Mindful Eating

Michael J. Muschel, MD FACC MS

Open the newspaper, turn on the radio or television, or read the magazine covers in the checkout line at the supermarket and you’ll be bombarded with tips and tricks for weight loss. Eat for your blood type, or only raw produce, or no carbs, or protein shakes, or powerhouse smoothies. Our country has a mind-boggling obsession with WHAT to eat for weight loss but precious little focus on HOW to eat.

This point was driven home powerfully during my recent trip to Southern France. On the final day of the trip, members of our tour group sat and reminisced about the week we had spent together and discussed what each of us found the most interesting. What did I find particularly interesting? A quizzical look on our tour guide’s face one afternoon.

Let me explain. We were returning from shopping and browsing in a small village market. As we boarded the tour bus, our guide – a genteel and elegant French woman – stared at something in the hands of one of the members of our tour. “Where did you get that?” she asked, incredulous. “That’s very unusual since most stores wouldn’t sell that here.”

The item in question? A cup of coffee in a paper to-go cup. “Look out the window at the people on the street,” the guide continued. “Do you see anyone holding a coffee to-go? Certainly not!” And she proceed to explain that in Provence, a person who wants coffee sits down in a cafe, often in the company of another, and is served coffee. Seated. At a table. The coffee is served in a china or ceramic mug. That’s the way the French people drink – with more attention to HOW than to WHAT. And that’s the way they eat.

What a great lesson. It brought to mind the cardiologist’s “French paradox”– the famous observation that the French do not have much heart disease, especially considering the croissants, butter, creamy dressings, and desserts that are staples of their cuisine.

Could the regular intake of red wine, with its heart-protective antioxidant compounds, explain this? Maybe. But an equally compelling explanation is the French way of eating, which contrasts dramatically with the eating habits in the US and other Western countries. This not a new observation, nor even my own. Mireille Guiliano, wrote her best-selling book, “French Women Don’t Get Fat,” based on this idea. For me, seeing the idea live, looking at that busy pedestrian-packed street with nary coffee cup to be found, eating rich dinners French-style for an entire week in a French chateau, and taking mental notes was uniquely instructive.

What are some of the characteristics of French eating? They are eating-related practices that reflect mindful eating that is never distracted or absent-minded, hurried, or multitasked.

The phrase “mindful eating” refers to being actively engaged and fully present in our culinary experiences. In contrast, mindless eating implies the very opposite, eating when distracted and without full awareness, a practice that can cause you to eat too much.

I have a new commitment to eat more like the French, and be slimmer and healthier for it. I encourage you to give it a try.

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For Heart-healthy Eating, Try Mediterranean

Michael J. Muschel, MD FACC MS

In early 2013, The New York Times reported on a scientific study that adds another bit of support to the link between a Mediterranean-style diet and heart disease prevention. Since the 1950s, we have known that people living in countries and regions bordering the Mediterranean Sea — Southern Italy, Greece, Spain — have less heart disease than people living in other westernized countries.

Epidemiologists and scientists have long suspected that the “Mediterranean diet” common to these populations, one that is high in fruits and vegetables, whole grains, legumes, nuts, and olive oil and includes red wine, while restricting red meats and dairy products, is responsible for this health benefit.

Observational studies over the years have indeed confirmed that population groups whose diet closely adheres to these Mediterranean dietary principles have a lower risk of heart disease. But these early reports on large groups of people needed to be confirmed by clinical trials that track and compare the health of subjects who are randomly assigned to different diets.

Dietary Modifications Save Lives

The first of such randomized clinical trials, the Lyon Heart Study, began in 2001. In this French study, patients who had suffered a heart attack (myocardial infarction, or MI) were randomized to follow either a carefully supervised Mediterranean diet or a standard low-fat, low-cholesterol diet. The Mediterranean diet group had dramatically lower incidence of recurrent heart attacks, supporting the idea that dietary modifications could indeed save the lives of heart disease patients.

So what makes this study so exciting?

It was the gold standard, a large, randomized clinical trial that looked at whether heart disease might be outright prevented by following a specific diet. This means that the results can be applied to the general population at large rather than just to those with heart disease or a history of heart attacks

30% Lower Occurrence of Heart Attacks

The 7,500 individuals enrolled in this new study, conducted in Spain, had heart disease risk factors, e.g., smoking, high blood pressure, family history of heart disease, and/or high blood cholesterol but were healthy otherwise. About one-third were instructed and regularly coached in the details of a traditional heart-healthy, low-fat diet. Another third were instructed in the specifics of a Mediterranean diet and were closely monitored. This group also received large quantities of olive oil for daily use. The remaining one-third also regularly received guidance and provided feedback on Mediterranean eating, but was supplied with large quantities of nuts. After about five years, the number of new heart attacks, strokes and cardiac deaths was 30 % lower in each of the Mediterranean diet groups as compared with the low- fat group. This study supports the potential role of the Mediterranean diet in preventing cardiovascular disease.

Start Eating Mediterranean Now

Can this good news motivate those of us at risk for heart disease to eat in a more heart-healthy way? Some of my patients despairingly tell me that it is too late for them since their blood vessels and heart are too far gone. That’s not true. The average age of subjects in this most recent study was over 60 years!! Even participants with years of heart-unhealthy eating lowered their risk after switching to a Mediterranean diet. I also hear from patients that diet won’t make a difference because they already are taking Lipitor, Crestor or another cholesterol-lowering drug. They’re wrong. Many of the patients in the Spanish study were in fact taking these very medications and still benefited. This shows that diet and medication work together for even greater effects – each is good and both are better.

So start today by making one or two small changes to bring more Mediterranean foods into your diet. Your heart, and your taste buds, will thank you!

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Paying It Forward and Getting Paid

Ben Wiener

@BeninJLM  Rare Medium posts, hopefully well done.

TL:DR — Being nice often pays tangible dividends when you least expect it, and sooner than you’d think

Raising my first venture capital fund was very hard. I had no track record, and was advancing an investment thesis and a geographic focus that were not obvious. Initially, prospective investors were hard to find and I was pressured to close any “fish” I could get onto a hook.

One such fish was Lou (not his real name). Lou was primarily a (very successful) real estate investor, but extremely knowledgeable about venture capital. He had invested in numerous startups as well as a number of VC funds. We met periodically over a few months and he really got into Jumpspeed’s unique opportunity and thesis.

Things seemed to be coming to a head when we had our third or fourth meeting. We’d covered everything. I was hoping for — expecting — a meaningful commitment.

“Ben, I like what you do. I get it. It’s really interesting.”

Great.

“But I’m not going to invest. I’ll tell you why. You’re too nice.” He paused.

“You can’t be a nice guy and succeed in this business.”123

I was quite upset. And I completely disagreed. First, I didn’t agree that I’m “too nice.” And I certainly didn’t agree with the argument that being nice precludes VC success. But he was firm, and our tango was over.

A bunch of funny things happened after that.

Later that year, one of my early picks, Breezometer, was named “Most Promising Startup in the World” by the White House as part of President Obama’s worldwide GEW initiative. I wrote a blog post describing how I’d only had the opportunity to invest because I’d been nice.

I’m now investing out of Jumpspeed’s second fund. A few months ago, I was looking over the list of LPs (limited partners, the investors in the fund), who’ve joined Fund II thus far. I was trying to identify patterns among the participating LPs to see where I was having success, and how I had initially connected with them in order to determine how I could find more LPs like them. I found that I could trace all of my LPs to no more than eight individual initial points of contact or referral.

Then I thought about how I had met or connected with those eight people. I realized that I had connected with all but two of them, through some act of kindness, non-business favor, or other “good deed” that was not an investment pitch. Being unintentional and nice had gotten me to 71% of Jumpspeed’s current LPs, representing close to 80% of the fund’s capital.

Some examples:

  • On one of my trips to the US I flew in a day early to make a condolence call to a relative, who’d lost his father. I knew how hard the loss was and just wanted to spend part of Sunday with him, before the US work week started, since we don’t get to see them that often and I hadn’t been at the funeral. While we were just sitting around he tried to deflect the conversation away from his grief. “What are you up to these days ?” he asked. “Investing in startups.” He paused for a minute. “You know, you should talk to my friend Mr. X. He might be interested.” “You know him? I’ve been trying to get to him for a year,” I said. “I’ll email him right now,” he said. Fast forward, and Mr. X is Jumpspeed’s largest individual investor.
  • Over 20 years ago when I was a law student, I talked my way into a Securities Analysis course across the street at the business school. I wanted to learn about stock picking though at the time I had no plans to become a professional investor. I developed a nice relationship with the professor, who’d had a successful Wall Street career. After I moved halfway around the world and got involved in startups, we didn’t keep up much, but once I started investing in startups I found myself drawing upon some of the wisdom and insights I had gleaned from him. Even though his lessons were in the context of public stocks I found some themes resonated in very early-stage, pre-product/market fit startup investing. I hadn’t spoken to him in around fifteen years, but I reached out to him prior to a US visit, just to get together and let him know how valuable those lessons now were to me, and how grateful I was to him for letting me into the course and spending time with me over two decades earlier. I know that many teachers never get that kind of feedback from former students and I thought it would be cool for him to hear that so long after, and so far away, and in such a different context, his lessons on evaluating risk were so valuable to me. I swear I had no intention of pitching him — to the best of my knowledge his sole focus was public market trading. He responded kindly to my note and said it would be a pleasure to catch up. We blocked an hour between my other meetings. An hour and a half into our meeting we were deep into Jumpspeed’s opportunity, thesis and portfolio. He was fascinated. We were both really late for our next meetings. He leaned forward and said: “Let me ask you something. How would you feel if I put some money into your fund?” Goosebumps. My professor and mentor investing in my fund? “I thought you don’t do this kind of thing,” I said. “And I promise that’s not why I wanted to meet with you.” “I know,” he said. “But if I do invest, it’s not to do you a favor. I like what you’re doing and I want to make money with you. Send me the documents.” A week later he become one of the largest investors in my fund.
  • I often speak to groups passing through Jerusalem. These can be student groups, elder hostels, business executives or others who are making their way through Israel to get a taste of the “Startup Nation” vibe. I’ll host them at my office for an hour to tell them the unique story of Jerusalem’s startup renaissance — it’s an inspirational, underdog story about resilience, entrepreneurship, diversity, opportunity and breaking stereotypes. I get asked to make this presentation often. I swear I do it just because I enjoy “evangelizing” about Jerusalem’s poorly-understood ecosystem. There’s no way I can expect any direct benefit for Jumpspeed from these presentations. Sure, every once in a while, as a group leaves our office on to their next stop to see the Western Wall or Yad Vashem, someone will ask me for my card, but I never hear from them again and don’t expect to. Until Brad showed up.
    Brad was in the corner of the room accompanying an MBA group from a Colorado university. As the group filed out after my presentation, Brad pulled me aside and asked me for my card. He introduced himself as an investor assisting with the MBA program and traveling with the group. “Your story and investment approach is interesting,” he said. I replied that I thought I had focused more on the ecosystem than my fund, but OK, I appreciated it. He was interested in my fund. “I want to check you out — if you’re for real I’d like to invest.” I figured he was probably caught up in the moment but sure enough he emailed me a week later from Colorado. He grilled me over the phone. He spoke to founders I’d invested in. He spoke to founders I’d rejected. He spoke to lots of people. I kept giving him anything he asked for. Finally he said: “I’m in, And I’m recommending you to all of my friends.” Turns out he has a lot of friends — Brad’s group represented almost half of my new fund’s initial close.

These people aren’t just investors in my fund. They are the largest investors in my fund. And there are more of these stories; these are just the most significant ones. I would not have a fund today, without these stories.

I would not have a fund today, if I hadn’t been nice.

I’m not saying that I’m always nice — though I try to be. But it’s pretty clear to me by now that when I have been nice, it has in many cases paid tangible dividends, often very quickly, and in all of those cases, specifically when I had no ulterior motive, or expectation of reward. It just happened. I “paid it forward” — and to my great surprise I got paid back.

As I thought further about these stories and the lesson learned, I dug up Lou’s contact information and emailed him. With the utmost and most sincere respect for his business experience and acumen, I wrote, I just wanted to remind him of me, and our final conversation, and update him about what had happened to me and Jumpspeed as a result of my being “nice.”

I just wanted to share the lesson with him, though I guessed that if he did respond to me at all, it most likely would be another off-putting dismissal. I was prepared for that, and resolved in advance to use it as further motivation.

I got a ping back right away. The fastest response I’d ever received from him.

Hey, he wrote, nice to hear from you. We’ve actually been following your progress from afar and have heard things are going well. We’d like to take another look at Jumpspeed towards the end of the year……

I swear I didn’t reach out to him in order to..…..you get the gist.

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Is a College Education Worth It?

College educations are an enormous drain on family budgets so it’s a constant question for parents and students, is a college education worth it? By ‘it’ we mean worth the money, time and effort. Will you actually have a better life with a college degree? We’re going to delve into this debate.

Is it worth the money?

The average cost for a single year at a public university for an in-state student is $20,000. It’s more than $34,000 if you’re from out of state. These figures include tuition, room and board. Financial aid and scholarships are available for many students, however, that’s not something you can count on. Over 44 million Americans hold about $1.4 trillion in student debt. No wonder this is a debate that’s close to our hearts.1
College Board estimates the following annual budgets for undergraduate students in 2017/18. These numbers include transport and living expenses:
$17,580 (community college)
$25,290 (in-state students at a four-year public college)
$40,940 (out-of-state students at a four-year public college)
$50,900 (private non-profit four-year college)2

Remember these are averages and don’t take into account the large variation in tuition fees charged by the different institutions. Prestigious public universities may charge fees as high as the private sector. For example, the University of Michigan (one of the highest-ranked public US universities in the QS World University Rankings®) estimates a total of $62,176 in annual costs for out-of-state students in fall/winter 2018/19. This includes tuition, room and board, books, study supplies and miscellaneous items.3

Although these estimates are provided by the institutions, evidence suggests that potential students often overestimate the costs of higher education. Financial aid is very complex and it’s difficult to fully know how much you’ll have to pay.4

Then, what about the interests costs? How quickly will you be paying your loans? These are answers you won’t have until your future reveals itself.

How Much Will You Earn?

Is there are a direct correlation between your level of education and how much you earn? Yes. The average salary for someone educated to the level of a high school diploma earns a median weekly salary of $678 or $35,256 per year. Comparatively, the average salary for someone educated to the level of a Bachelor’s Degree earns a median weekly salary of $860 or $59,124 per year and it goes up the higher your level of education. There’s also a higher unemployment rate amongst those with lower education levels.5

Research indicates that it is financially worth it to complete college, based on a purely financial model where we take into account the earnings foregone when you’re studying and the cost of the degree versus your future earning estimates. This is true even when someone with a higher qualification is doing the same job as someone with a lower education.6

Is earning potential the measure of happiness?

Although many researchers have alluded to the fact that money doesn’t buy happiness, there is also evidence to suggest that it does if it’s spent wisely. (Boven and Gilovich, 2003).7 Philip Oreopoulos and Kjell G. Salvanes, “Priceless: The Non-pecuniary Benefits of Schooling.” Journal of Economic Perspectives 25, no.1 (Winter 2011): 159–84. [/note]

However, it’s not just the money that a college degree may buy you. Higher education will more than likely provide more opportunities to consider for your career path. Many of the higher level jobs that you can only access with a college degree offer less labor-intensive work and therefore offer more physical longevity for your career.

Even after considering family background and income, workers with more schooling hold jobs that offer a greater sense of accomplishment, more independence and opportunities for creativity, and more social interactions than jobs available to non-college graduates.8 College graduates tend to enjoy better health outcomes on average.9

Happiness is a complex issue and one that can only be truly measured by the individual although it’s worth restating that both financial and non-financial gains are more likely for you if you complete further education.

The Changing Landscape

The information presented above presents a fierce argument for the advent of college education. But what of the future colleges? Already college offerings have changed greatly since the 1970s with the introduction of for-profit institutions such as Xerox PARC. Some degrees offer much more practical offerings than others.

Staley and Trinkle (2011) talk of the landscape of higher education changing rapidly and disruptively. There’s a growing variety of higher education institutions and the cultural environment and the competitive ecosystem are influencing this change. The rate of change in industries may cause employers to take a more holistic view over what skills and characteristics their employees need. For example, where employers are looking for business graduates with high levels of communications skills, it might actually be best to look to the arts and humanities areas when communications skills is their most important attribute.

Globalisation is likely to play a bigger role as more international students are looking to Asia and other countries outside of the U.S. To combat these changes some universities are partnering with international institutions or setting up their own branch in those countries.

The emergence of an ‘invisible’ college may also have an impact on the traditional hierarchical education system. Knowledge networks that we have access to through the progression of technology will offer new ways for people to educate themselves and share that knowledge.

More than 60% of students enrolled in college are now over 25 years of age and more than 60% of students are now working full-time while pursuing their education.10
Where colleges used to treat these types of students as the exception the statistics now show they are to be taken much more seriously. This is a cultural shift that may affect the way colleges structure their delivery and messaging.

These are just a few of the possible trends that will affect higher education change, remembering that the rate of change today is faster than what we’ve been used to and is increasing. You only have to remember the overnight shutdown of the taxi industry to feel the ‘here one minute-gone the next’ possibilities of our future jobs.

Summary

The current research indicates that college is well worth the time, effort and money whether it be for financial or non-financial gain. Yet our times are changing and so is higher education structure and expectations. It will be very interesting to see how the landscape alters and how we make decisions with it. Research is one thing, but your experience and your opinion matters.

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Is Cyberbullying a Big Issue, Really?

Cyberbullying has become one of the major new issues affecting parenting of the decade, at least that’s what it feels like. Is the worrying really warranted? Many of the victims of cyberbullying are also victims of traditional bullying. Traditional bullying is something we’re all fully aware of and there are already ways in which these are being addressed in schools. However, one of the biggest issues around cyberbullying is that it mostly occurs outside of school.1
When it’s outside of school it’s out of the schools jurisdiction.

“Bullying occurs when an individual (or a group of people) repeatedly and intentionally cause harm to another person (or group of people), who is unable to avoid being targeted. Bullying can include:

  • Physical bullying (hitting, damaging property)
  • Verbal bullying (insults, teasing, intimidation)
  • Social bullying (lying, spreading rumors, excluding, damaging someone’s social reputation)
  • Cyberbullying (hurtful texts, posts, images or videos, imitating others online).”2

The Issue

Cyberbullying is unique in that the perpetrators have a level of anonymity about them. They can execute their bullying at any time of the day or night, and it’s usually outside of school hours. They can get to their victims in their own homes and cause more widespread public embarrassment. It tends to happen to slightly older children around 14 years of age or when they are given more access to electronic devices.

Cyberbullying is a problem for parents primarily because it’s new territory. There is no frame of reference to rely on because it isn’t something the older generations dealt with when they were growing up. Anything new is imminently more terrifying. What are the statistics? Are they really worth worrying about? What’s to be done about it?

Adults often think that there is an epidemic of cyberbullying and believe it is more common than data shows it to be. In fact, cyberbullying occurs much less frequently than traditional forms. Adults may also mistakenly believe that students are more upset by incidents of cyberbullying than students report being.3
Does this indicate that some of the education is getting through?

It is estimated that between 15% and 35% of young people have been victims of cyberbullying and between 10% and 20% of individuals admit to having cyber bullied others.4
Victims of cyberbullying are at greater risk of self-harm and suicidal behaviours than non-victims.

In the USA it is estimated that nearly 14.6 million youth may experience traditional bullying and 6.2 million may experience cyberbullying as either a victim or perpetrator. Both traditional bullying and cyberbullying have similar attributes and overlap considerably with as many as 88 % of victims (or perpetrators) of traditional bullying also being cyberbullying victims (or perpetrators).5

There’s a whole list of statistics around bullying in America here. The most encouraging statistics indicate that although bullying awareness is increasing there is a slight decline in the prevalence of bullying, but only slight. Many programs have been used within schools to prevent bullying but we really haven’t found ‘the cure’.

Why do kids bully?

Perhaps the best way to tackle this problem is to go directly to the source. Why do kids bully in the first place? Primarily it’s learned behavior. This may be learned behaviour from their parents, teachers or coaches, older siblings who were bullied themselves or other kids. Kids who bully are often craving attention and a feeling of empowerment. They may be feeling neglected at home or exposed to drug and alcohol problems on a regular basis. You can read more about why kids bully here.

The Symptoms

People who are involved in cyberbullying are over 85% more likely to be involved in traditional bullying.[noteJuvonen J, Gross EF. Extending the school grounds?–Bullying experiences in cyberspace. J Sch Health. 2008 Sep;78(9):496–505. doi: 10.1111/j.1746-1561.2008.00335.x. [PubMed] [Cross Ref] [Ref list][/note]
]Bullying can result in emotional distress, depression, anxiety, social isolation, low self-esteem, school avoidance, decreased academic achievement and substance abuse for the victim and the bully. These issues may continue into adulthood.
A very small number of bullied children might retaliate through extremely violent measures. In 12 of 15 school shooting cases in the 1990s, the shooters had a history of being bullied.6

Telltale signs of bullying include:

  • Changes in sleeping and eating patterns,
  • Frequent tears or anger
  • Feeling ill in the morning and not wanting to go to school
  • Changing friendship groups and
  • Unexplained bruises, cuts and scratches.

    What Should We Do About It?

The great thing about bullying, whether it be cyberbullying or traditional bullying, is that everyone can do something to help.

Bystanders

If you’re a bystander, you can be a friend to a victim. You can catch up with them after school, sit with them on the bus, ask them to join in your activity or whatever makes you comfortable. You can also stand up to the bully when you see it taking place. Let them know that what they’re doing is mean and should be stopped. You don’t need to do this publicly. Online you can direct message them. Be careful not to bully them back. If you’re worried about retaliation then tell an adult.

When you tell an adult you can include suspected bullying as well as the real thing but try to include as much detail as possible. Once you’ve told someone, if you think they haven’t done enough about it, follow up with another adult. Stamping out bullying is really important.

For the Victims

Preventive measures for potential victims include finding enjoyable activities that promote confidence and self-esteem, modeling how to treat others with kindness and respect, and encouraging people to seek positive friendships.

The Other Victims

We’ve talked about cyberbullying and bullying victims in schools throughout this article, however, bullying is an issue that may continue after school. It can happen in the workplace from co-workers as much as from bosses. It may also occur in other groups.

For the Parents

Parents can help by monitoring their children’s online and offline activities and social interactions, and encouraging their child to talk about any troubling experiences. If bullying has occurred, parents must be careful not to react with anger or take action without consulting their child. Young people often hide bullying from parents because they fear the parent will make things worse.7

It is helpful for parents to use the LATE strategy:

  1. Listen
  2. Acknowledge it hurts
  3. Talk about options
  4. End with encouragement.

Summary

It’s nice to know that cyberbullying may not be the epidemic that we thought it was, however, bullying is still an issue that has long-lasting effects for the victim, the bully, and friends and family. Cyberbullying is adding another layer of complexity to an already complex problem. The more troubling issue is that we don’t really know how to solve the problem. We have tried a number of school programs, but only moderate results have been achieved. We need you to help us solve this problem. Your voice matters.

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