Sept 4

8 months in the books. Labor Day weekend is here and there are only a few official weeks of Summer left. With any luck, we are through the heat waves and the devastating storms. With any luck we have been stretched but not torn, challenged but not beyond our limit.

A person's "ability to manage and positively adapt to adverse conditions", known as resilience, has been shown to support both physical and mental well-being as we go through life.....and it is one of the critical strengths we can hope for during periods of prolonged uncertainty like the kind 2020 has seen.

With that in mind, and with a holiday that celebrates hard-working-people providing a perfect backdrop, now may be a great time to reflect on where we stand in this category and make some adjustments if needed.

So how do you know whether you're resilient?

In truth there's probably no perfect way to know, but we can get close by rating ourselves on the following 14 statements on a scale of 1 (strongly disagree) to 7 (strongly agree):

1. I usually manage one way or another

2. I feel proud that I have accomplished things in life

3. I usually take things in stride

4. I am friends with myself

5. I feel that I can handle many things at a time

6. I am determined

7. I can get through difficult times because I've experienced difficulty before

8. I have self-discipline

9. I keep interested in things

10. I can usually find something to laugh about

11. My belief in myself gets me through hard times

12. In an emergency, I'm someone people can generally rely on

13. My life has meaning

14. When I'm in a difficult situation, I can usually find my way out of it

Now add up your scores. Did you score above 82? If so and you can maintain that outlook as you age (so says the research) you are more than twice as likely to report good health later in life.

Maybe more importantly, the following factors are known to underpin this capacity and high rating:

Optimism, adaptive coping styles, community involvement, social support/connectedness, physical independence, high mobility, physical well-being and self-rated "successful" aging.

What does this mean for those of us who'd believe the next 8 months may require as much (or more) resilience as the last 8 have?

Well - getting moving, improving health and keeping life's challenges in perspective can go a very long way.....in a very short time. When you're ready, we're here.

Work hard and stay strong. Bend, but don't break.

Have a great Labor Day,

Mike E.

Aug 28

I woke up early wishing I had remembered to bring some coffee grounds. It was early and the cabin was especially quiet. For me, it was the kind of moment that marks a vacation. A slow start to the morning, on my own terms with some peace in knowing that each member of my family was nearby and safe. But it would've been better if I was prepared with fresh coffee.

My curiosity got the better of me and I took a peak at what happened with Hurricane Laura while I slept. I hoped the news stories of wind speeds well into the triple digits and a possible 20 foot storm surge were exaggerated. It made me think of the people who were in the path of the storm and hope they made the choices required to stay safe. A few of the news stories made it sound especially grim calling the expected surge "un-survivable". It really brought to life how much was riding on each person's choices and it made me think about the complex web of agencies, people and job tasks that go into the many phases from preparation to restoration. I hoped many of the lessons learned after Katrina, 15 years in our collective rear-view would be implemented smoothly this time.

Scanning the list there were 3 critical concepts that seemed to jump off the page, universal pillars of success from prevention to restoration, whether in the face of a storm or staying safe on the job.

Resources - these are the "inputs" which ensures the output of safety & security. Time, energy, money, tools, etc - success is far more likely when we've got what we need.

Preparedness - thinking ahead, weighing the odds and readying ourselves for what "could be" helps us to recognize gaps in our plan and fill them in so we can ultimately stay on the right side of the risk/reward curve.

Communication - it's not always words but it's at the heart of all of our systems and interactions. The ability to quickly & effectively relay, receive and process information is often the difference between success and setback.

Want to get somewhere safely and on-time?

Having a full tank of gas or a charged up battery certainly helps (resources). Taking a peak at traffic prior, getting on the road with some extra time built in for the unexpected keeps the stress of the situation manageable (preparedness) and staying in communication with the drivers (signals, mirrors, etc) and the environment (road signs, road conditions, etc) takes a complex activity with lots of risk and keeps us on the right side it.

Want to keep yourself from experiencing pain at work? According to this recent study - the factors that matter are very similar.

Having the physical capacity (strength, range of motion, balance) and the right mindset (ability to focus, confidence in skills) are KEY resources. Reviewing the steps required to do the job, making sure the tools are accessible, planning in breaks and posture changes allow for us to work within our safe limits - Preparedness. Listening to our body for signals of fatigue, keeping an eye on the time to make sure we are balancing the work/recovery clock and staying in tight communication with our team all minimize the load and therefore risk.

The concepts are simple. Doing them well takes effort. The payoff is worth it, even if it's just as small as a hot cup of coffee in the quiet of the morning.

The homestretch of the summer is here. Our thoughts are with those who are impacted by the storm.

Stay strong,

Mike E.

Aug 14

"Fatigue makes cowards of us all" as the saying goes....and no one is quite sure who said it first. Although it sounds like Vince Lombardi (one person it's often attributed to), the quote has also been attributed to US Army General George Patton. It probably doesn't matter. Whoever did actually say it first couldn't possibly have known how far down the rabbit hole the statement would take us.

Whether it be the quest to quantify and qualify the factors of fatigue which leave us uncomfortable, irritable and error-prone when we hit our threshold, or the endless supply of performances we hold up as "heroic" when people find a way to defy those same factors, it holds a place of importance and mystery in day to day life.

Take for example this week's prime time show of endurance - 5 overtime periods in a playoff hockey game - FIVE! Even in defeat, the losing goalie was breaking records for saves. How is this possible? What will it do to these players over the next games? Will injury rates go up? Plenty to speculate about there.

But it's not just "fun and games" (and professional athletics) is it? What about if it's experienced during high-stakes work like natural disaster restoration? Is it the same?

Well, no.....and yes.

No - disaster recovery work is rarely done by people with endorsement deals or deep interest in personal jersey sales. They are simply playing a different game altogether.

And yes, understanding the factors and knowing how to proceed is critical if we are to find that "zone" which seems to live in the space between hard-earned success and the risks of injury/illness/disease to get there.

Take for example this recent paper which profiled National Guard Medical Personnel during intensive disaster training. Highly trained people doing meaningful work who, when they got tired (as measured by a simple rating 0-9 scale which has been around since 1990), made substantially more errors......exactly as the researchers expected.

What really stood out to me was how significant the difference was - those who felt energetic averaged 91% accuracy (error-free) and those who felt really fatigued only 60% - a full 30% difference. Like many who perform high-risk tasks as part of their work, these included life-or-death decisions, so an error rate of 4 of every 10 chances is a little scary. If we were to give it a letter grade, the well-rested folks would be scoring an "A" or close to it where the tired folks would almost be failing....yikes.

What's the take-away?

We shouldn't be afraid of fatigue. As humans, our systems actually get stronger when we see it as a warning light and refill the tank with rest to RECOVER fully from it. However, as seen in research environments and the real world, since our performance clearly begins to degrade and the risk of failure climbs quickly when we begin to sputter and run out of gas, we should definitely respect it.

If you're running on fumes, please reach out to discuss a refueling and RECOVER strategy any time.

Stay strong,

Mike E.

July 31

Great performances seem to defy the odds. They seem to fly in the face of logic and reason, as if to showcase some other-worldly bank of energy that champions tap when the competition within the competition begins. In the 2020 US Olympic marathon trials for example, it was the 3 top finishers in the Men's race who did it......which was the same on the women's side; each of the top racers demonstrating an ability to dig deeper, maintain focus and ultimately run faster in the second half of the race. To perform even better as fatigue set in and the competition faded in order to get the win. It's similar in mindset to one of my favorite traditions, called "four fingers", which, as I interpret it says something like, "when it really counts, count on us"......and made Tuesday morning attention grabbing.

It was already warm by 7A, and it had every indication it was going to get hot. The group was huddling up to do what all great teams do - talk through the current status (where things are), compared to historical trends (how things typically go) to determine a strategy that could unleash greater successes (how to make things even better) in the second half of the year. The details of the conversation were striking. Ultimately, much like the marathon, it was the tale of two halves; a story of a historically strong start but some troubles maintaining the pace as the heat that July brings set in. To a data-geek like me, it was the kind of insight that could be game-changing, something to be leveraged for a new personal best.....a great new way of using the past to predict the future and maybe even anticipate common roadblocks and pitfalls.....something we can all learn from this time of year.

Because here we are.....almost 50% through the Summer (approximately 6 of 13 weeks) and a little more than that through 2020 overall (58%). The temps are soaring which makes fatigue and all of the risks that come with it right at our doorstep. There are plenty of distractions that are begging us to lose our focus and ruin the strong-start many groups, despite all of what the year has brought, have achieved to get within striking distance of a top performance from a health & safety perspective.

What do we do now?

Well - if you're Aliphine Tuliamuk (female champion) or Galen Rupp (male champion) or those who might benefit from their strategy, you stay patient, not changing much at this point. For them it wasn't until the race wasn't until mile 22 and 18 respectively that they decided to push and run their fastest miles. The focus of the champion, able to leave enough energy in the tank to perform when the moment demanded it. Their combined approach (no surprises maybe) averages out to 76%....almost exactly a "four fingers", last quarter push....resulting in success.

What can we learn from top competitors?

Well, getting off to a solid start in 2020, despite mega-challenges is something to be appreciated, yet there's still plenty of race in front of us, and so, if we want to “win” and make 2020 a banner year, now is the time to put effort into our focus and try to stay relaxed. Energy management is what this stretch of race calls for......because we've just started running.....the race within the race hasn't begun just yet.

Keep fueling and recovering well. Take some stretch breaks along the way. Hydrate, keep cool and call us if you need some guidance. The moment to “race” will be here soon, and there are plenty of individuals, teams and departments vying for a spot on the podium. Nothing would be better than the “everybody wins” of a safe second half.

Stay strong. Have a great weekend,

Mike E.

July 17.

As I bit into a ripe peach on Tuesday I found myself with an urge to drive North. Not way North, like the mountains (although that sounds cool).....but just a few miles to a place where some fond family memories have been made. I flashed back to rows and rows of apple and peach trees and a time when my kids were young enough that I could lift them up so they could reach for the "really good ones" at the top.....and this is almost the perfect time of year to go.

Of course it's not only peaches. Gardens everywhere are starting to produce....another great sign that summer is in full swing and whether you're a fresh fruit/veggie lover or just someone who is trying to stay vibrant, young and healthy, this is great news.

In addition to the almost countless benefits of eating fresh, low-processed, high fiber foods (there are MANY), some recent research from the University of Colorado has given us an even better understanding of why - especially if, summertime also means barbecue.

For a while now we've known that consuming certain foods (especially red-meats and animal sources of protein) ramps up the production of a byproduct called TMAO, which has been tied to heart disease and accelerated aging at the cellular level. With that in mind, it's been suspected that foods that neutralize this production could help minimize that harm or even reverse the signs of aging. And now, with the help of certain gut bacteria, it seems the theory is right.

How can we nudge these bacteria into action?

Well, certain foods that contain a substance called dimethyl butanol, such as grapes & moderate amounts of red wine, certain balsamic vinegars, citrus and cold-pressed oils such as olive/grapeseed as well as certain fish-oils all have the track-record of getting this started.

It's not a cure-all. It doesn't mean the piece of parsley will counteract all the impact of a 40 oz. steak.....but what it does mean is we've got another solid tactic and a perfect time of year to experiment with it.....and since we know the same approach has a strong impact on priming the immune system and keeping it ready to fight whatever we might be exposed to.....it can help us win the summer.

A trip for pick-your-own may not be in the cards for everyone.....but picking up a handful of fresh veggies and working them into your summer meal prep can go a long way.

Have a great weekend, win the summer,

Mike E.

July 2.

I remember reading the 2007 study which said a very short survey could predict success in West Point cadets, National spelling bee champions and Ivy Leaguers. The simple conclusion was a reassurance of one of the principles that had been ingrained during my childhood - and something we've all read in the famous "Tortoise and the Hare" parable. Paraphrased "keep making progress.....because people who take on AND stick with long-term goals out perform those who don't.....even in some of the most challenging environments".

Of course, a lot has happened in the +/- 13 years since that time.....this year alone has been challenging enough to distract many (most?) people from a long-term view. With a world that is changing as fast as ours is currently, just getting through the day seems noble enough. But an idea that just keeps coming up probably shouldn't be entirely ignored. In 2019, Duckworth and her team showed that even after 10 years, "grit" was still a very strong predictor of success at West point and even as recently as last month research on some of the toughest of the tough - Marine Reconnaissance Trainees using both wearables and surveys - showed that success was predicted more by mindset/mentality than by physical abilities.

We're getting ready to celebrate our freedom and independence......maybe something we can fall into the trap of thinking was a goal of history.....something that we enjoy but someone else achieved. But maybe if 2020 has provided us anything, it's a chance to zoom out a little bit and remember that although we have surpassed many amazing milestones as a nation, we still have room to grow in the long term view.

I'm no historian of course......I don't even play one on TV......but I hope that as we each take a moment to enjoy our freedoms in our own way this (hopefully long) weekend, we can pause long enough to toast the stamina it takes to succeed in an ever challenging world.....and stoke the grit it will take to get "there".

Here's to all of US.....the endurance required to succeed and the independence we enjoy on our way.

Stay strong,

Mike E.

JUNE 19.

We're pretty much there everyone. The longest day of 2020 is upon us. This Saturday kicks off the "100 days of Summer" (94 to be exact).....which is that period of time when daylight peaks, the gardens produce, the weather fatigues and dehydrates us a little faster, energy demand surges and......those who are able, retreat for some (physically distanced we hope) vacation.

Songs are written about this time of year. Nostalgia bombards our senses with the sights, sounds and even smells of "summer". If you spend time "in the country".....maybe it's the sweet tinge of wild flowers, honeysuckle and morning dew that brings you back. If you're a beachgoer maybe it's funnel cake or some other sweet-treat on the boardwalk? Or suntan lotion?.....Or at least a dozen sights that are uniquely summer.

Perhaps the most prototypical icon of summer is the beach body, which in a society where youth and vibrance is prized, often translates to "health". Now, in fairness, we know that those two things, strong/toned body and the vitality we call "health" are often correlated, they are not the same. It hopefully goes without saying that a fit looking body does not actually guarantee health.....in fact it may be the effort that matters more than the result.

Since health is an active, ongoing and never fully "achieved" phenomenon, it's the doing, the action, that really matters. Sure there are ways of testing where we stand (run a mile in less than 10 minutes, do 25-40 push ups without stopping, all are solid markers for most adults) but health doesn't come from studying for the test.....but rather from stimulating the system and nudging it to stay efficient.

In the last 30 days alone research has demonstrated that taking the time to exert ourselves through exercise can:

• Improve memory and brain blood flow

• Help the body recycle cellular proteins needing repair

• and potentially reset the cellular body "clock" for those who are having trouble sleeping

When we combine this with the benefits of lowering inflammatory load and stimulating vitamin D (both known benefits of physical activity, particularly when performed outdoors) known to lower the risk and impact of COVID19 we are left a very simple strategy:

MOVE......enough to get out of breath and break a sweat.....as many times over the next 94 days as possible.

Start small.....build up.......and enjoy the massive benefits.

Win the summer.

Stay strong,

Mike E.

JUNE 5.

In many ways, we are a product of our environment. Take for example the very simple (sounding) combination of safe sidewalks, solid public transportation and scarce parking. When these are the norm, it is more likely people will walk from place to place when they need to get around. This of course has significant ripple effects - it impacts our social experience, we may see and meet more people who are also walking nearby; it might impact our consumption patterns, we may shop more local to where we live or only purchase what we can reasonably carry. We might even delay or skip buying something rather than make multiple trips. It even impacts our health - people from "walkable" cities tend to have lower blood pressure overall.

Of course, it doesn't end with our physical environment. Our social environment can similarly impact our actions, which in turn, impacts our health. Whether we feel a strong sense of CONNECT & trust with the people and institutions around us plays a role in the often delicate balance between pushing ourselves (physiological effort and stress) to complete the day's work and charging up and recovering fully for the next day.

But what happens when our environment drastically changes? What if everyone just stopped walking around? Or what if you suddenly felt disconnected from the people and institutions you trust? Would that have an impact on our risk and therefore our health?

Well, it certainly could. That kind of change, playing out right now, is having an impact on health. It stresses our physiological systems and can leave an imprint all the way down to our genes.

But here's the good news. As humans we are incredibly adaptable.....it's probably one of our greatest features.....we can acclimate to new circumstances if we give our bodies and minds a chance to do so. When we do the hard work of listening and learning, whether to our body or the cues from the world around us and people in it, we can adapt "what we know" and begin to change......and when we do this hard work of change, we can grow and get better.

Take for example an experiment most of us run every single year around this time. It's something we are so good at we usually don't pay much attention to it. However, it is something that has major implications for our health AND something we've started again this week. We will naturally be fitter and stronger if we allow ourselves to adapt fully and we can do it safely if we listen to what our body is telling us.

The exposure? Heat, forcing us to adapt and change.

Heat makes our heart run a bit faster: we have to pump a little harder to push the blood toward the skin to help us stay cool. We like to say "heat stress is heart stress"....and it can tire us faster than usual. Our natural tendency is to slow down a bit - which works if we can, however sometimes we're not able, so instead we have to plan in extra rest during the next 8-14 days.

Heat makes us dry out a bit faster: as humans our "engine" is both air cooled and water cooled, so our hydration status plays a big role in our ability to regulate heat. If you are pretty well tuned into thirst, simply noticing how thirsty you are (or aren't) when you wake up and adjusting can work well. In one study, rating thirst 0-10 was closely correlated with actual hydration status. If, on the other hand, like me, you can get into your day and forget to drink fluids, setting a reminder or tracking it can help.

Heat changes our "output" too: as we dry out the concentration of salt in our body can change. This is a classic "not too little, not too much, just right scenario"; Not enough salt (hyponatremia) is dangerous and high concentration, the other end of the spectrum, tends to have other ripple effects like changes in blood pressure, muscle function, etc. Paying attention to both urine color AND the volume of output in the 30 minutes after drinking 16-32 oz of fluid can provide reliable clues.

Here's the take-away. We are adaptable creatures and we can do amazing things when we embrace the need to change. The world has certainly presented us very compelling reasons to change, scenarios we must adapt to if we are going to live and thrive. Some of them are physical, some social, some are viral, some environmental.....all are complex and hard.....but we can adapt and will come out stronger for making the effort.

Stay strong,

Mike E.

MAY 22

With almost 50 health-oriented videos and a new home ergo section on the website, if you're looking to thrive, we've got you covered. Here are a few of the "little things" we discovered and posted this week:

ERGO: You can use two towels shaped like a cross to create an ergonomic solution for the problem of using a laptop on a deep and cushy couch. Video here. Got other COVID19 inspired DIY home-ergo fixes? Send us some pics, maybe we'll feature YOU in a video.

MOVE: Exercise is "good stress" on the body. However, since too much of a good thing can become a bad thing AND a hard session can leave us stressed for as long as 24 hours, understanding how much we can personally "absorb" matters to proper dosing. Video here.

CONNECT: One of the fastest ways to build a connection with someone is to genuinely listen, find something you can authentically agree on and build from there. Video here.

ENDURE: Journaling may be the fastest way to improve emotional resilience and the closest thing to Dumbledore's cool memory pool.....IF you are willing to go deep into your personal journey to get it all "out" on paper. Punchline? It only took 4 sessions to make a difference. Video here.

RECOVER: And if you missed it last week, blood pressure can be lowered in 30 SECONDS if you're willing to go deep.....in this case, into breathing. Video here

ERGO: Got an external keyboard & mouse? A stack of books and a binder can turn that laptop erg-trap into a solid step in the right direction. Video here

Unfortunately we are not out of the woods with this thing.....and we probably won't be for a while....until we are, we will keep bringing you the latest and best info needed to thrive.

Stay strong,

Mike E.

MAY 8

The article described the protocol in place at the hospital system supported by Yale University. It was authored by some of the brightest clinical minds with some of the best resources at their disposal. The gist was pretty clear - this was the best, latest attempt in an ever changing and incredibly confusing game.From the article this was listed under a header titled "The Haze of Battle":

"Yale has updated its algorithm several times since the virus first hit Connecticut weeks ago. A team including pulmonologists, critical care physicians, pharmacologists, infectious disease experts, and cardiologists, including Dr. Desai, are constantly monitoring the situation and making changes as new information comes in."

The only simple take-away I could conclude was that dealing with this virus "downstream" (when people are acutely ill) is incredibly complex. Even after weeks of exposure to cases and learning around the clock, there is just not a ton of consistency in how it acts, making it very hard to treat in those who are impacted.

Looking for answers, the next stop was a revisitation of the NYC experience. It was the story of 5700 people hospitalized and the characteristics were still fairly confusing: Some patients spiked a temperature (30%). A few had rapid breathing (17%). A few more had a drop in their blood-oxygen levels (20%).....but the most common clinical sign was an elevated heart rate (43%). The heart rate statistic was certainly helpful, but probably not definitive as it's reasonable to assume that for many (if not most) people, simply being in the emergency room with everything going on could create enough anxiety to elevate someone's heart rate.

This took us back to Italy, this time as discussed in a letter to the New England Journal of Medicine, where the authors reported, a 58% increase in heart events during the COVID19 crisis as compared to the year before in the same region. A fairly striking statistic by itself, but when considered alongside the NYC data, where a full 94% of people admitted to the hospital had at least 1 baseline health condition (most commonly high blood pressure, diabetes and obesity) the story was coming into focus.

Simply put, the most common health pattern for those hit the hardest by the virus may be "metabolic syndrome", a common and highly preventable cluster of disease risks known to significantly increase heart health risk. It includes elevated blood pressure, excessive weight carried around the middle, difficulty regulating blood sugar as well as blood lipids (cholesterol and triglycerides which unfortunately was not reported in the NYC data).

What's the take away message?

Moderate exercise, increased consumption of fiber, especially from brightly colored fruits & veggies, and efforts to get consistent/adequate and uninterrupted sleep are not only as "good for us" as they've always been, they are now one of our best strategies to stay clear of the haze.

Reach out with questions.

Stay strong,

Mike E.

April 24

The number of deaths had reached 12,000. The cost of damages was more than $64 billion in current dollars and there was no easy answer in sight. Despite the general consensus that those on the frontlines were acting heroically, it was clear that they were struggling not to lose ground and to get on the right side of the risks they faced, something had to change.

Although it may seem that I am describing the COVID19 situation in New York City 7 to 10 days ago, this is actually an account of the United States, circa 1972, as it relates to fires.

It was the result of an exhaustive dive by the experts into the factors at play. It was titled "America Burning", and at 192 pages it went deep into the factors that made America the leader in the world in lives lost per citizen.

And with sentiments like the following:

"If part of the money spent on responding to the tenement fire had been spent instead on enforcing a tough fire prevention code, would the fire have occurred at all?"

It was also the moment that everything started to change. It wasn't super exciting. It didn't make the headlines or the movies. It was quiet and mostly under the radar, but it mattered.

Fire codes got tightened. Fireproof building materials became the norm. Cars were manufactured in ways that lowered the risk of catching fire. As a result, fires dramatically fell......by about 64% over 34 years, even while the population grew by 44%.

43 years later there are many parallels to the situation we're in. As this article explains when high risk is present, this virus causes a firestorm. They are internal to our physiology this time (inflammatory storm) and the professionals on the frontline are reacting heroically but there are opportunities to lower our risk and prevent catastrophe.

We can change the internal conditions that promote fire risk.

As the team relayed on the website this week:

• moderate exercise, lowers baseline risk by stimulating a critical enzyme, even 1 session.

• Eating patterns like the Mediterranean diet (high in fruit/vegetable/fiber/polyphenols) can lower baseline inflammation.

• Spending time relaxing in nature can lower baseline inflammation.

Prevention isn't always super exciting, but it doesn't have to be complex. Whether it's fires or physiological firestorms, we can all play a role in improving our personal odds of success while giving the heroes the best chance to succeed.

Let us know if you need a hand.

Stay strong,

Mike E

April 10

It's been all COVID19 all the time. It has been both tough to see the toll the virus is taking on so many and at the same time, inspiring to witness so many brave humans in every corner of the world stepping up and doing what they can.

It is so easy to feel held helpless by this thing; to feel stressed as only uncertainty seems to be able to do even while we know we are getting closer to what the experts believe is the peak......and therefore the other side.

Here is the good news:

If you've been paying close attention to the COVID19 research you know that we've learned a TON about how this little bug is making its way into our systems. It is exploiting a very particular enzyme that sits on the outside of our cells.

We have learned that since this particular enzyme has an important role in controlling inflammation in our body, when it is being bombarded with virus we are unable to properly regulate the inflammatory response which is at the root of many of the complications people are working through ("inflammatory storm" or "cytokine storm" that is being talked about).

Similar to a natural wild-fire risk going up in dry and windy conditions, we have learned that those with higher levels of resting inflammation are at particularly high risk of complications because of their internal conditions. This explains why those with underlying health conditions known to relate to high inflammatory loads (hypertension, diabetes and other cardiometabolic disorders) are more heavily impacted than those without.

Finally we have learned that each one of us has the opportunity to re-balance our resting inflammation levels through tried and true methods - that if there was ever a time to make an investment in your health now may be it.

In addition to some of the most well-known ways to balance inflammatory load (avoid smoking, limit saturated and trans fat, exercise regularly), here are a handful of inflammatory re-balancing tactics that we covered this week. You can find the videos on the prevention website.

1. MOVE - moderate exercise helps the body clear inflammation. Although any type of exercise can help, some research suggests the greatest impact on the ACE (enzyme) pathway comes in with higher volumes (300 min/wk). Although we recommend building up slowly, this is an excellent way to "soak up" inflammation.

2. FUEL - inflammatory load can be lowered by improving the body's ability to process both sugar and fat. High (saturated or trans) fat meals have often been a target for elimination because they've been shown to immediately increase inflammation, consumption of healthy whole foods (fruits/veggies/nuts/seeds) as well as lean protein (whey/fish) and a few other additives (vinegar, wine) have all also shown to lower inflammation. Moderate (30%) calorie restriction has also been shown to lower inflammation.

3. RECOVER - sleep management can play a major role in inflammation management. After achieving enough sleep (quantity) and restful sleep (quality) it is important to work toward maintaining a normal sleep pattern (sleep/wake cycle).

We hope you're hanging in there and, whether you are sheltering or exposed are staying on the right side of this situation.

Stay strong,

Mike E.

March 26

There are so many storylines it's almost impossible to keep up. There's the numbers lesson which makes it very clear why the reversal of exponential growth (aka "flattening the curve") is so important if we're going to get to the other side. There's the story of the doctors, nurses and respiratory therapists who are fighting mightily but being stretched to the brink with critical shortages of supplies and equipment looming.....it's nothing short of heroic and adds a very human element to the numbers story. And then there's the story of the economic fallout, the $2 trillion dollar emergency stimulus that the government is trying to pass as I type this.....another historic thread in the storyline.

For me, one of the most under-appreciated stories might be this one. It's an incredibly powerful headline that sort of jumps off the page in my opinion and reads something like this:

"Increased health status equals increased COVID19 resiliency, as much as 7 to 11 times."

The data from China shows a very stark contrast. 1 out of every 10 individuals who had cardiovascular disease before contracting the virus were not able to battle back. This was a very different story for those without chronic conditions where 99 of 100 who were infected were able to bounce back.

Does this mean that healthy individuals shouldn't be taking precautions or be aware of the risks? Of course not.

Does it suggest that the experience in China (where the data came from) will be an exact match to that which we will have in the States? No, nothing is certain.

But it does make it very clear that currently health promoting actions are a critical weapon in the fight.

Moderate exercise, nutrient-dense and high-fiber foods with an emphasis on foods that are known to support a healthy immune system (e.g. foods high in natural sources of beta-carotene), 6-10 hours of deep/uninterrupted sleep each night, managing stress without relying on coping strategies that are known to suppress the immune system like smoking and excess alcohol, and regular social connection (even within the rules of distancing) are not just important, they are becoming increasingly critical.

It is with that in mind that the team is publishing a daily video brief, usually between 2 and 4 minutes, to boil down the science into need-to-know and easy-to-share bits and dropping them on the website.

In addition, we know that even the healthiest bodies are going to feel the strain of this stress as it wears on. With that in mind we are ramping up outreach efforts in hopes to connect with as many individuals as possible. If you don't hear from us and/or your group wants/needs a checkpoint you can send your name/location/group on any of the following channels:

1. TEXT your name and location to 844.931.1912 or

2. CALL the hotline 833.776.2281 and press 1 or

3. Email preventionservices@pro-activity.com

The take home message?

If we stay calm, invest some effort into the many cool health-promoting habits that are known to support a healthy immune system and CONNECT regularly, we can continue to do what it takes to change the current trajectory.

Stay Strong,

Mike E.

March 12

The hive is buzzing. Lots of conversation, lots of planning and lots of scrambling about the latest coronavirus and the resulting health concern (COVID-19). I've gotten emails and information from just about every organization that has my name. From schools & clubs that my kids attend, to the workplaces I visit, the colleges I lecture at and even the church I attend, it seems everyone is trying to get (and stay) ahead of the viral-risk we face. Generally speaking, this is a good thing - if, as a society, we can stay calm and do the right things (personal hygiene, social distancing and staying vigilant in our lookout for symptoms) we can keep this risk tamped down and get over this latest hurdle.

On the other hand, I'm always a little let down that official sources fail to mention the many ways that we can help ourselves from the "inside out".....meaning, ways that we can increase our odds of success by taking action that make us a less hospitable "host", should we come into contact with this (or any other) virus. This of course doesn't replace the main strategies.....but it can enhance them. So, with that in mind, here are a few headlines you may not have heard of.....with some citations if you have a few minutes to geek out about it:

1. MOVE - Simply put, exercise improves the immune system. Of course, it's a bit more nuanced than that because there is some evidence that prolonged/max-intensity exercise can leave us depleted and possibly (although hotly-debated) more susceptible to things like the common cold. THIS excellent review with no less than 249 references dives deep and shows that (1) during even a single bout of short term exercise our immune response is heightened, (2) following exercise our immune system remains in a state of alert helping to recognize and kill off invaders and (3) triggering this effect regularly, that is, having an exercise habit improves the immune system on the long term. Oh, and it helps to prevent most major diseases....pretty powerful stuff.

2. FUEL - Although we've mentioned the anti-inflammatory impact of healthy eating (especially eating plenty of fresh fruit & vegetables) which has major implications for pain and disease, the news gets even better when you consider THIS research review of 83 different studies and THIS randomized controlled trial (the gold-standard of research). They both showed improved immune function in healthy eaters who are getting adequate "plants" in their diets.

3. RECOVER - as I mentioned last week, sleep quantity AND quality have been tied to immune function, healing and overall health. There is a TON here. One of my favorites, sponsored by the US military, showed that adequate sleep out-performed even nutritional supplementation as it related to healing times; that is the body could repair the skin faster when it was well rested. The skin is the most critical barrier we have - keeping it healthy matters. One other particularly interesting finding (described HERE) is that when we get enough good sleep our immune cells (T-cells) can bind tighter to virus-infected cells which increases the efficiency of ridding the body of them. THIS editorial for example makes it clear that sleep can even impact the effectiveness of vaccines.

4. ENDURE - The number of studies linking stress to immune health is impressive. How we deal with stress is critical when it comes to staying healthy. If we have good coping mechanisms (like numbers 1-4 above) we will usually bounce back quickly from the stresses we face.....but HERE is where it gets very interesting (in 1 geek's opinion) - stress, as measured through a very accessible measurement (HRV which can now be gathered from a wearable on our wrists) has been tied to immune function. Yep, our heart rhythm and timing can tell us about the health of our immune system.

5. CONNECT - Last but not least, our ability to stay connected even if we wind up having to be physically isolated for health purposes can make a difference. This is especially true when stress (as measured by HRV) is well maintained. THIS 2019 STUDY showed that people with high stress (low HRV) and indications of loneliness had more risk associated with immune markers.

Great news right? The same ELEMENTS that keep us healthy and strong from an injury and illness perspective keep our immune system strong: 20 minutes of physical activity, plenty of fruits/veggies, adequate sleep, avoidance of high-risk stress coping (smoking, excess alcohol, etc) and connecting with friends & family (even if by phone or video call) can go a long way at readying us for the current risk.

Have a great weekend,

Mike E.