Food Addiction…Real or Not?

Below is an article from CNN that I read this morning.  See my comments at the end!

CNN Article

Scientists have finally confirmed what the rest of us have suspected for years: Bacon, cheesecake, and other delicious yet fattening foods may be addictive.

A new study in rats suggests that high-fat, high-calorie foods affect the brain in much the same way as cocaine and heroin. When rats consume these foods in great enough quantities, it leads to compulsive eating habits that resemble drug addiction, the study found.

Doing drugs such as cocaine and eating too much junk food both gradually overload the so-called pleasure centers in the brain, according to Paul J. Kenny, Ph.D., an associate professor of molecular therapeutics at the Scripps Research Institute, in Jupiter, Florida. Eventually the pleasure centers “crash,” and achieving the same pleasure–or even just feeling normal–requires increasing amounts of the drug or food, says Kenny, the lead author of the study.

“People know intuitively that there’s more to [overeating] than just willpower,” he says. “There’s a system in the brain that’s been turned on or over-activated, and that’s driving [overeating] at some subconscious level.”

In the study, published in the journal Nature Neuroscience, Kenny and his co-author studied three groups of lab rats for 40 days. One of the groups was fed regular rat food. A second was fed bacon, sausage, cheesecake, frosting, and other fattening, high-calorie foods–but only for one hour each day. The third group was allowed to pig out on the unhealthy foods for up to 23 hours a day.

Not surprisingly, the rats that gorged themselves on the human food quickly became obese. But their brains also changed. By monitoring implanted brain electrodes, the researchers found that the rats in the third group gradually developed a tolerance to the pleasure the food gave them and had to eat more to experience a high.

They began to eat compulsively, to the point where they continued to do so in the face of pain. When the researchers applied an electric shock to the rats’ feet in the presence of the food, the rats in the first two groups were frightened away from eating. But the obese rats were not. “Their attention was solely focused on consuming food,” says Kenny.

In previous studies, rats have exhibited similar brain changes when given unlimited access to cocaine or heroin. And rats have similarly ignored punishment to continue consuming cocaine, the researchers note.

The fact that junk food could provoke this response isn’t entirely surprising, says Dr.Gene-Jack Wang, M.D., the chair of the medical department at the U.S. Department of Energy’s Brookhaven National Laboratory, in Upton, New York.

“We make our food very similar to cocaine now,” he says.

Coca leaves have been used since ancient times, he points out, but people learned to purify or alter cocaine to deliver it more efficiently to their brains (by injecting or smoking it, for instance). This made the drug more addictive.

According to Wang, food has evolved in a similar way. “We purify our food,” he says. “Our ancestors ate whole grains, but we’re eating white bread. American Indians ate corn; we eat corn syrup.”

The ingredients in purified modern food cause people to “eat unconsciously and unnecessarily,” and will also prompt an animal to “eat like a drug abuser [uses drugs],” says Wang.

The neurotransmitter dopamine appears to be responsible for the behavior of the overeating rats, according to the study. Dopamine is involved in the brain’s pleasure (or reward) centers, and it also plays a role in reinforcing behavior. “It tells the brain something has happened and you should learn from what just happened,” says Kenny.

Overeating caused the levels of a certain dopamine receptor in the brains of the obese rats to drop, the study found. In humans, low levels of the same receptors have been associated with drug addiction and obesity, and may be genetic, Kenny says.

However, that doesn’t mean that everyone born with lower dopamine receptor levels is destined to become an addict or to overeat. As Wang points out, environmental factors, and not just genes, are involved in both behaviors.

Wang also cautions that applying the results of animal studies to humans can be tricky. For instance, he says, in studies of weight-loss drugs, rats have lost as much as 30 percent of their weight, but humans on the same drug have lost less than 5 percent of their weight. “You can’t mimic completely human behavior, but [animal studies] can give you a clue about what can happen in humans,” Wang says.

Although he acknowledges that his research may not directly translate to humans, Kenny says the findings shed light on the brain mechanisms that drive overeating and could even lead to new treatments for obesity.

“If we could develop therapeutics for drug addiction, those same drugs may be good for obesity as well,” he says.

Dr. Court’s Comments

I agree with many of the statements in this article.  I do believe brain chemistry plays a major role in why people make the wrong food decisions.  Altering brain chemistry to improve symptoms of various problems is a large part of my practice.  I disagree that it’s only the ‘fat’ in these foods that are addictive.  If you feed a rat a fatty food like frosting it also must contain a lot of sugar and carbohydrate.  How are we to know that these addictive behaviors were not a result of the carbohydrate in the food that the rats ate?

We must also consider that these rats were fed a steady diet of unhealthy fats as well.  Avocado’s are high in fat.  I seriously doubt that if you fed the rats avocado they would become addicted. It is the type of fat that is terribly important.

Carbohydrates and simple sugars have long shown to increase levels of serotonin and dopamine.  It stimulates the feel good receptors in our brains.  I think it’s a large leap to assume it’s the fat that’s the problem.  Mainstream research wants to focus on fat as the culprit behind all disease, but it may not be.  I think we would serve ourselves better if we took a step back and examined carbohydrates for their addictive traits.  I think we’d see a much stronger correlation between simple carbohydrates and overeating than with fatty foods.

Consider that most fast food meals are a combination of unhealthy fat and simple carbs.  Anecdotally, many people will tell you that they get a lift when they eat their daily McDonald’s value meal.  For them it is a kind of ‘food fix’ that makes them feel good.  This feeling of satisfaction and happiness, however, can be changed.  Over time, by making the right choices of food people begin to lose their cravings for sugary/carby foods.  I routinely put people on detoxification programs and initially the diet is hard for them because they crave starchy foods.  It is a rare occasion that someone comes to me after a detox and tells me they craved nothing but fatty foods.  It is almost always the carbohydrates that people miss.

After all, as human beings our physiology is geared to go after carbohydrates.  They are the simplest and easiest way to get energy into our bodies.  There is a primal drive to consume carbohydrates.  Wouldn’t it make sense then that we might have some genetic predisposition to be “addicted” to carbohydrates?  I believe so.

Dr.Gene-Jack Wang, M.D., the chair of the medical department at the U.S. Department of Energy’s Brookhaven National Laboratory, in Upton, New York had a great quote in this article.  He said:

“We make our food very similar to cocaine now,” he says.

Coca leaves have been used since ancient times, he points out, but people learned to purify or alter cocaine to deliver it more efficiently to their brains (by injecting or smoking it, for instance). This made the drug more addictive.

According to Wang, food has evolved in a similar way. “We purify our food,” he says. “Our ancestors ate whole grains, but we’re eating white bread. American Indians ate corn; we eat corn syrup.”

You will notice the examples he cited were both of the refined carbohydrate type, not fat. In my practice this has always been the case.  People are not addicted to fat.  They are addicted to the simple carbohydrates that are so prevalent in Western diets.  Think about it yourself; would you rather have a fatty pork chop or a carbohydrate laden doughnut?  Almost everyone would choose the doughnut.  Yes, I am aware doughnuts tend to be high in fat, but when you choose doughnut it isn’t because the fat appeals to you.  It’s the sweet, fluffiness that pings your brain.

While I applaud this study for recognizing that there is more to weight loss than simple calorie-in calorie-out, I think the researchers may have come to the wrong conclusions.  Next time they should try and isolate sugar from fat and test the hypothesis with more controlled variables.

Taking Responsibility for your Health

The debate over health care will continue to rage.  The fact that health care reform has passed will not end the debate.  Many Americans, myself included, believe that people who make poor decisions for their overall health should pay more for their health care.  If you choose to eat one meal per day at McDonald’s, don’t expect me to pay for your health care. 

The notion that providing more people with insurance will reduce health costs in this country is a ridiculous one. The problem of sky rocketing health care costs is not one of lack of insurance.  It is there because too many people make the wrong decisions about how to live their lives.  They choose not to eat healthy, not to exercise and not to supplement their diets with missing nutrients.  Those people we will call “omitters.” They omit something from their life (like healthy food and exercise) that causes them to be less healthy.  Then there are people who actually contribute to their own demise.  They smoke or drink alcohol excessively for example.  Those people we will call “destructors.”  There are many people that fit into these categories and most people are a combination of omitters and destructors.

I can already hear the complaints while some of you are reading this.  You are saying, “But it is much more complicated than that…!”  There are other factors that play into it including socioeconomic status, income level, education level, etc.  While I believe that to be true, I only believe it to a certain point.  The vast majority of people, regardless of income level know that smoking is bad for you, yet they continue to smoke.  The vast majority of people know that excessive alcohol consumption is bad for you.  The vast majority of people know that exercise is good for you.  I don’t care what income level people have or what education level people have, these are known facts that most choose to ignore.

A perfect example

I was giving a lecture to a large group of people.  It was about diet and health and how to improve your own health with simple diet and exercise.  After the lecture a woman came up to me and told me how much she enjoyed the lecture and that she’d learned a lot.  She also said that she’d love to come in a see me as a patient, but couldn’t possibly afford it.  All of her money was accounted for and there was no extra room in the budget.  As I spoke with her I noticed that she smoked.  I asked her about it and asked how many packs per day she was smoking.  She told me about a pack.  She also told me that her husband smoked about a pack and a half per day.  I told her that I would certainly recommend that she and her husband stop smoking and if she did that there would be more than enough money in the budget to cover my services.  She agreed, but said “her husband” would be unwilling to stop leaving her without enough to cover my services.  This was a classic example of not taking responsibility for her own health.  She did not want to quit smoking, in my opinion, and was sure her husband would not either.  If she was truly concerned about her health and wanted expert guidance she would have quit and saved the money and been able to afford my services to help her to better health.  I have broken down just how much they would have saved if they’d quit smoking.  It is staggering.

Depending on your location, a pack of cigarettes costs between $4.50 and $5.  Let’s take the middle and use $4.75 to calculate our numbers.

The wife’s yearly costs in cigarettes = $1733.75

The husband’s yearly cost in cigarettes = $2600.63

TOTAL COST is $4334.38 per year!

They would save more than $360 per month if they both quit smoking.

Unfortunately, this woman never came in as a patient in my office.  It’s too bad because we could have done wonders in terms of improving her health and overall quality of life.  She is a classic destructor.  She added something into her life that will shorten her lifespan and decrease its overall quality.

Another reason people claim they can’t stay healthy is because they can’t afford a membership to a gym.  That’s a very poor excuse.  You don’t need to go to a gym to exercise.  If you have access to the outside, you can exercise.  Walk, run, skip, do anything.  Just be active.  There are also unlimited amounts of body weight exercises that one can do in their home.  Simple examples include push-ups, lunges, jumping jacks and core training.  These are all easily done inside with no equipment.

So, if you’re reading this and you aren’t healthy, which one are you – an omitter or destructor?  Are you a little of both?  The first step is recognizing that you are doing something incorrect in your lifestyle that is possibly causing you to be unhealthy.  You may say that it only affects you, but it doesn’t.  Over time it causes a drain on funds in the health care industry and forces everyone else to pay more in taxes.  If everyone stayed active and ate right, health care costs in this country would plummet and we wouldn’t need to argue about it any longer.  Will this prevent every disease?  No.  Will it go a long way?  Absolutely.

Breakfast in America

My wife and I spent the night in Burlington last night with some friends. This morning we went out to breakfast and found some pretty ridiculous things on the menu. It really illustrates why Americans are so overweight.

I must admit that I cheated and ordered a breakfast sandwich but a cheat once in a while isn’t a big deal. The problem is that most people eat like this all the time. Below are two unbelievable examples of what is offered at restaurants all across the US.

Diet, Exercise can prevent 1/3 of all breast cancer cases

Recently, researchers have concluded that one third of all breast cancer cases in Western countries could be prevented if women ate healthier diets and exercised more.  This is great news for all women and a shift in the thinking of most of modern medicine.  Most of traditional medicine, funded by the pharmaceutical industry, has focused too much on treatment and screening and not enough on actual prevention.  While treatment for breast cancer is extremely important, the best treatment is doing everything you can to avoid it.

When you read most information on breast cancer you will see ‘prevention of breast cancer’ in the same sentence as ‘mammograms’ and ‘self breast exams.’  Mammograms and self breast exams never did anything to prevent breast cancer.  They are great for early detection which is important in the outcome of many cases of breast cancer, but they do nothing to actually prevent it.  True prevention means you never get a disease.  Finding it early in its course obviously means it was not prevented. 

Reseasrchers are finally cathcing up with what people in natural and holistic health have been saying for years.

“What can be achieved with screening has been achieved. We can’t do much more,” Carlo La Vecchia, head of epidemiology at the University of Milan, told The Associated Press. “It’s time to move onto other things.”

Breast cancer is very common in the U.S. unfortunately.  In 2009 there were 190,000 new cases of breast cancer and just over 41,000 deaths.  A women’s overall lifetime chance of developing breast cancer is about 1 in 8.  Obese women are 60% more likely to get breast cancer.  Breast cancer is fueled by estrogen and fatty tissue produces estrogen.  The theory is that women who are overweight produce more estrogen thereby increasing their risk of developing breast cancer. 

Many breast cancer agencies have been careful not to issue guidelines on weight for fear of offending women or causing them to feel responsible for their diagnosis of breast cancer.  That might be the most ridiculous and irresponsible notion I have ever heard.  That’s like the American Heart Association not issuing guidelines on weight because they don’t want you to feel responsible for your heart attack, or the American Heart and Lung Association not telling you to stop smoking because they don’t want you to feel guilty if you get lung cancer.  What the breast cancer associations should be doing is issuing strict guidelines on diet and exercise to empower women.  By issuing these guidelines they would be telling them that they have a choice and can do something to reduce their overall risk!  Yes, breast cancer is a complex disease with many factors to it and diet and exercise won’t stop every case, but why not do everything you can to prevent it? 

Women need to be on diets that are anti-inflammatory.  These are diets that are natually low in carbohydrate and high in healthy fats.  These low glycemic diets will reduce insulin production, reduce fat storage and reduce estrogen production significantly over a woman’s lifetime.  (See our post about the dangers of inflammation and samples of healthy foods.)  Exercises should be varied.  Weight training mixed with cardiovascular training is best.  Weight training maintains lean muscle mass which inhibits fat deposition and cardiovascular training keeps the heart healthy. 

I am not suggesting in any way that if a woman gets breast cancer it’s her fault because she did not exercise.  Quite the contrary actually.  Most health professionals do not treat proactively and have no advice for women on what they should do to protect themselves from various diseases.  They are handcuffed by their education to simply give a pill once a disease becomes diagnosable.  I can’t tell you how many times I have patients come to me who are “waiting to be treated” for a disease that they are on their way to developing, but it hasn’t quite met the requirements just yet.  This is the worst model of medicine, but it is unfortunately the most prevalent.

More and more we are seeing that diet and exercise (big surprise) is the best way to prevent a whole host of diseases.  What needs to happen is that the focus shifts from disease treament to disease prevention.  That is truly the only way that we are going to reduce health costs and improve the health of our country.

More Terrible Advice Doled out from the ‘Experts’

My receptionist recently read a piece in our local newspaper and brought it to the office for me to see.  I was floored.  It was in ‘Annie’s Mailbox.’  This is an advice column syndicated in many newspapers throughout the country and can be found on the web.  It is a descendant of the Ann Landers’ column from years ago.  This is truly supposed to be an advice column.  I mean, people actually write them and ask for their advice!  I tend to take these columns with a large grain of salt because the people answering them are often not qualified to answer the questions being asked, nor are they qualified to sort through the research, should they do any, while gathering information to supposedly “inform” us.  Below is the text from that article in which a grandmother is concerned for her grandchildren because they eat very poorly.  I have highlighted some of more interesting points.

Dear Annie: My son and his wife have been married 12 years and have two beautiful daughters. But I am terribly concerned about their eating habits. This is doubly difficult, as my daughter-in-law is the boss in this family and thinks she knows everything. My son is no better. He never ate properly when he lived at home, even though we tried. I hoped he would marry someone with better common sense about food.

I have never said anything outright, but I have often subtly tried to let them know how I feel. They eat nothing but pasta. They cook fresh vegetables, but don’t insist that the kids eat them. At Christmas, the 6-year-old wasn’t allowed to have a second dinner roll because it wouldn’t leave room for dessert. The 2-year-old ate olives, pickles and some pie, but wouldn’t touch the ham, mashed potatoes with gravy, or carrot sticks.

Our little grandchildren are often sick and on antibiotics. I can’t count the number of times they have had viruses, colds and ear infections. I don’t even want to go to their home because it upsets me so. What can I do? — Worried Mother

Dear Mother: Believe it or not, your grandchildren are eating just fine. Having an extra roll or mashed potatoes with gravy is no healthier than pickles and olives and has no bearing on their colds and ear infections. A lot of adult eating disorders can be traced back to parents who turned the dinner table into a battlefield. Please trust your son and his wife to care appropriately for their children, and turn a blind eye to the food issues. You can’t win — and you could lose a great deal.

First of all, those children eat terribly if their grandmother is correct in saying all they eat is pasta and no vegetables.  That is the worst thing for humans to eat too much of.  It may not cause problems for young children who have fast metabolisms and need lots of energy to grow, but it sets up extremely poor habits for them as adults.  If they continue on that type of a diet they’ll be overweight and diabetic by the time they are in their forties.

My biggest problem with this article is the ‘advice’ that Annie gives them.  She tells this grandmother that her grandchildren are eating just fine and that what they eat has nothing to do with getting colds and ear infections!  Since when does what you eat have nothing to do with your immune system?  Maybe ‘Annie’ knows something I don’t know.  Well as it turns out ‘Annie’ is two women.  She is either Kathy Mitchell or Marcy Sugar (ironic, huh?).  Both write this column.  It is not spelled out which wrote the advice above but their backgrounds certainly don’t warrant that they should be giving anyone health advice.

Kathy Mitchell’s background is as a typist, secretary and office manager to Eppie Lederer, a.k.a Ann Landers.  Marcy Sugar started her work in the Ann Landers’ office by doing basic research and clerical tasks, then she moved into bookkeeping.  Clearly both of these women are more than qualified to give advice on what is healthy for children to eat, right?

The problem is that too many people take what they read in the newspaper as gospel and the advice that was given in this article is awful.  First of all, what you eat has everything to do with your immunity.  For example, pasta is filled with gluten.  Gluten is a very potent allergen in human beings.  Constantly bombarding a young digestive tract with gluten causes the immune system to focus on the wrong things.  It will focus on allergens rather than viruses and bacterial.  The grandmother states that her grandchildren are constantly getting sick.  If it isn’t the junky diets these kids are eating then what does ‘Annie’ attribute it to?  Are they just sick kids and there’s nothing that can be done about it?  Definitely not.

Secondly, diet is a huge part of immunity for another reason that ‘Annie’ overlooks.  If these children are not eating fruits and vegetables (as is stated in the article) they aren’t getting enough vitamins and minerals to fuel their immune systems.  Vitamin C and vitamin A are too very simple examples of nutrients that are essential for immune function.

Lastly, ‘Annie’ says this in her advice; “You can’t win – and you could lose a great deal.”  What kind of an attitude is that?  What is there to “win?”  This woman clearly wants her grandchildren (and her son and wife) to be healthier.  I understand that ‘Annie’ is saying it could cause a rift within the family and possibly ruin relationships.  But what about the fact that when people eat like this they have higher rates of cancer, diabetes and even death?  Is that not the biggest loss anyone can have?  Is ‘Annie’ suggesting just to give in and watch her family eat it’s way to an early grave?  It appears that way.

Advice columns like this have little merit and hopefully people see through them.  I fear, however, that judging by the popularity of these columns some people actually take them seriously and listen to the advice.  This advice column gives the completely wrong advice saying that those children eat just fine.  They eat the opposite of just fine.  They eat horrible diets and if they aren’t changed, those poor children are in for a lifetime of bad health.

Self Admitted ‘Couch Potato’ Gets Weight Loss Surgery…By the way, she’s 14

Below is an article from CNN about weight loss surgery for a child of just 14.  I have blogged about this before so I won’t belabor the point, but please see my comments at the end of this article.

Norwood, Massachusetts (CNN) — One-third of America’s youth is now overweight or obese, according to the Centers for Disease Control and Prevention.

In Norwood, Massachusetts, 14-year-old Maria Caprigno no longer wants to be one of those statistics.

Maria has been overweight since she was about 3 years old and as she got older, she just got heavier. She told CNN her eating habits were to blame.

“I’m a junk-food person and because I’m a couch potato I don’t like to get off the couch,” she said. “It’s also kind of just like my genes: Both my parents are heavy and that’s just the environment I was raised in.”

Maria said people have stared at her all her life because of her weight.

“The first thing that goes through their mind is, ‘Why is she so fat?’ And, ‘Oh my god, she’s so fat. Why doesn’t she just hop on a treadmill?’ And I think people don’t really understand that it’s not just exercising … it’s extremely hard.

“I get self-conscious,” she said. “I don’t like to go to crowded places — like if a mall’s crowded, I’ll sit in the car.”

The CDC says obesity rates for Maria’s age group, those 12 to 19 years old, have tripled since 1980. Maria pleaded with her mother to find a doctor who would perform weight-loss surgery on teenagers.

Dr. Evan Nadler, who started a program for adolescent surgery at National Children’s Hospital in Washington, said he felt “compelled” to help Maria.

“Her BMI [body mass index], which is a measurement we use to determine how obese someone is, put her in the highest risk category. Not just morbidly obese but two categories higher than that,” Nadler said. “So I felt that withholding a known therapy that works based on her age alone was really almost unethical.”

Between 2000 and 2003, some 800 teenagers went under the knife to lose weight, Nadler said.

Before she was approved for surgery, Maria had to meet with a nutritionist, a pediatric cardiologist and a psychologist. In the end, Maria was approved for an experimental procedure known as a “gastrectomy,” during which about 80 percent of the stomach is removed, including the part of the stomach that controls appetite.

Nadler said the procedure “basically restricts the amount of food that can come into the stomach at any one time and it really makes the patient have a sense of fullness or a lack of hunger.”

Maria had the “gastrectomy” last month and already has lost about 45 pounds. Today she weighs 400 pounds and is down to a size 32. Maria said she would like one day to be a size 12 but isn’t trying to reach a specific weight.

“It’s not about the numbers; I want to be at a healthy size,” she said.

“I want to be able to go into a normal store and buy something and be able to wear it. I want to be able to run. I haven’t been able to run since I was 5 years old. I want to be able wear a bathing suit without feeling embarrassed.

“I just want to be normal.”

But Dr. Edward Livingston, a Texas surgeon who also has helped adolescents lose weight, said surgery for teenagers can be risky. He has turned away most teens sent to him for evaluation, he said, and has operated only on those more than 500 pounds with serious health risks such as blood clots and congestive heart failure.

Adults are a different matter because they are more emotionally mature,” Livingston said. “They know what risks they want to take and they can buy into the procedure. Kids don’t really know what they’re getting into, so I think you have to be really careful with children before doing these operations on them.”

Livingston noted that only a limited number of studies have been done on weight-loss surgery’s effects on teenagers later in life.

“We don’t really know the full spectrum of positive or negative outcomes for the procedures,” he said.

Nadler, who operated on Maria, said he fully agrees that “we need to study this more. But I don’t think it’s fair to the Marias of the world to keep them from having this procedure based on their age alone.”

In his own study, Nadler followed 41 teenagers for two years after weight-loss surgery. He said they lost half their excess body weight and their health had improved.

Maria said she was well aware of the risks of surgery, but after trying about a dozen different diets, she said, surgery was her only option. Now, she said, she is well on her way to becoming a healthy teen and adult. She works out playing the Wii video game and walks every day with her brother after school. She is eating a high-protein diet.

“This surgery is a tool in your tool box to becoming healthy,” she said. “It is not the quick fix. You need a lot more. You need to exercise you need to make the right food choices.”

In a letter to the insurance company seeking coverage for this procedure, Maria wrote she needed this surgery to make it to her 15th birthday. She said, “Doctors have told me for years that if I keep gaining weight I’m not going to see 18 and that has terrified me. I want to live. I want to do so many things.”

Dr. Court’s Comments

Now, I have one major problem with this situation and it should be clear if you’ve read this blog before.  She freely admits that her diet and activity level are horrible.

“I’m a junk-food person and because I’m a couch potato I don’t like to get off the couch,” she said. “It’s also kind of just like my genes: Both my parents are heavy and that’s just the environment I was raised in.”

The above statement, in my book, should rule her out for surgery.  If she had said she has tried and tried and tried to lose weight and it hasn’t happened then maybe (maybe!) she should be a candidate for bariatric surgery.

This surgery removed 80% of her stomach.  No one can possibly know what kind of an affect this will have on a developing child or the affects it will have 30 years down the road.  The stomach starts the digestive process and breaks food down so that the small and large intestine can do what they’re supposed to do and that’s absorb nutrients.  If the stomach can’t do this (say, for instance, because it has been removed!) nutrients and vitamins and minerals may not be absorbed.  Over a life time, what does this do to overall health?  No one knows and that’s dangerous.

I don’t blame this young girl for the position she is in.  She was obviously brought up in a home that was not conducive to activity or healthy eating.  That is her problem!  Genetics are not to blame.  The genetic card is played way too often.  People need to realize that genetics loads the gun but the environment pulls the trigger.  The environment this poor girl has been exposed to has created this problem, not her genes.  If one grows up in a home where they are abused, studies show that, unfortunately, they are more likely to abuse their children.  Is this a genetic problem?  No, it’s environmental because of learned behaviors just as exercise and eating habits are learned behaviors.

While this surgery will achieve the goal of weight loss for this young girl, it will not last because her habits of inactivity and junk food will not change.  And just because you are thin does not make you healthy.  If she continues to eat junk food, albeit smaller amounts of junk food, she will still be unhealthy.  What she needed was someone to build her a program of diet and exercise to lose weight.  While this is harder and takes dedication it is safer and much more effective in terms of actually achieving health.  In my opinion, this should be mandatory before surgery is even attempted, but there are far too many surgeons willing to make money on people where conservative measures are better options.

My Take on “Health Care” Reform…

In light of the recent health reform bill that passed the legislative branch of the government and that President Obama has signed into law today, I thought I would take a closer look and see who will actually benefit from this historic piece of legislation.

This health reform does little to change the actual problems with health care in the United States.  This bill will not make us any healthier.  It may insure more people, but having health insurance does not make you healthy.  As a matter of fact, one could argue that people without health insurance are the ones who watch their health more closely so they can avoid the large doctors bills that might accrue should something happen.

The reason Americans are so unhealthy has nothing to do with insurance coverage.  It has everything to do with lifestyle choices.  You can’t drive through many towns in the country and not see at least 3 or 4 different fast food chain restaurants.  They provide a service that people love – quick, easy good tasting meals.  Some argue that they actually taste good, but you can’t argue with results.  Check out these numbers:

McDonald’s claims to have served over 99 billion people.  It’s right on their signs.  Some have changed to say “billions and billions served” to reflect the even higher numbers suggesting it is now too high to count.  I tend to agree, it is probably too high to count.  But let’s take the 99 billion as our number.  We can safely assume the number is at least that high in the United States alone because we are “rounding down” to put it plainly.  If we consider that McDonald’s started in 1948 with the process we would recognize as fast food, that means they’ve served 4,374,723 meals per day to reach 99 billion served in the last 62 years. No wonder America has a health problem.  This just McDonald’s.  This doesn’t take into account Pizza Hut, Burger King, Wendy’s, Jack in the Box, Taco Bell, KFC or any other fast food chain!

Big Pharma Wins Again (Ugh…)

It is clear that our problems go far beyond a lack of health insurance coverage in this country.  Another part of the problem is our thought process when it comes to health and being sick.  When most people get sick (or have an ache or pain, etc…) their first thought is, “What pill can I take to get better.”  There’s nothing wrong with taking an antibiotic if you have a raging bacterial infection or taking a life saving drug if it indeed is life saving.  These cases, however, are the vast minority of cases!  Drugs are over prescribed and the benefits over sold while natural and more cost effective treatments are available. They aren’t marketed like pharmaceuticals and aren’t patentable like pharmaceuticals so they aren’t recognized as well. 

The pharmaceutical lobby had a lot of work ahead of itself when the talk of health care reform began.  They eventually got behind the reform and supported it wholeheartedly.  And now we know why.  They made out like bandits in this reform!

Initially, price control on pharmaceuticals was discussed.  This was a huge point of contention for the pharmaceutical industry.  Once this was eliminated support for the reform bill was gained.  As evidence the industry spent an estimated $100 million in TV advertising, grass-roots organizing and other marketing efforts to promote reform.  Many people will point to the concessions the industry agreed too.  They agreed to contribute $85 billion toward the cost of the bill in the form of industry fees and lower prices paid under government programs over 10 years.  While $85 billion certainly is a lot of money, it pales in comparison to industry revenue.  Take this into consideration – the top 12 pharmaceutical companies had a combined revenue of $237.7 billion in 2006 alone (the most recent year for which I could find statistics)!  When you consider that the $85 billion is spread out over 10 years you realize it really is just a small drop in the bucket for them.  Consider that the hospitals agreed to a much higher number of $155 billion over the next 10 years mainly by accepting lower fees through medicare.

What you must also realize is that the pharmaceutical industry sees this as a way to gain another 32 million costumers.  These are the individuals who are currently uninsured and who do not take prescriptions, see the doctor or get surgery unless they absolutely have to.  Big Pharma sees them as an untapped resource.  No longer will these people leave prescriptions unfilled or forgo their Lipitor because it is too expensive.  The pharmaceutical industry will more than make up for the $85 billion in revenues with sales of more drugs from more insured people.

This legislation, while historic and idealistic, will do little to curb the ridiculous health care costs in this country.  This is for two reasons.  First, the bill does nothing to actually change health care.  We are in this situation because we view health and health care backwards.  People get procedures and drugs paid for once they are already sick.  It should be just the opposite.  Pay to prevent illness.  Insurance companies should be paying people to go to the gym and paying for office visits to nutritionists in the same way they pay for an office visit to your primary care.  Secondly, the bill did nothing to change the price of pharmaceuticals.  These prices are artificially inflated and insurance companies still pay it.  This is a huge burden on the finances of this country.

Hopefully I’m wrong and this significantly improves the health care industry in this country, but the major problems were not addressed.  I am sorry to say that in 10 years I think we’ll still be in the same boat.

Finally, “modern” medicine catches up a little…

I have been touting the benefits of vitamin D for years.  A multitude of studies have shown that it is beneficial for many things, not just for healthy bones.  Now a new study, published in Pediatrics, shows that even infants need to supplement with vitamin D.

New research has shown that a significant portion of mothers and therefore infants are deficient in this life saving nutrient.  A second study in Pediatrics reports that 58% of newborns and 36% of mothers were deficient in vitamin D, according to blood tests. Although taking prenatal vitamins helped, more than 30% of moms who took them were still deficient. Getting lots of sunlight helped raise vitamin D levels in moms, but not in their newborns.

I always recommend extra vitamin D to my pregnant patients in addition to their regular prenatal vitamin.  Although prenatal vitamins are beneficial, they are entirely too low in vitamin D.  The fact that 30% of moms taking prenatals are still low in vitamin D proves it.

I have also have mothers question why I would recommend vitamin D to them during the summer months.  The first reason is that most people don’t get outside enough to get adequate vitamin D production.  Secondly, when they do go out, modern medicine has scared them into thinking they need to rub chemical laden creams into their skin to “protect” it.  Sunscreen blocks the production of vitamin D and who knows what it does to an unborn child.

The old recommendation of 200 international units (IUs) per day is extremely low.  They have doubled the recommendation up to 400 IUs per day and in my estimation that is still far too low.  While breast feeding is always best it does not provide enough vitamin D for the baby especially if mom is also low.  The best way to increase vitamin D in your baby is to supplement with it.  It is very inexpensive and comes in liquid form.  This new recommendation, while a step in the right direction, needs to be increased even more.

How Much Should My Baby Get?

Below is a good recommendation of how much vitamin D infants and babies should obtain.

Infants and children under the age of one should obtain a total of 1,000 IU (25 mcg) per day from their formula, sun exposure, or supplements. As most breast milk contains little or no vitamin D, breast-fed babies should take 1,000 IU per day as a supplement unless they are exposed to sunlight. The only exception to this are lactating mothers who either get enough sun exposure or take enough vitamin D (usually 4,000–6,000 IU per day) to produce breast milk that is rich in vitamin D. Formula fed babies should take an extra 600 IU per day until they are weaned and then take 1,000 IU a day, as advised below.

Children over the age of 1 year should take 1,000 IU per every 25 pounds of body weight per day, depending on latitude of residence, skin pigmentation, and sun exposure. On the days they are outside in the summer sun, they do not need to take any; in the winter they will need to supplement accordingly. (From www.vitaminDcouncil.org)

These recommendations are safe and effective.  The alternative is not taking any at all and putting your child at risk for a host of diseases.  Below is the reduction rates for many diseases with adequate vitamin D levels.  These rates are all from published, peer reviewed studies.

• 35% reduction in all cancers with serum levels of 38 ng/ml or higher.
• 83% reduction in breast caner with serum levels of 50 ng/ml or higher.
• 17% reduction in ovarian cancer with serum levels of 47 ng/ml or higher.
• 60% reduction of colon cancer with serum levels of 43 ng/ml or higher.
• 18% reduction in Non-Hodgkins Lymphoma with serum levels of 38 ng/ml or higher.
• 66% reduction in Type I diabetes with serum levels of 53 ng/ml or higher.
• 54% reduction in multiple sclerosis (MS) with serum levels of 55 ng/ml or higher.
• 30% reduction in heart attacks in men with serum levels of 35 ng/ml or higher.
• 49% reduction in kidney cancer with serum levels of 48 ng/ml or higher.
• 37% reduction in endometrial cancer with serum levels of 51 ng/ml or higher.

The bottom line is that to gain all of the benefits of vitamin D you need to keep your serum levels between 55 and 65 ng/ml at the very least.  To achieve this level, supplementation is a must even if you live in a sunny climate.

Toxicity?

This is a question I hear a lot.  People always ask me, “But isn’t vitamin D toxic?”  While vitamin D can become toxic in extremely high doses, the fear of toxicity is completely unwarranted.  The fear of toxicity is rampant, especially in traditionally trained physicians.  These fears are unnecessary and here’s why.  I will routinely recommend 6,000-10,000 IUs per day to my patients.  The toxicity levels established and accepted are 40,000-50,000 IUs per day for several months at a time.  No one takes that much and no one is recommending people take that much.  What about if people get regular sun?  Good question.  If regular sun exposure occurs I reduce my recommendations accordingly.  Secondly, all of my patients get their serum levels checked.  If the number starts to creep too high, I reduce their recommendations.  Simple as that.

Vitamin D is a critical vitamin in the body and it does far more than anyone thought just 5 years ago.  The risk of toxicity is relatively unfounded simply because most people cannot attain enough, either from sun, supplement or food, to actually reach toxic levels.  The flip side of that is not having enough, and the dangers of that far outweigh the dangers of having too much.  Vitamin D is easy to supplement with and to reach the most beneficial levels, supplementation is necessary.

Drugs shown to have no benefit (and some risks) for diabetics

The results of a new study in diabetics has shown that adding drugs to drive blood pressure and blood-fats lower than current targets did not prevent heart problems, and in some cases caused harmful side effects.  This study was launched 10 years ago by the federal government to see if lowering blood sugar, blood fats or blood pressure would reduce heart attacks and strokes in diabetics.  The results showed that the drugs had no effect on reducing incidence of heart attack or stroke and for some caused serious side effects.

The results were called ‘disappointing’ but from my perspective this couldn’t be better news.  Had this study had positive outcomes it would have given another reason why every diabetic should be on more drugs to ‘protect their hearts.’

The studies were presented Sunday at an American College of Cardiology conference and published on the Internet by the New England Journal of Medicine.

They involved people with Type 2 diabetes — the most common form and the one rising because of the obesity epidemic. Diabetics have more than double the risk of dying of heart attacks or strokes than people without the disease.

The first piece of the study — about blood sugar — was stopped two years ago, when researchers saw more instead of less risk with that approach.

For the blood-fat study, researchers led by Columbia University’s Dr. Henry Ginsburg recruited more than 5,500 diabetics who also had another health risk, such as high blood pressure or cholesterol.

All were given a statin — cholesterol-lowering pills sold as Lipitor and Zocor.  Half also were given Abbott Laboratories’ blockbuster drug, TriCor; the rest got dummy pills. TriCor is a fibrate, a drug that lowers blood fats called trigylcerides while boosting “good” cholesterol.

Nearly five years later, the groups had similar rates of heart attacks and strokes.

The blood-pressure part of the study was led by Dr. William Cushman, preventive medicine chief at Veterans Affairs Medical Center in Memphis, Tennessee. About 4,700 diabetics were treated with various medicines to keep their systolic blood pressure — the top number — either below 140 or below 120.

The intense treatment did not reduce the number of heart attacks, although it prevented more strokes, a less common problem. Side effects were greater with the intense treatment.  (Excerpt from usatoday.com)

The question raised in the article I read was ‘what should diabetics do then?’  First of all, they ask this question like medication is the only answer for these people.  Many millions of people have type II diabetes or are on their way to having it.  The first thing that should be done is avoid the disease in the first place.  Type II diabetes is not a disease in the classic sense.  It is no more a disease than obesity is a disease.  It can be avoided with a healthy lifestyle.  Proper nutrition should be a class in school just like science or math.  The fact that children learn more about the planet Mars than they do about how to truly eat nutritiously is ridiculous. I am not suggesting the sciences are not important, but I bet most kids couldn’t tell you the difference between a carbohydrate, a fat and a protein other than ‘fat is bad for you’ (which is wrong anyway).  True nutrition in which carbohydrates are emphasized less and healthy fats are emphasized more would go along way to reducing the health care crisis in this country.  The low fat paradigm will not work because it is inconsistent with human physiology.

I am not so naive to think that if children were educated from a young age about health and nutrition that we could prevent every case of type II diabetes.  With that said ‘what do diabetics do then?’  They change their lifestyles immediately upon diagnosis. It’s as simple as that.  I have many patients who have been diagnosed with type II diabetes and we routinely improve their outcomes with diet and supplementation.  The solution is simple; change the diet to a low carbohydrate diet, increase exercise and support them with supplementation designed to increase insulin sensitivity.  The trick is not to lower blood sugar intensely (as this study’s goal was) it is to change their hormonal picture.  While on our program blood sugar levels do decrease because of the diet but the real change is insulin regulation.

In the article I read the answer to the question ‘what do diabetics do?’ was answered by what most would consider a prominent physician.  He said:

Focus on healthy diets and lifestyles, and take tried-and-true medicines that doctors recommend now to control health risks, said several experts, including Dr. Clyde Yancy, a Baylor University cardiologist and president of the American Heart Association.

I agree totally with the first part of the statement although I am sure the “diet” he is referring to is of the low fat variety which will not work for diabetics.  Diabetes is a disease (an I use ‘disease’ lightly) of carbohydrate metabolism.  Eating a low fat diet forces one to eat more carbohydrates.  Where is the logic in that!?

The second part of the statement is completely and totally ridiculous.  He tells us we should use “tried-and-true medicines that doctors recommend now to control health risks.”  The medications used in this study are the very drugs that almost every medical physician in this country would call “tried and true ways” to reduce cardiovascular disease.  Find me a medical physician who has any answer besides medication Lipitor or Zocor for lowering cholesterol and I’ll be surprised.  They did not make mention of the specific drugs they used to lower blood sugar or blood pressure but I am sure they are the common ones I see everyday in practice.  A statement like the one from Dr. Yancy simply doesn’t make sense in the context of what was studied.

Type II diabetes is a disease almost exclusively brought on by years of dietary indiscretions.  The fix is not drugs and this study shows that.  The fix is diet and lifestyle modification in which people significantly reduce carbohydrate consumption and begin to exercise.  Doing this improves health outcomes and has no side effect to worry about.  Depending on chemicals to do the job for you won’t work.

Kraft Foods Trying to get “Healthy”

Kraft Foods has announced that they are going to cut salt in all of its foods sold in North America by an average of 10% over the next two years.  Specifically the move will reduce the sodium in Oscar Mayer Bologna by 17% and Easy Mac Cups by 20%.  This move is likely in response to the recent push to begin to reduce the overall salt consumption by Americans.

While I think this is a noble effort by Kraft Foods, they continue to bark up the wrong tree.  It’s not the fact that people are eating Easy Mac loaded with salt that is making America unhealthy.  It’s the fact that they’re eating Easy Mac in the first place! You can’t blame Kraft Foods for this.  They are a business and have every right to produce a product and try and make a profit.  The problem is that by reducing the salt content a large portion of the population will begin to see their Oscar Mayer Bologna sandwich as less detrimental to their health.  Reducing its salt content does not make it significantly better for you.

While Kraft Foods is trying to get healthier, they are also trying to increase their business by trying to appeal to people that are more “health conscious.”  This is evidenced by their own words.

“We are reducing sodium because it’s good for consumers, and, if done properly, it’s good for business,” said Kraft executive Rhonda Jordan. “A growing number of consumers are concerned about their sodium intake and we want to help them translate their intentions into actions.”

Again, it isn’t the salt in the foods that are making them unhealthy.  It is the foods themselves.  Easy Mac, for example is loaded with simple carbohydrates and when eaten regularly contributes as much to heart disease and diabetes as McDonald’s french fries.  It is also loaded with ingredients that most of us cannot pronounce and exist exactly nowhere in nature. Let’s start out by looking at the ingredients for in one Easy Mac Cup.

Ingredients: ENRICHED MACARONI PRODUCT (WHEAT FLOUR, GLYCERYL MONOSTEARATE, NIACIN, FERROUS SULFATE [IRON], THIAMIN MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), MODIFIED FOOD STARCH, SALT, MALTODEXTRIN, POTASSIUM CHLORIDE, ACETYLATED MONOGLYCERIDES, MEDIUM CHAIN TRIGLYCERIDES, APOCAROTENAL (COLOR), CHEESE SAUCE MIX (WHEY, CORN SYRUP SOLIDS, PALM OIL, MILK, MILKFAT, MILK PROTEIN CONCENTRATE, SALT, CONTAINS LESS THAN 2% OF SODIUM TRIPOLYPHOSPHATE, MEDIUM CHAIN TRIGLYCERIDES, NATURAL FLAVOR, CITRIC ACID, MONOSODIUM GLUTAMATE, SODIUM PHOSPHATE, LACTIC ACID, GUAR GUM, CALCIUM PHOSPHATE, MILK, DRIED ONIONS, YELLOW 5, ARTIFICIAL FLAVOR, YELLOW 6, ENZYMES, CHEESE CULTURE).

The first ingredient, “enriched macaroni product” is called so because they enrich it with B vitamins.  They know people will not consume something that doesn’t have at least some nutritional value (or most people won’t) so they enrich their pasta with B vitamins to make it more appealing.

It also contains monosodium glutamate or MSG.  MSG is a flavor enhancer but it is terrible for your health.  MSG is an excitotoxin which means that it binds receptors in the brain and excites neurons to death.  Children are particularly susceptible and they just happen to be the target audience of Easy Mac.  Russel Blaylock is a neurologist who has studied MSG and says it may aggravate many neurological conditions.  His book called Excitotoxins the Taste that Kills is a good book and if you have questions regarding MSG you should read it.

The rest of the junk in there like “yellow #5” and “yellow #6” and “artificial flavors” are also horrible for your health.  There are also a bunch of unnatural preservatives so it can sit on your shelf for 6 months and you can still eat it.  Here is a good rule of thumb.  If you can’t picture the ingredient in your head in its natural state, you shouldn’t eat it.

Now the “nutrition” in this isn’t good either.  The carbohydrate count in one Easy Mac Cup is 39g.  This roughly the same as consuming 8 teaspoons of sugar.  Remember, for every 5 grams of carbohydrate you consume it is equal to one teaspoon of sugar.  Would you eat 8 teaspoons of sugar for dinner?  If you answered ‘no’ then you shouldn’t eat an Easy Mac Cup for dinner either.  The sodium is quite high, but if you aren’t eating junk food like this all the time, you don’t need to worry about your sodium intake.  If you continue to eat processed foods you will over consume sodium….and carbohydrates, and artificial dyes and chemicals, and a lot of other things that aren’t good for you.

Don’t be fooled by the hype of salt reduction in processed foods.  It doesn’t make them any better for you.  They are still loaded with simple carbohydrates which are a major contributor to disease in this country.  They are also still loaded with chemicals and preservatives.  If you’re going to eat macaroni and cheese (and I don’t recommend it often) eat it as naturally as possible.  You could make a great mac and cheese with 3 simple ingredients.  Whole wheat macaroni, milk and cheese.  Spice it to your taste with salt, pepper or garlic.  The downfalls of eating pasta are many, but once in a great while of OK.  Do yourself a favor if you’re going to eat it and don’t eat it from a plastic cup.