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Latest Posts

Glycemic Load: How To Lose Weight Without Being As Hungry

I’ve written before here about the glycemic index, that measure of how fast a food causes your blood sugar to rise. High glycemic foods, like simple sugars, cause our blood sugars to rise quickly resulting in a pouring out of insulin, a rapid fall in our blood sugar, and we become hungry again soon. Protein in our diet blunts this glycemic index effect, as does eating more complex carbohydrates such as vegetables.

An new concept has emerged that complements the glycemic index, called the glycemic load. The glycemic load reflects how much total carbohydrate is released in your body from various foods. While carbohydrates, sugars and starches, are a core part of our nutrition, we know that eating a lot of them results in more hunger and we end up eating more calories and gaining weight. Low carbohydrate diet plans have shown some advantage over low fat diet plans for losing weight, although both work if the total calories eaten are reduced. Read more »

*This blog post was originally published at eDocAmerica*

The Four Pillars Of Health

I recently moved my work to the Palm Springs area of California. I am the Vice President for Primary Care at Eisenhower Medical Center in Rancho Mirage, California. My duties include starting a new primary care practice where I also work as a family physician. This week I developed a preventive medicine presentation I will be giving to groups of people, mostly seniors, in our area. I would like to share my key messages here.

Balance is the key to health in many ways. Our lifestyle choices play the major role in whether we are healthy or sick, outweighing our genetics and the bad luck of getting a disease for no apparent reason. There are four areas where lifestyle play a major role in our health. Do these four things and you are likely to be healthy:

Eat Right: We are what we eat, so what goes in our body is vital to our health. The mainstay of our nutrition should be vegetables and grains. We should avoid the saturated fats found in many animal meats and dairy, and the trans fats found in many fried foods and pastries. Eat healthy fats like those found in nuts and quality vegetable oils, such as canola and olive oil. We should avoid simple sugars that make us hungry and have protein at every meal (Nuts, low fat dairy, lean meats and fish). We should avoid excess salt. Do not eat many more than your body needs to maintain a healthy weight. See my other blogs since I write here about nutrition every month.

Be Active: Use it or lose it is a good rule for keeping our bodies healthy. Look for opportunities in your daily life to walk more, climb stairs and be active. Then, devote 5 of the of the 168 hours in a week to one or more physical activities of your choice. Being physically active is the best long term predictor of living a long and healthy life.

Sleep Well: We trained our children in how to sleep, but many of us forgot the lessons. Prepare for a good night’s sleep by winding down our daily activities, turn down the lights, and leave the problems of our day behind. Imagination is ok for adults to use to enter the world of sleep. As adults, 6 to 8 hours of refreshing sleep is usually enough to replenish our bodies.

Manage Stress: Stress can wear down even the healthiest body. Be aware of our stress levels at home and at work, and seek ways to reduce the stressors. Some of us thrive on a certain amount of stress, that is fine. We know when we are distressed because we are not at ease and not smiling as much. I like these three rules for handling stress: 1. Don’t sweat the small stuff, 2. Everything (just about) is small stuff, and 3. If you cannot fight, and you cannot flee, then flow.

Take a moment to reflect on these four “pillars” in your life and see what adjustments you can make to preserve your health.

*This blog post was originally published at eDocAmerica*

Hidden Food Ingredients: Don’t Believe The Health Hype

Do we need to be a detective to find out which foods are healthy?

Magnify Glass


In yesterday’s Washington Post,  Jennifer LaRue Huget, blogger for “The Check Up” writes about the new unhealthy line of Kraft Lunchables.

Kraft calls the new line “wholesome,” but are they?

Turkey and Cheddar Sub Sandwich seems like it could be a healthy choice, but actually it is filled with fat, sodium and sugar.  Here’s a complete list of ingredients that may shock you.

Digging a little deeper

I’m curious now to find out what’s behind the “New Deep Dish Cheese Pizza.”  Here’s how it’s described:

You won’t have to dig deep for our Deep Dish Pizza, made with Kraft 2% Mozzarella and 2% Cheddar, deep dish crust made with whole grain, Tombstone Pizza Sauce, Tree Top® Applesauce, Mini Nilla Wafers, spring water and Tropical Punch Kool-Aid Singles.

It doesn’t sound so bad, does it?  Low fat cheese, whole grain crust, pizza sauce, applesauce, mini Nilla Wafers, spring water; what’s so bad about that?  One more ingredient includes Tropical Punch Kool-Aid Singles.  Hmm…what was wrong with just the water?  Why add all that sugar?

Okay, I’m digging deeper now to read the ingredients.  Well, take a peek, and you decide.  The long list of ingredients isn’t healthy.  The Deep Dish Pizza is filled with fat, calories, sodium, cholesterol, and sugar.

Read the Ingredients

It’s really important to read the ingredients and not just the label.  The packaging and wording are created in such a way to capture your attention and it gives the appearance that it’s healthy, but in fact it is not.

Playing detective

You could actually make a game out of this with your kids.  Take them food shopping with you and have them take the “Food Label Challenge Test.”  (I just made that up).  Show them the package and the front label, ask them if they think it’s healthy or not.  Have them read the ingredients, you may be surprised at what you find!  The little gumshoes may enjoy the challenge.

So remember, make sure the next time you’re out food shopping, read the ingredients, not just the front label. Playing detective might not be such a bad idea; you may be surprised at what you find in your foods.

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

Magical Thinking Of The Week: The Anti-Inflammation Diet

Alternative medicine practitioners love to coin magic words, but really, how can you blame them? Real medicine has a Clarkeian quality to it*; it’s so successful, it seems like magic. But real doctors know that there is nothing magic about it. The “magic” is based on hard work, sound scientific principles, and years of study.

Magic words are great. Terms like mindfulness, functional medicine, or endocrine disruptors take a complicated problem and create a simple but false answer with no real data to back it up. More often than not, the magic word is the invention of a single person who had a really interesting idea, but lacked the intellectual capacity or honesty to flesh it out. Magic is, ultimately, a lie of sorts. As TAM 7 demonstrates, many magicians are skeptics, and vice versa. In interviews, magicians will often say that they came to skepticism when the learned just how easy it is to deceive people. Magic words in alternative medicine aren’t sleight-of-hand, but sleight-of-mind, playing on people’s hopes and fears.

A reader has turned me on to another magic word I hadn’t known about. It’s called the “Inflammation Factor”, and is the invention of a nutritionist named Monica Reinagel. Like most good lies, this one builds on a nidus of truth.

Inflammation is a medical term that refers to a host of complex physiologic processes mediated by the immune system. Inflammation gets its ancient name from the obvious physical signs of inflammation: rubor, calor, dolor, tumor, or redness, heat, pain, and swelling. As the vitalistic ancient medical beliefs bowed to modern science, inflammation was recognized to be far more complex than just these four external characteristics. In addition to being a response to injury and disease, the cellular and chemical responses of inflammation can cause disease. For example, in asthma and food allergies, a type of immune reaction called type I hypersensitivity elicits a harmful type of inflammation. Coronary heart disease, the biggest killer of Americans, is believed to have a significant inflammatory component.

But nothing in medicine is perfectly simple. For example, corticosteroids, which can be used effectively to treat the inflammation in asthma are not effective against the inflammation in cororary heart disease. It’s just not that simple.

But while inflammation may not be that simple, people can be. People want easy answers, and quacks are happy to step in to provide them.

So Ms Reinagel has invented a diet, available for sale in a book called The Inflammation Free Diet Plan. Her premise is that inflammation is at the root of all major diseases, and that your diet can affect inflammation, thereby improving your health.

While the hypothesis is intriguing, each step of the argument has problems, leading to an invalid conclusion.

Inflammation is the root of all disease

No, it’s not. “Inflammation”, which is actually refers to a lot of different processes, plays an important role in many diseases. But not all inflammation is the same.

The most important factor in fighting inflammation is the food you eat every day.

Um, no. If you have a staph infection on your arm, your eating habits will not change the amount of heat, pain, swelling, or redness. The kernel of truth here is that diet can affect various measures of inflammation, such as C-reactive protein (here is one of many examples). There’s a long leap between this fact and the conclusion that diet can “stop inflammation”.

The benefits of reducing inflammation are immediate as well as long term. You’ll notice that your skin looks younger, your joints feel better, and your allergy symptoms improve. At the same time, when you reduce inflammation, you also reduce your risk of heart disease, Alzheimer’s disease, cancer, osteoporosis, diabetes, and other complications of aging.

It’s a very long walk from the claim that reducing inflammation is “a good thing” to proving that your particular diet reduces inflammation and thereby improves health . A hypothesis is not true simply because it sounds pretty.

Who wouldn’t love a magic book that would prevent and cure all illness? Perhaps you’ve noticed that these books come along every few months. None of them ever has the one true answer. Life is much more complicated and beautiful than any magic book. It may be a lot more difficult to commit science than to commit quackery, but in the end it’s a lot more satisfying and a lot more useful.

*”Any sufficiently advanced technology is indistinguishable from magic.” –Arthur C. Clarke’s Third Law

*This blog post was originally published at Science-Based Medicine*

Get Your Fruit On

Get Your Fruit On! I love this new tagline from Tropicana. Statistics show that 7 out of 10 Americans are not getting enough fruit in their daily diets. The Dietary Guidelines encourage us to get 2 cups of fruit per day. For those who do get their fruit, many are getting it from 100% orange juice.

Children are especially susceptible to not getting enough fruit. An 8 ounce glass of 100% orange juice has:

  • 2 servings of fruit
  • 120% of Vitamin C
  • 13% of Potassium
  • 15% of Folic Acid
  • No Sugar Added
  • 110 Calories

Tropicana is actually donating up to a quarter of a million fruit servings in the form of Tropicana Pure Premium 100% orange juice to the USDA Summer Food Service Program and the School Breakfast Program. Both programs offer free or reduced price nutritious meals to children in low- income areas. Tropicana did this by getting 5,000 Americans to pledge to increase their fruit intake.

Other tips to Get Your Fruit On (courtesy of Elizabeth Ward, RD):

  • Add in-season fruit to your morning bowl of oats or cereal.
  • Blend a smoothie using your favorite fresh or frozen fruit and a cup of OJ
  • Create a breakfast trail mix by combining dried fruit, nuts, and cereal. You can also use this as a snack.
  • Assemble breakfast fruit kabobs using pineapple chunks, bananas, grapes, and berries.
  • Drink a glass of 100% fruit juice at breakfast.

This post, Get Your Fruit On, was originally published on by Brian Westphal.

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Latest Book Reviews

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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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