Five tips for staying healthy in 2019 with Natalie Ikeman


Natalie Ikeman PA-C outside the WCCO studios in Minneapolis

Hey what’s up Healthy Matters people!

On the Healthy Matters radio broadcast this week, my colleague Natalie Ikeman, MPAS, PA-C from Hennepin Healthcare’s Golden Valley Clinic joined us by phone to offer some tips for staying healthy in 2019.

You know what is really cool about her advice?  It is achievable even for people like me and you!  She doesn’t tell you to go to the gym 7 days a week.  Or run 10 miles.  Or eat nothing but pine cones every day. She gives advice that real people can follow.

I asked Natalie if she would be guest write this blog post and she agreed so most of this post is her words.

To listen to the podcast of the show (Healthy Matters show #523, January 20, 2019), including Natalie’s portion at time 22:05, click the logo here:

In this post you will find:

Continue reading “Five tips for staying healthy in 2019 with Natalie Ikeman”


Women’s heart health: your questions answered

Michelle Carlson, MD & Jill Jordan, PA-C, , MMS, RD

Think men and women are just the same?  No, I didn’t think so.  But when it comes to heart disease, much of what the medical community talks about is focused on men’s heart health.  So on the Healthy Matters radio broadcast last Sunday, we focused on women’s heart health.

I was joined in the WCCO studios by two women whose careers are focused on caring for hearts.  They are Dr. Michelle Carlson, a cardiologist, and Jill Jordan, a Certified Physician Assistant with clinical practice in Cardiology.  Not only are these two really knowledgeable about cardiology in general, they are particularly tuned into the health of women.  Not only that, they do cool work with cancer and heart disease.   And I can personally vouch that they are approachable providers with a good listening ear and wise advice for their patients.

Three things you can do to learn more:

  • Listen to the podcast of the Women’s Heart Health show by clicking the logo here. It is Healthy Mattes Show #482, April 8, 2018

  • Click Dr. Carlson and Jill Jordan’s pictures here for their bio and contact information, or go to the Heart Center at Hennepin Healthcare to learn more and including info on making appointments.
Michelle Carlson, MD
Jill Jordan, MMS, PA-C, RD








  • Read on for brief and informative answers to listener questions that we did not have time for on the radio broadcast.  Heart attack, jaw pain, ischemia, family history, varicose veins, valves, exercise, diet, yoga.  It’s all here!  The responses are directly from Dr. Carlson and Jill Jordan.  Don’t miss the last question (scroll down!) about heart disease and cancer.   Pictures and links, too!

Continue reading “Women’s heart health: your questions answered”


Can you exercise your way to a lower weight?

Hey friends!  Back in April I had just returned from “doctor college” in San Diego and I intend to share bits of what I learned there.  Previous posts in this vein have been:

This post is about exercise and weight loss.  Specifically:  Is exercise an effective way to lose weight?

Hmmm . . . . donuts.

Anybody else have a somewhat idle piece of exercise equipment in your house?  The picture at the top of this post is my actual basement treadmill.  On the plus side, it is a terrific place to hang shirts while ironing.  On the negative side, I’m delinquent in my ironing duties.

It is a pretty rare bird indeed who doesn’t sometimes want to lose some weight.  I’m in this group.  Although I’m a rather skinny, lanky guy – I do have that bit of a gut that hangs out more than I’d like.  And I’m a runner, at least much of the time, so I’m thinking . . . WHAT GIVES?  How can I exercise as much as I do and still have weight in places I don’t want it?

I have been told it is not a dearth of exercise that is leading to a big belly, but it is an abundance of donuts.

And who am I kidding, if there is anything that ought to be in abundance, it’s donuts, I say. Continue reading “Can you exercise your way to a lower weight?”


Getting to – and maintaining – a healthy weight

By D. Bernard & Co, Melbourne (photographer) Adam Cuerden (restoration) via Wikimedia Commons

It is practically an expectation in health and wellness forums to talk about weight loss after the first of the year.  New Year’s resolutions being all the rage in January.  Perhaps you plan to lose a few pounds this year?

For me, it’s always around the middle where I put on a few pounds.  You know, the little beer belly.  The muffin top.  The love handles.  Begone, all of ye!

I was doing so well last fall, eating right, exercising more and so forth.  Then winter in Minnesota hit.  Now it gets dark at 4:30 in the afternoon.  The perpetual ice slick on the sidewalks turn running or walking outside into a potentially bone-shattering experience.  I mean, literally, bone-shattering as in broken hips and wrists.  It has been so cold outside that your teeth hurt the minute you leave the house.

So I tend to hibernate a bit.  Evenings on the couch reading next to a warm fire, although evoking images of Norman Rockwell, are not the way to shed pounds.  Especially if I’m eating unhealthy foods all evening and maybe having a glass of wine with my chocolates.  Wow that is starting to sound good:  warm fire, wine chocolates, a good book . . . ah, but I digress.  I’m supposed to be talking about diet and exercise here.


Reminds me of a post I did about the challenges of staying active in northern climates. Check it out here.

To show you the depth of my dedication to the cause of fitness, I included a recent photo of me above.  Yup, that’s me all right.

Healthy life choices

So we talked weight loss and healthy livin’ on the show this week.

Natalie IkemanTo help me out, I invited a repeat guest to last Sunday’s Healthy Matters broadcast.  Joining me on the radio show was Natalie Ikeman, who is a Physician Assistant HCMC’s Golden Valley Clinic.  She runs “The Great Slim Down” weight loss program which you can check out here.



If you missed the show, you can to the podcast by clicking the “Play” arrow here: Healthy Matters logo alternate


Tips for losing weight and keeping it off

Natalie gave us some great tips from her work with patients trying to lose weight.  I’ll review some of them here.

Make goals.  

With her patients, Natalie meets monthly to set goals.  The good news is that they don’t have to be huge undertakings.  The goals can be small changes in your daily lifestyle which you continually adjust, a process which Natalie refers to as “turning up the dial” on your goals.

Just a few examples of achievable goals are:

  • Stress management tactics
  • Better food choices
  • Portion control when eating
  • Finding time for daily movement, like taking small walks on your lunch hour

Nothing big, nothing huge, just small changes to your daily routine.

People who are successful at weight loss have some common characteristics:

Natalie’s patients in the Great Slim Down have lost an average of about 16 pounds.  That is not only impressive but it is a sustainable amount of loss.  She points out a few characteristics of these patients:

  • They keep a daily record of their food intake.  The simple act of recording what you eat – whether on paper or using one of the many apps for your mobile device – makes a person aware and less likely to fool themselves into thinking they are eating healthier than they really are.  People usually eat more calories than they realize!
  • They are active often in their daily lives.  They find a way to move throughout the day.
  • They are striving to meet their own goals, not goals set by someone else.
  • They hold themselves accountable by sticking with it.

Pop (soda for those of you not from Minnesota) is not a healthy choice.

The sugar in soft drinks has virtually no nutritional value, and in fact, it probably leads to weight gain.  For more on that, see my previous blog post, “Just a spoonful of sugar . . . is really not good for you.”

After Natalie and I suggested that we ought to avoid so much sugary soft drinks, a few listeners asked if diet pop is healthier.  In a word, no.  Although diet soft drinks are probably better than sugary drinks, they also contain ingredients that lack much nutritional value.  Maybe stick to water!

So how about water?

For years, decades really, people have been taught to drink more water.  Most of us probably remember the “8 glasses a day” advice.  That is, in fact, what I told patients for years.  But the reality is that there is not a lot of scientific evidence that otherwise healthy people need to drink more water than they already do.  In other words, if you are thirsty you get a drink and if you are not, you don’t.

Photo: Jean Fortunet
Photo: Jean Fortunet

So that’s it?  Is that all there is to the water story – that it doesn’t matter?

Well, maybe not so fast. . . as we talked about on the radio program, there are some studies from this past year that suggest that there really is a benefit to drinking more water.  One study found that more water was associated with less obesity.  You can read about that one here.  Another study found that drinking more water made people consume fewer calories, – check out this article about that one from the Atlantic.

I should caution that no single study can be used to definitely prove anything.  Truth with a capital “T” is hard to come by in medical science!  So whenever I refer you to studies like these, I do so to get you thinking about your own situation and not to imply that one study is proof of anything.  Replication is the key in scientific studies (the findings of one study must be confirmed with separate studies).

But the water studies are at least thought-provoking.  It makes sense to me that if you are focusing your liquid intake on water, you will be less likely to drink soft drinks and fruit juices that are loaded with calories and sugar.  That has to be a good thing.

As Natalie said on the show, none of us should be “drinking our meals.”  Amen to that.

Move more

One half of the healthy equation is Eat Less.  The other half is Move More.  But how?  Most of us are not about to lace up our running shoes and hit the pavement for a long run.  Most of us can’t get to the gym for a run on the treadmill or an exercise class.  If you can do those things – great!

But lots of us have physical limitations that prevent vigorous work outs.  And gym memberships ain’t cheap!  So what can we do?

Let’s turn to Natalie again.  As a companion to “The Great Slim Down” program, she has produced a series of short videos to give you ideas for exercise that may be right for you.  Some are low intensity, others more vigorous.  Some require standing and moving while others can be done by people from a seated position.

Here’s an example of one of Natalie’s videos:

To see the rest of them, go to the HCMC YouTube channel.  If the link doesn’t work, simply search online for “HCMC YouTube channel” and click Playlists.  You’ll find them there.

Housework is good for you

Listen to the show podcast (the player is above in this post).  We talked about housework as a form of exercise.  And you know what?  It works.  One listener to the show moved nearly 10,000 steps in one day simply doing housework.  I complained that now I really have no excuse not to vacuum the house.  Rats.

The Great Slim Down

I’ll close with one last word about the Great Slim Down.  If you are in the Minneapolis area and struggling to lose some weight, maybe you should see Natalie.  Simply call 612-873-6963 or check out the Golden Valley Clinic site here.  No better time than now!

Thanks for reading.  Hope you are all having a good day, a good week, a good winter where ever you are!





The finer things: Beethoven’s 5th, Dutch bicycles, and naked saunas

Concergebouw interior emptyBeethoven, bicycles in Holland, and naked saunas.  Now if anything screams “get your in-depth medical information here” . . . well let’s just say you’ve come to the wrong place.

But among other things, my life the past two weeks has involved, yes, numerous encounters with my man Beethoven, dodging bicycles in Amsterdam, and naked saunas in Finland.

I’ve had an interesting two weeks.  I’ve been away from the Mother Ship (aka Hennepin County Medical Center) for a while so haven’t had a chance to write or post anything medically relevant.  Instead I’m going to subject you, dear reader, to some musings from my recent travel experiences when I was fortunate to serve as the tour physician for the Minnesota Orchestra as it played incredible concerts to sold-out European audiences.  I’ll try to weave a bit of medical perspective into this post but mostly get ready for my ramblings about things that make me happy  – which when you think about it is a cornerstone to a healthy life.

And if you want to know what Beethoven has in common with either Dutch bicycles or with naked people in Finnish saunas, well you’ll just have to read on at your own peril. Continue reading “The finer things: Beethoven’s 5th, Dutch bicycles, and naked saunas”


I eat too much butter: motivating for healthier living


For breakfast a few days ago I ate French toast and bacon.  I melted some butter and soaked the French toast in it then covered it all in maple syrup.  Then I drank about 4 cups of coffee.  Later that day I ate a handful of chocolate-covered raisins.  And a bunch of tortilla chips straight from the bag with salsa.  I snacked on crackers and cheese later.  Somewhere in there I grilled a steak and drank a 16-oz IPA, followed by more chocolate-covered raisins.   I did exercise a little, having dug up some shrubs in the yard, so there’s that.

I got on the scale.  10 pounds heavier than last year. All in my expanding belly.

This little parable of mine represents a sad lack of healthy living on my part.  At least our dog, Zoe, joined me by finishing half the bag of tortilla chips and leaving the empty bag on the floor, thus preventing me from doing the job myself.

The next day I signed up for the Twin Cities Marathon in a moment of either insanity or brilliant goal-setting. Continue reading “I eat too much butter: motivating for healthier living”


Procreative success and Blue Zones: Dr. Meghan Walsh visits the studio

Procreative success and Blue Zones?  The whole thing sounds like it may not be suitable for discussion in mixed company.  But rest assured, it’s all good, nothing indelicate going on here.  This is a post about living long and living well.  Please read on . . .

On my HealthyMatters radio broadcast last Sunday, we talked a great deal about keeping your heart healthy – after all, it was Valentine’s Day and I’m not above doing a cheesy tie-in between chocolate hearts and actual cardiac health.  I’m sentimental like that.  But good thing I brought someone to keep me from milking the sappy heart analogies too much . . . Meghan studio

To help me out, I asked my super smart good friend Dr. Meghan Walsh to join me – you’ll want to click on the Listen to Podcasts link on the right to hear her advice about broken heart syndrome, aka stress cardiomyopathy, and other heart topics.  She’s a hospitalist (cares for people in the hospital) with a focus on cardiology – in other words she totally knows what is going on when you have a heart problem.  And she should know a thing or two about keeping it healthy.  Too bad she hails from “the wrong side of the tracks” (which to a Minnesotan like me means she’s from Wisconsin).

Lately, though, I’ve been thinking about living longer and living well.  I talked about “Living to 100” on TV last week , I wrote my last blog post on “Living to 100,” and I just worked a week in the hospital where I pronounced the deaths of two people and cared for several more in the last weeks of their lives.  Let’s just say longevity is on my mind.  So Meghan and I talked about not just heart health, but how to actually live longer in general.  And during the show, she brought up the concept of Blue Zones.

Say what?  Blue what?

Well it turns out some cool people have looked all around the world and located little pockets where people actually do live a good deal longer than the rest of us.  And they do so with vigor and purpose and vitality.  This intrigued me, and having looked into it more, I’d like to share it with you.  Read on for more . . .

So what the heck is a Blue Zone?

Turns out there is a guy from Minnesota named Dan Buettner who worked with National Geographic to identify areas in the world where people actually live longer than the rest of us – and then to try to figure out how they are doing it.  I haven’t met Dan but I’d sure like to.   He called these areas Blue Zones:blue zones


After studying these areas, where people routinely live longer than in most other communities (even living to 100 and beyond), the researchers learned some key factors – and none of them required fad diets or going to the gym!  He wrote a book by that name and he’s given some really engaging talks about it.  They will really get you thinking:

In his work on Blue Zones, Dan Buettner learned that these 5 communities shared 9 important characteristics, grouped into 4 categories.    Note that all of this is his work, not my own – I want to give appropriate credit –  but I’m going to paraphrase them here and include how some of it makes sense in my own life.  Maybe it will in yours as well.

And you’ll just have to read to the end to learn about procreative success.

Move naturally

  1.  Moderate, regular physical activity.

Communities in which people live the longest tend to be quite active, but it is not through intentional exercise – at the gym or anywhere else.  Rather, they structure their communities and routines so that movement is a routine part of daily life, not scheduled like we do.  Gardening.  Taking the stairs.  Regular hikes for leisure.  Mix the cake batter by hand rather than use the mixer.  Stuff like that.

Right outlook

2.  Life purpose

The Okinawans of Japan have a saying  – ikigai – which basically is the reason you get up every day.  The Blue Zone researchers found that having a sense of purpose is worth 7 years of extra vigorous life expectancy.  So many of us, however, retire from our jobs somewhere in our mid-60s, then try to figure out what to do that feels meaningful after that.  But Dan found that really old people in Japan still maintained a sense of life meaning – be it fishing, holding great-great-great grandchildren, or doing martial arts.

Here in Minneapolis, this week I admitted to the hospital a woman in her 80s who broke her hip while playing volleyball. Her goal was to get well enough to get back to her active life.   The take-home point is not that she broke her hip; that was an acceptable risk to her.  The take-home point is that she was out playing volleyball.  Awesome.   (Full disclosure – I changed a couple bits of her history to protect her privacy – but the message is the same).

3.  Stress reduction

People who live longer tend to know how to chill out.  They do this in ways that are meaningful to them, something we could all learn to do.

I’m about as Type A as they come and tend to talk too quickly, move too quickly, eat too quickly.   Guilty as charged.  When walking around Lake Harriet with Julie, my wife, she often grabs my hand.  I like to think it is for romantic reasons, but as she points out, it’s to keep me at a pace that doesn’t require her to jog to keep up.  So calming down is not a strength of mine.  But I do try.  Like live classical music concerts.  For me, a heavenly evening is spending an evening at Orchestra Hall listening to the Minnesota Orchestra.  I don’t talk to many – or any – people since I usually go alone.  For my wife, and many of my colleagues who are doctors, stress reduction means a ritualized practice of meditation.  For you it may be something else.  But we need to learn to sloooooooow down.

(Quick aside – we recently did a HealthyMatters show on meditation with a cardiologist colleague of mine, Steve Goldsmith, and a Buddhist master, Marc Anderson.  Listen to the podcast here).

Eat wisely

4.   Moderate calories intake

This is one I’ve been harping on for years when giving my own presentations on living long.  Portions sizes today = obscene!  Believe me, when you go to one of those big sports bar restuarants, you know the kind with 98 big screen TVs lining the walls, there is nothing OK about the size of that plate of food.  There just isn’t.  There are enough calories on that plate for two or even three meals.  Eating less is something we can and should do – and there are tips to help.  Like reminding yourself before every meal to stop eating when you are 80% full like the Okinawa folks.  Or putting the food on the plate in the kitchen, rather than serving family style at the table where you are tempted to take more helpings.  Or just use a smaller plate.  Simple as that.

5.  Plant-based diet

I’m sorry if you are in the meat-producing business, but I have to say it.  It is pretty clear that we need to eat, as I say, “lower on the food chain.”  Plants and legumes should be the mainstay of our diets – and the more colorful, the better!  The dark green, rich red, and bright orange ones are best.  This is pretty well established advice.  If you do eat meat, make it lean and in much smaller portions than we are used to.  The meat – if present at all – should be the size of a deck of playing cards.  The veggies, whole grains, and legumes should take up most of the real estate on your plate.

6.   Moderate alcohol intake, mostly wine

A glass or two of wine daily is probably reasonably good for you, at least if you look at the communities where people are living a long time.  Many of us doctors have been saying this for years, and there is some evidence to back it up.  After all, people in Provence seem to do OK with it.  I always qualify this recommendation, however, because it just isn’t for everybody.  For instance, if you have alcohol dependence or addiction to alcohol or other substances, certainly this is a really, really bad idea for you.  And as a doctor, I see people all the time who drink 7 drinks on a Saturday night, thus averaging out to one per day for that week.  Sorry, doesn’t work that way.

Right tribe

7.   Engagement in spirituality or religion

This is a common theme in the Blue Zone communities.  People who live to 100 typically are part of a spiritual community of some sort.  And they aren’t hit-or-miss about it – they show up several times per month for some sort of spiritual connection.

I was in Jerusalem on Yom Kippur last year.  Talk about honoring the holy days – the entire city shut down in what seemed to me a collective nod to the spiritual.  And my Muslim friends pray faithfully many times a day.  And Christians like the Adventists of Loma Linda reverently keep the Sabbath.  Just examples – your faith traditions may be vastly different and that is OK, but the idea of regular spiritual engagement as a factor in how long you live – well that intrigues me.

8.  Engagement in family life

Communities in which people live to 100 tend to be very family-centric.  They take care of both their children and their aging parents.  Old people are honored in the family.  It turns out that taking care of your family makes you live longer.  A good read about this is Atul Gawande’s Being Mortal.  I recommend it.

9.   Engagement in social life

Isolation isn’t good for you.  That seems to be clear.  This makes sense to me – particularly in our culture where our “friends” may well be people we barely know on our social media accounts.  Watch the TedTalk that I referenced earlier in this post and learn of the close-knit group of people in Okinawa who are life-long companions throughout the life journey of the group.  Through good and bad.  Wow.

When I was in medical residency we had a group of friends that hung out regularly to de-stress, commiserate, laugh.  We called ourselves the “Plexus” a name whose origin is a long and probably boring story.  Meghan Walsh was part of the Plexus.  But the group sort of scattered after our residency at Hennepin County Medical Center though some of us have stayed in touch.  Our friends come and go sometimes.  Not a good thing, perhaps.

Meghan and me studio

Here’s Meghan and me at the studio – the remnants of the Plexus.  (And now if I could just lose that gut . . . !)

OK, as promised . . .  what is procreative success?  Sounds like something good, eh?

According to Dan Buettner, this is the genetic goal, if you will.  It means that we are programmed to see our children and our children’s children and if we do, that’s considered success, at least evolution-wise.  So all this longevity talk – well, evolution and our genes have little to say about that.

So look to the Blue Zones for help.



Staying active on the frozen tundra

Downtown in winter HCMCAs most of my radio listeners know, I’m a runner.  Like many of you, I find a few miles on the paths of Minneapolis to be relaxing, rejuvenating and probably pretty good for me.  But here in Minnesota, the weather presents some challenges.

So how do you stay active in winter, whether running, walking, or just getting to your car?  Here’s what we’re up against – check out the view from my office on this balmy February day.  HCMC is on the left, the Star Wars sandcrawler behemoth invading downtown from the right is USBank Stadium, still under construction.  Not your ideal running conditions, eh?

As a doctor, I know there are risks to everything, including being active outside.  Your asthma may get worse or you may fall and break your wrist – there are real risks and of course, you should tailor your exercise regimen to your own situation – but in general being active beats the alternative!  So we soldier on – off for a run.

Here’s my route on the street by my house:

Mpls street winterPretty, don’t you think?

Of course you could exercise inside – there is always the gym and the dreaded treadmill.  To be sure, that’s better than sitting on the couch.  But to me, a mile on the treadmill feels like an eternity, and it’s a bit soul-sucking to be lined up with a bazillion other people, all plugged into their headphones, running like hamsters.  Much better to be outside, I think.

For those of you living in southern California, you can get all smug now.  For those of us in God’s country (aka Minnesota), let’s talk about surviving a winter run (or walk).  Basically there are 2 concerns, both of which sadly happen with some regularly:  a) falling on your tuckus, and b) freezing various body bits.

Continue reading “Staying active on the frozen tundra”