August 27th, 2008 by Dr. Val Jones in Uncategorized
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Recently, the FDA has required that supplement manufacturers accurately identify the ingredients of their products on their labels – though this mandate does not address efficacy or safety claims. Supplement manufacturers may make all sorts of claims about their products, without needing to provide evidence to support them. In fact, supplements may even contain ingredients known to be harmful. The FDA provides a short list here.
Does the FDA’s ingredient disclosure rule protect us (note that some manufacturers have until June, 2010 to comply)? I have a feeling that it is a little bit like keeping people honest with their taxes – the threat of a potential audit is supposed to galvanize citizens into proper documentation of their receipts and business expenditures, but the fact that the IRS doesn’t have the bandwidth to audit more than about 1% of the population (and they usually target those with higher incomes) means that some people “cheat” on their taxes.
The same holds true for supplement manufacturers. They know that they’re supposed to accurately represent the contents of their products on the label and engage in good manufacturing practices – but the chance of the FDA actually performing chemical tests on their product (since there are hundreds of thousands of them out there) is so low that they have no real incentive to comply. Many of them probably feel that they’ll cross that bridge when they come to it. After all, supplements are a $20 billion/year industry.
A new study in the Journal of the American Medical Association reviewed the contents of one small subtype of supplements – traditional Ayurvedic medicines. They found that 1 in 5 samples (of 193 products sold via the Internet at 25 different websites) contained lead, mercury, and/or arsenic. I hope that this sobering statistic will make consumers think twice before reaching for that next “miracle cure.”
The FDA has an excellent (though somewhat dated) review article here. In it, they recommend the following:
To help protect themselves, consumers should:
- Look for ingredients in products with the U.S.P. notation, which indicates the manufacturer followed standards established by the U.S. Pharmacopoeia.
- Realize that the label term “natural” doesn’t guarantee that a product is safe. “Think of poisonous mushrooms,” says Elizabeth Yetley, Ph.D., director of FDA’s Office of Special Nutritionals. “They’re natural.”
- Consider the name of the manufacturer or distributor. Supplements made by a nationally known food and drug manufacturer, for example, have likely been made under tight controls because these companies already have in place manufacturing standards for their other products.
- Write to the supplement manufacturer for more information. Ask the company about the conditions under which its products were made.
Interested in purchasing supplements from companies who voluntarily submit their products to rigorous testing? Try consumerlab.com Their mission is “to identify the best health and nutritional products through independent testing.”
However, in my opinion, very few supplements offer any valuable health benefits (beneficial vitamins and minerals for certain populations include Vitamin D, Calcium, folic acid, and Vitamin B12).
The American Academy of Family Physicians found no evidence to recommend a single weight loss supplement. A healthy diet combined with regular exercise is the most important “supplement” you can take for optimum health.
And one thing I’m sure of – you don’t need any extra arsenic, lead, or mercury in your diet. Be careful what you put in your body!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 26th, 2008 by Dr. Val Jones in Uncategorized
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If you’re trying to lose weight, it helps to have a specific plan. I found this out the hard way. Over the past few months I’ve watched my weight creep up very slowly into my discomfort zone. I resolved to reverse the trend by “trying harder to eat healthy food” and to “walk more.”
Seasoned dieters will point out that these vague resolutions were destined to fail, and unfortunately that’s what’s happened. However, my scale has galvanized me into action and I have prepared a very specific plan of attack. I’m going to walk 10,000 steps per day (based on my pedometer) and I’m going to follow the Atkins Diet.
Some of you may gasp, “But Dr. Val, surely you know that the Atkins Diet isn’t healthy!” Yes, that’s what I thought initially too. However, a quick review of the new Atkins Diet site suggests that it may not be as bad as we make it out to be. The old “all you can eat bacon and cheese” approach is not really what Atkins is about. Instead, it’s a staged approach to cutting down on the refined carbohydrates in our diets. The first stage (which only lasts 2 weeks) is quite strict (only 20 grams of carbs/day) but after that you can begin adding back some of the complex carbs that are important to a balanced diet. Spinach has almost no carbs – so I’m going to give Popeye a run for his money this week!
Here’s what I like about the Atkins Diet: 1) it’s really easy to follow 2) you never have to feel hungry 3) I’m an omnivore, so lean meats are enjoyable to me 4) it addresses my personal dietary issue head on: carb addiction.
What I don’t like so much is this: 1) protein can be quite expensive, so expect your grocery bill to increase on this diet 2) you must not cheat, especially in the induction phase – it will throw off the whole process 3) no more cereal or Nutella – ack!
The Atkins Diet is not for everyone – those who have a history of gout, kidney stones, osteoporosis, or kidney problems may not be good candidates as a high protein diet can trigger gouty and kidney stone attacks and can worsen osteoporosis. Also, vegetarians might find it difficult to get enough protein from carb-less sources. And finally, red meat consumption is associated with colon cancer, so if you’re planning to stay on the Atkins diet for long periods of time, try to limit the red meat intake.
However, research has shown that a very low carb diet is an effective approach to weight-loss (perhaps even more effective than other diets) and has a favorable impact on blood cholesterol, insulin, and glucose levels.
Wish me luck on my new journey – and feel free to join me in my online weight loss group so that we can do this together.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 22nd, 2008 by Dr. Val Jones in Uncategorized
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Last night’s blog talk radio show with Dr. Anonymous was outstanding. Dr. Ramona Bates was the guest of the evening, and I called in (around the 30 minute mark) to discuss subjects ranging from how a surgeon saved my life, to medical boards, to my cat’s “security quilt” – created by Ramona.
Towards the end of the show we had a radiologist from India (Scanman), a surgeon from South Africa (Bongi), a family physician from California (Theresa Chan), a LDS pre-med (Mary) and a medical student from Texas (Enrico) all call in to praise Ramona’s blog.
Blogging can really unite people from all corners of healthcare in new and exciting ways.
Listen to the show here.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 22nd, 2008 by Dr. Val Jones in Uncategorized
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My friend and fellow blogger Dr. Kevin Pho just published an op-ed in USA Today explaining why cutting physician salaries will not reduce healthcare spending. Here is an excerpt:
The number of physicians who do not accept new Medicare patients is dramatic; in states like Texas, this number can exceed 40%. No wonder, as Medicare pays less than half of doctors’ fees. This scenario comes as a record number of Boomers approach Medicare age.
Those without Medicare are not spared the consequences. Seniors sometimes delay their care, leading to expensive treatment in the emergency department. Doctors who lose money seeing Medicare patients could pass on the costs to the privately insured.
According to the Kaiser Family Foundation, there are more significant drivers of health costs, including new prescription drugs, technology and administrative needs. Princeton economist Uwe Reinhardt estimates that physicians’ take-home pay represents roughly 10% of national health care spending. Cutting physician pay by 20% would only reduce spending by 2%.
I’ve also blogged about the plight of primary care physicians – as their salaries do not allow them to meet their high overhead costs.
As decreases in Medicare reimbursements begin to make it impossible for small practices to afford their supplies, rent, and coding and billing staff, more physicians will simply stop accepting Medicare patients. This means that the taxes that Baby Boomers have been paying all their lives will essentially not result in a guarantee of good medical coverage in their retirement. They may need to pay out-of-pocket to purchase additional insurance or to have a good primary care physician available to them 24-7.
Concierge practices like Alan Dappen’s may fill a gap in care. With full price transparency, availability via email and phone 24 hours a day, 7 days a week, house calls, and affordable fees – savvy patients will realize that his services are well worth the small out-of-pocket expense (on average, his patients spend $300/year on his services).
What’s my bottom line? I think we all need to save as much as we can of our own personal funds in case government programs do not provide us with adequate health coverage in our futures. At least if we grow our own healthcare nest egg, we’ll have more care choices in the future. And those choices may one day be a matter of life and death.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 20th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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Usually I prepare a weekly (or bi-weekly) feature called “Heard Around The Blogosphere” but this time I’d like to devote my list to images – things SEEN around the medblogosphere. Here’s my top 10 list:
1. Paul Levy’s feet (he is the CEO of Beth Israel/Deaconess Hospital in Boston – and he has some pretty impressive bunions)
2. Doggie scuba gear – I doubt the dogs enjoy it
3. Prosthetic limbs inspired by “retro” furniture – from Medgadget.com
4. TV sunglasses for use at the dentist’s office – now that will keep your mind off things!
5. A fake necktie is actually a cooling device – anesthesiologist Joe found this interesting Japanese invention for men.
6. Beer goggles from the Happy Hospitalist
7. Bizarre bread sculptures that resemble human body parts – from Boing Boing
8. Too many fingers – art by Street Anatomy
9. A skeleton necklace – found by Happy Hospitalist
10. Margarine ad with something lost in translation – Fail BlogThis post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
