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Why Is It Always the Same New Year’s Resolutions?

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By Eugene Y. Chan, MD

First, Happy New Year!  But what is it about our New Year’s Resolutions?

Are we always stuck on this endless treadmill of making the same ones?

How can it be the same one as last year?

Weight loss, exercise, love, friendship, success, money.  We seem to yearn for the same things, that gives us hope.  To hope is to be human.  We may never seem to reach them, they are ideals that we hold in our heads.  That is what is so powerful about it.

Size 2, no size 0 is better.  Grade A, no A+.  2000 sq. ft, no 3000.  Part of this is an inner thirst for the betterment of ourselves.  It  is what makes us build cities, send rockets to Mars, and to understand DNA.  But what is it that makes some of us able to do it and other not?

Someone once said to me, “Your life is made up of the sum of all the little decisions that you make from day to day.”  Likewise, the amount of willpower and mental focus that you give each minute, of each meal, each rep, or each hug, creates who you are.  A businessman who greets someone with a half-hearted smile will not be as successful as the one who remembers your name, dog, and the color of your tie.  An artist who paints only when told to will only see his works on his desk.  Don’t be that.

Send your spaceship to Mars,

See your art in the MoMA,

Find your inner DNA,

Live each minute of your life with gusto.

Be well and stay focused.

Happy 2014.

The CLAREX EFFECT (Concise)

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The CLAREX Effect

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By Eugene Y. Chan, MD

What is the CLAREX Effect?  We often get asked this question.  I initially formulated CLAREX based on my experiences at the Brigham and Women’s Hospital, where I saw a significant number of patients needed a boost after spending too much time in the hospital.  Some of these were from alcohol intoxication, malaise, and general deconditioning.  I wanted to create something that did not require an IV, but was able to help people bounce back quickly and be productive.  For me, especially after long shifts at the hospital.  

The CLAREX Effect has several uses:

1.  Mental Clarity Recovery.  After a late night or long night, CLAREX helps you bounce back and be productive.  We have received a lot of great feedback from different people about this aspect of CLAREX.  The effects are most noticeable after long, stressful days or even for post-celebration recovery.

2.  The Intelligent Workout.  How many times have you wished you crammed an hour of workout into 30 minutes?  CLAREX helps you stay focused while you are in the gym, obstacle course, or playing field.

3.  Increase Studying Performance.  Studying, or any mental activity requires active neurons.  Caffeine has a short-lasting effect and wears off quickly.  CLAREX is designed to help you stay focused for long periods of time, days, or even weeks at a time to achieve the best possible performance.

Essentially, CLAREX is a productivity supplement that works on your natural biochemical pathways and it does not contain any caffeine and is completely stimulant-free so you can feel good that you are using it.

 

 

Quick Ways to Improve Your Attention

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by Eugene Y. Chan, MD

Ever wonder why you can’t sit still and finish your work?  This is a general problem with the population at large these days.  The quick answer is that there are too many distractions:  smart phones, the internet, kids, and television.  Yes, these are things that can ultimately cause you to be unfocused, unproductive, and unnerved.  This decrease in attention has indeed been studied by numerous groups out there.  For instance, Higginbotham et al. 1993 showed that both normal and diagnosed children with ADHD, when subject to active and passive distractions, led to decrease in performance.  It is no question that distractions, especially sensory ones related to visual and auditory, are undesirable.  On the other hand, this is not the only reason.  For instance, Booth et al., 2005 demonstrated that there is a decreased inhibitory network in those with ADHD, suggesting that there is an underlying physical basis for decreased attention. What should you do about it?

  • Unplug!  Have dedicated periods of time in your day where you are free from your phone, TV, internet, and any electronics.
  • Practice focusing.  This can be done by reading, writing, or some other active form of concentration.  This forces your mind to exercise its inhibitory neurons.
  • Eat carefully.  See previous post, avoid any refined sugars, avoid stimulants, go for small meals, and wisely supplement.

Take care and stay focused.   Booth, JR et al.  Larger deficits in brain networks for response inhibition than for visual selective attention in attention deficit hyperactivity disorder (ADHD).  2005.  J. of Child Psychology and Psychiatry.  46:1, pp 94-111. Higginbotham, P. and Bartling, C.  1993.  The effects of sensory distractions on short-term recall of children with attention deficit-hyperactivity disorder versus normally achieving children.  Bulletin of the Psychonomic Society, Vol 31(6), Nov 1993, 507-510.

The Post-Workout Protein Window

A Collaboration between Captain Clarex AKA Eric Ballenger and Dr. Eugene Y. Chan M.D.

Why is it, that so many people put such an enormous amount of thought into what they eat all day long, and not immediately post-workout? Everyone training muscle, regardless of their chosen mode of exercise, must take their post-exercise nutrition seriously in order to provide their muscle with the required raw materials. Since all types of exercise use carbohydrates for energy, it is inevitable that muscles require carbohydrates afterwards. Therefore, post-workout carbohydrates are important to refill this key ingredient in your muscles.

However, any amount of carbohydrates will not do. You need to consume enough carbohydrates to promote a substantial insulin release. Insulin is the hormone responsible for shuttling glucose into muscle cells. Furthermore, insulin leads to increased glycogen synthesis in liver and muscle cells. Insulin has overall anabolic, or “building up,” effects on the body. The addition of protein to this post-workout carbohydrate routine adds the basic building blocks for this overall anabolic process (Miller et al., 2003; Volek, 2004). There many recommended ratios out there concentrating on the glycemic index and the carbohydrate to protein ratio, including a 4:1 or 5:1 ratio (Cordain, 2010). Researchers have utilized a 0.8 g of carbohydrates per kg of body weight as a recommended amount for stimulating anabolic effects of insulin (van Loon et al., 2000). At a 4:1 ratio, this is 0.2 g protein per kg of body weight. An increased consumption of essential amino acids may lead to a more positive protein balance. For instance a 0.4 g/kg may by better. A protein intake range of 0.2 g/kg to 0.4 g/kg is therefore appropriate.

While your post-workout feeding should be rich protein and carbohydrate, this meal should be fat free. The consumption of essential fats is one of the most overlooked areas of daily nutritional intake but during the post workout period, eating fat can actually decrease the effectiveness of your post-workout beverage. Since fat slows down transit through the stomach, eating fat during the post workout period may slow the digestion and absorption of carbohydrates and proteins.

 

 

Cordain, L. The Paleo Diet for Athletes: A Nutritional Formula for Peak Athletic Performance. December 16, 2010.

Miller, S.L., K.D. Tipton, D.L. Chinkes, S.E. Wolf, and R.R. Wolfe. Independent and combined effects of amino acids and glucose after resistance exercise. Med. Sci. Sports Exerc. 34:449-55, 2003

Van Loon, L., Saris, W.H., Kruijshoop, M., and Wagenmakers, A.J. Maximizing postexercise muscle glycogen synthesis: carbohydrate supplementation and the application of amino acid or protein hydrolysate mixtures. American Journal of Clinical Nutrition. 72(1):106-111, 2000.

Volek, J.S. Influence of nutrition on responses to resistance training. Med. Sci. Sports Exerc. 36:689-96,2004.

Food for Thought for the Holidays

By Eugene Y. Chan, MD

The holidays are approaching us fast and typically there are two big fears that confront us:  (1) how do I not gain weight? and (2) how do I survive my holiday party?  Thanksgiving and the holidays are synonymous with gluttony, binge eating, and over indulgence.  Furthermore, there are numerous holiday parties that you need to attend, whether out of obligation or for fun.  Given the joyous time of year, there is plenty of opportunity to get carried away.  Fortunately, there is time to prepare.  

First, regarding weight gain, there are several key realizations.  The first is that the stomach has unique properties.  It is an expandable container, made of smooth muscle.  If it is in a compact state for weeks prior to your binge eating episode, you will feel full faster and will not consume as much.  On the flip side, if you occasionally have large meals, you stomach will have lost its elasticity, very much like a balloon that has been inflated and deflated multiple times, and you will be able to consume a lot more.  Second, your stomach and digestive tract secrete enzymes that require a certain time of upregulation, through gene expression and protein translation.  Without certain key enzymes, the nutrients of certain foods do not make it into the body.  So you could utilize this to your advantage.  If you avoid fatty foods routinely, it is unlikely that a single meal of fatty foods will lead to significant weight gain.  The lesson here in understanding the anatomy of your stomach as well as the molecular response of it to food is simple:  if you eat healthy and in small portions on a routine basis, the impact of a single large meal is unlikely to have significant impact on your daily trip to the scale.  Of course, it all goes without saying that you should continue to remain active and exercise often.

Ok, what should you do about those holiday parties?  Holiday parties tend to be a great time to network, build camaraderie with your colleagues, all through a relaxed atmosphere.  Part of this is a liberal amount of beer, wine, and cocktails that loosen up even your stiffest co-worker.  The key here is moderation for you.  Since you don’t want to be the individual that gets talked about the day after, setting a drink limit and goal for yourself prior to the party is most important.  Discussing your goals with a colleague of similar professional mindset would help you solidify your resolve.  In the event you did have one too many, how do you make it to work?  The answer is simple:  drink plenty of water and take a product designed for post-celebration recovery.  The key is to get your Kreb’s cycle back up and running since an excess of ethanol builds up NADH, which signals the Kreb’s cycle to slow down.  As you know the Kreb’s cycle is central to generating ATP, your body’s main form of energy.  By supplementing key cofactors for enzymes in your Kreb’s cycle, you can get it back up and running in no time, and feel great in the process.  

With that, good cheers for the holidays and be well.

 

A Lethal Dose of Caffeine

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By Eugene Y. Chan, M.D.

Recent news about tragic death of Anais Fournier hit the web.  She was 14 and she died after consuming two 24-ounce Monster Energy drinks over a 24-hour period.  She had an underlying heart arrhythmia that may have predisposed her to the adverse effects of caffeine.

Caffeine is a small molecule alkaloid that is found in many different types of plants.  It has a receptor-based mechanism of action that antagonizes the action of adenosine.  In clinical medicine, adenosine is sometimes utilized to treat certain irregular heartbeats, including some supraventricular tachycardias.  Decreasing the action of adenosine can therefore lead to a faster heart rate and can also predispose the heart to irregular heartbeats.  In the case of the very unfortunate 14-year old, she consumed caffeine which decreased action of the adenosine, thus increasing her likelihood of a fatal arrhythmia.

How much is too much?  One may say, “Let us calculate the lethal dose.”  The LD50, or lethal dose for killing 50% of tested animals, for rats is 192 mg/kg.  Extrapolating this to a 14-year old weighing 50 kg, this LD50 is 9.6 grams of caffeine.  Of course, these studies were not conducted in humans so this is only a ballpark estimate.  In a typical energy drink, there is approximately 200 – 300 mg of caffeine, although in some energy drinks, the actual amount is unclear, based on how the products are labeled.  We can assume that Anais probably consumed < 1 gram of caffeine from her two energy drinks, yet this was a fatal dose for her.  What the LD50 calculation is missing is both an understanding of both statistics as well as pharmacogenomics.  Statistics tells us that some individuals may very well have adverse events at a much lower dose of caffeine.  Part of this is based on a genetic makeup and how we react to certain molecules.  This is called pharmacogenomics.  In the case of Anais, she likely had a genetic cause of her underlying cardiac arrhythmia.  She may very well have been a slow metabolizer of caffeine, also based on her genetic makeup, leading this molecule to linger in her system much longer than that of her counterparts.  Without a whole genome study, of course, we would never know.

Overall, the lesson here is that receptor-based molecules, such as caffeine, can be extremely dangerous, depending on the specifics of your medical and genetic background.  For most people it may be fine, for others, it can unfortunately take push you over the threshold of safety.

Why you need mental clarity

By Eugene Y. Chan, MD

Somewhere around 3 AM in the morning at the Massachusetts General Hospital one day, I remember a particular instance of having to draw blood from a very ill patient.  By that time, I had already worked for 20 hours straight, with my beeper ringing every few minutes.  What is so urgent that requires a blood draw at this hour?  I looked at the patient’s medical record and saw a history of HIV and HCV.  This patient was in renal and liver failure.  I looked for a suitable vein in the antecubital fossa but could not find any.  I look elsewhere on the arm, but still no.  My eyes were feeling heavy from my day and also staring closely in the dark to look for a thin blue vein that I could target.  Finally, I found a potential vein, on the dorsal surface of the foot.  It was so thin and collapsed, but it was my only hope.  I knew that if I were not careful, I could indeed inadvertently stick myself, which could put me at risk for both HIV and HCV.  I also knew that I did not draw the patient’s blood, she would have a high likelihood of not making it through the night.  It is in times like this, where if your mind wanders, even for a brief moment, the outcome would be highly undesirable.  This is when you need mental clarity, this is when you need that moment of unwavering focus.  Have you been in a circumstance like this?  Maybe not treating a patient, but interviewing for a most coveted job, giving the most important sales presentation, or pushing yourself to win that race?  Fortunately, the outcome that morning was positive, the important medical tests were highly informative for the course of her care and the patient made it through the night.  There are situations like that that arise often, and often unexpected, and you have to be prepared to make those yours.  Stay focused and be at your best, always.

Clarex’s Busy Weekend!

Clarex was all over the place this past weekend. We were at the Whole Foods in Cambridge and Newton, cheering on bicycle riders as they began a trip from Boston to Raleigh, handing out samples with HubHelmet and even at Fenway Park! Clarex was stocked on the shelves, and great times were had by all.

The day began as early as 8 for our Street Team, who were up bright and early to attend the The Pablove Foundation’s long-distance bike ride.It funds pediatric cancer research and programs to improve the quality of life for children living with cancer.The 1000-mile bike ride from Boston to Raleigh began with a nice breakfast for riders, family, and supporters to chat and enjoy at the Whole Foods on Prospect St. in Cambridge. Not to mention we had our team there handing out samples and taking photos of the event, which you can view here. The kickoff also had another perk for Clarex-our product was officially on the shelves! What an accomplishment! So be sure to visit the Whole Foods on Prospect St. to buy Clarex directly along with your other groceries.

Meanwhile, Captain Clarex was at the Whole Foods in Newton, setting up his demo. Clarex is also now sold at the Whole Foods in Newton, and many people got to learn about eliminating mental limits with Clarex. There were trial sizes to test out, and the product being sold right there in the store for those who wanted to continue to increase their focus. After all, Clarex is all natural and caffeine-free!

We also had some samples to give away with HubHelmet, a new service that allows Hubway users access to helmets for safe riding. Be sure to look out for HubHelmet available with all Hubway stations soon! Clarex was a big hit, and it’s great for bike riding so you can focus more on your ride and enjoy it.

Clarex was also at Fenway Park this Saturday as well! After attending teh Pablove Foundation’s kickoff event, Team Clarex attended College Day @ Fenway. where lots of college students received samples. Everyone there had a fantastic time, especially our street team members who got to pose with the World Series trophies! Check out the photos here.

And to think this is just the beginning! Keep on the lookout for Clarex on our Facebook page to learn where we will be next. Comment with any suggestions or feedback-we love to hear from our fans!

-Team CLAREX

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