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

Latest Posts

Potassium And Exercise: Sports Drink Or Orange Juice?

As I stutter through recovery from LungMutiny2010, I’m paying more attention to my diet. So as I try to go out for my 10-minute walk everyday, I still drink some sports drink — usually Gatorade made from the massive vat of powder you can buy at Costco.

We tend to get plenty of sodium in our diet — far too much in the U.S. actually — but I always worry about potassium when I’m sweating (Disclaimer: I am not an exercise physiologist or a cardiovascular or nephrology physician.)

I always thought that the widely-sold sports drinks were the best sources of potassium outside of eating bananas or some dried fruits. I was surprised to learn that an 8-ounce serving of orange juice contains 18-fold more potassium than an 8-ounce serving of Gatorade® (450 mg vs. 25 mg). Who knew? Read more »

*This blog post was originally published at Terra Sigillata*

High Blood Pressure & Eye Damage

Ever wonder what the doctor is looking for when she shines the light into your eyes, up close and personal?
This is what she sees if the patient has severe hypertension. The retina shows blurring of the optic disc (in the middle left) and the white areas are called “cotton wool spots”. The blurry part at the bottom is a partial retinal detachment. The patient’s blood pressure was 220/150.

*This blog post was originally published at EverythingHealth*

Dairy Products May Help To Reduce Chronic Disease

Happy Thanksgiving everyone – I thought I’d blog about food today, and to try to persuade you to trade that pumpkin pie for a glass of milk…

I learned some interesting things at the Dairy Science Forum on November 13th in DC. Dr. David McCarron presented some compelling data on the effects of the DASH diet on reducing blood pressure. The DASH diet is fairly high in dairy products (2-4 servings/day), fruits, and vegetables. In comparison with a low-salt diet (which reduces systolic blood pressure by an average of 1 point), the DASH diet can cause an average reduction in systolic blood pressure of ten points. If you have high blood pressure (and your kidneys are functioning normally) you probably shouldn’t worry all that much about the salt. It’s more important to stick with the DASH diet.

I interviewed Dr. McCarron about the role of dairy in blood pressure management. Here’s what he had to say:

Dr. Val: If salt isn’t the real enemy, and dairy can help to reduce blood pressure, why isn’t that message getting out?

Dr. McCarron: We have national nutrition policies in place that are old and out of date. The healthy eating paradigm – low fat, low sugar, low salt – was established 40+ years ago and when new evidence is obtained, it’s really hard to crack through that illusion of knowledge. There is excessive mistrust of new data because of the attitude that if it conflicts with our previous beliefs, it can’t be true.  I believe that the Internet will be critical in allowing the evidence to bubble up. For example, a diet rich in dairy food is absolutely associated with a reduction in virtually all chronic medical conditions. We have data to support this for people of all ethnicities and from around the world. I think that consumers are looking for clarity and simplicity in their nutritional advice – and basically they need to know that a healthy diet requires 3-4 servings of dairy and 5-6 servings of fruits and vegetables/day. If you do that alone (along with regular exercise) you’ll be amazed by the results.

Dr. Val: What is the proposed mechanism by which dairy has all these positive effects?

Dr. McCarron: It’s almost impossible to nail down specific mechanisms because milk products contain so many ingredients (electrolytes, key vitamins, bioactive proteins, and essential fatty acids). Trying to understand which piece is impacting very complicated physiological control mechanisms within the body (that have 30-40 different vectors feeding into them) is extremely difficult. In fact, the permeatations make it almost impossible. We can’t come up with the proof that we do for drugs (which contain only one bioactive ingredient). What we do know, though, is that dairy is a vital component for chronic disease reduction and prevention. Unfortunately the policy people say, “you haven’t explained to me how this works, so I’m not going to consider it.”

Dr. Val: But what about the research suggesting that whey protein contains lactokinins that function similarly to ACE inhibitors (a type of blood pressure medicine)?

Dr. McCarron: That’s been known for over a decade. There’s no question that there are small peptides (proteins) in milk that have a positive impact on blood pressure, mood disorders, and weight reduction. The industry doesn’t want to talk about it because it makes milk sound like a drug, which isn’t effective marketing. Also the average consumer doesn’t have enough background to understand what that means (lactokinins have ACE inhibitor-like effects in vivo), so we need to simplify the message and disseminate it via the Internet.

References:

NEJM, 1998 Effects of Dietary Patterns On Blood Pressure

Am J Hyper, 2004 McCarron and Heaney

JAMA, 2002 Pereria et al

Science, 1984, McCarron et al

JAMA, 1996, Bucher et al

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 »