• Jan17

    100 Years Ago, JAMA Thought that a Liter of Water at Meals Was Too Much

    Posted in: Aging and Costs of Aging, Common Conditions, Obesity and Weight Loss, Vitamins and Supplements, Wellness and Health

    JAMA has a section called “100 years ago” in which the Journal of the American Medical Association (JAMA) quotes a column from its archives, verbatim.

    Last week, it was

    January 13, 1912

    WATER-DRINKING WITH MEALS

     ”…While the ingestion of moderate quantities of water with meals may be harmless in persons with good gastric motility, since the excess of water is rapidly expelled into the intestine, it is likely to be harmful in persons whose motor power is below par: and it is probable that there are many such who do not consider themselves ill enough to consult a physician.

    Furthermore, nothing that has been said is intended to lend any support in the American custom of drinking water that is ice-cold…”

    I do think we’ve made progress since them. There’s Vitamin Water, Noah’s Spring Water (pH 8.4, sparkling and delicious), cold water to help you use lose weight, and water to hydrate athletes.

    But it just goes to show: doctors, in all our wisdom, come to conclusions slowly. And that’s what most of us get paid for: slow conclusions and caution.

    I get paid for something different: trusting patients own experiences with medication, supplements, food and beverage; and their own observations of what works (and doesn’t work) for them.

    Informed by the best modern science, and that’s what it is, people can actually lower cholesterol, triglycerides, blood pressure, blood sugar, weight, obesity, overweight; eat an optimally anti-aging diet and the best foods, beverages and dietary supplements and minimize interactions between them;  and wipe out back pain, allergies and much more.

     
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  • Dec19

    What to Look For on an Olive Oil Label

    Posted in: Common Conditions, Drug Food Safety, Wellness and Health

    Both NPR and the NYT have had features showcasing why most olive oil sold in the U.S. is not what it claims to be.

    There’s a long unsavory history of diluting olive oil (and its healthfulness) with sunflower, corn and not oils. My Brooklyn grandfather used to tell me brewing not bath tub gin, but bathtub oil!

    So here is a quick primer on what to look for to make sure you get the real thing: I also posted this on the NPR site, and it has more “likes” than anything else, except the post complaining that brands were omitted!
    Look for
    a. extra virgin olive oil in dark green glass or in packaging that shields it from light: not clear plastic. ever.
    b. the words “cold pressed”
    c. a harvesting date on the bottle
    d. for CA oils (my preference, as the CA standards are stricter than international), look for the California Olive Oil Council Seal (COOC): it means
    • Less than .5% free oleic acid
    • No chemicals or excessive heat during a mechanical extraction
    • Blind tasting showing flavor characteristics and no taste defects

    3 of my favorites (All have the COOC seal, I have visited all, have planted 15 trees with first harvest next year, and am lucky enough to attend the Paso Robles Olive Festival every year! check it out next August!)

    McEvoy Organic Extra Virgin Olive Oil http://amzn.to/tPCDzB
    Apollo-Mistral Organic EVOO http://amzn.to/o8c8b9
    O Meyer Lemon Olive Oil http://amzn.to/pdT1zU

     
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  • Dec2

    Statins on Sale: Is Generic Lipitor a Bargain?

    Posted in: High Cholesterol, Vitamins and Supplements, Wellness and Health

    The most popular Rx’d drug in America, Lipitor, went generic this week as atorvastatin. Lipitor sales were $8.7 billion last year, and 3.3 million people take it. If you have insurance, request the generic. Watch your copayment drop from $25 per month to a generic copayment to $10.

    If you don’t have insurance and pay out-of-pocket, your cost will go from ~$150 a month to maybe $15, in about 6 months.

    But is Lipitor a bargain at 90% off? Yes and no.

    Yes: if you have diagnosed heart disease, statins prevent one death for every 48 patients treated for 3 to 5 years. I recommend them.

    No: if you don’t have heart disease, statins taken daily, as directed, prevent one heart attack (a nonfatal one) for every 60 patients treated for 4 years.  Because the reason to improve cholesterol is to prevent heart attack and death from heart disease.

    Statins do cause many extra costs: liver testing every 3 months, worries about calf and thigh pain and myopathy, and for a few unfortunates, rhabdomyolysis: basically, liquid muscles and kidney failure.  Lipitor especially interacts with beer, wine, chapparal, comfrey, grapefruit and St. Johns wort.  And antifungal meds, calcium channel blockers, cyclosporine, niacin, fibrates and digoxin.

    What could you do instead?

    You could take an effective dietary supplement, like Cholest-Off or Benecol Smart Chews (Caramel). You could read about lowering cholesterolt in Controlling Cholesterol for Dummies, or learn what the Wall Street Journal and New York Times advise, highlighted on this blog.  You could discover other ways to save on prescription drugs.

    Maybe smartest of all, you could check your own cholesterol, at home, with CardioChek…minimizing statins and taking control of your own health.  Because you are your own best investment.

     
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  • Nov8

    Research on Men: Why They Don’t Go to Doctors (and what might help)

    Posted in: Aging and Costs of Aging, Common Conditions, Obesity and Weight Loss, Wellness and Health

    At KevinMD, Dr. Joel Sherman writes smartly about why men avoid going to the doctor.  One reason: it reminds them of mortality. A second reason: a potential prostate exam. A third: they have to wait, a lot. Plus, telling a female receptionist about a male-related problem is not great.

    Note to middle aged men: erectile dysfunction is an early warning sign for heart disease, until proven otherwise.

    Men get more heart disease and die younger than women. Going to the doctor is usually an event (a screening exam, unable to move because of back spasm or broken limb) rather than a process (cancer prevention, for example).  Research on men backs this up.

    In my office, men often come in for lifestyle advice, weight loss help or nutrition consultation if they have a close friend or relative who recently became ill. Say, someone who had a high calcium score (over 400) or had a heart attack or prostate disease diagnosis.

    That’s especially true in men under 60; men over 60 know they need to protect their health. And they know that seeking help is an acceptable behavior, as is staying healthy.

    Sometimes another doctor requires them to come in, or a wife/girlfriend/mother/daughter/lover makes them. It takes courage to come in.

    45% of men don’t have a primary care physician, and 10% can’t remember when they last saw a doctor. 9% would avoid doctors even if they had blood in urine or semen.

    On KevinMD, above, a nurse writes about her husband: “He’s a little overweight (20lbs).  He says, “I’ll go when I lose weight”.

    It’s understandable that men feel that way.  But not necessary. What if it was a game, or competitive, or there were rewards involved, or it was actually fun?

     
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  • Oct12

    Routine Supplements: Help, Hype, Hazard or Hope?

    Posted in: Aging and Costs of Aging, Common Conditions, Drug Food Safety, Vitamins and Supplements, Wellness and Health

    Half the U.S. takes at least one supplement daily. My personal favorite is a guy who came into my office with a Trader Joe’s double-handled bag and deposited 33 bottles on my desk. 45 minutes later…*

    Three reports this week again show that dietary supplements can act like medicine–they can help, or they can make things worse.

    The first large report showed that multivitamins and iron supplements, separately, increased mortality and cancer risk in older women (mean age 61),  The second showed that 400 IU of vitamin E daily increased prostate cancer in healthy men.  And the third, from Institute of Medicine authors, cautioned about overdoing Vitamin D…not more than 600IU daily, vs the Endocrine Society recommendations (1000-2000 IU of vitamin D3 daily).

    Lots of info is missing: supplement quality is hard to monitor, and many contain binders, fillers, additives, artificial preservatives, coloring and flavors; dosages matter; so do other interactions.

    But supplements are disease-specific. Just not as gently as food (usually), or as sharply as medication (often). Dr. Weil will give you a free vitamin recommendation + 25% off your order for specific conditions.

    Some specific supplements improve wound healing, especially important to the post-operative patient and clinician. Others are FDA-approved for lowering triglycerides (omega-3s, making a prescription medication) and macular degeneration (ditto). Folic acid supplements taken by pregnant women reduce risk of severe language delay in 3 year olds; in men, however, they may increase the risk of colorectal cancer.

    The bottom line: there’s hope. If you take a supplement, you should do a Therapeutic Trial.

    Start and stop the supplement (well-researched, high quality) on the basis of which symptoms you expect it to improve. Write them down, on a scale of 1 to 10: 4 or  or 8 or 12 weeks later, gauge them again. Then pull out the paper and see if you made progress.

    *… his simplified supplements meant a clearer head, clearer urine and a clearer approach to his own health.

     
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