The LILI Letter — November 2025

November,

Have we all recovered from the Halloween candy coma? Election Day, Veterans Day and the ultimate eating day, Thanksgiving, are observed this month. “Movember,” which encourages moustache-growing in recognition of men’s health, is observed also. Rather than making Thanksgiving about eating too much, let's make it about gratitude. After all, the word “Thanksgiving” does not mean “eat until you can’t move,” it means “give thanks.” It’s a holiday we can ALL celebrate, which I like very much. Wishing all of you many good things for the gratitude list. 😊

In good health,
Jennifer James

Success story

In my health coach training, and continuing education for it, the “generative moment” is one of the jewels we try to create. It often comes with asking thought-provoking questions, and a willing client/patient to explore areas or think about their lives in a new way. What is a generative moment? It is the "a-hah" moment, an insight, when we make a connection we had not seen before. It can be earth-shaking.

Generative moments have occurred during sessions with my patients. Once they put two and two together, and realize what they are doing, albeit subconsciously, their world changes. They realize they need to eat more, or that they use food to comfort themselves due to an abusive childhood, or that they are terrible at setting boundaries to allow self-care.

We can do this on our own. Meditating regularly is one way to lay the groundwork for generative moments. Think of an issue in our lives where there is a negative emotional charge, or where we continue to struggle. What is really going on here? What is beneath this? How does it make us feel? What are we afraid of? How would our life change if we stopped this behavior? What would we lose? What would we gain? What would we tell a friend to do in a similar situation? If we keep asking questions, we may eventually uncover what is really going on.

Give it a shot. One never knows, it may give us a new insight. Shazam!

Do you really know…pears?

A fresh pear…what a pleasure. Thought to originate in China thousands of years ago. Ancient Romans and Greeks considered them “food of the gods.” Pear cultivation increased in the 1600’s in Europe, with an explosion in varieties. We have 3000+ today! Pears were brought to the Americas by the colonists. The growing conditions in the Pacific Northwest are so ideal, that 87% of pears grown in the US are from there. Pears are high in fiber, and a good source of potassium and vitamin C. Try the indulgent pear recipe below.

Now you know

I recently read an article that outlined the origins of the obesity epidemic in the United States. According to the author, it all started in the late 1970’s when a confluence of factors created the perfect storm for obesity rates to skyrocket. The increase in consumption of ultra-processed foods, due to a variety of reasons, is the researchers’ hypothesis fueling the epidemic.

• Sugar-sweetened beverages were consumed in higher quantities.
• Fast food restaurants proliferated.
• Ultra-processed foods were more available (sodas, chips, cookies, candy, etc.).
• The price of sugar plummeted in 1980, making ultra-processed foods cheap and tasty.
• Legislation passed by Congress increased subsidies to farmers, to grow corn, rice, wheat, soybeans. These are ingredients widely used in ultra-processed foods.
• The tobacco companies, RJ Reynolds and Philip Morris, acquired Kraft, General Foods and Nabisco in the 1980’s. They developed hyperpalatable (“super tasty”) foods to boost profits. The tobacco companies have mostly exited the food industry, but leave behind a legacy of irresistible, ultra-processed foods.

A perfect storm indeed. We are living the aftermath of these factors. The food environment we live in is not conducive to good health. We have to fight for ourselves in this situation, and cook more at home, make healthier snack choices, ditch the sugary drinks and stop eating so much fast food and ultra-processed foods. It’s on us, folks.

Temple, NJ. The origins of the obesity epidemic in the USA-Lessons for today. Nutrients. 2022, 14, 4253.

O’Connor, A. The Washington Post. (2023, October 4). Many of today’s unhealthy foods were brought to you by Big Tobacco. University of Michigan, LSA Psychology.

The gall of it!

Our gallbladders are often taken for granted. As long as they work as they should, we don’t think too much about them. If we develop gallstones, which prompt a cholecystectomy (removal of the gallbladder), it can be an uncomfortable and painful experience.

Why do we need a gallbladder? It performs a precise function of storing and squirting just the right amount of bile (gall) into the small intestine during digestion. Our livers make bile, which is like dish detergent, which breaks up fats and oils during digestion. Bile ducts drain bile from the liver into the gallbladder. The gallbladder stores it until needed. High-fat meals require a bigger squirt of bile than low-fat meals. A hormone in our small intestine (cholecystokinin), tells the gallbladder how much bile to contribute. It is all very elegant. If the gallbladder is removed, the liver continues to make bile, which slowly drips into the small intestine through the common bile duct. We no longer have the luxury of a precise amount of bile based on the fat content of a meal. Hence, many do better on a low-fat diet after their gallbladder is removed.

Bile consists of three ingredients: cholesterol, bilirubin and bile acids. As long as the amounts of these ingredients “follow the recipe,” all is well. An imbalance can create stones. Gallstones made purely from cholesterol resemble kernels of corn. Those made from bilirubin are much darker, and look like dark gray or black pebbles. Others can be a combination of the three ingredients.

Other factors increase the risk of gallstones. They occur much more frequently in women due to higher levels of estrogen. Obesity, having children, having Native American or Hispanic ancestry, hormone replacement therapy, a family history of gallstones, and a slower gut transit time (time for food to make its way through the intestines), all increase the risk. Stress, which slows the gut when we are in fight/flight mode, can indeed be a factor. Normal-weight people also develop gallstones, and those on GLP-1 Ras, such as Ozempic, which slow gut transit time, can be at risk. If a gallbladder does not contract much, it is more likely that sediment will form.

Many people have gallstones and never know it. Gallstones can cause all sorts of trouble if they escape from the gallbladder. They can get stuck in the common bile duct, back up bile and possibly pancreatic secretions. This can be extremely painful (and dangerous). There is a procedure, “ERCP,” (endoscopic retrograde cholangiopancreatography), which can visualize the gallbladder and pancreas, and even remove gallstones stuck in the common bile duct. It is pretty amazing what modern medicine can do, but what a hassle!

If we don’t want gallstones, what can we do to decrease our risk?

• Maintain a healthy weight or lose weight SLOWLY, not quickly.
• Eat a low-fat diet with plenty of dietary fiber (whole fruits, vegetables, whole grains, beans and lentils, and nuts).
• Exercise
• Calm down, and let the gut do its job
• Avoid being female or having children (I’m kidding, folks)

Sound familiar? Isn’t it interesting how the same recommendations lower the risk for all sorts of health issues, including gallstones. Take note, my friends.

Cleveland Clinic. (LR 2022, May 3). Gallbladder disease.

Gratitude

As I am writing this, I have to confess, I am not feeling it today. To write about gratitude when one is not in a very good mood, takes some digging. No one is living their “Plan A,” that I know of. I’m not. Many things hit from out of nowhere. Our lives may have evolved along a trajectory that is often due to chance, not our choice. Our childhoods, particularly if they were not the best, can set us back before we even get out of the gate. This year has been a steady stream of expensive surprises for me. Not what I had planned.

We all know people who see the glass as half empty. We may be one of those people. We always see what is wrong, lacking, out of order or not good enough. We are never satisfied with the way things are. We want people to behave the way we think they should behave. We want what we want. It is often about me, me, me, and how things “never go my way.” Nothing is ever good enough. We may think, as my sweet Aunt Louise said, on a very bad day, that “people are no damn good!” I think we all feel this way at times. How dare other people, and life in general, treat us so badly!! Life is just one big disappointment.

Enter gratitude, which sits on the other side of the fence. It acknowledges and appreciates others, it sees they are important too, and that they have helped us in many ways. We realize how blessed we are, on many levels. We notice all of the wonderful things in our lives, and are grateful for them. We stop trying to control everything and everyone. We stop fighting life. We soften up and enjoy it.

We cannot take full credit for everything we do; our success is always with the help of others. I remember Elizabeth Warren, during the 2019 presidential campaign, pointing out that, “Nobody in this country gets rich on their own — even Jeff Bezos.” She argued that the success of billionaires relies on the collective efforts of many people. Their own workforce, the engineers and workers who design and build roads, and the truck drivers who transport goods. He did not create the internet, but he has certainly profited from it. I think of all the people in my life who taught me how to ski, read, play the violin, cook a meal, save money, drive a car and write. I could not do these things without their help. We do not exist in a vacuum.

For this month, rather than focusing on what isn’t right, isn’t working, or not good enough, and how people “really should behave,” let’s focus on what IS working. What are the good things? What are we grateful for at the end of each day? Make it a habit to look over the past day and note at least three good things that happened, or three things (or people) we are grateful for. As for me, I feel better already. Today is a good day. 😊

Caramel pears

Pears are such a delectable fruit. Eating a fresh one is the best way to enjoy one. Making a dessert with them is another possibility. This is simple, yet so elegant.

• 3 large ripe, firm pears, cut into eighths

• 2.5 Tbsp. brown sugar

• 1.5 Tbsp butter

• 1 Tbsp oil

• Freshly grated nutmeg

• Whipped cream

Heat the butter and oil in a cast iron skillet on medium high heat. Place the pear sections, cut side down in the skillet. Cook until the sides begin to brown. Flip to the other side, and cook for a few more minutes, browning the other side, and softening the sections. Remove pears from the skillet and place in a bowl.

Add the brown sugar and stir to combine with the butter/oil and juices. Grate in the nutmeg. Stir to reduce slightly.

Pour the brown sugar/butter/oil/nutmeg mixture over the pears, stirring to combine. Add a squirt of whipped cream. Enjoy!

6 servings

1 serving = 120 calories (includes 1.5 Tbsp. whipped cream)

November support groups

Mondays, 2-3 p.m.
Heart Center Conference Room
ORMC Medical Plaza, Suite #200
Free to graduates of ORMC weight loss classes

Gratitude is riches. Complaint is poverty.

— Doris Day