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The Dangers of Flip Flops?


I wrote about an interesting podiatric phenomenon last summer: “flip flop foot.” Some people experience cramping between their toes after walking around in flip flops for significant periods of time.

Flip flops seem comfortable and easy to wear (I like them because they don’t pinch wide feet) but they actually create more work for your foot and leg muscles than regular shoes.  You may not realize it, but when you wear flip flops your toes must grip them extra firmly to keep them from sliding off or sideways.  So you actually contract many extra toe muscles (like the adductor hallucis and the flexor hallucis brevis) with each step you take.  Wearing flip flops for long hours can give you actual cramps in these muscles and others.

But here’s another potential danger associated with flip flops: skin cancer! Dr. Benabio over at The Derm Blog rightly points out that we often forget to put sunscreen on our feet (that may not have seen the light of day since last summer). This puts the skin of our feet at risk for blistering sunburns, and in the long term, skin cancer.

So as you enjoy the warmer weather, take good care of your feet. Walking a mile in your own shoes might be better than doing so in your flip flops.This post originally appeared on Dr. Val’s blog at

The momScore: How Does Your State Rank On Maternal Health Issues?

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Do you know your state’s momScore? Revolution Health and I have teamed up with leading medical experts and mommy bloggers to create a new health index just in time for Mother’s Day: the momScore.

Check out this fun interactive map that ranks states by 10 key maternal health variables*:

  • Access to prenatal care
  • Availability of childcare services
  • Number of insured moms
  • Maternal mortality
  • Affordability of childrens’ health insurance
  • Air quality
  • Family paid leave policy
  • Infant mortality
  • Risk of pregnancy complications
  • Violent crime rate

We also created a combined average of these variables (weighted according to expert perceived importance) to get an overall ranking. So, do you know where it’s best to be a mom in the United States?

Apparently, Vermont ranks most favorably (on average) in all of these variables. Don’t live in Vermont? Check out how your state compares.

Would you like to discuss your state’s rankings with others or debate the momScore? You can post your comments in our interactive momScore community. This is a really exciting opportunity to discuss women’s health issues in a fresh new way. I hope that the momScore will challenge states to strengthen their efforts to keep moms and babies healthy. At the very least, we’ve made a lot of Vermonters quite smug.

*Variables are based on state reporting to the Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention (CDC), and the United States Census Bureau, as well as leading non-profit organizations such as the Kaiser Family Foundation and the American College of Obstetricians and Gynecologists. For more information about momScore methodology, click here.This post originally appeared on Dr. Val’s blog at

Dr. Val: Poster Child for Skin Cancer Risk

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May is skin cancer awareness month, and Revolution Health has created an awareness campaign to help people become more educated about their risks. In a unanimous vote, I was selected as the blogger/spokesperson for skin cancer awareness – probably because I’m “the fairest in the land.” Well, the truth is I’m so white I’m actually closer to light blue – couple that with a high freckle count and green eyes and you’ve got one very high risk lady.

So I’ve decided to see a dermatologist once a year for a full skin check. I must admit that the first year I went I was convinced that I’d be biopsied into oblivion. The only way to be sure that a mole is not cancerous is to take a sample and check it under the microscope. So any doctor with a conservative eye would need to do a lot of “rule out melanoma” testing, right? Wrong. I was happily wrong. Dermatologists are trained to recognize individual freckle and mole patterns, and don’t do a biopsy unless they see an “ugly duckling” mole – one that stands out from all the others. I was so excited to escape the office with my skin in tact that I vowed to be obedient and return for a yearly check up.

If you are fair skinned and/or have had a significant amount of sun exposure in your life, or if people in your family have had skin cancer, you should definitely check in with a dermatologist to make sure you don’t have any suspicious moles. The doctor will tell you how frequently you should have follow up exams.

Here are some things you can do right now:

Find out if you’re at risk for skin cancer and learn what you can do to prevent it.

See what skin cancer looks like.

Check out my recent interview with Dr. Stephen Stone, past president of the American Academy of Dermatology, about skin cancer and about tanning salons.

Coming soon: the true story of my blogger friend who had a basal cell carcinoma removed from the side of her nose. She required plastic surgery to fill the gap, but it looks great now!This post originally appeared on Dr. Val’s blog at

Can You Trust Your Health News?


I just discovered this wonderful non-profit organization devoted to rating the quality of the journalism behind health news reports. Health News Review was founded by Gary Schwitzer, a journalist devoted to consumer empowerment through accurate, spin-free health reporting.

The fun part of this website is that if you see a health segment on Good Morning America, the CBS Evening News, or other TV or major media outlet you can check with the experts at Health News Review to find out if the information you heard was accurate.

Here’s an excerpt from a recent review of a news story that was reported in an irresponsible manner:

This story about a spa-based treatment for reduction of adipose deposits provided little viewer education.  Its sole purpose appeared to be as a hook for a more in-depth broadcast which was to occur in that night’s prime time programming.  It did not inform viewers about lipo-dissolve in a balanced way or in a manner that would allow them to understand the likelihood of having the adverse outcomes.

The story did not discuss the quality of the evidence available supporting this treatment as effective or ineffective.  It contained only anecdotal examples about lipo-dissovlve gone bad.  However – this is inadequate information on which to base a decision, even a cosmetic one.  Although the women interviewed had adverse effects from the treatment, the story gave no indication of whether these outcomes were exceptions or were the rule.

The approach followed a typical TV news formula:  promote something as “sweeping the country…new phenomenon…hottest thing since Botox… reportedly tens of thousands of procedures completed”, then slam it as expensive and unsafe.

Where was the shoe leather journalism to hang some facts on those bones?  Why did they have to say “reportedly” tens of thousands of procedures completed?  Reported by whom?  What did ABC’s own investigation find?  Were any trials done?  What were the quantifiable benefits and quantifiable harms?

Maybe that evening the ABC 20/20 program answered some of these questions.  But for the viewers up early (and possibly not staying up for the 20/20 program), the morning program was a shoddy tease.

If the Health News Review gains enough momentum and recognition, maybe we can raise the quality of health journalism on a national basis. Fear of exposure of shoddy journalism could pressure the media to do a better job of giving us accurate and trustworthy information. Here at Revolution Health our medical experts are doing their best to clarify and comment on the news for you in their blogs. Don’t believe everything you hear on television… if something sounds too good to be true, check it out with the Health News Review or Revolution Health experts to get to the bottom of things.This post originally appeared on Dr. Val’s blog at

When is Weight Loss Surgery an Appropriate Option?


I’ve wrestled with this question for many years: “When is weight loss surgery an appropriate option?” I used to do weight loss research prior to working at Revolution Health. My studies focused on using “natural” methods to reverse type 2 diabetes – in other words, weight loss via diet and exercise. My study subjects were all obese, and most had struggled with weight for decades.

At some point during the trial, people would often ask: “Can’t I just have surgery for this and not have to struggle so much?” And I would gently remind them that surgery was no picnic, and to try diet and exercise first. “But it’s so hard!” they would say. I would acknowledge their difficulties and offer lots of empathy, and firmly encourage them to stick with their diet. In the end I found that only half of my study subjects could manage to stay on the diet for months at a time. So what should the other half do? Give up and let their diabetes ravage their bodies?

My friend and colleague Dr. Charlie Smith rightly points out that weight loss surgery can dramatically improve the health of people who have been unsuccessful at losing weight through diet and exercise. Heart disease, diabetes, and cancer rates were dramatically improved for morbidly obese people after weight loss surgery. So there is a clear benefit for some people to have the procedure.

However, the caveats should not be overlooked. First of all, weight loss surgery does not guarantee long term weight loss. It’s possible to gain back all the weight lost if eating behaviors are not changed. The human stomach is amazingly stretchy, and even if it’s surgically reduced in size, with repeated overeating it can eventually stretch to accommodate large meals again. Secondly, some types of weight loss surgery (like gastric bypass) can affect the body’s ability to absorb critical vitamins. Without enough of these nutrients, one can end up severely anemic, and osteoporotic just to name a few serious side-effects. And finally, the surgery itself is quite dangerous, carrying with it a potential risk of death as high as 1 in 200!

So weight loss surgery can be life-threatening, and is not a quick fix for a long term problem. However, morbid obesity itself is so dangerous (with the increased risk of heart disease, diabetes, and cancer) that it may require this extreme intervention to actually save lives. For people who have more than 100 pounds to lose, and have sincerely tried diet and exercise without success for a prolonged period, then weight loss surgery may be an appropriate option. For those whose lives are not at risk because of severe obesity, it doesn’t make sense to undergo such a risky procedure.

Are some people successful at losing a large amount of weight and keeping it off without surgery? Yes! The National Weight Control Registry keeps a list of thousands of Americans who have lost at least 30 pounds and kept them off for at least 6 years. What’s their secret? You guessed it – regular exercise and a calorie controlled diet. Some other things that these “successful losers” have in common: 1) they eat breakfast 2) they have a cardio machine at home 3) they weigh themselves regularly.

If you’d like to meet a group of people who are working towards long-term weight loss success, feel free to join my weight loss support group. We have weekly challenges, tools and trackers, a vibrant discussion group, and free medical insights to help you along your way. Weight loss is really hard to achieve by yourself. It takes encouragement, support, and a community of like-minded folks who are determined to make a difference. You can do it!… and I’d be honored to support you along the way.

P.S. There’s a special group forming at Revolution Health for folks who need to lose 100 or more pounds. It’s called “Overweight But Not Giving Up.”  Check it out.This post originally appeared on Dr. Val’s blog at

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