7 Ways to Make This Year Better

Over the past couple of weeks, I've been talking to patients and friends about how the past year went for them. Almost without exception, I have heard how tough a year it has been, and not surprisingly; the economy is anemic, the natural world is in increasing disarray, the presidential race has illuminated a vast and perhaps unbridgeable cultural rift in our country, and the media has managed to scare the bejeezus out of everybody with terrorist ghost stories. For a lot of people, it's not a pretty world out there, and the future isn't terribly bright. But here's the secret. You can change things. Not just internally, though that is part of the process. But your will is part of what makes the world. Collectively, mankind creates the reality we live in, not only through shared values and beliefs, but also through our intent. We can create a bountiful, beautiful world, or we can create one marred by anger, fear and want. Each individual contributes to the collective reality, some to a greater degree than others, simply because they understand how to exert their will in a way that creates a large impact. Most of us, frankly, do not have that strength of intent. But we all have the ability to alter the environment immediately around us, using the raw material of the collective gestalt.

There are seven concrete acts that you can do that will change the world around you. Do these consistently, and watch the results.

Meditate

Meditation is a sure-fire way of harnessing the wild and often wasted power that exists within all of us. In the past two years, there has been a tremendous amount of research on meditation and the changes it creates, and it is the most powerful behaviour modification tool that exists. Even within a few weeks of beginning a daily meditation practice, beneficial neurological changes begin to appear. After a year or more, these changes become quite profound.

Even better, there are endless ways to meditate. Every religion in existence has some form of meditation, and engaging your spiritual side can amplify the results of your meditative practice. If you are atheist or do not adhere to any specific metaphysical tradition, mindfulness meditation has positive, powerful results.

The down side, if there is one, is that it needs to be practiced virtually every day. Once you've instilled it as a habit, this won't seem so daunting.

Exercise

Exercise is the pill for almost every ill. There are few conditions that exercise doesn't improve, and there is nobody that can achieve true health without it. And there are no excuses for not exercising. Over the years, I've gotten patients with every chronic disease under the sun to exercise, and all of them have improved from it.

You don't need a gym membership, either. A terrific cardio workout is no further away than the street out your front door. Want to lift weights? Do a bodyweight routine that uses leverage against gravity to build muscle. No time? No way. Get off Facebook.

Exercise also creates neurological as well as physiological changes that are beneficial for meeting the challenges that life throws at us. I, for one, appreciate the feeling of power and strength in my body when I am about to undertake something arduous, whether it is a long, busy day at work or a difficult meeting. My outer strength feeds my inner strength, and if you want to be powerful in this world, the power starts in your arms, legs, heart and hands.

Goalsetting: Do it right

Most people don't reach their goals, not because their goals are too difficult, but because they set the wrong kind of goals. Goals should be process-oriented, not object-oriented. For example, instead of setting a goal of, say, getting a new job this year, your goal should be talking to 10 people every week who can help you find the job you want. Instead of setting a goal of buying a new car, set a goal of putting aside $XX every week.

Process goals have the advantage of giving you frequent, positive feedback. You get that warm fuzzy feeling of looking at your growing bank account at the end of each week and realizing that you've met your goal, rather than slogging along at a goal that looks far, far away. We're designed to respond to instant, positive feedback. It's hardwired into us. Make use of that.

Additionally, process goals are more flexible than object goals. If, somewhere along the way, you decide you would much rather get that awesome commuting bike rather than a new car (a very wise decision, I might add), you don't have to change your goals at all.

Process goals will get you where you want to go, even if the end result is hidden in the far-off mists.

Time management

Look, I'm not going to mince words here. You're going to die, sooner rather than later, and you really don't have a day to waste, except for those days you choose to waste. But make time wasting a conscious choice, not a default behaviour,

Some spiritual traditions (I'm looking at you, Zen) encourage you to ignore the past and the future, and concentrate only on the present as the only time that exists. That is all well and good for focusing your attention on important matters, but it really puts the damper on long-term planning, which is not a good thing. The argument goes that if you take care of today, tomorrow will take care of itself, but that's not always true. Our environment changes constantly, and those who are not looking at the changes coming their way are the ones who will be injured by the surprise of their arrival.

Here's the thing: Buy a 50-cent notebook, steal one of the free pens from my office, and write down everything that you need or want to do. Don't worry about time, date, or priority. Just write it down, and make sure to cross them off when you've finished a task (that warm fuzzy feeling again).  You'll be surprised at how much that you thought you couldn't get done that you are suddenly accomplishing.

Also, keep the notebooks. They, as much as a daily journal, will give you a point of reflection of your life over the course of the years.

Keep it clean

Energy (and that, after all, is what we're talking about, the accumulation, control, and direction of energy) is attenuated by chaos and strengthened by order. If you're one of those people who says "Oh, my (desk, room, office) is messy, but I still know where everything is," give it up. Give it up right now. I used to be one of you, and what I sadly discovered that all the tightly focused concentration and intent and willpower would get dissipated into a steamy mess when it hit the clutter of my desk.

You want your willpower to do something for you? Don't make it march through a swamp to get to where it can do you some good.

In fact, write "clean it up" as the first entry in your new 50 cent time manager. And when you finish the first page, write it on the top of the next. And the next...

Seek the wisdom of others

Face it, you don't know everything, even if you, like I, think you do. Find mentors to help you walk your chosen paths. Find friends who will feed you when your pack is getting empty. Find assistants who are really, really good at the things you do poorly, and treat them like the gods and goddesses they are.

I often say that I am grateful to my patients, because they have taught me most of what I know as a doctor. And I know, it sounds like some cheesy marketing pablum, but it's true, dammit. I cannot tell you the number of times I have walked in the exam room to greet a new patient, and to their surprise, rather easily fixed their problem. But that's only because I had a patient last week that had the same problem, wasn't responding to the normal approach, and kept me up nights thinking about what I wasn't doing to get them better.

So, invite others into the reality you are creating and, to the extent that they are willing and able, allow them to help you create your world with you.

Wash, rinse, repeat

The common thread with everything I've said is that you can't do it once. You've got to do it frequently, often daily. Which initially sounds like a huge grind.

But the fact of the matter is, it only takes six weeks to create any new habit, good or bad. How long have you been practicing the habit of eating Doritos and watching sitcoms? Years, right? So take these six activities, do them for six weeks, and then email me and let me know what happened.

I'd say good luck, but you won't need it. Follow these guidelines, and you'll be making your own luck.

Heart Disease Myths

This month being national Heart Health month, I'll be doing a series of articles on heart disease and how to avoid it. I mean, how to really avoid it, as opposed to the have-this-scan take-this-pill approach to prevention. In fact, it is just that approach to health that has got most of the population walking straight toward the heart attack guillotine. In 20 paragraphs or less, I'm going to show you how to reverse that death march.

The problem is that mainstream medicine has failed miserably at reducing the rate heart disease. After billions of dollars and a half-century of research, heart disease remains this country's number one killer, causing 36% of all deaths.  The claim is often made, based off of a CDC report, that there are fewer people dying from heart disease, and that is true; but that's not because fewer people have heart disease, it's because we can keep people alive longer after heart attacks. They still have heart disease, and are usually very sick, but at least they're not dead. Which is wonderful for those people who are living with heart disease, but honestly, wouldn't it be far better to stop the disaster from happening in the first place?

A more honest method of measuring our ability to prevent heart disease is to measure it's prevalence, or what percentage of the population has heart disease.  In terms of the percentage of the population that has heart disease, "Among adults 18 years and older, the prevalence of heart disease and stroke between 1997 and 2009 has remained essentially the same," according to this report. So, in fact, we aren't really winning the war against heart disease. Instead, mainstream medicine is simply propping up the corpses and declaring victory.

While mainstream medicine pats itself on the back for its "success," the science-based skeptics among us can plainly see that they have been an utter failure at preventing heart disease. The heart of the problem, if you'll forgive the allusion, is that mainstream medicine has built its "prevention" approach on a shaky therapeutic foundation, one predicated more on profitability than on true prevention. These heart disease myths, while they are making lots of money for high-cost, high-tech clinics, surgeons, and pharmaceutical companies, are ignoring the scientific research which conflicts with the profit imperative. The sooner we recognize these myths for what they are, and discard them in favor of evidence-based prevention, the sooner we can reduce the number of Americans dying from heart disease. At the current rate, one American dies from heart disease every 40 seconds. I think we can do better than that.

Heart Disease Is Not A Disease

This may sound spectacularly absurd, but the fact of the matter is, most heart disease does not begin as a pathological process. Heart disease is not a disease in the same way that multiple sclerosis, thyroid disorders or many forms of cancer are diseases. What we call heart disease is actually an unholy conglomeration of lifestyle choices. Stop, for a second, and think about how evolution has molded our bodies. We are designed to live in physically-demanding environments where energy is obtained only with significant energy output. Our ancestors of only a few thousand years ago lived in places where the energy balance between alive and dead was as thin as the edge of a stone blade. Nutrition varied tremendously, from place to place and from season to season. Our bodies developed to adapt to them all. Our systems were honed to provide the best possible performance in those circumstances.

Simultaneously, historical evidence shows that heart disease was not prevalent in pre-industrial societies, from the medieval English to nomadic Ethiopians. What these unlettered, unhygenic people did that we do not is make use of one of the basic premises of medicine, Davis' Law. In non-technical terms, Davis' Law, and it's logical brother, Wolff's Law, boil down to this: Use it or lose it. The heart is a muscle, and the less you use it, the weaker it becomes. What happens to weak hearts? I don't think I really have to tell you.

The real truth is that heart disease is, first of all, the beginning of the failure of a weak, underused muscle: Your heart. What the research actually shows, as opposed to the faux science you have been handed, is that the number one risk factor for heart disease is cardiopulmonary fitness, or in other words, how strong your heart and circulatory system is. The stronger your heart, the less chance you have of having a heart attack or stroke. This influence is so strong that it overrides genetic influence, smoking history, cholesterol levels and weight. For example, if you smoke and do regular, vigorous cardiac activity, you will have a lower risk of heart disease than an unfit non-smoker. If you've got an extra 25 pounds around the middle, but can pound out 50 miles on a bicycle, you are unlikely to die of a heart attack, even though your BMI would make a cardiologist gasp in fear. Our hearts are designed to be used, and used hard. We are made to chase our food with foot and spear, lift logs, roll stones and dig dirt. And the less we do that, the weaker our hearts become. Once a week on the stationary bike while reading the Sunday funnies doesn't turn the trick. You have to pant, sweat and push on an almost daily basis.

You can do this by going to the gym, or by engaging in a home bodyweight/cardio workout. But that takes a lot of self-discipline, more than most of us have. So my suggestion is to incorporate high levels of physical activity into your everyday activities.

Am I suggesting that this we turn our lives into a daily replay of some Scottish highland games? Well, not completely. But if you do want to actually prevent heart disease, it's time to make some changes. Keep the car in the driveway for any trip less than 1 mile. Chop wood to supplement your normal house heat. Ride a bike to work every day, shovel snow instead of blowing it, rake leaves instead of blowing them, and quit blowing away time in front of the television. In our society, we have made physical activity the special time, the consecrated time of the modern American. It's time to reverse that, by integrating high levels of physical activity in our lives and sitting down for our sacred space.

Diet is another lifestyle choice that contributes to heart disease. The confusion that the mainstream medical community faces is that it has no idea what a healthy diet really is, though it hasn't prevented them from promoting an ersatz "heart healthy diet" that fails to do much for anyone. The research shows that vegetarians have a much lower risk of heart attack; it also shows that people eating a meat-heavy Adkins diet also have a lower risk of heart disease.

So, if you want a healthy heart, what are you supposed to do? Become an omnivorous vegetarian?

The problem with the studies purporting to demonstrate the components of a heart-healthy diet is that they fail in two regards. First, they do not take into account what I call individual biochemical diversity, something that I have seen to be of tremendous importance in the nutritional treatment of disease. Second, they ignore the rather extraordinary fact that we do not absorb only energy and nutrients from our food; we also absorb information.

Individual biochemical diversity simply means that we all process our food differently. Some of those differences are genetic, making an eastern European's nutritive processes significantly different from those of a Maori. As a result, though both may suffer from the same malady, the nutritional therapeutic intervention will be different for both. So, yes, for some people, a heart-healthy diet is a vegetarian diet. For others, avoiding heart disease means lots of protein. The trick is finding out what kind of diet (and there are more than just two) will best prevent heart attacks for you.

Secondly, and perhaps more importantly, is the concept of xenohormesis. Living things produce certain molecules in response to certain stressors. When those organisms become food, we ingest those molecules, and our body recognizes the signal that the food is giving us. For example, an animal produces certain molecules when it is stressed because its food supply is low. When we eat that animal, we are informed that a famine may be on the way. So guess what? We start storing energy. And energy is stored as -- wait for it -- fat. And, just for giggles, guess how stressed out an animal that has spent the last month of its life in the execrable conditions of a feed lot is? Guess what its meat is full of? Yup. All those chemicals that tell us that a famine is coming.

The study of xenohormesis is in its infancy, but its a safe bet that the "food as information" paradigm plays a much larger role than we currently understand. The trick is, if you want to stay healthy, eat healthy foods.That means locally grown, locally raised, and if not FDA-approved organic (which is the worst kind of organic, mind you) at least raised with no help from Monsanto.

Cholesterol Doesn't Matter. At All.

This is the part where all of the pseudo-skeptics start getting the vapours and call up the quackwatch hotline. But the fact is, when it comes to heart disease, cholesterol doesn't matter. 

I have come to that conclusion, in part, after examining the epidemiological data over the past 30 years, which demonstrates that, although we've reduced cholesterol levels on a nationwide basis, the rate of heart disease, as I mentioned above, has not budged. My conclusion has come after reading multiple studies, often cited in the literature as a justification for the creation of a cholesterol panic, and finding that in many cases, the researchers' own data does not support their conclusions. And, in some cases, the data has been fabricated, or massaged, to produce the desired outcomes.

And I'm not the only physician to arrive at that determination. Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine, is among many prominent doctors who have looked behind the cholesterol curtain and found the same thing I have -- biased research, bad science, and a public health policy more interested in your wallet than your health.

I could write entire chapters on the damage that the cholesterol myth has done, and perhaps someday I will. Suffice it to say now that, whatever your medical doctor has told you about cholesterol, just ignore it. And, though I risk bringing the wrath of the FDA on my head for saying this (I would certainly never say this to a patient, as recommending pharmaceuticals is not part of my scope of practice), if you have no heart disease, and your MD has given you pills to bring down your cholesterol levels under the guise of prevention, just chuck them. They are likely to do you no good at all.

So I promised you an effective preventive strategy for heart disease in twenty paragraphs, and this is number 20. So here's the deal. Turn off the TV. Hide the car keys. Whatever it is, pick it up yourself and carry it with your own two feet. Sweat and gasp for breath at least once every day. Sprint to the mailbox like you're waiting for your lover's letter. Quit eating crap. Plant or mammal, if it died more than 60 miles from you, don't eat it. Eat anything that's fresh or unprocessed unless it disagrees with you. And one other thing: Ignore most of what you've been told about how to prevent heart disease.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Must-Have Android Health Apps, Part II

It should come as no surprise that many of the free apps in the Android market are ineptly named -- after all, these are programmers doing their thing, not marketeers. Expecting a programmer to come up with a sexy title is a little bit like having a chiropractic doctor create a drug name. "Sideffecta" is the first one that comes to my mind, which is probably why SmithKlineBeechamKilla hasn't come around knocking on my door with money in hand.

Which is all a backdoor way to introduce the Center for Alternative Medicine's second winner in the Next-Year-It-Will-Be-Annual Health App Awards: Jefit

I don't know where the name comes from (somebody's android dog, maybe?) but just ignore that. This is the best app a gym rat could ask for.

Maybe a little background is in order. Back in the stone ages, I spent my summers working for the AMC Trail Crew, in the high peaks of the White Mountains. It was intense physical labor, consisting of cutting trees with axes, rolling multi-ton rocks up and down jagged slopes, and carrying ridiculously heavy loads of tools, supplies and food up steep mountain trails. And if you spent your winters as a student of the liberal and hard sciences, as I did, that first week of summer could be a real bear. So I took it upon myself to start keeping in shape during the off season.

Now this was long before gyms became the cheery, chic places they are now. At the university I attended, the weight room was in the corner of the basement of the fieldhouse, and was occupied by two groups -- the football team, and the body-builders. It smelled like stale sweat socks, or worse if somebody's lunch got the better of them in the middle of some squats, had one Nautilus machine and a bevy of free weights, bars and benches. No juice bars, no stereo, no carpeting, just a fan to blow around the stale air.

I knew little about lifting. All I knew is that I needed to be stronger than I ever had been before by the time spring rolled around. While the football squad was less than welcoming, the bodybuilders, who worked out in the odd times that I had available, were a pretty friendly crowd. They took me under their wing, and taught me a lot about lifting, in that time-honored personal transmission of tradecraft that occurred before the internet. And though some of them were assuredly juicing, I was never part of that inner circle in which the "true knowledge" was imparted.

So I learned -- the good techniques as well as the bad -- and gradually developed an addiction to the art of being strong, an addiction which has never really left me. One of the techniques that I learned was that you couldn't evaluate your progress unless you wrote it down. And as you altered your routines to combat your weaknesses, as a general might alter his troop strategy, you were lost unless you had a map of where you had been. After a while, I began keeping a small spiral-bound notebook in my gym bag in which I charted my progress. I still have a few of those notebooks tucked away up in the attic. Last time I looked at one, I could see where the ink had run from my sweat dripping on them, and the thing still smelled like that poorly-ventilated room with a wall of mirrors.

Fast-forward to the next century. I have a dedicated workout room in my house, equipped with weights, which sees heavy use in the winter as my long cycling trips become warm-weather memories. In the corner sits a stool with a 3-ring notebook, pages full of workout information -- weight, sets, reps, rest times -- the unrefined data documenting what is no longer my preparation for a season's high-altitude adventures, but is instead my fight against age and encroaching debility (not to mention my number one prevention strategy against infection, cancer and heart disease).

Until a couple of months ago, when I stumbled onto Jefit in the Android Marketplace (you were beginning to wonder if I was ever going to get around to actually reviewing the application, weren't you?). After looking over many of the purported apps for tracking exercise, none of them come close to doing as good a job as Jefit.

The opening screen allows you to define multiple routines, and assign them to particular days. You can set up a profile with measurements from weight to bicipital circumference. There are a wealth of pre-defined exercises, with visual triggers, and even animated demonstrations. You can also define your own, for those of us who have found, err, novel ways of exercising, or who employ some of the Naked Warrior training techniques which have gained popularity with the rise of the UFC.

You can also add your one rep max data, which will be tracked automatically. After setting up your routines, use is simple. You do the exercise, then use the drop down values on the screen to input weight and rep. Hit the "Save and Time" button, and your data will be logged and the timer set for your next exercise. The input fields default to your last used value, on the assumption (in my case, all-too-frequently correct) that you haven't thrown another plate on for this set. If you are proceeding to another exercise, the timer screen will tell you what it is and how much you lifted last time, so you can set up your equipment during the rest period.

When you've finished your routine, the app tells you "Congratulations" -- always a nice thing to hear, even if it is coming from your smartphone -- and gives you the option of reviewing your log or exiting.

And that's it. Jefit offers a clean, simple interface that doesn't take too much thought when your brain is awash in that pecular combination of enkephalins and Substance P that are the hallmark of a good weight-training session, and your hand is trembling too much to accomplish fine coordination skills. The app will soon have a website to which you can upload your data and track it more thoroughly, in much the same way that my previous winner, Endomondo does.

In any event, it is the perfect next-generation replacement for my old spiral-bound notebooks, and keeps my workouts incredibly productive. What more could an aging gym rat ask for?

A Girl, A Trike and A Disease

Every patient who walks into my exam room receives -- at no extra charge! -- a critical evaluation of their exercise regimen, or lack thereof. At this point, regular exercise has been proven so critical in the prevention and treatment of so many disorders, from depression to cancer to heart disease to the cold and flu, that in my not-very-humble opinion, any primary care doctor who does not investigate, evaluate and manipulate their patient's exercise program is committing malpractice. Yes, it's that important. It's like not taking a patient's blood pressure or pulse. A person's participation in exercise is one of the vital signs of wellness. Frequently, my job is to find exercises that will work within the boundaries set by a patient's existing disorder while at the same time optimizing it to reduce or eliminate the effects of that same disorder.

Among the chronic diseases, one of the most problematic in the exercise prescription department is Multiple Sclerosis (MS). Because of this cruel disease's frequently erratic behavior, coupled with its prediliction for shaving away a small slice of one's competence with each renewed assault, it is hard to find and develop good exercises for my patients suffering from this disease. What was possible last week becomes impossible the next. Problems in balance or sudden weakness can make many standard exercises impossible or dangerous. And the fear of such occurrences can negate even the most committed patient's determination and my craftiest motivation strategies.

Being a recidivist transportation cyclist,  an environmentalist, and a man with a grip on the purse that would make a Scotsman proud, it has rarely come as a surprise to my patients when I suggest cycling as a good all-round exercise. Bicycles are cheap, and every time you ride it to the grocery store, you save money, while at the same time becoming healthier and increasing your longevity. As the great Oregon Congressman Earl Blumenauer once said:

"Let's have a moment of silence for all those Americans who are stuck in traffic on their way to the gym to ride the stationary bicycle."

Cycling would be an excellent activity for my MS patients as well, were it not for the unpredictable and troubling manifestations that could make it downright dangerous.

Which is why I suggest a fun, albeit unusual, alternative: Trikes.

No, these aren't your average 4-year-old's Big Wheel. I'm talking about performance trikes, trikes that have been ridden to the furthest reaches of the Himalayas, in the fastest bicycle races in the world, and on the road. They are trikes that can be ridden every day, as fast or as slow as you want, without concern for the types of crashes that can befall you on a two-wheeler.

For that reason, I think trikes are an excellent source of rich cardiovascular exercise for my patients with MS. And here's how many have taken me up on my suggestion: 0. None. Nada.

Well, all of my patients with MS, and all of you reading this blog who have MS or have friends or relatives who are suffering from the effects of  MS, I want you to take note of this name: Denise Lanier. Denise is a writing professor at Broward College. Her poetry has appeared in Bloomsbury Review, Cake, Luna, Best American Poetry blog, and various anthologies. And she has MS.

In her blog, Wonky Woman on a Bent Trike, Denise writes about her two most powerful tools for fighting this disorder (in addition to her undeniable intelligence and phenomenal willpower): A mobility dog and her trike.

This weekend, after much training, Denise will be riding her trike in the New York City Marathon, as a disabled entrant in this world-famous race, and the first entrant to do it on a tricycle.

But is she doing it for herself? For an MS charity? Certainly not - that would be too self-serving for a woman as generous in spirit as her. Denise has chosen the Leary Firefighters Association as the beneficiary of the dollars she has raised. Go here to read what Denise has to say about the foundation. Then go here and donate.

But more important than any of that, read the words this woman has written, about herself, her MS, and her fight toward health. For anyone with a chronic disorder, she is an inspiration.

And I hope everyone reading this blog (all 6 of you) will join me this weekend in following her progress and cheering her on. In her most recent post, she suggests some ways to do it:

Here’re some ways for you to follow my progress in the marathon on race day, this Sunday, November 7th:

Online Athlete Tracker:  free race-day service, visit ingnycmarathon.org on November 7th

Text Message Athlete Alert:  sign up at ingnycmarathon.org to receive on-demand updates, one-time setup fee of $2.99

Tune In:  NBC4 New York offers live coverage of the entire race; after the race catch the 2-hour highlight special on NBC Sports

Marathon App:  for iPhone, iPod Touch or iPad, download it today!"

Then go out and buy a trike. And ride it.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Must Have Android Health Apps, Part I(a)

This app was not on my original list of must-haves. However, when planning a training ride the other day, I realized that none of the apps I had reviewed for cycling actually had the ability to import a gpx (route or track) file, and instead of recording where you had been, could tell you where to go. Well, ok. I have enough people telling me where to go without really wanting to add to the list. But not infrequently, I will spend some time on a site like ridewithgps.com, or gmap-pedometer.com, creating a "custom" training loop. The varied topography of Litchfield and northwest Connecticut makes it possible to design a route with the amount and type of climbing you want, depending on your climbing goals.

Unfortunately, routing apps don't work very well for creating loops, nor do they take into account your training desires in point-to-point route design. Thus the use of sites like those mentioned above to create the ride of my dreams -- or at least my dreams for that day.

And on those occasions when you are riding on a pre-planned group ride, having your route in your GPS (or in this case, smartphone) saves you from fumbling with cue sheets in the wind, rain, and at busy intersections while you try to figure out which way you are supposed to turn on Reallybighill Road. Or, better yet, prevent you from riding those extra "bonus miles" that you get awarded for veering off course. (My worst day involved 15 bonus miles, but that's another story).

Which is where Must-Have App I(a) fits in. Called OsmAnd, this app allows you to import a .gpx file, either a track or a route, and will give you on-screen or verbal directions as you move down the road.

OsmAnd is free and open source, which means a number of developers are welcome to add their coordinated input to the project. It is also intentionally designed to minimize resource use, both on your phone and in terms of internet access -- a big bonus now that unlimited service plans have gone the way of Vioxx.

Another big bonus is that OsmAnd itself is not only open source, but employs open source maps as well, from the Open Street Maps project. Which means the maps are more accurate, as a larger number of people are available to evaluate the data and make corrections. There is also the OpenCycleMap project which, while currently largely UK-based, holds the promise of creating cycling-specific maps worldwide. OpenCycleMap currently has maps for part of Litchfield County here in Connecticuty. It's an effort worth keeping tabs on, if not actively supporting.

This app does exactly what I wanted it to do. Using ridewithgps, I mapped out a short 20-mile route that would end by taking me past the farm, where I could pick up some milk and eggs on the last few miles and get them home before they spoiled (a route that also, I might add, require me to carry the groceries up a minimum of hills).

Ridewithgps created the .gpx file, which I then downloaded to my Android. I fired up OsmAnd, which on command immediately found my file and created the route. The program worked almost flawlessly, guiding me through  the unfamiliar stretches and turns. The screen updated my location on the map, and an icon in the upper left hand corner told me how far to the next turn and which direction I was headed.

As I noted in the previous review, satellite coverage in my area can safely be graded as somewhere between "less than spectacular" and "I get better satellite coverage in caves." So there were a few spots were the app wasn't quite up to speed on my current position. But it handled the confusion with aplomb, updating itself as soon as it got reacquainted with its satellites. And the constant turn reminder permitted me to estimate the location of the turn, even if the app itself was behind me.

If there are any hiccups in this app, it is only in the installation. It does not automatically create the file folder where you need to place the gpx files, though it does tell you exactly where the folder should be and what it should be named. Similarly, the voice configuration data has to be downloaded separately, from the OsmAnd website. Those sorts of issues are of little consequence, though, compared to the value of the application.

But once those two tasks are accomplished, you're ready to go. This app is not resource intensive, downloading map tiles only as needed and working offline as much as possible; nor did it seem to draw down the battery power any more than any other application using the gps features.

If you are a cyclist or runner that likes to design their own routes, then OsmAnd is the application for you. You can download it from the Android Marketplace or from the website.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

3 Must-Have Android Health Apps, Part I

When the Verizon cellphone account headed for expiration, I decided to (a) look for a better deal, and (b) do some serious upgrading. My old folder did its job and did it well, but had gone a wee bit hinky on me over the past few months,  randomly shutting down, making phone calls on its own, occasionally beeping uncontrollably, and generally acting like a patron of the Pig & Whistle at last call on a Saturday evening. Being a fan of Open Systems software, I was naturally drawn to phones running the Android operating system, and the increasingly large ecosystem of apps surrounding it. So I ended up with a Samsung I897 smartphone. And, of course, immediately began looking at the 1.3 gazillion health and fitness apps for it.

Most of them, unsurprisingly, are less than impressive, and fall into one of several categories. There are the Body Mass Index calculators, calorie counters, weight loss trackers, and celebrity fitness apps. The first group does nothing more than a pencil and paper, hand calculator or a smart digital scale can do; the second group has utility if all you want to do is reduce input, not recalibrate your diet for a healthy intake; and the only appeal of the final group is to assure you that "YES, YOU CAN LOOK LIKE HER," or alternatively, "YES, YOU CAN GET HER," depending on your gender and orientation.

But after slogging my way through the swampland, I found what I consider to be the three Essential Health Apps. They are available for both Android and iPhone platforms, and all three of these applications have the twin advantages of Doing Something Useful and Doing What They Say They Can Do. Neither of these attributes should be taken for granted in the world of applications software.

Two of these apps are for fitness, and the third is for nutrition. All three are free. And if you are engaged in any level of healthy activities, I encourage you to download them and employ them.

The app we will review today is, to my mind, the best reason for getting a smartphone. Health App #1: Endomondo

Endomondo is an application for cyclists, runners, bladers, skiers and walkers. Like all of the other apps in this category, it uses the phone's built-in gps to track your location, and will report your speed, distance traveled, and average speed as well as other assorted data, both visually and verbally. You can look at a screen that resembles the cyclocomputer on your bicycle, or follow your progress on a map. And at user-set times, Endomondo will verbally give you your performance data. All of these are typical of the breed. However, Endomondo goes a notch higher than the competition in several respects.

First of all, Endomondo's use of the gps is far better than any of the other apps in this category that I tried (I tested the top 6.) I live in an area where gps reception is dicey. I've had $500 gps units sit in front of my house for minutes trying to get a fix on its location, only to report failure and retire from the field.

Endomondo, it seems, can variably adjust its filters on the fly to accept weak-signal situations. As soon as I punch the start button, Endomondo is ready to ride, while others -- notably SportsTracker, SportyPal, and CardioTrainer -- took several minutes to acquire a position fix. And My Tracks, allegedly a premier program, never did get a location fix over the course of a 25 mile ride.

Even with the acceptance of lower-level gps signals, Endomondo's accuracy did not notably suffer. In 25 and 30 mile rides, the app was within .05 miles accurate, as compared to a cyclocomputer which had been previously calibrated against a measured 100-mile distance, and the Endomondo distance measurement fell within the range of error of the calibrated device.

In comparison, CardioTrainer gave me an extra 5 miles over a 25-mile distance, something for which I was grateful but hesitant to accept, even though the CardioTrainer error boosted my average speed to the minor diety level.

SportsTracker can occasionally get a fix, and once fixed, would track with admirable accuracy. But before it would let you take off, you had to add a name and description to your ride. And since my rides are usually unremarkable, this feature made little sense. After all, how many times can you type in "milk run"?

SportyPal's interface was unsuitable for low-signal conditions. Until the gps would initialize, it would seize, leaving me sitting in the driveway waiting for the software to get ready. And that's just not an option in my world.

In comparison, I liked Endomondo's no-muss, no-fuss startup. You just picked your activity (surprisingly enough, the list includes "transport cycling" as an option, which pleased me to no end), pressed the "Start" button, then started. Clean and simple.

Endomondo also has the ability to gather heart rate data from a bluetooth-equipped sensor, which it will incorporate into your ride data.

At the end of your activity, you press "Stop," and all of your data is automatically uploaded to your online Endomondo account.

Online, you can look at your history, your maps, graphs of your ride data in a few different formats; but best of all, you can interact with friends. There are activity challenges constantly going on, and if you set up your phone app to do so, you can allow your friends to track you online in real time. Your friends can help you along by sending freeform text messages via endomondo, which are then read to you by the phone's text-to-speech engine. Imagine how much fun it can be, as you struggle up some desperate incline, to hear your best friend cheering you on with such encouraging phrases as "speed it up, lard butt!" or "enjoying your ice cream stop, pal?"

(Such exhortations can be made somewhat more enjoyable, I found, by equipping your phone's text-to-speech engine with a sexy British accent, making your buddy's ribbing much more pleasant.)

Although some may not like them, the social networking features of Endomondo are definitely a selling point for me. Misery always loves company. So that, plus the easy user interface and the weak-signal GPS performance make this my Number 1 health app.

NEXT UP: We take the Android to the gym and let it show its muscle.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Beyond Avandia: Diabetes Treatment Without Drugs

Even if you don't follow health news closely, it would have been hard to miss the recent headlines as the diabetes drug Avandia went "on trial" before the FDA.

The problem was simple: Avandia tends to kill the people who take it by giving them strokes and heart attacks. So some intelligent people thought it should be taken off the market.

Before all was said and done, it was revealed Avandia's maker GSK had manipulated  risk analysis data, one of the panel's scientists was on the payroll of a GSK competitor, and in the end the FDA figured that killing off some people with diabetes wasn't so bad after all and let Avandia stay on the market.

Missing from the whole discussion was the idea that you don't need Avandia or any other drug to treat type II diabetes!

Type II diabetes is a nutritional and lifestyle disease. The best way of combating any disease, whether it is cancer or the common cold is by addressing it at the source, not by tossing drugs at the symptoms. And the best way of addressing diabetes is by the selective use of foods that help your body naturally regulate your blood sugar, and through exercise routines specifically designed to keep blood sugar levels within a target zone.

Which is how my patients with diabetes improve their health. Of course, I can't say that anything but a drug can cure diabetes, even though the research clearly demonstrates effective diabetic management through exercise and nutrition. I'll leave the quack claims of "cure" to the makers of drugs like Avandia, who are quite willing to sacrifice your health for their profits.

But here's the key fact: It can be more effective, safer, and less expensive to use non-drug therapies to improve the health of people with type II diabetes. And even if you are already taking drugs for diabetes, alternative therapies can still assist your health.

Thus, if you are one of the many thousands of Americans with no health insurance, you have a choice: You can pay a considerable percent of your monthly income on Avandia and its brethren (a one-month supply of Avandia typically costs $170), or you can see me (New patient examination and in-house labs: $150) and I'll help you develop a plan that will allow you to manage your diabetes. You will be in control of the treatment and its costs.

Even if you have insurance that would cover the costs, would you prefer to run the substantially increased risk of death by treating the disorder with drugs? Or would you prefer to take a safer path to better health?

Everybody deserves a choice. The problem is, there aren't many doctors offering one.

I am offering you a choice. A safer, more cost-effective choice. If you want to talk to me about diabetes, click here.