Category Archives: Diet and Nutrition

Straight, No Chaser: When Eating Goes Wrong, Part II – Bulimia

Bulimia…-nerviosa-1

If you read Part I of this conversation on eating disorders (anorexia nervosa), you will recall that eating disorders are a mix of an abnormal body image combined with abnormal behaviors that lead to medical consequences. Today’s Straight, No Chaser is on bulimia, yet another dangerous eating disorder.

The ‘Bizz-Buzz’ of bulimia nervosa is ‘binge-purge.’ What that means is bulimics engage in frequent episodes of eating excessive amounts of food (bingeing) followed by one of several methods of eliminating what was just ingested (purging). This methods include forced vomiting (most common), use of diuretics or laxatives, fasting or excessive exercise. It is important to note that the bulimic feels a lack of control over these episodes.

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Bulimia is an especially dangerous disease because it usually occurs in secret, and victims are able to hide it. This means symptoms will typically be further along when discovered. Bulimics usually manage to maintain a normal or healthy weight despite their behavior and may appear to be the person who ‘never gains weight’ despite ‘eating like a horse.’ This is a key differentiator between bulimia and anorexia. Otherwise, the two diseases do share some of the same psychological pathology, including the fear of weight gain and the unhappiness with physical appearance.

Treatment considerations for bulimia are similar to those for other eating disorders. A combination of psychotherapy, reestablishment of normal nutritional intake and medications usually leads to marked improvement. Again, the particular challenge with bulimics is discovering the condition in the first place. As with anorexia nervosa, treatment for bulimia nervosa often involves a combination of options and depends upon the needs of the individual. Medications may include antidepressants, such as fluoxetine (Prozac), if the patient also has depression or anxiety.

Let’s recap by revisiting where we started with our conversation on anorexia. Our society doesn’t do the job it should in promoting a normal image of health. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is obese by medical standards, this becomes even more of a problem. The levels of stress, anxiety and depression resulting from this reality sometimes leads to eating disorders. Remember, eating disorders aren’t just habits. They are life-threatening conditions. If you or a loved one is suffering, please seek help immediately.

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Post-script: If you’re wondering about the above picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth.  I know. It’s not your best look.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, Gastrointestinal, Mental Health

Straight, No Chaser: When Eating Goes Wrong, Part I – Anorexia

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Simply put, our society doesn’t do the job it should in promoting a normal image of health at either end of the body size spectrum. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is disproportionately obese by medical standards, this becomes even more of a problem, as individuals give up on realistic goals and settle into unhealthy eating habits that lead to disease due to obesity.

Most people are aware of two eating disorders (on the low side that is; obesity is another conversation): anorexia and bulimia. It is important to note that eating disorders are real medical and mental diseases. It is equally important to understand that they can be treated. It is vitally important to understand that when left untreated these disorders lead to a much higher incidence of death than in those without these conditions. These diseases cause severe disturbances in one’s diet, so much so that individuals spiral out of control toward severe disease and death in many instances. Sufferers of eating disorders often have a distorted self-image and ongoing concerns about weight and appearance. (This is as true for those pathologically overweight and in denial as it is for those pathologically underweight.)

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Today’s Straight, No Chaser discusses anorexia. Anorexia nervosa is an eating disorder with nearly a 20 times greater likelihood of death that those in the general population of a similar age. Why, you ask? Simply put, anorexics are suffering the consequences of starving themselves. Anorexics have a maniacal and relentless pursuit of thinness, even in the face of being extremely thin. They couple an unwillingness to maintain a healthy weight with an intense fear of gaining weight. They possess a distorted view of their bodies and severely restrict their eating in response. They are obsessed.

Other symptoms and habits of anorexics include a lack of menstruation (among females, though men suffer from anorexia, too), binge-eating followed by extreme dieting and excessive exercise, misuse of diuretics, laxatives, enema and diet medications. The medical manifestations of anorexia are serious and can include osteoporosis or osteopenia (bone thinning), anemia, brittle hair and nails, dry skin, infertility, chronically low blood pressure, lethargy and fatigue, and heart and brain damage. It’s worth noting again that people die from anorexia. It is a disorder to be taken seriously.

The key components of treating eating disorders in general are stopping the behavior, reducing excessive exercise and maintaining or establishing adequate nutrition. The pursuit of adequate nutrition is vital enough that when patients develop dehydration and chemical imbalances (i.e., electrolyte abnormalities), they need hospitalization to correct deficiencies.

Specific management of anorexia involves addressing the psychological issues related to the eating disorder, obtaining a healthy weight, and consuming sufficient nutrition. This may involve various forms of behavioral therapy and medication. Regarding medication use, although some (such as antipsychotics or antidepressants) have been effective in addressing issues related to anorexia such as depression and anxiety, no medication has been proven effective in reversing weight loss and promoting weight gain back to a healthy/normal level. Similarly, behavioral therapy has been shown to assist in addressing the roots causes of anorexia but insufficient in addressing the medical issues that the disease contributed to or caused. Ultimately, it appears that a combination of medications, other medical interventions and behavioral therapy is the most effective course. As is the case with most illnesses, the earlier treatment is initiated, the better the outcome tends to be.

Please maintain a sufficient sensitivity toward those with anorexia. It’s a life-threatening condition, not the punch line of a joke about someone’s appearance.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, Mental Health

Straight, No Chaser: The Health Benefits of Dark Chocolate, aka Happy Valentine’s Day!

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Happy Valentine’s Day! Got Dark Chocolate?

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As you may know if you’re a regular reader, Straight, No Chaser is big on you enjoying life and making healthy choices while doing so. In that spirit, on this day of roses and chocolates, we’re here to share with you the benefits of dark chocolate.

That’s right. Chocolate does have health benefits, but all chocolate is not created equal. If your loved one gives you chocolates today, that’s great (if that’s your thing). If s/he gives you dark chocolate, that’s an extra level of loving!

Straight, No Chaser has previously discussed the health benefits of antioxidants. Here’s the thing: antioxidants are substances that prevent or delay cell damage caused by free radicals. Free radicals are molecules that are byproducts of many activities that create cell damage. Think about cigarette smoke, trauma (even excessively vigorous exercise), excessive heat and sunlight (and its radiation), to name a few examples. The process of creating and releasing these molecules is called oxidation. The key point is free radicals are unstable and too many of them lead to a process called oxidative stress. This process is implicated in the development of many illnesses, including Alzheimer’s disease, cancer, cataracts and other eye diseases, cardiovascular diseases, diabetes and Parkinson’s disease. Antioxidants fight this process; this is why foods rich in antioxidants are called superfoods!

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Here are the known benefits of dark chocolate:

  1. It lowers blood pressure.
  2. It increases the levels of antioxidants, which reduces the incidence of heart disease of other conditions.
  3. It potential slows the onset of many (if not any) disease made likely by increased levels of free radicals. This points to benefits for brain health, slowing aging, cancer prevention and many other conditions.

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Here’s how to enjoy the benefits of dark chocolate:

  1. Remember, it’s dark chocolate (not white chocolate or milk chocolate) that provides these health benefits.
  2. Offset the extra calories you’re ingesting by exercise or otherwise eating less.
  3. Don’t drink milk while enjoying your dark chocolate; it appears to interfere with the body’s absorption of the dark chocolate.
  4. Go for European dark chocolate if available. It’s richer in cocoa phenols (the specific compounds known to lower blood pressure).
  5. Remember that a dark chocolate diet is not a thing! This is you making healthy choices even as you enjoy sweets.

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So if you’re going to chomp down on a truffle or bon-bon today, make it dark chocolate. And hold the milk. Happy Valentine’s Day!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Cardiology/Heart, Detoxification, Diet and Nutrition, General Health and Wellness, Health Prevention

Straight, No Chaser: Let’s Boost Your Metabolism

fat crying

It would be improper for me to have dragged you through the mud for three days and depressed you into thinking you can’t improve your situation. Hopefully, you’re not feeling that way. You should now have a better understanding of how the body works, how to count calories and how to compare yourself to a baseline for health. What left is giving your body a leg up on your efforts. Yep, I’m talking about boosting your metabolism. Any of you that have been with me for a while know that means I’m not promoting something you’ll find in a bottle, although there are many good supplements that can assist in that effort. I’ll refer you to your (or my) favorite personal trainer for those considerations. As always, I want to offer you the tools to be self-empowered. To that end, here’s five Quick Tips to boost your metabolism. Why five? Because five is easier to implement than six. Once you get these five down, let me know, and we can get a bit more intricate.

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1. Eat smaller meals, and eat more frequently. It’s true. More meals more often is better, but only if they’re smaller. Calorie counting is still a major part of the equation. The point of more frequent meals is preventing the body from going into starvation mode, which slows your metabolism as the body attempts to conserve energy. If you do this, you’ll discover those meals are smaller and you will get closer to eat more appropriate portions than we typically do. Also, make those in-between meals healthy choices like a handful of fruits or nuts.

2. Prime your pump. Remember, it’s all about your heart’s ability to efficiently move blood around the body anyway. The healthier your heart is, the better your metabolism will be. You need aerobic exercise that increases your heart rate for 20-30 minutes at a time. Learn your target heart rate for your age, and exercise to get into that range. Your metabolism will better approximate that of a fine tuned machine rather than a sputtering old car.

3. Weight train. This is very simple. The more muscular you are, the more calories you will burn, especially relative to someone of the same weight who is obese. Not only will you become a finer calorie-burning machine, in this case you actually will look better! Add weight training to your exercise regimen.

4. Choose the fish (and not the fried variety). Fish oil contains substances called omega-3 fatty acids (EPA, DHA) which increases levels of fat-burning enzymes and decreases levels of fat storing enzymes. Daily ingestion has been shown to help by approximately 400 calories a day.

5. Enlist a personal trainer. Everyone needs help and motivation. Some of us need a lot of help and a lot of motivation. We also need expertise. There’s nothing more frustrating than working hard yet not seeing any results because you’re working incorrectly. A good trainer can put you on the path, supervise your regimen, and hold your hand through the process. The minutia of age, sex and body habitus considerations that also play a role in this can be managed by a good trainer. Your ideal trainer will have knowledge of nutrition, wellness and supplements that are tailored to your specific considerations. This will get your metabolism revved up!

By the way, if you’re into green tea, caffeine or spicy/hot peppers, enjoy them for their other benefits, but don’t expect them to contribute significantly to your efforts to improve your metabolism. At least that’s what the consensus in the medical literature points out.

metabolism rev up

Finally: yes, it’s true that metabolism naturally slows with age (starting as early as age 25); everyone has heard that fact. However, here’s what you don’t usually hear: that’s not inevitable and is more a result of your becoming less physically active than just aging. That demonstrates the need for you to be even more diligent in your efforts. Good luck, and I welcome your questions and comments.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, General Health and Wellness

Straight, No Chaser: Healthy, Sustainable Weight Loss – Let’s Get Started

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How to Lose Weight, and What is Healthy Weight Loss (AKA, How Much, How Soon and How)?

Let’s start with the How. Commercial voice: “You should contact your physician before starting any weight loss routine”. We ended things on the last post talking about the caloric balance equation, which (simplified) means you need to get off your derriere, and close your mouth. Without getting too technical, to lose weight, 1 pound equals 3,500 calories, so your net caloric intake must be cut by at least 500 calories per day to lose a pound a week. Here are some Quick Tips to cut calories (and I will not be discussing any of the popular diets or medical remedies (with one exception in the next post); you can see your physician or nutritionist about those. Besides, guess what? Most of you don’t need a fad diet. Keep it simple. And…more importantly, you should be more concerned with healthy regimens that help you keep the weight off, not drastic efforts that have proven to have quick short-term but unsustainable long-term outcomes).

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1) Work out: If you can sprint, do so. If you can’t, jog. If you can’t jog, walk. I like working out while watching sports, because my heart’s pumping anyway. Weight training at the same time is even better. Once you hit a good exercise regimen, your metabolism will improve, making weight loss that much easier.  By the way, the next post is on metabolism; stay tuned.

2) Hungry?  Start counting calories.  Use this standard to determine what your daily calorie intake should be.  Meal plan so you don’t exceed that level.  Remember the caloric equation to lose weight: Amount expended minus the amount eaten should be 500 calories a day.  In the next post, I’ll give you a Quick Tip for an extra 400 calories a day you can lose.

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3) Still hungry? Try brushing your teeth. Don’t laugh. It actually works. And it gives you nice teeth. Otherwise try drinking water or chewing calorie-free gum. All these are nice, simple inexpensive appetite suppressants.

How Soon? It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1-2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. Think health instead of weight, and the weight will improve.

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How Much? If you were my patient (but you’re not!), I’d tell you to forget about ideal body weight and BMI – for now. Focus on a modest weight loss, like 5-10% of your current weight. Even this success will improve your blood pressure, cholesterol and blood sugar levels. Once you accomplish that goal, do it again. So even if the overall goal seems large, see it as a journey rather than just a final destination. Seek to learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time. To that end, I love healthy challenges. Try a 30-day water instead of pop (soda)/coffee, etc. challenge, or even better, give yourself a 30-day ‘fruit for dessert challenge’ or ‘salad of your choice for lunch’ challenge. When that’s done, immediately do it again.  Learn to integrate healthy habits into your quest to lose weight, and you’ll increase the odds of having sustainable weight lost. At the end of the day, it’s been well established that those who maintained a significant weight loss report improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence. Good luck, and check back for the next post on how to fine-tune your metabolism!

find the best way to lose weight and tips

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, General Health and Wellness

Straight, No Chaser: Moving Toward a Vegetarian Diet

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Ok… I’m glad to have finally come across a diet option that has struck a nerve. The post on principles of vegetarianism has raised a lot of questions, and I’ll take this space to answer some of the more common and important ones.

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1. I’ve always heard vegetarian diets are low in protein. Is this true?
It’s more correct to say vegetarians need to ensure they are taking enough protein. If you’re not eating red meat, you will still get plenty of protein by eating fish, dairy and eggs. If you are a strict vegan or have mostly eliminated fish, dairy and eggs, protein options include items such as whole grains, nuts and seeds, peanut butter, beans/legumes (e.g., navy beans, split peas and chickpeas) and protein from soy.
2. Can you identify various options for soy protein?
Sure. There’s soy cheese, nuts, milk and tofu products. Veggie burgers and chicken substitutes also will get you there.
3. Any dangers in these substitute foods?
Yes. You still need to limit sugar, salt and fat. Excessive cheese isn’t a good thing. Focus more on the low-fat options such as beans and use cheese for variety.
4. Are vegetarians at nutritional risk beside low protein?
Vegetarians need to focus on eating adequate amounts of iron, calcium, zinc, Vitamin B12 and omega-3 fatty acids. The way foods are fortified now, this isn’t as big of a difference as it once was, although you rarely will go wrong working with a nutritionist as you make this dietary change.

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5. Please give examples of various foods that address the nutritional concerns of vegetarians.

Calcium: Sources of this mineral include milk, seeds, beans, nuts, green vegetables, and foods fortified with calcium such as fruit juices.

Vitamin B12: You’ll find adequate amounts in dairy products, eggs and other foods labeled as fortified with B12.

Vitamin D: Vitamin D is found in fatty fish, egg yolks, cereals and soy milk labeled as being fortified with vitamin D.

Zinc: Zinc is abundant in beans and foods labeled as being fortified with zinc, such as milk and cereals.

Iron: Iron is found in beans, green vegetables, and foods labeled as being fortified with iron, such as cereals.

Vitamin C: Vitamin C helps the body increase iron absorption, so eating foods that are high in vitamin C (e.g., bell peppers) at the same meal as iron-rich foods is a good thing.

If you’re serious about making the conversion to a semi- or fully vegetarian diet, discussing your plans with a nutritionist is a good idea. Of course, you can talk to a nutritionist anytime at http://www.sterlingmedicaladvice.com or 844-SMA-TALK.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Straight, No Chaser: An Introduction to Vegetarian Diets

 Vegetarianeat

If you are on a vegetarian diet, congratulations to you, but if you’re not, you still should be interested in the principles that make a vegetarian diet a healthy choice. Even if you think you have no interest in becoming a vegan but still want to eat a healthy diet, you will find yourself inching relatively closer to a vegetarian diet.  After all, the various vegetarian diets are just the maximal application of increasing your intake of fruits and vegetables.

Before we even define the different types of vegetarian diets, let’s answer a simple question: “Why in the world would I ever consider being a vegetarian?” The answer to the question is best given by discussing some outcomes of interest.

  • Vegetarians generally have longer life expectancies than meat eaters.
  • Vegetarians are less likely to have heart disease.
  • Vegetarians are less likely to be obese.
  • Vegetarians are less likely to have high blood pressure.
  • Vegetarians are less likely to have certain types of diabetes.

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The vegetarian diet focuses of the products of plants. These include the following types of foods: fruits, vegetables, seeds, nuts, whole grains and legumes (beans, peas and lentils). There are different types of vegetarian diets (representing levels of strictness), including the following:

  • Vegan: only plant-based floods (with “nothing from anything with feet”)
  • Lacto-vegetarian: Plant-based foods with an allowance for some dairy products
  • Lacto-ovo vegetarian: Plant-based foods with an allowance for some dairy products and eggs
  • Semi- or partial vegetarian: The diet excludes red meat. It includes plant-based foods with an allowance for dairy products, eggs and certain meats (chicken and fish).

If you’re a semi-vegetarian, you may be further categorized based on the meat you eat:

  • Pescatarians eat fish but not red meat, pork or poultry.
  • Flexitarians (aka semi-vegetarians) occasionally eat red meat.

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Now look back at the last six bullet points. The closer you get to being a strict vegetarian, the lower your risks of high blood pressure, diabetes and other certain other medical conditions. You can think of each bullet point as a stepladder to better health.

The point of this is there’s more than one approach to incorporating the principles of vegetarianism. You don’t have to be an absolutist to make your diet healthier. Just remember, the more plant-based your diet is, the healthier you’ll be. We’ve discussed this previously in the healthy eating plate. The bottom line remains the same. Most of you reading this don’t eat enough fruits, vegetables, whole grains or legumes. The more your diet is tilted away from red meats and toward these options, the healthier you’ll be.

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The next Straight, No Chaser will discuss specific concerns of vegetarian diets.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition