Tag Archives: Diet

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

Diet and Nutrition, Mental Health, , , , , , , , , , ,

anorexia_nervosa11

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.)
anorexia-nervosa
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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Straight, No Chaser: How Many Calories Do You Need a Day?

General Health and Wellness, Health Prevention, , , , , , , , , , ,

calories
Let’s put this post (at least the end of it) under the category of things you do but really don’t think about.
How many calories should you take in per day to function (meaning produce the energy you need for your activities of daily living)?  It actually depends on your gender, your age and your level of activity.  Let me start by defining the types of lifestyles, according to the Institute of Medicine.  If you are in the third category (active), I doubt that you’re worried.
Sedentary means a lifestyle that includes only the light physical activity associated with day-to-day living.
Moderately active means a level of physical activity equivalent to walking about 1.5-3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
Active means a level of physical equivalent to walking more than 3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
That breaks down as follows:

  • For women between 14-50, the number is right about 2000 kcal/day (calories) if you’re moderately active and 1800 if you’re sedentary.
  • For men between 14-50, there’s some greater variance, but the 2500 kcal/day works if you’re moderately active and 2200 if you’re sedentary.

In short, that averages to about 600-800 calories per meal, with the low-end being for sedentary females and the high-end being for moderately active males.
soda1
Now consider, 16% of the calories in the average American diet come from refined sugars.  Fully 50% of that total comes from beverages with added sugar.

Every 12 ounces of non-diet of pop/soda you drink contains about 150 calories.  

Your average dessert ranges from 300-500 calories.  

The most popular one, only one cup of ice cream, contains 270 calories.

I’ll let you take the math forward from there.  However, the take home point is obvious.  Suffice it to say, the link between pop, deserts and obesity has been well established.  Here’s three Quick Tips for you.

  • Try finding a drink with fewer calories if you want to lose calories (and weight).  It’s water, not Coke, that adds life.
  • Try eating your favorite fruits as dessert.
  • Also, consider just walking 3-4 miles a day.  It’s not that hard, if you just do it.

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.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Diabetes Basics and the Importance of Education

Diet and Nutrition, Endocrine/Metabolic, Health Prevention, , , , , , , , ,

diabetesed

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. 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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: A Look at Detox Diets

Medical Treatment, Toxicology/Drugs, Health Prevention, , , , , , , , , , , , , ,

detox-diet1

Detox-Diet2

Everyone who talks to me about detox is motivated and sincere about making an improvement in his or her health.  Therefore, it’s important that they be shown respect and encouraged.  However, some of these same individuals exhibit a level of desperation that is counterproductive and leaves them subject to fads and scams that are doomed to long-term failure. The first question I ask is “Are you trying to improve your health or weight?” These are often separate considerations. Of course, I’m hoping they answer, “Both.”  Interestingly, that happens less often than you might think. Next, I’ll ask if they’re engaged in some basic, fundamental activity (click here), which is rarely the case. Once people discover the latest, greatest thing, they tend to lock in on it and just have to go for it.  So be it.

So… today and tomorrow, I’m going to discuss two very common “quick-fix” approaches to detoxification. Let’s start with the “detox diet.”  For the purposes of this discussion, all detox diets are variations of the same theme. I hope this doesn’t disappoint you or come off as dismissive, but the point of the matter is that from a medical standpoint, these actions are reducible to a set of physiologic actions that either produce biological effects or don’t.  Giving a car a new coat of paint doesn’t make it an airplane.  Similarly, taking a quick detox diet doesn’t make you healthy if you return to the same conditions that produced your pathology in the first place.  Folks, it really should occur to you that given the rates of obesity and disease that exist, if these diets really worked, the pharmaceutical and medical communities would be all over them because of their potential for profit (and of course the potential for good…).  Here’s what detox diets do and don’t accomplish.

The Premise: Going on a diet for a few weeks can clear your body of toxins, which will improve your health.
The Short Term Effects: Proponents of detox diets often claim or note the following during the diet:

  • Weight loss
  • More energy
  • Better mental focus

The Long Term Effects: Proponents of detox diets often make the following claims about the benefits of the diets:

  • Health promotion
  • Prevention of new diseases
  • Cure of chronic diseases

What’s Really Happening: Have you ever heard that correlation is not causation?  If you engage in any activity involving backing away from fats, drinking more water, taking in less sugar and processed food, eliminating alcohol and caffeine, and taking in more fruits and vegetables, you’ll feel better!  In fact, I’m all for it.  Refer to this blog post where I give you details on how to naturally, healthily and sustainably do this.
Now, here’s the question. Is your detox diet just a two to four-week “challenge,” or is it the launching pad for a set of lifestyle changes? The problem is that people use these diets with their better principles, but they usually don’t sustain them.  In fact, the diets themselves generally are not sustainable because they’re too restrictive. If you tried sustaining some of these diets, you’d end up hospitalized.  You’re much better off applying fundamental principles that will slowly and steadily improve your health and also help you lose weight. By the way, those long-term claims have been roundly and routinely debunked by the medical community, which has every incentive to want to discover new ways to treat disease.
Precautions and Risks

  • Before starting any diet, you need to discuss what you’re trying to accomplish with your physician. I’d venture a bet that most would not approve one of these diets, especially if you suffer from any chronic illness, especially diabetes, mental illness, moderate to severe (and poorly controlled) high blood pressure or cardiac disease. They also won’t approve it if you’re pregnant or at the extremes of age.
  • Based on the components of these diets, you are introducing certain specific risks.  These include vomiting, diarrhea and dehydration, electrolyte loss and imbalance and disruption of the function of your digestive system.

Let’s finish with two pointed questions and answers.
1.  Should I go on a detox diet?  I encourage almost any activity that motivates you to improve your health and has been shown to improve your health. If you want to naturally detox, apply these principals as the basis for a lifestyle change. As your body recovers, your natural detoxification system will take over and do just fine (assuming you are otherwise healthy).
2. I quick-flush my system with a diet every few months. Is this healthy?  It depends on what you’re doing as a “quick-flush” and even more so, what you’re doing in-between. Focus on enhancing your natural detoxification system. I can’t say that a one-time or intermittent initiative to kick things off would be a terrible thing — if you stay with the program. In the best case scenario, it’s like going to get a dental cleaning every six months. You’ll still have decaying teeth and disease if that’s the only thing you’re doing. On the other hand, if you’re brushing and flossing every day, then the six-month check up is quick (and in this case, maybe superfluous).  I’m much more concerned with you sustaining a healthy approach toward the desired goal.
Next up, and the last in this series on detoxification will be a look at colonics.  Until then, bottoms up!
Feel free to ask 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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Natural Methods of Detoxification

Detoxification, General Health and Wellness, Health Prevention, , , , , , , , , , , , , , , , , , , , , ,

Natural-Detox
It seems that at least once a week I get asked to comment on colonics, detox diets, juice fasts, etc.  It seems to me that these are all rather extreme places to start.  How about we just talk about the threats that exist, how to avoid them, how to understand the natural detoxification process and how to optimize it?
On some level, our body is at constant war with our surroundings.  We are finely tuned machines (until we’re not).  We are well designed and equipped to filter the air we breathe and the food we eat, and to repel external poisons from penetrating our bodies.  That’s a very good thing, because toxins are everywhere.  We eat and drink them.  We inhale, absorb and ingest them.  Usually we do these things unwittingly, but for various reasons, a good number of us do these things intentionally.  By definition, toxins have harmful effects on our bodies.  Buildups of these substances can cause damage and eventually death.
In the first part of this five-part review of toxins and how they affect us, I want to point out how the body is equipped to combat and eliminate toxins – until and unless we poison it.  In the second part, I’ll offer Quick Tips to enhance your ability to naturally detoxify.  In the third part, I’ll discuss what and where the toxins are that we must combat.  In the fourth and fifth parts, I’ll discuss some of the exotic (or should that be esoteric?) methods promoted to detoxify the body.
Let’s start not by talking about toxins, but by discussing how the body protects you.  There are four areas in particular to review: the skin, the lungs, the kidneys and the gastrointestinal tract (particularly your liver and intestines).
Skin: The skin is actually the body’s largest organ, and it’s the largest organ of elimination.  It is in constant contact with the environment and is our primary barrier against disease, keeping out microorganisms, dusts, pollens and other substances with no good intentions.  The constant battle leaves your skin’s pores clogged, subject to infection, lacerations, and premature aging.
Lungs: The lungs are the vessels of life, bringing oxygen into the body to supply the needs of all your organs and systems.  However, have you looked at the atmosphere lately?  Smog’s everywhere, not to mention allergens and cigarette and cigar smoke.  If the air you’re breathing is poisoning the lungs themselves, your ability to keep poisons out of you and exhale away carbon dioxide incrementally become diminished to disastrous effect.
Kidneys: Your kidneys are one of the two primary ways you visibly eliminate waste.  Consider them the blood’s strainer.  You really should learn to watch your urine.  It tells a story about your health.  If your urine is not clear to light yellow, something’s going on.  If you come to me with cloudy, straw-colored, bloody, pink, or brown urine, those all tell me about different medical conditions you could be experiencing.
Your liver and intestines: Now we’re looking at your stools.  Consider that if you were ideally healthy, you’d have a bowel movement with the same frequency with which you ate.  At the other end of the spectrum (no pun intended), you could be constipated, or your bowels could be obstructed.  You have bacteria that live in your intestines that also help naturally detoxify wastes, but that only works as intended if you continue to have stools.  The more contact time your body’s intended waste has with your intestinal tract, the more of it that will be absorbed.  Fortunately, the intestines have additional barriers in its membranes that fight against toxins reentering the body.  Your liver serves a vital function in detoxifying many directly poisonous substances. It uses its natural chemicals to facilitate excretion of toxins by the kidneys.
Most everything you think you know about extrinsic supplemental ways to detoxify are poor substitutes for what a healthy body will achieve.  If you focused on your health and fitness, you could rest assured that your body would protect you, and you could also save a ton of money avoiding all those fad diets and other ‘previously secret’ methods of detoxification.
Feel free to ask 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.

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

Diet and Nutrition, Mental Health, , , , , , , , , , ,

anorexia_nervosa11

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.)
anorexia-nervosa
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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: How Many Calories Do You Need a Day?

General Health and Wellness, Health Prevention, , , , , , , , , , ,

calories
Let’s put this post (at least the end of it) under the category of things you do but really don’t think about.
How many calories should you take in per day to function (meaning produce the energy you need for your activities of daily living)?  It actually depends on your gender, your age and your level of activity.  Let me start by defining the types of lifestyles, according to the Institute of Medicine.  If you are in the third category (active), I doubt that you’re worried.
Sedentary means a lifestyle that includes only the light physical activity associated with day-to-day living.
Moderately active means a level of physical activity equivalent to walking about 1.5-3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
Active means a level of physical equivalent to walking more than 3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
That breaks down as follows:

  • For women between 14-50, the number is right about 2000 kcal/day (calories) if you’re moderately active and 1800 if you’re sedentary.
  • For men between 14-50, there’s some greater variance, but the 2500 kcal/day works if you’re moderately active and 2200 if you’re sedentary.

In short, that averages to about 600-800 calories per meal, with the low-end being for sedentary females and the high-end being for moderately active males.
soda1
Now consider, 16% of the calories in the average American diet come from refined sugars.  Fully 50% of that total comes from beverages with added sugar.

Every 12 ounces of non-diet of pop/soda you drink contains about 150 calories.  

Your average dessert ranges from 300-500 calories.  

The most popular one, only one cup of ice cream, contains 270 calories.

I’ll let you take the math forward from there.  However, the take home point is obvious.  Suffice it to say, the link between pop, deserts and obesity has been well established.  Here’s three Quick Tips for you.

  • Try finding a drink with fewer calories if you want to lose calories (and weight).  It’s water, not Coke, that adds life.
  • Try eating your favorite fruits as dessert.
  • Also, consider just walking 3-4 miles a day.  It’s not that hard, if you just do it.

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.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Gluten, Wheat and Celiac Disease

Diet and Nutrition, Gastrointestinal, General Health and Wellness, , , , , , , , , ,

Gluten free signal

One of the reasons I enjoy writing this blog is it brings me closer to understanding you. As you respond to posts or query me, I get to better appreciate the breadth of your concerns. I realize that much of what physicians do in clinical practice is talk AT you. Sometimes physicians assume that you know better because we do. Your issues often involves uncertainty about the nature of your symptoms, and, in real-time, you tend not to appreciate that symptoms are incredibly non-specific, meaning the same set of symptoms show up in multiple diseases and conditions (as you’ll noted from the picture below featuring possible symptoms of celiac disease). Many times, you’ll be researching a topic on the Internet, see symptoms you have and say, “That sounds like me! That must be what I have.” The relationship of symptoms to disease really isn’t anywhere near that linear.
Weight loss is an example of something patients think about differently than physicians. When a patient wants to lose weight, s/he may think of everything under the sun from the latest diet craze, surgery or other potential “quick-fixes.” On the other hand, a physician will parrot something about calorie control, healthy eating and exercise, assuming you know better than to entertain miscellaneous information aimed to strike fear into your hearts or give you false expectations. (If you need a refresher on that consideration, check here.) In many of these instances, physicians may never even address your questions, because we’re so busy promoting the standard of care.
This month, we’ve been discussing nutrition with probably a dozen different blogs posted on various topics. Do you think the most common questions I’ve received have involved application of the healthy eating plate or simple tips to healthier eating? Nope. They’ve been more along the lines of esoteric concerns – or at least concerns that only affect rare segments of the population – so much so that physicians typically wouldn’t even think to discuss them with patients.
Two such discussions involve the consumption of gluten and wheat. Let’s answer those questions and clear up any confusion you may have. Thank you for your willingness to engage in straight talk. Indeed, your concerns are real, and our mission at Straight, No Chaser and www.sterlingmedicaladvice.com is to get you the information and advice you need.
What is gluten?
Gluten an important protein found in all forms of wheat, barley and rye. It is also found in other foods such as deli meats, soy sauce, vitamins, some chocolate, some toothpaste and imitation crab. For the purpose of this blog, let’s relegate your wheat concerns to gluten.

celiac1

Why do I care about gluten?
You probably don’t and probably shouldn’t, unless you have a specific disease called celiac disease, which is related to the adverse effects of an extreme sensitivity to gluten. Some humans (only some and not many at all) have difficulty digesting gluten. In fact, the ingestion of gluten in those with celiac disease can cause damage to the intestinal lining, causing chronic (ongoing, continuous) diarrhea and abdominal pain. This can result in potentially life-threatening concerns, but it only occurs in less than 1% of the population.
The other reason you may have heard about gluten is the existence of a diet craze based on avoiding gluten (having to do partially with limiting carbohydrates).
Why is this an issue?
As societies have moved to diets with higher consumption of refined wheat flour, the sensitivity to gluten has expressed itself more often. As is often the case, when you over consume or are overexposed to substances, danger ensues. That is not the same as saying you need to avoid any and everything on earth that could potentially cause you harm.

celiac-disease-symptoms

Do I need to give up wheat and gluten completely?
Absolutely not, unless you have celiac disease or demonstrated allergies to these substances. This is simply another example of your needing to understand the issue. As with most overstated concerns, solutions are to be found in the same principles of healthy eating described throughout Straight, No Chaser. (Feel free to research our many topics by typing your topic of interest into the search engine over on the right side of the page.)
In this instance and others, what happens all too often is folks create new problems running from other, perceived ones. Substituting high-calorie, high-fat products for wheat and other products containing gluten is not a healthy decision and has been shown to increase weight gain and the risk of diabetes. The principles of any successful efforts to diet remain the same. Your best bet is to learn principles of healthy eating and incorporate calorie control and exercise into your regimen. Embrace moderation across the board, and enjoy learning to make healthy eating an adventure by adding variety to your meals.
One final caveat: There’s nothing wrong with, and potentially much to gain from, asking your physician about your individual risks for celiac disease. Just understand that unless you have the symptoms (e.g., diarrhea, abdominal pain, bloating, fatigue, headaches and joint pains to name a few), you likely will cause your physician to scratch her or his head.
 

Straight, No Chaser: Diabetes Basics and the Importance of Education

General Health and Wellness, , , , , , , , ,

diabetesed

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.
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.

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

Diet and Nutrition, Mental Health, , , , , , , , , ,

anorexia_nervosa11

Simply put, our society doesn’t do the job it should in promoting a normal image of health at either end of the 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.)
anorexia-nervosa
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.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight No Chaser In The News: New Weight Loss Pill On The Market, aka The Problem With How We Approach Our Health

Diet and Nutrition, General Health and Wellness, , , , , ,

WEIGHT-LOSS-PILL1

The headlines say that the U.S. Food and Drug Administration (FDA) has approved a new weight-loss pill. The marketing will attempt to convince you that your health can be secured by what’s in a pill bottle. The Straight, No Chaser view is this roll out illustrates a few of the problems with our approach to health.

weight loss Miracle-Cure-Pill

Problem #1: We react after the fact and look for miracle cures.
There are now three weight-loss pills approved by the FDA. They all are appetite suppressants. Aside from the fact that safe and healthy ways to control one’s appetite exist, I’ve told you on many occasions that you won’t find your health in a pill bottle. The medicines you take are largely meant to treat disease. Even your vitamin pills can be replaced by vitamins in the healthy foods you eat, and you don’t need those pills unless you have a documented vitamin deficiency or have been directed to take them by your physician.

detox-diet1

Problem #2: We don’t try hard enough to simply reverse what caused the problems we’re having.
Diet and exercise, exercise and diet. If you are not beginning and ending the conversation with these considerations – and only incorporating any supplements or medications as bridges to facilitate the transition to a healthier lifestyle – you are going to be disappointed. Look at this quote from the manufacturer’s press release: “When used as directed in combination with a healthy lifestyle that includes a reduced-calorie diet and exercise, (New Drug that I’m not promoting) provides another treatment option.” The quote could have just read the following: “…a commitment to a healthy lifestyle that includes a reduced-calorie diet and exercise will always give you the best chance to produce the results you desire (and certainly more than any reliance on medication)…”

weight loss 1 day diet SERIOUSLY?

Problem #3: The purported solutions don’t fully address the problem they claim to address.
You don’t even have to read the fine print. None of the weight-loss drugs approved by the FDA even promise massive weight loss. In other words, you’re just taking the pills and hoping for the best.

fenphencover

Problem #4: The purported solutions sometimes cause different problems than they address.
According to the FDA, the warning label for the newly approved drug will come with a warning that it might increase suicidal thoughts. Other possible side effects include increasing heart rate and blood pressure. Guess what? Obesity already increases heart rate and blood pressure; you don’t need a pill for that. Even worse, in the past some obesity drugs (remember fen-phen?) have been linked to serious heart problems and were pulled from the market.
By no means am I attempting to be flippant here. My concern is real. Consumers are prone to grab at whatever hope is offered, and a slickly marketed weight-loss pill is a great way to attract consumers, even at $200/month and when many insurers won’t cover the cost. Some of you will even swear by your pills. You can do much better for yourself by making a commitment to a lifestyle change that involves healthy eating, moderate exercise, stress reduction and all around better choice.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offer. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress.

Straight, No Chaser: Diabetes Basics and the Importance of Education

General Health and Wellness, , , , , , , ,

diabetesed

Diabetes is a disease in which education is vital. For a diabetic, knowing the disease well allows him or her to better prevent long-term consequences of the disease. It also allows the diabetic to make real-time adjustments when sick or otherwise  in danger acutely. In Straight, No Chaser, we’ve provided a series of posts meant to empower diabetics (and you can review any or all of them via the search box on the right). Remember, it all should start with a basic understanding of the disease.
We eat, and the process of digestion is for the purpose of converting food into glucose (sugar) that’s used by our body for energy. The blood delivers the glucose to different organs of the body where the cells take it up for use. In order for that process to work, an organ that’s part of the digestive tract called the pancreas has to produce a hormone called insulin. Insulin facilitates the glucose getting from the blood to inside the cells. Diabetes is a disease where insulin isn’t being made by the pancreas or isn’t working optimally.
Now think about what happens when you’re not getting sugar into your cells. It’s as if you’re starving (because physiologically, you might as well be). You get symptoms such as weight loss, hunger, fatigue and excessive thirst. Because your cells don’t have energy, they aren’t functioning well. In fact, blood and nerve vessels lose significant function, resulting in significant vision loss and lack of sensitivity in your extremities. Anyone who’s been a diabetic for about 10 years know this because you’re wearing glasses and because you’ve lost a fair amount of sensation, especially in your feet. There are other symptoms that are variations of the same theme, including excessive urination, dry skin, increased infection rate and slower healing from those infections – all due to poor function of your blood vessels.
Sometimes diabetes is a disease that happens to you because of unlucky genetics (or simply a family history). Other times it is a disease that you find. Risk factors for developing diabetes includes obesity, older age, and physical inactivity. Gestational diabetes (i.e. that occurring during pregnancy) is an entirely different conversation.

diabetes-treadmill

Let’s take a moment to discuss prevention and treatment. There are different types of diabetes, but the risk of one form of diabetes in particular can be reduced by – you guessed it – diet and exercise. In fact, diet, exercise and medications are the three legs of the diabetes treatment stool regardless of type. Some patients require regular insulin injections and others require pills. Still others who are successful with diet and exercise are able to markedly reduce, and in some instances eliminate medications.
If you’re a diabetic, make an investment in your education. It could not only save your legs or eyes, but it may just save your life. I welcome your questions and comments.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Gluten, Wheat and Celiac Disease

Diet and Nutrition, Gastrointestinal, General Health and Wellness, , , , , , , , ,

Gluten free signal

One of the reasons I enjoy writing this blog is it brings me closer to understanding you. As you respond to posts or query me, I get to better appreciate the breadth of your concerns. I realize that much of what physicians do in clinical practice is talk AT you. Sometimes physicians assume that you know better because we do. Your issues often involves uncertainty about the nature of your symptoms, and, in real-time, you tend not to appreciate that symptoms are incredibly non-specific, meaning the same set of symptoms show up in multiple diseases and conditions (as you’ll noted from the picture below featuring possible symptoms of celiac disease). Many times, you’ll be researching a topic on the Internet, see symptoms you have and say, “That sounds like me! That must be what I have.” The relationship of symptoms to disease really isn’t anywhere near that linear.
Weight loss is an example of something patients think about differently than physicians. When a patient wants to lose weight, s/he may think of everything under the sun from the latest diet craze, surgery or other potential “quick-fixes.” On the other hand, a physician will parrot something about calorie control, healthy eating and exercise, assuming you know better than to entertain miscellaneous information aimed to strike fear into your hearts or give you false expectations. (If you need a refresher on that consideration, check here.) In many of these instances, physicians may never even address your questions, because we’re so busy promoting the standard of care.
This month, we’ve been discussing nutrition with probably a dozen different blogs posted on various topics. Do you think the most common questions I’ve received have involved application of the healthy eating plate or simple tips to healthier eating? Nope. They’ve been more along the lines of esoteric concerns – or at least concerns that only affect rare segments of the population – so much so that physicians typically wouldn’t even think to discuss them with patients.
Two such discussions involve the consumption of gluten and wheat. Let’s answer those questions and clear up any confusion you may have. Thank you for your willingness to engage in straight talk. Indeed, your concerns are real, and our mission at Straight, No Chaser and www.sterlingmedicaladvice.com is to get you the information and advice you need.
What is gluten?
Gluten an important protein found in all forms of wheat, barley and rye. It is also found in other foods such as deli meats, soy sauce, vitamins, some chocolate, some toothpaste and imitation crab. For the purpose of this blog, let’s relegate your wheat concerns to gluten.

celiac1

Why do I care about gluten?
You probably don’t and probably shouldn’t, unless you have a specific disease called celiac disease, which is related to the adverse effects of an extreme sensitivity to gluten. Some humans (only some and not many at all) have difficulty digesting gluten. In fact, the ingestion of gluten in those with celiac disease can cause damage to the intestinal lining, causing chronic (ongoing, continuous) diarrhea and abdominal pain. This can result in potentially life-threatening concerns, but it only occurs in less than 1% of the population.
The other reason you may have heard about gluten is the existence of a diet craze based on avoiding gluten (having to do partially with limiting carbohydrates).
Why is this an issue?
As societies have moved to diets with higher consumption of refined wheat flour, the sensitivity to gluten has expressed itself more often. As is often the case, when you over consume or are overexposed to substances, danger ensues. That is not the same as saying you need to avoid any and everything on earth that could potentially cause you harm.

celiac-disease-symptoms

Do I need to give up wheat and gluten completely?
Absolutely not, unless you have celiac disease or demonstrated allergies to these substances. This is simply another example of your needing to understand the issue. As with most overstated concerns, solutions are to be found in the same principles of healthy eating described throughout Straight, No Chaser. (Feel free to research our many topics by typing your topic of interest into the search engine over on the right side of the page.)
In this instance and others, what happens all too often is folks create new problems running from other, perceived ones. Substituting high-calorie, high-fat products for wheat and other products containing gluten is not a healthy decision and has been shown to increase weight gain and the risk of diabetes. The principles of any successful efforts to diet remain the same. Your best bet is to learn principles of healthy eating and incorporate calorie control and exercise into your regimen. Embrace moderation across the board, and enjoy learning to make healthy eating an adventure by adding variety to your meals.
One final caveat: There’s nothing wrong with, and potentially much to gain from, asking your physician about your individual risks for celiac disease. Just understand that unless you have the symptoms (e.g., diarrhea, abdominal pain, bloating, fatigue, headaches and joint pains to name a few), you likely will cause your physician to scratch her or his head.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Healthy Eating Tips

Diet and Nutrition, , , , , , ,

OLYMPUS DIGITAL CAMERA

If you want to eat healthy, you really must learn about and try to eat in accordance with the Healthy Eating Plate. It doesn’t get more complicated that that, and you shouldn’t attempt to make it much more complicated.
Today, I’m going to speak on recommendations from the U.S. Department of Agriculture Center for Nutrition Policy and Promotion, which I’m building upon for your success. These bakers’ dozen of tips represent simple, easy-to-do tasks to keep your meals healthy.
1. Eat at home. This accomplishes so many things. If you eat at home, you know exactly what you’re eating. That quality control is important, and it allows you to both save money and get creative in your pursuit of health.
2. If possible, take the cooking out of your hands. Those of you with less self-discipline would do well to simply express your healthy desires to your loved one. Give her or him directions on your health goals and eat what’s brough to you.
3. Use a smaller plate. This act with help you with portion control. If you’re one of those who must finish your plate, this will help prevent you from overeating.
4. Stop eating when you’re full. The body actually is trying to tell you when you’re hungry and when you’re not. Try to overcome that voice in your head that tells you “finish your plate.” Calorie control is the vital component of health.

healthyeating

5. Make half your plate colorful fruits and vegetables. If you just remember dark green, red and orange colors and consistently full of nutrients and healthy, you’ll do well. Think of tomatoes, sweet potatoes and broccoli as examples.
6. Eat slowly. Even if you’re not chewing each morsel 20-25 times before swallowing, learning to savor your food will improve your eating experience and promote a sense of fullness and satisfaction with smaller portions. No, it won’t necessary make you want even more.
7. Lean. Protein. Limit your red meat. Learn to appreciate lean meats, such as chicken, turkey and seafood. Beans and tofu are also excellent protein sources. When you do eat beef and/or pork, ask for lean cuts.
8. Seafood, not see (more) food. Make it your main course at least twice a week.

wholegrain

9. Whole grains. Just say the words and look for the words. When you’re buying breads, look for 100% whole grain. At a restaurant? Specifically ask for whole grains in your breadbasket. You cannot assume your breads are whole grain otherwise.
10. Avoid the extra fat. There’s no good in eating healthy if you cover the goodness with heavy sauces, gravies, syrups or salad dressings. Ask if low fat, low-calorie alternatives exist.
11. Got dairy? Learn to move beyond whole milk. Fat-free, low-fat, soy or almond milks (or yogurt without a daily drink) are all better options and provide the same amount of calcium and other nutrients without all the fat and calories.
12. Satisfy your sweet tooth in a different way. Learn to enjoy a fruit cocktail, yogurt parfait, baked apples or other healthy options as your dessert. All you’re really wanting is a dab of sugar anyway!
13. Learn variety; build your choices. Have you ever tried mango, kiwi, lentils or kale? If so, did you give up after the first taste? Many healthy foods need to be prepared to your liking. Think seasonings and preparation. Get creative!
Whatever you do, fast food is not the option. Invest a touch of time into these very simple tips and undo the bad luck to be found if most of your diets.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: A Look at Detox Diets

Medical Treatment, Health Prevention, , , , , , , , ,

detox-diet1

Detox-Diet2

Everyone who talks to me about detox is motivated and sincere about making an improvement in his or her health.  Therefore, it’s important that they be shown respect and encouraged.  However, some of these same individuals exhibit a level of desperation that is counterproductive and leaves them subject to fads and scams that are doomed to long-term failure. The first question I ask is “Are you trying to improve your health or weight?” These are often separate considerations. Of course, I’m hoping they answer, “Both.”  Interestingly, that happens less often than you might think. Next, I’ll ask if they’re engaged in some basic, fundamental activity (click here), which is rarely the case. Once people discover the latest, greatest thing, they tend to lock in on it and just have to go for it.  So be it.

So… today and tomorrow, I’m going to discuss two very common “quick-fix” approaches to detoxification. Let’s start with the “detox diet.”  For the purposes of this discussion, all detox diets are variations of the same theme. I hope this doesn’t disappoint you or come off as dismissive, but the point of the matter is that from a medical standpoint, these actions are reducible to a set of physiologic actions that either produce biological effects or don’t.  Giving a car a new coat of paint doesn’t make it an airplane.  Similarly, taking a quick detox diet doesn’t make you healthy if you return to the same conditions that produced your pathology in the first place.  Folks, it really should occur to you that given the rates of obesity and disease that exist, if these diets really worked, the pharmaceutical and medical communities would be all over them because of their potential for profit (and of course the potential for good…).  Here’s what detox diets do and don’t accomplish.

The Premise: Going on a diet for a few weeks can clear your body of toxins, which will improve your health.
The Short Term Effects: Proponents of detox diets often claim or note the following during the diet:

  • Weight loss
  • More energy
  • Better mental focus

The Long Term Effects: Proponents of detox diets often make the following claims about the benefits of the diets:

  • Health promotion
  • Prevention of new diseases
  • Cure of chronic diseases

What’s Really Happening: Have you ever heard that correlation is not causation?  If you engage in any activity involving backing away from fats, drinking more water, taking in less sugar and processed food, eliminating alcohol and caffeine, and taking in more fruits and vegetables, you’ll feel better!  In fact, I’m all for it.  Refer to this blog post where I give you details on how to naturally, healthily and sustainably do this.
Now, here’s the question. Is your detox diet just a two to four-week “challenge,” or is it the launching pad for a set of lifestyle changes? The problem is that people use these diets with their better principles, but they usually don’t sustain them.  In fact, the diets themselves generally are not sustainable because they’re too restrictive. If you tried sustaining some of these diets, you’d end up hospitalized.  You’re much better off applying fundamental principles that will slowly and steadily improve your health and also help you lose weight. By the way, those long-term claims have been roundly and routinely debunked by the medical community, which has every incentive to want to discover new ways to treat disease.
Precautions and Risks

  • Before starting any diet, you need to discuss what you’re trying to accomplish with your physician. I’d venture a bet that most would not approve one of these diets, especially if you suffer from any chronic illness, especially diabetes, mental illness, moderate to severe (and poorly controlled) high blood pressure or cardiac disease. They also won’t approve it if you’re pregnant or at the extremes of age.
  • Based on the components of these diets, you are introducing certain specific risks.  These include vomiting, diarrhea and dehydration, electrolyte loss and imbalance and disruption of the function of your digestive system.

Let’s finish with two pointed questions and answers.
1.  Should I go on a detox diet?  I encourage almost any activity that motivates you to improve your health and has been shown to improve your health. If you want to naturally detox, apply these principals as the basis for a lifestyle change. As your body recovers, your natural detoxification system will take over and do just fine (assuming you are otherwise healthy).
2. I quick-flush my system with a diet every few months. Is this healthy?  It depends on what you’re doing as a “quick-flush” and even more so, what you’re doing in-between. Focus on enhancing your natural detoxification system. I can’t say that a one-time or intermittent initiative to kick things off would be a terrible thing — if you stay with the program. In the best case scenario, it’s like going to get a dental cleaning every six months. You’ll still have decaying teeth and disease if that’s the only thing you’re doing. On the other hand, if you’re brushing and flossing every day, then the six-month check up is quick (and in this case, maybe superfluous).  I’m much more concerned with you sustaining a healthy approach toward the desired goal.
Next up, and the last in this series on detoxification will be a look at colonics.  Until then, bottoms up!
Call us at 1-844-SMA-TALK or login at www.SterlingMedicalAdvice.com to chat more.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: When Eating Goes Wrong, Part I – Anorexia

Mental Health, , , , , , , , , ,

anorexia-nervosa

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, 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 (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.)
Today, I’ll discuss 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, they’re 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 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.
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Straight, No Chaser: Quick Tips on Boosting Your Metabolism

Cardiology/Heart, General Health and Wellness, Health Prevention, , , , , , , , , ,

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

Cardiology/Heart, Personal Training, Health Prevention, , , , , , , ,

obesity6obesity5
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).
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.
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.
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!
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Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

General Health and Wellness, Health Prevention, , , , , , , , ,

obesity1Obesity.jpg
Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight.  We’ll also set the table for losing weight by discussing why weight gain occurs.  It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss?  What’s the balance between family predisposition and the foods I eat?
No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?
The most simple way to answer this is that weight gain occurs from an energy imbalance.  You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both.  I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound.  It takes work.  This is the simple answer as to why fad diets don’t work long-term.  You can’t cheat the equation.  The moment you stop being diligent, you’re headed in the wrong direction.  Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
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Straight, No Chaser: How Many Calories Do You Need a Day?

General Health and Wellness, Health Prevention, , , , , , ,

soda1
Let’s put this post (at least the end of it) under the category of things you do but really don’t think about.
How many calories should you take in per day to function (meaning produce the energy you need for your activities of daily living)?  It actually depends on your gender, your age and your level of activity.  Let me start by defining the types of lifestyles, according to the Institute of Medicine.  If you are in the third category (active), I doubt that you’re worried.
Sedentary means a lifestyle that includes only the light physical activity associated with day-to-day living.
Moderately active means a level of physical activity equivalent to walking about 1.5-3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
Active means a level of physical equivalent to walking more than 3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
That breaks down as follows:

  • For women between 14-50, the number is right about 2000 kcal/day (calories) if you’re moderately active and 1800 if you’re sedentary.
  • For men between 14-50, there’s some greater variance, but the 2500 kcal/day works if you’re moderately active and 2200 if you’re sedentary.

In short, that averages to about 600-800 calories per meal, with the low end being for sedentary females and the high end being for moderately active males.
Now consider, 16% of the calories in the average American diet come from refined sugars.  Fully 50% of that total comes from beverages with added sugar.

Every 12 ounces of non-diet of pop/soda you drink contains about 150 calories.  

Your average dessert ranges from 300-500 calories.  

The most popular one, only one cup of ice cream, contains 270 calories.

I’ll let you take the math forward from there.  However, the take home point is obvious.  Suffice it to say, the link between pop, deserts and obesity has been well established.  Here’s three Quick Tips for you.

  • Try finding a drink with fewer calories if you want to lose calories (and weight).  It’s water, not Coke, that adds life.
  • Try eating your favorite fruits as dessert.
  • Also, consider just walking 3-4 miles a day.  It’s not that hard, if you just do it.

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