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

Latest Posts

American Academy Of Pediatrics Endorses Guidelines For Checking LDL Cholesterol Levels In Kids

Why would a pediatrician draw blood from your 9-, 10-, or 11-year-old at his or her next annual wellness visit? Because the American Academy of Pediatrics (AAP) recently endorsed updated guidelines that call for checking LDL (bad) cholesterol levels in all kids between the ages of 9 and 11.

The cholesterol-test recommendation created quite a stir. But wait, there’s more. The guidelines also call for annual blood pressure checks beginning at age 3, and periodic blood sugar measurements starting between ages 9 to 11. There’s also a strong recommendation for kids and adolescents to limit sedentary screen time to two hours or less per day, and to get at least an hour a day of moderate physical activity.

The biological basis for these guidelines is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. In many cases, Read more »

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

What To Include In Your Diet To Lower Harmful LDL Cholesterol

Low-fat diets, move over. When it comes to lowering cholesterol, a “portfolio” diet that includes cholesterol-lowering foods such as oatmeal, nuts, and soy products is better.

Several years ago, researchers at St. Michael’s Hospital and the University of Toronto created what they called a “dietary portfolio of cholesterol-lowering foods.” It went after cholesterol by adding to a heart-healthy diet specific foods known to lower cholesterol: margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds.

In a head-to-head test against the low-fat diet traditionally recommended by the American Heart Association, the portfolio approach was the clear winner. (You can see the makeup of the test diet here.) After 24 weeks, it lowered harmful LDL cholesterol by 13%, while the low-fat diet lowered LDL by only 3%. As an added benefit, the portfolio approach also lowered triglycerides and blood pressure, and did not depress the level of beneficial HDL cholesterol. The results were published in the Journal of the American Medical Association.

What I appreciate about this study is that it Read more »

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

Statins Reduce Heart Disease Risk, But Probably Not Because They Lower Cholesterol

When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers.

“…My cholesterol is this…What do you think?”

“…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.”

All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa.

I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?”

But more often than not people want to know about cholesterol.

Okay. It just so happens that this week brought some very interesting news concerning the treatment of abnormal cholesterol lab values. News that big-picture docs have to like. Read more »

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

The Simple Truth About Cholesterol

The New York Times recently ran a piece that wondered if doctors were treating patients with cholesterol-lowering medication unnecessarily because a web-based calculator over estimated a person’s risk. The program was proudly sponsored by the pharmaceutical roundtable and was available at the American Heart Association.

The implication was obvious. Simple tool determines an individual’s risk for heart attack or death from heart attack. It over estimates risk. Patients treated unnecessarily. To be also clear, the program did underestimate risk as well.

Unfortunately, the article missed an important point. While the simplified calculator may not be as accurate as the more complex algorithm used by the National Cholesterol Education Program, the truth is doctors are likely to be overtreating patients not because the former program is presented by the pharmaceutical roundtable, but for another reason. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Kids Who Eat School Lunch Are Less Healthy In General

Research from the University of Michigan suggests that say one in three middle school youth who regularly eat school lunches are obese or overweight. They are also more likely to have higher cholesterol levels than kids who bring lunches from home.

The study included 1,076 middle school students who completed questionnaires about what they ate and how much physical activity they got as well as how many screen hours they logged each day.

Compared with kids who ate school lunches, kids who brought lunches from home were:

- Less likely to be overweight or obese (25% vs 38%)

- Less likely to eat two or more servings of fatty meats like fried chicken or hot dogs daily (2% vs. 6%)

- Less likely to drink two or more sugary drinks a day (7% vs. 19%)

- More likely to eat at least two servings a day of fruit (49% vs. 33%)

- More likely to eat at least two servings a day of vegetables (50% vs. 40%)

- Had lower levels of LDL (the bad cholesterol) Read more »

This post, Kids Who Eat School Lunch Are Less Healthy In General, was originally published on by Nancy Brown, Ph.D..

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 »