• 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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  • 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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  • 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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  • 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!

     
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  • 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.

     
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