The LILI Letter — July 2025

July,

What do you like most about the month of July? I love the fireworks, parades and the rodeo. We celebrate Utah Statehood this month along with Independence Day, as a former British colony. A lot to celebrate. What can you celebrate in your life? A new baby? A good job? Our beautiful mountains? For the elders in the bunch, a life well-lived, in spite of the aches and pains? Pausing to be grateful never hurt anyone. Wishing you a festive and fun July.

In good health,

Jennifer James

Success story

Has your life gone the way you thought or hoped it would? No? Join the club of just about everyone living on Planet Earth. How do we negotiate the turn of events in our lives that we don’t see coming? Are we able to pivot, and be open to what is transpiring in our lives, even though we don’t want it to be that way?

I observe nature a lot, and notice that nature is much more adept at this than humans tend to be. They deal with reality more easily and adapt more quickly, otherwise they perish.  If one puts out a birdfeeder and fills it with birdseed for a while, the birds (and possibly squirrels) will find it. If one stops putting seed in the feeder, the birds will check back a few times, then they will move on. They don’t hang around all day waiting for the seed to show up. They need to find a more reliable food source. Stay with me here: if a human was visiting the feeder, it would likely hang around longer. “If I wait long enough, more seed will appear! Something must be wrong, or they would put out the seed. Was it something I said? Are they upset with me? I wonder why they aren’t putting the seed out? I really like the seeds they put out. I am really upset about this. How dare they not put out birdseed anymore!” And on and on. Eventually the human will move on too, but not without a lot of consternation.

I know that was a silly example, but I hope you see my point. To accept reality, to not be afraid of what is true, and work with it, is a priceless (and rare) skill. We don’t live in the past, or in the potential future, we live now. Accept what is happening now. We may long for how things used to be, or what they could be, but that is not our current reality. The more easily we can adapt to reality, and let go of how we want things to be, versus what is, our lives will be better. We will not be mired in the past or in wishful thinking. I realize it may take a while for the emotional fall-out to catch up with a disappointment. A little tough love peptalk today. What element of reality are we too afraid to face? Short skirts don’t look good on us anymore? Our abusive spouse will never change? We can’t afford to buy the house we want? Better to know the truth, the whole truth, and nothing but the truth. And then adapt as nature would.

Do you really know...cucumbers?

Cucumbers have been around for at least 3000 years, and are one of the most popular home garden vegetables. They are a member of the curcubitaceae family, and being a vine, need a lot of room to grow. They are related to squash and melons. Originally from India, the ancient Greeks and Romans enjoyed them, with Tiberius insisting on having them at every meal. Catherine of Aragon wanted cucumber in her salads. There are over 100 varieties, and are eaten fresh or pickled. Some cucumber trivia: the inside can be 20 degrees cooler than the outside, (hence, “cool as a cucumber”), they are 96% water and contain only eight calories in one cup sliced. For a tasty recipe using the cucumber, please see below.

Magnesium supplements: Hype or help?

I have a number of patients who take a magnesium supplement to help them sleep. There are so many things that affect our ability to sleep, such as electronic screens before bed, a large meal, feeling anxious about something, whatever. Expecting one nutrient to ensure a good night’s sleep piqued my curiosity, so I did some investigating.

Magnesium is a mineral that is required by the human body for good health. It is a cofactor (“helper”) that catalyzes over 300 biochemical reactions in the body. The systems affected by magnesium are many: energy production, blood sugar and blood pressure control, synthesis of DNA and RNA, bone integrity, muscle contraction, nerve conduction, and maintaining heart rhythm. Half of it is in our bones, the rest is in our soft tissues, and a small amount in our blood. The kidneys excrete magnesium into the urine to maintain balance. If our magnesium status is low, the kidneys excrete less. Magnesium deficiencies are rare, since it is available in all plant foods. If a plant food has been overly processed, such as refined grains, the magnesium content plummets. We are more in danger of magnesium toxicity, and a few people have died from taking too much.

Magnesium is part of chlorophyll, the green pigment in plants. It helps the plant  absorb sunlight and convert it into energy. Therefore, green leafy vegetables are an excellent source of magnesium. It is also found in dried beans (legumes), whole grains and nuts. It is also found in fish, chicken and red meat. The Recommended Dietary Allowance (RDA) for adults 31-55+ years of age, it is 420 mg per day. I occasionally track my food intake with cronometer.com, and I am usually pretty good at consuming enough, as I eat a lot of green salads, whole grains, beans and nuts and seeds. Pumpkin seeds contain 162 mg in a quarter cup, 1 cup of cooked spinach has 131 mg. Those two foods supply 70% of the RDA! For the lowdown on magnesium content of foods, check out the USDA nutrient content list for Magnesium. FYI, only 40-50% of the magnesium we consume is absorbed by our gut.

As for supplements, there are a variety of these, with magnesium paired up with other minerals. The two best to take are magnesium glycinate and magnesium citrate. Magnesium oxide is used in stool softeners, so that won’t help with a good night’s sleep! Some experts recommend 200 mg of magnesium before bedtime, which is half of the RDA. Toxic amounts of 5000 mg per day have resulted in some deaths. So, it is not something to take with abandon.

But, do they work? There is not a lot of research on this, so the evidence is scant. The studies were not conducted on a large number of people. After looking into this, I have to ask, why can’t we just eat a few whole grains, green vegetables, and nuts/seeds? We can tally our intake to see how we do. Use the cronometer app or website to tally our magnesium intake.

For a good night’s sleep, turn off the electronic screens one to two hours before bed, have a calming routine, don’t eat late, avoid caffeine after 12 noon, don’t exercise strenuously before bed, and put all of your worries onto paper before hitting the hay.

America's fiber crisis

An astounding 95 out of 100 people do not eat adequate amounts of dietary fiber in the United States. The RDA is 21-25 grams per day for adult women, and 30-38 grams per day for men. The higher ranges are for younger adults. Our current intakes average 15 gm per day for women, 18 gm per day for men. Dietary fiber is a type of carbohydrate that is not digested by our GI tract. It is found in all plant foods that have not been overly processed, such as fresh fruits and vegetables, nuts, seeds, whole grains and legumes (dried beans and peas).

The bacteria in our colon use dietary fiber for their food. If we don’t eat enough fiber, the healthy bacteria are not well-fed, which can lead to all sorts of problems. These bacteria produce short-chain fatty acids, which feed the cells lining our gut. A diet low in fiber leaves both the bacteria and the cells in our colon underfed. Other issues that come about from too little dietary fiber are constipation, higher blood sugar levels, less fullness after eating a meal and increased risk of colorectal cancer, cardiovascular disease, hypertension, obesity, type 2 diabetes, stroke, other GI disorders, such as diverticulosis and consequent bowel resections and metabolic dysfunction. As an anecdotal aside, one of my patients who knows many weight lifters and body builders, related that they always focus on eating protein (meat, cheese, eggs, protein powders and shakes, etc.).  Several of his acquaintances ended up needing bowel resections. I have counseled patients myself where a person in their 40’s already had two bowel resections. My patient’s diet? Fast food, sodas, sweets and very little whole foods. Other conditions can cause gut problems, not just diet, but it is an important factor in the health of our digestive tract.

Why are our fiber intakes so low? Two big reasons are the popularity of low-carb, high-protein diets, such as the keto diet. Low carb also means low fiber, since many of the foods high in carbohydrates (grains, fruit, legumes) also contain more fiber. Fiber is not found in animal-based foods, such as meat and cheese. The second reason is the overconsumption of ultra-processed foods, where the fiber has been stripped away. Most whole grains are reduced to refined grains, which removes the bran layer, (and germ), where the fiber resides. Many of the ultra-processed foods may add fiber back to the product, in the hopes of making it look more appealing. The USDA even allows fiber extracted from whole foods, and those created in a laboratory, to be added to foods. A steady diet of fast food, sodas and desserts does not contain much fiber. Turning to a fiber supplement really isn’t the way to go, because it doesn’t correct all of the other nutrient deficiencies inherent in a junk diet.

In the weight loss class, I would ask people to record their fiber intake for a day. Very few people were actually consuming enough fiber.  We don’t eat our fruits and vegetables, we don’t eat many whole grains, beans or nuts, and we prefer the tasty junk foods over much healthier choices. The foods that contain the highest amount of fiber? The “3-B’s”: beans, bran and berries.

We have a choice. Choose a whole-foods, plant-based diet for plenty of dietary fiber. My diet averages 30-40+ grams of fiber daily. How do I do it? I eat three servings of fruit per day, four or more servings of vegetables daily, nuts and seeds daily, dried beans and lentils frequently and the vast majority of grains I buy are whole. Make the transition to a higher-fiber diet gradually, by adding a few more foods here and there. If you make the switch too quickly, your gut will not be happy (more gas and diarrhea). We need to drink more water as well if we eat more dietary fiber. In the long run though, we are doing something good for our entire body, and our diet will be the healthiest it may have ever been.

Making peace with our aging bodies (or not)

It seems that lately I am in conversations with high-achieving men, who are lamenting the fact their bodies will not allow them to do what they have always done. Backpacking, long distance bicycling, hiking and heavy weight lifting, to name a few things. This is often due to new health issues, injuries, arthritis or needing a joint replaced. We don’t lose weight as quickly either. Women deal with this as well. My friends, myself and other older people I know are contending with the same thing. We hurt more, we don’t recover as quickly from strenuous exercise, and it seems we injure ourselves more often, trying to do what we have always done. It is an incredibly frustrating situation. We rebel, and carry on as if we are still younger, but our bodies tell us otherwise. Some of my patients have actually expressed hatred towards their body. Ouch!

I am one of the healthiest people I know, knock on wood, but I deal with a number of things too. My knees aren’t as springy as they used to be, I can’t do strenuous exercise two or three days in a row without paying a price for it. It is easier to gain weight. My body also seems more sensitive to lack of sleep and worries. It is a new frontier.

We can keep pushing (and injuring) ourselves, or take a step back and assess this new reality. Our older bodies seem to do better with more moderate, consistent exercise and strength training. Shocking our bodies with extreme bouts of exercise is not the best approach. It hurts! We can exercise at any age, safely, with the right approach. We have patients in their 90’s in our cardiac rehab program. We need to gradually work up to what we can do, without hurting ourselves. Strength training becomes more important as we age, and it is critical that we include this. We need to start slower with lighter weights, and progress as our bodies respond.

We can still be healthy and fit, and be grateful we can still exercise, albeit differently. We just need to realign our expectations of what we can do, safely, and enjoyably (facing reality, again). It may not be what we did in our 30’s, but we can still have a good time, get a good workout, and let the rest go. I am trying to take my own advice here. It is difficult. If we have to start dealing with this, well, maybe we should thank the good Lord we have lived a long enough life to have these issues!

Agua Fresca de Pepino (Cucumber Lime Cooler)

Agua frescas are very refreshing beverages popular in Mexico that use fresh ingredients. This version uses cucumbers. You can make this as sweet or tart as you like. For a very green beverage, don’t peel the cucumber. If you want to use a sweetener other than table sugar, such as stevia or monk fruit, go for it.

1 large English cucumber, unpeeled, cut into chunks
6 cups of water
Juice from 3 limes
1/3 cup sugar or to taste, or other sweetener
Fresh mint leaves

Using a blender, puree the cucumbers and water until very smooth. Strain into a container, such as a pitcher. Discard the pulp. Add the lime juice and sugar, mixing until sugar is dissolved. Pour into a tall glass with ice, garnish with a few mint leaves. So refreshing! Or, store in the refrigerator for a day or two. Add a few mint leaves to steep.

6 servings; 1 serving = 50 calories

July support groups

Mondays, 2-3 pm

Heart Center Conference Room, Suite #200

ORMC Medical Plaza

Free to graduates of ORMC weight loss classes

My physical body may be less efficient and less beautiful in old age. But God has given me an enormous compensation: my mind is richer, my soul is broader, and my wisdom is at a peak. I am so happy with the riches of my advanced peak age, that, contrary to Faust, I would not wish to return to youth.

— Robert Muller