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1. Mind Body Spiritual Connection Exercise & Movement Nutrition Mindfulness $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500 $500 $500 $500

2. An article in JAMA recommended that every adult American supplement their diet daily with this • A banana • Vitamin E 400 IU daily • An apple • A multivitamin • A cup of coffee

3. Recommended for all adults based on several health trends: • Junk food consumption is on the rise • People are spending less time outside (less vitamin D) • Elderly people tend to be deficient in several nutrients • Prevention of neural tube defects improved with folate supplementation • Limited evidence that supplementation leads to overdose • Most brands are equivalent -Price does not correlate with quality • Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults: clinical applications. JAMA. 2002;287(23): 3127-9.

4. This colorful fruit contains more antioxidant by weight than any other. • Blueberries • Strawberries • Raspberries • Blackberries • Oranges

5. Some thoughts on antioxidants: • Free radicals linked to a number of health problems • Antioxidants decrease their levels • Some evidence that high doses in certain conditions can be harmful or not effective: Vitamin E and colon cancer • Easiest to recommend in foods • Some evidence that a mix of antioxidants may be superior to high doses of just one • Use of antioxidants for people getting chemotherapy or radiation therapy questioned

6. This component of food not only helps with GI motility, but may protect against colon cancer and lower cholesterol levels • Omega-3 fatty acids • Fiber • Complex carbohydrates • Polyphenols • Caffeine

7. Fiber • Nondigestible carbohydrates cellulose (wheat) gums (oats and legumes) pectin (apples, citrus) hemicellulose (bran) • Partially fermented in colon • May be soluble or insoluble • Some contradiction with studies on fiber and colon cancer • Fiber from oats beans, psyllium, or fruit pectin can lower LDL -9% in one study

8. This group of essential fatty acids, found in walnuts, flax, and fish, decrease inflammation and reduce the risk of heart disease. • Trans-fatty acids • Omega-6 fatty acids • Arachidonic Acid • Gamma linoleic acid • Omega-3 fatty acids

9. GISSI Study (11,324 Men) 850 mg/d fish oil

10. The most heart healthy diet is • The Atkins Diet • Mexican Diet • German Diet • American Diet • Mediterranean Diet

11. Mediterranean diet has.. • Low glycemic index carbohydrates • Rich in omega-3 fatty acids/fish • Rich in Olive Oil • Fruits, vegetables beans & grains • Limited saturated fat.

12. The Dietary Guidelines for Americans in 2005 Recommend this amount of exercise • 30 Minutes of moderate exercise most days of the week • 60 minutes of moderate to vigorous physical activity most days to prevent weight gain and 60 to 90 minutes of daily physical activity to sustain weight loss • 40 minutes of walking daily • 30 minutes of vigorous exercise three times a week.

14. The words T’ai Chi come from the Chinese phrase meaning: • Fluidity and Flexibility • Strength and Gentleness • Masculine and Feminine Energies • Supreme Ultimate • One with the Flow

15. Which of the following does not describe the Sun Salutation? • A chanted ritual performed at sunset to prepare for the evening meal • A series of 12 movements in yoga, gracefully linked into one fluid motion saluting the sun • Yogic asanas (poses) which are often done in series at the opening of a yoga practice • A Yogic series coming from Hatha yoga and including mountain, plank, and downward dog poses, among others—designed to stretch the body in multiple, opposing directions

16. Sun Salutation

17. Which of the following is not a benefit of moderate aerobic exercise? • Increased blood hemoglobin levels • Increased cardiac output • Decreased insulin sensitivity • Improved psychological health • Improved reaction time and balance

18. De-

19. Therapeutic Dancing has been shown to do all of the following except: • Increase feelings of self-esteem and confidence • Increase joint flexibility and strength • Lead to frequent stress fractures of the fibula • Increase aerobic capacity • Leads to greater sense of social connectedness

20. Movement & Dance Work like you don’t need money, Love like you’ve never been hurt and Dance like no one’s watching!

21. Yoga is derived from this word that means union of mind and body • Hippie • Yoke • Yoko Ono • Yoganna • Yuppie

22. We are only human!

23. Abdominal Breathing is a relaxation exercise that does all of the following except • Lowers blood pressure • Improves blood and lymph flow • Stimulates the parasympathetic nervous system(relaxation response) • Cures a stressful lifestyle • Enhances immune function

25. Double Jeopardy

26. Expressing stress related emotions through journaling has been found to • Reduce the risk of cancer • Improve severity of symptoms in rheumatoid arthritis and asthma • Reduce the risk of a secondary cardiac event post Myocardial Infarction • Improve mood at the time of writing

27. Disclosure/Journaling • Smyth JM, et al. JAMA, 1999 • Effects of Writing About Stressful Experiences on Symptom Reduction in Patients with Asthma and Rheumatoid Arthritis. • Study Group: Wrote about a stressful life event for 20 mins/d for 3 days • Control Group: Wrote about daily events • 107 patients. • Asthma: 20% improvement in lung function vs no improvement in control • RA: 28% reduction in disease severity vs no change in control.

28. Forgiveness means to • Tell someone who has hurt you that what they did was OK. • Free oneself from the control of the 'offender’ and the emotions that are retained from being hurt. • Reconcile with the person who wronged you. • Is a simple and straight forward process.

29. Drop Beneath your mind’s thoughts and …..observe. Emotions Judgment Thoughts Awareness I am an old man and have known a great many troubles, but most of them never happened.-Mark Twain-

30. How many “F”s are there in this paragraph? FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERIENCE OF YEARS. • 2 • 3 • 4 • 6

31. “There is nothing good or bad but thinking makes it so.” Hamlet

32. Mindfulness Meditation is The practice of emptying your mind by focusing on the breath The practice of intentional slow deep breathing The practice of non judgmental awareness in the present moment bare of decision, and commentary

33. Peace………It does not mean to be in a place where there is no noise, trouble or hard work. It means to be in the midst of those things and still be calm in your heart. -unknown Mindfulness

34. One of the ways to know that you are practicing mindfulness successfully is, You will experience being calm all the time You are able to know that you are present with whatever arises You will feel like you are floating between being awake and being asleep

35. Extreme Sports • Extreme situations force you to be in the present moment. • These life threatening events bring you into the now. • Can be addictive • How can we do this without threatening our lives?

36. During meditation thoughts • Are something to be avoided • Are a sign you are not doing it right • Both 1 and 2 • Naturally will come and go

37. MeditationAlex Grey (Harvard anatomist and artist)

38. When teaching mindfulness to patients experiencing chronic pain • One should work closely with a physician to provide appropriate medication for the person prior to learning mindfulness • It is necessary to teach them to distance themselves from the actual felt physical sensations in their body through observations • Support patients to directly experience and label the physical sensations of pain ie “ burning, pulling, stretching, throbbing, pressure”etc

39. Mindfulness & Pain % Pain • 51 pts with chronic pain not responding to traditional care. • 33% had a 65%  in Pain • 50% had a 50% reduction in pain Kabat-Zin. Gen Hosp Psychiatry. 1982 Apr;4(1):33-47.

40. The practice of mindfulness meditation requires Quiet secluded place The proper support cushions The lotus sitting position None of the above

41. Ice fishing

42. Which of the following best describes spirituality? A) Miserable renunciation B) Tormenting celibacy C) Abandoning the world D) Unconditional happiness Lahiri Mahasaya

43. Spirituality is a constellation of practices that awaken the heart and mind. • Rodger Walsh, MD, PhD UC-Irvine

44. Happiness • “Spirituality is difficult to define or measure…[but is essentially] a journey toward, or experience of, connection with the source of ultimate meaning. Spirituality includes connection with one’s self, with others, with nature, and with a higher power. This connection is often with a greater story that makes sense of one’s life. Spirituality may or may not involve formal religion.” —Gregory Plotnikoff MD, Director, Univ of Minnesota Center for Spirituality and Healing, from Rakel,Textbook of Integrative Medicine

45. Which is a universal form of transferring inner wisdom and guidance, and helps us understand life? • Cigarettes • USMLE • Myth and stories • Jury duty Yoda

46. Myth and Stories • “The guiding principle of myth and stories is an interior road map that guides us in our intimate search for an experience of being alive. Mythology is the song of the universe, the music of our lives. Comparable stories are found in divergent traditions, calling us to a deeper awareness of the very act of living itself. Myth teaches us that we are at this moment participating in one of the very greatest leaps of the human spirit to a knowledge of our own deep inward mystery.” —Joseph Campbell, Sarah Lawrence College, The Power of Myth

47. Medical, Cognitive and Surgical therapy, are encompassed by this most essential component of healing. A night on the town Knowing the right answer Bossing others Love (Spirit)

48. Love (Spirit )or Unconditional Positive Regard • “There is a correlation between the disappearance of a serious medical problem and falling in love. I wish I could arrange for patients to fall in love more often. If I could figure out how to do that, I would be a very successful practitioner indeed.” —Andrew Weil, MD, Director Integrative Medicine Univ Arizona, Spontaneous Healing

49. The biggest obstacle to true happiness is… A) Not having a lot of money B) Medical school C) George Bush D) Addictive thinking Eckhart Tolle

50. Addictive Thinking…(example of assessment and tx plan)