Well, we’ve made it halfway through what has been an undeniably challenging decade. Hopefully, the second half compensates with some relative peace and quiet. I know many of my members report developing or slipping back into some less health-promoting habits and are looking to make some changes in the New Year. That’s right, the often-joked-about New Year’s resolutions.
 
Rather than rehashing the trite SMART goals, let’s talk about some statistics and the more unusual approaches to succeeding at your resolutions, which can help put things into perspective for you.
 
Resolution Stats

• Those that make resolutions are ten times more likely to change their behavior than people who do not—so make one!
  
  
• Resolutions that incorporate a new behavior are more likely to succeed than those which avoid an old behavior.
  
  
• People who choose one resolution are more likely to succeed than those who set multiple goals.
  
  
• Those who anticipate and plan for obstacles are more likely to succeed than those who do not.

 
Approaches

• For built-in motivation, align your resolutions with your values. For example, if your resolution is to sleep more, tie your resolution to the pitfalls of excessive social media consumption or TV use. If you watch less TV and spend less time scrolling at night, you are more likely to hit the hay earlier.
  
  
• There is no reason to swallow the elephant whole. Take smaller bites! In other words, break the resolution down into smaller resolutions. For example, one study found that those who resolved to volunteer 200 hours a year were more likely to reach and even exceed that goal if they broke down that resolution into volunteering 4 hours a week, instead.
  
  
• Tie the resolution to a reward so it’s associated with pleasure and not seen as a chore. If you resolve to hit the gym 5 days a week, plan a small donation to your favorite charity if you successfully hit your goal.
  
  
• On the flip side, tie a “punishment” to a backslide, so it’s associated with pain. Using the example above, if you miss your weekly gym goal, make a donation to a charity not aligned with your belief system—ouch!
  
  
• Some say misery loves company. Hold yourself accountable to another person by setting the resolution with a friend or a group (can be virtual). You will be less likely to backslide if you know you are there to support others. Camaraderie is a great motivator!
  
  
• Think like a Marine – Improvise, Adapt and Overcome. Life rarely goes as planned, so pivot when challenged, as there is usually more than one path to victory. Using our gym example, what happens if your car is in the shop, and you cannot drive to the gym? Go walking for the time you would spend at the gym so that you’re still getting exercise, just in a different environment.
  
  
• Moreover, if you journal your progress, you will be able to reflect upon and learn from past successes or challenges.
  
  
• Seek professional guidance-there is no harm in hiring a coach! Consider the cost your financial accountability partner!

 
And, of course, I will use this opportunity to remind you of the Motivated Mondays program available to you via my partnership with Concierge Choice Physicians. If you were enrolled last year, you will be auto enrolled for 2025. If you are a new member or have not previously participated in Motivated Mondays, then you’ll soon receive an email inviting you to participate.
 
Good luck and, as always, feel free to comment below or reach out directly with any personal questions or concerns.

​With Thanksgiving approaching, my heart is filled with immense gratitude and warmth. I want to take a moment to express just how thankful I am for each and every one of my concierge members. Your decision to join my concierge program and prioritize your health is something I deeply appreciate.
 
In an era where healthcare often feels like a series of rushed appointments and impersonal interactions, I knew I needed to forge a new approach to patient support and enhance the service my team and I provide. My concierge program became the solution, helping us to build a more personalized patient environment, fostering a mutual dedication to improving health outcomes.
 
This journey has been incredibly rewarding for me, not just as a physician, but as a partner in your health. I’ve seen firsthand the positive changes and improvements that come from a more engaged and proactive approach to healthcare. It’s been inspiring to witness your progress and to work with you to maintain and improve your health over time, with greater continuity and understanding.
 
Together, we are not just managing health. We are thriving.
 
The opportunity to make a real difference in people’s lives is truly fulfilling, and I thank you for making that possible.
 
Practicing Gratitude for Your Health
 
“The heart that gives thanks is a happy one, for we cannot feel thankful and unhappy at the same time.” -Douglas Wood
 
In the spirit of Thanksgiving, I encourage you to identify all that you are thankful for and to develop a regular practice of gratitude. Gratitude is like a personal trainer for your mindset—just a few reps a day can boost your mood and strengthen your outlook!
 
Your practice doesn’t have to be hokey or complicated. It can be as simple as writing one line in a journal each day or keeping a note in your phone to share something that happened that day for which you are grateful.
 
For example, you can start by writing a note that states, “Good things always happen to me.” Then, throughout the day, look for positive things that occur and write them down.
 
When we regularly acknowledge and appreciate the positive aspects of our lives, we shift our focus away from stress and negativity, which can help lower levels of the stress hormone, cortisol. This shift not only improves emotional resilience but also supports better mental health by reducing symptoms of depression and anxiety. Furthermore, gratitude can enhance physical health by encouraging healthier lifestyle choices, such as improved sleep quality and more consistent exercise, which contribute to a stronger immune system and better cardiovascular health.
 
A Final Note
 
Thank you once again for reminding me why I chose this profession, and for being a major contributor to my gratitude practice each day.
 
As we move forward, I remain dedicated to ensuring your membership exceeds your expectations. Your feedback and experiences are invaluable, and I encourage you to share them with me and my team so that we can continue to improve and adapt to better serve your needs.
 
I wish you and your loved ones a wonderful Thanksgiving.

Background
 
Over the past 20 years, medicine has made incredible advances, and those of us in practice can attest to the incredible ways in which we can extend the life of our patients, beyond what we could have ever anticipated in medical school. But with longer lives comes the spectrum of cognitive decline and neurodegenerative diseases, namely dementia—an umbrella term for a number of neurodegenerative diseases, including mild cognitive impairment (MCI) and Alzheimer’s disease (AD). In early June, a rare, albeit small (n=51), randomized clinical trial was published in Alzheimer’s Research & Therapy that determined the effectiveness of lifestyle changes on the progression of MCI and AD, and I am inspired by the findings.
 
It is estimated that 40% of global dementia cases are related to 12 modifiable risk factors. (Many of which also impact heart disease. Remember, what affects the heart affects the brain!). Several previous, small studies have shown the effectiveness of intensive lifestyle changes on the progression of MCI and early AD, but none had a control group nor were they randomized. That is what sets this study apart.
 
What did the study address?
 
Over the course of 20 weeks, participants and their spouses or study partners adapted the following lifestyle changes:

• A diet of minimally processed, plant-based, whole foods (no Beyond Meat here—remember, some plant-based foods can still be highly processed!), low in added sugar, refined carbs and harmful fats. Calories were unrestricted.
  
  
• Taking select* supplements. *Please consult me before divesting yourself of hard-earned money prior to taking something that may not be appropriate for your biochemistry or that interacts with medications prescribed for you.
  
  
• Moderate daily exercise, such as 30 minutes of walking or other cardio exercise, and mild strength training three times per week. Specific exercise guidelines were based on age and fitness level.
  
  
• Stress management via an hour of meditation, gentle yoga or breathwork daily.
  
  
• Support groups for participants and their spouses or study partners, 3 days a week.

 
In the study, all interventions were supported via 4-hour Zoom sessions three times a week for the participant and spouse or study partner.
 
The study aimed to determine if:
 

• these specific multi-modal intensive lifestyle interventions could affect MCI or cognitive function in cases of early dementia
  
  
• there was a correlation between the degree in lifestyle changes and the change in cognitive function
  
  
• the degree in lifestyle change affected the degree of biomarkers

 
What did they find?
 

• There were significant differences between the study group and control with regard to all four cognition and function tests, either by improvement over the control group, or less deterioration than the control group.
  
  
• There was significant correlation between the degree of lifestyle change (how closely participants adhered to the protocol, i.e. a dose response) and clinically relevant biomarkers for AD/MCI and cognition and function tests.
  
  
• Only the study group experienced positive microbiome changes.

 
Interestingly, in one of the biomarkers, the degree of change was similar to that affected by the clinical trials for new intravenous medications!
 
My takeaway
 
This study provides yet another reason for us to eat real food, move more, breathe better and connect more—all of which have multiple benefits to our health and wellbeing.
 
Let’s continue to work together on the path toward better health and wellness. Don’t forget, my concierge members also have access to the Concierge Choice Physicians Motivated Mondays program which provides a year’s worth of mini-resolutions focused on the prevention of cognitive decline through lifestyle changes. To sign up for the weekly emails, please contact CCP’s Erica Rios: [email protected]
 
Click here to visit past editions of Motivated Mondays.
 
Study source:
Ornish, D., Madison, C., Kivipelto, M. et al. Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer’s disease: a randomized, controlled clinical trial. Alz Res Therapy 16, 122 (2024). https://doi.org/10.1186/s13195-024-01482-z
​