A Vitamin D Study Worth Ignoring and Good News at MDPrevent

It seems like everyone wants in on the Vitamin D hoopla. A study published in Mongolia (not sure if it's Outer Mongolia-the place many often refer to as a wasteland) shows that children who increase their Vitamin D levels suffer fewer cold symptoms. The only problem is that it only works with children who are Vitamin D deficient due to lack of sun during their winter (maybe it is Outer Mongolia).

There is no one, including me, that will argue that the body needs Vitamin D and without an ample supply your body will not function properly. And by not function, that includes an immune system incapable of warding off even the simple and ubiquitous cold virus. But the real debate is what defines a clinical relevant deficiency and what's the best way to treat it. I vote sun, wild Salmon, and almond milk in that order over supplements. Nevertheless, while the question of deficiency still begs an answer, with all the studies now underway, I hope the question won't stay unanswered for long. For the moment, I encourage patients to consciously raise their levels if it is below 30.

On another note, it's turned out to be an unexpectedly busy summer. Without warning, MDPrevent is suddenly inundated with patients wanting access to our medical care, particularly our weight loss and diabetes education services. Word of mouth has generated excitement about our drug-free, fully paid for by Medicare approach to successful weight loss. Even doctors such as cardiologists and endocrinologists we've never met are now referring patients to us because they are witnessing first-hand the weight loss success their other patients are enjoying.  It's both exhilarating and exhausting at the same time. It's actually getting tough to schedule new patients.

Why is it working? What have we discovered that seems to elude others? The answer is simple. Teamwork. Our program combines the skills of a physician, a registered dietitian, and a clinical psychologist. Each of us works in unison to guide, encourage, and cheer each patient on. The result is that patients are steadily losing weight, lowering cholesterol, and starting to enjoy their former selves again.

For those of you who have referred friends, relatives, and neighbors, we say thank you. I suspect so do the people you referred.

Finally, someone asked me the other day if I enjoy what I do. I said of course because what can be more gratifying than seeing people turn their lives around and feel in control again for the first time in many years!  It really does feel good to do good!

I hope you all have a wonderful and relaxing Labor Day weekend.
 

That's Nuts!

Every once in a while a study comes along that makes you want to smile. Not because the news is so great, but because the implications are amusing. Don't get me wrong. For those who have such a problem, I guess this really is good news. For the rest of us and perhaps the ladies, it is just a really interesting finding. In fact, it's so interesting that I can only wonder who came up with the idea to study it in the first place. In this case, it appears to be the California Walnut Commission.

So here's what the study showed. Men, in the case of the study mostly young men aged 21 to 35 (mean age 25), who added 75 grams, a little less than a cup, of whole-shelled walnuts a day to their diet improved their semen parameters.

According to Wendie Robbins, PhD, of the University of California, Los Angeles, and colleagues, after eating these 75 grams a day of walnuts for 12 weeks, these young men had better sperm vitality, motility, and morphology compared with those who avoided tree nuts altogether.

It also turned out to increase a very healthy omega-3 fatty acid called alpha-linolenic acid as nuts, and walnuts in particular, have a high concentration of this fatty acid in addition to omega-6 fatty acids, antioxidants, and micronutrients like folic acid.

Unfortunately, there was no report that having more virile sperm had any effect on the young men's sexual performance. Nor was there any information regarding what effect such walnut consumption would have on older men's sperm. Also, before you go out and get nuts about walnuts just be aware that 75 grams equals about 500 calories. As far as I'm concerned these are good calories, but still a lot of them.

For men who have low sperm counts or less effective sperm, and are trying to father a child, this study appears to offer another avenue of pursuit.  For the rest of us, we should keep eating nuts for the same nutrients, but obviously for different benefits.  Who knows what they will find out tomorrow about the benefits of walnuts and other nuts? I can't wait.

Vitamin D Takes A Couple Of More Hits

Two new studies challenge the sweeping hysteria about the need to supplement with Vitamin D.

In one retrospective study looking at Medicare records, researchers could find no link between Vitamin D deficiency and macular degeneration. Based on this study, if you are self-prescribing Vitamin D to treat your macular degeneration, I would strongly consider stopping.

The second study involved men with prostate cancer who are on hormone depleting therapy. This therapy can lead to osteoporosis so it was always thought wise for these men to supplement with Vitamin D and calcium. This study shows that not only doesn't adding these two supplements help, but they may actually be increasing the severity of the cancer. That's on top of the calcium's effects on adding to the risk of calcification of the arteries and heart attacks.

So based on this information you would say that it is probably best to avoid Vitamin D supplements. But wait, there's more. In April 2012, a study showed that high dose Vitamin D supplementation in patients with low risk prostate cancer seemed to help the patients do better with lower Gleason scores, one of the biomarkers for prostate cancer. But wait again.  In this study, involving 52 patients, led by D.T. Marshall of the Medical University of South Carolina and colleagues, 55% did better, 11% had no change, and 34% did worse.

My read on such a study is to basically ignore it because the number of participants was too low, a good percentage got worse and we know little else about their diets, etc.

So what's the answer on Vitamin D? I say sun. It's the only natural way to increase your Vitamin D levels. Of course, don't burn yourself, but 15-30 minutes a day strategically spread out should avoid any such problems in most people. However, that may not be YOU, so if you can't spend even that amount of time in the sun, your next best choice is wild salmon. If you can't or refuse to eat wild salmon, then fortified foods are your next best choice before supplements.

Yesterday, I reviewed 300 study headlines on supplements, particularly about their antioxidant effects, on pubmed.com, and read about 40 abstracts of some of the studies. This effort fortifies my belief that supplements just aren't cracked up to be what their manufacturers and marketers want YOU to believe.

But I also confirmed something else. The studies showed consistently that even with fruits and vegetables, once your body has the vitamins, minerals, and nutrients it needs, giving it more does nothing. It's like filling a canister. Once it's filled, any more added is just spillover. The principle here is that more of a good thing is not better when it comes to your nutritional state. That's the biggest problem I think posed by most supplement products. They operate mostly on the principle of get more to play it safe. More vitamins, more minerals, more antioxidants. YOU don't need more that YOU need and as recent studies suggest, more may not be safe for YOU.

The real take away from all three studies quoted above is that Vitamin D supplementation may not be the panacea that many proclaim it is on a daily basis. Tread cautiously, my friends, when it comes to taking supplements and heed the Latin phrase, Caveat Lector, "Let the reader beware." That includes reading my blog with a bit of caution as well. Nothing written here should be construed as medical advice. The only medical advice you should heed is from a doctor that knows your medical history personally and discusses treatment with YOU directly.

You

Everyday, a new medical study is announced purporting to tell the American population how to live, eat, work, play, etc. Some tell you what to do while others caution the opposite. While some studies reaffirm previous studies, many are diametrically opposed. In fact, the more sensational and controversial the headline, the more likely you are to hear about it. This reality gives me constant pause for thought. How does anyone figure it all out in such an environment?

Of course, all studies are not the same. Some are well constructed, scientifically valid, and worth consideration. In previous blogs, I've discussed how to differentiate between good and bad studies.  In a nutshell, a large double-blind randomized controlled study done by a reputable university, not paid for by a commercial interest, done by researchers with no financial conflict of interest is the most trustworthy study.  Most people never read the actual study so they have to rely upon a trustworthy news source for a reasonable interpretation of what the study's results actually mean in practical terms. Even then, results can be reported in such a way to support one bias or another.

Consider this Olympic inspired example. The United States and China were in a contest. The U.S. came second and the Chinese were second to last. Who did better?  It depends. If there were only two participants in the contest, then China came in first, or second to last, and the U.S. came in second, or last. See how not knowing all the facts allows for some clever manipulation. I've seen this happen more times than you would predict.

Why am I telling you all this? The reason is when YOU read about a study that sounds reasonable and valid, YOU would still be foolhardy to implement its finding(s) on your own without consulting a physician. Why? Because no matter how well constructed the study, by definition, studies are limited in the number of variables they consider. They can't look at all the variables that may affect YOU. They don't consider everything YOU eat, what medications YOU take, your medical and family history,  allergies, food sensitivities, age,  gender, race, etc. In other words, they don't know YOU and in fact, the results may have no value to YOU.

For example, cars typically need four wheels. A study was done with cars that had three wheels, but needed four. Adding a fourth wheel improved the performance of the car. The headline blares, "Adding Wheel to Cars Improves Performance." You read this headline and think that adding a wheel to your car will also improve its performance. The only problem is that your car already has four wheels and a fifth wheel not only makes little sense, but may also actually impede your car's performance.

According to the recent issue of Consumer Reports, there are 55,000 dietary supplement products now marketed in the U.S. That's 55,000 reasons for someone to sell you on the value and greatness of their product. These products also often need to advertise/market their products in mainstream media to get your attention. That's a lot of product information coming at you on a daily basis. Who's on the other side of this tsunami of info?  Hardly anyone because there is no money in telling you what not to take. There are only a few of us in the U.S. expressing caution about dietary supplements and virtually none of us gets paid to do so. It's lonely on this side of the aisle, but it's a worthwhile endeavor.

Ultimately, taking advice from a news source without consulting your physician is outright foolish and dangerous. Forgive my bluntness, but I'm tired of seeing so many people fooled into spending their hard earned money on bad products that may actually harm them. Don't be a guinea pig. Discuss your options with your physician and take a rational approach to your health needs. There's only one YOU and you need to take care of him or her by making the right decision for YOU. Got it?

IMPORTANT ALERT: Blood Pressure Medication and Lip Cancer

This is a special alert for patients taking blood pressure medications such as hydrochlorothiazide (a diuretic) and Nifedipine (calcium channel blockers).  According to a new observational study, both of these drug classes appear to increase a patient's hypersensitivity to sunlight. The study shows a link between these medications and the development of squamous cell skin cancer of the lips. It is believed that the combination of increased sun sensitivity and sun exposure is the culprit.

DO NOT stop taking these medications without the advice of a doctor. However, if you are on these medications, please limit your sun exposure. If you limit your sun exposure, you will unfortunately increase your risk of a Vitamin D deficiency. Therefore, please make sure to get more Vitamin D in your diet from sea kelp, sea vegetables, wild salmon, and vitamin D fortified foods.

The Only Thing I Know For Sure Is That We Need To Keep Learning

About 30 years ago, I read an article about agriculture that had a profound impact on my thinking. The article was about soil erosion and basically stated that what had long been considered an incontrovertible truth about how to avoid soil erosion turned out to be the exact opposite. The idea that something held as an absolute truth could prove to be absolutely wrong has given me pause to think about such 'truths' to this day.

Thirty years later, a new study about exercise emerges that reminds me of what we consider absolute truths may not be so. For as long as I can remember, exercise has been associated with increasing your metabolism. It's been widely believed that exercise contributes to weight loss by burning calories and increasing your metabolism, which is believed to keep revving and burning calories even during the cool down phase.  While certain people argued that exercise was not an effective way to lose weight because they were unsuccessful losing weight despite much exercise, it was still a tenet of the weight loss movement. For example, Weight Watchers allows you to add extra "points" based on the amount of exercise you do.

The new study, which is a wonderful study, titled Hunter-Gatherer Energetics and Human Obesity, (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0040503) studied the Hadza tribe of hunter-gatherers in Tanzania. Strapping members of the tribe with a GPS device and having them swallow so-called doubly labeled water, a liquid in which the normal hydrogen and oxygen molecules have been replaced with versions containing tracers, researchers were able to quantify their levels of physical activity, energy expenditures and metabolic rates. What they discovered is groundbreaking!

The study showed that contrary to popular belief, exercise slows down one's metabolic rate so that calories burned are actually far less than expected.  What's amazing is that this is intuitive and yet for so long everyone believed otherwise. Think about it for a moment. If your body doesn't eat for several hours, we think (I'm now officially afraid to say anything for certain any more; well, maybe some things) your metabolic rate slows down as your body tries to conserve energy, as it doesn't know when energy will be replenished. Applying that same principle to exercise, when the body senses a loss of energy consumed by increased activity, it makes sense that it will slow down its burn rate to conserve energy.

This doesn't mean that you aren't burning calories and you can't lose weight by exercising. It simply means that you burn less than you think, which means don't think you can eat a lot more because you had a good exercise session.

By now you couch potatoes are turning to your spouses or friends and smugly telling them you were right all along about exercise. Well not so fast.  Exercise is still critical to good heart and brain health. Exercise keeps the heart functioning well and exercise has been shown to be as effective as anti-depressants in treating many cases of mild to moderate depression. But that's not all. Two new studies published online in the Archives of Internal Medicine support the tremendous impact of exercise on lowering the risk of death among diabetic patients, and that weight training may reduce the risk for the disease even without aerobic activity.

Quoting medpagetoday.com, "In a large prospective trial, moderately active patients with diabetes had a lower risk of total mortality compared with those who were completely inactive...according to Diewertje Sluik, MSc, of the German Institute of Human Nutrition in Potsdam, and colleagues. And in a separate prospective study, men who did weight training only at least 150 minutes per week had a 34% lower risk of developing diabetes to begin with ...according to Frank Hu, MD, PhD, of the Harvard School of Public Health in Boston, and colleagues."

I also previously wrote about a study that shows that exercise can return the inflexible blood vessels of pre-diabetics to normal as well.

So while exercise is not the great weight loss panacea it was once thought to be, it is still a critical component of a healthy lifestyle. Keep exercising, but more importantly, if you want to stay slim or lose weight avoid the four whites--white sugar, white flour, white pasta, and white rice. If you watched 60 Minutes this past Sunday, you now know that some scientists view sugar as toxic and cancer causing. Just another good reason to choose whole foods like fruits, vegetables, nuts, beans, and whole grains. And of course, don't forget my favorite, Wild Salmon.  Bon appetite!

Will The Consumer Reports Issue On Supplements Make A Difference?

I have always respected Consumer Reports (CR). It takes no outside commercial money and it runs no advertisements. It simply tells it like it is. Will it's new report on the dangers of dietary supplements make a difference? Probably not.

With an article in the magazine reporting that there are over 55,000 supplement products on the market and with the current law squarely on the side of supplement marketers, allowing them to sell their products with almost impunity and without the need for any scientific validity whatsoever, the salvo fired by CR will probably make little difference.  Supplements have become a big business with reports estimating the industry sales being somewhere between $28 and $100 billion.  They will not go gently into the night.

That's a shame because as CR states frankly, and I've been bellowing for months (see my two YouTube videos titled, Why Supplements and Vitamins Are Usually A Waste Of Money and May Be Harmful, at http://www.youtube.com/watch?v=TzU1UN1Wr0o  and  http://www.youtube.com/watch?v=MSc5xtnPZl0 ), these products are not just a mostly big waste of money, they are potentially harmful.

The most important part of the article by CR is its reference to the over 100 people who died from these products. It is important to get this out in the media stratosphere because supplement marketers often claim their products never kill anyone and therefore there is no harm in taking them. Well they do kill and the numbers are probably much larger than reported because the connection between use of products and untimely death is probably often missed.  I find that patients often forget to mention one supplement product or another that they have been taking. Unlike prescriptions, there is usually no formal record of a patient taking a supplement. (One of the things we do at MDPrevent during an Annual Wellness Visit is make a record of such use.)

At this point, if there is still any single reader of this blog taking even a single supplement without having consulted his or her physician, no matter how many times you read or heard how wonderful it is and how great it makes you feel, please stop immediately. You simply can't rely on information you get from the internet or friends. Anyone who has ever been burned by a stock pick from a friend knows what I mean.

Please, please, please come to your senses and stop relying on pills for your health and salvation. Learn how to eat properly to enjoy the benefits of a healthy and long life. Find a doctor knowledgeable in nutrition and supplements to help you make good choices. It's your life, health, and money at stake. Isn't it worth getting it right?

Consumer Reports Investigates Vitamins and Supplements: Ten Dangers That May Surprise You

If you haven't seen this yet, I'll let the news release from Consumer Reports below speak for itself. All I can say is Yay! that Consumer Reports is willing to take on the supplement industry and shine the light on the dangers of supplement products. You may want to consider purchasing the latest issue for all the facts.

Release Date: 08/02/2012

Consumer Reports Investigates Vitamins and Supplements: Ten Dangers That May Surprise You

Plus, advice for protecting yourself against hazards associated with vitamins, minerals, herbs, and other nutritional supplements


YONKERS, NY — In a new report in its September issue and online at www.ConsumerReports.org, Consumer Reports identifies ten hazards that might surprise the large swath of American adults—more than 50 percent—who take vitamins, herbs, or other nutritional supplements.
“Patients sometimes assume that supplements are safe because they are ‘all natural,’ but not all supplements are truly natural. In fact, one of the greatest safety hazards to consumers involves supplements that have been spiked with prescription drugs or toxic metals,” said Jose Luis Mosquera, M.D., medical adviser, Consumer Reports, and an internist who specializes in integrative health and medicine.
Consumer Reports identifies ten hazards distilled from interviews with experts, published research, and its own analysis of reports of serious adverse events submitted to the Food and Drug Administration (FDA), obtained through a Freedom of Information Act request.  Here are some of the hazards discussed in the report, plus advice for staying safe:

Supplements are not risk-free.  More than 6,300 reports describing an excess of 10,300   serious outcomes, including 115 deaths and more than 2,100 hospitalizations, 1,000 serious injuries or illnesses, 900 emergency-room visits, and some 4,000 other important medical events, streamed into the FDA from supplement companies, consumers, health-care providers, and others between 2007 and mid-April 2012.  CR notes that the reports by themselves don’t prove that supplements caused the problems, but the raw numbers are cause for concern. Current laws make it difficult for the FDA to order a problem product off the market. In fact, to date, the FDA has banned only one ingredient, ephedrine alkaloids.

Protect yourself: Search the FDA’s website at www.fda.gov for warnings, alerts, or voluntary recalls involving a supplement you are thinking of taking.  If you suspect you’re having a bad reaction to a supplement, tell your doctor. You can also report your problem to the FDA at 800-332-1088 or www.fda.gov/medwatch.

Some supplements are really prescription drugs.  According to Daniel Fabricant, Ph.D, director of the FDA’s Division of Dietary Supplement Programs, dietary supplements spiked with prescription drugs are the “largest threat” to consumer safety.   Many recalled products have the same or similar active ingredients as prescription drugs such as sildenafil (Viagra), tadalafil (Cialis), and sibutramine (Meridia, a weight-loss drug that was removed from the market in 2010 because of evidence that it increased the risk of heart attacks and strokes). Others contained synthetic steroids.  “As a result, adulterated products can cause some of the same side effects and interactions that a consumer may be trying to avoid by opting for supplements instead of prescription drugs,” says Dr. Mosquera.

Protect yourself. Consult your doctor if you are having trouble in the bedroom (it could indicate an underlying health problem).  And try to slim down with diet and exercise.  Build muscle by weight training.  

You can overdose on vitamins and minerals.  Unless your health-care provider tells you that you need more than 100 percent of the recommended daily intake of a particular nutrient, you probably don’t.  Megadoses of the fat-soluble vitamins A, D, E, and K can cause problems, and even some standard doses may interfere with certain prescription medicines.  “Surprisingly, some people may experience adverse effects from even normal doses of a vitamin or mineral supplement, especially patients with digestive issues or those who take blood thinners,” says Dr. Mosquera. 

Protect yourself: Using information from the labels on the supplements and food you routinely consume, add up your daily exposure to everything, and then check CR’s “How much is too much?” table to see if you’re overdoing it.

You can’t depend on warning labels.  For one thing, the FDA doesn’t require them on supplements with one important exception, iron.  In a market basket study of 233 products purchased online and in the New York City metropolitan area, Consumer Reports found wide variations and inconsistencies in labeling.

Protect yourself:  Make sure your doctor or pharmacist knows what supplements and prescription drugs you are taking or thinking of taking.  You can also check for interactions by using Consumer Reports’ “Guide: 100+ Commonly Used Supplements.” To access the free guide, go to www.ConsumerReports.org/health and click on “Natural Health.”

Heart and cancer protection: not proven.  Omega-3 pills and antioxidants are widely thought to reduce the risk of heart disease and cancer, respectively, and millions of women take calcium to protect their bones. But recent evidence casts doubt on whether those supplements are as safe or effective as assumed.  The report notes that the widely held view that fish-oil pills help prevent cardiovascular disease hit a snag when a study of 12,500 people with diabetes or prediabetes and a high risk of heart attack or stroke found no difference in the death rate from cardiovascular disease or other outcomes between those given a 1-gram fish-oil pill every day and those given a placebo.  These findings were published in a June 11, 2012, issue of New England Journal of Medicine online report.  

Consumer Reports also notes a recent blow against calcium supplements by German and Swiss researchers who followed almost 24,000 adults for an average of 11 years.  They found that regular users of calcium supplements had an 86 percent increased heart-attack risk compared with those who didn’t use supplements, as reported in the June 2012 issue of the Journal Heart. 

Protect yourself: Lay off the antioxidant supplements and reduce your cancer risk safely by quitting smoking, avoiding excessive alcohol, and eating a healthy diet that includes plenty of fruit, vegetables, nuts, legumes, and whole grains.

Publication date 08/02/12

© Consumer Reports 2012. The material above is intended for legitimate news entities only; it may not be used for advertising or promotional purposes. Consumer Reports® is an expert, independent nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. We accept no advertising and pay for all the products we test. We are not beholden to any commercial interest. Our income is derived from the sale of Consumer Reports®, ConsumerReports.org® and our other publications and information products, services, fees, and noncommercial contributions and grants. Our Ratings and reports are intended solely for the use of our readers. Neither the Ratings nor the reports may be used in advertising or for any other commercial purpose without our permission. Consumer Reports will take all steps open to it to prevent commercial use of its materials, its name, or the name of Consumer Reports®.

I Will Never Tell You To Relax

When I was in medical school some 30 years ago, I was taught never to tell a patient to relax. Nothing seems to make someone less relaxed than being told to do so. The alternative advice was to tell them to clench their toes and then slowly let go and feel the sense of relaxation sweep up your legs into the rest of your body. Showing them how to relax proves much more effective than telling them. That actually seems to work and I've tried it on myself numerous times.

I share this anecdote because it is a good prelude to today's topic. How do you tell someone about the dangers of stress without stressing them out?  That would seem to defeat the purpose of alerting them. I'll come back to this paradox later.

It's been an acceptable axiom for some time now that stress wreaks physiological damage on our bodies, even perhaps on the chromosomal level. I've seen references to a study that revealed that the telomeres which are the end of our chromosomes, shorten secondary to stress. Scientists generally believe that when a telomere shortens to a certain length, typically a cell undergoes apoptosis or cell death.

Along comes a meta-analysis study by Tom Russ, MRCPsych, of the National Health Service Scotland, and colleagues that reviewed 10 British cohort studies that showed that the risk of all-cause mortality or reasons for death in adults with the lowest level of psychological distress -- termed subclinically symptomatic -- was significantly higher than that of asymptomatic adults at an age- and sex-adjusted hazard ratio of 1.20 (95% CI 1.13 to 1.27). In other words, stress increases your likelihood to die from any number of reasons.

To quote medpagetoday.com, "The study measured the association of psychological distress with death by any cause, cardiovascular death, cancer death, and deaths from external causes using data from the Health Survey for England. The survey included data from 1994 to 2004 on 68,222 adults ages 35 or older, mean age 60 years, who were free of cardiovascular disease and cancer, and who lived in a private household in England at baseline."

As an observational study, in which results are observed as opposed to created, the study has its limitations. For example, we don't know the cause and effect relationship. Did people who became unhealthy develop more stress and therefore die at higher rates or did people who became more stressed thereby became unhealthy, which led to their death? There is no good way to do a high quality study of this kind because you can't have a group that you stress out to see if the stress will kill them. So, we are left with correlative studies such as this one as our best science. Notwithstanding, I think we can all agree that stress is not a good thing.

I know that whenever I hear about the dangers of stress to my health it raises my stress. It's like someone telling you not to think about something and you start thinking about it incessantly. The mind is a wonderful machine that still escapes our full understanding. Still, we have to work with what we know and that is it is better to be somewhat relaxed than somewhat stressed. In the book, The Longevity Project, by Doctors Friedman and Martin, we learn that a little bit of neuroticism is a good thing. I wrote about this some time ago. It's healthy to be aware of your surrounding and potential dangers. It's normal to worry about finances and relationships. It becomes unhealthy when you are consumed by such thoughts.

So how do we find a healthy balance between legitimate worries and irrational thoughts? I think the answer is focus. Ask yourself what is the focus of your life? Is it on potential and possibilities or what has gone wrong? Is it on tomorrow or yesterday? Is it on things you have to be grateful for or things that bother you? For some people making these choices is easy. If you are one of them and your focus is on the positive, I suspect that you enjoy life more than most. If you are hampered by a continuous stream of consciousness that accentuates the negative, you need to address this proactively. You can't ignore it; you need a plan. Speak to your clergyman, a doctor, or anyone you think may help.

I share these concerns about stress because despite the fact that it may raise you stress in the short-term, you will be better off in the long term by developing effective ways to lessen its toll on you.

As the studies suggest, living with stress means dying early from stress. Don't let yourself become a statistic.

What A Difference A Day Makes

Over the past few months, the big health related news was the Institute of Medicine's report regarding the increasing percentage of obese Americans. The expected increased girth of the nation raised alarms because of all the other medical problems that are likely to ensue.  Unfortunately, we will not have to wait because a new medical report by Virginia Fried and colleagues was just released by the U.S. National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention. The report titled, NCHS Data Brief, "Multiple Chronic Conditions Among Adults Aged 45 and Over: Trends Over the Past 10 Years," is truly frightening. 

According to new research, between 1999-2000 and 2009-2010, the number of Americans aged 45 and older with two or more chronic conditions has grown, with senior citizens especially at risk of developing both diabetes and high blood pressure. The study reveals that the percentage of Americans in the 45 to 64 year age group with two or more of the conditions grew from 16 percent to 21 percent and in the 65 and older age group, the percentage increased from 37 percent to 45 percent.

The report also revealed that 23 percent of adults aged 45 to 64 with at least two chronic conditions -- out of the list of nine -- either didn't receive necessary medical care or delayed it because of cost. That's up from 17 percent a decade earlier. The percentage of people in that group who didn't get necessary prescription drugs due to cost also grew from 14 percent to 22 percent over the period. Isolating individual conditions in people aged 45 or older, high blood pressure grew from 35 percent to 41 percent, diabetes from 10 percent to 15 percent, and cancer from 9 percent to 11 percent.

The most troubling part is that these numbers are expected to get even worse.  But I have reason for hope because of someone I spent time with today.

I met with a patient of MDPrevent today who has been participating in our LEAN Weight Loss program.  Prior to starting the program, her cholesterol was about 230, her fasting blood sugar was around 120, and her body mass index (BMI) was over 30. In the span of a few months, she has shed 16 pounds, dropped her BMI to 27.5, dropped her cholesterol to the 160s, and her fasting blood sugar to around 105. She accomplished this without any medications, surgery or supplements. She did it simply by changing the way she eats based on what she learned in our program. The best news is that her program was covered 100% by Medicare so it didn't cost her a penny.

Starting a new practice over the past couple of years has had its challenges. However, today it all came together when I witnessed first-hand again what a profound effect a change in lifestyle can have on someone's health. I am so proud to be part of such an effort and take great satisfaction in knowing that our team of Preventioneers are truly making a difference one life at a time. The best news is that our program is covered 100% by Medicare for those who qualify.