• Archives

  • 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.

     

  • 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.

     

  • 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.

     

  • May7

    What Can I Eat to Heal and Recover from Surgery?

    Posted in: Aging and Costs of Aging, Arthritis, Obesity and Weight Loss, Vitamins and Supplements, Wellness and Health

    Last year, my Mom had her first operation: a total knee replacement.

    Active and curious, and having recently celebrated her 29th birthday again, her mother was turning 100 shortly and needed assistance.  Mom wasn’t able to get around well enough to help, with her osteoarthritis and pain.

    A month before the operation she asked me, “What can I eat to heal and recover from the surgery?”

    It turns out that there’s a good answer to this. It can be divided into wound healing, building bone, rebuilding muscle and guarding against weight gain.

    A blog is too short to cover each category in depth, but fortunately, there is a largely untapped literature about nutrition and post-operative care.

    The key: wounds heal from the inside out. Many patients need additional arginine and vitamin C, just to name two nutrients, pre-operatively and post operatively.  Lowering oxidative stress improves healing.  The peri-operative period is the most critical.

    Building bone is a function of vitamin D, calcium and magnesium, and the right hormones.  Smoking prevents bone from being built. And food can facilitate it.

    Rebuilding muscle is something that has nutrition, and dietary protein, at the center. I often encourage my patients to have a little protein-rich food at every meal, especially breakfast.  Omega-3 fatty acids, especially DHA (almost solely from fish and from algae, which is where fish get their DHA) improve muscle building post-op.  My Mom took them.

    Recent data have shown that total knee patients gain an average of 14 pounds post-op, and it’s not all muscle.  Gaining that much weight post-op delays recovery and increases instability.

    Post-op patients need satisfying, lower calorie recipes written on prescription slips: high calorie, high sugar foods that are highly processed should never appear, and would never be reimbursed.  But strategic nutrition can improve strength, healing, flexibility and stamina. And should.

    Although my grandmother passed away just after reaching 100,  my Mom has recently returned from Hawaii, Carmel, New York City and points unknown, without a cane or a pain pill, nearly as good as new.  In fact, better.

     

  • Nov30

    Expert Report: Vitamin D/Calcium: The Right Stuff?

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

    The IOM expert report on Vitamin D and Calcium suggests two changes: increasing your vitamin D intake from 200IU (under age 50) to 600IU daily, or 800IU if you are 71 or older; and not supplementing with calcium.

    The new safe daily upper limit of vitamin D is 4000IU; for calcium it’s 2000mg, which increases kidney stone risk.

    The IOM believes this much of each is best for bone health. Much of the public and many physicians believe that vitamin D is needed for more than that. People love supplements– and almost half of U.S. adults take them.

    Especially in Winter, especially for dark-skinned Americans, vitamin D helps the body’s own immune system fight flu virus and improve multiple sclerosis.

    I recommend few supplements, because high quality meals can contain everything you need. But pregnant and nursing women, newborns and the elderly on restricted diets need specific supplements.

    Few foods, except wild salmon, mackerel, herring and caviar(!) have much vitamin D; the dairy adds vitamin D to milk, just enough to prevent rickets.

    The smartest and safest approach is to have your 25-hydroxyvitamin D level measured. Your doctor can order it, or you can with this vitamin D kit. The test uses radioimmunoassay, the most accurate testing available.

    The IOM thinks your level should be 20ng/ml; many vitamin D experts think it should be 30ng/ml; an independent group of vitamin D researchers (not vitamin sellers) thinks 40ng/ml. Ask your MD.

    And check out a new national federally funded Vitamin D/Omega-3 study testing 2000IU daily, for optimal health.

     
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