How much exercise do I really need?

Two and half hours a week of moderate intensity exercise is what is recommended by the American College of Sports Medicine and the American Heart Association. Ideally, this means 30 minutes, five times per week, of activities such as jogging, ballroom dancing, biking or swimming. Moderate intensity means you’re working in the intermediate zone. If you’re able to hold a conversation with the person next to you while doing that activity, you’re in the zone. 
If you don’t have time for five workouts per week, recent evidence in the Journal of the American Medical Association suggests that cramming 150 minutes into the weekend, the so-called “weekend warrior” model, transfers similar health benefits to spreading out fitness across the week. The only risk here is overuse injury, such as a case of Achilles tendinitis from running 10 miles on a Saturday after not doing any exercise all week.
Newer evidence about high intensity workouts known as HIIT (High Intensity Interval Training), shows that intensity minutes reduce required exercise time by almost half. This means if you’d like 30 minutes of exercise but you only have 15 to spare, you’re in luck. As I’ve outlined in my book “The Workout Prescription,” ramping up intensity minutes reduces time requirements, and is safe for anyone.

 Unlike moderate intensity, high intensity exercise means you’re huffing and puffing and conversation is difficult. Although they’re tough, HIIT workouts don’t have to be fancy. They can be set up anywhere, a living room, a garage, or a basement. All that’s needed is an open space, a light set of dumbbells, and a strong dose of motivation.

HIIT programs are generally safe for all ages but we generally recommend touching base with your physician if you’re over 40 and haven’t been previously active before starting this type of program.

 Why it matters so much

There are obvious benefits to exercise. People feel better, they look better, and they perform better in all aspects of their lives when they exercise regularly. Seen through the prism of the medical community, the medicine of exercise has strong scientific benefits that go far beyond the desire to fit into that new suit or pair of yoga pants.

Across the spectrum of the human body, irrefutable evidence shows that exercise isn’t just about getting a good workout, it’s about staying healthy in a broader sense. Exercise can treat depression, anxiety and sleep disturbances. For your heart, it lowers blood pressure, cholesterol levels, the risk of heart attack and stroke. Exercise reduces the risk of inflammatory bowel disease and both prevents and treats type 2 diabetes, the most expensive health problem in the United States with annual costs over $100 billion. Regular exercise has even been shown to reduce the frequency of 13 types of cancer including breast, colon, ovarian and endometrial in a large, recent study of 1.44 million subjects.

The major health benefits of exercise kick in at 150 minutes per week of moderate intensity, or at 75 minutes per week of high intensity work.

Exercise is the most efficacious drug known to humankind, works for everyone who takes it, has no side effects, and is free.

That’s why there’s a push to include exercise, as determined through a fitness tracker, as a fifth vital sign along with height, weight, pulse and blood pressure. Movement promotes health and wellness, so why not start tracking it?

The best exercise for you

The ideal form of exercise for you is … something that you’ll actually do! As I discussed in my previous column, smiling and fun promote exercise compliance. If you’re smiling, keep doing exactly what you’re doing.

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In terms of body maintenance, most exercise recommendations involve a combination of endurance training such as walking or swimming, flexibility training such as yoga, and strength training. Although there’s no exact science here, finding the correct formula usually means picking some of each of these activities. This might mean jogging twice per week, trying a HIIT workout once or twice per week, and taking a yoga class. There’s no exact answer, the key is to find what works for you, smile and work hard.

Do as much exercise as you can, there’s no upper limit. When possible, try and keep your total above the recommended weekly “dose” and you’ll be more likely to stay out of the doctor’s office and on your field of choice.

Dr. Jordan D. Metzl is a sports medicine physician at the Hospital for Special Surgery in New York and the author of five books including “The Workout Prescription.” He has completed 34 marathons and 14 Ironman triathalons.

George Clooney is ready for fatherhood

Story highlights

  • Clooney and his wife are expecting twins
  • A pair of names are already off the table

While in Las Vegas at CinemaCon to promote his new film “Suburbicon,” which Clooney directed, he also made time to talk about his growing family with wife Amal.

The first time father told Extra his “amazing” wife is doing well.

“I don’t have anything to do” he said. “There is nothing I can do to help, but make tea and stuff.”

Clooney told E! he couldn’t be more excited.

“I didn’t know that we’d have kids,” he said. “I was very happy that we were going to get married and then [a pregnancy] seemed like the next step.”

Clooney said the couple is shying away from picking names for the twins prior to their birth.

“Because I’ve had friends pick out names around their parents and then it becomes … whatever name you pick they’re like, ‘Oh, I don’t like that,” he said. “That guy’s a prime minister … Can’t name her Susan. ‘You remember your Aunt Susan?'”

There are at least two names that have already been shot down.

“My wife says I can’t name them Casa and Amigos,” Clooney joked to Entertainment Tonight. “That’s the one thing I’m not allowed to do.”

Casamigos is the name of Clooney’s tequila company.

Will Congress finally vote on ISIS war?

But a vote on the war threatens to expose the divisions over the US military campaign between hawks and doves that have lingered since the Obama administration began fighting ISIS in 2014.

On the one hand, congressional approval for the ISIS war could be a public affirmation of President Donald Trump’s plans to accelerate the military campaign and potentially give the commander in chief a freer hand to ramp up troop deployments across the Middle East.

On the other, anti-war lawmakers could press for restrictions on troop numbers and their theater of battle, imposing limits that don’t exist under the current post-9/11 authorization for fighting al Qaeda that successive administrations have until now relied on to fight ISIS as well.

The bipartisan group of lawmakers that for years has tried to force Congress to authorize the war against ISIS, arguing Congress is giving up its constitutional authority to declare war, says Trump’s desire to accelerate the ISIS campaign stresses the need for a formal vote on the war. 

“I haven’t thought that this war against ISIS is constitutionally authorized from the beginning,” said Democratic Connecticut Sen. Chris Murphy. “Now that we’re talking about a potential massive increase in troop presence, we need to put some boundaries around it congressionally.” 

The White House has yet to weigh in directly on the issue, but like the Obama administration, the Trump administration says it has the legal authority to conduct its ISIS campaign even without congressional approval.

But one top administration official signaled the administration also sees a benefit to a new ISIS war authorization — albeit for different reasons than many Democratic advocates.

Defense Secretary James Mattis told a Senate panel last week that he wants them to authorize the war against ISIS because, “I think it would be a statement of the American people’s resolve if you did so.”

“I thought the same thing for the last several years, I might add, and have not understood why the Congress has not come forward with this, at least the debate,” he added.

Congress has been reluctant to debate — let alone vote on — a war authorization, due to an inability to find consensus as well as political concerns that a vote could be used against them later on, as Hillary Clinton’s vote in favor of the Iraq War was.

“I think Congress should weigh in and say what the support should look like, but the devil is in the details” of any authorization for use of military force, Washington Rep. Adam Smith, the top Democrat on the House Armed Services Committee, told CNN. “I don’t want the AUMF to be a blank check to the President to do anything he wants, anywhere, anytime, for any reason.”

Mattis delivered a plan to Trump to accelerate that campaign, and additional US troops in recent days have deployed to Iraq and Syria, including an air assault as part of a major offensive led by US-backed fighters to retake a dam near Raqqa, Syria. Soldiers from the 82nd Airborne Division were deploying to Iraq in the “low hundreds” this week, according to a US defense official.
The Trump administration is also looking at stepping up the US military’s involvement in Yemen’s civil war, and has loosened the rules for counter-terrorism missions in parts of the country.

Democratic Sen. Tim Kaine of Virginia and Republican Sen. Jeff Flake of Arizona tried to team up to pass a war authorization during the Obama administration, and they told CNN they’re now reworking a bill that can get support from both parties.

“We had a bill in for a couple of years nobody was interested in — we tried to wordsmith differences between Democrats and Republicans — so we’re actually exploring some different ways of coming at it,” Kaine said. “It’s the beginning of an administration, a new plan on the table might be time to look at it, and I think Gen. Mattis helps us move in that direction.”

Other Democrats predicted Trump could force Congress’ hand to pass a war authorization if he were to dive too far into military adventurism.

“I’ll tell you what will make it happen, is if the President takes some kind of aggressive military action that’s unexpected and that is not envisioned as just a continuation of the Global War on Terror,” Missouri Democrat Claire McCaskill told CNN.

But for Republicans, a “robust” war authorization is what’s needed so the commander in chief’s hands are not tied.

“The draft that the Obama administration put out … it was very, very limiting, extremely limiting,” said Alaska Sen. Dan Sullivan. “It might have a better chance now that we have a White House that probably will have a different outlook.”

Mattis said at last week’s hearing that he does not support limitations on time or geography in a war authorization. 

“Due to the nature of this enemy’s threat, that would only work to help the enemy,” Mattis said in response to a question from Sen. Lindsey Graham, a South Carolina Republican, about geographic restrictions.

Senate Foreign Relations Chairman Bob Corker, whose committee would handle legislation to vote on the war, said he wanted the administration to articulate its ISIS strategy first, and then Congress could consider passing an AUMF.

“We’ve said from day one, even back under the Obama days, we’d like for the administration to lay out a strategy. That never really happened,” the Tennessee Republican said. “I do think these guys are formulating one and we’ll see where it goes.”

Dishonesty all around on Gorsuch

In an op-ed for The Arizona Republic, Sen. Jeff Flake declared, “Even President Obama’s two Supreme Court nominees were recognized for their ability to do the job and confirmed without incident.” Sen. John Cornyn of Texas quoted The Wall Street Journal when he tweeted, “Never in U.S. history have we had a successful partisan filibuster of a Supreme Court nominee.” Senate Majority Leader Mitch McConnell accused Democrats of using “obstructionist tactics” to thwart the confirmation of Judge Neil Gorsuch to the Supreme Court.

Their hypocrisy is palpable.

In referencing President Barack Obama’s “two” Supreme Court nominees, Flake is conveniently forgetting to tell his readers that Obama made three nominations to the Supreme Court, not two: Justices Sonia Sotomayor and Elena Kagan, whom the Senate confirmed, and Judge Merrick Garland, whom Senate Republicans refused to consider even though Obama had almost a year left in his term.

Cornyn surely knows that Senate Republicans effectively engaged in a partisan filibuster of Garland’s nomination by refusing even to hold hearings.

And McConnell must recognize that he himself led “obstructionist tactics” to prevent Garland, as Obama’s nominee, from joining the court.

Regardless of the “alternative facts” the Republicans are peddling, we should all understand the GOP’s tactics last year in opposing Garland for what they were: a blatant power grab that ultimately worked.

For their part, Democratic senators who are opposing Gorsuch are not immune from this affliction. There is no principled reason to oppose Gorsuch beyond politics. On any objective measure he is qualified for the job. If Justice Antonin Scalia had passed away this past February, after President Donald Trump took office, then there would be little justification for Democrats to filibuster Gorsuch’s nomination. The Republicans’ brazen action last year on Obama’s nominee clouds the current debate.
Both sides should acknowledge what is really going on: Republicans refused to consider Garland for purely political reasons; Democrats are going to filibuster Gorsuch for similarly partisan justifications.
This state of affairs shows that the Supreme Court confirmation process is broken. As Justice Ruth Bader Ginsburg herself recognized, some Republican senators who voted to confirm her in 1993 “today wouldn’t touch me with a 10-foot pole.” The Senate voted to confirm Ginsburg by a 96-3 vote. That kind of bipartisanship on Supreme Court nominees is unfathomable today.

What can we do to fix the problem? For one, senators on both sides need to start telling the truth about their real motivations. Republicans should not hide behind a false claim that the Senate treated Obama’s nominees fairly.

Democrats should acknowledge that their filibuster of Gorsuch is directly related to the Republicans’ failure to consider Garland. Actually telling the truth — which should not be so unfathomable — will help voters discern whether to trust the current incumbents come the next election. Senators’ actions should have consequences, but it is difficult for average Americans to evaluate their senator’s activities without honest and accurate information.

In addition, Senate Republicans and the Trump White House should offer Democrats an olive branch. Perhaps it is an agreement to consider only names from a pre-approved list that the Democrats provide for the next vacancy. Maybe Republicans would agree to give Garland a vote if a liberal such as Ginsburg steps down. Or perhaps there is something else that would cause both sides to stand down.

And both because they are in the majority and because they were at fault last year by being so political with the Garland nomination to the Supreme Court, Republicans should be the first actors in a ceasefire. Although the confirmation process was already breaking down somewhat before last year, McConnell pushed it over the edge by refusing to consider Obama’s choice with almost a full year left in the presidential term.

Good leaders know how to compromise for the good of the country. McConnell should show his leadership skills. Both sides are obscuring their real motives for their partisan actions. Neither side’s spin is good for the country.

To get that message across to the Senate, let’s tell our representatives they must acknowledge what they are really doing and force them to account for their political power grabs. It would be the first step in fixing a truly broken process.

Senator opens investigation into manufacturers

The companies were targeted based on their role in manufacturing some of the opioid painkillers with the highest sales in 2015.

The United States is in the midst of an opioid epidemic. According to the United Stated Centers for Disease Control and Prevention, since 1999, the number of drug overdose deaths involving prescription drugs has quadrupled. During the same time period, the sales of prescription drugs have also increased four-fold. In 2014, nearly 2 million Americans abused or depended on prescription drugs.
McCaskill is the senior Democrat on the Senate Homeland Security and Governmental Affairs Committee. This is not her first effort in attempting to uncover what has contributed to this epidemic. Earlier this year, she requested the Department of Justice Office of the Inspector General open an investigation into the role of drug distributors in the opioid epidemic. In addition, she’s also been involved in investigating Medicare Part D’s role in preventing abuse of prescription narcotics.

‘Single-handedly destroying families’

“I hear it everywhere I go: ‘Drug overdose deaths, the vast majority of them related to prescription opioids or heroin, are single-handedly destroying families and communities across Missouri and the country,’ and I refuse to just stand by and watch, we have an obligation to everyone devastated by this epidemic to find answers,” McCaskill said in a statement.

This is not the first time the Senate has investigated the relationship of drug manufacturers in the opioid epidemic. In 2012 the Senate Finance Committee began looking into the relationship between drug manufacturers and pain organizations that advocated for their use. The findings have yet to be released.
In addition, counties and cities across the country have begun filing lawsuits against manufacturers for their roles in the drug epidemic. In Cabell County, West Virginia a complaint was filed (PDF) earlier this month alleging that between 2007 and 2012, drug companies and distributors, including pharmacies such as Walgreen’s and Rite Aid, sold nearly 40 million doses of prescription opiates such as hydrocodone and oxycodone to county pharmacies. The county population during those years grew from just over 94,000 to just over 96,000 people. Similarly, nearby Kanawha County, West Virginia, filed a lawsuit (PDF) at the same time alleging the drug companies sold 66 million doses of these medications during the same time period when the county population ranged from about 191,000 to 192,000 residents.
The cities of Everett, Washington and Chicago, Illinois (PDF) have also filed similar complaints, alleging aggressive marketing and deceptive messaging about the risks of opioid painkillers.

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“All of this didn’t happen overnight. It happened one prescription and marketing program at a time. The vast majority of the employees, executives, sales representatives, scientists, and doctors involved with this industry are good people and responsible actors, but some are not. This investigation is about finding out whether the same practices that led to this epidemic still continue today, and if decisions are being made that harm the public health,” said McCaskill.

In response to the investigation, Purdue Pharma issued the following comment: “The opioid crisis is among our nation’s top health challenges, which is why our company has dedicated itself for years to being part of the solution. OxyContin accounts for only 2% of the opioid analgesic prescriptions nationally, but we are an industry leader in the development of abuse-deterrent technology and advocating for the use of prescription drug monitoring programs. We are reviewing Senator McCaskill’s letter and will respond accordingly.”

Netflix’s binge-worthy soap in teen’s suicide

Adapted from a 2007 young-adult novel, and counting writer-director Tom McCarthy (“Spotlight”) and Selena Gomez among its creative team, the series oscillates between the recent past and present, gradually puttying in the circumstances surrounding Hannah (Katherine Langford), who, a la “The Lovely Bones,” essentially narrates her own tragic tale.

The twist is that Hannah recorded a series of cassettes detailing what transpired, which are being circulated posthumously among her friends. “I’m about to tell you the story of my life,” she explains in soothing tones near the outset. “More specifically, why my life ended.”

Each hour thus advances the ball forward gradually, highlighting the contributory role of a different peer in Hannah’s orbit. The current story primarily unfolds from the perspective of Clay (Dylan Minnette), a shy boy who worked with Hannah and obviously harbored feelings for her.

Beyond chronicling the cruelties and pressures of high school’s caste system (certainly pretty well-worn territory), “13 Reasons” unwraps a series of escalating incidents and consequences. The made-for-Netflix device, meanwhile, enhances the mystery, since many of the kids have already heard all the cassettes, know who Hannah blames and hint that she might not be a wholly reliable narrator.

The producers have done an exceptional job casting the teen roles. Despite its focus on the kids, though, the show doesn’t completely reduce the parents to a Charlie Brown cartoon. Kate Walsh plays Hannah’s desperate mother, while Steven Weber is the school principal, clearly concerned about liability issues regarding the tragedy that occurred on his watch.

From a commercial standpoint, “13 Reasons Why” feels like an ideal Netflix show — tailored to a hard-to-reach demographic, offering the kind of mystery that’s meant to be binged.

The main disclaimer, having seen the entire first season, is that the show doesn’t deliver a tidy ending, which merely creates possibilities for a second season. It’s worth noting, too, that the drama doesn’t shy away from several key moments that are clearly not for the faint of heart, so if teens tune in, younger siblings should beware.

The grim details are arguably necessary to tell Hannah’s story without romanticizing it — always a danger when dealing with teen suicide — and help viewers understand why she felt so hopeless. “Maybe you did something cruel,” she says on the tapes during the second episode. “Or maybe you just watched it happen.”

In a sense, “13 Reasons Why” turns its audience into voyeuristic bystanders as well. Yet while Hannah’s fate isn’t pleasant, as presented in this enticing, slickly constructed package, it’s hard to look away.

“13 Reasons Why” premieres March 31 on Netflix.

Emily Deschanel on final ‘Bones’ show

It was around 5 a.m. on a day back in December when Emily Deschanel closed the door on a 12-year chapter in her life and finally hung up her lab coat as Dr. Temperance Brennan on Fox’s “Bones.”

The previous night was a lot more than a typical day in the lab, however.

The cast and crew of “Bones” were on location filming the climax of their series finale episode — an intense scene where Brennan and Booth (David Boreanaz) take on vengeful killer Mark Kovac (Gerard Celasco).

Boreanaz was at the helm, serving as director on the action-filled night, full of shoot outs, running, falling, and, eventually, a lot of tears.

Deschanel had planned to come back the next night for a few more scenes, but a half hour before they were set to depart set, Boreanaz told her that he could get everything he needed that evening.

“It was a little bit of a shock,” Deschanel said. “It was emotional. I burst into tears and choked up and said goodbye to people. It was really strange — and then it took two hours to drive home.”

How to say goodbye

It was a bit of a long goodbye for “Bones.”

Fox announced in February 2016 that the show was renewed for what would be a 12th and final season — “a good run,” Deschanel calls it.

The show’s final episode aired Tuesday.

Showrunners had time to plan one final arc and a proper farewell for loyal fans, who’d followed the show to 23 different time slots over the years.

Executive producer Jonathan Collier, who’s been with the show for six seasons, wanted to bring character stories full circle with something impactful. So he and fellow showrunner Michael Peterson looked to the past to find the show’s future.

In a Season 1 episode written by longtime executive producer Stephen Nathan they found their answer — a storyline that recalled Booth’s time as a sniper and a particular instance where he killed a boy’s warlord father during his son’s birthday party.

“We thought this would be a great way to show an emotional journey for Booth for the show,” Collier told CNN. “He finds healing and redemption.”

Kovac was killed in the series finale.

“[Booth] reached a place with Brennan where he’s no longer in pain,” Collier said of the finale. “Or he at least has the tools to deal with his pain.”

Emily Deschanel and David Boreanaz in the series finale episode of "Bones."

For Brennan, the episode contained another twist. Following a lab explosion in the penultimate episode, she lost the scientific, crime-solving abilities for which she’s become famous. Doing this allowed the writers to show how much she’s grown, Collier said.

Though the character identified herself purely by her abilities in the early seasons, the last 12 years have proven to Brennan that she’s so much more than that.

“She defines herself by her abilities, by this enormous ability she has and this brilliance and this capability, and what happens when you strip that away?” he said. “Maybe something even more important remains….We wanted to have that emotional wholeness at the end.”

Deschanel was fascinated by the concept and encouraged the writers to explore the idea to its deepest depths.

The finale has an especially emotional scene where Booth and Brennan share a sweet conversation in the office about how much Brennan — with her abilities or not — means to Booth.

“I thought they did a great job coming up with a story that really kind of wraps up a lot of storylines and characters,” she said. “It’s dramatic but also satisfying in many ways. I thought they did an amazing job.”

Is this REALLY the end?

The finale also set up all of the show’s favorites for the future.

Camille (Tamara Taylor) and Arastoo (Pej Vahdat) adopted three children. She took a six month leave to help her children settle in.

In her absence, Hodgins (T. J. Thyne) was appointed temporary director — or “king of the lab,” one of the show’s running jokes.

Aubrey (John Boyd) got a promotion that would keep him in D.C. instead of moving across the country. And Angela (Michaela Conlin) wrote a children’s book.

The writers solved a long-time mystery, as well — the meaning of “447,” a number that has popped up repeatedly on the series and has been the subject of fan speculation.

In the closing scene of the final episode, a scene between Brennan and Booth reveals the number is essentially a metaphor for perseverance.

“Oh, that was [decided] up until the end,” Collier said, laughing. “We were trying to figure it out. We all had different ideas for what it should be. All of us weighed in and it was going on for a long time.”

The goal was to leave viewers with a sense of peace and hopefulness, Collier said.

“The characters are okay; they’re well and good,” he said. “The big thing, too, is I really hope it’s a positive message that adversity can be overcome. Everyone has problems in their lives. These people have a problem every week, and a huge problem at the end. But they’re together and they overcome it.”

But is this really the end for “Bones?”

The cast and producers have been open about the fact that the decision to end the show was prompted by the network — but there’s no hard feelings. And no reason to close the door on a possible return of some kind in the future, said Deschanel.

“I would not rule it out,” she said.

Meditating can help you live to 100

In the past, my family and friends would’ve typically described me as pleasant but hurried. My baseline restlessness and edginess, however, have now nearly vanished.

Without difficulty, I have sustained attention when my young children spend time with me. Instead of constant surveillance of my phone, there is an ability to quickly hyper-focus on the task is at hand and a corresponding joy of living in a distraction-less world.

This change seems to have started the end of last year, after I spent a morning meditating with the Dalai Lama.

First off: Yes, I do feel a little ridiculous writing a line like that, and I didn’t feel worthy of his invitation at the time. Even though I meditate, I’ve never been sure whether I was using proper technique or whether there was an acceptable way to meditate in the presence of His Holiness.

If he was looking forward to a good meditation partner, I worried he was unlikely to find it in me. Even my posture is terrible when sitting cross-legged on the floor. My back starts to hurt, followed by my knees. Thus, my breathing, which is supposed to drive my focus, sounds raspy and uneven. All this makes my mind race instead of slowing down and calming.

Just thinking about meditating with His Holiness was making me anxious.

Nevertheless, who says “no” to a chance to meditate with the Dalai Lama? I agreed to join him early the next morning at his private residence.

A practice that begins at 3 a.m.

At 81 years, old, the Dalai Lama keeps a very active schedule. I met him in Mundgod, India, at the Drepung Monastery, where he was overseeing a symposium bridging Buddhism and science.

The monastery itself is a dazzling bejeweled structure built 600 years ago. Inside, there are enormous golden Buddhas standing next to ornate walls. The discussion hall itself is grand but warm, with doors and windows open to the hot South Indian sun.

For three days, his Holiness moderated sessions on weighty metaphysical topics such as the criteria for valid reasoning, the fundamental constituents of the universe, origins of life and the subjective experience of the mind.

It was fascinating and mind-bending — but also mentally exhausting. It was difficult to stay awake, let alone keep up with the rapid-fire debate between the Buddhists and the scientists. Yet his Holiness was mentally engaged and inquisitive throughout, even more remarkable given more than half the comments were being translated for him.

The Dalai Lama typically wakes about 2:40 a.m. and starts his daily meditation routine at 3 a.m., even as most of his staff is still snoozing.

This was the backdrop when one of his senior staff members picked me up outside the monastery early one morning. We drove in a three-car convoy to the gates outside his private residence.

From there, several more staff members escorted us to a small conference room where his security detail was slowly waking and drinking their morning tea. Finally, his chief of staff walked me just outside the personal quarters of the Dalai Lama.

Meditating is hard for him, too

There were a few minor instructions before we entered. Eye contact is not a problem, and shaking hands is acceptable if you use two hands, not just one. Try not to turn your back to him when leaving the room, and instead walk backward, as much as possible facing him. When sitting cross-legged on the floor, don’t point your feet at the Dalai Lama. And the correct address is “your holiness.”

Shortly after, the doors opened, and I nervously walked into a very modest room where the Dalai Lama was sitting on a raised platform, already deep in meditation. I slipped off my shoes, sat cross-legged at a slight angle on the floor to avoid my toes being pointed in his direction, closed my eyes and started to focus on my breathing.

All my meditation insecurities immediately started to kick in. After a few minutes, I heard his deep, distinctive baritone voice: “Any questions?”

I looked up and saw his smiling face, starting to break into his characteristic head-bobbing laugh.

“This is hard for me,” I said.

“Me, too!” he exclaimed. “After doing daily for 60 years, it is still hard.”

It was at once surprising and reassuring to hear him say this. The Dalai Lama, Buddhist monk and spiritual leader of Tibet, also has trouble meditating.

“I think you will like analytical meditation,” he told me. Instead of focusing on a chosen object, as in single-point meditation, he suggested I think about a problem I was trying to solve, a topic I may have read about recently or one of the philosophical areas from the earlier sessions.

He wanted me to separate the problem or issue from everything else by placing it in a large, clear bubble. With my eyes closed, I thought of something nagging at me — something I couldn’t quite solve. As I placed the physical embodiment of this problem into the bubble, several things started to happen very naturally.

The problem was now directly in front of me, floating weightlessly. In my mind, I could rotate it, spin it or flip it upside-down. It was an exercise to develop hyper-focus.

Less intuitively, as the bubble was rising, it was also disentangling itself from any other attachments, such as subjective emotional considerations. I could visualize it, as the problem isolated itself, and came into a clear-eyed view.

Too often, we allow unrelated emotional factors to blur the elegant and practical solutions right in front of us. It can be dispiriting and frustrating. Through analytical meditation, His Holiness told me, we can use logic and reason to more clearly identify the question at hand, separate it from irrelevant considerations, erase doubt and brightly illuminate the answers. It was simple and sensible. Most important, for me — it worked.

Meditation for skeptics

As a neuroscientist, I never expected that a Buddhist monk, even the Dalai Lama, would teach me how to better incorporate deduction and critical thinking to my life — but that is what happened.

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It changed me. And I am better for it. I practice analytical meditation every day, usually early in the morning. The first two minutes are still the hardest, as I create my thought bubble and let it float above me. After that, I reach what can best be described as a “flow” state, in which 20 to 30 minutes pass easily.

I am more convinced than ever that even the most ardent skeptics could find success with analytical meditation.

Over the holidays, I spent as much time as possible relaying the Dalai Lama’s teachings to my family and friends and teaching them basic principles of analytical meditation. This was the gift I most wanted to share with them. And now with you.

Greatest rise in heroin use was among white people, study says

More people die from drug overdoses than from guns or car accidents. At the peak of the AIDS epidemic in 1995, 43,115 people in the United States died from the disease.

Furthermore, since 1999, the number of overdoses from prescription opioids like oxycodone and hydrocodone, as well as illicit drugs like heroin, have quadrupled. In fact, heroin now accounts for one in four overdose deaths in the United States.

Now, a new study in the journal JAMA Psychiatry looks beyond the total number of overdose deaths to get a better picture of how heroin use patterns have changed since 2001. Since then, the number of people who have used heroin has increased almost five-fold, and the number of people who abuse heroin has approximately tripled.

The greatest increases in use occurred among white males.

Heroin use on the rise

The authors evaluated the responses of 79,402 individuals, as collected from the 2001-2002 and the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions, a longitudinal study conducted by the National Institutes of Health to evaluate alcohol and drug use and abuse. While heroin use between whites and non-whites was fairly similar in the 2001-2002 results, at 0.34% and 0.32% respectively, by 2012-2013 the percentage of whites who had used heroin jumped to 1.90%. Just 1.05% of non-whites in 2012-2013 used heroin. Heroin use also increased significantly among those with a high school education or less, as well as those who lived at less than 100% of the federal poverty line.

The authors of the new report write “these trends are concerning because increases in the prevalence of heroin use and use disorder have been occurring among vulnerable individuals who have few resources to overcome problems associated with use.”

According to a 2016 Surgeon General’s report on alcohol, drugs and health, only one in 10 of those with a substance use disorder receive any treatment.
“The good news is that among all drugs of abuse, heroin and opioids have by far the best treatment medications available. Methadone and buprenorphine have proven effectiveness data, they not only reduce the chances of dying from an opioid overdose by 50%, they support people being in recovery from their addiction and reduce health care costs and improve a wide array of other outcomes,” said Caleb Banta-Green, an associate professor of health services at the University of Washington. Banta-Green was not involved in the study.

Starting with prescription drugs

The study also confirmed the idea that many heroin users start by using prescription opioids like oxycodone and hydrocodone. Approximately one-third of all white heroin users reported using prescription drugs for non-medical purposes in 2001-2002. By 2013 more than half of all white heroin users started by initially using prescription drugs. For non-whites, the number of people who started by using prescription drugs before heroin actually dropped in the same time frame.

An accompanying editorial by Bertha Madras, a psychologist at McLean Hospital in Massachusetts and former deputy director in the White House’s Office of National Drug Control and Policy pointed to the shift in treating pain as a major factor in understanding the current crisis. She noted that in the past two decades, the number of opioid prescriptions has risen three-fold.

“This shift in practice norms was fueled by acceptance of low quality evidence that opioids are a relatively benign remedy for managing chronic pain,” she wrote. “These vast opioid supplies created a risk for diversion, opioid misuse and disorder, and overdose death.”

The study did not find any significant difference when looking at what age groups were using heroin, but heroin dependency and addiction was significantly higher for those below the age of 45 than those above. That should be a cause of concern, said Banta-Green, who noted that one of the costs of overdoses and abuse to society is lost productivity.

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A county-by-county study released Wednesday by the Robert Wood Johnson Foundation, calculated that drug overdose deaths resulted in a 778 years of potential life lost for every hundred thousand people. This report also found that most of the increase in premature deaths in 15- to 44-year-olds is due to drug overdoses. And while no community is immune to this crisis, suburbs, which used to have the lowest rates of premature deaths from drug overdoses now have the highest rates.

The authors of the longitudinal study note that “heroin use appears to have become more socially acceptable among suburban and rural white individuals, perhaps because its effects seem so similar to those of widely available [prescription opioids].”

The findings of these new reports are in line with earlier research over the past two decades about increasing heroin and opioid overdoses. “The trend isn’t a surprise — the takeaway is what matters. Heroin use disorder is a serious medical condition with which individuals are likely to struggle for the rest of their life. We need to give them the tools they need to survive and thrive,” said Banta-Green.

Clinton makes political remarks

“There is no place I’d rather be than here with you,” Clinton said, before adding: “Other than the White House.”

During her keynote address at the annual conference hosted by the Professional BusinessWomen of California, Clinton spoke largely about women’s equality and peppered in criticism of President Donald Trump and the Republican Party.

“Obviously the outcome of the election wasn’t the one I hoped for, worked for, but I will never stop speaking out for common sense benefits that will allow moms and dads to stay on the job,” Clinton said.

Besides a few comments in public gatherings and tweets from her personal account, Clinton has largely laid low since the election. She was spotted after the election in the woods near her New York home and, along with her husband former President Bill Clinton, she attended Trump’s inauguration.

She called Republicans’ attempted replacement for the Affordable Care Act “a disastrous bill,” adding that the Trump administration has been “met with a wave of resistance” that indicates the protests against Trump’s policies are just getting started.

“People who had never been active in politics told their stories at town hall meetings.” Clinton said. “They were people who had something to say and were determined to be heard.”

During the question and answer portion of her appearance, she grew incredulous at the GOP health care debate.

“Really? Take away maternity care?” Clinton said. “Who do these people talk to?”

Clinton also focused on issues like inclusivity and diversity of women in the workplace and the need for the private sector to make better efforts to bring more women to the table.

“Advancing the rights and opportunities of women and girls is the great unfinished business of the 21st century,” she said, while noting that women’s representation in Washington is “the lowest it’s been in a generation.”

‘A lifetime of practice’

The former secretary of state also responded to racially charged incidents directed at two prominent black women today.

In one, White House press Secretary Sean Spicer told April Ryan, a longtime White House correspondent and one of the few black women journalists in the press briefing room, to “stop shaking your head” and accused her of being “hell-bent on trying to make sure that whatever image you want to tell about this White House stays.”

In another, Fox News host Bill O’Reilly came under fire for racist comments mocking Rep. Maxine Waters’ hair, saying her hair looked like a “James Brown wig.”

O’Reilly later apologized, but not after a slew of controversy. Tuesday, Clinton said Waters had been “taunted by a racist joke about her hair.”

Women of color, said Clinton, have “a lifetime of practice taking precisely these kinds of indignities in stride.”

‘Resist, insist’

On the policy front, Clinton criticized the US for still not having a national paid family leave policy and said those who do benefit from such policies are often among the highest income workers. Clinton called on the private sector to do more to help.

“You’re the people who figured out how to fit computers in the palms of our hands,” she said. “You have the power.”

But overall, Clinton offered an optimistic tone in the face of Trump’s victory.

“Where some see a dark vision of carnage, I see a light shining on creativity and opportunity,” she said, referencing the inaugural address.

She offered the audience her new mantra: “Resist, insist, persist, enlist.”

She encouraged the audience to “resist actions that go against our values as Americans,” insist on “putting people first,” “persist” like Sen. Elizabeth Warren did when she was prevented from reading a letter written by Coretta Scott King about Sen. Jeff Sessions, and “enlist” others by running for office or opening a business.

“I’ll be right there with you every step of the way,” she said.