Healthier You with Dr. Elizabeth Smoots

Benefits of Meditation

Elizabeth Smoots, MD — Thu, 27 Aug 2026 09:48:39 GMT

Numerous studies have demonstrated the health benefits of meditation. The term means directed concentration. Meditators learn to focus their attention on the breath, repeated words or phrases (called a mantra), or a sound, body sensation or visual image.

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In the process they elicit the relaxation response. Heart rate and breathing slow. Blood pressure and levels of the stress hormone cortisol decrease.

Scientists have found meditation an effective antidote for anger and worry. It’s also beneficial for dealing with chronic pain, panic disorder, anxiety and depression. Meditation has also been found to have beneficial effects on high blood pressure, heart disease, cancer, irritable bowel syndrome, psoriasis and many other ailments.

The best way to find out how to practice meditation is in partnership with your health care team. You can also learn the ancient practice through books, tapes or classes. Here are some tips on how to get started:

Pick a place and time free of distractions, e.g., on arising.
Sit on a comfortable chair or cushion with your spine erect.
Close your eyes and quietly take slow, deep breaths.
Turn your attention to a specific focus. Each time your mind wanders gently bring your attention back to your focus.
Learn creative ways to meditate 10 to 20 minutes each day. You can practice it while falling asleep, eating or doing routine chores or activities in a safe place.

Scheduling a time and place to regularly practice meditation is important in order to get the benefits.

This newsletter is for educational purposes only. It is not intended as a substitute for medical advice or treatment; before adhering to any recommendations in this newsletter consult your healthcare provider.

Herbs & Spices: Basil

Elizabeth Smoots, MD — Thu, 06 Aug 2026 13:28:25 GMT

I’m growing a lot of basil in my garden this summer. Fresh basil is great as a beautiful garnish, added to herb salads, or made into pesto sauce. It also provides bountiful health benefits. Let’s take a look at the advantages of eating basil. I’ve also provided my favorite recipe for dairy-free pesto.

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What is basil?

The botanical name for basil is Ocimum basilicum. It’s warm weather herb that’s popular in Italian and Asian cuisines. Sweet basil is the most commonly grown variety of this herb. Purple basil has reddish-purple leaves and a bold flavor. Thai basil has flat, pointed leaves and a flavor that pairs well with Asian cuisine.

Health benefits

Basil is rich in many nutrients. It’s an excellent source of antioxidants, anti-inflammatory phytonutrients, essential oils and vitamin K.

Research has shown that people who consume basil regularly as a seasoning in their diet may experience a number of health benefits. The antioxidants in basil help reduce oxidative stress—a process that can damage cells and lead to inflammatory diseases like arthritis and inflammatory bowel disease. Basil’s essential oils can reduce the risk of cancer. The herb also has cardiovascular benefits. Animal studies show it may lower cholesterol and help decrease elevated blood pressure levels.

And basil has even more potential benefits. It may improve immune function and blood sugar levels. Mental health may also be positively impacted—with an improved mood and less anxiety as well as better thinking, ability to reason and memory.

The best way to consume basil is as a seasoning for food in the form of fresh or dried leaves. First check with your health care provider if you take medicine. Basil can interact with blood-thinning drugs and other medications.

And now for my recipe for dairy-free pesto sauce. It’s good with vegetables, potatoes, white beans and vegetable noodles or pasta.

Dairy-free pesto

4 cups basil leaves

4 cloves garlic

4 Tbsp pine nuts

1/4 cup extra virgin olive oil

1-2 pinches red pepper flakes (2 for spicy)

Black pepper to taste

1/8 tsp salt

Directions: Put garlic, pine nuts, salt and spices in a food processor. Process until the mixture has a granular appearance. Add the olive oil and basil leaves. Pulse until the pesto reaches the desired consistency. Keep in refrigerator for up to 1 week. Or freeze it in ice cube trays, then pop out the frozen cubes and transfer them to a freezer bag for storage in the freezer for several months.

Say "No" to Ultra-Processed Foods

Elizabeth Smoots, MD — Thu, 16 Jul 2026 12:36:05 GMT

About 70 percent of the foods sold in most grocery stores are ultra-processed. These highly processed foods supply 60 percent of the calories consumed by American children.1 In contrast, nearly three-quarters of American shoppers say they are seeking to avoid highly processed foods.2 This is quite a mismatch. Here’s the lowdown on ultra-processed foods, including how you can more easily identify them and cut your consumption.

What are they?

Many foods are processed in a limited fashion to make them safer or more convenient. Examples include pasteurized milk, frozen vegetables, flour, ground coffee and fermented foods. The modification of ultra-processed foods, however, takes it to a whole new level. During very extensive processing, the foods are broken down into individual components. Then some of the components are recombined using specific industrial methods. Industrial ingredients and food additives are often utilized to enhance the flavor and make the foods especially tantalizing. Ultra-processed foods are frequently designed to create food cravings and can be quite addictive.3

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Are they harmful?

We are what we eat. An unhealthy diet is now the leading global cause of death. A review in the British Medical Journal found that diets high in ultra-processed foods are associated with a higher risk of heart disease, diabetes, obesity and cancer. The rate of premature death is also higher. Moreover, ultra-processed foods can disrupt hormone activity and sleep quality, damage immune function and trigger chronic inflammation. The foods are associated with autoimmune disease, digestive issues and skin conditions. In other studies, a high consumption of ultra-processed foods raises the risk of depression, memory loss and cognitive decline; brain development in children may be impacted.4

How to identify them

“If the ingredient list is long and includes items you wouldn’t find in a home kitchen, it’s likely ultra-processed,” says the Food Integrity Collective. Common culprits include modified starches, protein isolates, emulsifiers, artificial sweeteners and other food additives and synthetic ingredients. The extent and intensity of processing matters; evidence indicates the amount of food processing is a key factor that drives poor health outcomes.5

New labeling

A new certification label has recently been released. It’s called the “Non-UPF Verified” label. The abbreviation on the label is short for non-ultra-processed food verified. Look for it to start appearing on the labels of foods verified to be not ultra-processed.

“To qualify, at least 70 percent of a product’s ingredients must be minimally processed,” according to the Food integrity Collective, the organization that runs the verification program. Additional restrictions are placed on the remaining 30 percent of ingredients for foods to qualify for the verification label.6

The bottom line? In the long run, choosing minimally processed whole foods is the best way to support your physical and mental health.

A plethora of ultra-processed foods are found in most grocery stores.

Ultra-Processed Foods. FDA, 9/18/25. www.fda.gov/food/nutrition-food-labeling-and-critical-foods/ultra-processed-foods?

Nonultraprocessed.org

See footnote 2.

Prepare for West Nile virus Season

Elizabeth Smoots, MD — Thu, 25 Jun 2026 12:23:28 GMT

Mosquitoes aren’t just a nuisance. They carry West Nile virus and other serious diseases. The peak time for illness from West Nile virus occurs when mosquitoes are biting in summer and early fall. Are you ready to protect yourself and your family? Here’s what you need to know to fight the bite.

How it’s spread

West Nile virus is usually contracted from the bite of an infected mosquito. The mosquitoes become infected after feeding on birds carrying West Nile virus.

The virus isn’t transmitted directly from person to person through casual contact or kissing. Rare sources of infection include blood transfusions, organ transplants, breastfeeding and pregnancy (from mother to child). Blood transfusions are now screened in the U.S. for West Nile virus.

The virus was introduced to New York City from Africa and the Middle East in 1999. West Nile viral infections have increasingly spread across our country every summer since then. The virus has been detected in birds, animals or mosquitoes in all 48 states of the continental U.S., with human cases reported in all of these states. Each year about 1,300 severe West Nile illnesses and 130 deaths in humans are reported to the Centers for Disease Control and Prevention. Many more people have milder forms of the illness.1

What to watch for

Four of five people with the disease have no symptoms. Up to 20 percent of infected people develop mild symptoms including fever, fatigue, body aches, nausea, vomiting, skin rash and swollen glands. One in 150 of those afflicted go on to develop serious illness. For severe symptoms such as high fever, headache, neck stiffness, confusion, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis, immediately contact a physician or call 911. The illness can result in death, especially in people over age 50.2

Avoiding infection

The best way to prevent West Nile viral disease is to avoid mosquito bites. Practical steps you can take to avoid getting infected and help stop the spread of disease include:3

Get rid of standing water where mosquitoes might breed. At least once or twice a week drain bird baths, fountains, animal troughs, flower pots, buckets, barrels, outside toys, plastic covers, and stagnant ponds or puddles. Children’s wading pools should be emptied and stored on the side when not in use. Drill holes in tire swings to let any water drain out.
Clean rain gutters and make sure they drain properly.
Wear long sleeves, long pants, socks and a hat outside when mosquito exposure is possible. Loose-fitting, light-colored clothing is best.
Use an insect repellant registered with the Environmental Protection Agency. Follow label directions carefully.
Wear clothing and gear treated with permethrin.
Stay indoors dusk to dawn when mosquitoes are most active.
Make sure window and door screens fit tightly and are in good repair.

For more information: Centers for Disease Control and Prevention, www.cdc.gov

Centers for Disease Control and Prevention. cdc.gov

See footnote 1.

See footnote 2.

A Well-Designed Exercise Program

Elizabeth Smoots, MD — Thu, 04 Jun 2026 10:53:55 GMT

Are you still doing the same old exercise? It may be time to reassess. Our needs change during different periods of our lives. What was good at a younger age may no longer be of benefit as the years pass.

One size does not fit all with exercise. We all have different needs. Age, fitness level, interests, availability of leisure time and any chronic health conditions all need to be taken in consideration in designing an exercise plan that’s right for you.

A balanced exercise program contains several essential components. The American College of Sports Medicine makes the following recommendations on the types and amounts of exercise that healthy adults generally need for overall health and fitness.1 These physical activities can be performed at one time or spread throughout the day.

Aerobic exercise

Examples include walking, running, biking, racquet sports, swimming and aerobic exercise machines like treadmills or elliptical trainers.

Frequency: At least five days per week for moderate-intensity exercise, or at least three days/week for vigorous-intensity exercise

Intensity: Moderate or vigorous exercise

Time: At least 30 min per day (at least 150 min per week) for moderate-intensity exercise, or at least 20 min per day (at least 75 min per week) for vigorous-intensity exercise

Strength training

Weight lifting, dumb bells, bar bells, resistance bands, cable machines and weight machines are considered strength training.

Frequency: Two to three days per week with at least 48 hours of rest between sessions

Intensity: One or more sets of 8 to 12 repetitions for each of all major muscle groups. For muscular endurance, aim for 15 to 20 repetitions with lighter weights.

Time: 20 minutes

Neuromotor exercise

This includes balance exercises as well as agility and coordination activities.

Frequency: Two to three days per week

Stretching

Frequency: Two to three days per week

Intensity: Stretch each of the major muscle-tendon groups in each stretching session for the time shown below.

Time: Hold each stretch for 15 to 30 seconds, for a total of 60 seconds of stretching per muscle-tendon group.

Precautions before you begin

It’s important to talk to your health care provider before starting an exercise routine. Your provider can look for problems that increase your risk of illness or injury from physical activity. Exercise risks may be elevated for certain health conditions such as high blood pressure, high cholesterol, chronic lung disease, type I or type II diabetes, kidney disease, arthritis or injuries.

After evaluating your fitness, health conditions and medications, a health professional can design a fitness program that gradually improves your flexibility, balance, strength and endurance. This could be your primary care provider or a physical therapist. Your health professional can determine the frequency, intensity, duration and type of activities that are likely to be the best fit for your circumstances. If you’re taking medications affected by exercise or weight loss, or if you have been physically inactive for a long time, your health professional can make adjustments that are individualized for you.

To reduce the risk of injury, remember to start slowly and gradually increase the frequency, duration and intensity of exercise. Walking is often a good place to start.

Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. American College of Sports Medicine Position Stand. Medicine & Science in Sports & Exercise, July 2011. journals.lww.com/acsm-msse/Fulltext/2011/07000/Quantity_and_Quality_of_Exercise_for_Developing.26.aspx

Extraordinary Eggs

Elizabeth Smoots, MD — Thu, 14 May 2026 13:32:51 GMT

Eggs are a great source of high-quality protein and essential nutrients. A number of questions frequently come up when it comes to eggs. The first thing people usually ask is “How many can I eat?” Another common question: “How do I buy good quality eggs?” Let’s start with the health benefits of eating eggs and go from there.

Egg nutrition

Eggs are high in cholesterol but low in saturated fat. That’s good since the saturated fat we eat contributes more to LDL (bad) cholesterol than dietary cholesterol.

Eggs are also excellent sources of protein and nutrients. Each large egg contains about six grams of protein. Other essential nutrients include vitamins A, B complex, D, E and K as well as the minerals selenium, iodine, zinc and iron. Eggs are one of the richest dietary sources of choline, a nutrient required for a healthy brain and nerves. A deficiency can hasten memory loss. It’s difficult to reach the adequate intake for choline without consuming eggs or taking a dietary supplement. As a result, many Americans—especially seniors—are deficient in choline. Eggs also provide lutein and zeaxanthin, antioxidants that help maintain eye health and protect against eye diseases, especially of the retina, such as macular degeneration.

How many to eat

In general, healthy individuals can consume up to one egg a day as part of a heart-healthy diet. The American Heart Association recommends that adults without heart disease limit egg intake to one egg per day, or seven eggs a week. The Association also suggests up to two eggs per day for healthy older adults with normal cholesterol levels who consume a healthful diet since eggs are nutrient-dense and convenient to eat.1

Some caution is required for people with diabetes, abnormal blood cholesterol, high blood pressure or an increased risk of heart failure. According to the Cleveland Clinic, people in those groups should consume no more than four egg yolks a week. For these groups, the American Heart Association advises caution and suggests consulting with a healthcare provider about egg consumption. The overall diet of the individual and other sources of saturated fat may need to be taken under consideration.

Buying quality eggs

The quality of eggs largely depends on the lifestyle of the chicken. Hens forced to live in a small cage inside a crowded barn with a poor diet and no outdoor access produce low quality eggs. As a result of living in a toxic environment, the chickens have higher levels of stress hormones and pro-inflammatory chemicals. These stress hormones and pro-inflammatory chemicals get transferred into their eggs. (They also get transferred into whoever eats the eggs.) An unhealthy lifestyle can also cause the chickens to produce eggs that are less nutritious.

Fortunately, you can find better options than this when you’re trying to buy eggs. The Cornucopia Institute has published an online Egg Scorecard. It scores eggs on a large variety of factors. These include the outdoor access of the chickens, the spacing allotted for each bird, the type of hen houses, sources of feed, animal welfare, enhancements to the quality of life, commitment to the organic label and transparency.

The Egg Scorecard’s ratings are limited to those that are organic. The Institute notes, however, that even 1-star organic eggs are better than conventional eggs, which are usually raised in factory farms or under less-humane conditions. Therefore, you could surmise the rank of conventional eggs to be a 0 or lower on this scale.

What do you want to ideally aim for? Eggs ranked as 4 or 5 in the Scorecard have the highest overall quality. “When you can’t afford a 4 or a 5, a 3 is a solid choice,” says the Cornucopia Institute.2 And eggs rated 1 or 2 still provide better quality than that of conventional eggs.

See how different brands of eggs stack up using the Egg Scorecard here.

Regularly eating eggs supports a lower risk of cardiovascular disease-related death. Monash University, 2/5/25. monash.edu/news/articles/regularly-eating-eggs-supports-a-lower-risk-of-cardiovascular-disease-related-death

Organic Egg Scorecard. Cornucopia Institute, 5/28/25. cornucopia.org/scorecard/eggs/

Pesticides in Produce: 2026

Elizabeth Smoots, MD — Thu, 23 Apr 2026 13:10:10 GMT

Three-quarters of conventional produce contain pesticides that don’t wash off. They’ve been absorbed into the plants’ tissues. These residues can potentially harm the nervous system, disrupt hormones, lower fertility and increase the risk of weight gain, diabetes and cancer. But you can reduce your exposure to pesticides while still eating plenty of produce. And there’s a way to do that even on a budget.

A sensible plan

Each year the Environmental Working Group (EWG) provides an updated list of the top 12 fruits and vegetables with the highest amounts of pesticides. They call this their Dirty Dozen (TM) list. They also provide a list of the fruits and vegetables with the lowest amounts of pesticides called the Clean Fifteen (TM). The data for the lists comes from the U.S. Department of Agriculture and the Food and Drug Administration. This year’s tests detected traces of 264 different pesticides.1

You can use these lists to reduce the pesticide exposure from your diet. Here’s how.

For fruits and vegetables on the Dirty Dozen (TM) list, the EWG recommends buying organic whenever possible. More than 95 percent of produce tested on the Dirty Dozen (TM) list contained pesticides. You can use your discretion for items on the Clean Fifteen (TM) list since they are less heavily sprayed. The EWG says nearly 60 percent of the Clean Fifteen (TM) fruits and vegetables contain no detectable pesticides.2

See the newly released 2026 list below. Of the 47 fruits and vegetables tested, number one contains the highest pesticide residues and number 47 has the lowest.

The Dirty Dozen (TM)

Spinach
Kale, collard and mustard greens
Strawberries
Grapes
Nectarines
Peaches
Cherries
Apples
Blackberries
Pears
Potatoes
Blueberries

The In-Betweens

Green beans (organic recommended)
Bell and hot peppers (organic recommended)
Lettuce
Tangerines
Cucumbers
Celery
Cherry tomatoes
Winter squash
Tomatoes
Plums
Tomatillos
Oranges
Summer squash
Raspberries
Grapefruit
Snap peas
Eggplant
Sweet potatoes
Cantaloupe
Broccoli

The Clean Fifteen (TM)

Kiwi
Mushrooms
Carrots
Bananas
Mangoes
Watermelon
Cauliflower
Cabbage
Asparagus
Sweet peas (frozen)
Onion
Papaya
Avocados
Sweet corn
Pineapples

Here’s what I do: I type the full list on a single sheet of paper. I print two copies. I keep one copy on the refrigerator, where I can frequently refer to it. Using the second copy, I cut out the Dirty Dozen (TM) list, and take it with me when I go shopping.

For a free digital copy of the list, go to: ewg.org/foodnews/full-list.php

EWG’s 2026 Shopper’s Guide to Pesticides in Produce (TM). Environmental Working Group, 3-24-2026. org/foodnews/summary.php

See footnote 1.

Let Hunger Be Your Guide

Elizabeth Smoots, MD — Thu, 02 Apr 2026 12:34:01 GMT

You know the signs: Growling or rumbling in your stomach. Weakness or loss of energy. Slight headache or trouble concentrating. Irritability or crankiness. Hunger symptoms like these will let you know when your body needs to be nourished—if you pay attention to them. They’ll also let you know, based on when they go away, roughly when you’ve had enough to eat.

But not enough of us are paying attention to these cues, diet experts say. As a result, the U.S. obesity epidemic continues to spiral out of control. More than two-thirds of us are overweight or obese. Since excess weight endangers the health of so many Americans, what can we do to get back in shape?

Author Michelle May, MD, suggests that we let hunger tell us when and how much to eat. May is the author of “Am I Hungry? What To Do When Diets Don’t Work.” She has also written a book series titled “Eat What You Love, Love What You Eat.” Here’s a summary of May’s advice on how to make healthier food and activity choices.

Instinctive eating

We’re all born with the ability to manage our weight naturally without dieting, weighing or measuring, says May. Babies and children are the classic examples of instinctive eaters. And perhaps you know an adult who doesn’t struggle with food and weight issues.

In that instinctive eater, the desire to eat is triggered by hunger, which signals when the body needs more fuel. This kind of eater will choose her food and eat until she’s satisfied, then stop—even if there’s food left on the plate. She then goes out and burns calories working, playing, exercising, and living her daily life. Once the instinctive eater has used up her calories, she gets hungry again. She repeats the cycle several times a day, meeting her energy needs while maintaining a healthy body weight since she’s eating based on hunger.

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Overeating cycle

Many people who struggle with weight go through a different cycle. In this scenario, eating may be triggered by an external cue such as time of day, food aromas, or seeing other people eat. Or sometimes an emotional cue like stress, boredom, loneliness, anger or sadness may trigger eating. In either case, the person is more likely to choose less-nutritious convenience or comfort foods than if she was eating based on hunger. She is also more likely to eat quickly, secretly or automatically—not really noticing what goes in her mouth.

Since hunger didn’t tell her to start eating, what will tell her when to stop? Perhaps some external cue like an empty bag, or the physical discomfort of a very full stomach, will prompt her to quit. She may also feel lethargic and uninterested in exercise after overeating. So her body will store the excess calories as fat.

Non-diet approach

Diets are not working for most people, says May, because diets don’t address why people are overeating in the first place. To make a real difference in long-term weight control, physical activity, nutrition, and emotional well-being all have to be addressed.

“Weight management is about moving closer to instinctive eating again where you’re in charge of your decisions,” May says. How to get started? “Listen to your hunger signals so you can determine when to eat and how much food is right for you.”

Sinus-Allergy Connection

Elizabeth Smoots, MD — Thu, 12 Mar 2026 13:10:45 GMT

Each spring when pollen counts soar, allergy symptoms blast off into the stratosphere. Common signs include a runny nose, itchy throat, sneezing, nasal congestion, teary eyes, and sometimes a sinus infection. Wait a second—a sinus infection?

That’s right. Unfortunately, sinus infections frequently afflict people who already have more than enough trouble from allergies.

Here’s how the unease of allergies may set you up for a sinus infection and what you can do about it.

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Link between hay fever and sinusitis

About 35 million Americans have allergic rhinitis, or hay fever. And another 31 million people in this country suffer from sinus infections every year. Although people with the one are not always the same as people with the other, many times they are. What is the connection?

In both children and adults, studies have detailed an association between nasal allergies and sinus infections.

Acute sinusitis. This starts abruptly like a typical cold and may start to get better, but then gets worse, or lingers beyond 10 days in the sinuses. Pain in the face and teeth, fever, and a thick, greenish nasal discharge are typical.

Studies indicate that about half of all children with allergies have problems with acute sinus infections. Likewise, about 25 percent of adults with an acute sinus infection have allergies. Adults and kids with year-round allergies to mold and dust mites are especially prone to repeated acute infections of their sinuses.

Chronic sinusitis. In this condition, nasal congestion and drainage, postnasal drip, cough and fatigue start gradually and last longer than 30 days.

Several studies have shown that up to 67 percent of adults with chronic sinus infections also have allergies. And, in one study, 37 percent of children with chronic sinusitis turned up positive for allergies on skin testing.

Allergy treatment beneficial

Sinus infections are no joke. The discomfort they create contributes to learning difficulties at school, decreased productivity at work, and reduced quality of life. In fact, sinus infections are one of the most frequent reasons for people to call their doctors.

The good news is that treatment of allergies can help reduce recurrent episodes of acute sinusitis. Studies also suggest that better hay fever management may help resolve symptoms in patients with both allergies and chronic sinusitis.

Consult your health care provider if you have allergies, sinus problems, or both. Curbing allergy symptoms may help you avoid or minimize sinus infections. For a complete rundown on your allergy treatment options, refer to my book Allergy Guide: Alternative & Conventional Solutions. It’s found online wherever books are sold.

Probiotic Benefits

Elizabeth Smoots, MD — Thu, 19 Feb 2026 14:02:27 GMT

You’ve probably heard of probiotics. What exactly are they? Probiotics are live, microbial food ingredients that have beneficial health effects. Certain bacteria and yeasts have been used for this purpose in many cultures around the world. Common examples include yogurt, buttermilk, sour cream, kefir, tempeh, miso, raw sauerkraut, kimchi and other cultured or fermented foods. A growing body of evidence suggests that there are several good reasons to add more probiotics to your diet.

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Defense against disease

The average human gut is home to trillions of microbes. Most of the bugs are “friendly” bacteria that live there while performing important roles. They do jobs like crowding out harmful germs, improving digestion, protecting the lining of your intestinal tract, and keeping your immune system functioning in tip-top form.

In order to maintain a healthy balance of microbes in your body, it helps to consume “good” bacteria from food. This helps to cut down on the “bad” bacteria in your body. Evidence suggests that the healthier shift may help alleviate certain disease conditions. Some examples:

Diarrhea. Taking probiotics can help prevent diarrhea caused by antibiotics or disease-causing germs. A study of hospitalized older patients found that those who consumed a yogurt drink twice daily had a 22 percent reduction in diarrhea caused by antibiotics compared to patients who drank a sterile milkshake.

Irritable bowel syndrome. A daily dose of probiotics may help reduce abdominal pain and other symptoms, according to some studies.

Colds and influenza. Probiotics may prevent or shorten the duration of some contagious illnesses. They do this by increasing natural killer cells in your blood, which work to ward off invading germs. One study of healthy working adults found that those who took probiotics had half the number of sick days as those receiving a placebo.

Vaginal infections. Women with recurrent yeast or nonspecific bacterial infections may find probiotics helpful in conjunction with other treatments.

Eczema. Some studies suggest that probiotics may help ease eczema and other allergy-related skin conditions.

Obtaining the cultures

For general health, it’s best to get your probiotics from food. Eating six to eight ounces of yogurt a day is a good place to start. Or try having small amounts of fermented foods with each meal. Treatment of certain ailments may require taking a supplement; look for one that contains at least one billion colony forming units (CFU) of the specific types of microbes you need in each dose.

Certain groups of individuals should check with a doctor before consuming any type of probiotic. Heading the list are infants, the elderly, and those with chronic disorders or a weak immune system.

Another word to the wise: Testing by independent laboratories has detected poor quality control in many probiotic supplements. Some brands do not contain the amounts on their label. Research brands carefully before buying, or seek advice from your physician.

A final way to boost your body’s probiotic arsenal is to make sure that the helpful bacteria in your gut get enough food. The microbes like to munch on prebiotics. Good sources of prebiotics include garlic, onions, asparagus, beans, flaxseeds, oatmeal, jicama, Jerusalem artichoke, bananas and other fruit.

Affairs of the Heart

Elizabeth Smoots, MD — Thu, 29 Jan 2026 14:03:01 GMT

You have probably heard of the main risk factors for heart disease: smoking, diabetes, family history and high blood pressure and cholesterol. Many people may not be as aware that emotions can also play a role in whether or not we succumb to a heart attack.

A growing body of evidence suggests that chronic anger, anxiety and depression can be deadly to those with coronary artery disease. Heart patients who frequently blow-up or suffer from depression increase their chances of having a heart attack. In one study loneliness led to a death rate of 50 percent, compared to a rate of 17 percent in those who got the social support they needed.

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These findings are not confined to those who already have heart disease. In a study from Duke University, apparently healthy people whose test scores reflected low self-esteem, difficulty concentrating, low motivation or despair had a 70 percent greater risk of heart attack.

Although no one knows exactly why this link occurs between temperament and heart disease, scientists have some ideas. When we’re under stress, our bodies respond with the “fight or flight” reaction. Levels of the stress-hormone adrenaline increase, blood pressure climbs and our pulse rate may skyrocket. These changes increase the oxygen supply to vital parts of the body. But they also increase the workload on the heart and may sometimes trigger arrhythmias, or irregular heartbeats.

Whether you are hot-headed or shy, you needn’t worry yourself to death. The key is to acknowledge your feelings and use them wisely for solving problems. Here are some tips to take to heart:

When you’re angry, talk it over or discuss it later when things have calmed down. It sometimes helps to examine your feelings with a neutral person.
See your primary care physician if anxiety, depression or stress frequently get you down. In many cases relaxation training, counseling, medications or a combination of conventional and alternative therapies may help.

Feeding Your Microbiome

Elizabeth Smoots, MD — Thu, 08 Jan 2026 13:40:27 GMT

Feeding your microbiome is much like fertilizing your garden. Both need proper nutrition in order to thrive. What foods do friendly gut bacteria like to eat? Their favorite foods are called “prebiotics.” These are substances consumed by friendly gut bacteria that produce beneficial health effects for their human hosts. Prebiotics are nondigestible, fermentable types of fiber, including inulin, fructooligosaccharides (FOS), galactooligosaccharides (GOS), resistant starch, arabinoxylans, beta glucan, pectin and polyphenols.

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Health effects

Prebiotics provide food for the microbiome. Studies show numerous health benefits for humans when friendly gut bacteria get the food they need. Prebiotics support the growth of beneficial gut bacteria and reduce colonization by harmful microbes. They strengthen the gut lining and help prevent leaky gut. They improve immunity and have anti-inflammatory effects. Other benefits of prebiotics include reducing acne and other skin problems, lowering allergy risk, balancing hormones, regulating blood sugar, lowering LDL (bad) cholesterol, supporting weight loss and improving mental health. In addition, they improve calcium and mineral absorption, reduce constipation and increase the production of short chain fatty acids that nourish gut cells.

Best prebiotic foods

Friendly bacteria in in the human gut need prebiotic fibers to survive, multiply and thrive. Here are some of the best sources.

Vegetables

Chicory root, Jerusalem artichokes, asparagus, garlic, onions and leeks are good sources of the prebiotic inulin. Carrots contain pectin. Mushrooms contain beta glucan.

Fruits

Bananas are rich in fructooligosaccharides. Apples, citrus and kiwi have the prebiotic pectin. Berries contain polyphenols.

Legumes

Beans, peas and lentils are good sources of galactooligosaccharides.

Whole grains

Oats and barley contain beta glucans. Cooked and cooled rice has resistant starch. Whole wheat, rye and barley are good sources of arabinoxylans.

Most whole plant foods contain some prebiotics. Eating a wide variety of plants helps encourage a diverse microbiome. Dine on as many different types of fruits, vegetables, legumes, nuts, seeds and whole grains as you can over time. Keep trying new plant foods. Consume at least some of them raw since cooking can reduce the prebiotic content of some foods. Start with small portions of foods rich in prebiotics to give your gut microbiome a chance to adjust.

On Guided Imagery

Elizabeth Smoots, MD — Thu, 11 Dec 2025 15:47:30 GMT

Guided imagery is not just about visualizing something. The relaxation technique may utilize sight, sound, taste, smell and touch to make imagined scenes seem as real as possible. A trained therapist or professional audio recording can lead you through a guided imagery session, which often consists of a series of visualizations or imaginary sequences. Popular reasons to use this mind-body technique include stress reduction, supporting lifestyle changes and improving physical and mental well-being.

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Mind-body benefits

Stress reduction. Guided imagery has been shown to relieve stress and promote relaxation. Studies indicate is helps decrease levels of the stress hormone cortisol. The relaxation technique also has beneficial effects on sleep quality.

Supports lifestyle changes. The technique encourages planning and preparation for desired health goals. It also increases internal motivation.

Pain reduction. It can decrease pain caused by musculoskeletal conditions. People with chronic pain, arthritis or fibromyalgia may benefit.

Improves emotional/mental health. People who engage in guided imagery may feel calmer and have better emotional regulation. This may result in a reduction in anxiety and depression symptoms.

Getting started

Trained mental health professionals or integrative health care providers may be able to help you get started. Other options include books, audio or video recordings, or computer apps on guided imagery or visualization.

Establish your personal health goals. Find a quiet place and a comfortable position, usually lying down or in a sitting posture. You can utilize guided imagery techniques to help you focus on your goals. For greatest effectiveness, schedule regular sessions for you to practice the mind-body technique.

The Beauty of Bioflavonoids

Elizabeth Smoots, MD — Thu, 20 Nov 2025 16:32:29 GMT

The beautiful yellow, red and orange colors of citrus fruit come from a group of phytonutrients called “bioflavonoids.” These plant pigments are composed of a flavone with attached methoxy groups, which scientists refer to as “methoxylated flavones.”

Bioflavonoids have unique benefits. They are potent antioxidants and possess strong anti-inflammatory effects. These plant nutrients are especially useful for varicose veins, heart disease, peripheral vascular disease, high cholesterol, cancer and optimal immune function.

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Beneficial effects

Vascular disease. People who bruise easily often take vitamin C with bioflavonoids. These nutrients work together to reduce capillary fragility and strengthen capillary walls. Besides helping maximize the benefits of vitamin C—by helping prevent its breakdown in the body—bioflavonoids improve vascular tone and blood flow. This can be beneficial for chronic venous insufficiency, varicose veins and hemorrhoids.

Heart disease. People with higher intakes of bioflavonoids have a reduced risk of cardiovascular disease, according to some studies. Animal studies show a reduction in total cholesterol, LDL (bad) cholesterol and triglycerides with regular consumption of dietary bioflavonoids.

Cancer. Research indicates that bioflavonoids may prevent cancer cells from dividing and multiplying. They may also help keep cancer from spreading, according to early evidence.

Immune function. Bioflavonoids can improve immune function. They boost immunity to bacteria and viruses and regulate immune responses within the intestinal mucosa. These improvements are related to their antioxidant and anti-inflammatory properties.

Side effects

Bioflavonoids have antiplatelet effects when taken in extra-large amounts as supplements. They may increase the risk of bleeding when used with blood thinners or dietary supplements with antiplatelet effects. Bioflavonoid supplements are often stopped two weeks prior to elective surgery. They may also increase the toxicity or reduce the effectiveness of some drugs. Grapefruit is especially problematic in causing food-drug interactions. Consult with your health care provider before consuming grapefruit or bioflavonoid supplements with medications.

Best sources

Citrus fruits are the main source of bioflavonoids. This includes oranges, tangerines, grapefruit, lemons and limes. Other sources include fresh fruit such as berries and tree fruits. Eat the fruit raw for the best phytonutrient absorption and health benefits.

It’s healthiest and safest to get your bioflavonoids from food instead of dietary supplements. Nature is the best source of beautiful bioflavonoids.

Ergonomic Know-How

Elizabeth Smoots, MD — Thu, 06 Nov 2025 16:38:28 GMT

Ergonomics is the science of designing spaces to fit the people who work and live there. The discipline’s goals are to decrease muscle fatigue, improve function and reduce the risk of musculoskeletal disorders. Common factors that increase the risk for these disorders include maintaining an awkward body position for long periods, sitting for long periods, repetitive tasks and lifting heavy weights.

On the other hand, maintaining good posture is the key to avoiding musculoskeletal injuries and disorders. The strain on your tendons, ligaments and muscles is reduced when your joints are in proper alignment.

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Following are some practical ergonomic tips. Check to see how well you are doing at work, at home and while using transportation.

Chair. Find a chair with a straight back or low-back support. Adjust your chair height so your knees are level with, or slightly below, your hips. Aim to keep your thighs parallel with the floor, with your lower legs perpendicular to the floor. Your feet can rest flat on the floor or on a low stool. Sit tall with your neck straight, pelvis forward, and stomach and buttocks tucked in. Keep your shoulders back and your head positioned over your shoulders.

Desk. Make sure you have enough room under the desk for your legs and feet. Adjust the desk height or put sturdy blocks under the desk legs to raise it to the correct height.

Keyboard and mouse. Keep your wrists straight, upper arms close to your body, and hands at or slightly below your elbows.

Monitor. Place your computer monitor about an arm’s length away from your face. Adjust the height so that the top of the screen is at or slightly below eye level.

Driving a vehicle. Adjust your seat height so that your hips are slightly higher than your knees. This puts your back and pelvis in a more neutral position. According to Posture Direct 1:

If the car seat is relatively too low, this can encourage a domino effect where the pelvis tilts backwards, lower back rounds, upper back slouches forwards, shoulders round forwards and head pokes forwards.
If your legs are in a more of a straightened position and you suffer from tight hamstrings, your pelvis will start to rotate backwards and cause the entire posture to slouch.

In addition, slide the car seat forward or backwards so it is positioned at a reasonable distance to the foot pedals. When your feet are in position over the foot petals, your knees should be bent at approximately 120 to 135 degrees.2

Bed. While sleeping, rest on your side or back, not on your stomach.

For more on adjusting your work and living spaces to fit you, consult a physical therapist or your health care provider.

Another tip. Sitting or staying in the same position for prolonged periods causes your blood to stagnate. Take regular breaks every 30 to 60 minutes to move, exercise and stretch. This increases the blood flow to your muscles and skeleton. It also improves their oxygen supply and helps carry waste products away from them. Otherwise, a buildup of these products can lead to musculoskeletal stiffness, pain and fatigue.

Proper Posture for Driving. Posture Direct, 5/1/2024. posturedirect.com/9-tips-to-improve-your-posture-whilst-driving/

Decrease Inflammation with Diet

Elizabeth Smoots, MD — Thu, 16 Oct 2025 13:03:28 GMT

Diet commonly contributes to chronic inflammatory conditions. Heart disease, diabetes, arthritis, digestive disorders, cancer and other chronic disorders often have a dietary component. The good news is that a nutritional approach can help reverse many chronic diseases.

Inflammatory foods

The most common risk factor for chronic disease is the consumption of excessive amounts of inflammatory foods. The main culprits are processed foods, sugar, refined starch, processed meats and certain oils. Examples include white bread, white rice, crackers, cereals, donuts and cookies. The processed-meat category consists of lunchmeats, ham, bacon and hotdogs. Oils high in omega-6 fats such as safflower, corn, cottonseed and peanut oils are inflammatory. Dairy products may trigger inflammation in people who are sensitive to them as can gluten-containing grains.

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Anti-inflammatory foods

Whole foods contain a wealth of inflammation-fighting compounds. Vegetables, fruits, beans, nuts and seeds are the richest sources.

Vegetables. They contain a multitude of different phytonutrients that help decease inflammation, promote healthy gut bacteria and strengthen the immune system. Eating a variety of vegetables in a rainbow of colors is the best way to reduce inflammation. Superstars include dark green leafy vegetables; cruciferous vegetables like broccoli and cabbage; colorful vegetables like peppers, beets, winter squash and tomatoes; and sulfur-rich vegetables like onions, garlic, radishes and mushrooms. People with chronic inflammatory diseases should aim for eight to nine cups of vegetables per day.1 2

Fruits. They contain fiber, antioxidants and phytonutrients that help fight inflammation. Bright colors are clues to which fruits are highest in phytonutrients.

Legumes. They provide plant protein, fiber and phytonutrients with anti-inflammatory effects. Enjoy them in a variety of shapes and colors.

Nuts and seeds. They contain a host of nutrients that provide anti-inflammatory benefits. Almond, walnuts and Brazil nuts are great options as are pumpkin, flax, sunflower and sesame seeds.

Whole grains. They provide fiber and certain phytonutrients unique to grains.

Healthy fats. Oily fish such as salmon, anchovies and sardines are excellent sources of anti-inflammatory omega-3 fatty acids. Extra-virgin olive oil contains monounsaturated fats and anti-inflammatory flavonoids. Other sources of healthy fats include avocados, omega-3 enriched eggs and grass-fed beef.

Fermented foods. Fermented foods like yogurt, sauerkraut and kimchi promote healthy gut bacteria. These bacteria manufacture anti-inflammatory chemicals inside your gut that provide beneficial effects for your entire body.

Herbs and spices. Turmeric, ginger, cinnamon, rosemary and thyme are popular examples. Most herbs and spices are excellent sources of antioxidants and phytonutrients.

The bottom line

Food is the best source of natural anti-inflammatory action. Eating a variety of vegetables is key. People with chronic inflammatory diseases should aim for eight to nine cups of vegetables per day. Other whole foods that contain inflammation-fighting compounds include fruits, legumes, nuts, seeds, herbs and spices. For more on this topic, click here to read “Tame Inflammation with Food” and here for “Eat the Rainbow.”

Eat the Rainbow. drsmoots.substack.com/p/eat-the-rainbow

Core Food Plan Comprehensive Guide and Core Food Plan (1800-2200 Calories). 2022. Institute for Functional Medicine. ifm.org

Know the ABCs of Vitamins & Minerals

Elizabeth Smoots, MD — Thu, 02 Oct 2025 12:57:19 GMT

Getting the nutrients you need is essential for good health. Every cell of your body must receive the requisite raw materials to maintain optimum function and vitality. You can meet most of your requirements by eating a varied diet consisting of vegetables, fruits, legumes, whole grains, lean meat, fish and low-fat dairy products. But some groups of people are not getting the basics when it comes to important nutrients.

Here, in A-to-Z order, is a list of vitamins and minerals. Take a moment to see how you stand.

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Vitamin A. It may prevent age-related macular degeneration. But excess amounts are linked to hip fractures and birth defects. Safest approach? Consume beta carotene from plants, a pre-vitamin that your body converts to vitamin A as needed. Best sources: carrots, yams, squash, peppers, and dark green vegetables.

Vitamin B6. It’s necessary for nerve health, but some older people don’t get enough. Best sources: Meat, poultry, fish, nuts, legumes, and whole grains.

Vitamin B12. Research has linked adequate B12 levels with bone and brain health. One study of 2,500 men and women found those with low levels had reduced bone mass, which increases fracture risk. Older people may not absorb B12 well from food and may need a supplement. Best sources: Fish, meat, poultry, dairy products, eggs.

Calcium. It builds strong bones in children and young adults. But many people don’t get enough, especially teens and folks over 50. A deficiency can lead to osteoporosis and high blood pressure. Best sources: Dark green vegetables, dairy products, canned fish with bones, soy foods, fortified juice or cereal.

Vitamin D. The chief function is to maintain normal bone and blood levels of calcium and phosphorus; weak bones may result when there’s a shortage. Insufficient amounts are also linked to high blood pressure, heart disease, type 1 diabetes, rheumatoid arthritis, ulcerative colitis, multiple sclerosis, and certain cancers. Older people, and those who live or work indoors or in northern climes, are at increased risk for vitamin D deficiency. The recommended daily amount is currently set at 400 units from birth through one year, 600 units from age one through 70 years, and 800 units after age 70. For pregnant and breastfeeding women, the recommendation is 600 units a day. Best sources: Sunlight, fortified milk, fish, fish liver oil.

Vitamin E. It prevents oxidation of body cells. Oxidation has been linked to numerous chronic diseases, including arthritis, cataracts, dementia, cancer and aging. The bulk of studies have not shown that taking vitamin E supplements helps prevent heart disease or cancer. Best sources: Whole grains, beans, nuts, seeds, vegetable oils.

Folate. This B vitamin should be taken daily by women of child-bearing age to prevent neural tube birth defects. It may also help prevent some forms of cancer. Best sources: Dark green vegetables, whole grains, fortified cereals, beans, bananas, orange juice and avocados.

Talk to your health care provider if you’re at risk for vitamin or mineral deficiency. Heavy drinkers, poor eaters, smokers, pregnant or nursing women, and people with chronic diseases or taking medications may need supplements under a physician’s guidance.

How to Avoid Exercise Injuries

Elizabeth Smoots, MD — Thu, 18 Sep 2025 13:15:32 GMT

Sports injuries increase each fall when people suddenly boost exercise after taking it easy over the summer. Many of these injuries are avoidable. Some simple measures can help you continue to enjoy physical activities in the months ahead.

Start slowly and easily. Gradually advance the time and intensity of your physical activities. Aim for increases of no more than 10 percent in a week.

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Always warm up first. Ease into each exercise session with activities that raise your body temperature a bit. Try a short walk or jog followed by sport-specific movements and stretches.

Cool down at the end. Finish each workout with a gradual slowing of your pace. Then stretch out, holding each stretch for at least 30 seconds.

Why stretch? Studies indicate that flexible muscles and tendons are less likely to be injured. Right after exercise when your muscles are warm is the most effective time to stretch.

Get properly outfitted. Make sure you have properly fitting shoes that are not worn out. Invest in good equipment and protective gear, for example, helmets for biking, or arm and leg pads for skating.

In addition, work with an exercise trainer, physical therapist, instructor or coach to learn the proper techniques for your sport.

Listen to your body. Take a break if a movement is painful or just doesn’t feel right. Consult your health care provider about any unusual exercise-related symptoms. Also, get your provider’s approval before significantly boosting your activity, especially if you have a chronic health condition or are unaccustomed to exercise.

For more on preventing exercise injuries, including sports-specific information, go to the American Academy of Orthopedic Surgeons at aaos.org.

Tai Chi Benefits Body and Mind

Elizabeth Smoots, MD — Thu, 28 Aug 2025 10:59:36 GMT

Millions of people throughout the world today practice tai chi, an ancient Chinese system of exercises devised to strengthen and relax your whole body. The full name is tai chi chuan (pronounced tie chee chwan), which in Chinese means “supreme ultimate power.”

Tai chi combines breathing, eye movements, martial arts and mental concentration with slow, gradual movements, making it an ideal form of exercise for older people. The goal in tai chi is not to strain or over-exert yourself, but to achieve mental and physical harmony and balance.

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According to Chinese belief, yang (positive, active or light) and yin (negative, passive or dark) are opposite elements that must be balanced in order to achieve good health. The movements of tai chi are designed to flow smoothly from one to another, each yin pose balanced with a yang posture and vice versa.

Although it may look deceptively simple, a lot is actually happening during tai-chi training. The exercises strengthen your entire body, including muscles, ligaments, bones and internal organs. Tai chi reportedly can lower your blood pressure, and has beneficial effects on heart function.

Gentle range-of-motion exercises in tai chi also improve flexibility, balance and coordination. In one study, older people who practiced tai chi regularly reduced their risk of falls and other accidents by 50 percent.

Finally, the mental concentration involved in following the exercise sequences can release tension, improve relaxation and self-awareness and help clarify your thoughts. To get started, first get your physician’s okay. Call your local library, community or senior center or YMCA for books, tapes and classroom instruction. Then, consider the challenge of tai chi.

The Power of Polyphenols

Elizabeth Smoots, MD — Thu, 07 Aug 2025 13:02:50 GMT

Polyphenols are a class of compounds with a phenol ring found primarily in plants. These plant nutrients have antioxidant, anti-inflammatory and anti-aging properties. Research has shown that people who eat diets rich in polyphenols have a lower risk of chronic diseases. Many chronic illnesses such as cardiovascular disorders, arthritis and autoimmune conditions caused by chronic inflammation can be curbed with these compounds.

Research results

Several studies have looked at the health benefits of dietary polyphenols. The PREDIMED study followed more than 7,000 participants who ate the Mediterranean Diet over a 5-year period. The study found that death from any cause was reduced by 37 percent in people who consumed the highest amounts of polyphenols compared to those eating the lowest amounts of polyphenols.1 In another study, the DIRECT PLUS trial, higher polyphenol intake was associated with reduced biological aging.2 Additional research indicates polyphenols may be beneficial for cognitive function, vascular health, improved intestinal microbiota diversity and cancer prevention.

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Where to find them

Of the many types of polyphenols, some of the most common ones you may have heard of include flavonoids, anthocyanins, catechins, stilbenes, lignans and phenolic acids. These polyphenols are widespread in nature, and you will find them in many plant foods. Some good sources include colorful vegetables and fruits, cruciferous vegetables such as cabbage and broccoli, leafy greens, herbs such as oregano and thyme, extra virgin olive oil, shitake mushrooms, lemon or lime and tomatoes.

The following foods and drinks are especially rich sources of polyphenols when consumed in the listed amounts.3

Berries. One-half cup per day provides the following polyphenols: anthocyanins, quercetin, elligitanins and phenolic acids.

Green tea. Drinking two cups per day provides catechins such as epigallocatechin-3-gallate (EGCG).

Garlic. Eating two cloves per day provides such polyphenols as cetechins, phenolic acids and polyphenolic organosulfur compounds.

Turmeric. Consuming one-half teaspoon of the dried spice daily provides the polyphenol curcumin.

Rosemary. One-half teaspoon of the dried herb per day contains polyphenols such as rosmarinic acid, caffeic acid and luteolin.

The bottom line

Consuming a plant-dense diet rich in polyphenols is an excellent way to reduce the inflammation and oxidative stress linked to many chronic diseases. Green tea, berries, garlic, turmeric and rosemary are especially good sources of these plant compounds. Polyphenols have been shown to curb chronic diseases and promote health and longevity.

Polyphenol Intake and Mortality Risk: A Re-analysis of the PREDIMED Trial. BMC Medicine, 5-13-2014. bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-77

The Effect of Polyphenols on DNA Methylation-Assessed Biological Age Attenuation: The DIRECT PLUS Qandomized Controlled Trial. BMC Medicine, 9-25-23. bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-03067-3

Fitzgerald, Kara. Younger You: Reduce Your Bio Age and Live Longer, Better. Hachette Book Group, Inc., 2022.