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Children and families are more connected and are working together. Similarly, Nicholes said that both her home garden and the We Sow, We Grow community farm are places her family can spend time together without planned activities. I do think that in society, we're losing that ability to have togetherness without having something scheduled, she said. Time in the garden is just without any type of expectation at all. The public nature of community gardens provides that space for entire neighborhoods. Nicholes established We Sow, We Grow specifically to build relationships with her neighbors. On the tongue, sweet is sweet! So, what do we do when faced with contradictory information? What if you watch an internet video or read a blog post that sounds very scientific and claims that sweetener XYZ is perfectly fine while fasting? For me, it's an easy decision. I personally want to err on the side of caution. If there is a possibility that something is going to cause me to release insulin during the fast, I am going to avoid it. Nothing gets between me and my fat-burning superpower! Trust me when I tell you that no one wanted to have stevia during the fast more than I did. Once I learned the science behind insulin release, I searched and searched for a rationale that would allow me to keep stevia in my coffee (and allow me to continue chewing gum, drinking zero-calorie sodas, sipping flavored waters, enjoying my fruity and sweet herbal teas, etc). Once I became truly honest with myself, however, I realized there wasn't one. The truth is, though most of us would consider flying to the moon a brave act, if you aren't afraid, you can't be brave. Courage requires fear to label an act courageous. Were Buzz Aldrin and Neil Armstrong afraid? You can bet that when they were the first to step onto the moon in 1969, adrenaline was flowing.

Still, it seems they've never characterized this as an anxious experience, even with the uncertainty of what they would encounter on this strange terrain. In a recent interview, Buzz Aldrin mentioned being completely focused on the mission. If Neil Armstrong was anxious, he might have said something like, Get me off this crazy boulder. I miss Earth. Instead, he made the famous remark, That's one small step for man, one giant leap for mankind (Though just a tip, Neil. Next time say humankind! Foreign physicians typically need to do their residencies in the United States to obtain a license. Historically, American physicians were self-employed in small groups, what is often colloquially referred to as onesies and twosies. More recently there has been consolidation, with growth both in larger physician groups and hospitals' employment of physicians. Today there are about 230,000 physician practices, with 40% or fewer having 4 or fewer physicians. Similarly, the rate of physicians being employed by other organizations rather than self-employed has increased rapidly: in 1983 76% of physicians owned their own practice, but by 2016 that number had declined to 47%. Physician salaries in the United States are high. The precise amount paid is hard to determine because different survey samples produce different results. On average American physicians make $299,000, with primary care physicians making an average of $223,000 and specialists $329,000. Pediatricians and pediatric specialists are among the lowest earners. the highest-paid physicians are orthopedic surgeons, who earn nearly $500,000, and cardiologists, who earn an average of $450,000. The experiments were different, but in both cases, the animals that were permitted to eat as much as they wanted became obese from excess calories and lack of exercise, which is also what happens with people. Both studies showed that a variety of age-related diseases, including diabetes and cardiovascular disease, were delayed in the monkeys with restricted diets. These are the same diseases that are delayed when you fight obesity. But only the University of Wisconsin study showed a significant increase in life span.

At one point, I was one of the reviewers on the Wisconsin program, and when we visited the research facility at the university, I wasn't the only one who noticed that over the past year or so, the animals being fed restricted calories had come to weigh almost as much as those that were permitted to eat as much as they wanted. There's only one explanation here, I said, and that is that somebody sabotaged the experiment. The other reviewers agreed, and we wondered what the study's researchers would say about this. When we arrived for the review panel the next day, one of the researchers explained that a caretaker had felt sorry for the animals with restricted diets and gave them almost as much food as she gave the control group. I didn't want our animal care workers to do the same thing in any of our studies, so when I got back to Einstein, I attended their next meeting and told them what had happened in Wisconsin. I explained that while the concerned caretaker thought she was helping the animals on restricted diets by feeding them more, if they had gotten fewer calories, they would have had healthier and longer lives. What better way to connect with people than food? A study of students in southwest Detroit found that after participating in a community garden program twice a week, children had more positive attitudes about their neighborhood than before. They built relationships with adult neighbors and friendships with other kids. As Kameshwari Pothukuchi, author and a researcher from Wayne State University, summarized: Community gardens also foster contacts between people from diverse cultural, ethnic, and class backgrounds in non-threatening environments in which they may communicate about common interests or shared concerns. Even though we don't have a community garden in my neighborhood, I've seen similar things working in my own garden. It's right next to the bus stop and near the community center, so we always have folks walking by. A number of neighbors have stopped to chat with me as I work in the garden, whether to discuss their own gardening ambitions or just admire the amount of produce we get from our scraggly mess. She proudly informed me that she lost. In addition he's become a walking, talking neighborhood ambassador for youth gardening. After playing at a local park one summer afternoon, he invited our neighbor and kids over to our garden to check it out on their way home. When I decided to eliminate those sweet and food-like flavors during the fast, it changed the way I experienced intermittent fasting and made the process truly effortless. And there is one more thing I want to emphasize: prior to implementing a truly clean fast, I had also started to experience a slow but steady weight regain, and the minute I gave up stevia and other sweet tastes during the fast, that weight gain completely reversed and I went on to lose two more jeans sizes over the next year, even though I had declared myself at my goal weight over a year earlier. Eliminating the sweetness during the fast made a huge difference for my body. Now that we understand the relationship between sweet tastes and insulin release, let's move on to the second fasting goal:

This is a tough one for many people because there is a lot of chatter in the intermittent fasting world that insists that consuming fat is just fine during the fast because it won't lead to insulin release. Bring on the butter in your coffee! Chug some MCT oil! Get yourself into ketosis faster by drinking a magical ketone drink! There is a mistaken thought that consuming excess fat or exogenous ketones during the fast will somehow magically make your body burn more of your own fat than if you fasted clean. Let's examine the science behind both energy sources and understand why we don't want to include them in our fast. Always remind yourself that adrenaline can be triggered by many experiences other than fear, such as an unfamiliar situation. The brain's determination that the body requires energy or focus (like when in competition) can start up when engaged in any activity you find exciting or exhilarating, or when feeling overwhelmed, uncertain or, yes, afraid. The experience of non-fear-based adrenaline can be described by many names, such as being in the zone, good anxiety, and eustress. Some of these names suggest that there are positive stressors, such as the aforementioned roller coaster ride or playing well in a tennis match. Other names and associations suggest adrenaline can be a motivator, pushing you to do your best, when so desired. Nevertheless, all names for the experience of adrenaline without fear speak to my point. And that is, if you experience adrenaline and there is nothing you fear in that moment, then it is not anxiety! And what does this non-anxiety-based adrenaline do? The same things that all adrenaline does. It increases energy, expands lung airways, maximizes concentration, improves reflexes, enhances tolerance to pain, quickens heart beat to propel more blood to the muscles to make you stronger, tightens vision, and more. Physicians who own their own practices make more than those employed by larger organizations. Physicians in less populated areas also tend to earn more. For instance, the highest-paid physicians work in North Dakota. There are 154 medical schools (and 36 doctor of osteopathy schools) in the country, which produce just under 20,000 medical graduates and 6,500 doctors of osteopathy each year.

Many of the leading medical schools are private. Many, but not all, states also have one or more state-financed medical schools. Tuition at private medical schools is approximately $65,000 per year, but it is lower at state medical schools. Most students borrow money to pay for medical school, with the average medical student graduating with over $190,000 in debt, while only 15% of medical students graduate with no debt. Is there a physician shortage? The answer is hotly debated. Since caloric restriction looked like it was extending health span and life span, the research community was curious to learn how it affected levels of growth hormones, sex hormones, thyroid hormones, insulin levels, and cortisol levels. As it turned out, animal models whose levels of hormones were maintained at caloric-restricted levels in isolation did not realize extended life spans. So far, the only decrease that's known to make a difference in longevity is the decrease in growth hormones. From my standpoint, the study about caloric restriction that's most relevant to humans is one that showed how genetics change the effects of caloric restriction. Jim Nelson, a colleague from San Antonio, gathered other colleagues to this fascinating study in which he bred two mice that were genetically very different. Eventually, the mice produced male and female offspring with forty-one genetically distinct backgrounds. All the mice were either fed ad libitum or fed restricted diets, but unexpectedly, only about half of the caloric-restricted animals lived longer than the ad libitum mice, and the other half lived shorter. This means that genetic background is very important and that caloric restriction cannot be universally applied. Whether caloric restriction will lead to a longer life in humans also depends on our genetic backgrounds. And how many calories we should restrict ourselves to may also depend on our DNA. As the sun set, they stood in our backyard chomping on fresh green beans and cherry tomatoes. From building community it's a natural step to serve others. Sharing knowledge can be one form of service. Nicholes continues to build connections by welcoming questions and requests for advice.