10 New Years Resolutions for 2023

Unlikely that we stick them all, but worth a try perhaps.

New Year’s Day is a convenient, motivational, and essentially arbitrary starting point for a lot of changes we might make in our lives. January 1st has been the start of a “new year” since around 700 BCE, thanks to the Roman King Numa Pompilius.

But does it really feel like a new year emotionally - in the dead of winter, surrounded by dead plants, empty eggnog cartons, and minimal sunlight? Maybe we are setting ourselves up for failure by turning over new leaves when there are no leaves on the trees. If I were a Roman king, I think I would have chosen the spring equinox as a time of optimism, renewal, and positive change instead.

And so in the spirit of resolutions that might be doomed to failure, here are 10 that we should probably give a try this winter… or in the spring if we fall short?

Summer?

Help me count these down…

~

#10 - Tune out social media more often, for your mental health.

I know there are benefits to scrolling through Facebook photos of friends and family, but there is also a lot of missing out to be reckoned with, and unrealistic portrayals of happiness. Twitter is often toxic, Instagram too distracting, TikTok addictive like high fructose corn syrup laced with Chinese surveillance. I don’t often use these services really, so maybe I’m wrong. And I’ve found Twitter helpful in keeping up with medical experts. But to quote the dark wit of Wednesday Addams, from the new Netflix hit series: “I find social media to be a soul-sucking void of meaningless affirmation.”

Instead of listing a bunch of studies about the negative effects of social media and all its algorithms - try just tuning it out for a week instead. See how you feel, and what you get done. The paradoxical disconnect I feel when using social media makes me think of the first lines in that William Wordsworth poem:

The world is too much with us; late and soon, 
Getting and spending, we lay waste our powers;
Staring and scrolling, the siren light from the window shouts,
As we drift, and forget one another's company.

Wordsworth is lamenting the disconnection of people from nature as his world modernized, industrialized, and consumerized. Yet in that changing world of the 1800’s we still had real human contact and a shared reality. Presently we human beings are losing to the glowing world in our devices, in a competition for attention and partnership.

And yes, I added those last 2 lines in the quoted poem. Did you catch that fake poetry?

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#9 - Don’t follow medical advice from fringe politicians, controversial celebrities, and attention-seeking, conspiracy-minded doctors.

Among many reasons for the mass burn out of healthcare professionals, and the exodus of more than a quarter of the workforce, has to be the exhaustion we feel trying to compete with those giving bad advice with larger megaphones. Never has being in the mainstream been more important, boring as that is. Vaccines and boosters have small but real risks, and no one ever said anything in the universe was completely risk free. But the next time a fringe doctor or celebrity tells you that vaccines and boosters are bad, remember this:

From December 2020 through November 2022, we estimate that the COVID-19 vaccination program in the U.S. prevented more than 18.5 million additional hospitalizations and 3.2 million additional deaths. Without vaccination, there would have been nearly 120 million more COVID-19 infections. The vaccination program also saved the U.S. $1.15 trillion in medical costs that would otherwise have been incurred.

Those numbers are astounding. Sit with them for a few moments. There’s no room for Covid complacency in 2023, either.

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#8 - Start working on your anxiety and depression before they become a problem again.

If you’re fortunate enough to be in a good place right now, but have had the experience of not being in a good place before, now is the time to build your fortress against mental health problems. Like the little pig who builds his house out of bricks, or the ant who works hard all summer and gathers food for the winter, there are many parables about preparing and fortifying ourselves when it seems like there is no immediate need. If you are prone to anxiety - meditate regularly, take 5-2-7 deep breaths daily, exercise, sleep, eat well, reduce or avoid caffeine, get counseling or cognitive behavioral therapy, and continue your medication depending on the situation and your doctor’s consultation. Same sort of advice for depression.

Picture the ant hustling all summer… but taking 15 minutes a day to sit and actively chill her mind.

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#7 - Go a bit easier on chocolate.

I’m just making sure you’re still awake with this provocation! The cacao in chocolate contains various antioxidants that are good for the heart, immune system, and brain. Eating chocolate has also been shown to reduce stress levels, improve athletic performance, and help with diabetes somewhat. The darker (and the less sugar) the better.

But like everything pleasurable, there is always a catch or two. Eating too much chocolate can be harmful in terms of total calories, and more importantly, calories from sugar. Sugar is not good. Chocolate may also worsen heartburn and migraines. And a recently published study in the prestigious medical journal Consumer Reports found troubling levels of lead and cadmium in many brands of chocolate. It’s worth a quick review before your next chocolate purchase, because I learned in medical school that eating lead and cadmium is not good. Everything in moderation. Savoring it brings more pleasure, too.

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#6 - Keep wearing a high quality mask inside public areas like stores and airplanes, get your bivalent booster already, and take an antiviral when you do get Covid.

The news and images out of China are looking tragic, with models predicting a million deaths coming. Hyper-contagious variant XBB.1.5 is taking over in the U.S., and is estimated to represent 40% of all cases now. It is causing a rise in hospitalizations over the past 1-2 weeks, mostly for the over 65 population. It doesn’t have to be this bad.

• Masks work, N95’s are best, and should be deployed indoors right now if you want to reduce your chance of a nasty case of Covid, flu, RSV, or all the other viruses that missed us so dearly.

• Rapid tests are still covered 100% by insurance. They are about 70% sensitive. It takes courage to be different and test before higher risk gatherings. Be courageous.

• Long Covid can be life-changing. It’s more common in people in their 30-50’s than other age groups. I previously wrote about a study out of the UK that estimated 20% of people in this age group develop long Covid after infection (defined as persistent symptoms for at least 3 months), with 5% reporting symptoms bad enough to impact their daily life and activities.

• Only 15% of eligible people (including kids >5 yo) have received a bivalent booster in the U.S. That’s pathetic, especially now that we have this data:

  • In November 2022, rates of hospitalization for unvaccinated people were 16x as high as for people who got all their shots including the bivalent booster. Purely natural immunity is not holding up as well as vaccines plus/minus prior infections. And rates of hospitalization were 2.7x higher even in vaccinated/boosted adults who did not get the bivalent dose.

  • For people over age 65, this translated into a 90% reduction in hospitalization for those who got their bivalent booster.

  • Dr.

    Katelyn Jetelina
    , who writes the essential
    Your Local Epidemiologist
    , summed this up quite well recently: "We have ~9 lab studies and 1 real world study showing the fall boosters provide: Greater protection against infection and transmission… Broader protection (against new variants)… and Longer protection against infection and severe disease.”

• Finally, when in doubt take an antiviral like Paxlovid or remdesivir when you’re sick, especially if you are at higher risk of severe disease. Paxlovid has been proven to reduce your risk of severe disease, hospitalization, death, and long Covid. That metallic taste, and maybe 10% more rebound symptoms than we see with untreated infections? Don’t worry about that stuff. Worry about your cells (in green) being mobbed by the senseless viruses (in purple).

  

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#5 - Arrive 30 minutes before your doctor appointment.

Because your doctor is probably running 20-40 minutes late. It’s all very logical, and who doesn’t have lots of free time they would like to spend in a waiting room reading brochures about Cologuard? Memorizing the Patient Bill of Rights posted on the wall is also good fun! I would get a fish tank for the waiting room, but then I would have no time to write this letter.

What’s that? You still want me to get a fish tank?

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#4 - Start eating a Mediterranean diet.

The pace of modern life has made it really difficult to eat well. But if we can develop a plan to eat more along the lines of a Mediterranean diet, studies show we can have less chance of cardiovascular disease, inflammation, cognitive decline, obesity, and diabetes. The plan starts with preparing a shopping list, sticking to the outside aisles at the grocery store, devoting time to and finding satisfaction in cooking more at home, staying active, and not eating alone. Fat in the diet is not the enemy. Rather the kind of fat matters, and should primarily come from healthy sources like olive oil, nuts, and seeds.

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#3 - Get 7-8 hours of sleep.

If I had to pick one of these resolutions personally, this would be it for 2023. Every year, every day, every excruciating morning that I find myself not getting enough sleep, I recommit to getting to bed by 11. And then life expands like a sponge and the day is fleeting, and by 11 PM I’ve just settled down enough that I can do something for myself. But we all know intuitively that sleep is good, and 7 hours seems to be the sweet spot. Insomnia can be helped by practicing good sleep hygiene. Many frustrated people who are resting in bed but not fully asleep are actually in a light stage of sleep that is more restorative than they might worry… so don’t worry. Learn more about sleep apnea, and talk to your doctor if you have risk factors. Alcohol and screens are bad for sleep.

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#2 - Repair bonds and friendships with people of different political beliefs.

This one used to be easier I think. But some of the loneliness and sadness we feel, and the consequent negative health effects of the past decade, have come from slowly losing friends and family to the political riptides. There is a good article in Psychology Today on how to handle political differences in the family. If tensions are high and political conversation is likely to get heated, focus on shared interests, memories, experiences, or the people you care about. And when you do engage on political differences, try not to win a battle, but rather start building a mutual understanding.

Much easier said than done, but we should be bigger people than we have been, and start trying. Myself included for sure.

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#1 - Eat less ice cream.

To question the supreme joy and pleasure of ice cream is indeed a sure fire way to incite passionate rage in your audience. It’s borderline sanctimonious. I even feel this in the office when I recommend eating less ice cream to patients seeking advice about how to lose weight or improve their blood test results. I think I’ll go now, before it gets ugly. Maybe we should just eat ice cream once a week, and not right before bed? But then again, what has been the point of the last 3.7 billion years of evolution on Earth, or the last 4,000 years of human civilization, if not to invent and deliver us the wonder of ice cream, and hot showers. Among all the coming advances in artificial intelligence, robotics, and bioengineering, if we can figure out a way for humans to eat ice cream, while in a hot shower, and without causing weight gain - then the price of progress will have been completely worth it.

When you do buy ice cream, get full fat ice cream, not the low-fat stuff. It tastes better, and the fat slows the absorption of sugar and blunts the glycemic index. Pay extra for less ingredients. Milk + cream + sugar +/-eggs + natural flavor is more or less the equation you are looking for.

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Happy New Year!!

I wish you and I both luck in trying to incorporate some of these resolutions for 2023. I think we can stay healthier and happier by reducing time spent tangled in social media algorithm nets, listening more to mainstream experts, maintaining good mental health when we don’t need to, going easy on stuff like chocolate and ice cream, cooking and eating more like Mediterraneans, continuing to take Covid seriously, spending more time in our doctors’ waiting rooms, sleeping more, and gently reengaging with friends and family whom we think have the wrong political and moral ideas.

This is certainly not a comprehensive list, but it’s the best I could cobble together on a day off. Feel free to add some that I’ve missed in the comments, or let me know which of these might seem like a good priority to you.

Take good care, and cheers,

Ryan