• Sep29

    New Tools for #youdoit #hcsm Self-Empowerment

    Posted in: Common Conditions, Diabetes, Media, Obesity and Weight Loss, Wellness and Health

    Participatory patient care (#youdoit #hcsm) is getting more press, and well it should.

    I believe patients are way ahead of most clinicians on nutrition, fitness and lifestyle change. The American College of Physicians has cautioned internists to “Tread Lightly” (full disclosure: I’m quoted).

    The social web (blogs, tweets, facebook posts and google plus, YouTube videos, more) has the potential to bridge the gap between patients and clinicians, who can continue to be experts and curate the best stuff. Click here.

    These sites, and the savvy brands that understand them, will give people a stronger voice in their own health care decisions (Susannah Fox at Pew is eloquent about this).

    Here are 5 web tools for self-empowerment getting some warranted attention.

    TextWeight: just like it sounds: simple, brilliant, creates accountability.

    FitBit: a pedometer, calorie counter and sleep monitor all in one. Now syncs with their site.

    Skinnyo: organizes and offers up-to-16 person challenges of all sorts that make it easier to stay healthy: download-able diary, community, more.

    Myfitnesspal: log your meals quickly and easily, search a 1m food database, discuss in forum, get mobile apps; diet agnostic.

    Healthmonth: a health game which literally spins the wheel, uses nutrition and behavior change to help people improve habits in a fun and sustainable way: plays with fitbit.

    One good question: will trusted brands bring about better health with their own social media policies and communications?

    Not just food and pharma brands, but companies which spend more on health care than coffee (Starbucks) or steel (General Motors)?

    The future of diabetes control, weight control, stronger bones, fewer strokes and heart attacks, better cholesterol levels and happier digestion may depend on it.

     
    1 Comment

  • Aug23

    It’s Time for Some Q and As

    Posted in: Diabetes, Food FAQ's, High Cholesterol, Vitamins and Supplements, Wine and Tea

    I am taking a short break from farming activities (avocados, anyone?) and newsletter writing to answer some reader questions. You can also post these on Facebook or Google Plus and I will try to answer there.

    Q.  I am wondering if you think it is a good idea to minimize the cheese, chicken and fish animal proteins? The research I have read suggests that the positive qualities of those products can be found in plant based foods, and without the saturated fat, cholesterol or mercury.  My understanding is that type 1 diabetes has been linked to the casein in cows milk when given to infants, and that animal protein may be related to auto-immune diseases.

    A: In general, yes, about animal proteins–moderate more than minimize.

    I think most of the problem is in overprocessing and some of the hormones and toxins with which they are raised/to which they are subjected, instead of the saturated fat and cholesterol.

    Cholesterol in food (unless you eat 2# of shrimp or 3 egg yolks daily) doesn’t raise cholesterol in the blood.

    Most saturated fat probably raises the risk of heart disease but food is a mix of nutrients, and I think its source is the main thing.

    The other question is harder: type I diabetes has been linked to casein, but so has latitude, and the confounding factor may be vitamin D levels: http://www.ncbi.nlm.nih.gov/pubmed/19100644.

    Infants exposed to casein early in life may be at increased risk for diabetes, but the data are not conclusive.

    So I would not avoid milk because of diabetes risk, but I would want to know where the milk came from, whether the cow received rBGH, growth promoters and so on.

    Of concern, Japanese cattle recently ate radioactive rice straw; whether it harms people to eat radioactive milk is unknown, except in high doses…but the yuck factor is pretty high.

    Q.  Hi, I saw you for the first time on PBS yesterday and was intrigued. I recently lost my job and health insurance and figured since I eat everyday, I might as well eat better. It has to be cheaper than healthcare insurance. I’m Mormon and don’t drink alcohol. Is there a non-alcoholic drink that has the benefits of wine?

    A.  Red grape juice, pomegranate juice and other dark fruit juices do provide many of the benefits of wine.

    However, alcohol raises HDL, which juices do not, but they do provide tannins, flavonoids and anti-inflammatory chemicals which are helpful with inflammation.

    Q:  You seem to be looking at and using a variety of ways to share your information to as many people as will listen. Which I think is fantastic. Have you considered a weekly or monthly conference call for people using a service, like go-to-meeting.com, where you can have interactive discussions or presentations?  I have no clue what is required on the presenter’s part, however.

    A: I have thought about it and like the idea. I’ll send out a poll to newsletter subscribers and ask if they would like that, and how much it should cost.

    I think I would likely use Skype (Kris Carr uses it for her coaching, apparently) and I think it would be fun.  Let’s see!

     
    2 Comments

  • Aug9

    Do Statins Raise Diabetes Risk?

    Posted in: Aging and Costs of Aging, Diabetes, High Cholesterol, Vitamins and Supplements, Wellness and Health

    Probably, in higher doses.

    A study of 18000 people without heart disease, called JUPITER, shows that Crestor (rosuvastatin) 20 mg showed that for every 1000 patients on high dose (40mg and up) statins, there are 6 more cases of new diabetes over 2 years.

    Crestor also prevented 11 cases of heart attack, stroke, arterial revascularization, hospitalization or death from heart disease, in that 1000 patients.

    The newest study includes 32,752 patients without heart disease.  Again, 2 cases of diabetes, versus 6 or more cardiac events prevented in a 1000 people over 5 years.

    If you actually have heart disease or angina, then the numbers for taking a statin are different.

    • 1 in 83 life saved
    • 1 in 39 prevented a non-fatal heart attack
    • 1 in 125 prevented stroke
    • 1 in 167 developed diabetes

    Is that worth the trade-off?

    I try to find ways for my own patients to get off high doses of statins, especially 80mg doses, because of myopathy and pain.

    A cholesterol registry can chronicle how people control cholesterol naturally.

    I suggest that any patient 40 and over get screened every 3 years, and make sure they don’t suffer from abnormal lab test syndrome.  And I help them make lifestyle changes that help them reduce their need for cholesterol medication.

    Statins can be important medications, and their benefits can be greater in diabetics than nondiabetics.

    But there’s no sense in tempting fate. Let’s enjoy life, and avoid getting diabetes in the first place. Lower your cholesterol with what you eat.

     
    2 Comments

  • Aug2

    Response to Bittman’s “Tax Bad Foods”

    Posted in: Aging and Costs of Aging, Diabetes, Food FAQ's, High Cholesterol, Obesity and Weight Loss, Wellness and Health

    As a physician and professionally trained chef, I write recipes on prescription slips. I try to practice what Mark Bittman of the New York Times eloquently preaches in Tax Soda, Subsidize Vegetables.

    Yet a healthy diet is like penicillin–simple, powerful, and with increasing rates of resistance, from physicians.

    Physicians are not trained to speak with patients about diet and nutrition, much less cooking and food shopping.

    Physicians are also better paid to prescribe medication and do procedures than to ask patients to switch from soda to water.

    Writing recipes on prescription slips changes this dynamic.

    Putting foods, recipes and meals in pharmacies and on managed care and hospital formularies might help patients get the food and health care they need, economically.

    Healthy hospital food, like that at Planetree’s New Milford Hospital is a good start.

     
    2 Comments

  • Jun22

    Diet Smart Not Hard…And Check Your Sex

    Posted in: Aging and Costs of Aging, Common Conditions, Diabetes, High Cholesterol, Hypertension, Obesity and Weight Loss, Stroke, Wellness and Health

    Dr Oz says “break it down and make it simple”.  Dr. Roizen says “diet smart, not hard: small changes make a big difference.” They recommend in their new YOU: Losing Weight

    * Recruit your team. You need someone to cheer for you and take the fries from you.
    * Plan Your Plate.
    * Take a You-Turn. We all make mistakes: take an authorized U-turn and turn things around.
    * Keep moving! Walk just 30 minutes a day.

    They’re right, especially for women who want to lose weight.

    But for men and women, there’s something to add to this advice, which I also give often to my own patients.

    It taps into something we all care about: sex, sex drive, performance and looks. Not to mention hormones.

    I’m for it. Whatever my patients care about most will help them make the changes that are best for their energy level, heart, liver, kidneys and their family.

    Here is a clip I’ve shown at recent talks: it’s a little risque, but it’s national TV.

    When I show it to audiences, I ask people if they think it is frivolous, unprofessional, meaningful or important.

    I also ask whether it changes their view of belly fat. Does it for you?

     
    1 Comment
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