Tylenol...Aspirin..Ibuprofen

These common over-the counter drugs are treated like...well, like candy by some people, because of their easy accessibility. They are also often interchanged as treatments by the lay person, though each has very different side effects and each is metabolized differently. In the case of Tylenol, or acetaminophen, the liver is the target metabolizing organ and that translates to thousands of individuals with liver disease, failure, because of abuse of this popular pain reliever.

There is a maximum daily dose for every over-the-counter pain reliever. Exceed that dose, and do it chronically, and you have a recipe for serious health complications. Remember also, that in the case of Tylenol's active ingredient, it might be an ingredient in another pain pill you are taking. For example, Percocet has acetaminophen in it - so if you are also taking Tylenol, you may not even realize how much active ingredient you are getting in a day. Rule of thumb - if you need daily pain relief, and are self-medicating with over-the-counter medications - you need a doctor consult, or at minimum, a discussion with your local pharmacist. Just because it is over the counter, doesn't mean it is innocuous.

Billy May autopsy may teach heart lesson

Though preliminary autopsy results are not conclusive, it appears that the pitch king may have died from a heart event, more than likely an arrythmia related to prior heart disease. If you assess May from a health perspective, you can see he was overweight and much of his weight was what is called central obesity, fat carried in his abdomen. It's impossible to know, without asking close friends, family, if he managed stress well. Certainly stress can amplify inflammatory changes that are present and contributing to heart disease. If he traveled alot - he may have also had sleep deprivation, which again, can contribute to cortisol elevations and inflammatory changes.

The first sign of heart disease can unfortunately be a cardiac event - sudden death. Hypertension, or high blood pressure can be silent; so can increasing levels of plaque acumulation. If you are lucky, you are getting yearly physicals and some of these "silent issues" can be picked up early by tests. If you are still "lucky" you may experience headaches from high blood pressure or angina from clogged arteries trying to maintain blood flow when stressed, so you have early warning signs and can seek help. For as many as 30% of the population who have heart disease, you find out you have heart disease when you die - a terrible and often times avoidable outcome.

Since Mr. May was scheduled for hip surgery, I would think that he had been "cleared for surgery" however, sometimes that is done just before surgery. It's unclear if he was being treated for hypertension, cholesterol issues, weight issues or other health conditions. What is clear is that we can learn something from this initial autospy information. Heart disease is the #1 killer of men and women. As we age, risk of heart disease increases. It also increases if you carry excess weight, eat a highly processed diet, are sedentary, undergo high levels of stress, have diabetes or even pre-diabetes. Know your risk by learning the facts. Go to http://www.americanheart.org/.

You can also sign up for my free daily health tip at http://www.healthgal.com/ and pick up a copy of Fat Families Thin Families at http://www.amazon.com/.

Michael Jackson...Farrah Fawcett

As a medical and lifestyle journalist, I often try to find a health message in every story that comes across my desk. Farrah Fawcett recently asked at the end of her documentary, "what is your fight?" In her case, cancer invaded her body, and the media tried to invade her privacy. She fought both with an incredible tenacity, seeking both traditional and alternative treatments for her battle against cancer (what health practitioners often call the 1:2 punch); then proactively sought to undermine the invasion of her medical privacy, by herself sharing details of her diagnosis, and then helping to snare those at UCLA who sought to leak private medical details. Her fight was for dignity and extended quality of life.

Michael Jackson's fight was against the pain of a burned scalp, broken leg, painful back AND against a lost chidhood that he seemed to forever pursue. His talent they say, will probably never be surpassed; his demons, obviously may now, never be conquered. I live close by to his family compound in Encino, and the helicopters relentlessly circle over his home. I imagine that one of the outcomes of his story may again be that of Anna Nicole Smith - enablers who were giving him serious medications, without closely monitoring the mixture of those drugs. He may have needed these medications, but when you mix anti-depressant drugs, pain killers and other prescription medications, there has to be clear respect and a "line in the sand" as to dosage, frequency of use and the understanding of their interactions.

Cardiac arrest can occur due to a variety of causes. In Farrah's case, her liver was failing and after that comes multiple organ failure. In Michael's case, we may not know for several weeks the cause of his heart's failure. What we can learn is "to fight our battles" be they health battles, work challenges, relationship struggles. And if we are faced with health challenges - be they physical or mental - we need to "fight the fight." At the end of the day all we have are our days on earth.

Farrah Fawcett...Michael Jackson

Two deaths, two icons - one death expected, though it still came as a surprise this morning. After a long battle with rectal cancer, Farrah Fawcett finally succumbed to a disease that she had managed to thwart, a second time, for three long years. Later this afternoon came the shocking news that Michael Jackson, talent extraordinaire had suddenly died of an unconfirmed heart event. Only, fifty years old, that diagnosis in someone who did not seem to have a family history or chronic history of heart disease, seems inexplicable.

Heart disease is the #1 killer of men and women in the US. Health professionals know that heart disease can remain undiagnosed; precursors to heart disease like high blood pressure can remain silent for years. What is clear is the Michael Jackson was under stress, alot of stress for years. Lawsuits, money issues, the challenge to remain relevant in the music world - stress of that nature can cause cortisol changes and inflammatory changes that can damage organs slowly and insidiously. There will more than likely be an autopsy (a family member says that a doctor was called to the house last night but he left without suggesting a hospital visit) and final determination of exact cause of death. If there is a moral to this medical story it is that stress, even if not the ultimate cause, probably had a hand in this young death.

Air is a cancer risk

My son is currently interning in Shen Zhen, China, where air pollution is so bad - the sun is never seen. Though any remnants of his childhood asthma seemed to be in check for several years, we put him back on significant dosages of a multitude of medications 2 weeks before he left, and he planned on maintaining the regimen until returning home. Based on today's air pollution impact news, I guess I'm glad we don't live in Cerritos, California.

According to new research, 2.2 million people are living in cities where the air pollution may indeed be a very serious health risk. Many of the people assessed in this study - 847,000 - lived in New York. The worst single city is Cerritos, CA, which is situated between two main freeways. Experts who reviewed the risk that pollution creates, still admit the risk is lower than say, smoking. But the risk cannot be ignored, mostly because it impacts so many people. The government needs to address toxic pollution. Your kids are being exposed to it everyday, and cumulatively, will have many more years exposure than their parents - unless we do something about it....quickly.

Diabetes type 2.....denial

We need to stop this tide of diabetes type 2 (connected to obesity) that is sweeping through the child and teen population in the US. Experts say that there may have been some genetic mutations and body chemistry changes in the last several decades that seems to put us at a heightened risk of diabetes. But in order for this physiologic change to express itself - you have to do an awful lot of eating, of the wrong things, in the wrong portion sizes, coupled with an incredibly sedentary life. A recent USA Today headline offered that - most types of diabetes can be stopped in childhood. Well that requires that parents and kids to get off the ......denial locomotive.

If parents will be willing to model behaviors of good choices in eating and an active lifestyle, then that's the lesson their young children will learn. If parents have been yo-yo dieters, or have emotional relationships with food, or run their household like a fast food restaurant/candy store, showcasing the latest processed foods and treats, then they will encourage obesity and diabetes to come "a callin." If, on the other hand, parents seek help, and that can be in the form of a team of professionals, a single knowledgeable health professional, well reviewed (not trendy) books, guides and even online sources, then there is a chance we can break this horrendous obesity/diabetes statistic streak.

We need to stop being big losers and start using common sense, coupled with a recognition of the dire consequences of early obesity and diabetes. Scared straight is a better approach, followed by sensible habit changes and a hopeful but realistic outlook, that lead to long term health goals. Care enough to stop the early diabetes madness and let's save the children.

Specifically how can you start?

• Clean out that frig and pantry completely, and re-stock with sensible guidelines


• Get specific guidelines of what you and your kids should be eating, including servings from each food group and portion sizes


• Cut sugar, sodium and processed foods


• Drop the liquid calories


• Get moving in enjoyable ways, but make sure you have daily exercise that raises your heart rate
• Take your kids to the supermarket and experience "nutrition" with discussion, taste testing, weighing, and label reading


• Turn off the TV, video, computer


• Find a book like Fat Families Thin Families that offers strategies and ways to engage in a family lifestyle makeover.

Soda tax: good or bad idea?

The controversey swirling around a soda tax really boils down to a simple question - will it help to curb purchase of the drink or impose extra cost with no real benefit or health payoff? Experts have sourced soda as one of the many foods that are contributing to an untenable obesity epidemic, among children and adults. And no doubt, along with trans fat, an excess of processed foods and snacks, high sodium foods, other sugary beverages, soda is indeed a daily part of most American diets. I've even witnessed babies getting soda in their bottles or sippy cups....parents, is that really necessary or a healthy way too feed your child?? The reality is that soda is far more an insidious evil than most of us realize.

Dentists say that the leading chronic childhood disease is tooth decay. Of course, many of the kids who suffer from this condition are poor children, underserved by dental health opportunities. But drinking soda daily - and most kids do by age 5 - can cause mouth decay across economic lines. So maybe we need a soda tax and a really good health campaign that hammers home the reality that soda can contribute to obesity and dental decay. I have a feeling that a 1-2 health punch message may, along with added cost in the form of a tax, curb the love affair we are allowing our kids and ourselves to have with "liquid candy."

Swine flu...Pregnancy...Diabetes...Herpes...HIV...Depression...STDs...Obesity

No, today's column is not about all of the above diseases and conditions. It's about the fact that the number of adults who seek health information on the internet has doubled in the past 2 years. That "ties" the internet with books and magazines for third place, when it comes to sources adults use for health information. First place is still held by doctors/health professionals and second place is usually friends and family.

Half of current online health searches are done for someone else's health issue, and quite often information is gleaned from blogs or online comments made by others (this is now being called "passive consumption"). It's obvious that the internet is open 24 hours a day and you can remain anonymous while seeking information. You can also get information from sources worldwide, and you can use the internet to assess a recommendation made to you by a doctor.

The key is to use reputable websites like those sourced from the FDA, CDC, WHO and also expert-based, reviewed medical sites like WebMD, Intelihealth, Mayo Clinic. I write for healthcentral.com, a website that sets up "connections" devoted to specific individual conditions and illnesses.

New fast food fare...Kids health...Project vitality...Cupcake rage

I am heartened to see that not only Subway is offering healthier menu options, but now other fast food chains have climbed on the bandwagon AND....parents and kids are taking note. In general there seems to have been a shift in food choices: colas, chicken nuggets/strips, French fries and hot dog sales are down, while soup, grilled chicken sandwiches, yogurt, carrots, milk and fruit purchases are up. Interestingly enough, so are the sales of orange and grapefruit soda. Do you really think they are healthier??? Think again. You can now get smaller burgers and apples that look like French fries, reduced sodium chicken tenders, calcium fortified apple juice and fat-free chocolate milk at Burger King. Mcdonalds offers yogurt and apples and Wendy's kids meals now have mandarin oranges. It's a start, but obviously parents need to help their kids to find and embrace these healthier choices and portion sizes. It does seem that fast food corporations are getting the message that we need to offer these food shifts. The choice is up to us.

Though there are raging epidemics of obesity and diabetes among kids, on a larger evaluation scale, parents seem to be "doing right" healthwise, by their kids. Specifically we are choosing to breastfeed way more than moms did in the late 80's; SIDS (sudden infant death syndrome) statistics are down when compared to this time in 2004; we are still doing well when it comes to kid vaccinations, especially against chicken pox; more pregnant women are taking folic acid, and significantly less married-pregnant women are smoking when compared to statistics in 2005. We still need to work on lifestyle related issues and conditions like obesity/diabetes.

Albert Lea, a town of 18,000 has accepted the challenge and help from Vitality Project, a new organization that involves the AARP and a National Geographic explorer/documentary producer. The goal? To use his latest documentary findings - habits of communities that embrace health and enjoy longevity - and implement them in a US city. In this case, Albert Lea, MN, is the first recipient of the Vitality Project organizers, who arrived one month ago, to help implement healthier habits. There is already a virtual schoolbus, groups of kids who walk to school with seniors and their parents, better food offerings at truck stops (smaller portion, healthier choices), a shift in the community to eating more produce, empasizing physical activity and social activities, and a community generally coming together to find purpose and meaning in their lives. City officials are encouraged to fund more bike paths, garden plots and farmer's markets; citizens are encouraged to form walking and biking clubs; school and business cafeterias, grocery stores and restaurants are asked to revamp their food choices; motivational seminars round out the new regimen. The big question? Once the Vitality Project organizers leave, can the town sustain the changes.

Finally, the champion of healthy eating, MeMe Roth has stuck her controversial and big mouth into the school scene again, and the subject is cupcakes and birthday celebrations at school. Let's face it - if you add up all the "celebratory foods" your kids are exposed to - it's way (or weigh) too much!! Do the math - 30 kids in school means 30 "parties - then you go to the "outside school" parties, then the holiday school and outside holiday school parties and graduation and anniversary and "summer has come" and "I got 100 on my test" and "it's a special weekend" and "I fell down" and "my friend made fun of me" celebrations (with treats)....face it parents - the kids are getting way too many "happy/sad/celebratory "treats, and frankly, you are defining celebration (and emotional therapy) as only possible if treats are present. So why not compromise with one celebration a month in school to cover all the birthdays in that month (it will also help parents to pool the costs in these trying times)? And why not start celebrating and treating highs and lows with something other than food (some of the time)? As for MeMe, me-thinks she needs to continue her battle with a bit more grace and a bit less attitude. Let's get the job done withsome reasonable and elegant discussion. I'll throw in brownies made with....prune puree.

H1N1 vaccine...Teach yourself fullness...Join "vitality project"

In the news today:

(1) Novartis AG has used cell technology, rather than traditional egg technology, to produce the first batch of H1N1 vaccine. The company will probably be able to have the vaccine ready for sale after September. The first batch will be used for pre-clinical evaluation and testing, and is currently being considered for clinical trials. Currently Novartis has an order from HHS for $289 million dollars worth of vaccine.

(2) Dr. Louis Aronne, director of the Comprehensive Weight Control Progtram, at New York Presbyterian-Weill Cornell Medical Center, has released a new book which suggests that weight loss is not about will power or priorities-it's about your body, brains and hormones. His assertion that you need to "teach your belly to be full" is not new, nutritionists and dieticians for years have been extolling the notion that you need to have certain daily habits, in place, without fluctuation, to support long term weight loss. His tips include:

• Eat a protein based breakfast daily (stimulates metabolism/prevents major blood sugar fluctuations


• Eat a salad before each meal (watch the dressing)


• Exercise in the am to stimulate your metabolic rate AND to "get it done"


• Watch less TV


• Get adequate sleep or look at sleep and certain medications as a possible contributor to your weight issues

My book, Fat Families Thin Families, offers those same recommendations but I also strongly asert that you need to create a home "team" environment that offers mostly healthy foods, acknowledges portion control, AND that asks everyone to climb on the "healthy habit train" whether or not you need to lose weight. Good health patterns are not soley about weight.

The Vitality Project is coming to Albert Lea, Minnesota, care of a collaberation between AARP and author/producer Dan Buettner. It's goal is to take the habits of communities around the world who seem to live "long and healthy lives" and bring them to the American obesity scene. The Minnesota community is "teaming up" (just like my book suggests), as a super-large family, to change lots of habits and environmental flaws in the community. Kids now walk to school as "virtual buses," accompanied by seniors and parents, schools are emphasizing nutrition, truck stop restaurants are offering healthier, portion controlled fare, and the general approach is to walk more, eat more fruits and vegetables and stay productive/enjoy life.

Adult Immunizations...H1N1 Flu...in the news

The increasing incidence of whooping cough in adults tells us that we need to really focus in on adult vaccinations or boosters. It is so clear that when you have a baby, there are a series of vaccinations and re-vaccinations that need to be given during their lifestime. As adults, we seem to forget that some of the protection these vaccinations give us is not lifelong. Tetanus seems to be the only booster shot routinely discussed by adults and their doctors. That means that if you are under the care of a physician, and seeing him once a year for a general health check (or for ongoing disease), you need to review your childhood vaccination schedule and determine if you are indeed, due for some boosters. Every city public health agency has the immunization schedule for adults and kids, so if you do not have a regular doctor, you can access this document and decide if you do need to go into a doctor's office for some shots. The danger of having whooping cough is that if you come in contact with an infant not yet immunized, you can infect the child, for whom this disease can be life-threatening.

The latest H1N1 victim in NY was an 11 year old Brooklyn public school student, who did have a pre-existing heart condition. That brings New York City's death from H1N1 total, to 15. Almost all of the deaths were among people who had pre-existing health issues including obesity, asthma, heart disease, diabetes whch explains the viruses ability to compromise those who already struggle with somewhat serious health conditions. With the official name H1N1 pandemic, the CDC and WHO have now clarified the global import (not virulence) of this virus. Understandably, parents are concerned about the seriousness of this virus, and it is certainly imperative that children and teens with any of the above mentioned health situations be in touch with their doctors immediately, if they believe they have contracted the H1N1 flu.

It's a pandemic....obesity is the top news

It's official that the H1N1 flu has been catagorized as a pandemic - the first global flu epidemic in 41 years. Infections continue to climb in the United States, Europe, Australia, South America and in Hong Kong, schools are officially closed for 2 weeks n response to flu numbers. The recommendations remain the same: wash hands frequently, sneeze and cough into your sleeve and not your hands, stay home if you are sick and avoid sick individuals when possible. If you suspect a complication or if you have ongoing chronic health issues - seek medical help immediately. Tamiflu is still the treatment of choice to reduce symptoms and shorten duration of illness.

Several headlines in the news pertain to obesity:

The diabestes drug, exenatide, when combined with diet and exercise, helped non-diabetic obese patients lose more weight than similar individuals who just received diet and exercise instruction and support. Many doctors feel that drug therapy is an important element of treatment for obesity. Expected drug side effects include mild/moderate nausea and diarrhea (these symptoms were not contributory to the weight loss). The drug seems to decrease food intake because patients feel fuller.

Obese women who suffer with PCOS (polycystic ovarian syndrome) seem to lose weight and do well when their doctors give them diet advice and continue to advise and follow up on them. Many doctors feel ill equipped, pressed for time or fear losing patients if they offer such advice. This study shows that doctors should "give it a try" and offer general advice on diet and exercise after finding a way to broach the subject of their patients weight. Metformin, a diabetes oral drug, can help some of these women maximize their weight loss.

Children who are depressed can exhibit increased levels of the stress hormone, cortisol, another confirmation that obesity and depression can be linked in kids as well as adults. This study confirmed that abnormalities of cortisol play a direct role in both obesity and depression. Doctors should screen obese children for depression and kids with depression should be screened for eating disorders and the possibility of a high risk for developing serious weight gain.

Breast feeding is one of the greatest "health gifts" you can bestow upon your child, and the longer the better. But if mom is choosing to eat high fructose containing foods on a regular basis, mostly in the form of sweetened drinks, during pregnancy and/or breast feeding, then they may be more likely to have children, especially sons, who will be prone to becoming overweight. The actual mechanism may be an induced risk for an unbalanced metabolism, that makes the children susceptible to overeating and becoming overweight.

If your vitamin D levels are within normal limits at the start of a diet, new research shows that you will have more successful weight loss on that lower calorie diet. If you maintain those vitamin D levels or increase them, you may have more success with losing that resistant abdominal fat. In general, experts feel that we all need to target higher daily intake of vitamin D.

It seems that brown fat is a good fat to have, and adults and especially women do have some stores of this fat. This information may help scientists to figure out ways to maintain or even increase our stores of brown fat, which in turn, may help us to lose weight effectively or to maintain a healthy weight.

When choosing a diet, recent research show, a moderate carb diet may be your best choice. Of course, the carb choices you make should include fruits, vegetables, and high fiber/whole grain choices as your primary, portion controlled carb choices.

Weightlifting for ......back pain?

Almost everyone has had an episode of back pain. Most of us have been spared the "excrutiating back injury" or the chronic remnants of pain from an old injury. The old school of thought for treatment of back pain was: bed rest, pain killers and anti-inflammatory agents and "hope for the best." There has been research over the years to suggest that movement restriction can actually cause stiffness and excacerbate the situation, so the newer recommendation was to use bed rest for the very acute stage of injury and pain, and then to slowly begin movement, with medications as necessary. Now, another researchers weighs in with a new study and weightlifiting seems to be the key.

Pushing those sore muscles with weight training and improving overall body strength may reduce back pain and the chronicity of the back pain. In this study of 240 men and women, weightlifting enhanced quality of by as much as 28%, and the more frequent the training, the better the results. The participants had no surgery, and none of them suffered from damaged vertebrae or nerve root problems. Most of the men and women had lower back pain as a result of injury to soft tissue of the lower back. The theory behind the strengthening (of the whole body) is that we tend to injure our backs when we are fatigued, so making our body's strong in general will help us avoid a sudden injury. Also, when you use your back for specific tasks, it still involves using your core or abdominal muscles, bracing with your legs and then having your arms work to possibly lift something or move something. So all body parts are involved and all body parts need to be strong.

Once you have the injury, movement helps you to avoid stiffening and then the overall atrength moves help to substantially reduce injury as the back (and other areas) get stronger. The researcher's approach was to gradually introduce weight workouts and then after several weeks, begin a heavier, more demanding work out. The goal - lifting about 75%-80% of maximum lift ability, so the end point of the exercise plan is challenging, but not dangerous or unreasonable.

For more information on nutrition and exercise and family wellness check out:

www.healthgal.com

www.fatfamiliesthinfamilies.com

Sleep....aging....and a sugar is a sugar

In today's news, it becomes clear that getting your zzzs...or not...has a host of health implications. Want to avoid the risk for high blood pressure? Then it's important to get adequate sleep, and that means restful, good quality sleep. Another area of your life impacted by sleep is your wrinkle destiny. Yes, adequate sleep can help to delay premature wrinkles. I've also heard that sleeping on silk sheets and pillowcases, and trying to sleep on your back is another good habit (still working on those). Finally, cumulative poor sleep patterns can hasten your risk of developing diabetes type 2, especially in the presence of other risk factors.

And about those sugars. though I am strongly in favor of waving the "HFCS (high fructose corn syrup) red flag," because it is so strongly present in processed foods, it is scientifically delusional to think that other sugars are somehow significantly superior. America is struggling with obesity, because we, as a nation, have totally lost our ability to assess portion size and we are simply eating too many foods high in fat, sodium and sugars (of any kind). We also eat way too much meat-based protein and we don't exercise enough. That being said, it is clear that gaining and losing weight is an extremely difficult endeavor, complicated by entrenched habits and emotional cues, as well as some contribution of genetic and familial destiny. Most of us cannot simply "willpower our way" to sustained weight loss. It requires behavior modification, a diet and exercise plan that stays in place after you hit "goal weight," and utilizing health professionals either full time or part time to enable our education and progress.

CA takes a giant leap regulating child-care center food

NY has led the way to a certain extent, on city-wide and state-wide changes, that impact the health of those individuals who live there. There are smoking bans, a recent requirement to post full nutritional breakdowns at fast food chains and city-wide efforts to maintain walking and running paths. California also has made an effort to promote healthful living, with no-smoking bans, and now a new bill has been proposed by Assemblywoman Julia Brownely (D-Santa Monica) to require child-care centers to follow certain minimal nutrition standards.

Specifically the bill, AB 627, would require that child-care centers:

• Serve low fat or fat free milk (not whole milk) to children over age 2


• Limit the use of sugary cereals


• Eliminate sweetened drinks


• Eliminate deep frying any foods

The bill would also establish an 18 month pilot program to evaluate the impact of implementing stronger nutrition and physical activity standards. Since child care centers, churches, community centers and other services may be locations that routinely serve more than one meal a day to chilkdren, these are places where quality of nutrition needs to be evaluated and then changed or modified based on assessments. There are better choices than fried potatoes, fruit in canned syrup, whole milk and other processed foods - and any increased expenditures for healthier food choices, can be offset with creative purchasing and bulk product opportunities.

Right now 350,000 children age 5 and under at least part time, if not full time, in child care. Los Angeles county 2230 child-care centers and 7800 family child-care centers. Those in favor of the bill feel that any center that gets federal funds, should have to comply with certain nutrition standards. Additionally, it is felt that these eating patterns establish lifelong adult patterns - so this intervention may help to impact and shift eating patterns and choices to healthier ones, long term. Currently 20.7% of the country's pre-schoolers are obese and 25% of kids ages 2-5 in California overweight or obese. A bill like this may be imperative, and currently only West Virginia and Michigan require that child-care centers in their respective states comply with federal dietary guidelines.. If the bill is passed, compliance would be required starting January of 2011, though no specific penalties would be imposed for non-compliance.

Antioxidants...yo-yo dieting...Kelly Clarkson

In the news today was an interesting study regarding anti-oxidant supplements and the beneficial impact of exercise on insulin levels. Exercise has a very positive impact on our health, and when it comes to diabetes, it is both a weapon to prevent the risk and a weapon to reduce the severity of the disease. Eating fruits and vegetables, that are rich in anti-oxidants, is considered another key to preventing diabetes or managing it if you have the disease. But this new study showed that taking anti-oxidants like vitamin C and E actually blunts the beneficial impact of the exercise on insulin levels. This may be one of the many cases where vitamins sourced from food behave differently when they are taken as manufactured supplements. Always choose foods over supplements when it comes to vitamins. there are cases when we cannot get enough vitamins from food, and then your doctor can determine which supplements you need. (Source, Journal Watch General Medicine, June 4, 2009;citation http://dx.doi.org/10.1073/pnas.0903485106)

There are alot of opinions regarding weight cycling or yo-yo dieting. Many experts and health professionals feel that an increasing/decreasing/increasing again burden of weight, can impact the heart negatively. Others say, keep trying to lose the weight, even if you have some weight gains and losses and gains again - overall, it is better to keep trying to get the excess weight off. A new study suggests that weight cycling does not increase mortality in middle-aged or older women. So the conclusion would be that you should persist in dieting and trying to get excess weight off, especially if you have risk factors for disease or frank disease. Hiring a personal trainer and/or nutritionist and allowing them to work as a team to help you (and your doctor) is one approach that might reduce the yo-yo dieting cycle, especially if you continue the relationship during early months after you hit goal weight.

Kelly Clarkson does not seem to be able to escape the weight discussion that fills the tabloids. In fact, she is "tired of hearing the fat joke." It's been going on for seven years, ever since she became the first American Idol and started her music career. She has always admitted to loving food and says she is just fine with her body. I cannot imagine the pressure of scrutiny that most high profile individuals are forced to endure. It's almost impossible to "feel pretty" when the measuring stick is so daunting. The reality is that most healthy people do not have picture perfect bodies. If they are well nourished with great energy stores they will appear clear eyed and energetic but they may not be size 4, nor perfectly proportioned and they may have cellulite. Healthy does not equal skinny. It does mean that you should know if your weight is in a safe range for your height and it does mean that your blood sugar, cholesterol, blood pressure and waist measurement should all be "healthy numbers." Let's let Kelly make that personal determination on her own.

Obesity...Food...Fiber

Today's news covers a road range of topics all under the "food and weight" sector.

Kellogs is adding fiber to its kid targetted cereals, namely Froot Loops and Apples Jacks, with other kid favorite selections to follow. By 2010 most of the kid line will have at least 3 grams of fiber/per serving. Fiber inclusion seems to be what consumers are demanding. Let me point out that 3 grams of fiber is pretty puny if you are only choosing cereal as your daily source of fiber. Certainly Bran Buds, Wheat Germ and other cereals are far better choices to even mix in with your favorite cereal in order to target more than 3 grams of fiber at breakfast. Another "boost the fiber option" is to add 1/2 cup of berries. Of course, you should also be choosing whole grain/high fiber breads at lunchtime, and whole grain side dishes for dinner. And no insult to Frito-Lay, but their recent effort to adress this consumer request, has resulted in a new campaign of SmartFood snacks, and it is really a camoflage approachto get you to somehow justify a poor snack choice - by adding in a small amount of fiber to the food. Snacks should taste good and be good for you and my "super snack" list would include nuts, fat free yogurt, small smoothies made with fresh fruit and soy milk, cut up vegetables and hummus or bean dip (if you crave a crunch) or fruit plus a small serving of low fat cheese - not chips with added fiber. Really.........

Wherever fast food is a "new option" (like in Bulgaria), consumers say that would rather add in exercise than give up the fast food delight. New "fast food love" is tough to abandon according to some new statistics. In the US people admitted to eating junk food when they are down, trying to exercise to compensate for bad eating/health habits, while fewer admit to "eating whatever they want." And how often do we weigh ourselves here in the US? In this study, on average, 5% weigh daily, 10% once every couple of days, 13% once a week, 7% whever they feel their clothes are getting tighter, 19% not at all.

Finally a new weight reduction surgery is coming to the US - and it is less invasive. Doctors will soon be able to pass a somewhat thick tube down your throat and position staples in the stomach, that will create a narrowed passage, slowing food transit and making you feel full faster, with less food. Candidates are showing marked weight loss outside the US with this new surgical approach, and test subjects in the US are also having weight loss success.

Gastronomic Bombs

The Center for Science in the Public Interest puts out lists of foods that they deem "true offenders" of our health. The CSPI calls them Xtreme Eating (opportunities) and makes it clear that even if you follow a healthy diet most of the time - these eating splurges are so unhealthy that they jeopardize your health "in the moment," possibly putting you at risk for a sudden heart attack or stroke (especially if you already have strong risk factors for disease).

So what made their short list this year??

• Applebee's Quesadilla Burger with 1820 calories, 45 grams of saturated fat and 4410 mgs. of sodium


• Olive Garden's Tour of Italy with 1450 calories, 33 grams of fat and 3830 mgs. of sodium


• The Cheesecake Factory Fried Macaroni and Cheese with 1570 calories, 69 grams of saturated fat and 1860 mgs. sodium.

The key here is to understand that a small food splurge is one thing; eating a meal that has an enormous dose of saturated fat and/or sodium and or big dose of calories to boot is asking for a "health crisis on a silver platter."

Gardasil and Bio-identical Hormones

Recent testing seems to reveal that using the HPV vaccine (Gardasil) in young women ages 24-40, who show no signs of HPV, may have a significant protective effect. Since this group is at high risk for HPV (considered a risk for cervical cancer) exposure, this new application to safeguard a significant part of the female population from contracting HPV. The caveat is that you have to be tested to make sure that the cost of the vaccine is warranted, since many women in this age group may have already contracted HPV. If you have HPV, the vaccine offers no benefits.

Many women fail to realize that bio-identical hormones are not regulated by the FDA. The testing done to determine your bio-identical hormone needs is not standardized. And the bio-identical hormones have their own benefits and risks - this is not an innocuous treatment. Purity and inconsistency of doses is also a significant problem in this industry, and this can offer additional risk to patients.

Tamoxifen..Lung cancer..Anti-depressants..Hormone therapy

In the news today, researchers have found additional troubling news about hormone therapy. Studies indicate that lung cancer seems to be more fatal in women taking hormone therapy (estrogen-progestin combination). Smokers currently taking HT should be weaned off, and those thinking about taking hormones should be discouraged, based on these new findings. If HT is used, the lowest dose for the shortest period should be used in these female smokers. Researchers are planning to take a look at those women just using estrogen, to see whether it alone, without progestin, causes the same higher rate of lung cancer fatalities. Lung cancer is the world's top cancer killer with more than 162,000 deaths in the US last year.

Breast cancer survivors who take Tamoxifen should be cautious in their choice of anti-depressant use. A new report found that Prozac, Paxil and Zoloft can interfere with the benefits of the Tamoxifen, wiping out it therapeutic effect completely. This puts those women at a higher rate of breast cancer recurrence. Since not all anti-depressants confound the Tamoxifen benefits, doctors should carefully assess the anti-depressant choice.