• Jan17

    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.

     
  • Jan11

    Treadmills and elliptical trainers are some of the best aerobic exercisers available for weight loss 2012, and Consumer Reports picked its top models this month (reviews to come).

    But if you already have a treadmill or an elliptical, or want to start more simply, select a pedometer (around $30) or a GPS watch (around $200) or both.

    Consumer Reports rates equipment as follows:

    Top 3 pedometers: Mio Trace Acc-Tek, the new Omron GOsmart Pocket HJ-112 (or get the tried and true Omron HJ-112) and the Yamax Digi-Walker CW-701.

    (I especially like both Omrons)

    Top 3 GPS watches: Nike+ SportWatch GPS, the Garmin Forerunner 210 and the Timex Ironman Global Trainer GPS Speed + Distance T5K267F5.

    (I especially like the Garmin)

    These are less expensive than a treadmill: I tell my patients to get 3 pedometers, because inevitably one is lost, and one is always somewhere you meant to put it on, but forgot. They’re invaluable, especially when you’re trying to get to 10,000 steps!

     
  • Jan2

     
  • Dec19

    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

     
  • Dec13

    I got my annual increase in health insurance premium last month with no increase in coverage. “Starting with your January invoice…(we will bill you) an increase of $38 or a 14 percent increase from your previous monthly rate.”

    Ouch. So I started shopping for alternatives.  I have no health problems except a chronic battle to avoid overweight, work at being fit, and try to practice the lifestyle I preach.  Luckily, I haven’t had to use my health insurance in 20 years.

    I found another, similar plan from the same large national health insurance company. The new plan provides comprehensive coverage and is nearly identical, for $68 less than the new rate.

    I thought: $800+ saved annually is certainly worth the hassle of a re-application and documentation of any and all health concerns encounters I could remember. I assumed the health insurance company wouldn’t or couldn’t transfer my data from one of its plans to another of its plans (though it would lower healthcare spending).

    So I re-applied online, and got a call from MaryAnn RN.  She informed me that I could continue with the application if and only if I had a physical examination, lipid and diabetes tests, height, weight, blood pressure and a documented past medical history.

    Why? Not because I was sick.  But because I was not sick.  “It’s because nobody has eyeballed you in the past two years”, MaryAnn explained.  I actually had seen an optometrist…but “they don’t count”,  she said. “Besides, even healthy people can get sick.”

    Indeed they can: acute illness does often arise unannounced, though chronic diseases often suggest themselves well before you get one.

    Interestingly, the U.S. Preventive Services Task Force recommendations suggest a lipid test every five years and a diabetes test every three years, not every two years, as now required by the insurer.

    Hmmm. An insurer leveraging its offer of insurance outside of professional guidelines for clinical testing? Unheard of.

    Yet there it is: the insurance company penalty for being healthy. Healthcare spending wastefulness 101.

    My triumph of being healthy enough to avoid having to see a clinician for 24 months is not rewarded by the disease treatment system that is most health care today.

    Our disease treatment system values medical and surgical intervention.  It doesn’t value eating well, exercising, avoiding tobacco, sensible drinking, managing stress and getting enough sleep: behaviors that aim to prevent disease and actually do.

    MaryAnn suggested walking-in to a walk-in clinic.  I’ve long supported these clinics: I like the idea of democratizing care for those who cannot afford it. Nurse practitioners do a great job of staffing these centers, which could also teach nutrition and give out my ChefMD recipes: many Walgreen’s still do, after I co-hosted Health Corner TV.

    I haven’t decided whether to walk-in yet: a visit to a clinic will cost $100 and half a day (the nearest one is over an hour away). If my exam and lab work are acceptable and if the insurer doesn’t raise rates mid-year, not accounting for the time off work, I could still save money. So, I’m thinking about it.

    But what really ticks me off is the stupidity.

    *I could have been seen for a blemish within the past two years by a physician assistant, been told that it was a blemish, and qualified for the cheaper, nearly identical health care plan, without any of these crazy new requirements.*

    The insurer’s algorithms of  “insured person eyeballed” apparently don’t care who does the eyeballing or what they eyeball.  Any clinician (except an optometrist, I guess) will do.

    I know I’m lucky.  I haven’t fallen off a ladder or driven a nail through my hand at my urban mini-orchard, or ballooned 75# up despite being embraced by treats, great cooks and frequent travel, or developed a bump, rash, bleed or bruise that wouldn’t go away.  And I work at staying healthy.

    Too much, according to the health insurer. Never mind that helping people take control of their own health with what they eat and how they live is what matters most!

    The insurance system in America penalizes the healthy if they want to have even catastrophic insurance…just like it penalizes those with chronic disease and pre-existing conditions, who want to have any insurance.

    If you want to stay healthy, and see the doctor only when you choose, you might just have to choose a DIY health care plan, or be subjected to tests that you might not really want or might be  unnecessary.  In my opinion, that’s no way to care for people.

    Now I’d like to hear from you.

    Have you tried to stay healthy enough to avoid having to see the doctor?

    Has your health insurance company worked with you, or against you?

    What strategies have you tried to get the health insurance you want to have?