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The Benefits Of Participating In Clinical Trials

For several years I’ve been preaching in the pages of the Harvard Heart Letter about the importance of taking part in clinical trials. Why? Because I believe they improve medical care, telling us what works and what doesn’t. Figuring it was time to put up or shut up, I volunteered for a clinical trial. I’m glad I did—I learned a lot, received excellent care, and saw first-hand the effort it takes.

The trial was called Targeting Inflammation Using Salsalate in Type 2 Diabetes, or TINSAL-T2D for short. It was being conducted at 16 centers, including the Joslin Diabetes Center in Boston, a short walk from my office. Its aim was to see if an old drug called salsalate (a cousin of aspirin) could arrest low-grade inflammation that may—emphasis on may—make muscles resistant to the effects of insulin and eventually tip the body into type 2 diabetes.

I responded to an ad for TINSAL-T2D and, after undergoing a few preliminary tests, was accepted to take part in it. I was given a bottle of blue pills and asked to take several of them every day. No one—not lead investigator Dr. Allison Goldfine, not study nurse Kathleen Foster, and certainly not me—knew if the pills were the real thing or a placebo. I was also asked to check my blood sugar every morning, and to show up monthly for blood tests and questions galore.

I just finished my year-long stint, still not knowing whether I was taking salsalate or a placebo. I really don’t care, though I’m keen to know if salsalate worked as hoped, something I’ll learn when the results are published.

Why bother?

Read more »

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

Curing Type 2 Diabetes: Surgical Vs. Non-Surgical Weight Loss

Science Translational Medicine

Science Translational Medicine

The April 27, 2011 issue of Science Translational Medicine included a study titled “Differential Metabolic Impact of Gastric Bypass Surgery Versus Dietary Intervention in Obese Diabetic Subjects Despite Identical Weight Loss.

Melissa Bagloo, MD, Assistant Professor of Clinical Surgery at the Center for Metabolic and Weight Loss Surgery, NYP/Columbia, explains the context and importance of this study.

Q: What did this study find?

Dr. Bagloo: For years, surgeons have observed that gastric bypass surgery cures diabetes in over 80% of patients with diabetes. This improvement in blood sugar levels happens almost immediately after surgery, and far before any significant weight loss occurs. What’s more, studies have found that when patients lose the same amount of weight through diet as other patients lose after surgery, those who had surgery experience significantly better improvement in their diabetes than those who lost weight non-surgically. So we know surgery dramatically improves or resolves diabetes, but we do not know why this happens.

This recent study in Science Translational Medicine found an important clue as to why this effect may occur. The researchers found that Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Know Thy Calories: Nutrition Labeling Guidelines For Restaurants

As part of the new healthcare legislation (Affordable Care Act), the FDA has now published its guidelines for restaurants to inform consumers of the calorie counts of food. It establishes requirements for nutrition labeling of standard menu items for chain restaurants and chain vending machine operators.

This is important because Americans now consume an estimated one-third of their total calories from foods prepared outside the home. Consumers are generally unaware of the number of calories they consume from these foods, and being overweight or obese increases the risk of a number of diseases including heart disease, type 2 diabetes, stroke, and cancer.

Here’s what the guidelines say:

– Restaurants with 20 or more locations must disclose the number of calories in each standard menu item on menus and menu boards (have 19 chain locations? You get a pass. Daily specials also get a pass.)

– Additional written nutrition information must be available to consumers upon request (total fat, saturated fat, cholesterol, sodium sugars, carbs, fiber, protein, etc.)

– The menu must say that the additional nutritional information is available. Read more »

*This blog post was originally published at EverythingHealth*

Alcohol And Cancer: A Beverage Guide For The Holidays

Guest post submitted by MD Anderson Cancer Center*

When you raise your glass at this year’s holiday toast, choose your beverage wisely. Research shows that drinking even a small amount of alcohol increases your chances of developing cancer, including oral cancer, breast cancer and liver cancer.

Yet, other research shows that drinking small amounts of alcohol may protect the body against coronary heart disease and type 2 diabetes. Some evidence even suggests that red wine may help prevent cancer.

Researchers are still trying to learn more about how alcohol links to cancer. But, convincing evidence does support the fact that heavy drinking damages cells and contributes to cancer development.

Confused? Use our beverage guide to choose a drink with the lowest health risk, and learn your recommended drink limit and what alcoholic drinks to avoid. Read more »

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

Taking The Mystery Out Of Clinical Trials

About 10 days ago I appeared in Phoenix as a speaker at a regional education seminar put on by the Leukemia and Lymphoma Society. My topic was sharing my experience as a participant in a clinical trial. I was delighted to do so, as I feel that trial saved my life and restored me to good health.

I am hoping my words encouraged others to consider being in a trial. There are no guarantees of the result, but trials are always worth considering. Unfortunately, few patients do. That may limit their choices and certainly holds back research that could help others. What a shame.

Clinical trials are defined as human subject research. It is through these trials that we determine if new drugs or devices can better serve patients than what is currently available. Clinical trials are available for almost every disease — although finding these trials can be challenging. Read more »

*This blog post was originally published at Andrew's Blog*

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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