Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Weight Loss Tips For ABC News

The weather is heating up, and soon most of us will be back in shorts and t-shirts…  and worrying about looking good in our dreaded bathing suits. I had the opportunity to offer some evidence-based weight loss and fitness tips to ABC News in Washington, DC. You can view the clip or read my summary below:

Read more »

Marathon Runners May Benefit From A Carbohydrate Calculator


Recently, about 27,000 runners began the annual 26-mile, 385-yard (42.195 kilometers) mass run from suburban Hopkinton to Boston.

But if past marathons in Boston and elsewhere are any indication, perhaps up to 40% of these optimistic and determined souls will slam into a sudden sensation of overwhelming, can’t-do-this fatigue several miles (typically about five) before they get a chance to experience the glory of crossing the finish line.

It’s called “hitting the wall.”

Getting through, around, or over hitting the wall is part of the mystique of marathon running, although there’s a physiological explanation that’s not all that mysterious: when runners hit the wall, their bodies have run out of the carbohydrates needed to sustain intense physical activities like long-distance running.

Benjamin I. Rapoport believes many runners could avoid hitting the wall if they put a few key facts about themselves and their target marathon time into the online calculator he created, which can be found at The calculator will tell them how many extra calories they should get from pasta, rice, or other high-carbohydrate food or drink before (and in some cases, during) running a marathon. Read more »

*This blog post was originally published at Harvard Health Blog*

Physical Activity Versus Physical Fitness: It Could Mean The Difference Between Life And Death

My neighbor Ed was a thin man all his life. He maintained an ideal body weight by combining regular physical activity with a modest intake of calories. He was a “young” seventy year-old who looked the picture of heart health.

Ed regularly read the newspaper while walking on his treadmill, he hit a golf ball straighter and longer than his peers, and he wore the same size jeans now than he did in college 50 years ago. What’s more, he bragged about his low blood pressure, normal cholesterol level and perfect blood chemistries. He took no pills. I think he went to his primary care doctor each year just to show off his health.

The morning he woke with crushing chest pressure and shortness of air stunned him. “This couldn’t be a heart attack?” he thought. An hour later, minutes after his urgent heart catheterization showed severe blockages in all three of the main coronary arteries, a sternal saw provided a heart surgeon access to his dying heart.

Ed did well. The story had a happy ending. He still looks the picture of health, but now there’s a scar on his chest and a few pill bottles in his medicine cabinet.

How can a human who exudes heart health go to bed well and wake up with severe heart disease? What’s missing? What could Ed have done differently? Could his doctors have measured anything—over and above the traditional risk measures—that might have suggested his obviously higher cardiac risk? Read more »

*This blog post was originally published at Dr John M*

Healthy Thought For The Day

A new blog has entered the medical world.  She’s only a couple months old, but she has an awesome name: happy internist.   happy internist shows us all   how to die healthy:

my patient saw her gynecologist.  he told her to eat right, get lots of exercise, and lose weight.  that way, he said, you can die healthy.

What a great quote.  It’s called finishing strong.  Given what I know about the incredible pain and suffering I witness everyday from self induced disease, dying healthy is a goal worth living for. Death is inevitable.  Dying healthy takes hard work and personal sacrifice.

She was discovered at this week’s Grand Rounds, where Dr Val has done an excellent job of organizing the best of this week’s Internet medical offerings.

*This blog post was originally published at The Happy Hospitalist*

Do Democrats And Republicans Have Different Work Out Regimens?

In Washington, even exercise gets political.

This morning, the WSJ reported that a small group of Congressmen, primarily Republicans, have embraced the adrenaline-infused exercise regimen that is P90X. They jump, stretch and flex to the tune of Tony Horton, a man who clearly checked the right box on career day. The 90-day results-intensive program celebrates its “I couldn’t move the next day” sensations.

On the other side of the ideological spectrum resides the pragmatic approach of the White House. Last month, the NY Times described the regimented, non-boot-campish routine espoused by Mr and Mrs Obama. Our current executive branch favors a personal trainer who likes working people hard, but…”as politely as possible.”  The president adheres to a common sense program of regular morning exercises that balances cardio and strength training. Calm, measured and balanced.

Both approaches to exercise appeal to me. Read more »

*This blog post was originally published at Dr John M*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »