Incorporating Exercise Into Your Lifestyle


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I recently moved to San Diego and everyone loves exercise here. There is 1 kick-boxing studio, 2 yoga studios, a tai chi studio, a krav maga studio, 2 places to learn dance, a pilates studio, 2 gyms, all within walking distance of my place. Not kidding. Of course, I want to participate in the healthy San Diego lifestyle, but I’ve been nervous about doing something too intense for fear of aggravating my back pain. And then of course there is the time issue. So whats a girl to do if she cant break it down like Richard Simmons?

In the world of healthy eating and activity research, I have been hearing whispers of the importance not just of EXERCISE, but how sitting still for hours on end is bad for you. In fact, a recent study has been making the rounds, talking about how sitting is the new smoking. It started with a scientist named James Levine, who has been talking about how 2 hours and 15 minutes of small movements rather than sitting amount to what he calls “non-exercise activity thermogenesis” or NEAT – basically you burn calories doing a little activity every day that is not say, a structured activity that is considered exercise like going to Pilates. And basically, he says that not having this NEAT in our lives is WORSE than smoking.

So what does that mean for me and everyone with low back pain who needs to take it easy? I have been concentrating on low impact exercises, like swimming, elliptical, and small movements. I’ve been stretching. But I’ve also been incorporating lifestyle exercise into my life. What does this mean? Heres a little list of 8 things I do:

  1. Its as simple as parking far away from the door at the shopping center – sometimes that one little walk can be a thousand steps! Thats what my fitbit says anyway.
  2. Keep my fitbit charged
  3. Park on the bottom level of the parking garage and take the stairs all the way to the top where there is a walkway to the campus.
  4. Sit on an exercise ball
  5. Work on my laptop while standing (and make sure you fidget and move around!)
  6. Try to get up and stretch every 20 minutes. This is key if you have back pain
  7. Walk to the cafe to do work – preferrably one thats further from me(and order tea instead of a latte! unsweetened iced tea with a splash of almond milk and one packet of raw sugar – YES PLEASE!)
  8. Park on the other side of campus from where my class is

A couple of extra that I dont do to make it 10 :-P

  1. Stand up and watch TV or play video games (My husband does this). Kids can be on a trampoline.
  2. Do some grocery bag bicep curls

I have to say, this helps keep my step numbers at least in the 6-7000 range if not 9000. For me to break 10000, I usually have to be at the gym for a half hour.

3 Ways to Improve Your Energy During the Day


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Ever felt that 3 PM crash? Do you feel tired even when you got 8-hours of sleep the night before? One of the best way to avoid groggy and tiredness is to improve your sleep and wake up habits. Below are 3 key habits that impact how much energy you have for the day.

  1. Wake up without your alarm clock. The key to avoid that groggy morning feeling is to wake up naturally so you can avoids being jerked out of deep sleep. When you sleep, most people cycle through 5 stages of sleep throughout the night. The lightest stage is called REM (rapid eye movement) sleep, which is the last stage before you wake up, and also the stage where you dream. When you wake up from REM sleep stage, you wake up feeling well rested. However, when you wake up during non-REM sleep stage, (such as from the interruption of your alarm clock) you feel groggy and tired. Studies have even shown that waking up during deep sleep can negatively affected short-term memory and cognitive abilities!
  2. Avoid the snooze button. Do you sometimes find yourself waking up before the alarm? When you know what time you need to wake up the next day, your body will naturally prepare for the set wake up time by releasing the stress hormone hours prior so you will wake up naturally. If you try to go back to sleep, your body releases the opposing hormones that helps you sleep, counteracting with the hormones that wakes you. Result: you feel groggier and more confused.
  3. Avoid the morning rush by getting ready the night before. Morning rush can increase the stress hormone, leading to an adrenaline-inducing energy jolt that will lead to a crash later in the day. Pre-plan your morning and prepare as much as you can (lay out your clothes, pack up your bag night before, etc.) so you can avoid the unnecessary stress that can drain your energy.


Roasted “Chick-peas” Indian Style


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Indians love their snacks, and I am no exception. When you go to India, your hosts make it their job to fill your day with deliciousness. First there is breakfast, then there is “coffee” which is between breakfast and lunch and includes more than coffee, then there is lunch, then there is “Tiffin” which comes between lunch and dinner and includes lots of bad for you snacks, and then finally there is dinner.

So naturally, I love snacks and I often feel “snacky”. I have been seeing reIMG_1444cipes for roasted chickpeas all over pinterest. I really do enjoy them, but I realized that the Indian grandmas and home-makers of the world have made sure of one thing despite all kinds of cosmic shifts and changes in political winds – that prices at the Indian grocery store stay amazing.

A common thickener used for gravies and chutneys is called “Chana Dalia” and can be found in Indian Groceries, and nowadays, online. It looks like this:

Chana Dalia

Given that both my parents have diabetes, I’ve been trying to stay away from refined carbohydrates. Now, I should say that the resistant starch found in beans breaks down with heat, and Dalia have been roasted. The fiber shell has also been taken off. However, take a look at the nutrition info on these babies here. Lots of protein, and lots of fiber. I thought they would be a pretty good base for a snacky dish :).

Once you get how to make a Tadka – “spices tempered in hot oil” – Indian cooking is basically the same from dish to dish. Heres a great article on tempering of spices. For this tempering, I used cumin, black mustard seeds (optional), curry leaves (optional but when added really give the dish a nice flavor and fragrance), and dried red chillis. The cumin lends a lovely spicy fragrance, and the black mustard seeds lend a pungent taste. These spices are in addition to the chilli powder, turmeric, salt and garlic powder that you add. Once you have the ingredients, this dish takes just about 15 minutes to make.

Here’s the finished product! Dont you just want to reach in with a spoon? nom nom. Thats my lunch-box in the background. IMG_1446


  • 3-4 cups chana dalia
  • 1 tsp chili powder
  • 1 tsp salt
  • 1 tsp granulated garlic (can skip the salt and use garlic salt too)
  • A few grinds of black pepper
  • 1/4 tsp turmeric
  • For the tempering:
    •  3 tbsp of oil
    • 2 tsp cumin
    • 4-5 curry leaves (optional but they are so good) can be found online here
    • 1 tsp black mustard seeds can be found online here
    • 2-3 Dried red chillis

Directions: (Time approx 15 minutes)

  1. Toast the Chana Dalia in a non-stick pan on medium heat for about 7-8 minutes
  2. Once the dalia start to become a little brown around the edges, add the spices. Keep toasting for another 3-4 minutes until the chilli powder starts to darken
  3. In a separate small pan ( a small soup pot will do. For my tempering spices, I use this pan), heat a little oil. I use coconut as it has a high smoke point. Add the tempering spices except the curry leaves. When you hear the spices start to sputter, add the curry leaves. Be careful, as the oil can splash! The tempering is done when you see the dried red chillis start to turn almost black.  Heres a video to help you out! My ingredients are different, because the Tadka (tempering) varies based on the dish.
  4. Pour the tadka into the Dalia which is toasting. The oil from the tadka will help the coat the chilli powder, oil, turmeric and other spices in the non-stick pan.
  5. An option is to cut raw onions and serve this mixed with raw onions, 1 green chilli pepper chopped, chopped coriander, and lemon. The dish is very dry and heating, so the cooler raw ingredients help with that in the hot weather. The finished product looks like this when you serve it that way.


The Medicine Everyone Should be Taking


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If you could put all of the benefits of exercise into a pill, literally, everyone would take it!  Everything from your weight, to your blood pressure, mood, sleep, energy levels, and risk of cancer, are all improved with exercise!
Ensure a Safe Start
With so many exercise trends out there like Cross fit, Pilates, Tai Chi, Yoga, and Zumba (just to name a few), where does one safely start? This 7-question screening form  can give you an idea if you need to talk to your physician before you get started. However, If you have any concerns at all, I always recommend speaking with your doctor first.
How Intense?
Once you have the green light, what’s next?  If you haven’t been doing anything, I like to tell people walking is one of the best and easiest forms of exercise. All you need are your shoes and a safe place to walk.
Start Small…
You can start with something as small as a 5 minute walk out, then a 5 minute walk back.  As you feel more comfortable, increase your distance and time. A general rule of thumb is to not increase more than 10% time, distance, weight (if you are doing resistance training) at a time.  Also, remember to listen to your body. In terms of intensity, you should be working hard enough that you can still talk to another person, but are not able to sing.  If you can sing your favorite song, pick up the pace! If you want some structure, you can even download a free app such as, couch to 5K, which is designed to take you from no activity, to completing your first 5K.
…but Aim For the Stars!
Your ultimate goal should be to get at least 30 minutes of moderately intense physical activity (i.e. a brisk walk) 5 days per week, or 150 minutes per week. If you are looking for a free walking group, the non-profit Walk With a Doc is a great place to find a walking group near you with on-site physicians. Lastly, if you need some motivation to get started, here are a few of my favorite quotes…
– “Yesterday you said tomorrow.”
– “If you wait for the perfect conditions, you’ll never get anything done.”
– “No matter how slow you go, you are still lapping everybody on the couch.”
Today is your day to get moving!
Jon Bonnet is a current Sports Medicine Fellow at the University of Florida. Dr. Bonnet completed his Family Medicine residency at Duke University. He is an American College of Sports Medicine certified personal trainer and serves on the board of the American College of Lifestyle Medicine. Check him out at his linkedin profile.

Vegan Mofo Recipe: Family-friendly Chocolate Cup-Cakes with Vanilla Buttercream Frosting


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So Vegan Month of Food is here, and we at Practice-Vitality are making the effort. Sometimes, that means broadening your mind. We like to stick to recipes that are healthy, but it turns out that my cousin, hidden away in the beautiful hills of West Virginia, has been baking amazing vegan pastries – I had to display her work! You understand, right? I mean look at them! Plus they are mini-cup-cakes. Its all about portion control, right?

Vegan minicupcakes

Great. Todays Vegan Mofo theme is “Quick, Easy and Delicious”, and of course I have determined that this recipe is quick and easy and it is definitely delicious! It has been kid-tested, adult approved.

My cousin is a very spiritual person, and she often sends our family lovely little affirmations. In honor of her, here is a positive thought for you to consider while you munch on this delectable morsel of a cup-cake:

“A river of compassion washes away my anger and replaces it with love” 


  • Can interchange flour and sugar to adjust the sweetness
  • Can use brown-sugar

Chocolate Cake (Batter makes 24 mini cupcakes)


  • 1 1/2 cups all purpose flour
  • 1 cup granulated, white sugar
  • 1/4 cup unsweetened cocoa powder
  • 1 tsp baking powder
  • 1 tsp baking soda
  • 1/4 tsp salt
  • 1/3 cup use vegan butter or any oil of your choice
  • 1 cup warm water
  • 1 tbsp lemon juice
  • 1 tsp pure vanilla extract


  • Preheat oven to 350 and place rack in the center of the oven.
  • In an ungreased mini-cupcake pan, stir together flour, sugar, sifted cocoa powder, baking soda, and salt
  • Add melted butter or coconut oil, water, lemon juice, and vanilla extract. With a fork, mix all the ingredients together until well blended.
  • Depends on the oven – may need to bake for about 30 minutes, or until the cake springs back when lightly pressed, and a tooth pick inserted into the center comes out clean. Check after 13 minutes.
  • Remove from the oven and place on a wire-rack to cool.

Vanilla Butter-cream Frosting: 

  • 1 1/2 cup confectioners sugar
  • 1/2 cup unsalted vegan butter
  • 2 tsp vanilla bean paste
  • 1 tbsp almond milk (try adding 1/2 tbsp first, then check consistency. If necessary, add the other half )


  • Mix together util blended and creamy
  • Add vanilla bean paste and milk and continue to beat for another minute
  • If desired, add more vanilla bean paste to taste, or more confectioners sugar to make it stiffer

Serve to guests in an gorgeous display at a party, proudly proclaiming their vegan-ness :-)

Vegan minicupcakes display


3 Reasons Why you Should Be Doing Yoga



Among the Integrative Medicine modalities, Yoga has been front and center for a while now. Perhaps this is because it is truly integrative, allowing for a balanced practice of physical exercise, breathing control and meditation. Recent studies have suggested that yoga can have positive effects on body, mind and soul. Here are just 3 examples:

  1. Un-break your Heart: For instance yoga can modify cardiovascular risk factors through reducing stress, anxiety and depression. Also improving cholesterol, and reducing fasting blood sugar and glucose control. In fact, yoga can be used as a practical adjunct to cardiac rehabilitation after people have heart attacks!
  2. Mentally un-plug: As a mind-body intervention, yoga can improve physical and mental well-being, and improve sleep. Yoga helps people with something called self-regulation – the ability to accept things as they are without reacting. It also helps people with something called self-efficacy – basically believing in one-self. Amazingly, yogis learn these lessons on the yoga mat, but are able to generalize them into their lives off the mat, making for a better psychological life over-all
  3. Liberate your body: Using yoga to stretch muscles helps those who have contracted muscles from laying in the same position for too long – this is called spasticity. Yoga is a safe, inexpensive and an accessible way for the elderly and the disabled to improve their function, and allowing them to exist in society in a more satisfying way.

So this summer, get down with your down-dog and do some Yoga.

Parissa Massahikhaleghi graduated from medical school in Iran. She was inspired by the encounters with chronic diseases she had during medical training to pursue preventive medicine and public health. She obtained Master of Public Health from Loma Linda University with a concentration in lifestyle medicine. Regarding her passion for health promotion through education, she says “I have been fortunate to have all this education regarding health, and I wake up everyday to share at least little piece of it with others so they may improve their function in society via the benefits of a healthy lifestyle.”

Breakfast Recipe Roundup: Vegan MoFo Tribute


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Berry-peach Bubblegum Smoothie

Picture of smoothie from one of our original posts!

Hello all! We at Practice Vitality are not officially participating in Vegan MoFo’s BlogRoll, but have made a conscious decision to get caught up in the excitement! We love plant based recipes here at Practice Vitality. Why? Some of it is related to personal health conditions, and some of it related to early influences from the world of nutrition.

We will try to participate in Vegan MoFo in some shape or form (A blog post a day is a little much for us but social media posts are up our alley on the other days).

Today’s theme is “Rise and Shine! It’s MoFo time! Tell us about your breakfast.” Accordingly, here is a collection of a few breakfast recipes from our blog over the past few years. I can’t tell you how much fun it was to go through our old posts – a trip down memory lane!

Triple Power Flax Seed Energizing Oatmeal

Healthy Version of Tropical Greens Recipe

Protein Packed Spring Power Smoothie

Berry Peach Bubble Gum Smoothie

Lovely Lavender!

My most recent travels took me to the charming Provence Region of France. Alluring images of lavender fields occupied my mind long before my journey began. Just imagining their rich color, beauty, and aroma had a calming effect on my nervous system as I pushed through the last few months of my rewarding yet stressful job.

Image Source

A little history: Lavender, known as the soul of Provence belongs to the Lamiaceae, a botanical family that comprises several well-known aromatic plants such as thyme, savory, salvia and surprisingly mint. The first plants cultivated in Provence came from Persia and were later classified by the Greeks as “the precious plant”. The best time to see Lavender in Provence is between late June and early August, when it is harvested. Lavender is regularly used in beauty products and to spice up local cuisine.

Aside from its incredible fragrance, Lavender oil is known for its anti-inflammatory, antifungal, antidepressant, antiseptic, antibacterial, and antimicrobial properties. It can be used for a number of ailments such as sinus congestion, headaches, and muscle pain.  Insomnia, stress, and anxiety are some of the more common uses of Lavender.


Insomnia- Lavender has a calming effect on the mind and can help with deep relaxation. Researchers have found that lavender increased slow-wave sleep, the very deep slumber in which the heartbeat slows and muscles relax.

How to use? Dried herbs can be boiled to make in to a tea along with chamomile at bedtime.  Allow herbs to seep for 5-10 minutes before enjoying this relaxing beverage. Essential oil of Lavender can be used in an aromatherapy diffuser or you can try adding a few drops on a tissue under your pillow. I have a sachet of Lavender next to my bed which has helped me get over jetlag!


Anxiety and Stress – In clinical trials, Lavender oil aromatherapy has been shown to be effective in the management of stress and anxiety. Clinical Research has shown taking a specific capsule containing Lavender oil daily for 8-10 wks improved anxiety and sleep scores in those with Generalized Anxiety Disorder. It was also found that Lavender extract can be as effective as low dosage benzodiazepines for those with attenuating anxiety.

How to use essential oil of Lavender?  The essential oil of Lavender can be applied to any base oil such as olive, jojoba, coconut, or almond and can be used for massage. Adding 1-2 drops to a hot bath is another way to get the stress relieving benefits as Lavender oil also aids in muscle relaxation. Bath salts containing organic lavender are easily found online or in health food stores. I soak in lavender bath salts a few times a week right before bed and watch my stress melt away. During a particularly stressful or anxious moment, try smelling Lavender oil directly or adding a few drops to boiling water and steaming. Practitioners of aromatherapy believe that fragrances in the oils stimulate nerves in the nose which then sends impulses to the part of the brain that controls memory and emotion.

*When purchasing store bought Lavender oil, it is essential to make sure it is labeled Certified Organic as there are many synthetic lavender products on the market which can cause allergies. Growing Lavender at home is also another wonderful option!



Vegan Quinoa and Kale Dish


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Nothing screams healthy than quinoa and kale, but not only is this dish healthy but it is actually really tasty and filling as well. I also love that this is super easy to make (15 minutes and dinner is served)!

Quinoa is high in protein and fiber, and also a great source of folate…more on that at a later post.


  • 1 cup of quinoa
  • 2 cups of kale, chopped (option to use arugula or bok choy as an alternative)
  • 2 garlics, mashed and chopped
  • 1/2 cup of shredded carrots
  • olive oil or coconut oil
  • salt and pepper


  1. Cook quinoa in a pot with water until it sprouts and ready to eat (~15 minutes). Follow the boiling/cooking instructions on the quinoa package.
  2. In the meantime, heat a pan with oil in medium heat.
  3. Once the pan is hot, add the garlic and let it cook for 10 seconds, or until fragrant.
  4. Add the kale and shredded carrots. Cook for ~1 minute.
  5. Add the cooked quinoa and mix the ingredients together. Add sea salt, then seal the pan with a lid so the dish can simmer in low heat ~1 minute. Make sure you don’t overcook the kale.
  6. Stir the dish, and add pepper to taste. This can be served hot or cold. ENJOY!!!


How to Create Accountability in Weight Loss


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Positive behavior change is more complicated than “getting your act together.” We live in what is called an “obesogenic environment“. What does this mean? Coined by Australian academic Boyd Swinburn, the term essentially means that your environment is acting against you daily in very sophisticated ways in order to make you fail at your new year’s resolution to lose 10 pounds.

For example, to maintain a calorie-burning level of fitness a person should walk about four miles each day, which means about 90 minutes of walking, but to accomplish requires: (1) 90 minutes of free time each day, and (2) a safe neighborhood in which to walk. Right away, you’ve lost a third of the population.

Faced with all these challenges, how do you achieve success? The real answer is that this is a public health issue that everyone should get behind, but even before the battle is won at city hall, there are lots of evidence-based ways to tackle these challenges now.

  1. Detox your home. Throw out all the junk food from your home. If necessary, buy healthy versions. This may require that you have a discussion with your family. I had one patient who sat down with her husband and children and said “I need to make a change in my life. We cannot have junk food in the house.” The solution was to put all of the junk food in the house in a separate fridge in the garage. Now personally, I would have preferred that she lay down the law and said no junk food at all, but this was a big step and it made a big difference in her health.
  2. Create your own Environment. If you tend to stop at the vending machine to pick up a candy bar on the way to the boss’s office while dropping off your TPS report, try to a) take the stairs to your bosses’ office and b) go through an alternate hallway.
  3. Get a Fit Bit: Or another type of fitness tracker! Competition is a wonderful way of creating accountability. The evidence is still evolving on this one, but it seems like regardless of whether they work, they help motivate people to move.
  4. Get Support. Having a community of people who are also working on the same goal or who can function as a cheer-leader creates big dividends in your weight loss journey. Weight is more tied to whether you friends are thin, even more so than if you spouse is thin. Check out this Harvard study by a physician and sociologist. Healthy people infect other people with healthI am a big fan of using a health coach, but there are other ways to attack this too. For example
    • Ask a friend to be your buddy.
    • Join a group weight loss program.
    • Join a weight loss network such as or any of these 
    • If you own a fitness tracker or use a fitness app, take advantage of the social networking tools
    • Participate in walking programs or similar initiative

Do you have other suggestions for creating accountability? We would love you to share with us!




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