move, and of sleeping on my future mother in law’s couch. That said, I’m so grateful that I can move – rove really – up and down the city, bad knee and all. 

This storm should be a reminder to all of us. Don’t get complacent. Don’t take your ability to walk far and sweat for granted.

You think life will always come with a hot shower and a ride but now we know there WILL be times when it won’t. It’s hard to combat the way that our jobs and lifestyles literally force us to be sedentary and constantly make it easy to eat more than we need. 

You actually have to fight back. Not just hope you’ll be healthy by having a salad now and then, but work on it. Demand that your body be useful to you. Put it under some pressure sometimes.

I recommend the following.

1. Always take the stairs if it’s 5 flights or less.

2. Use a standing desk.

3. Use public transportation even if you have a car.

4. Leave your office at least once per day for a walk even if you bring lunch, even if it’s cold out.

5. Dedicate at minimum five full hours to vigorous exercise per week, spread out however you like. Vigorous means actually sweating. 

Part II: A Two Week Road Map to Happiness Via Your Belly

In my last post I talked about the connection between the gut and the brain, and how your enteric neuro-endocrine system (see last post if this term is eye-crossing), is affected by what you eat and then impacts your mood.

The reality is that eating refined sugar, preservatives, food dyes, other inorganic chemicals that are hidden in processed food, and even what I call “calorie-bombs” like fruit smoothies and bagels, whose simple sugars stream into your system at warp speed, is like waging toxic warfare on your gut.

And when your gut is unhappy, the neurotransmitters and hormones in your gut head off to your brain to make sure you are unhappy too.

If you are skeptical, try the following road trip away from your old food habits and see what happens to your outlook on life. Take two full weeks – enough time to acclimate – and cut out the toxic.

This means strictly avoiding all foods that come in plastic-wrap, tinfoil, cans, frozen containers, and airtight bags, and any other foods that have the capacity to sit in a fridge or on a shelf for more than a week without spoiling.

This does not apply to dried goods like whole-wheat pasta or quinoa.

This does apply to ice cream, canned soup, frozen dinners, any type of chips regardless of whether they say “healthy” or “baked” on the label, “energy” and “protein” bars, deep-fried foods, and drinks other than water or unsweetened tea.

This also applies to alcohol of any kind, and recreational drugs if you use them habitually.

If you’re wondering what’s left to eat, don’t freak out.

Step 1: Go to and write down some recipes that contain kale, broccoli, Brussels sprouts, Swiss chard, endive, turnips, and beets.

Step 2: If you’re someone who feels better eating meat, for these two weeks limit yourself to wild-caught, non-heavy metal-burdened fish like salmon, trout, and sole. Or go for cage-free vegetarian-fed chicken from your local farm if you must.

Step 3: Add some new whole grains into your diet like wheat berries, quinoa, steel-cut slow-cooking oats, and wild rice. Note: instant oatmeal has the fiber cooked out of it so avoid!

 Step 4: Make sure the only sugar you eat comes pre-packaged by Nature. This means tomatoes (organic ones in-season are sweet!), sweet potatoes, apples, pears, and carrots. Local and seasonal are better for your body, because we all evolved adjusting our meals with the seasons – Nature knows what she is doing. But, if you miss the tropics, bananas and mangoes make great desserts.

If you need a sweetener use a bit of raw honey, which is medicinal, pro-digestive, and pro-fertility. Avoid it if you have a lot of inflammation in your body as it is heating.

Step 5: For fats, cook with olive oil, or ghee (clarified butter). Dress your salads with flax oil and sunflower oil as a base. Snack on raw unsalted almonds, walnuts, and pumpkin seeds just a few at a time.

Step 6: Add some love. Avoid foods make in unhappy places by unhappy people. Their energies are pervasive and affect the energy of the food you eat. Instead make your own food for two weeks and be sure to send it some positive thinking as you prepare and eat it, because it’s going to BE you soon enough.

Each day notice how you feel having changed your diet, and write it down. When you crave a beer, go for a walk and drink a glass of water. Start to notice when your instinct is to eat for emotional reasons, boredom, or in response to stress. These two weeks might undo some of those impulses.

Most of all, notice if the way you see the world – or react to life – has shifted at all. You can always go back to your old way of eating.

In the long run two weeks will blow by while you give this plan a shot. Your happiness is worth it.

 – Dr. Robin

Feed Your Head – Why the Food You Eat Determines What You Feel and How You Deal: Part I

There are only two physical access points between the outside world and the inside of your body. One is your skin. The other is the mysterious tunnel that starts at your mouth and ends at your anus.

Your skin is absolutely important – it absorbs everything from nicotine to sunlight. But leaving it aside for now let’s look at what happens when food ventures from your mouth to your gut and how it impacts everything you feel on a daily basis.

Thanks in large part to the research done by Dr. Michael Gershon at Columbia-Presbyterian Hospital in NYC, we know that you have a second brain in your gut, called the enteric nervous system. At least 95% of the serotonin in your entire body lives in your intestines and your brain and your gut communicate with each other constantly.

Also living in walls of your gut are hormones referred to as entero-hormones. All hormones, regardless of where they are made in the body, by definition are chemical messengers that swim through your bloodstream and influence every system in your body to some degree. To what degree, exactly, depends on the receptor density in a particular organ or tissue for a particular hormone.

The lining of your intestine is also microscopically thin – one cell layer thick – and creates an intelligent membrane that, in a more intricately choreographed dance than any Russian ballet, absorbs the liquefied broken down version of what you chewed and swallowed into your blood, changing it’s address from external to internal. If you have even a low-grade allergy to one of the substances in what you ate, this – the point of absorption – is when your immune system goes on the attack, leading to unpleasantness.  

Two super crucial points here:

One, there is an enteric (i.e. intestinal) neuro-hormonal system that cross talks with the rest of the systems in your body and impacts those systems, either promoting equilibrium or throwing it off.

Two, the food you eat gets absorbed into your body for processing. From there, if the food contains any toxic materials, those toxic waste products flood first your blood and then your liver and your kidneys, which have to deal with the crisis. If the food is usable on a molecular level, it gets literally repackaged and turned into your tissues.

All of this is a tiny fraction of the evidence for why there is no separation between the food you eat and you, from your bones to your feelings.

 The good news is you have a choice of what items from the external world you put into your internal environment.

 Stay tuned for Part II, where we’ll talk about what foods to eat and what to avoid, to keep your head in line. 


Dr. Robin/Health Uncensored

WTF I’m A Doctor and I Can’t Afford Health Insurance

Today I went online to pay for COBRA, the program that will extend my health insurance from my last job for a monthly fee. That fee is $743.97

At my last job as a resident in a New York City hospital, my insurance came with the job, I had good coverage, and I didn’t have to worry about it, or even think about it.

Now because I’m a consultant, my job doesn’t pay for my health insurance. To keep the same insurance coverage I had before, the out of pocket insurance cost is, after I pay taxes, almost 20% of my income. Even if I never see a doctor. Even if I never fill a prescription.


Let’s start here. I am 31, with no major medical problems. I take one medication, the pill, and I take it like you’re supposed to – I’ve never been pregnant.

My BMI is 18.5. My blood pressure is typically 100/60 and my resting heart rate is 60. By every basic metric that we in medicine track to be sure you are doing ok, I am beyond ok.

And that doesn’t even get into my blood work, which so far has been perfect. My HDL is twice as high as my LDL and my total cholesterol is at the very low end of normal. (Normal by the way, is warped in our society – our “normal” ranges are based on a very overfed group of people. No one checked your LDL in the year 1600… our norms have become exaggerated based on very recent steady states that in reality aren’t so steady.)

In addition to all of that, I am vegetarian, and I don’t eat fast foot or junk food or even processed food. I spend $150 or more a month on yoga classes – if you look at my bank statements, you see that I keep paying Kula Yoga Project, Strala Yoga, and Vira Yoga money, so I must be using them. I also do some sort of cardio every couple of weeks, and would join a gym, but between the yoga, and how much I dislike the gym vibe, it doesn’t make sense financially.

Yes I should pay something for health insurance. I should pay for catastrophic coverage in case an accident should happen or a prolonged hospitalization should be required. I should pay something for prescription drugs. Drugs for high cholesterol, a preventable disease, should I need them, should be covered, but covered less than drugs for say, Cystic Fibrosis, which is genetically inherited.

I should pay something for the ability to go to the doctor’s office for a reasonable co-pay if I need to, and something so that if I need a procedure of some kind that is covered in some part too.

Insurance should be what it’s meant to be. A shared cost in society. A benefit to me in that it creates a collective bargaining power amongst all of us who put into the pool. Yes I should pay up something in advance, so I can get a life saving procedure I could never afford otherwise.

But I should also be rewarded for how I live. For the chronic diseases I will never get that are upwards of 90% of our health care burden. I should not pay 20% of my salary for services I will never use.

And while the example I cite, COBRA, is not the cheapest out there, it, or something just as expensive, is the only way I can continue to see the doctors I have been seeing for the past year — the ones who know me, the ones with whom I have a relationship.

Trust me, as a doctor, when you know your patient, when they are NOT a stranger showing up out of the blue whose history, context, and personality are foreign entities and therefore important but unknown variables that will influence their care and their outcomes, you do your job so much better. You are happier, your patient is happier, and the process is infinitely less wasteful.

I don’t have all the answers. I do think people should be rewarded for good behavior. I do think what I pay to Kula Yoga should be deducted from my health insurance costs because yoga keeps me both fit, and sane. And the absence of any fast food on my credit card statement should factor in, too.

So should my stats, ie the basic metrics by which we judge anyone’s baseline health  in medicine – BMI, heart rate, blood pressure, and fasting blood sugar.

I believe when we start taking people seriously who take their health seriously, our overall health care costs will be lower, and we will stop the insane waste that is me paying 20% of my salary to an administrative system I don’t use, for care I generally never need.

Food for thought,

Robin Friedlander MD

Waist Matters

This is the reality. If your waist is wider than your shoulders, or creeping close, then you are in huge, huge trouble. The fat in your middle is a festering inflammatory stew spitting out cancer juice and artery-hardening, pancreas-killing, Alzheimer’s inducing, ragefull sludge.

You do not have to starve yourself. You do not have to be skinny. And I know, in some cases the genetic odds are stacked against you. But I don’t care. If you can do anything about it, get your waist circumference down and save yourself.

In the early days your pancreas may just protest a little and your low back and knees might only whine quietly, but to themselves they are saying, “I’ll show you sucker.” In time the diabetic foot infections, wheelchair-confining back and knee pain, and stroke inducing cardiovascular disease will have their way with you.

Note, the lack of a numerical inch limit for males/females here is deliberate. We are all individuals. You know whether you are emaciated and starving, nourished but trim, or if your belly is toppling over your waistband a little more each year. I don’t expect you to measure yourself. I give you more credit than that. Observe and be honest. 

No words minced,

Health Uncensored

Probiotics Live in Yoghurt & Were Born to Help You

Bacteria get a very bad rap, but actually you literally couldn’t live without them. There are many kinds living in and on us every day, as the Human Microbiome Project has recently discovered, but the best understood are the ones that live in your gut, help you digest food and absorb medicine, and keep your tummy happy in a very essential way.

You might have heard of probiotics? They are just bacteria that are known to be helpful for digestion, and they are packed by the billions into yoghurt and fermented drinks like Kombucha.

It turns out that Lactobacillus, a common strain, will reduce the chance of getting antibiotic-associated diarrhea by 42% according to a new review of 82 different studies published in JAMA (Journal of the American Medical Association).

The best part is you don’t need a prescription. Lactobacillus and usually a few other probiotic strains can be found in your average affordable cup of grocery-store yoghurt.

If you are not impressed know that people in hospitals all over America are. Antibiotics can be very problematic when it comes to causing certain kinds of intractable diarrhea.

But yet again medicine proves what the hippies already know. A healthy gut needs healthy, helpful bacteria in residence, whether it’s dealing with the daily grind of your diet, or the sudden impact of a disruptive antibiotic as it makes its way through your system in search of its prey, which could be something as un-intestinally domiciled as a skin infection or a UTI.

Full disclosure: No, I am not paid by Fage. It’s just the yoghurt my boyfriend and I have at home. But Fage, if you’re reading this, I’m open to talking about the possibility.


Health Uncensored


Today I had to call a patient who had requested to see a nutritionist. She had been told by her doctor that she had pre-diabetes, and wanted to learn about what to eat.

Pre-diabetes means your poor besieged-by sugar-and-processed-junk pancreas is flagging a little on the insulin production, and your red blood cells (along with most of the rest of your body) are slowly being coated with sugar, or “glycosylated.”  Full blown diabetes is when your pancreas is shot or nearly so, and you need pills or insulin injections not to get really sick from the level of sugar in your blood. Insulin, by the way, is the hormone your body makes that, in a nut shell, gets your cells to move sugar out of your blood and into storage when there’s excess around.

I gave the patient the referral, but I also talked to her for a while. What to eat? Well, pre-diabetes is reversible, so literally, cut the crap, and eat what every one of us should be eating.

Lots of green veggies, whole grains like quinoa, millet, and unprocessed oats, nuts, plain yoghurt, olive oil, seeds, a little fresh fruit, fish, a little lean chicken and meat if you eat meat but not much. And, as I tell all my patients, “If it came wrapped in plastic, tin foil, Styrofoam, or tin, it didn’t come out of the ground that way and it wasn’t made by God so don’t eat it.” (I have no idea where I got the “God” thing but I think it sounds sort of final and fatalistic to say, and people seem to dig it – their eyes widen in fear or they laugh, so I know they are at least listening.)

There’s more to food than this of course, but if you start there you are in a good spot. 

Love, Health Uncensored