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

Latest Posts

Movie Popcorn Is Shockingly Fattening

After a holiday weekend of movie-going and eating that popcorn that smells so good in the theater, it was a shock to read the report from the Center for Science in the Public Interest that shows just how bad theater popcorn is. The researchers studied medium size popcorn from three large movie chains; Regal Entertainment Group, AMC and Cinemark.

The analysis showed that a Regal medium popcorn contains 1,200 calories and 60 grams of saturated fat. AMC popcorn was a “smaller” medium and contained 590 calories and 33 grams of saturated fat. This was before adding the butter topping. Cinemark wasn’t much better at 760 calories but it only had 3 grams of saturated fat.

Kudos to Cinemark for popping their corn in canola oil with less saturated fat. The other chains use heart unhealthy coconut oil, which is about 90% saturated fat. Lard is 40% saturated!

The study showed that a $12 medium popcorn and soda combination at a Regal movie would be the equivalent of three McDonald’s Quarter Pounders with 12 pats of butter. Read more »

*This blog post was originally published at EverythingHealth*

Yummy New Snack


I am always on the lookout for a new snack and I found one I just had to tell you about. I have a big sweet tooth so sweet snacks are usually my first choice (although I also do love my popchips). I firmly believe in the glycemic index for snacks and try to choose things with fiber and/or protein so that they give me sustained energy instead of a spike and drop in my energy. I hate it when I eat something only to be hungry or feel lethargic 30 minutes later.

The new favorite sweet snack is SmartFood popcorn clusters. Mmmmm. You may remember or still have on your store shelves the SmartFood popcorn that is cheddar flavor, but this is completely different. These are sweet and in individual bags.

The SmartFood clusters are sweet, sweet, sweet. They hit the spot a few minutes ago when I ate a pack. I had the Cranberry Almond flavor and it is tart along with the sweet for a nice combo. They also come in Honey Multigrain which taste JUST like caramel corn and a Chocolate Cookie Caramel Pecan Flavor which is a bit more rich than the others.

The reason I love them is that they are also nutritious (of course!). They have 5 grams of fiber (which makes them lower glycemic) and are an excellent source (20%) of calcium. They are made with brown rice syrup instead of high fructose corn syrup and are low in fat with no saturated or trans fat. Each pack is 110-120 calories and are quite convenient to throw into your purse or briefcase or desk drawer.

Check them out and let me know what you think. I found them in the chip aisle in my grocery store.

This post, Yummy New Snack, 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…

Read more »

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…

Read more »

See all interviews »

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.

See all cartoons »

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…

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 »

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…

Read more »

See all book reviews »