December 8, 2003 FTC Alters Stance On Media Firms, Weight-Loss Ads
By Ryan J. Foley. The Wall Street Journal. December 9, 2003
Glaxo Chief: Our Drugs Do Not Work On Most Patients
By Steve Connor, Science Editor. December 8, 2003
New Test to Aid Breast Cancer Patients
By T.A.Badger. The Associated Press. December 5, 2003
December 10, 2003
Reduced Vitamin D Levels Found in Chronic Pain Patients
University of Minnesota, Greg Plotnikoff, MD
Heavy Weight Lifting Is Dangerous for Some
By Thomas M. Burton. The Wall Street Journal. December 4, 2003
Antioxidants May Curb HPV Persistence
Journal of Infectious Diseases November 15, 2003
ADHD Drugs' Long-term Effects Examined
William Carlezon of McLean Hospital and Harvard Medical School
December 11, 2003
Egg Prices Hit 20-Year Highs, As protein Diets Catch On
The Wall Street Journal, December 10, 2003
Patterns: In Aging, Distress Takes Its Toll
By John O'Neil. The New York Times. December 9, 2003
U.S. to Warn Women of Mercury in Tuna-newspaper
Reuters, Dec. 11, 2003
December 13, 2003
Lycopene Inhibits Growth of Normal Prostate Cells
November 2003 Journal of Nutrition
Kids Who Watch More TV Eat Fewer Vegetables
Renee Boynton-Jarrett, Hard School of Public Health
Progression of Age-Related Macular Degeneration Associated With Dietary Fat, Transaturated Fat, Nuts, and Fish Intake
Arch Opthalmol.2003;121:1728-1737
New Investigational Treatment for Vision Loss Show Promise
http://www.alconinc.com [Retaane]
A Hug-Free Holiday: How Worried Should You Be About the Flu?
By Betsy McKay. The Wall Street Journal. December 9, 2003
Hydrotherapy and Exercise Help Arthritis Patients
Annals of the Rheumatic Diseases, December 2003
Morning Exercise May Make Sleep Easier
Anne McTiernan. Fred Hutchinson Cancer Research Center
Early Exercise Wards Off Osteoporosis
Journal of the American Academy of Pediatrics
New Patch Nixes the Liquid Lunch
By Louise Knapp. WIRED Magazine. November 28, 2003
Home Test for Signs of Menopause
By Jane E. Allen. LA Times. December 8, 2003
December 15, 2003
The Big Bad Flu or Just the Usual?
By Lawrence K. Altman. The New York Times. December 14, 2003
Giant Rats to Sniff Out Tuberculosis
NewScientist.com, December 16, 2003
Diet May Influence Hay Fever Risk
Allergy, December 2003
December 16, 2003
Low Selenium Linked to Pregnancy Complications
Am J of Ob and Gyn, November 2003
A Memory Patch?
By Jane E. Allen. Times Staff Writer. December 15, 2003. Findings published in Psychopharmacology
December 18, 2003
Liquor Industry's New Pitch: How to Drink Alcohol on Diet
By Christopher Lawton. The Wall Street Journal. December 17, 2003
Ginger For Morning Sickness Deemed Safe in Study
American Journal of Obstetrics&Gynecology, November 2003
Study Says Pollution Increases Chances of Heart Disease
C.Arden Pope III. Circulation
December 20, 2003
Dallas Barbers Become Blood-Pressure Specialists To Help Cut Hypertension in African-American Men
stephen.obrien@utsouthwestern.edu
Tooth Study Won't Prompt Smiles In Appalachia
Morbidity and Mortality Weekly Report, December 19, 2003
Half of Older Physicians to Seek Career Alternatives
Survey done by www.merritthawkins.com
Too Much Alcohol Bad for Blood Vessels
Arteriosclerosis, Thrombosis, and Vascular Biology, December 2003
Effectiveness of Leech Therapy in Osteoarthritis of the Knee
Ann Intern Med, November 4, 2003;139(9):724-730
'Six Degrees of Immunization' Strategy Proposed
Scientific American. December 17, 2003
Silver Cars May Be Safest:study
University of Auckland, New Zealand
Lifelong Inhibitions Hasten Rodents' Death
Proceedings of the National Academy of Sciences
December 27, 2003
States Mulling Laws to Help Curb Obesity
The Associated Press. December 24, 2003
"Multivitamins Could Save Medicare Millions"
Direct quote from "Family Practice News"; December 1, 2003. Page 38
The Science of Naming Drugs
By Donald G. McNeil, Jr. The New York Times. December 27, 2003
January 3, 2004
Why Running is Not for People
BMJ. Volume 327; 20-27 December 2003. page 1476
An Operation to Ease Back Pain Bolsters the Bottom Line, too
By Reed Abelson and Melody Peterson. The New York Times. December 31, 2003
Weighing Yourself in the Car
By Sabra Chartrand. The New York Times. December 29, 2003
Gastric Bypass Surgery Cures Diabetes
Jan 2004, Annals of Surgery
January 5, 2004
Eat Worms, Feel Better
BBC News, December 3, 2003
CT Scan Radiation May Affect Kids' IQ
British Medical Journal, January 3, 2004
Football Similar to Car Crashes
www.cbsnews.com Jan 3, 2004
January 8, 2003
Doughnut Makers Must Fry, Fry Again
By Shirley Leung. The Wall Street Journal. January 5, 2004
January 9, 2004
German Brewery Says Develops ,'Anti-Ageing' Beer
Neuzeller Kloster Brewery
American Stroke Victims Develop Foreign Accents
abcnews.com January 3, 2004
Need to Gain Weight? Try Dieting
Pediatrics 03:112(4):900-906
January 10, 2004
The Cooper Institute/Vitamin Supplementation Lowers C-Reactive Protein
American Journal of Medicine, Vol. 115, Number 9, published by Elsevier
More Cancer Patients Receiving Aggressive Care At End of Life
Dana Farber Inst: 617 632-5357
High Saturated Fat and No-Starch Diet
Mayo Clin Proc. 2003;78:1331-1336
Worst Drivers: Teens, Doctors, Lawyers
By Peter Valdes-Dapena, CNN/Money Staff Writer
Fish Oil Products Can be Purer than Fish
University of Southern California School of Pharmacy
January 12, 2004
Scientists Call for Safety Review of Antiperspirants
Phillipa Darbre, Reading University, UK
January 16, 2004
Yes, We Want a Doctor To Look Like One
Southern Medical Journal, December 2003
January 19, 2004
Feel-Good Herb is Safe HRT Alternative
Journal of Agricultural and Food Chemistry
Make That Steak a Bit Smaller, Atkins Advises Today's Dieters
By Marian Burros. The New York Times. January 18, 2004
Fish Oil for Mom May Prevent Allergies in Baby
Journal of Allergy and Clinical Immunology, December 2003
January 22, 2004
Vitamins Cut Alzheimer's Effect
Johns Hopkins University. Archives of Neurology
Johns Hopkins Study Predicts Nutritional Supplements Could Prevent Vision Loss in 300,000 People Over the Next Five Years
James P. Gills, Professor of Ophthalmology at Johns Hopkins University
January 24, 2004
The Amish Paradox
By Jeannine Stein. The Los Angeles Times. January 13, 2004
Good News: No More Coke. The Bad News: Snapple is Replacing It
The Wall Street Journal. January 12, 2004
Pediatrician Group Opposes Soft Drinks in Schools
Pediatrics, January 2004
Study Links Some Hair Dyes to Kind of Cancer
Dr. Tongzhang Zheng. American Journal of Epidemiology
Fatty Depo$its
By Bill Hoffman. The New York Post. January 22, 2004
U.S. Welcomes U.N.Anti-Obesity Plan
By Jonathan Fowler, Associated Press. January 22, 2004
January 26, 2004
Film Records Effects of Eating Only McDonald's For a Month
By David Usborne. New Zealand Herald. January 25, 2004
W.H.O. seeks Vaccine for New Bird Flu
By Lawrence Altman. The New York Times. January 23, 2004
New Evidence Bolsters Use of Heart Scans
By Thomas Burton. The Wall Street Journal. January 14, 2004
January 27, 2004
Cell Phone Explosion Burns Man's Buttocks
The Associated Press. January 27, 2004
Mayor Bloomberg Tries to End Atkins Feud
The Associated Press. January 27, 2004
Declining Testosterone Might Put Men At Risk for Alzheimer's
By Kathleen Fackelmann. USA Today. January 27, 2004
Make Tracks Like Bigfoot in These Shoes
By Martin Miller. The Los Angeles Times. January 26, 2004
January 28, 2004
Mad Cow Some Diet Aids Linked
By Michael O'Keefe and T.J. Quinn. The NY Daily News. January 28, 2004
Revenge of the High-Carb Diet-Ha! It Works, too
Archives of Internal Medicine, January 26, 2004
Antioxidant Intake Associated with Maintenance of Physical Strength in Older Individuals
The American Journal of Clinical Nutrition. February 2004
February 3, 2004
Sedentary Life Starts in Toddlers
Lancet, February 2003
Powder Found in senate Office Building Tests Positive for Ricin
from www.PBS.org U.S. Scrambles to Trace Ricin as Senate Offices Shut Down
By Shailagh Murray, Gary Fields and Sarah Lueck. The Wall Street Journal. February 3, 2004
On the Campaign Trail, Individual Health Initiatives Keep Candidates Hardy
By Jennifer Huger. The Washington Post. February 3, 2004
February 5, 2004
CDC Says Carbs to Blame for Rising Calorie Intake
Morbidity and Mortality Weekly Report, February 6, 2004
Intervention Program Helps Tots Turn Off TV
Archives of Pediatrics & Adolescent Medicine, February 2004
Hospitals No Place to Get Rest, Noise Study Shows
February, American Journal of Nursing
February 6, 2004
Hormone Therapy Draw Fire Anew
By Gautam Naik. The Wall Street Journal. February 3, 2004
Bid to Outlaw Hemp Food Fails in Court
By Terence Chea. Associated Press
Bat Spit Drug Aids Stroke Victims
BBC News. February 6, 2004
February 9, 2004
Doctors Urged to Discuss Patient Fitness
By Lindsey Tanner. The Associated Press. February 9, 2004
Optimism Doesn't Improve Lung Cancer Survival
Cancer, online edition February 9, 2004
Eating Chicken May Boost Arsenic Exposure
http://www.ajc.com/health/content/shared-auto/healthnews/foos/516998.htm#
Children Whose Mothers Eat Seafood High In Mercury While Pregnant Can Suffer Irreparable Brain Damage
Journal of Pediatrics
Mercury Risk To Newborns Alarming
By Joan Lowy. Scripps Howard News Service. February 5, 2004
Gene Is Linked to Higher Risk of Heart Attacks and Strokes
By Ron Winslow. The Wall Street Journal. February 9, 2004
February 11, 2004
Doctors Say Smoking Makes 120,000 Britons Impotent
British Medical Association's Board of Science
Black Cohosh, Does Not Have Estrogenic Activity
Int J Oncol. 2003 Nov;23(5): 1407-12
Children 27 Times More Likely to Develop Autism with Exposure to Mercury-Containing Vaccines
www.nationalautism.org
Eat Your Salmon
The Wall Street Journal editorial page. February 11, 2004
February 12, 2004
Malnutrition Leaves Obesity Time Bomb
By Emmas Ross for The Associated Press
U.N.Food and Agricultural Organization: http://www.fao.org
Atkins Medical Experts Present Food Pyramid Recommendations to Congress and Administration
Atkins Health & Medical Information Services
February 13, 2004
Drugs: Barry Bonds' Trainer Indicted in Drug Case
Ap, Bloomberg. February 13, 2004
Alleged Steroid Distributors Deny Charges
The Associated Press. February 12, 2004
February 14, 2004
Cod Liver Oil Eases Osteoarthritis Pain-Study
Cardiff University In Wales. Professor Bruce Caterson
European Smokers Snuff Out Cigarette-Package Warnings
By Jabeen Bhatti. The Wall Street Journal. February 12, 2004
February 17, 2004
Study Links Antibiotics and Breast Cancer
JAMA, February 19, 2004
Behavior Linked to Consumption of Fish Oil
January issue of the European Journal of Clinical Nutrition
February 18, 2004
Making Us (Nearly) Sick
By Elizabeth Agnvall. Special to The Washington Post. February 10, 2004
The headline for this story should be "Auditioning for a Disease". Many of you out there are auditioning for a disease. You haven't got the part yet, but you're a good candidate. And this is an amazing article in the Washington Post which looks at what are called pre-diseases.
We have changed, recently, our criteria for diseases. We used to define hypertension as blood pressure over 140 over 90. If either of those numbers are over that and you've got hypertension. It used to be 150 over 90 then it was lowered to 140 over 90. Now we have diagnosed a condition called pre-hypertension. If your blood pressure is, say 135 over 85, you've got pre-hypertension and that extends the catch basin for people who are eligible for medication by millions of Americans. It's happened already with osteoporosis. That is, a lot of women are on their way to osteoporosis. They have a pre-disease which makes them eligible for medical treatment.
We now have a condition called pre-diabetes. Newly revised criteria for diabetes have made it much more likely that someone might be considered pre-diabetic. And I say this is good. This is good in a way because this is what I do when I practice. A lot of people come in, they say they don't feel well, they'd like to prevent disease; this is the essence of preventative medicine.
Our first step is to take a look at their diet and lifestyle, provide then with natural support, perhaps with vitamins and supplements, perhaps invoking herbs, using medication as a last resort, but this is an incredible statistic.
Now a majority of Americans are considered to have at least one pre-disease or borderline condition. Over 50 percent of us are eligible for some sort of medical intervention. And this is not to mention the Americans who are eligible for some sort of prescription drug for achy muscles, pain in the neck, a little back pain. They could be taking Celebrex or Vioxx. Men with erectile dysfunction, millions and millions of men are now being pitched erectile dysfunction medication.
The population of the United States is not growing by leaps and bounds. We are not India. We're not China. Our population is going up slowly but not enough to increase the profits of the drug companies. So what we've done is, I guess in the guise of prevention in public health, we would have extended the criteria for treating people and now it's the exception rather than the rule, that are you perfectly healthy and don't require any medication.
Maybe in the year 2035 there will be a statue or a plaque commemorating the last healthy American, the last person on the North American continent who is not a candidate for some medication or another. Maybe that's the trend. Maybe that's where we are headed. Hopefully not.
Largest Public Opinion Survey Ever on Low-Carb Diets
Results of the latest of poll are in. We're not talking Kerry versus Bush, this is the real important stuff. The poll is about what Americans want to eat and this is the largest public opinion survey ever on low-carb diets. It was released this morning and it holds significant new information on a shift in American eating habits.
How pervasive is the low-carb trend? Well, in a survey of 1,800 U.S. adults by Opinion Dynamics Corporation in Cambridge, Mass., 20 percent of adults, said they had tried a low-carb diet since 2002. And 11 percent of Americans are currently on a low-carb diet. This is a much greater penetration of the diet into the American food culture than experts had previously thought.
19 percent of respondents, that's about 44 million adults who are not currently on a low-carb diet are very or somewhat likely to try one in the next two years. That's important news for marketers and you've seen the adoption of Atkins-friendly menus by restaurants, restaurants not traditionally associated with the healthiest food and this is going really wild -- lots and lots of products.
There's even a significant decrease in orange juice consumption. The folks in Florida, the citrus growers, and California are very unhappy about this because they think it is almost entirely attributable to greater than expected adoption of low-carb diets by consumers. The popularity of this diet approach is particularly pervasive among higher income individuals earning more than $75,000 a year. They are more likely to try such a diet.
And so is this diet a flash in the pan? Well, no. A lot of people are planning to go on it. And there's a lot of controversy as to whether there's going to be Atkins backlash. So far, though, high protein diets are holding sway.
What are the benefits of Buffalo Meat? What are the advantages and disadvantages of this alternative red meat?
Buffalo burgers are making in-roads in fashionable restaurants. Here's the deal: Buffaloes -- generally the meat is lower in fat than farm-raised steer, but there's a little bit of a gimmick here. This is not the buffalo of the American plains Indians. This is not the buffalo that grazed on grass and was a source of protein and fat and sustenance for the American Indians.
The buffalo industry is one where I think they are partially grass-fed. I do think they graze, but I also think it's permissible to feed them cornmeal and various other types of feeds, just like they feed cows. I have a saying coined on this program: "It's not 'you are what you eat', but you are what you eat eats." And although there's a romanticism about eating buffalo or bison, you're not getting Paleolithic meat like our stone-age ancestors consumed. It's probably preferable to conventional beef but it's not 100 percent.
Tonight, I consumed hamburgers that are from a company called Grassfed Beef and the idea here is that these are grass-fed cattle. They're not fed any cornmeal. Grass is actually a better food for the fat composition of cows and ultimately for our fat composition. There's more polyunsaturated omega-3 fatty acids in grass that these cows eat and ultimately that's what gets incorporated into our bodies when we eat grass-fed beef.
So you can get the information about that on the internet. The company that I use is called Grassfedbeef, grassfedbeef.com. And grassfedbeef.com is one of the websites where you can get information about this type of agriculture. I think it's sustainable. I think it's good for the environment. It doesn't take as much petroleum and fertilizers to raise the corn which ultimately goes into the cows. It's more energy efficient and it's healthier for people if they're going to make that choice.
You're asking about ostrich meat? Well, ostrich meat, again, it is domesticated. It's a wild animal. It's domesticated. It's kind of like the deal with salmon. You know, salmon, a wild fish, they domesticate it. You get farmed salmon. And if they feed it ground-up fish guts from garbage fish which are not suitable for human consumption, you may get additional residues of harmful PCBs in your system by eating that type of food. So I think it's a step up from conventional meat, but I think you have to look behind the claims to make sure you're getting the best possible animal protein.
What can be done for a man with erectile dysfunction and numbness in his feet?
He should get tests to evaluate circulation. We should find out if he's prone to circulatory problems. Even if he does not have obvious diabetes, the tests should be done. Perhaps a glucose tolerance test with insulin to see if his blood sugars are up. He may have -- I've referred a little bit sarcastically to this trend to diagnose pre-conditions, but I actually like doing that when we see people with mysterious problems where there is an unclear causation -- and this gentleman may have a form of pre-diabetes, which is causing numbness in the feet, circulatory problems and erectile dysfunction. It might be uncovered with the glucose tolerance test with insulin or a test called the hemoglobin A1c.
There might be some cardiovascular risk factors that are causing circulatory problems an ultra-fast CAT Scan or a carotid ultrasound might reveal the presence of plaque. There are actually tests that a urologist can do for circulation.
But bottom line, most frequently in young relatively healthy men, the cause of erectile dysfunction is psychological and this will respond sometimes to sex therapy, counseling, reassurance and loving support. I really don't have a problem with men using the erectile dysfunction medications. They can be helpful in regaining confidence, sort of breaking the ice. They get men off the losing streak and get them on a winning streak. I guess I'm starting to sound like one of those sports commercials that encourage men to throw the football through the tire, or hit a home run. But the analogy is appropriate. In the cycle of failure a man can break that vicious cycle. Frequently my patients get back on track and don't have dependency on these medications. I just think these drugs should not be used without figuring out if there's an underlying problem.
Another thing to check is testosterone. Men as young as 51, can have low levels of DHEA and testosterone. And if testosterone DHEA is low and sex drive is an issue, sex drive and sexual performance are different things. Some men have a perfectly strong sex-drive, it's just sexual performance that is an issue. This can happen in 20-year-old men who have very high levels of testosterone. But men over 50 or 60, testosterone levels may be declining and it's appropriate to address that. In my opinion testosterone replacement can be done safely if PSA is monitored.
Both testosterone and free testosterone should be checked
Please elaborate on the chemicals called parabens.
There are various parabens; methyl parabens, the whole family of parabens. They're a chemical that is used a lot as an emollient, that's used in many shampoos, face creams, moisturizers and I looked at some of the products I use and half the products had parabens in them to my surprise.
CALLER: That's what I found too, and I checked my tube of MetroGel which I use for rosacea and a huge percentage of that is parabens. So I guess I'm wondering how concerned you really are about this. I did look up the research on the internet and saw the study that was done in England and it seems like it would very hard to explain away.
Dr. Hoffman: They just did a study showing that antibiotics are correlated with breast cancer. That doesn't mean that antibiotics cause breast cancer has been conclusively proven. But in England what they found is that in women who have breast cancer they had higher levels of parabens in their breast tissue. And that's a concern because parabens are used in deodorants. That's a real portal of entry via the lymphatic system into the breast tissue and so the concern is maybe these things are causing problems.
The trouble with all these studies, we just don't know what's killing us or giving us cancer. There's so many things out there, and I think the approach to take is, let's reasonably limit our exposure to things that are correlated with cancer. And I think these products can be made very feasibly with natural ingredients without the addition of chemicals that have the potential to cause problems. That's all I'm asking for and we should read labels and ask the manufacturers to change the whole formula.
What should I do with a torn meniscus in the knee?
The straight forward method would be to do the relatively minor conventional surgery. It might be covered by insurance and you can have your knee operated on with what's called arthroscopic surgery.
The article in the New York Times that was written about a year ago on arthroscopic surgery concerned arthritis, not meniscal tears. You've got to distinguish. The New York Times said that arthroscopic surgery is pretty much overrated and a waste of time for knee arthritis.
There are a lot of elderly people, and a lot of baby-boomers, who just have plain knee arthritis. Their knee hurts. If they do not have a well-defined meniscal tear -- that's a tear in the cushioning that sort of insulates the knee joint -- then surgery is not likely to benefit them. But if you have a meniscal tear, that's where arthroscopic surgery actually really works. It was pioneered in athletes. It helped get football players and basketball players back in the game, and it can work.
Supplements that can help with healing of meniscal surgery and osteoarthritis are glucosamine and chondroitin sulfate, MSM, curcumin, bromelain, EPA (fish oil) and Avosoy.
What is your opinion on trying glucosamine and chondroitin and MSM for osteoarthritis?
You can take moderately high doses of MSM without problems. The biggest limiting factor with MSM in my opinion is not toxicity, but simply if you take too much of it, it can cause gastrointestinal irritation. It has a laxative effect and you'll notice that if you take more than five or ten thousand milligrams or five or ten grams a day.
Now, James Coburn and Robert Culp both of whom -- similar age guys, similar type of actors both suffered from severe arthritis and took very high doses of MSM. It was very well publicized. And James Coburn attributed his return to the film industry to his use of MSM. When he used it, he described a protocol where he was using it by teaspoons and tablespoons. We're talking 15, 30, 45 thousand milligrams of MSM. That would be a lot of pills if you took the capsules. I tell some people with severe arthritis to take the powder but of course they have to be careful about their gastrointestinal tract.
When patients have serious arthritis, I tell them take a half a teaspoon in green tea two or three times daily, as tolerated and I think that can be a very effective dose. If you can't stand that high a dose, just take a thousand milligrams capsules: two or three a day and you will get some benefit. Some of the products that contain just a little smidge of MSM along with the glucosamine and maybe some other things do not contain enough MSM to work. That's why I'm not big on some of these combo products.
Almost everyone I know, women of a certain age has been diagnosed with osteopenia or osteoporosis and it's beginning to sound like a trendy disease. What should I do?
Osteopenia is not a disease. It's a pre-disease. And if you look at the testing for this medication, the medication is really not designed to treat osteopenia, it's designed to treat osteoporosis. Osteopenia is natural. As you get older, your bone will decline in strength and it doesn't mean you're destined for a fracture. If you have osteopenia, you don't have to be on a medication.
What I do with my patients is I give them a chance to try natural therapy, which includes weight bearing exercise, calcium. I test for vitamin D, which is almost invariably low in women in the north especially in winter months. We supplement with magnesium, Lysine, Vitamin K, ipriflavone and all the components that help bone density. The product I formulated which has many of these nutrients is called Osteosupport. We check for levels of DHEA. If DHEA is very low in an osteoporotic woman giving her DHEA will not only help her bone density but also make her feel better.
The new star player on the osteoporosis front is a mineral called strontium. Now, a lot of people hear strontium and they go, "Oh my goodness, that's radioactive," it was Strontium-90 we heard about it in the 60s. Strontium is actually a natural mineral. It is a trace mineral like selenium, molybdenum or manganese. A new big study in the New England Journal of Medicine shows that strontium is extremely helpful not only at slowing down osteoporosis but at reversing it. It's available as a natural supplement, and I predict it's really going to revolutionize the approach to this disease. It's as effective as many of the drugs.
February 21, 2004
Measuring Procalcitonin Levels Could Help Reduce Inappropriate Antibiotic Use
Lancet 2004;363:600-607
A Device Developed in Israel Helps Lower Blood Pressure
By Vered Frechter. www.haaretzdaily.com. February 15, 2004
Lung-Cancer Vaccine Shows Promise In a Small Study
Baylor University Medical Center; Dr. John Nemunaitis
Sugary Foods Linked to Colon Cancer Risks in Women
Journal of the National Cancer Institute, February 4, 2004
Gluten Linked to Schizophrenia
BMJ, February 20, 2004
Fish Oil Capsules Cleaner Than Original Source
Canadian papers The Globe and Mail and CTV news
February 23, 2004
Ralph Nader
I'd like to comment on the candidacy of the latest entry into presidential campaign 2004, the surprise entry of Nader. Ralph Nader has entered the campaign and I had a bunch of health features in line for tonight, but I thought what I would do is go to the Nader website. No, it is not gonader.com for obvious reasons. There is potential for confusion about gonader -- a couple of alternative pronunciations. It's votenader.org if you want to check it out.
I thought I'd take a look at some of the policies that this erstwhile presidential candidate espouses in so far as they relate to the theme of this program, which is medicine. I think it's fair that we disseminate his views and comment on them. And I have to say, I was prepared to hate Nader when he went on Russert, on Meet the Press, and announced his candidacy last Sunday. I was like, what is this guy doing? He's going to muck up the election. He's on an ego trip. He's bitter because he hasn't gotten anywhere and this is his last hurrah.But I found him very focused. He is passionate, and he's a really committed guy. He's fully engaged in the fight for social justice. That's been the theme of his entire political career, a long career spanning four decades. And it was appealing to hear this "take no prisoners" rhetoric about what we ought to do in this country. We need a new direction, everybody agrees and this guy's telling it like it is.
So I took a look at the website to see what he has to say about health care and let's look at some of his views: He wants to make health care universally available. And I'm going to read from his statement: "We need to get these insurance companies out of administering health care, increase patient choice expand coverage and save money. The United States spends far more on health care per capita than any other country in the world but more than 45 million Americans have no health insurance. A single-payer program with full medical coverage should provide health care that provides comprehensive benefits with quality care and cost controls to all Americans throughout their lives." And that sounds good. It's a laudable goal because there's a lot of Americans who do not have health insurance, and that is a shame when a country as rich as America leaves people in the lurch. But I have some problems with that statement because this model does exist and it exists in Europe and in particular it's the system that prevails in England.
I was just in England. They have, essentially, a system of universal health care, but what happens? It's still a two-tiered system because the universal health care is universally lousy. If you're in serious trouble, you're going to get the care you need. But, essentially, health care is rationed and if you want an operation you have to wait. You have to wait even if you want a test. If you want a CAT scan or MRI's of which too many are done in this country admittedly -- you have to go on the list because there's cost containment on this. You can't just get an MRI right away. You've got to get on the government list. And you can wait and wait and wait.
I'll give you an example. I was in England to attend the wedding of a young policeman. He was a cop but he was on disability because he was injured -- get this -- because he had been jumped by a bunch of hoodlums and they kicked the hell out of him, dislocated his shoulder, severely injured it because he wasn't armed! Cops in England, most of them don't carry guns. They carry mace, they carry handcuffs, they carry walkie talkies, but they don't carry guns. So he was injured and he was waiting for several months for an appointment with an orthopedist. But worse yet, he was awaiting an MRI of his shoulder for months to find out what was wrong with his shoulder. It took him several months to get it and he was debating with his family whether, after the costs of the wedding, whether it was worth it to pay extra -- because you can do this in England -- and get the MRI ahead of time. He decided to wait it out, have the government pay for it and finally got the care that he needed. But he was waiting and languishing for months. So there's the reality behind the appealing rhetoric.
Anyway, Nader wants to end the war on drugs. He says the drug war has failed. I think we can agree on that. We spend nearly 50 billion annually on it and drug abuse continues to worsen. Nader's website says: "We need to acknowledge drug abuse as a health problem and the solution would be public health, social services, economic development," and, this is a strange phrase: "Tender supportive time with addicts in our depersonalized society." In other words, the problem with addicts is that they're alienated. They're depersonalized and they need tender support and time and I'm not sure how he's going to provide it. But his platform is he's going to provide it.
Nader also says: "It's time to bring some illegal drugs within the law by regulating taxing and controlling them". I guess he's saying we should have pot bars like they have in Amsterdam. We should say look, if people are going to smoke pot anyway let's just sell them joints like cigarettes and put a tax on them. The government will make money and no problem. But the problem I have with that is: Is pot really good? Is it really okay for large segments of the population to smoke a lot of pot? I mean I guess yeah, pot doesn't kill people, necessarily. People don't usually get addicted to pot but is it good for lots of people to addle their brains with pot? Shouldn't the government take a stand against pot like the government takes a stand against cigarettes?
Anyway, he says also that "Ending the drug war will dramatically reduce street crime violence and homicides related to underground drug dealing." So again, European countries have done that. They offer free drugs to addicts. But the problem is, in contradistinction to countries like Switzerland, or even England we have millions of addicts in America. Where would we get and pay for all the dope they need? I don't know, I'm just asking. Instead of fighting the drug war, yeah, we would save costs fighting the drug war, what would we do? Would we just have the government pay the Columbians and Afghans to grow dope for the Federal Governement and then buy up their entire crops and then dole out the heroin or cocaine to our large population of addicts and the addicts would docilely come to clinics and get their fix? Let's think this through folks!
He also talks about the environment. Of course this has an impact on health and I agree. One of the problems that I have with this current administration is that they're very lax on pollutants like arsenic and mercury and they often take the side of industry. It says on the Nader website that "65,000 Americans die each year from air pollution; 80,000 estimated annual fatalities from hospital malpractice; 100,000 Americans whose demise comes from occupational toxic exposures, or the cruel environmental racism where the poor and their often asthmatic children live in pollution sinks located near toxic hot spots that are never situated in" -- I think they invented a word here -- in "shrubbered" suburbs. Do you live in a shrubbered suburb? I know what they're talking about, nice, idyllic suburbs. But I hang out a lot in the suburbs and the air is bad there too. OK, I guess they put a lot of waste dumps and factories in the inner-city . .
. Nader continues: "We need to make environmental protection a priority for energy, trade, industrial, agricultural, transportational, developmental land use policies. Protecting the environment must be weaved throughout our governance." OK, agreed. Obviously I'm okay with this. But then, I saved up a few bucks like most Americans and most of that's in some crummy stock portfolio that lost a lot of money over the last few years but finally it's coming back. And if the Nader agenda goes through, I'd better tell my broker to sell everything because all of these companies are polluting to some extent, and can they really afford to put in the very, very aggressive controls that Nader is calling for? I wish they could, in an ideal world, yes. But is it something that we want immediately, without a view to the economy?
And finally, talking about foreign policy, Nader is talking about "expanding the many assets of our country to launch with other nations major initiatives against global infectious diseases such as AIDS, malaria, tuberculosis and virulent flu epidemics which have and are coming to our country in increasingly drug resistant strains." I'm all for that world health initiatives, but does the United States want to take primary responsibility worldwide to eradicate all the diseases of mankind? Well I guess he's saying if we pull out of Iraq, if we really scale down the military, scale down pork barrel to corporations, raise the taxes on rich people, we'll have money so we can go out in the world and cure all the problems including, his website says "bad drinking water," but one thing he's not for controlling is pot. Pot's okay, but he is urging tobacco control. That's another form of burning leaf and we haven't yet decided whether pot causes lung cancer, so isn't that a peculiar double standard?
Nader advances many, many agendas including "ending the spectrum of hunger, malnutrition and resultant diseases worldwide." We can do this, he's saying, and it is inspiring rhetoric. It's inspiring in its breadth and ambition and in its clarity as a vision for an ideal world. But I'm confused because if it was thirty years ago I would have reacted with certainty to all that rhetoric, I would be out probably on my campus starting to recruit for Nader. I had all the answers and a clearcut program for changing the world. But you know as the song goes, "I was so much older then, I'm younger than that now."
No Pain No Gain
Preventive Medicine,February 2004
Well, they say, "no pain, no gain." You may have heard your coach say that to you as he sent you on suicides during football training, but is that really the right way to exercise? Does it make sense?
Well, they actually studied this recently at Iowa State University and the results are found in the Journal of Preventive Medicine in February 2004. It says in this Reuters health article, "no pain, no gain" may be the mantra of coaches everywhere but it's bad advice for most exercisers research suggests. In a new study, pain or displeasure was the most accurate indicator that a person had crossed a threshold believed to be the optimum level of exercise.
The optimum exercise, it is said, is when your body is just transitioning from aerobic to anaerobic metabolism. That's the zone. There are actually books about this phenomenon, the Training Zone, and they're based on wearing elaborate pulse meters, mathematical formula, but according to the study -- this is a quote from one of the lead authors. As astonishingly simple as it sounds perhaps the most appropriate level of exercise intensity for health-oriented exercise is the intensity that does not feel unpleasant. The feedback that your body gives you is actually relevant to this critical transition between aerobic, in other words there's enough oxygen going to your tissue, and anaerobic metabolism. Anaerobic means there's no longer adequate oxygen going to your tissue. That's when the training effect kicks in because you're just stressing yourself a little bit. But if you go anaerobic without oxygen it's like holding your breath for a prolonged period and that, obviously, is not good. Otherwise, you could increase your muscles by just putting a clothespin over your nose and tape your mouth.
Suggestion is for people just starting an exercise program particularly those who are overweight the intensity that corresponds to their individual aerobic, anaerobic transition may be very low, perhaps not much faster than a stroll. So if it feels good do it, but "no pain, no gain" may not be applicable to exercise. If you're really knocked out from your exercise, unless you're like an Olympic athlete -- if you're training for the Tour de France, that's "no pain, no gain". Maybe that's applicable there but in general, not a good rule of thumb.
Is CoEnzyme Q10 a natural cure for heart disease?
Well it is and it isn't because CoQ10 is supportive to the heart because it supports what are called the mitochondria of cells. And the heart, as a very hard working muscle, is very rich in these tiny, little energy powerhouses. And anything that helps the mitochondria can help the beating of the heart. If you're suffering from a weak heartbeat, if you're suffering from arrhythmia, CoEnzyme Q10 can be helpful and I recommend it for virtually all my heart patients. But take a look at the case of Dr. Robert Atkins. Here's a guy who was a big proponent of CoEnzyme Q10 and he had congestive heart failure due to cardiomyopathy. And being a very, very smart guy and being a guy who definitely practiced what he preached, he would have been taking CoEnzyme Q10 and he still had problems. We don't know, perhaps he would have had even more serious problems after his viral cardiomyopathy. Maybe he would have been a candidate for a heart transplant had he not taken CoEnzyme Q10. We don't know the full story. CoQ10 helps to some degree but it is not a panacea against heart problems or in particular declining heart function due to congestive heart failure. I have seen ejection fractions increase "that is the pumping action get better" when patients are on very high doses of CoQ10, say 400-600mg. The drawback is that it is very very expensive and not covered by insurance.
Will supplements and various food interfere with Coumadin?
Yes, they do but here's my position. You should work with the doctor on getting as many of the nutrients back into his program as possible because there's a tendency on the part of medical profession, to say, "Oh, my goodness, you're taking Coumadin. Don't take any vitamins!" It gets them very upset because we know there's a possibility of drug nutrient interactions with Coumadin. They also tell you sometimes not to have any cabbage family vegetables, not to have any green-leafy vegetables not to drink any green tea. You stop doing many healthy things because of the Coumadin. Coumadin interacts with things like vitamin E, fish oil, vitamin K which is present in green tea and in certain multiples, possibly somewhat with CoEnzyme Q10. But what I suggest for my patients is that they introduce these things slowly and you get your protime checked very frequently, and you introduce one thing at a time slowly, see if it does have an impact on the protime. And if it does, then you have to cut back but most people find that they're able to take modest amounts of these important supplements while they're taking the Coumadin and if you have to adjust the Coumadin, I, as a physician, am willing to make the adjustments because I think it's more important to be able to take the supplements. But of course, if you're taking the supplements and the protime is bouncing all over and it's impossible to control the bleeding rate, then you have to reduce the supplements. But mostly I think these things can coexist. Get a cooperative doctor, get a doctor on board who understands and accepts that proposition
How do you manage Celiac Disease with a fistula?
Celiac disease is gluten intolerance, and in my opinion, there is a tremendous relevance to that because I believe the inflammatory bowel diseases, namely; Crohn's and ulcerative colitis are related to gluten consumption. I always check for that. And the diet that I prescribe for Crohn's is a gluten-free diet. It's always gluten-free. It even goes beyond restricting gluten; it suggests that people don't consume any grains at all.
A fistula is actually a hole in the intestine that may communicate with an adjacent organ like the bladder or to, literally, the surface of the body so this is something that has to be treated with antibiotics and possibly surgically. But surgery isn't always effective, and sometimes multiple surgeries have to be performed because the fistula comes back, or intestinal narrowing recurs. Surgery isn't a cure, it's just a stop-gap. An article in this week's New England Journal of Medicine (Feb. 26, 2004) takes a look at this problem and suggests that a powerful new bio-engineered drug called Infliximab (Remicade) may help fistulas heal without surgery, but side effects include susceptibility to serious viral infections, autoimmune diseases, and possibly cancer.
In the aftermath of surgery, check out a diet called the Specific Carbohydrate Diet. You can get a book entitled "Breaking the Vicious Cycle" by Elaine Gottschall. There's also a book called "Dangerous Grains" by James Braly that talks about the connection between gluten and a variety diseases including Crohn's. And that's the diet that you son should go on after surgery because if you have Crohn's disease, you can have surgery but the disease comes back. And some people require repeated surgeries and you can really reduce his likelihood of becoming a candidate for repeat surgeries if you follow the Gottschall diet.
There are a variety of supplements that are helpful for this. I treat a lot of patients for this with the diet and appropriate nutritional support
February 25, 2004
Vegetarians vs. Atkins: Diet Wars Are Almost Religious
By Gina Kolata. The New York Times. February 21, 2004
HRT Linked to Higher Risk of Asthma, Study Concludes
Archives if Internal Medicine. February 24, 2004
Boomers Want Fixes For, Not Acceptance of, Their Aching Joints
By Linda searing. The Washington Post. February 24, 2004
February 26, 2004
Hormone Therapy May Affect Hearing, Study Shows
Association of Research in Otolaryngology
Outeating Weight-Loss Surgery
By Tara Parker Pope. The Wall Street Journal. February 23, 2004
Nutritional Boost Helps Elderly Ward Off Colds
Journal of the American Geriatrics Society, January 2004
February 27, 2004
Guzzling Beer Helps Rats Stay Cancer-Free
International Journal of Cancer, January 2004
Genentech Wins FDA Approval for Cancer Drug
By David P. Hamilton. The Wall Street Journal. February 27, 2004
Study Finds Suggest Zip Code may Be Key Indicator of Community's Health
California Center for Public Health Advocacy
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