Q: We started to work two-month rotating shifts during the first pandemic surge. My family has recently complained that I’m increasingly irritable, moody, and negative. My weight, blood pressure, and blood sugar levels are creeping up too, and I’m always tired. Could this be because of the shifts?

A: You’ll need a comprehensive clinical evalu­ation to assess what else might be going on. We recommend you talk to your doctor for a defin­itive answer. That said, shift work affects stress levels, sleep quality, and overall health because of disruption of biological rhythms and may indeed contribute to your situation.

Our brain, other organs, and even our cells have biological clocks that strongly influence—in a rhythmic pattern—the way our bodies function and how we behave. Internal clocks regulate our hormones, our immune system, our digestion, and much more. These clocks are encoded in our genetic material, and the rhythms they produce provide special windows of time that are best suited for the various types of activities that we engage in daily (such as mealtimes and bedtime), and even the optimal timing for medications and radiation therapy on cancer.

The predominant body rhythm cycles every 24 hours and 11 minutes, or almost a day; hence, circa (almost) dian (day). It produces predictable changes such as reduced blood pressure during night-time sleep and a rapid rise to daytime blood pressure levels starting around 6:00 a.m. It’s not coincidental that the risk of a stroke or heart attack is highest between 6:00 a.m. and noon!

Our brain’s performance also varies with the time of day, dipping, between 10:00 p.m. and 6:00 a.m. in otherwise normal people, below the levels of someone legally drunk. We are naturally more prone to accidents and errors during those hours. The cycle disrupted by sleep deprivation, rapid travel across time zones (jet lag), and shift work has consequences (see table). Consistent bedtimes, wake­up times, and mealtimes diminish bio­ rhythm disruption and facilitate realignment.

Your situation may not permit avoidance of shift work. We recognize that there are some jobs that are needed to sustain our modern, 24/7 way of life. You may, however, be able to reduce the severity of the impact of shift work on your health and well­being. The most powerful resynchronizers include consistent, routine mealtimes, bedtimes, exercise, and, most important, sunlight exposure.

Sleeping in the dark and avoiding post-shift light, alcohol, caffeine, sedatives, and screen ­monitor light within 90 minutes of bedtime all help to realign your body functions with your biorhythms. Keeping a consistent schedule, applied even on your days off, will help your body’s adjustment, but frequent shift changes are not optimal.

Individually tailored, carefully and prayerfully crafted, wholistic lifestyle intervention will help you (and your co-workers) reduce your physical, psychological, and even your spiritual risks.

Short-term DisruptionLong-term Shift Work
Decreased:Increased Risk:
CreativityNoncommunicable diseases
Empathy/compassionDiabetes, hypertension, heart disease
Information processingObesity
Decision-making abilityDementia, anxiety, depression, “fog”
Micro-sleepsImmune function
ImpulsivityPsychological resilience

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries at the General Conference.

Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Q: My 28-year-old sister has breast cancer. Our mom died of ovarian cancer, and the doctor wants to test my sister’s genes. He mentioned that her high cholesterol needs to be controlled for best results with the cancer. I’m 33, and all four of us siblings have high cholesterol. What’s the link between cholesterol and cancer?

A: We’re sorry to hear about your sister’s diagnosis and encourage you and all your siblings—female and male—to get evaluated since your doctor suspects a hereditary cancer. Based on the history you provided, we also strongly recommend that you do some Internet-based research from trusted, accountable sources such as the Centers for Disease Control and Prevention,* and we remind you that prevention is more effective than any type of treatment available today. Early risk reduction and disease detection often produce greater survival, lower treatment complexity, and less cost.

Cholesterol biology is complicated. Our bodies naturally make as much cholesterol as is needed, but we can also get it when we eat foods of animal origin. For years correlations between high cholesterol in the blood and the likelihood of certain cancers have been reported. In some kinds of cancer—such as breast, prostate, testicular, and colorectal—lowering cholesterol levels seems to reduce the risk of getting and dying from these cancers. On the other hand, bladder and lung cancers do not appear to be associated with cho- lesterol levels, and the use of cholesterol-lowering drugs (statins) may increase the risk compared to the benefit. Specifically, increased dietary choles- terol is associated with an increased risk of breast cancer, and that’s probably what prompted the comment by your sister’s doctor. Some studies also estimate that for every 300 milligrams of cholesterol in the daily diet (about a two-egg omelet per day), the risk of pancreatic cancer increases by 24 percent, endometrial cancer by 18 percent, and throat cancer by about 25 percent.

In 2018 researchers at the University of California, Los Angeles, showed how cholesterol promotes tumor growth. In 2019 a scientific review concluded that both a high-fat, high-cholesterol diet and having elevated levels of blood cholesterol can affect cancer development because cholesterol handling is reprogrammed in cancer cells. In 2021 researchers at Duke University demonstrated the way breast cancer cells use cholesterol to fuel the mechanisms that make them impervious to the natural cell stress as they migrate (metastasize). Metastatic breast cancer is difficult to treat, so preventing the spread is preferable. Lowering cholesterol by lifestyle and, if necessary, with medications will interfere with breast cancer metas- tasis and be better for the affected person. Current cholesterol-lowering strategies include physical exercise, adequate sleep, stress reduction, and improved diets low in animal prod- ucts (saturated fat and cholesterol) and high in legumes, seeds, avocados, olives, and especially nuts such as pecans, walnuts, and almonds.

We encourage you and your siblings to find a health-care team that’s knowledgeable about lifestyle-based, wholistic risk reduction and follow their rational plan. Thank God for His evidence-based pathway to optimal health and wholeness even in our brokenness!

* https://www.cdc.gov/cancer/breast/young_women/bringyour- brave/hereditary_breast_cancer/index.htm

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries at the General Conference. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

You’re on death row. You’ve been diagnosed with a fatal illness that you may not have realized you have. And you’ve only been making the situation worse by your attitudes and actions.

As a matter of fact, we’re all in the same boat. Try as we might, there’s nothing, absolutely nothing, we can do to reverse our condition or save ourselves. Regardless of our rank, position, socioeconomic or even ecclesiastical status, none of us is able to save ourselves.

“But,” you may protest, “it’s not that simple; there’s more to consider.”

Really? Even those engaged in the God-appointed work of organizing a denomination were not placed in “exempt status.”

An Historical Case Study

Taking on an exaggerated workload, failing to mend fragile human relationships, or attending to the heart work that is high on God’s priority list serves only to hasten the progress toward the inevitable end. God has more in store for us than we have time to do, because we are doing what others should be doing, even as He is preparing them to do so. We have a sacred duty to attend to our well-being and arouse others to do this as well, but reject the notion and practice of imbalanced work, appetite, and self-reliance.

We must learn what God really requires of us, how to enjoy His Sabbath, to spend time with those in our care, to be tender and compassionate with our children and treat them as well as our associates with the spirit of forgiveness that Jesus possessed. We have to let our children find their highest pleasure with us, just as we find and lead them to find the unsurpassed pleasure of the Lord’s company.

And do not neglect to grow in intimacy with your marriage partner . . . both of you have peculiarly sensitive hearts. Yes, external problems will arise, but God wants us to have such a strong love for each other and to be in such harmony together and with Him that united in doing His assigned work, you can stand nobly, faithfully, and successfully. This will move us from saddening thoughts and saddening subjects to a place of cheerfulness, happiness, gratefulness, to greater reliance on God and unshakable confidence in Him who alone can do something about our diseased, terminal condition.

We must surrender ourselves to God so that He is in control of our mind, for that’s where our sense of well-being comes from.

The preceding narrative paraphrases some of the facets of a historic vision experienced by Ellen White on Friday, June 5, 1863, during Sabbath vespers at the home of Aaron Hilliard in Otsego, Michigan. Her comment about this is found in “Testimony Regarding James and Ellen White.”1 The vision came just 15 days after the successful incorporation of the General Conference. The Whites were to attend an evangelistic event. They were staying in the home of Aaron Hilliard when she went into vision for about 45 minutes. Sometime during the next day she wrote that she was shown some issues regarding her husband and herself, and she wrote a message to the church in Monterey.

Ellen White remarked that her experience on that day was a special blessing. Perhaps the tumult of church organization and wearying travel and her husband’s health were suspended for 24 hours but resumed later when she was able to write about the event and the insight shared with some of the members of the Monterey church, a church embroiled in issues of marital infidelity and misguided judgments. The family, specifically its integrity and protection, was a clear theme throughout. She perceived that God saw what we do, and that using our own distorted judgments was at odds with what He desires for us and the harmonious life we could have in Him.

The Hebrew term that best describes that Edenic perfection, completeness, and harmony is shalom. It is the profound, absolute peace that is exclusively of divine origin.

Not until August 18642 did Ellen White describe more fully the content of the vision in Otsego, but she wrote many letters and gave local and personal testimonies in the interim, including expressing the pain of the loss of their eldest son, Henry, in December 1863. The tone of her concerns appeared to be centered on integrity, Christlike attitude, mental health, and the spiritual component of well-being. Interestingly, the context within which “the great subject of health reform”3 was placed, as elaborated in the Otsego vision, is in the perfect origin of our species (and every other earthly creation) in the Garden in Eden.

“Adam and Eve in Eden were noble in stature, and perfect in symmetry and beauty. They were sinless, and in perfect health. What a contrast to the human race now! Beauty is gone. Perfect health is not known. Everywhere we look we see disease, deformity and imbecility. I inquired the cause of this wonderful degeneracy, and was pointed back to Eden.”4

This perfection, symmetry, and beauty, with all that is good and complete, in perfect harmony and everything at peace, is God’s ideal for us. When Eve and Adam fell, the entire order of things became distorted, and degeneration, decay, disease, and death entered the human sphere. But God, being love, mercy, and grace personified, had laid contingency plans from “the foundation of the world.”

The Hebrew term that best describes that Edenic perfection, completeness, and harmony is shalom. It is the profound, absolute peace that is exclusively of divine origin. Only God possesses this in Himself. He bestowed this upon our world at Creation, and we lost it with the Fall. But God promised to restore this to our first parents, and in the fullness of time He made good on that promise. God sent His Son in the flesh to reconcile humanity to Himself. “It was His mission to bring to men complete restoration; He came to give health and peace and perfection of character.”5 That is shalom!


While specific attention was directed toward the practical activities of daily life that contribute to or detract from our wholistic well-being, Ellen White’s 1863 vision placed the care of our health as a religious duty, and control of the mind as an essential component of overall health through His grace.

Even though disease prevention is prominent, when we position health practices within the framework of reforms and remedies, a presupposed “norm” already exists. Remedies are not used to prevent disease. The term inherently indicates treatment of a problem that already exists. When we place the practice of health reform as a preventive measure, people often mistakenly assume we are preventing death. This perverse aberration of the truth often leads to the idea of health being only a reflection of an individual’s ability to practice certain healthy behaviors. Then we set up a system of judgment and spiritual hierarchy based on health practices, and, even more sinisterly, health outcomes. Even the term self-control may distort the reality that this attribute is really a gift imparted by God through His Holy Spirit (Gal. 5:22, 23).

Christians do not engage in healthful practices in order to be saved, but rather because we are saved. We live healthfully in response to God’s desire and invitation for us to be one with Him, to be complete in Him, and to be the best version of ourselves for His glory. We are called to be ambassadors of shalom, and we should do everything in our power to remove all impediments that can interfere with our connection with God and our relations with each other as we run the race of this earthly life (Heb. 12:1-3).

We were created to be in harmony with God’s plan, and that required obedience to His laws. While we may focus on God’s moral law as divine, we shouldn’t forget that the physical laws that govern our universe from atoms to galaxies are also divine. Some of these natural laws govern our physiology and anatomy, ecology
and personal hygiene; cooperation with these laws is consistent with health. Ignoring the laws of health fosters sickness and disease. When we cooperate with God in His effort to re-create us, we are beneficiaries of a measure of shalom.

We do not belong to ourselves; we are not our own; we have been bought and paid for by God Himself. So in love and appreciation we honor God, not only in our minds but also with our bodies (1 Cor. 6:20). The kingdom of God is more than just what we eat and drink (Rom. 14:17); we should also appreciate God by caring about our total health and well-being. The lifestyle choices we make are important to Him. Whether we eat or drink or whatever we do, we should do it to honor God (1 Cor. 10:31). We live by His grace, in whom we live and move and have our being (Acts 17:28).

There’s no question that healthful habits promote better physical health and longevity in general. But we must be careful to note that while the risks of unnecessary disease, suffering, and premature death are reduced, we still live in a fallen world, damaged by sin and to be restored only when the new heavens and new earth are created as promised.

So healthy living is a necessity for all who can do so. But that will neither save us nor immunize us against all sickness and suffering. That will come when Jesus returns, and we become full partakers of His shalom and see Him face to face.

Meanwhile, we are counseled to preserve ourselves completely, body, mind, and spirit, until He returns and completes His promise (1 Thess. 5:23). A healthy body favors a clear mind that is better able to understand God’s truth, resist temptation, and face the spiritual onslaught of our daily existence by accessing God’s strength through His Holy Spirit.

We are all on death row. Ellen and James White had to deal with this reality personally in 1863, as we do now. Only God can change that. He gives shalom, and all honor and praise is His.

  1. Ellen G. White, manuscript 1, 1863.
  2. Ellen G. White, Spiritual Gifts (Battle Creek, Mich.: Seventh-day Adventist Pub. Assn., 1864), vol. 4a.
  3. Ellen G. White, in Review and Herald, Oct. 8, 1867.
  4. E. G. White, Spiritual Gifts, vol. 4a, p. 120.
  5. Ellen G. White, The Ministry of Healing (Mountain View, Calif.: Pacific Press Pub. Assn., 1905), p. 17.

Zeno L. Charles-Marcel is an associate director of the General Conference Department of Health Ministries.

Q:I will be scheduled for in-hospital surgery under general anaesthesia within the next three to four months, and I’m scared. I’ve heard that there are ways to reduce my risk. What can I do?

A:People undergoing medical-surgical procedures often feel anxious, stressed, or scared. Doctors are paying increasing attention to interventions to reduce presurgery jitters, anxiety, and stress to improve recovery and avoid delayed discharge from the hospital. Using the time you have before surgery to optimize your total health is a must-do for all who can. Some hospitals have “prehabilitation” programs, so see if such a program is available where you are.

We are privileged to respond to your question, but remember that these general health tips should not supersede or replace the recommendations from your physician.

Preparing for surgery takes planning. Have a plan, and prayerfully work that plan. By God’s grace, trust Him to do for you what you can’t do for yourself.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

The attendant at our local health food store said that some types of salt are more healthful than others and have less negative effects on heart disease and blood pressure. I have hypertension, but I always thought that salt is salt. Isn’t it?

As with many health issues today, what once appeared to be quite straightforward has become “complicated.” Even the word “salt” has different meanings depending on its use in regular language or in chemistry, for instance. We assume that we’re dealing here with the common, nonchemistry use of the word, which refers to “a crystalline food seasoning or preservative that gives seawater its characteristic taste.” In general use, “salt” and “sodium” are synonymous, even though salt is really only 40 percent sodium and 60 percent chloride. There’s evidence that chloride itself may also be an important link between salt and blood pressure, but we’ll concentrate on sodium in our response.

The sodium content in salt is thought to be responsible for salt’s effects on health. Sodium is involved in many important biochemical and physiological functions of our cells, tissues, organs, and systems. Flawed methodology of some high-profile studies a few years ago produced some confusion as to the effects of varied dietary intakes of sodium on heart disease, strokes, blood pressure, and overall death rates. Nonetheless, current evidence shows that as the
amount of dietary salt increases, so does the risk of cardiovascular disease. So it’s relevant to know if all types of salt are equivalent.

The claims that “some types of salt are healthier than others” is potentially true but not generally so. Salt varieties all have roughly the same amount of sodium by weight; so they will be expected to have the similar sodium-related health effects depending on the amount ingested. Nonetheless, each type of salt has a different sodium content by volume, so one teaspoon of table salt has about twice the amount of sodium as does one teaspoon of kosher salt (see table). So following a recipe and substituting one kind of salt for another may not only give different taste outcomes; it also may confer different health risks because the amount of sodium will vary—although not because of the inherent properties of the specific type of salt (sodium) itself.

A little salt is essential for life, but too much is dangerous, regardless of the source. Choose the type of salt for its culinary properties, not for speculated health benefits that are likely to be insignificant compared to an overall healthful, balanced diet. Also, it’s important to be careful about where we get our health advice.

Type of saltPercent of sodium by weightSalt in grams per teaspoonSodium content per teaspoonSpecial feature
Table salt (iodized)~ 396~ 2325iodine and anti-clumping chemicals added
Sea salt~385~ 1870potassium, iron, zinc included
Kosher salt~ 383~ 1120 
Pink Himalayan salt~ 375~ 1870iron oxide

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Q:Even though my husband and I have followed a healthy vegetarian lifestyle for more than 25 years, my husband was recently diagnosed with a difficult-to-treat cancer. How could this happen? Our oncologist has offered to enroll my husband, free of cost, in a “clinical trial” using a drug regimen that is potentially much more effective than the current standard treatment. The standard treatment includes an expensive medication that our insurance does not cover. Who wants to be involved in a trial? How dangerous is being in a trial? Aren’t “clinical trials” just experiments using people as “guinea pigs”? How can we be sure he is getting the new medication and not just a worthless sugar pill? We want to do the best for my husband. We’re scared.*

A:With all the advancement in cancer treatments, cancer is still a scary diagnosis. Most adults in the United States know—or know of—at least one cancer survivor; many people today have been considered cured! Your situation is serious but not hopeless.

A clinical trial is a research study in which human subjects are prospectively assigned some specific treatment to evaluate its effects on health outcomes. The patient is not on trial; the new treatment is. It is how we get to know how effective and safe (or not) treatments used on lab animals are for humans.

The feasibility and safety of human research are assessed by a mandatory review by a group that includes “regular,” or nonmedical, people who authorize or prohibit the study. Treatments now considered “standard” had to pass through this process with other volunteers. As with any treatment, even with lifestyle interventions, you should be provided (or seek out yourself) enough understandable information about it and reasonable alternatives to determine the potential benefits weighed against the potential risks and cost.

Because participants are randomly assigned, no one knows who will receive the “new” medication or the placebo; but everyone will receive at least the current standard. Your participation is voluntary and revocable at any time in the process. Call for prayer from your local church elders; involve your husband’s personal physician and longtime friends; prayerfully, carefully decide.

Healthful living reduces our risk of many diseases and can even reverse some diseases already established, but elimination of all diseases is not assured. Because our world is marred by sin, there is and will be sickness, suffering, and death. Yet this situation will not last forever, and we do not have to go it alone. Support from believing family, friends, and cancer survivors; being active in “doing the best you can under present circumstances”; and being especially close to God to find meaning even in hardship—all these bolster hope, the confident expectation of what God has promised: “Let not your heart be troubled” (John 14:1).

Plans are in place for the everlasting, permanent solution to cancer and all disease, even death. We join you in prayer. Hope’s strength is God’s faithfulness.

* This query and answer are phrased to protect the questioner’s identity while providing good information about clinical trials.

Peter N. Landless, a board-certified nuclear cardiologist, is director of Adventist Health Ministries of the General Conference. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Q:I follow the “grapefruit diet” to lose weight (fat). But my skeptical daughter says that grapefruit and some of the supplements I take can cause problems with my medicines. Is this true?

A:Your daughter is correct. Some “things we ingest” (TWIs), such as foods, beverages, herbs, and supplements, may affect how prescribed or over-the-counter medications work. We strongly encourage discussing all of your medications, supplements, and herbals with your doctor and pharmacist, who need to know what you are taking so they can advise you accordingly.

Amazingly, most medications and TWIs have unnoticeable or insignificant interactions with each other. The potential problem is that while medications are assumed to be given appropriately, and in safe doses for legitimate medical indications, they may interact with TWIs by increasing or decreasing their potency, or may augment or mask side effects. Medications may also affect a person’s nutrition by altering the absorption, utilization, or elimination of vitamins, minerals, and other food components. Additionally, herbal supplements (e.g., ginseng and Saint-John’s-wort) can negatively interact with other medicinal compounds.

If you are taking medicines for high blood pressure, high cholesterol, anxiety, allergies, or irregular or abnormal heartbeat, your grapefruit diet may be problematic, depending upon the specific medication, the amount of grapefruit in the diet, and your own genetics. Grapefruit, pomelos, and tangelos typically let more of the drugs they interact with enter the blood.

Medications Affected by Consuming Grapefruit
Amiodarone (Cordarone®)Lovostatin (Mevacor®)
Atorvastatin (Lipitor®)Nifedipine (Procardia®)
Buspirone (Buspar®)Sertraline (Zoloft®)
Carbamazepine (Corbatrol® Tegretol®)Sildenafil (Viagra®, Revatio®)
Fexofenadine (Allegra®)Simvastatin (Zolcor®)

For example, your “grapefruit diet” can cause increased absorption and blood levels of certain statin drugs (used to lower cholesterol), increasing your risk for liver and muscle damage that can lead to kidney failure. On the other hand, grapefruit (as well as oranges and apples) may cause less Allegra (fexofenadine) to enter the blood and decrease its effectiveness.

Grapefruit can be part of a nutritious diet, but even small amounts (six ounces of juice) affect how certain medications work for 24 hours. Grapefruit may reduce insulin resistance and promote lower all-day calorie intake, but similar weight loss is seen with water or grapefruit or grapefruit juice taken 20 minutes before meals.

You are commended for moving to a healthier weight; this is good, even though there is debate about the benefits of the “grapefruit diet” per se. A comprehensive lifestyle modification with sound nutrition, exercise, sleep, and water—yielding to the Holy Spirit for promptings and power—is a wise and wholesome investment of time and energy.

Medication Safety Tip: Always talk with your doctor before taking something new. Read labels and package inserts, directions, and warnings for possible interactions. Ask your pharmacist or doctor if you don’t understand something. Do not take capsules apart, mix medicines and supplements together, crush medicines, or dissolve medicines in food or drink unless you are directed to do so. These actions can change how the medications work. Never take medicines with alcohol (we advise that no one ever consume alcohol).* A full glass of water is best, unless told to do otherwise.

* See www.adventistreview.org/no-safe-level-of-alcohol-consumption-


Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Q:I am overweight and have been sedentary for years. I want to start an exercise program, but I’m self-conscious about going to a gym. Can I just start walking in my neighborhood? Is this good enough for serious exercise?

A:We encourage you to start moving; that is an important decision. Walking, placing one foot in front of the other and repeating the action, is proven to improve our well-being in many ways.

It is free and requires no doctor’s prescription, no special clothing or equipment, and no complex formula, so it is often underestimated as a risk-reducing and treatment modality. With the understandable exception of people with musculoskeletal challenges from illness or injury, walking is a deceptively easy and effective way to increase physical activity and fitness. Walking is ideal as a gentle start-up for sedentary individuals. It is, by far, the most “natural” way to move, burn calories and fat, and effectively manage your weight. It is customizable to your fitness and health goals as part of a comprehensive wellness regimen.

Walking to become physically healthier is not complex, but there are some basic safety issues that you should take into account. Please talk to your doctor before you start, get some suitable walking shoes, set some realistic goals with a friend or relative, and find an accessible, safe place to walk. Neighborhoods, shopping malls, parks, office corridors, riverbanks, boardwalks, seashores, outdoor trails, and even around the house (especially with stair climbing) are places people get their daily walking workouts. Because walking self-regulates its intensity and duration and has a low ground impact, for the prudent person it is quite safe.

After starting with what you can do, work your way up to comfortably walking for 30 minutes, 45 minutes, and then an hour—the recommended level for reducing the risk of diabetes, heart disease, certain cancers, and Alzheimer’s disease. Regularly walking faster than customary while still being able to talk while walking puts us in the “training zone,” which develops and sustains physical fitness. A 160-pound person walking at that pace typically burns about 100 calories per mile.

Walking helps . . .

Walking is an all-season, repeatable, self-reinforcing, habit-forming activity. A walk through the park, around the lake, or along the seashore can be spiritually uplifting. You can pray and memorize scripture as you take a 10-minute stroll after meals.

Walking is relational: try a walking “date” or join a walking club.

Walking is practical: park some distance away from your destination, take the stairs, and walk even if you’re on the escalator. You’ll sleep better, think clearer, get slimmer, and live well longer. It’s serious!

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Q: My husband is 69 years old, in overall good health, and recently retired. He has become extremely absentminded during the last two years. It’s affecting his quality of life. He was forced to retire at 65 by a new boss from a job he loved, and it hit him hard. He became depressed and was put on medication. He responded well to the medication, but now this absentmindedness has developed. Is this something we should just expect at our age, or could it be something more?

A: Concerns about declining thinking and memory skills rank among the top fears people have as they age. But unless forgetfulness and memory distortions occur abruptly, become extreme, or are persistent, they are usually not considered indicators of Alzheimer’s, or other memory-impairing illnesses. Moments of forgetfulness or memory distortions about facts, where we put the keys, why we walked into a room, or recalling someone’s name are common. But forgetting how to get back home from shopping, how to turn off the shower, or recognizing relatives or yourself requires prompt medical attention. Research shows that thinking skills, except vocabulary, generally decline over time.

Memory involves multiple parts of the brain that are responsible for three processes: intake (uploading), recording (storing), and retrieval (accessing for use). Illness, injury, chemical alterations, or degeneration may affect these functions and therefore reduce the brain’s ability, speed, and accuracy.

Short-term information is subject to spontaneous decay or competition among its elements for recall. Working memory uses this information along with what is retrieved from long-term storage as a scratchpad for decisions and actions throughout the day. Focus, information rehearsal, and moderate-intensity aerobic exerciseimprove short-term and working memory; while depression, anxiety, stress, medications, alcohol, and inadequate sleep impair them. Why some individuals are more affected than others is still unknown.

By God’s design, physical and mental activity is the best prescription for maintaining a healthy brain and a resilient memory. The capsules below may help you detect possible reasons for prompt medical attention for your husband.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.

Memory Capsules

Causal Associations
Inadequate sleep
Medical illness, e.g., low thyroid, infection, and head trauma
Depression, anxiety, and other mental illness
Medications, drugs, alcohol, and other chemicals
Preventive Measures
Get adequate rest and sleep.
Manage stress and anxiety.
Treat depression appropriately.
If you smoke or drink alcohol, STOP!
Do aerobic exercise and stimulating mental exercises.
Protect the brain from chemical and physical injury.
Coping Techniques
Say out loud and rehearse things to remember.
Associate new with old, established information.
Have a set place for things such as keys and reading glasses.
Break up information into chunks, e.g., telephone numbers.
Make a note or list or have a digital voice assistant for things to remember.
Cherish your spouse and keep them close at hand. ϑ

Q:A few of my friends have gone gluten-free as a health practice. They say they feel less bloated and better overall, but their diet seems so restrictive. Is going gluten-free healthful, and will it decrease my bloating?

A:Your question is a fairly common one, and we commend your friends for not being passive regarding their health.

Current estimates are that only .5 to 13 percent of the population have a diagnosable condition that warrants eliminating gluten, namely, celiac disease, nonceliac gluten sensitivity, and wheat allergy. Household members may also adopt a gluten-free diet for solidarity, ease, and elimination of cross contamination. But when market researchers ask gluten avoiders about their reasons for this dietary choice, about 40 percent say it is better for overall health. Some 45 percent cite reasons other than gluten intolerance or sensitivity, and more than 80 percent have no substantiating medical diagnosis. So your friends are not alone in this.

People with celiac disease have an immune reaction to ingested gluten, leading to widespread inflammation and damage to the gastrointestinal (GI) tract that interferes with the absorption of nutrients from food. This results in a host of symptoms and may lead to such problems as osteoporosis, infertility, nerve damage, seizures, and an increase in the risk of intestinal cancer.

Nonceliac gluten sensitivity may cause symptoms similar to celiac disease but without intestinal damage. Celiac disease is diagnosed by a special blood test and biopsy of the intestine. Even a very small amount of gluten can cause problems for those with celiac disease, so going gluten-free is, for them, not just very helpful—it’s a must!

Gluten is actually a set of proteins found in certain grains such as wheat, rye, and barley. They are not essential to your diet, but because gluten is part of commonly used grains, eliminating it is tricky. Breads, cereals, pasta, and beer all have gluten, and it hides in sauces, “natural flavorings,” vitamin supplements, some medications, even toothpaste. Most people without celiac disease on a “gluten-free” diet are usually not strictly gluten-free.

On the other hand, about one in every five Americans suffers from bloating, or trapped intestinal gas. This is far more common than gluten sensitivity. Smoking, acid reflux, certain medications, and mouth breathing may contribute to the overinflated sensation. Unabsorbed foods, such as lactose, gluten, and processed soy, and the overeating of foods that contain FODMAPs may also be implicated. FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, complex names for a collection of molecules found in food that can be poorly absorbed by some people. Wheat, rye, onions, beans, and mushrooms all contain FODMAPs. (Visit the link below for a more complete list.*)

Removing or reducing FODMAPs from your diet may eliminate bloating. Since every individual’s gut is different, try avoiding them for a few weeks to see how your body responds, then add them back one by one to find the culprit(s). This is far easier than going completely gluten-free and is less dangerous. Be sure to get adequate fiber and B vitamins in your otherwise health-promoting diet and lifestyle for the health and well-being that God desires we experience.

* www.monashfodmap.com/about-fodmap-and-ibs/high-and-low-fodmap-foods/

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.