Niacin Study

There is news today of a study evaluating the benefits of niacin supplementation.  This study was stopped early due to preliminary data evaluation showing lack of benefit.  The actual data from this study has yet to be release and will not be till the end of the year.  I will need to review the study design in greater detail prior to making any formal recommendations regarding niacin therapy.  This is available and I will have more information in the coming days.  There are other studies to date looking at niacin's benefit that have been positive and this trial is not expected to be the end-all, be-all answer.  In the meantime I recommend patients continue taking niacin (either by prescription or over-the-counter).  Please continue to check back for more information.

Pencol Pharmacy Evening Lecture

Here is a link to Pencol Pharmacy's next evening lecture on Mid-Life Wellness and hormone replacement.  It's a great option to gain some background information on these issues.

https://docs.google.com/viewer?url=http%3A%2F%2Fwww.pencolrx.com%2Fuploads%2F235261302547533.pdf

Reactor Situation in Japan

I recently received an overview from the Colorado Department of Public Health.  This information was distributed from Washington.  While I fully believe the government does not tell us the "whole story" most of the time, in times of large public health concerns they provide a good starting point from where to get information and are more reliable than many other sources out there.  The summary is likely far more detailed than most people would want to read but I decided to repost it verbatim.  The general consensus is that there is no current danger to the American food supply and that agencies are aggressively monitoring the situation.  Additionally there are no reports of dangerous radiation levels in the states.  Taking something for radiation exposure is not needed.


While I agree that the food supply is safe, it's as good a time as any to make some changes and buying some local products.  While produce season is not in fully swing locally, there is always a great supply of locally produced animal products, free of added toxins.  As we move deeper into Spring and Summer, explore the wealth of farmers markets around town and search out for local produce in grocery stores.  The less distance food needs to travel to your table, the less preservatives and processing it will likely have received.


Please click on the Japan tab in the health information section on the left for the full article.

Healthy Eating - Themes

     Probably the most discussed topic in the office is diet.  So much of our health revolves around what we put into our body.  It's well known that healthy eating and maintaining an optimal body weight are imperative to prevent and treat diseases like diabetes, hypertension, high cholesterol and heart disease.   What is less appreciated is the impact nutrition has on day-to-day well-being, encompassing all aspects of wellness.   In my opinion, what we eat has dramatic ramifications for the entire body, and remains the cornerstone of intestinal, psychiatric, hormonal, and musculo-skeletal health.   While we've all heard the idiom, “you are what you eat,” we often don't live this motto; that leaves us vulnerable to illness and poor quality of life.   My goals in medicine are prevention of disease and maintenance of a high quality-of-life.  What you eat is the foundation to achieve those goals.

      Below are general themes that I believe should be the guide on our dietary journey.   While our knowledge changes with ongoing research, I believe these themes will remain intact.   My beliefs and recommendations are pulled from many areas including personal experience, my formal education, reading of experts, and some plain common sense.   I'll attempt to reference specific people should I use direct quotes or copyrighted material.   However, much of what I believe is in common with others so general themes may be familiar from your own reading on the subject.  Below is a brief summary of the key themes in which I believe.

• Desire to be healthy!  Maintaining a healthy diet, foremost involves being aware of and caring about what you eat. You need to want to eat healthy food because our society has made it so easy to do the opposite.
• Be aware!  When you know what you are eating and the ingredients involved, it is much easier to do things positively.
• Take control!  Self-preparation is the simplest way to ensure good stuff is going in.
• Routine is good!  It's a lot easier to maintain healthy routines that continually trying to develop them.   Once you've developed good patterns, you don't have to think as much and can focus your energy to other areas of your life.
• Remember 90-10! Focus on what you do day-in and day-out as part of your normal routines (90% of the time) and make your changes and commitment there.   If your doing positive things most of the time, what happens during that final 10% isn't nearly as important.  Put simpler, you can still have Doritos once in a while.
• Quality counts! There's more to the dietary world than just carbs, fat and protein.  The quality of ingredients goes a long way towards keeping your body functioning at a high level.  This is especially true for animal products.
• Healthy diet is not only for weight loss!  Most people attribute making changes in what they eat to attempts at weight loss.   However, the true goal is to eat healthfully and this is important to those at any weight (or age).
• Have fun!  Eating healthy doesn't have to be painful.  Preparing and eating food is a great way to relax, spend time with family, and learn about places & people around the world.

Click here to read more details on individual themes!

Vitamin D

The Institute of Medicine released new Vitamin D guidelines yesterday.  I am in agreement with most of the major Vitamin D researchers that these new guidelines are too conservative and if followed directly will under-replace patients and  forgo potential health benefits.  I feel the data clearly supports an upper daily intake level of 10,000 units daily.  In reality, however, most patients only need between 2-5000 units of Vitamin D3 to achieve optimum levels.  I generally shoot for levels to be at 50 and above, though am quite comfortable with levels in the 80+ range.  Without any prior testing, I think it's reasonable for an average person to take approximately 2000 units daily.  By monitoring levels we can fine tune that dose to achieve most optimal blood levels.

Food Health Tips

I actually received this tidbit in a newletter from my mortgage broker but I thought it was really well done and had some great information so I shall pass it on...

Nutritionally, there is no perfect food, although a few come pretty close. And even if there were, who'd want to eat the same thing every meal, every day? Fortunately, variety and healthy eating can go hand in hand, particularly if you know where to look. Take a look at these foods that pack a nutritional punch and can be incorporated into a wide variety of meal plans.

1. Anything Fresh: With the fast pace of life today, it's hard to make time for fresh food. Why should you? Because food that's fresh, especially if it's locally grown, is often the healthiest diet choice out there. Fresh food contains a complete array of nutrients, which is just not available in many processed foods. Even in winter we can find root vegetables, apples and pumpkins.
 

2. Beets: Beets were one of the most successful crops in the Biosphere project. Basically, it simulated living on the moon. And if you had to pick one vegetable to take with you to the moon, you'd do well to pick beets. The roots and leaves are packed with antioxidant phytochemicals, provide much-needed minerals and vitamins, and are a good source of fiber.

3. Rye: Obesity statistics suggest a good portion of us could use some help battling the scale, and rye is on your side. Rye has an excellent reputation for helping us feel full, produces a low insulin response, and is typically a good source of fiber. It is a rich source of minerals, too.

4. Organic Berries: This isn't a hard sell, right? Juicy, bright, and tasty, berries add fiber, vitamins and antioxidants to your diet. These little gems appear to support healthy arteries, cognition, inflammation and eyesight. Many studies have found a benefit in drinking cranberry or blueberry juice for prevention of urinary tract infections.

5. Fermented foods: Face it Mr. Clean, the human body needs bacteria, and fermented foods provide "good" bacteria (probiotics) to give our native colonies a helping hand. Clinical trials continue to examine the benefits of probiotics on gastrointestinal complaints like diarrhea and irritable bowel syndrome, as well as for conditions such as colic and eczema in infants.

6. Legumes: This low-fat, no-cholesterol source of protein, fiber, vitamins, minerals, and phytochemicals is among the best foods we can eat. As a substitute for meat-based protein, beans can help support our drive for heart health. And the fiber and protein in legumes are excellent tools in our weight-management toolbox.

7. Cruciferous vegetables: Broccoli, radishes, the dreaded Brussels sprouts and cabbage are all members of this illustrious family of veggies. Associations between low incidence of some cancers and high intake of cruciferous veggies have led to more in-depth research on how these unassuming vegetables contribute to a healthy diet. Crucifers are especially rich in phytochemicals (including isothiocyanates such as sulforaphane), both of which are responsible for these vegetables' pungent or spicy flavor and appear to help the body's detoxification processes. The phytonutrients in these vegetables also seem to affect the body's ability to respond to free radicals. Steamed or raw, they retain the majority of their nutrients.

8. Organic Figs: Fresh or dried, these teardrops of deliciousness are a wonderful addition to any diet. High in fiber, potassium and manganese, figs can support heart health and weight management as part of a healthy diet and exercise program. They're great on their own as dessert or a snack, and they make a wonderful addition to salad, too. Choose the organic ones, though, especially if you are sensitive to sulfites.

9. Fatty Fish:  In this case, fat is good. Cold-water fish (like salmon and sardines) contain a high concentration of omega-3 fatty acids (specifically EPA and DHA) that appear to have a host of health benefits. Large, rigorous trials from around the globe have found evidence that diets with the highest levels of omega-3 fatty acids are also the most heart healthy. The American Heart Association recommends that healthy adults should eat two, 3-ounce servings a week, which is in line with the American Diabetes Association and the World Health Organization. For more information on which fish are sustainable, consult the Monterey Bay Aquarium "Seafood WATCH(R)" list for your area:www.seafoodwatch.org/cr/cr_seafoodwatch/download.aspx

10.  Whatever You Don't Eat Now:  Variety is important. It's so easy to get stuck in a food rut, especially if you're counting calories. So instead of eating yogurt and cherries as a snack every day, why not try oatmeal and blueberries? Or string cheese and an apple? Buying a farm share or visiting a farmer's market can be a good way to try new vegetables. And if something looks unusual - pick it up! You can put the power of the Internet to good use and find a recipe for anything in seconds flat. So try a purple pepper or a golden beet. A vibrant rainbow on the plate means more and varied nutrients for the body.

Flu Shots

It's flu shot time.  I follow CDC recommendations that everyone 6 months and older should get a flu shot unless there are specific reasons.  For those over 65 years of age, there is a high strength shot that is recommended.  I'm not doing shots at the office so I recommend going to your local pharmacy or supermarket where they are widely available.  For those whose insurance requires shots to be done at an office, I recommend going to MedExpress Urgent Care or one of the Walgreens Take Care Clinics.