• 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

  • Sep13

    Belly Fat for Women: the Dr. Oz 5 Step Plan

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

    Dr. Oz debuted his 5 Step Plan for Women Over 40 Who Need to Lose Belly Fat last night, and I spoke with Shirin Rafaee of KEYT, our ABC affiliate, about it.  No surprise here: women’s needs are different from men’s weight loss needs.

    Belly fat in men and women poisons your liver, blocks muscle from using sugar, and squeezes on your kidneys.

    And the perimenopausal loss of testosterone, thyroid hormone and melatonin make it harder for women to build muscle, burn calories and sleep well.

    His 5 step plan:

    1. Eat dinner for breakfast (i.e., eat more calories in the morning than late at night):

    The usual pattern is runway eating: start off with a small meal, and eat all your calories at the end of the day.

    2. Have a glass of red wine daily (i.e., the resveratrol may interfere with fat synthesis, and other red wine polyphenols may inhibit aromatase, an enzyme made by belly fat that converts androgens to estrogens).

    Men typically add alcohol to what they eat, whereas women are more likely to substitute alcohol for food.

    3. Get 25 grams of mixed fiber daily: psyllium husk, oranges, bananas, Kashi cereals.

    Men need 38 grams per day. Both men and women need a lot of water to hydrate that fiber, so it’s not concrete.

    4. Use a belly band (aka tape measure) to get your waist under 32″: inexpensive on ebay.

    For men, the optimal number is 37″.

    5. Confuse your muscles (aka mix it up: Tuesdays for arms and Fridays for legs dumbbells; a few weeks later, use kettle bells or resistance bands; a few weeks later, pilates)

    In women, the loss of estrogen is the main reason it’s hard to lose belly fat after 40: plus, your metabolism winds down 5% every 10 years, unless you work at it.

    But with a systematic, structured program, belly fat can be belly flat.

     
    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

  • Aug19

    When Omega-3s? After Bypass, During Fatty Liver, Before Eye Disease

    Posted in: Aging and Costs of Aging, High Cholesterol, Uncategorized, Wellness and Health

    Omega-3 fatty acids are powerful: with vitamin D, they’re something that almost everyone needs to supplement, no matter how good your diet.

    Why?

    Because people with heart disease who just had a coronary artery bypass graft (CABG) had a 49% lower risk for dying 30 days after their CABG than those who didn’t take 882mg of EPA and DHA (in a 1:2 ratio) after their surgery.

    That means extra DHA, and pure DHA is hard to find. Look for Thorne DHA and Thorne Super EPA Pro: molecularly distilled, no contaminants, pure, concentrated and as above and below, powerful.  To read more or to purchase, click “My Account” in the top right; and then enter the access code HCP1028244 to create a “Personal Account”.

    Because kids with fatty liver disease (the most common liver disease in kids, and pretty soon, adults) had a 99% lower chance of severe fatty liver if they took 250 mg/day of DHA than those who did not…and improved insulin sensitivity.

    And because omega-3s, especially DHA, can protect your eyesight and prevent AMD, the leading cause of blindness in people over 55 by protecting the nerves in your eyes and reducing inflammation..

    DHA is responsible for most of the heart-healthy benefits of fish oil, and gets transformed into EPA if you are short of EPA. Check with your doc before taking extra EPA: it can interact with other drugs.

     
    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
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