Second Middle Age & Coronavirus

It is safe to say that the Coronavirus has upended expectations and amplified fears of what will happen next in 2020.  We may have started out with ambitious plans for work or family in the new year, only to run headlong into the COVID-19 shut-down.  

A long-time friend and colleague recently sent me the following: 

“I have come across a new acronym which very appropriately describes our present situation. It is VUCA – Volatile, Uncertain, Complex and Ambiguous.”

Dr. Vijai Kumar, President and Chief Medical Officer, Excel Life Sciences

VUCA is an ugly acronym that is apt for our times.  

We have learned the distinctions between Coronavirus curfews, quarantine and the dreaded COVID-19 isolation (total separation of the side from the healthy within a family or living unit).  

What is worse, doctors and scientists are still in the early stages of understanding the Coronavirus and developing effective therapies or cures.  There is no vaccine and yet people condemn the future vaccine out of ignorance and fear.

The snail emerges from its shell when danger has passed.
A snail eventually emerges from its shell after danger has passed.

And if we are the lucky ones that have not been infected with COVID-19 or seen family members suffer or die from this serious illness, we may still suffer in the present and worry about the future.

The best public health practices (social distancing, wearing masks, etc.) come at a high cost – emotional, psychological and of course economic.

We ask ourselves – if I am not going to work/school and and stuck at home all day why can’t I at least do my yoga? (fill in the blank with whatever exercise or activity you have been avoiding  – you get the idea.)

So how can the lessons of Second Middle Age help us during the Coronavirus (COVID-19) Pandemic?

The reality is that when everyone is home, it changes everything. 

Living in the time of Coronavirus exacerbates our existing interpersonal, professional or financial problems. In my case, while there have been silver linings (more on that later), COVID-19 blocked my ability even to think about blogging.  Apart from occasional bursts on Instagram, I have not posted a single installment on between March 2 and today.

As one of the lucky ones, I am living in a place with a strong public health safety net, relatively low COVID casualties, and a gradual return to normalcy. And so I am back, thinking about what the lessons Second Middle Age, and how they may help me to navigate the profound uncertainties of the present and the future.  

What about you?  

Parenting 360 – Take 2

In your Second Middle Age you may need to ‘Parent-up’ – taking a role in care of both your own kids and your parents.  This is what Parenting 360 is all about.

There is a truism that everyone experiences special needs at some point in life.  For the truly fortunate, this comes with advanced age, and with the support of one’s own adult children or other loved ones.  Many of us may experience special needs through our own children and/or loved ones.

As the primary care-giver for an adult son with special needs, I have had the opportunity to learn over the last 25+ years that life can be very rich in love and in special experiences, so long as we live in reality and not in our dreams.* In Second Middle Age this reality only becomes more prevalent and more intense as we add our own mother and/or father to the mix.

Parenting-up may include supporting a healthy diet; basic – yes, important – also yes.

When our children were young – with or without special needs, for the most part we had the luxury of not worrying about the day to day lives of our parents.  Now as we ourselves enter our Second Middle Age, in many cases our special needs children need us now more than ever, with less or a roadmap to successful parenting.*  If we are lucky, we find ourselves playing the role of parent to our own mothers and fathers.

As hard as it may be to fight the good fight every day for your special needs child as he or she navigates early adulthood and beyond, it is a fundamentally different challenge to address the evolving needs of your aging parent(s).

In other words, at the same time that you may be struggling with how to support your child (or children) to gain greater independence, you come to terms with the reality that your mother and/or father is no longer able to live independently.

Generally speaking, no one wants to usurp the autonomy or authority of their Mom or Dad.  It does not feel right or good.  It is also generally an unwelcome intrusion on your parent(s), who may not recognize or accept diminishing capacity to manage day to day challenges of life.  

There are a number of ways to provide needed support, depending on the circumstances, and the important thing is to lean in and not to assume that everything is ok, just because your mom or dad says so.

Time is not on your side.  You can take the approach of waiting for an ‘action forcing event’ like a fall at home or an illness requiring hospitalization.  In my experience, this is a terrifying option and one I can not recommend.  The sad reality is that a parent who insists on living without assistance for too long will ultimately lose more of the independence that he or she was desperate to keep.

A better alternative is the truth, stated through repeated, gentle discussion, to the effect that you love your parent and that you seek to preserve the most meaningful forms of independence for as long as possible, in a safe and secure environment. 

One of the hardest, and yet most important things you may ever do, is simply to recognize at a certain point it is time to ‘take the wheel.’

The bottom line:   Parenting 360 is both a challenge and an opportunity.  If you get the opportunity to parent-up, that means that one or more of your parents is still in this world and that is a good thing.

* We are accustomed to our children needing our help; in some cases in fact we run the risk of becoming an obstacle to progress, doing too much and expecting too little.  At other times we withdraw support too soon or we may rely at our own peril on medical/other experts who in fact have no idea what they are doing.

The Microbiome Diet ABCs – C is for Curtail Processed Foods

Earlier installments in this series focused on Probiotics and Prebiotics, two extremely important elements in the Microbiome Diet that we need every day. Now we come to Processed Foods – the elephant in the room – likely the greatest challenge for your Microbiome Diet and healthy Second Middle Age.

Most of us have grown up surrounded by convenience foods aka Processed Foods. These include packaged snacks, instant soups, noodles (yes, Ramen I’m looking at you), crackers, cookies, fast food and the like.

During my lifetime, Processed Foods have become the norm, making up more than half of the daily calories for most Americans, filling our pantries and crowding our plates and supplanting important nutrient-dense whole foods.

  • What is Processed Food?

At bottom, all food that is not eaten raw has some element of processing.  The 2 million year history of food processing includes important innovations like the invention of bread, beer/wine and cheese.

Most food that we eat undergoes some form of preparation before reaching your plate. Fermented foods contain healthy bacteria (probiotics); cooking some foods may improve their nutritional profile an/or their bioavailability (the ability of the body to absorb nutrients of a food).  

Canning or freezing foods contributes to longer shelf-life and improved affordability, and accessibility of fruits and vegetables.  Researchers classify these necessary steps in commercial food preparation as ‘minimally processed foods.’

In contrast, Processed Foods that are problematic (and addictive) are generally highly refined with any natural fiber eliminated or reduced – think white flour vs. wholegrain flour, white rice vs. brown rice, etc. Processed Foods are stripped of most if not all naturally occurring vitamins, minerals and other micronutrients and include unhealthy levels of salt and sugar. Products labeled ‘enriched’ may have nutrients that are not well-absorbed (bio-available) by the human body.

Some researchers have dubbed anything going beyond the minimum processing required for canning, freezing or similar preparation as ultra-processed foods, defined as:

“[F]ormulations of several ingredients which, besides salt, sugar, oils and fats, include food substances not used in culinary preparations, in particular, flavours, colours, sweeteners, emulsifiers and other additives used to imitate sensorial qualities of unprocessed or minimally processed foods and their culinary preparations or to disguise undesirable qualities of the final product.”

The Processed Foods in question commonly include soft drinks, fruit drinks and milk-based drinks; cakes, cookies and pies; salty snacks; frozen and shelf-stable plates; pizza and breakfast cereals. When I was a kid we called these junk foods – though we did not know at the time also to include most breakfast cereals in this category.

  • Why does curtailing Processed Food matter?

When more than half of our calories come from foods that are produced to mimic whole foods with none of their nutritional content, we are shortchanging our own long-term health for immediate gratification.

Processed foods displace whole foods, increasing the likelihood of weight gain and associated inflammation that is linked to diseases of aging like Type 2 diabetes, hypertension and heart disease.  

Moreover, there is an increasing body of research indicating that the very qualities of Processed Foods that may make them so appealing and addictive – emulsifiers, stabilizers, lower fiber, increased salt and sugar – harmful the microbial diversity needed for a healthy microbiome. 

By eating Processed Foods, we rob our bodies of needed nutrients and undermine the body’s ability to fight off disease. A 2019 Tufts University study estimated that nearly 3 million people die every year from stroke and heart disease attributable to a dearth of fruit and vegetables in the diet. 

Assuming that we can tell the difference between frozen peas and potato chips, it becomes simple to focus on the need to favor minimally processed whole foods over Processed Foods wherever possible. 

As a child growing up in the Detroit area, my Bubbie Edna invariably welcomed her grandchildren into her home with a bowl of fresh cantaloupe. She showed her love in so many ways, and one of them was to make sure she gave us a hug and a healthy snack as soon as we came in the door.  We can show our love for our families, friends, and ourselves by doing the same.  

The bottom line: We should curtail Processed Foods at all ages; it becomes urgent and important for your healthy second middle age.

The Microbiome Diet ABCs: B is for Boost Consumption of Prebiotics

This week’s blog post is dedicated to Prebiotics –  the unsung heroes of the Microbiome Diet.

We have already talked about the importance of the Microbiome Diet for your healthy Second Middle Age, and also the benefits of adding Probiotic foods to your daily diet to introduce greater microbial diversity.

There is a more to the Microbiome Diet, however, than just adding (delicious) fermented foods. Your body relies on the essential nutrients found in Prebiotics for effective care and feeding of our microbial fellow travelers.  Prebiotics are vegetables, fruits and whole grains that provide important dietary fiber to support your digestive health and promote the continuing diversity of the Microbiome. Due to their concentration of dietary fiber, Prebiotic foods also play an important role in metabolism and overall health including regulation of blood sugar, serum cholesterol levels in the bloodstream, supporting weight management and promoting regularity.

Without getting overly technical, we now have reached a better understanding of the essential importance of Probiotics to promote human health: 

During the metabolic process, that interdependent relationship exerts beneficial health effects to the host. For instance, probiotics selectively receive different prebiotics as nutrients from the host, initiate fermentation in the colon, provide the host with additional genetic and metabolic attributes, boost the immune system, and be able to harness nutrients that are otherwise inaccessible.

Getting your optimum daily requirement: most Americans fall short of the Prebiotic optimum daily requirement of 35 and 50 grams per day, based on the USDA Recommended Daily Allowances. (The RDA excludes prepared breakfast pastries, cereals, cookies, cakes and other processed foods.) Don’t let this happen to you; there are so many great vegetables, fruits and whole grains out there for you.


Prebiotic vegetables include salad vegetables and dark leafy greens like kale, cruciferous vegetables, like broccoli, cauliflower, asparagus, cabbage, and Brussels sprouts, as well as peas, beans/legumes, tomatoes, lettuce, green beans, spring onions or leeks, cucumbers, sweet peppers, eggplant, okra, beets, and mushrooms.   A salad is a nice civilized addition to any meal, and can even be the centerpiece of a really satisfying lunch or dinner. 

If you eat a colorful salad at least once a day, your Microbiome will thank you.

Images courtesy of Dates & Pomegranates – Health from Nature, Derech Beit Lechem, Jerusalem

If you make a habit of keeping track of the salad ingredients in your refrigerator – e.g,. 1 – 2 types of lettuce, cucumbers and carrots as a baseline – you too can have satisfying salads on demand. Another shortcut to good eating:  when you make a salad, unless you include an extremely perishable ingredients like avocado, you can double the normal quantity and have it on hand for lunch the next day, or else for tomorrow’s dinner.  

By adding whatever different items you want to the basic salad waiting for you in your refrigerator, you can make it convenient to eat right. For variety, add chickpeas, kidney beans or other legumes. In much of the world, beans and legumes are dietary staples that provide complete proteins and other essential nutrients in combination with whole grains. (1/2 cup cooked is a single serving.)

Also, salads can do double duty.  Yesterday’s cut vegetable for topping a bean burrito or tostada can become the basis for a Mediterranean salad/antipasto plate with the addition of a few extra ingredients.

Just read the labels when it comes to salad dressings which may be high in added sweeteners, sugar and/or salt. (Delicious fresh ideas for healthy salad dressings coming soon to this space!)


There is no substitute for fresh fruit in terms of both fiber and nutritional content.  Prepared processed fruit products and fruit juices are not equals to the real thing (more on processed foods next week).  Peaches, cantaloupe, apricots, nectarines, watermelon and prunes are all good sources of vitamin A.  Citrus fruit (including oranges and grapefruits), strawberries and watermelon are great sources of vitamin C.  Bananas provide fiber and potassium, and dried fruits are an excellent source of iron. Mangoes, in season, are an almost unparalleled source of many important vitamins and are also high in fiber. 

Like salad vegetables, you’ll find it much easier to eat more fruit if you plan ahead, keeping seasonally available fruit around the house pre-washed and prepped. It is great to try to eat 3 – 4 fruits each day (a good size banana counts as 2 fruits). If you are concerned that too much fruit may upset your digestive tract, start out slowly and see how it goes.

Whole Grains

Sourdough whole grain foods combine the goodness of Probiotics and Prebiotics in one delicious package. I love all kinds of fermented wholegrain products, from Indian dosas (vegan crepes) to sourdough pancakes, English

and good old-fashioned sourdough rye bread. Looking beyond sourdough (yes, it is hard for me to get beyond sourdough …), whole grains may include whole grain breads, barley, brown rice, popcorn, bulgur (cracked wheat), and my all- time favorite old fashioned thick-cut oats for morning oatmeal. Generally speaking, a serving is 1/2 cup (cooked).

There is no end to the wonders of Prebiotics, both in terms of their importance for your Microbiome Diet as well as how good they will make you feel as you sail into your Second Middle Age. Don’t take my word for it; there is real science behind the benefits of Prebiotics for good health at any age: (Figure 4)

The Microbiome Diet ABCs: A is for Add Probiotics

This week I would like to go into a little more detail on naturally occurring Probiotics – an important element in your Microbiome Diet to promote great health in your Second Middle Age.

As outlined in last week’s post on the Microbiome Diet, consumption of natural probiotics can support the immune system and fight inflammation for your healthy Second Middle Age. 

There is an increasing body of research supporting inclusion of probiotic foods to enhance microbial diversity in the gastrointestinal tract for better longterm health. 

But what exactly are probiotic foods, and how should they be included in your diet?

Natural probiotic foods containing live bacteria include fermented dairy products, fermented soy and other vegetables (e.g. pickles), and sourdough bread. Lactobacillus and Bifidobacteria, for example, are 2 highly beneficial families of microbes found in fermented dairy products and other probiotic foods. They have been studied in detail for their beneficial effects on antibiotic-associated diarrhea, inflammatory bowel disease and irritable bowel syndrome.  

What does this mean in practical terms? 

While it remains unclear what the minimum recommend daily requirements are, it is a good idea to eat at least one serving of fermented dairy every day, i.e., one cup of  unsweetened kefir, yogurt or leben.   Culture-rich cheeses (blue, brie, camembert and also traditional cheddars, Gouda, and Gruyere or other Alpine cheeses) remain controversial as sources of important microbes.

Other highly nutritious and delicious probiotic foods include traditional pickles, e.g., kimchi, sauerkraut;  fermented soy (miso, natto & tempeh), Kombucha (fermented tea), & sourdough bread. And interestingly enough, the benefits conveyed by eating different probiotic foods appear to be varied and quite substantial. For example:

  • Kimchi has been studied for a number of health benefits, including clinical trials – studies of people actively eating Kimchi on a regular basis – where consistent Kimchi consumption has been associated with improvements in insulin resistance, blood pressure and cholesterol. Kimchi is a great way to add interest to your favorite foods and I like to add my home-made Kimchi (left) salads, veggie burgers, and just about anything that needs a little bit of a flavor kick. (If you make your own Kimchi you can make it more or less spicy to suit your own taste.)

  • Fermented soy products including miso, natto and tempeh, also include Lactobacillus, and may provide cardio-vascular and circulatory benefits.  I like to add 1 – 2 tablespoons of miso to stir fry sauces and marinades.
  • Sourdough breads (and sourdough pancakes, muffins, etc.), also contain Lactobacillus culture in symbiotic combination with yeasts, and are more nutritious than other breads, including higher levels of folate and antioxidants, and improved bioavailability.  (If you have never had a sourdough English Muffin you are really in for a treat.)

Once you get started, it can be fun to make fermented foods at home; e.g., baking your own sourdough breads, or finding your favorite recipe for sour dill pickles or kimchi.

When you buy probiotic foods, take a good look at the labels to be sure that they are truly fermented, i.e., including live bacteria or labeled as ‘bio-active.’. This is particularly important for sourdough breads – always read the small print.

Given all the different types of natural probiotic foods, chances are, you may already be enjoying delicious probiotics in your diet without even realizing it.

And every culture has its own traditional fermented foods.

What’s your favorite?  

The Microbiome Diet

This entry provides a brief overview of the Microbiome and why the Microbiome Diet is important, including Microbiome ABCs. This is a favorite topic of mine; I have been a student of the microbiome and the potential for development of practical tools to advance human health for some time. More to the point, I have some great recipes! So this is just a down payment on an important topic for good health in your Second Middle Age.

You may have seen headlines for Microbiome science breakthroughs over the last few years and you may wonder what it has to do with you. In fact the Microbiome is the biome that has been inside of you all along.

We all come equipped with our own personal microbiome – a collection of approximately 100 trillion non-human cells, including bacteria and fungi that co-exist mostly in balance with our estimated 30 trillion human cells.   Due to their small size, non-human cells  represent only 1 – 3% of typical body weight (and are not making you look fat).  

Somewhere along the line, our microbial fellow-travelers lost their ability to live outside of the human body and compete against interlopers — hostile, disease causing organisms —in their own self-interest. As my science mentor, microbiology pioneer Dr Ananda M. Chakrabarty likes to say, biofilms in the human body “possess the evolutionary wisdom of 3 billion years.”

Every organ of the body has its own microbiome; our intestinal bacteria, for example, manufacture vitamins, regulate insulin levels, boost our immunity, and can help to mitigate levels of stress and anxiety.

Over the last 10-20 years scientists all around the world have learned a great deal about the important role of the diversity of our microbiomes for human health and in particular for reducing inflammation associated with the aging process. The really great news is that the most important ingredients you need to support a healthy microbiome are as close as your neighborhood market.

Why the Microbiome Diet?

One of the most important things we have learned about the human microbiome is that it is highly transient, ie the microbial composition changes based on diet. Accordingly the ability of the microbiome to do its job to protect you is very much affected by the quality of your diet over time. The Microbiome Diet encourages the microbial diversity we all need for long term health.

Even – or perhaps especially – if you spent most of your life eating whatever you wanted, adopting a Microbiome Diet now may make a huge difference for a healthy Second Middle Age.

My Sourdough Rye-Spelt Bread – Probiotic and Delicious

The ABCs of the Microbiome Diet

Over time, following a Microbiome Diet should not be cumbersome or time-consuming. It is an intuitive and easy diet to follow, once you grasp the ABCs:

A – Add Naturally Occurring Probiotics: fermented foods.
Popular Probiotic foods include: unsweetened Kefir/Yogurt /Leben or other fermented dairy products, Sourdough breads, Miso, Kombucho, Kimchi, and Tempeh, among others

B – Boost Consumption of Prebiotics: fiber-rich whole fruits and vegetables, whole grain products and complex carbohydrates

C – Curtail Processed Foods: these include foods with fillers, colors, added sugars, high-fructose corn syrup, and/or artificial sweeteners, and other simple, low-fiber (refined) carbohydrates. This is all the stuff you already know is not good for you.

Adopting a Microbiome Diet is a delicious way to support your immune system to reduce inflammation for better health at every age. Anticipated benefits include potential for improved gastrointestinal functioning, ie reduction in stomach cramps and related constipation; possible reduction in anxiety and improvement in mood stability, and some suggest broader behavioral benefits for individuals on the Autism Spectrum and/or other Special Needs.

I hope this is helpful as a starting point. In the future I have a lot of recipes and even meal plans to share.

So stay tuned, and please also share your thoughts and experiences!

Your 2nd Middle Age: What are you doing for the next 20+ years of your life?

Do you remember that one kid in school who seemed preternaturally grown up, like a middle-aged adult? While life does not start in the middle for most of us, many people see their Middle Age years in retrospect as their most productive stage of life.

This Middle Age is generally defined as the years between 35 and 58, years that may be consumed by a range of important life challenges and opportunities. Our middle years may be important to us for many reasons, including relationship building, raising a family, spiritual growth, career development and/or financial success.  

Moreover, throughout the 20th century, people had limited expectations for life after Middle Age, perceived as a gateway to old age.  If life is a puzzle to be worked out, most people expected the pieces to be in place by the end of their 5th decade.

With the combination of life extension through emerging biotechnologies and rejection of societal expectations, your 1st Middle Age may be the prelude to a healthy, wealthy and wise 2nd Middle Age. 

Your 2nd Middle Age: take
a fresh look at the puzzle that is your life.

Now as we start 2020, we can take remake the puzzle, so to speak, and look beyond what I would now call the 1st Middle Age;  many people may have a robust 2nd Middle Age ahead of them, running from approximately the age of 58 – 80.

As I approach my own 59th birthday, I am thinking more about my 2nd Middle Age, and how to leverage what I have learned in my 1st Middle Age to enrich the decades ahead. My valued friend and colleague Dr. Ganzalo Laje and I hope to use this blog to explore some of the key issues relating to the 2nd Middle Age, including topics like:

– Microbiome Diet: Renewing the body’s ability to fight off pathogens for better health

– Parenting 360: Taking on the challenge of parenting our own our parents (as well as our Special Needs kids) 

– Alone Together: Successful singles & Couples Adjusting to the Empty Nest

– Benefits of Shaking it Up: Throwing the cards in the air for renewed joy and sense of purpose 

– Moving your Body: Maintaining / regaining flexibility, balance, strength and broader health benefits through movement

– After the Diet: Following the middle path for sustainable health

– Looking Within: Capturing Meaning through spirituality, meditation, contemplation or other practices to promote mindfulness and avoid rumination.

We hope you will join us on our journey to explore 2nd Middle Age, and that you will share your own, thoughts, experiences, hopes and dreams for this important period of life. The best is yet to come!

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