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

Latest Posts

A Helpful Vitamin Chart

Lately I’ve been worrying about Kevin’s refusal to eat broccoli, and wondering what exactly is so good about those green bunches of roughage. In browsing the Web for more detailed information on the matter, I found a helpful vitamin chart.

The table comes from the HHS–sponsored National Women’s Health Information Center — a good spot to know of if you’re a woman looking online for reliable sources. It’s a bit simple for my taste. In the intro, we’re told there are 13 essential vitamins our bodies need. After some basics on Vitamin A — good for the eyes and skin, as you probably knew already — the chart picks up with a quick review of the essential B vitamins 1, 2 ,3 ,5 ,6 , 9 and 12 (my favorite), followed by a rundown on Vitamins C, D, E, H (that would be biotin) and K:

Vitamins, Some of their Actions, and Good Food Sources
Vitamin Actions Sources
  • Needed for vision
  • Helps your body fight infections
  • Helps keep your skin healthy
Kale, broccoli, spinach, carrots, squash, sweet potatoes, liver, eggs, whole milk, cream, and cheese.
  • Helps your body use carbohydrates for energy
  • Good for your nervous system
Yeasts, ham and other types of pork, liver, peanuts, whole-grain and fortified cereals and breads, and milk.
  • Helps your body use proteins, carbohydrates, and fats
  • Helps keep your skin healthy
Liver, eggs, cheese, milk, leafy green vegetables, peas, navy beans, lima beans, and whole-grain breads.
  • Helps your body use proteins, carbohydrates, and fats
  • Good for your nervous system and skin
Liver, yeast, bran, peanuts, lean red meats, fish, and poultry.
  • Helps your body use carbohydrates and fats
  • Helps your body make red blood cells
Beef, chicken, lobster, milk, eggs, peanuts, peas, beans, lentils, broccoli, yeast, and whole grains.
  • Helps your body use proteins and fats
  • Good for your nervous system
  • Helps your blood carry oxygen
Liver, whole grains, egg yolk, peanuts, bananas, carrots, and yeast.
B9 (folic acid or folate)
  • Helps your body make and maintain new cells
  • Prevents some birth defects
Green leafy vegetables, liver, yeast, beans, peas, oranges, and fortified cereals and grain products.
  • Helps your body make red blood cells
  • Good for your nervous system
Milk, eggs, liver, poultry, clams, sardines, flounder, herring, eggs, blue cheese, cereals, nutritional yeast, and foods fortified with vitamin B12, including cereals, soy-based beverages, and veggie burgers.
  • Needed for healthy bones, blood vessels, and skin
Broccoli, green and red peppers, spinach, brussels sprouts, oranges, grapefruits, tomatoes, potatoes, papayas, strawberries, and cabbage.
  • Needed for healthy bones
Fish liver oil, milk and cereals fortified with vitamin D. Your body may make enough vitamin D if you are exposed to sunlight for about 5 to 30 minutes at least twice a week.
  • Helps prevent cell damage
  • Helps blood flow
  • Helps repair body tissues
Wheat germ oil, fortified cereals, egg yolk, beef liver, fish, milk, vegetable oils, nuts, fruits, peas, beans, broccoli, and spinach.
H (biotin)
  • Helps your body use carbohydrates and fats
  • Needed for growth of many cells
Liver, egg yolk, soy flour, cereals, yeast, peas, beans, nuts, tomatoes, nuts, green leafy vegetables, and milk.
  • Helps in blood clotting
  • Helps form bones
Alfalfa, spinach, cabbage, cheese, spinach, broccoli, brussels sprouts, kale, cabbage, tomatoes, plant oils. Your body usually makes all the vitamin K you need.

(From; table accessed 2/19/2011.)

Overall I’d say the chart is useful — a good place to start if you want to know, say, what’s a good, non-citrus source of Vitamin C. It could be improved by provision of more details, like the precise amount of Vitamin B2 per cupful of Swiss chard, and how preparing foods in distinct ways — like roasting, sautéing, boiling, or serving them raw — affects the nutritional value.

*This blog post was originally published at Medical Lessons*

First Monetary HIPAA Fine Issued

Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“:

The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996.

A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way.

When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like a test case designed to see just how far you could push HHS, and frankly how incompetent you can be while pushing. Seems HHS was having trouble getting Cignet’s attention. I bet they have it now.

*This blog post was originally published at GruntDoc*

We’re Overdosing On Sodium: Whose Responsibility Is It?

I confess to loving Campbell’s tomato bisque soup. I mix it with 1 percent-fat milk and it’s hot and delicious and comforting, but one of the worst food choices I could make because one cup contains more sodium than I should have in a day. Knowing this, I have already relegated it to an occasional treat. But by the end of this blog post I will do more.

We are overdosing on sodium and it is killing us. We need to cut the sodium we eat daily by more than half. The guidelines keep coming. The U.S. government has handed out dietary guidelines telling Americans who are over 50, all African Americans, people with high blood pressure, diabetes, or chronic kidney disease to have no more than 1,500 milligrams (mg) — or two thirds of a teaspoon — of sodium daily. That’s the majority of us — 69 percent. Five years ago the government said that this group would benefit from the lower sodium and now it made this its recommendation. The other 31 percent of the country can have up to 2,300 mg a day, say the guidelines from the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS).

Or should they? The American Heart Association (AHA) recommends that all Americans lower sodium to less than 1,500 mg a day. Excessive sodium, mostly found in salt, is bad for us because it causes high blood pressure which often leads to heart disease, stroke, and kidney disease and can also cause gastric problems. People with heart failure are taught to restrict salt because water follows salt into the blood and causes swelling of the ankles, legs, and abdomen and lung congestion that makes it difficult to breathe.

I saw one recommendation by an individual on the Internet to just drink a lot of water to flush the sodium out of your body rather than worry about eating foods that have less sodium. BAD idea, especially for people with heart problems who need to restrict fluids to help prevent fluid accumulation in their bodies. The salt will draw the water to it.

But cutting our salt consumption by half is quite a tall order for an individual consumer because Americans have been conditioned from childhood to love salt and we on average consume 3,436 mg — nearly one and a half teaspoons — a day. Sodium is pervasive in our food supply. We get most of our sodium from processed foods and restaurant and takeout food, sometime in unexpected places. Read more »

*This blog post was originally published at HeartSense*

New Dietary Guidelines Give Little New Guidance

There isn’t much new in the latest iteration of the “Dietary Guidelines for Americans.” Three years in the making, the 2010 guidelines (released a tad late, on January 31, 2011) offer the usual advice about eating less of the bad stuff (salt; saturated fat, trans fats, and cholesterol; and refined grains) and more of the good stuff (fruits and vegetables; whole grains; seafood, beans, and other lean protein; and unsaturated fats). I’ve listed the 23 main recommendations below. You can also find them on the “Dietary Guidelines” website.

The guidelines do break some new ground. They state loudly and clearly that overweight and obesity are a leading nutrition problem in the United States, and that a healthy diet can help people achieve a healthy weight. They also ratchet down sodium intake to 1,500 milligrams per day (about two-thirds of a teaspoon of salt) for African Americans and people with high blood pressure or risk factors for it, such as kidney disease or diabetes. But the guidelines also leave the recommendation for sodium at 2,300 milligrams a day for everyone else, a move that the American Heart Association and others call “a step backward.”

Vague language spoils the message

One big problem with the guidelines is that they continue to use the same nebulous language that has made previous versions poor road maps for the average person wanting to adopt a healthier diet.

Here’s an example: The new guidelines urge Americans to eat less “solid fat.” What, exactly, does that mean — stop spooning up lard or Crisco? No. Solid fat is a catchphrase for red meat, butter, cheese, ice cream, and other full-fat dairy foods. But the guidelines can’t say that, since they are partly created by the U.S. Department of Agriculture USDA), the agency charged with promoting the products of American farmers and ranchers, which includes red meat and dairy products. “Added sugars” is another circumlocution, a stand-in for sugar-sweetened sodas, many breakfast cereals, and other foods that provide huge doses of sugar and few, or no, nutrients. Read more »

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

Women’s Health In The U.S. Gets An “F”

The Oregon Health and Science University has published its fifth report card since 2000. It grades and ranks the United States on 26 health-status indicators for women. In 2010, not one state received an overall “satisfactory” grade for women’s health, and just two states — Vermont and Massachusetts — received a “satisfactory-minus” grade. Overall, the nation is so far from meeting the goals set by the U.S. Department of Health and Human Services that it receives an overall grade of “unsatisfactory.”

The national report card uses status indicators to assess women’s health:

  • Women’s access to healthcare services (medically under-served area, no abortion provider, no health insurance and first trimester prenatal care)
  • Wellness  (screening mammograms, colorectal cancer, pap smears, cholesterol)
  • Prevention (leisure time physical activity, obesity, eating five fruits and veggies/day, binge drinking, annual dental visits, smoking)
  • Key conditions (coronary heart disease death rate, lung cancer death, stroke death, breast cancer death)
  • Chronic conditions (high blood pressure, diabetes, AIDS, arthritis, osteoporosis)
  • Reproductive health (chlamydia, maternal mortality, unintended pregnancies)
  • Mental health
  • Violence against women 
  • Infant mortality rate
  • Life expectancy
  • Poverty
  • High school completion
  • Wage gap
  • The score on these varied status indicators fluctuated depending upon which state a woman lives. California and New Jersey ranked highest on state health policies, while Idaho and South Dakota ranked last on policies. Read more »

    *This blog post was originally published at EverythingHealth*

    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 »