Tag Archives: diet

Healthy Habits Top 10 List

Posted on January 29, 2013 by ushealthworks| Leave a comment

Every time we turn on the TV or pick up a magazine, we’re told to do this or don’t do that. And if we follow the guidance, it will greatly decrease our risk of getting some horrible disease.

If I added up all the reductions in risk I would live to be 143! Kind of puts a whole new spin on the Social Security solvency issue. At the risk of ruffling a few feathers, I would like to suggest some order to the risk hierarchy. A logical starting place, if you plan to live a long time and are actually doing something to facilitate it, should begin here.

1. Stop smoking (or don’t start). This is the most researched topic and has absolute consensus in the medical community. Smoking cuts 5 to 10 years off your life. If you do only one thing to help you live longer, do this one.

2. Diet. I am reserving the No. 2 slot for what you eat, not how much you eat.

If you want to live a long time, eat grains, fruits and vegetables and avoid meats of all kinds, especially red meat. This is also very well researched and results in a dramatic decrease in cancer and heart disease – the No. 1 and No. 2 killers in this country. Your life expectancy will increase by five or more years from this.

3. Exercise every day. Do some form of exercise 20 minutes every day and that will get you the most life for your time investment. Your life will be a few years longer, and perhaps more importantly, you will be able to do more things and feel better. The cancer and heart disease rates are lower in exercisers.

4. Treat lifestyle disease. We are talking hypertension, Type 2 diabetes, and high cholesterol. Some of these are a result of excessive living and some just genetic roulette – blame your parents. Treating these illnesses almost completely neutralizes the dramatic decrease in lifespan that they can cause. Treating these diseases can easily add a decade to you life.

5. Weight Control. It’s not what you eat, but how much. Excessive body weight contributes to hypertension, heart disease and cancer. This can easily take a decade off your life, and make the rest of it pretty unhappy.

6. Seat Belts. Protect yourself from an untimely death in a motor vehicle. There are about 40,000 deaths per year in theUnited Statesfrom motor vehicle accidents. Seat belts have added a bunch more years than Vitamin C and the rest of the alphabet combined.

7. Deal with your depression. Depression measurably shortens life, but makes it feel way too long. The solution can be regular exercise, good friends or medications. The important thing is do something about it. Living a long life takes the will to live – that means treat the depression.

8. Stay married or get married. Married people have a measurably lower mortality rate then unmarried people. Sounds curious, but this is a well researched and a reproducible fact. However, a good marriage helps you live longer and bad marriages don’t. Make sure you know the difference (hint – if your spouse is your closest friend, you have a good one).

9. Sleep well. Insomnia and poor sleeping contribute to accidents, cardiovascular disease and poor health. Sleep apnea is one treatable culprit and can add years to your life.

10. Take vitamins. This is No. 10 because vitamins have precious little good scientific evidence of extending your life. There are a couple of exceptions (like Niacin) but 98 percent of vitamins are unproven.

The recommendation here is start at No. 1 and go as far down the list as you can.

Take care

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy of photostock / FreeDigitalPhotos.net

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The Pearls – or Perils – of Holiday Living

Posted on December 4, 2012 by ushealthworks| Leave a comment

We are a society committed to excess in all things, which is perhaps never more apparent than the holiday season.

Bring on the holiday feast – more food, more wine, more sweets and eats (sorry, I found myself channeling Dr. Seuss for a moment). So let’s sort out the Christmas elves from the gremlins.

christmas tree in marunouchiphoto © 2006 François Rejeté | more info (via: Wylio)

This, more than anything else, is a season of exhaustion. We struggle through hundreds of self-imposed Christmas chores, struggling to fit more into an already overwhelmed schedule. Something must give, and that something is usually sleep.

Sleep Deprivation
It’s no small medical issue. The symptom list that results from not getting enough sleep is extensive: muscle aches, memory loss, lack of coordination and stomach distress. Diseases such as hypertension and diabetes are worsened by insufficient sleep time. And you can actually die from extreme lack of sleep. This has been proven in lab animals, but scientists have been reluctant to do the experiment on humans. However, some of us are experimenting with this on our own.

Pass the Eggnog
What is eggnog anyway? Traditional eggnog is made from milk, cream, sugar and raw eggs, with a shake of cinnamon or nutmeg. It’s not surprising that it’s quite high in fat and cholesterol, although some modern versions are a bit lighter. Brandy, whisky or rum is usually added. Interestingly enough, adding liquor actually improves the safety profile of eggnog. That’s because alcohol kills germs often found in raw eggs, like salmonella. That jigger of brandy you add may just prevent an unscheduled time out in your festivities.

Alcoholic Beverages
Eggnog isn’t the only holiday beverage consumed in excess. Has there ever been a holiday gathering where liquor consumption isn’t encouraged? We drink wine, spirits and aperitifs in celebration, and gift them as well. No self-respecting host would let a guest’s cup run dry. Because of this over-indulgence, the Thanksgiving to Christmas interval is famous for record amounts of DUIs and highway fatalities. Add a little liquor to the sleep deprived, and you are living dangerously. It may be time for a cab.

Food
The feast wouldn’t even be a feast without a ridiculous abundance of food. Actually the ham or turkey dinner and accompaniments isn’t the big problem with holiday eating, not at least until the third or fourth serving. It’s the fast food that’s a much bigger threat, as well as the steady intake of sweets that seem to surround us. Running around too short on time, we skip eating until it’s practically an emergency. Then we make hasty choices and go for immediate gratification. Fast food is represented in all its appealing variations at the food court at your local mall – how convenient. Does healthy food even stand a chance?

“Christmas Crud”
It’s a medical euphemism for the colds, strep throat, influenza, bronchitis and pneumonia that circulate this time of year. Our exposure to respiratory germs is greatly increased as we spend more time in crowds, at stores, gatherings and assemblies. Seldom are we not in sight of someone coughing, sniffling or sputtering.

Our immune system also isn’t at its best. Your body’s defenses work best when we follow our mother’s advice: get plenty of rest, consume good food and keep a low stress level. That is the makings of top functioning immune systems. On what planet does this exist at Christmas time? The result – a lot of exposure and little energy to defend yourself, a veritable “bug fest.”

Stress
Did we mention stress? Pick your flavor: money stress, shopping stress, party stress, over-commitment stress. Stress to decorate the house, wrap the presents and send out personalized and meaningful handwritten cards. We all suspect that stress can be a problem. Stress affects everyone a little differently, but insomnia, anxiety, chest pain and irritability are common. Stress is magnified when we don’t feel in control of our situation. Anybody’s Christmas list getting the best of them or is it just mine?

christmas tree 2004photo © 2004 scott feldstein | more info (via: Wylio)

Take a deep breath, maybe two. Your true friends and family don’t need to be impressed with your perfect cards – they like you anyway. Maybe your card list has too many people that you are no longer close to – they won’t miss you. What’s the real chance you can buy somebody the perfect gift, something truly special that they haven’t gathered in 40 or 50 years of consumerism? You don’t have a prayer. Make the gifts you give be time and attention – how about you make a lunch date with them and get caught up…in February.

This holiday season can be less of a heath disaster if you simply avoid excess in order to make your Christmas a merry one.

Happy Holidays!

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

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Sushi: More Than Just Raw Fish

Posted on April 3, 2012 by ushealthworks| Leave a comment

Japanese cuisine has worldwide popularity and nothing is more synonymous with Japanese food than sushi.

The term sushi is associated with raw fish dishes that we see as healthy culinary art forms that many people feel taste great. The forms and traditional types vary greatly. Raw seafood is the foundation for dishes that are consumed and stand on their own merit. Many presentations also include rice, nori and numerous other ingredients, such as vegetables and some seafood that may already be cooked.

However, sushi isn’t limited to raw fish and rice. Condiments such as soy sauce, wasabi paste (a distinctive cousin to horseradish), tofu, soy beans, eggs and mayonnaise are often components to some dishes.

Fish is a wonderful source of high quality lean protein. It is low in saturated fats, cholesterol, and carbohydrates. Salmon, mackerel, herring and tuna are rich in omega-3 fatty acids, which are linked to many health benefits.

Tofu, soy beans, nori, the dried seaweed wrapper commonly used in “rolls,” are all excellent nutrient sources of minerals, calcium, vitamin D, folic acid and antioxidants. Not all ingredients are limited to raw fish. Shrimp, eel, geoduck and crab are often cooked before they are featured in a roll.

The wide array of creative rolls and styles seems endless with something to suit any taste. One must be thoughtful about some of the ingredients in some contemporary rolls, like cream cheese, fried foods, mayonnaise, and soy sauce that greatly increase the calories, sodium and fat contained in your dish. Overall, the benefits of enjoying sushi and sashimi are diverse and outstanding.

The risks of eating sushi are very low, but are worthy of consideration. The general contamination of seafood with mercury is virtually unavoidable. Unfortunately, this neurotoxin contaminates all open waters of rivers, lakes and oceans. Some caution should be exercised in choices of fish variety and quantities consumed by those who are at greatest risk of mercury consumption.

Women who are pregnant, nursing or planning to get pregnant, young children, elderly or people who have a compromised immune system, should limit their consumption of seafood to only 12 ounces per week.

Some species of seafood are likely to have higher mercury levels, such as tuna, swordfish, shark and mackerel. This doesn’t mean that they need to be avoided entirely. They just need to be consumed in limited quantities, emphasizing variety with other kinds of seafood that may be lower in mercury content, such as salmon, trout, crab and shrimp.

There are additional risks with undercooked or raw seafood that remain low if products are handled and stored properly. There are FDA guidelines for the industry that include freezing fish for precise amount of time to kill parasites.

Still, poor handling or dishonest vendors can provide tainted food that is contaminated with bacteria or parasites. The most common symptoms from eating contaminated raw fish are nausea, vomiting, diarrhea, abdominal pain, headache and fever. One must rely on a reputable dealer and trust your restaurateur to provide sanitary products of high quality. Although eating raw seafood is simply a greater risk than cooked fish, experts agree the health benefits outweigh the risks.

Enjoy the nutritional benefits of a wonderful culinary art with thoughtfulness and peace of mind. Also keep in mind to strive for variety and eat sensible portions.

By Dr. Bruce Kaler

Image: piyato / FreeDigitalPhotos.net

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Food Allergies at a Glance

Posted on May 10, 2011 by ushealthworks| Leave a comment

The topic of food allergies is murky and confusing. Many reactions reported as allergy to a food product are really mere intolerance, over-eating or other factors. True food allergies are thought to occur in 8 percent of children under age 5 and only 3 to 4 percent of adults. The frequency of allergies does not vary much around the world, while both genders are equally affected.

True food allergies can cause reactions that differ from mild digestive issues, rash, hives or difficulty breathing. Anaphylaxis is the most severe form of allergic reaction, with onset within 20 minutes of ingestion that progresses rapidly, resulting in hives, shortness of breath, rapid pulse and even death if not immediately treated. Although estimates of life-threatening reactions vary widely, it comprises only a small number of the overall allergic reactions to food. True food allergies usually occur within 2 hours or less after ingesting the food. Onset of swelling or tingling around the throat, lips, face or hives and itching are early signs. It can progress to dizziness, nausea, vomiting or difficulty breathing. Which symptoms and how rapidly it progresses may be different in one person to the next.

Food intolerance is only sensitivity to a food that is driven by a different physiologic mechanism that causes much milder symptoms and does not lead to more severe reactions. A good example of this is lactose intolerance, or sensitivity to milk and dairy products. Due to an enzyme deficiency, it often results in abdominal gas, discomfort, cramping and diarrhea. It is a lot more common and vastly different than a true food allergy.

FOOD by Wolfgang Wildnerphoto © 2011 Wolfgang Wildner | more info (via: Wylio)

The most common food allergies are eggs, milk, peanuts, tree nuts (i.e. walnuts, pecans) wheat, and shellfish (shrimp, lobster, crab, clams). Regular fish and chocolate are much less common allergens than anecdotes suggest.

Food intolerance can be confused with an allergy. Only a small amount of a food can trigger a severe allergic reaction. Food intolerance, food poisoning, stress, a virus, medications, food additives (preservatives, coloring) can all produce similar but milder symptoms, particularly intestinal problems. So it can be confusing at times to ascertain what the origin of the reaction may be.

A family history of food allergies, asthma or eczema increases the risk of true food allergies. Allergic individuals may cross react between certain allergens. Some of those sensitivities can extend between dissimilar items that may not be obvious. Consulting your healthcare provider, an exam and possible testing may be able to provide peace of mind, appropriate treatment and identify what to avoid in the future.

The most important aspect of managing food allergies is avoidance. Unfortunately there is no specific treatment. Antihistamines are still the first line of defense in both children and adults at the onset of a food allergy. If severe, prompt medical attention may be needed. Food allergies in children often change over time. The onset is most common in the first few years of life but can occur at any age. Allergies do get better in some children as they get older. Research shows there is no relationship between allergies and when new foods are introduced after 6 months of age.

Variation in personal experience seems to be the rule. Family and personal history of allergies are stronger predictors of future course. The severity of a past reaction cannot predict the severity of a future reaction.

When in doubt about food sensitivities or allergies, simply avoid it! Consult your healthcare provider to help with any confusion.

– Dr. Bruce Kaler

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Cholesterol – the Good, the Bad and the Ugly

Posted on April 8, 2011 by ushealthworks| Leave a comment

I have recently been concerned by the eternal question: should I eat only the top or only the bottom of a slice of pizza? Perhaps I need to invest in a new Zen calendar, just live for the moment and eat the darn pie. This of course is a sideways approach to a quick and dirty discussion of good and bad cholesterol.

Rainbow Pizzaphoto © 2008 Food Recipes | more info (via: Wylio)

What is cholesterol anyway?

Cholesterol is a fat that is in the chemical class called a sterol (kind of sounds like steroid, doesn’t it?). In fact steroids and vitamins are made from cholesterol. Cholesterol occurs naturally in plants and animals. You actually make it in your body. Cholesterol is also an essential part of your cell membranes. Cells, you might remember, are your little engines of life. You won’t go far without them. So cholesterol is a good thing in many ways. Don’t hear that very often, do you?

But, like so many other thing in life, excess leads to trouble – like the glass of red wine versus the whole bottle phenomenon. A little cholesterol goes a long way.

The trouble occurs in the handling and transport of cholesterol in your body. The liver is the main source of cholesterol production. The intestines absorb dietary cholesterol. Cholesterol is a fat, and fats don’t mix well with blood (blood is water based).

Your body makes lipoproteins which function like a soap to transport cholesterol. Soaps dissolve oil in water. For the record, Tide gets the grease out by surrounding the grease particle with molecules that dissolve in water on one end, and in oil/fat on the other end? The grease is suspended in the water in kind of a porcupine looking thing, with the soap acting like quills – how’s this for a mental picture.

These cholesterol containing particles (porcupines) are called lipoproteins, and come in several flavors, some more tasty than others. Low Density Lipoproteins (LDLs) are the bad guys. They are low density because they have more cholesterol and less protein. These have been associated with heart disease, stroke, and any manner of metabolic mayhem. They float around and are a large part of the plaques that form in arteries – the higher the LDLs, the worse the risk. LDLs are increased by dietary sources such as cheese, egg yolks, and meats like beef, pork and chicken, even shrimp. They are decreased by reducing animal fats in the diet and some medications.

HDLs are the good guys – you want lots of them. Their formal name is High Density Lipoprotein. They have a higher protein to cholesterol percentage, making them dense. They function to gather cholesterol from areas where it is problematic (in the wall of blood vessels) and transport it back centrally for disposal.

The medical community has increasingly seen HDLs as one of the most important factors in a healthy lifestyle. Many things raise the HDL levels. Among them are exercise, weight loss, moderate alcohol intake, a low-fat diet, fish oil supplements and quitting smoking. Medications can also be used to raise HDLs.

To tie up a few loose ends:

• Trans fats are not naturally occurring. They are made in factories as a food additive and used in the fast food and pastry industry. Eating trans fats is a pretty bad idea as a little of these fats really raises the bad cholesterol.
• Saturated fats (animal fats) also raise cholesterol.
• Poly unsaturated fats do the opposite – they lower cholesterol.

The answer to my original question about pizza (if you have been holding your breath) is of course a choice.

If you believe in the Atkins diet, eat the top of the pizza (protein and fat) and throw away the crust (carbohydrate). If you think cholesterol is more worrisome than weight, eat the crust and sauce (for the lycopene) and throw away the top.

My plan is to live in the moment and eat the very occasional whole pie with a glass of red wine – and exercise tomorrow.

Take care,

Dr. B

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HCG and Weight Loss (Or Lack Thereof)

Posted on November 16, 2010 by ushealthworks| 1 Comment

Where I work in Scottsdale, Arizona, is probably second only to Hollywood in the med-spa business. 

It’s reassuring to know that day or night, weekend or even holiday, in an emergency I can get a walk-in Botox shot or an HCG supplemented diet. I sleep better knowing these things.

Hypodermic Needle Stomach Injection 3-1-08 8278photo © 2008 Steven Depolo | more info (via: Wylio)

The HCG diet ads are so plentiful, I don’t even hear them anymore. It was with mild surprise one day when I realized they were actually talking about injecting people with HCG as part of a diet. HGH seemed plausible, but HCG?

For those that think acronyms are a silly, HCG is Human Corionic Gonadotrophin and HGH is human growth hormone. HCG is a pregnancy hormone, and it is secreted by the placenta and helps keep progesterone levels high to maintain the pregnancy. It’s the hormone that is tested to confirm pregnancy. HCG doesn’t seem a likely candidate for injecting non-pregnant people, even males, to assist in weight loss.

This is the second or third cycle for this particular medical diet fad. It tends to re-emerge roughly every 25 years, which perhaps not coincidentally, is about once every generation. If you remember HCG not working in the 70s, you are not likely to pay for it today. How in the world did this pregnancy hormone get hooked up with weight loss?

For that we have to travel back in time to the early 1950s and to India. India was a brand new country at that time, having just emerged from British rule. There were still some British medical types hanging around acting like they owned the place. One such British endocrinologist was Dr. Simeons. He did studies on pregnant Indian women on starvation diets (pleasant thought – not! There is no mention on why Dr. Simeons didn’t do this research on pregnant British women in London. Medicine was a lot more wild and wooly in those days, which are thankfully passed. But I digress…)

Anyway, he injected these starving pregnant women with HCG and they seemed to lose more fat than protein. He also studied overweight males with Froelich’s Syndrome (pituitary failure). They were also put on a 500 calorie diet and given HCG shots. They also managed to lose considerable weight. He theorized that giving supplemental HCG in extreme diets hastens weight loss and spares protein-producing for a more healthful weight loss. This doesn’t even make medical sense, but this became quite the fad in Italy where Dr. Simeons had a clinic. Pretty soon everyone was injecting all manner of HCG preparations in the pursuit of lean living.

Rapid weight loss that spares protein and preserves vigor is the holy grail of the dieting world. Many attempts to prove Dr. Simeons’ theories about HCG-assisted weight loss have failed to reproduce any measurable benefit from the HCG. It seems the severe 500 calories restriction diet was the actual cause of the weight loss, and it had nothing to do with HCG. That is not too surprising since HCG is a pregnancy hormone.

Lose weight nowphoto © 2009 Alan Cleaver | more info (via: Wylio)

Injecting HCG as part of a diet was popular in the 50s, in the 70s, and now in the first decade of the new millennium. HCG is still little more than an expensive placebo. Its popularity seems to be related to the income it produces rather that any measurable medical benefit, other than to fetuses. It’s really hard to sell an unusually harsh diet, but combine it with a magic weight loss shot with a medical name, and you have an industry.

Take care,

Dr. B

U.S. HealthWorks’ Dr. Thomas Miller recently spoke with KXLY-TV in Spokane about the HCG diet. His interview can be found here.

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The Care and Feeding of Your Colon

Posted on August 20, 2010 by ushealthworks| Leave a comment

Like your heart, your colon is an organ that you totally ignore when it’s working, but it can make you plenty miserable if it doesn’t. 

Let’s start out with a mental picture. Put a tennis ball in a sock. Now try to make it come out the end of the sock by squeezing the sock. Got the picture? (Sorry).

That is how the colon works. 

The colon is a hollow tube about 8 feet long. The walls of the colon have muscles that form constricting rings. When these muscles contract in waves, it causes the colon to squeeze, working from one end to the other.

The colon does a couple of pretty important jobs. The remnants of digestion that enter the colon have the consistency of thin mud. Excess water is absorbed into the walls of the colon. Without this function, you would have a permanent case of diarrhea. Vitamin K is also absorbed in the colon, which is useful in keeping you from bleeding to death from the minor injuries of daily life. Pretty important stuff for such a lowly organ.

The American diet does not make for a happy colon. The reason for this is our food is “too good” that almost 100% of it is absorbed. One might say that the American diet is the rocket fuel of foodstuffs. There is so little indigestible material that it almost eliminates the need for a colon.  Therein lies the rub.

This low residue diet might be OK on dog food labels, but in humans it results in highly compact, low volume stools. The colon has to squeeze pretty hard to get that moved through the tube. Sometimes it squeezes so hard, the wall tears (the sock rips). That is how diverticula are formed (little pockets in the walls of the colon).

Another unfortunate effect of highly concentrated diets is the passage through the colon is very slow. Keep in mind that the stuff that goes into the colon is the stuff the body didn’t want. This causes whatever bad stuff you ate (like toxins or pesticide residue) to have more time to cause trouble. 

Going back to our tennis-ball-in-a-sock-analogy. If we wanted to make this easier, we could replace the tennis ball with a dozen marbles. Just a little squeeze would easily move the marbles through the sock. This is what happens when we add indigestible material (fiber) to the diet. We don’t make the colon work so hard, so it doesn’t get traumatized and cause diverticulae. Also, the transit time through the colon is faster, so some of toxic substances that enter the food chain (pesticides, cattle hormones) spend less time in your colon – that means less colon cancer.

Constipation of course, is also not a problem. The fiber traps cholesterol and removes it from you body. This is in addition to any cholesterol-lowering program you are on.

There is a veritable plethora of benefits to providing some fiber to the diet. “But,” you say, “Who has time for bran muffins and food with the consistency of sawdust?” Here we have an easy answer. There is a grain grown in India that has a husk that is indigestible, and when ground up, mixes well with almost any water-based beverage – psyllium. It is sold under various brand names (Metamucil among others). Simply take a rounded tablespoon and mix it with some juice and/or water. Drink it down morning and evening, and it will keep your colon busy and out of trouble. 

A happy colon will make a happier you.

Until next time,

Dr. B


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