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Why Are Humans So Drawn To Sunlight Despite Its Negative Consequences?

Sunny-beachIt doesn’t make sense: If sunlight causes cancer, why are human beings so drawn to it, flocking to sunny beaches for vacation time and hoping for sunshine after a rainy spell?

One answer, says David Fisher, chief of dermatology at Harvard-affiliated Massachusetts General Hospital in Boston, may be that humans are literally addicted to sunshine so our skin can make vitamin D. New evidence suggests that we get the same kick out of being in the sun that we get from any addictive substance or behavior. It stimulates the so-called “pleasure center” in the brain and releases a rush of feel-good chemicals like endorphins.

So there may be more than a desire to look good in a tan behind the urge to soak up the sun’s rays. This craving may be a survival mechanism that evolved over thousands of years because humans need vitamin D to survive. Skin makes this crucial vitamin when it is exposed to sunlight. There isn’t much vitamin D in food (except in some of today’s fortified foods) so the human brain rewards us with a rush of pleasure when we seek out the sun and get vitamin D.

Seeking sunshine can be downright dangerous. As Fisher points out, Read more »

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

Vitamin D For COPD: Why That Won’t Be Enough

I am frequently extolling the health benefits of Vitamin D because almost weekly there is a new study that correlates high vitamin D levels with reducing some disease.  The latest is from the American Journal of Respiratory and Critical Care Medicine and research shows that high doses of vitamin D supplementation improved respiratory muscle strength in patients with Chronic Obstructive Pulmonary Disease (COPD).  The patients that did not receive supplemental vitamin D had blood levels of 22.8 compared to 53.8 in the supplemented group.  The patients who were supplemented had improved respiratory function, strength and less shortness of breath.  It certainly didn’t cure or reverse COPD but the improvement was an encouraging trend in this terrible chronic disease.

In reading about this it got me thinking about COPD and the fact that it is one of the most common reasons for hospitalization and disability in the United States. It is a progressive disease that affects the alveoli (small air sacs that exchange oxygen) and small bronchioles of the lungs.  These airways and air sacs lose their elastic quality and become thick and inflamed.  Mucus forms and patients become progressively short of breath and eventually need supplemental oxygen just to breathe.  COPD is the fourth leading cause of death in the United States.

Did you know that most COPD is caused by Read more »

*This blog post was originally published at EverythingHealth*

How Much Vitamin D Do You Need?

Hand-and-sun

How much vitamin D is enough, and what’s the best way to get your daily dose of the so-called sunshine vitamin? It depends who you ask.

I just attended the latest Forum at the Harvard School of Public Health. The title, “Boosting Vitamin D: Not Enough or Too Much?” was a tip-off that we weren’t going to get a simple take-home message. (Watch a video of the event beginning Wednesday, March 30.)

Some background: Vitamin D isn’t really a vitamin. It’s a hormone. The body makes it when sunlight strikes the skin. This converts a cousin of cholesterol into a substance that ultimately becomes vitamin D. It is best known for helping the digestive system absorb calcium and phosphorus, so it is important for bone health. New research suggests—emphasis on suggests—that vitamin D may also be involved with regulating blood pressure, fighting cancer, and improving the immune system. Read more »

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

Still The “Incredible, Edible” Egg

Enriched chicken feed may have resulted in eggs having less cholesterol and more Vitamin D than previously measured, reports the U.S. Department of Agriculture (USDA).

A large egg today has about 185 milligrams of cholesterol, down 14 percent from 215 milligrams in 2002, according to new research from the USDA’s Agricultural Research Service, reports USA Today. Also, an egg today has 41 international units (IUs) of Vitamin D, up 64 percent from 25 IUs measured in 2002. (That’s still only about 7 percent of the 600 IUs recommended per day.)

The agency regularly does nutrient checks on popular foods, this time analyzing eggs taken from store shelves in 12 locations around the country. The American Egg Board said in a press release that hen feed is made up mostly of corn, soybean meal, vitamins and minerals. Nutrition researchers at Iowa State University are also looking into reasons why cholesterol in eggs is decreasing.

The government’s “Dietary Guidelines for Americans” recommend that most people eat less than 300 milligrams of total dietary cholesterol a day, and people at a high risk of cardiovascular disease should eat less than 200 milligrams a day. The average American man consumes about 337 milligrams of cholesterol a day and the average woman consumes 217 milligrams, reports the Los Angeles Times.

One egg a day fits within the average, healthy American’s diet, reports WebMD, citing research funded by the Centers for Disease Control and Prevention and by the American Egg Board — owners of the slogan “the incredible, edible egg.”

*This blog post was originally published at ACP Internist*

Improving Health For Older Adults

New clinical trials and published research are giving us information on how to improve health in elderly patients. Here are some brief points from the Cleveland Journal of Medicine that were surprising to me:

— Each year 30 percent of people age 65 or older fall and sustain serious injuries so preventing falls and fractures is important. Vitamin D prevents both falls and fractures, but mega doses of Vitamin D (50,000 mg) might cause more falls. A better dose is 1,000mg a day in people who consume a low-calcium diet. 

— Exercise boosts the effect of influenza vaccine.

— The benefits of dialysis in older patients is uncertain, as it does not improve  function in people over age 80. We don’t even know if it improves survival. Older patients who receive dialysis for kidney failure had a decline in function (eating, bed mobility, ambulation, toileting, hygiene, and dressing) after starting treatment.

— Colinesterase inhibitors (Aricept, Razadyne and Exelon) are commonly used to treat Alzheimer disease, but they all can have serious side effects. Syncope (fainting), hip fractures, slow heart rate, and the need for permanent pacemaker insertion were more frequent in people taking these drugs. The benefits of these drugs on cognition is modest.

— A new drug called Pradaxa (dabigatran) will likely prove to be safer than Coumadin (warfarin). Over two million adults have atrial fibrillation and the median age is 75. The blood thinner warfarin is critical for prevention of strokes but it caries a high risk of bleeding and drug levels have to be monitored frequently. Dabigatran will probably replace warfarin, but it will probably also be a lot more expensive.

As I often say, medicine and science are constantly changing and evolving. As new evidence comes forth, physicians and patients need to re-evaluate they way we do things.

*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…

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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…

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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…

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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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