Paging Dr La Puma

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?

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May31

Food Lowers Cholesterol: New Studies

Posted in: Aging and Costs of Aging, Food FAQ's, High Cholesterol, Vitamins and Supplements, Wellness and Health

Wayward cholesterol levels are some of the easiest labs to treat with the right foods: I help my patients do it here in the office, have taped ChefMD videoblogs and spoken with journalists about it.

And the research continues to mount.

Last week, an Australian meta-analysis of 14 studies showed that, on average, the equivalent of 5 ounces of tomato sauce (25 milligrams of lycopene) or 2.5 ounces of tomato paste (ditto) lowered LDL cholesterol as much as small doses of statins–about 10%.

Lycopene from tomatoes is 4x better absorbed if the tomatoes are cooked, and eaten with a drop of luscious oil, btw. Thus, sauce and paste.

Two other studies which Katherine Hobson highlighted last week in the Wall Street Journal suggest that medication for this purpose, well, may not be all it is cracked up to be.

One found that extended release niacin (Niaspan, a form of vitamin B3, available only by Rx for raising HDL) didn’t protect against heart attacks when added to statins.

The other found that a fibrate called Tricor, also by Rx, didn’t prevent heart attacks and strokes, also when added to a statin.

These are, individually, multi-billion dollar drugs.

Studies like these make me think there should be a cholesterol registry– a place where the best natural approaches to lowering cholesterol can shine.

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May13

The Cost of Calories: A Disruptive Technology

Posted in: Aging and Costs of Aging, High Cholesterol, Obesity and Weight Loss, Wellness and Health

Eating for health doesn’t have to be expensive. And it’s some of the best medicine: for weight loss, for pre-diabetes, for cancer prevention, for cholesterol control.

Courtesy of MyMoneyBlog are easy ways to understand the cost of calories.

In speaking with health professionals about what is new and next in nutrition, and the power of writing recipes on prescription slips, the subject of how much food costs does come up, but it’s usually the last question, after those about resources, food prescriptions and prevention.

For the food-buying public, cost is usually the first question. Getting real about the high price of cheap food is the biggest stumbling block for most people, and why not?

The most precious commodity for many people is time, followed by immediate, check-to-check cost. Then food quality and nutrition.

We spend almost as much away from home (48.6 percent) on food as we spend for food at home (51.4 percent), as of 2009.

Saving health care dollars down the road often takes back seat to getting the kids fed, the car fixed and the job done. Mark Bittman persuasively and lucidly writes that the U.S. can save $1 trillion dollars by reforming the American diet.

We’re eating 23% more in the U.S. than we did in 1970. And that’s just quantity: quality of calories also makes a difference (cool interactive info-graphic here, from Civil Eats). And there’s no better control of quality than your own hands.

Could cooking could be a disruptive technology in health care?

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Apr18

Is Sugar Toxic? Gary Taubes’ Lab Reports

Posted in: High Cholesterol, Obesity and Weight Loss, Wellness and Health

Gary Taubes blew the top off the New York Times readership with his carefully researched “What if it’s all been a big fat lie?” about fat and heart disease in 2002 (translation: it’s the type of fat that matters, not total fat).

He’s doing it again with “Is Sugar Toxic? (translation: yes, it’s poisoning you now).

Now he posts his state-of-the-art lipid lab results (which I also order for patients) to prove his minimal heart disease risk. He eats primarily meat and eggs.

Any of my patients would be proud: (except one thing: the CO2 of 19, which is probably because he’s often ketotic, and has to blow off CO2 to normalize his blood pH).

Three questions:

a. What is the effect of sustained ketosis on heart disease risk?.

Ketosis mimics starvation, pushing the body to burn fats rather than carbs (because there are no carbs!) for fuel. Fatty acids and ketones result.

Ketogenic diets work in about 50% of kids with specific seizure conditions. They reduce appetite but are difficult to sustain (Atkins is a modified ketogenic diet). In a small study in kids, there were worrisome cardiac changes: I don’t know of adult cardiac data.

b. What are the other heart disease risk factors? Smoking, high blood pressure, diabetes and pre-diabetes, sedentariness, family history of early heart disease, high waist-to-hip ratio.

Let’s assume these are not a problem for Mr. Taubes. But not so for everyone else. Some of these have to do with food, and some not. Even if sugar is the problem. And it might be.

c. Is it practical?

To eat without most carbs and sugar, especially fructose, is virtually impossible in the U.S. and even more so abroad.

But Taubes’ idea that “we all respond to the carbohydrate/insulin effect differently”, and for weight loss “getting rid of all the grains and much or most of the fruit, and then eating more of whatever foods they happen to eat or like that provide protein and fat” deserve exploration.

People with celiac disease learn to cook, to read labels, to avoid gluten, because it’s toxic to them. Will we see the same for obesity, heart disease and sugar? Let’s hope so.

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Mar4

Do We Need a Cholesterol Registry?

Posted in: High Cholesterol, Wellness and Health

The National Weight Control Registry (NWCR) has documented exactly what people do who have lost weight and kept it off. Over 5000 people have lost an average of 66 lbs and kept it off for 5.5 years.

The research of the weight control registry helps me coach my clients to long term weight loss too. I use it every day both in ChefMD and in Chef Clinic.

Many of my patients have lowered their LDL cholesterol levels by 50% and raised their HDLs by 40% with diet and lifestyle changes.

So I thought it might be helpful to create a site like NWCR which told the stories of people who have been successful, including changing the shape and size of their cholesterol, from unhealthy to healthy.

Chef Clinic is teaming up with nutrition firm Provident Clinical Research to work together to make this a reality. If you’re in the Chicago area, Provident is offering free cholesterol screenings currently.

I mention the idea of a cholesterol registry in my first PBS Special, raising money for public TV (the Special airs nationwide starting March 5 2011: @EatCookHealthy has local PBS broadcast times a few hours before air time; Super Healthy Combo pledge gifts here; video preview available).

What should a cholesterol registry do? Should it do research, offer testing, tell best stories, create or rank supplements, give best recipes, or give discounts on meds and tests? What would interest you?

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