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Eating: A Food-Based Approach

The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts -– a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical –- be it vitamin E, fish oil or omega-3. Instead we are being asked to call a potato a potato and a piece of steak — well, a piece of steak.

If you haven’t heard about this sea change yet, you are not alone. The food science industry that markets “food products” for our consumption has done a good job giving their laboratory creations a semblance of health with phrases like “low fat” and “high in vitamin C.” For our part, the medical community is also to blame. Despite evidence to the contrary, we have been slow to renounce the “fat is bad” mantra or break away from the nutrient-based approach to eating that first swept the country over 30 years ago. Read more »

*This blog post was originally published at BeyondApples.Org*

JAMA’s Breast And Ovarian Cancer Article: Getting The Facts Straight

Journalist Andrew Holtz has been a colleague for longer than probably either one of us wants to remember. He is currently one of our story reviewers on HealthNewsReview.org. In fact, he was one of the reviewers on four stories we analyzed last week on the same study. He thought there were some important take-home messages that rose above the walls of our formal systematic review, so he wrote this guest blog post, and we thank him for it:

The Sept. 1 issue of the Journal of the American Medical Association included an article that is likely to have a strong influence on the advice given to women who have a very high risk of breast and ovarian cancer linked to mutations of the BRCA1 and BRCA2 genes. Of the four stories we reviewed, only the AP report scored well on our review criteria.

I know what my first journalism professor, Marion Lewenstein, would have done with at least two of the stories: Given them an “F” for factual errors without further consideration of their merits. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Physician Burnout: Doctors And Patients Deserve Better

A new patient recently said he was referred to me after his last doctor had left medicine. His old doctor always looked unhappy and burned out, he noted.

Burnout affects more than half of doctors, according to researchers at the University of Rochester School of Medicine. Beyond mere job dissatisfaction, these doctors are emotionally exhausted to the point where they lose focus. They tend to be more depressed — perhaps one reason why doctors have a higher suicide rate than the general population.

While burnout can happen in any profession, the performance of stressed-out doctors can hurt someone else: Patients. Read more »

*This blog post was originally published at KevinMD.com*

The Improbable, Unsinkable Glucosamine

Glucosamine is widely used for osteoarthritis pain. It’s not as impossible as homeopathy, but its rationale is improbable. As I explained in a previous post:

Wallace Sampson, one of the other authors of this blog, has pointed out that the amount of glucosamine in the typical supplement dose is on the order of 1/1000th to 1/10,000th of the available glucosamine in the body, most of which is produced by the body itself. He says, “Glucosamine is not an essential nutrient like a vitamin or an essential amino acid, for which small amounts make a large difference. How much difference could that small additional amount make? If glucosamine or chondroitin worked, this would be a medical first and worthy of a Nobel. It probably cannot work.”

Nevertheless, glucosamine (alone or with chondroitin) is widely used, and there are some supporting studies. But they are trumped by a number of well-designed studies that show it works no better than placebo, as well as a study showing that patients who had allegedly responded to glucosamine couldn’t tell the difference when their pills were replaced with placebos. Read more »

*This blog post was originally published at Science-Based Medicine*

Patient Safety: Doctors Must Report Each Other’s Incompetencies

Recently, JAMA published a study concluding that doctors are hesitant to report incompetent physicians or those who were impaired. According to the article:

“…more than a third of docs don’t think they’re responsible for reporting those who aren’t fit to practice, according to the results just published in JAMA. And only 69 percent of the docs who knew about an impaired or incompetent colleague reported them.

To those who advocate that the medical profession self-police, the numbers aren’t encouraging. Read more »

*This blog post was originally published at KevinMD.com*

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…

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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…

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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…

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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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