Dr. Dorothy Hitchmoth: “You do not have to train like a triathlete to improve your health”

Walking, stretching, and weight resistance activities are the most natural forms of exercise. If you can walk outside, even better. You do not have to train like a triathlete to improve your health. Again, I think most people set thresholds that may be unattainable, so I always encourage people to start with natural movements that you can fit into your day, all day. A simple walk, several trips up the stairs in your house or at work, and carting around the laundry basket count in my world. Maybe you can do some squats with your laundry basket!

I had a distinct pleasure of interviewing Dr. Dorothy Hitchmoth, an Innovative strategic alchemist and thought leader motivated by a passion for preserving vision, health and quality of life.

Dr. Hitchmoth is a nationally recognized executive and professional team leader who has advocated for patients, colleagues, and the public through countless symposia, public lectures and motivational speeches. She is a well-liked consensus builder with noted achievements in changing and improving the way we think about taking care of patients. She has a 24-year history as a physician executive and a dynamic track record of achievement in strategic systems change in government, private, and corporate sectors to include single location and hospital systems process improvements that include award-winning quality and safety improvements as well as successful product launch. Her leadership accomplishments, as part of state and national advocacy teams, have resulted in numerous changes in state and federal laws affecting patient access and care. She also successfully led national education campaigns for new product and service launches in the ophthalmic imaging, nutraceutical, pharmaceutical, and integrative medicine arenas. She is a prolific writer with countless publications.

Thank you for joining us! Can you share with us the story about how you first got involved in wellness?

It was about 10 years or so into my career when I decided there had to be a better way to help patients than what I was doing. I had achieved a lot by that point in my career. I was an accomplished author and professor and the youngest service Chief at an academic hospital with world renowned medical and optometry school affiliates. I had received many accolades but found no solace in these facts.

I felt no satisfaction in the expertise I had developed by caring for so many unwell patients with a plethora of blinding eye conditions that I could identify with facility. It was particularly bothersome to come to the realization that treatments were not cure and cure might indeed be prevention. At that time, there was a lot of buzz about a group of studies funded by National Eye Institute. This group of studies, which is ongoing today, helped eye doctors understand the importance of diet, nutrition, and lifestyle on the course of Age-Related Macular Degeneration (AMD), a potentially blinding eye disease accounting for a large proportion of blindness in the elderly across the globe.

It was also during this time that I came across a phrase from the oldest Chinese medical text, “The superior doctor prevents disease, the mediocre doctor attends to impending sickness, and the inferior doctor treats the full-blown disease.”

I realized quickly which kind of doctor I wanted to be and became ferociously determined to practice in a holistic manner that supported how patients live not die. I also realized that I was seeing patients at all ages and stages of disease and that I had an obligation to provide them with the best possible information to help them stay well. You have to really get to know your patients and gain their trust to influence their choices. I continue to be humbled by the enormity of this task and have come to understand “patient heal thy self” in a much more profound way.

Can you share the most interesting story that happened to you since you started your career?

I have been fortunate. I love what I do, and I feel like I am on a journey as I listen to each patient who visits my practice. They all have interesting stories to tell which become an indelible part of who you are as a person and doctor. Patients share a lot when the exam room door closes, and I have gained more wisdom and insight from my patients than any health or medical advice I might have shared over the years. I have largely cared for geriatric patients who will tell you stories that bring you around the world and through life, if you listen.

It was an honor and a privilege to take care of our nation’s veterans during my 22 years at the VA. It has been an equal pleasure to serve patients in my rural community in New Hampshire for a near equal tenure. It is pure transcendence when a complete stranger provides you with a firsthand account of a difficultly or triumph. I have had the honor to gain insight from war heroes, Nobel laureates, suffragettes, and pig farmers of equal distinction.

The most interesting story I heard this week came from a patient whose father lived through the Spanish Flu of 1918. I leaned in for sure given the current searing events of the COVID global pandemic. I certainly understand the science of past pandemics but to hear about the personal strife of a time gone by was a gift. The patient was able to arc his father’s story, about the loss of his first wife to a terrible and untimely disease, to our modern world which suddenly seemed not so modern to me. I took pause in the knowledge that infectious disease can still cause humankind to stand still.

Can you share a story with us about the most humorous mistake you made when you were first starting? What lesson or take-away did you learn from that?

Well, I would love to make fun of myself but why do that when you have intern and resident stories that are much more humorous, at least from my perspective. The best thing that ever happened to me is that I became a teacher. I did not set out in my career to pose as an academic or mentor, but after decades of teaching medical trainees, I still find humor in the fact that I ever attained professor status.

Just like my patients, young doctors have taught me how to be a better person, and they have provided me with humility and fodder regularly. I distinctly remember the face of a young intern as she entered my office to present a case. She said, “I cannot get a pressure on his left eye, and there is something wrong with it.” I calmly said, “Okay, let’s go have a look together.” I entered the room, greeted the patient, and asked him to kindly put his head in the microscope. My examination quickly revealed that the patient had a prosthetic left eye. I quietly said to the patient “how long have you had that fake eye.” He replied, “Since shrapnel hit my face in Vietnam.”

I made sure to look at the face of my intern as I asked the patient. She had a look of relief and horror at the same time. We all had a good laugh at lunch that day, perhaps even that week. It was the topic of rounds, and I am still giggling as I write in recollection. I would love to have a chat with that intern today. I am sure she has accomplished many things because she was kind, empathetic, considerate, and smart. Doctors enjoy no omniscient, whether experienced or not.

Can you share with our readers a bit about why you are an authority in the wellness field? In your opinion, what is your unique contribution to the world of wellness?

I honestly believe that doctors, as part of a community of caregivers, should help patients stay well and heal. Therefore, I have spent the last half of my career to date studying, learning, pouring over the medical literature in order to best understand what prevents blindness and poor health. I suppose I have attained some authority in this regard because of my willingness to share my knowledge. I am on the executive board of the Ocular Nutrition and Wellness Society and a senior editor for the annual “Wellness Essentials for Clinical Practice,” which is published by Review of Optometry and distributed to almost 40,000 eye care providers each year.

I also truly believe eye doctors (optometrists in particular) are particularly well positioned to promote a healthy lifestyle. We are positioned on the front line of health care in nearly every community in the U.S. So, I have made it my mission to proliferate this belief and share knowledge. I lecture, cast, write, and present cases of healing and prevention in the hopes that my colleagues will join what I, and many others in healthcare leadership, now consider mainstream practice.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

There is a famous quote by Isaac Newton, “If I have seen further than others, it is by standing upon the shoulders of giants. For me, this is truth. I have had so many friends and mentors in life and in my career, it would be difficult to name them all. I shudder at the possibility that I might leave someone out. However, if I could point to a single point of light and strength, it would be my mother. She is one of the smartest, most resilient people I know. She, like no one else, has taught me the value of perseverance and to judge people by their ability to overcome adversity.

I also have great admiration for a colleague of mine, Dr. Kerry Gelb. He is a wellness evangelist, and we share the same passion for helping patients. I consider him a mentor in many ways. I was honored when he asked me to participate in his documentary film “Open Your Eyes”. This documentary unfolds a beautiful story about what an eye exam can reveal about your health. The film was to premier in New York City this past weekend, but the COVID crisis has pushed this to a future date — one that I hope we can all celebrate and share soon.

Ok thank you for all that. Now let’s move to the main focus of our interview. Can you please share your “5 Non-Intuitive Lifestyle Tweaks That Will Dramatically Improve One’s Wellbeing”? (Please share a story or an example for each, and feel free to share ideas for mental, emotional and physical health.)

1. Tell jokes — There is an old adage “Laughter is the best medicine.” This has been found to be true in scientific study. We now understand the physiological effects of simply smiling and that regular belly laughter can result in a longer life.
2. Learn to meditate — Meditation has been shown to lower blood pressure, increase mood, and improve concentration and overall sense of wellbeing. When your brain is in balance, you improve your chances for changing behavior, and health is all about changing what you do. There are thousands of applications and devices to help anyone learn to meditate. One of my favorites is the “Muse” device. You can use the device on your own or with a group, and once you have mastered simple meditation, you can share the device with others so they can learn. There are a lot of great cell phone applications, as well. I advise that you use what works and provides the most motivation. Talk to your friends and find out who meditates. You might be surprised.
3. Understand food labels — Simply removing high fructose corn syrup from your diet could dramatically improve your cholesterol levels and blood sugar and help prevent mood crashes. If you learn how to identify this one food and eliminate it from your diet, you are on your way. If you really want to learn the detrimental effects of sugar on your health, I highly recommend you follow Dr. Robert Lustig (aka: the “Sugar Doctor”). He has committed his life to eliminating the health-robbing ingredient, and he has written several books on the subject.
4. Also, it is very important to understand supplement labels. Look for natural, high-quality, bioavailable ingredients. Another key is to look for third-party certifications such as NSF Contents Tested and Certified or NSF Certified for Sport. This certifies that what’s on the label is in the bottle and reviews toxicology to verify product formulation and ensure the product contains no undeclared ingredients or unacceptable levels of contaminants. Finally, verify that the supplement was manufactured in an FDA cGMP facility. This simply means the manufacturer is compliant with FDA regulations.
5. Find your tribe — There is good science about the benefits of being with family or friends, no matter how you define this. Maintaining a sense of belonging helps elevate the brain’s happy hormones. Happiness leads to longevity and is a common characteristic shared by centenarians around the globe.
6. Eat real food — We all need to eat to live. However, there are many manufactured and processed foods that literally cause you to crave more food than you need. This is why I am constantly repeating the message “it’s not your fault.” People tend to blame themselves for weight gain, fatigue, and lack of a sense of wellbeing. In reality, we are what we eat, and on an increasing basis, processed or “fake” foods have collectively created a state of humanness that is unhealthy and unhappy. Eat fruits and vegetables every day. This is step #1 to a healthier life, and then refer back to #3!

As an expert, this might be obvious to you, but I think it would be instructive to articulate this for the public. Aside from weight loss, what are 3 benefits of daily exercise? Can you explain?

The single most important reason to exercise is to feel and see better. I think most of us associate exercise with weight loss and physical development. However, more importantly, exercise helps to boost mood and improves blood flow to your brain and eyes. In my opinion, your brain is the most important organ when it comes to staying healthy. I am an eye doctor, and I am emphatic about explaining to patients that your eyes are an extension of your brain — in fact, they are inextricable. Better brain health equals better eye health.

If you are sad, depressed, lack energy, or suffer from addiction, exercise can help. I think most people understand that you can lose weight, but exercise is really about keeping your brain in good shape. Feel good hormones, oxygen, and nutrients flood the brain during exercise and for hours afterwards. Research has even shown that glaucoma, macular degeneration, cataracts, and other eye diseases can be prevented or slowed through exercise, but you need to feel good to keep your diet on track.

Sadly, the number of people suffering from poor mental health is growing at an alarming rate. This is the single most important reason to get off your seat. If you think and feel better, all other behavioral changes needed to improve health are more likely to follow. Making changes to your diet are a lot harder to make if you are unmotivated, anxious, or depressed. We also know that foods that are good for your eyes, like those that contain lutein and zeaxanthin, are also critical to brain health. In other words, exercise can help you make better food choices.

For someone who is looking to add exercise to their daily routine, which 3 exercises would you recommend that are absolutely critical?

Walking, stretching, and weight resistance activities are the most natural forms of exercise. If you can walk outside, even better. You do not have to train like a triathlete to improve your health. Again, I think most people set thresholds that may be unattainable, so I always encourage people to start with natural movements that you can fit into your day, all day. A simple walk, several trips up the stairs in your house or at work, and carting around the laundry basket count in my world. Maybe you can do some squats with your laundry basket!

I am not really joking when I say that. Any opportunity to do a curl or squat at the knees or reach overhead counts! For example, I no longer sit at my desk for conference calls. I walk continuously when possible. Humans are designed to move, not sit, so get up and do something — anything. I started recommending the exercise program by Marie Osmond White. She is a PBS star and has a wonderful program that can be followed by anyone of any fitness level. She focuses on keeping the body nimble.

I always ask my healthy aging patients what they do to stay that way. Invariably, they are in constant motion, but rarely are they high performance athletes. Not that I discourage high performers, but for the rest of us, it is good to know that a common element of centenarian lives is that they move constantly and naturally. Personally, I love yoga and Pilates, but I have been known to curl my favorite cast iron pan in the kitchen.

In my experience, many people begin an exercise regimen but stop because they get too sore afterwards. What ideas would you recommend to someone who plays sports or does heavy exercise to shorten the recovery time, and to prevent short term or long-term injury?

My advice when it comes to starting any new exercise regime is that you start low and slow. If you are totally deconditioned and you think it is a good idea to run three miles and do 3 sets of squats with two twenty-pound dumbbells hanging from your hands — think again. That’s why I encourage activities that follow your natural movements. You can increase the intensity and frequency of exercise slowly over time, but the physical rewards start immediately for the brain and the heart. Again, folks tend to put too much pressure on themselves to perform.

I also feel the need to make a slightly stronger statement if you have experienced a recent injury or if you have high blood pressure, a heart condition, diabetes, or other chronic illness. Talk to an exercise or rehab specialist and your doctor and start slow. Sports injuries and accidents around the home can result in the inability to perform even basic exercise for an extended period, so do yourself a favor and be careful. I also strongly recommend a program called Vitality for people living with diabetes. This is the modern-day version of a health coach, except you get access to a health team that has proven outcomes. https://www.vitalitygroup.com/

There are so many different diets today. Can you share what kind of diet you follow? Which diet do you recommend to most of your clients?

I avoid making any specific “diet” recommendations because everyone is a little different. The number of diets on social media and elsewhere makes it really confusing for most people. My own mother would say, “Just tell me what to eat.” So, my answer is fairly simple: “Eat mostly plants (vegetables, nuts, seeds, sprouts).”

If you want something more specific, read more about what Mediterraneans or the Okinawans eat (my mother is Italian, and I lived in Okinawa for three years). As you can imagine, for those who really want to optimize their health, food can be your medicine. I recommend a few simple rules to start.

1. Ditch high fructose corn syrup, trans fatty acids, white bread, white rice, white flour, and processed meats.
2. Eat vegetables every day, fermented ones too.
3. Watch what you drink. There are unbelievably sugar-loaded, high-calorie drinks whipped up by talented baristas on every corner of the U.S.
4. I personally take one tablespoon of Carlson’s Cod liver oil per day and Vitamin D3 without fail. I eat fatty fish regularly, so I might skip the cod liver oil on those days.
5. I am not a vegetarian, keto, or vegan, but I trend in that direction. Again, eat mostly plants.
6. My favorite vegetarian doctor is Dr. Michael Gregor, and my favorite cell phone app is the recipe app from the “Forks over Knives” documentary. It has a nice group of recipes and a couple of clicks gets you a shopping list. I also use a recipe application called “Plan to Eat.” This program allows me to collect recipes from all kinds of diets, websites, and books.
7. I also have a number of patients endorsing “Noom.” This is a behavior modification program that you can download to your phone. I have not tried it yet, but this is one my patients keep buzzing me about.
8. Moderation is key.
9. Meat is okay, but we just eat too much of it, and boy, have we messed up what our animals eat. Who the heck thought it was a good idea to box animals up and feed them food worse than what is healthy for humans? I am a strong advocate of eating animal meat from naturally grazing animals, if you must. I buy from three local farms, Yankee Farmers Market, Harding Hill Farm, and Musterfield Farm, but don’t tell anyone!
10. Also, I love doing interviews like this because invariably, someone sends me a really cool tool, app, or recipe, and I am all the better for it. Again, find a healthy tribe that shares recipes and eat, live, and be merry!

For those individuals that just don’t want to change (no plants/vegetables) or who continue along the lines of the SAD diet (Standard American Diet), you are likely lacking very important nutrients. Unfortunately, health statistics tell us that most people are not eating healthy. For these folks and for others with specific disease states, I do recommend supplements in a variety of formulas.

My favorite eye care supplements are made by EyePromise. They have formulas for patients concerned about macular degeneration, occasional dry eye, the impact of diabetes on eye health, and visual performance (sports), as well as formulas that help mitigate the harmful effects of blue light from computers, phones, and tablets. They even have a formula for children and teens. They use food-sourced ingredients and have a company mission that I can stand by.

It is important to supplement the eyes with ingredients like lutein, zeaxanthin, and Omega-3 fatty acids, especially if you have a poor diet or have risk of certain eye diseases. There are other important ingredients for the eyes and the brain, so I encourage you to talk to your doctor, nutritionist, or follow the Ocular Nutrition and Wellness Society on social media.

There are some great nutrition and supplement companies. Stick with brands that you know well, are affordable, and come with recommendations. I ask all my patients what they eat and, most importantly, watch closely for magnesium, Vitamin K2, Vitamin D, and Vitamin B deficiencies.

It is critical that doctors also ask about medications that I call “drug muggers.” There are several prescription medications on the market that can cause nutritional deficiencies, and it is important for patients to understand what those are.

Is there a particular book that made a significant impact on you? Can you share a story?

I have read hundreds of books written by respected scientists and doctors. Too many to pick from. However, a recent favorite was actually written by a lady who I describe as a pissed-off grandmother turned health advocate. The book is “Toxic Staple,” and it is written by Anne Sarkisian. She actually lives in my home state, and I had the pleasure of meeting her. I am always intrigued by “health” books written by patients with firsthand experience. She does a beautiful job of describing what happens in the bellies of those who have Celiac Disease or who are gluten intolerant or sensitive. I am very interested in the gut microbiome and watched my own sister-in-law go through a few years of hell because of a failure to diagnose a severe gluten intolerance. I encourage anyone to read this book.

Another regular that I recommend is “Vitamin K2 and the Calcium Paradox” written by Kate Rhaume-Bleue.

You are a person of enormous influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I think the future of healing will be accelerated by a better understanding of the human gut and a relatively new field of scientific study called “Nutrigenomics.” I also hope that one day, artificial intelligence will help doctors and caregivers pull the best in scientific discovery straight to the homes of my patients so they can take immediate, meaningful action toward better health. Right now, our world is in the middle of a global pandemic. Perhaps some might think this is a silly time to talk about wellness. However, part of battling infectious disease is improving the collective health of our nation and the globe. Now is the time to pay attention to the habits and dietary choices that can weaken your immune system and set them ablaze in the public forum.

I am no Forrest Gump; however, I would love to start a new trend here and now. A trend that reaches those with social barriers preventing good health. If I could hold a candle to one issue, it would be that of food insecurity in our poorest neighborhoods and all schools. Children and young people are our future, and I look to them to help demand strong health and nutrition education and choices. I envision a better state of health that starts with children.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

“Let Food by Thy Medicine.” — Hippocrates

My father always used to say, “I eat to live; I do not live to eat.” I think a slight modification of his idea might be just right. I can see it, no pun intended. Hippocrates was the father of medicine, and he has a cool name — perhaps that will do it. My favorite quote comes from him so why not “Hippocrates.” A proverbial shout “Eat to Live” movement if you will.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US, whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them :-)

Yep, Dr. Robert Lustig or Dr. Anthony Fauci — who could not love this guy!

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