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Still The “Incredible, Edible” Egg

Enriched chicken feed may have resulted in eggs having less cholesterol and more Vitamin D than previously measured, reports the U.S. Department of Agriculture (USDA).

A large egg today has about 185 milligrams of cholesterol, down 14 percent from 215 milligrams in 2002, according to new research from the USDA’s Agricultural Research Service, reports USA Today. Also, an egg today has 41 international units (IUs) of Vitamin D, up 64 percent from 25 IUs measured in 2002. (That’s still only about 7 percent of the 600 IUs recommended per day.)

The agency regularly does nutrient checks on popular foods, this time analyzing eggs taken from store shelves in 12 locations around the country. The American Egg Board said in a press release that hen feed is made up mostly of corn, soybean meal, vitamins and minerals. Nutrition researchers at Iowa State University are also looking into reasons why cholesterol in eggs is decreasing.

The government’s “Dietary Guidelines for Americans” recommend that most people eat less than 300 milligrams of total dietary cholesterol a day, and people at a high risk of cardiovascular disease should eat less than 200 milligrams a day. The average American man consumes about 337 milligrams of cholesterol a day and the average woman consumes 217 milligrams, reports the Los Angeles Times.

One egg a day fits within the average, healthy American’s diet, reports WebMD, citing research funded by the Centers for Disease Control and Prevention and by the American Egg Board — owners of the slogan “the incredible, edible egg.”

*This blog post was originally published at ACP Internist*

4 Super-Healthy Foods

Healthy shoppingRaise your hand if you want to eat healthy.

Healthy eating isn’t just good for cinching your waistline — it’s great for overall health.

From glowing skin, to heart health, to maintaining healthy teeth and bones; eating foods packed with certain nutrients can also protect your immune system and fight infections.  It can boost your libido and decrease that lousy (LDL) cholesterol and boost your good (HDL) cholesterol.

Healthy eating shouldn’t be a struggle. It’s easy to get sucked into the marketing trap when you’re food shopping and you encounter all those in-store specials. Sometimes, those specials are just bad for your health. Read more »

*This blog post was originally published at Health in 30*

American Obesity And Sugar-Sweetened Beverages

We are a nation stricken with an epidemic of obesity, which contributes to the incidence of diabetes and heart disease. Each of these has been linked to consumption of sugar intake, and in particular, sugar-sweetened beverages.

There’s nothing evil about sugar — it’s just that too much of it in certain forms is bad for you. For the purpose of definition, sugar-sweetened beverages contain added, naturally-derived caloric sweeteners such as sucrose (table sugar), high-fructose corn syrup, or fruit juice concentrates. Read more »

This post, American Obesity And Sugar-Sweetened Beverages, was originally published on Healthine.com by Paul Auerbach, M.D..

How To Lose Weight Eating Pizza And Oreos

I’ve been waiting for this soup for weeks. Eleven weeks, to be exact. That’s how long I was enrolled in a research diet study, and unable to eat anything other than the food they provided me, which was nowhere near as delicious as this soup.

The study is designed to compare the effects of three different diets — the American Diet, the Mediterrnean Diet, and a high-protein diet — on weight loss and cardiovascular disease risk. 

I randomized to the American Diet, meaning that Thursday’s lunch was a slice of pizza with potato chips and an afternoon snack of Oreos and chocolate pudding, Saturday’s lunch was hamburger and fries, and the most veggies I ever saw at one sitting was a measly stalk of broccoli.

Despite this, I lost 30 pounds over the 11 weeks of the study, primarily because my caloric intake was only 1,200 calories per day, carefully calculated based on my basal metabolic rate. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Cheerios: A Drug?


I really don’t think the cholesterol lowering effects of Cheerios are comparable to how a drug may help lower cholesterol, but the Food and Drug Administration (FDA) is saying that the claims Cheerios is making on it’s boxes are similar to those made by drug companies. And, by the way, it is against the law. The FDA sent General Mills a letter (read the whole letter here) saying that the phrases they are using on their packages and website are misleading consumers.

Here is snapshot of what FDA said in their letter:

Unapproved New Drug
Based on claims made on your product’s label, we have determined that your Cheerios® Toasted Whole Grain Oat Cereal is promoted for conditions that cause it to be a drug because the product is intended for use in the prevention, mitigation, and treatment of disease. Specifically, your Cheerios® product bears the following claims on its label:

• “you can Lower Your Cholesterol 4% in 6 weeks”
• “Did you know that in just 6 weeks Cheerios can reduce bad cholesterol by an average of 4 percent? Cheerios is … clinically proven to lower cholesterol. A clinical study showed that eating two 1 1/2 cup servings daily of Cheerios cereal reduced bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol.”

These claims indicate that Cheerios® is intended for use in lowering cholesterol, and therefore in preventing, mitigating, and treating the disease hypercholesterolemia. Additionally, the claims indicate that Cheerios® is intended for use in the treatment, mitigation, and prevention of coronary heart disease through, lowering total and “bad” (LDL) cholesterol.

You may or may not think this is a big deal, but I can tell you that the FDA takes health claims seriously. There are only certain FDA approved claims that food companies are allowed to make on a product label. In this letter they also included the website as part of the label since the web address www.wholegrainnation.com is listed there. So that means that everything on the website also needs to comply with the official FDA health claims.

Cheerios is a great cereal that is low in sugar and has soluble fiber. I am sure they will correct their language to comply with the FDA’s request and this will blow over. Keep eating your Cheerios with low fat milk and a handful of blueberries. Yum!

This post, Cheerios: A Drug?, was originally published on Healthine.com by Brian Westphal.

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

Click here for a musical take on over-testing.

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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