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December 2007 - Posts

  • Medical Myths

    Happy New Year, everyone!  Welcome to 2008!  I hope everyone had a good holiday.

    I'm going to start the year off by telling you about 7 common medical myths out there.  Aaron Carroll, a pediatrician at the Regenstrief Institute in Indianapolis, and Rachel Vreeman, a pediatrician at the Indiana University School of Medicine, recently published a letter in the British Medical Journal.  In this letter, they outlined 7 myths that many people, including many doctors and other health professionals, believe.  So let's take a look at these myths and debunk them, shall we?

    1.  People should drink at least 8 glasses of water a day

     

    Nobody knows for certain where this common recommendation came from.  However, it's not based on any hard scientific evidence.

    We used to preach this recommendation in 20/20, but after reviewing the scientific evidence, we changed our recommendation to 6-8 glasses per day.  Where did we come up with this recommendation?  Well, the standard recommendation is 1 milliliter of water for every calorie of energy you expend each day.  We estimated that the men in 20/20 are expending, on average, about 2,750 calories per day, and the women are expending about 2,450 calories per day.  Thus, the water recommendation for men is 2,750 milliters per day, and it's 2,450 milliters for women.  If we estimated that you get about 1,000 milliters of water from the food you eat, this leaves 1,750 milliters (about 7 glasses) for the men and 1,450 milliters (about 6 glasses) for women.  There are also epidemiological studies that suggest that 6-8 cups are associated with a lower risk of bladder cancer and kidney stones.  So, we set our recommendation at 6-8 cups.  There is no need to exceed 8 cups, with the exception of frequent exercise in extremely hot and humid environments, where greater water intakes may sometimes be necessary.

     2.  We only use 10% of our brains

     

    Here we have a case of communal reinforcement.  People have been spouting this "fact" since 1907, and nobody has bothered to question it.  Yet, numerous brain imaging studies show that no area of the brain is completely silent or inactive.

    3.  Hair and fingernails continue to grow after death

    Sounds creepy, but it's not true.  After death, your skin dries out and retracts, which gives the appearance that your fingernails and hair are growing.  But they aren't.  Hair and fingernail growth require complex hormonal regulation that stops after death.

    4.  Shaving hair causes it to grow back faster, darker, or coarser

     

    Clinical studies have shown that shaving hair does not make it grow back faster, darker, or coarser.  Like myth #3, it's all an illusion.  Shaved hair lacks the finer taper seen at the ends of unshaven hair, giving the impression of coarseness.  Also, the new hair has not been lightened by exposure to sun or other chemicals, giving it a darker appearance.

    5.  Reading in dim light ruins your eyesight

     

    Every time I'm reading, my grandmother is alwasy telling me, "You need more light.  You're going to ruin your eyes!"  But there is no scientific evidence that this is true.  While it can cause temporary eyestrain, there is no evidence that there is permanent change in the structure or function of the eyes.

    6.  Eating turkey makes people especially drowsy

     

    People say this because turkey contains tryptophan, an amino acid that is involved in sleep and mood control, and can cause drowsiness.  However, turkey does not contain an exceptional amount of tryptophan.  In fact, it has no more tryptophan than other types of meat.  Pork and cheese has more tryptophan than turkey!  Also, the presence of other food at a holiday meal will slow the absorption of tryptophan.  Finally, the presence of other amino acids in the meat will compete with tryptophan for crossing the blood-brain barrier.

    The reason you become sleepy after a holiday meal is because large meals decrease blood flow and oxygenation to the brain.  That glass of wine that you had with dinner may also have something to do with your drowsiness.

    7.  Mobile phones create dangerous electromagnetic interference in hospitals

    This one is more controversial, but there is not one reported case of a death caused by the use of a cell phone in a hospital.  There have been occasional reports of things like incorrect readings on cardiac monitors or false alarms.  In a study out of the Mayo Clinic in 2005, researchers did 510 tests with 16 medical devices and 6 cell phones.  They found the incidence of clinically important interference was only 1.2%.  Other studies have had similar results, showing minimal interference that only occurs when cell phones are used in less than 1 meter from equipment.  Other studies have found no interference when cell phones were used in a "normal way".  So, while there is some evidence that cell phones can create some weak interference in some instances, there's no evidence they are dangerous when used in a normal way in a hosptial setting.  Despite this myth, many hospitals have banned the use of cell phones.

     

    So there you have it.  So the next time someone tells you that you only use 10% of your brain, ask them where the other 90% went :)

     

    Posted Dec 31 2007, 10:26 AM by jkrieger with 6 comment(s)
  • The Biggest Loser Finale

    So did anyone catch the Biggest Loser finale on Tuesday night?

    Looks like both twins won.  Jim won out of all the eliminated players, and Bill won the entire thing.

    I was happy to see both the twins win.  They both worked very hard throughout the show, and I liked their attitudes.

    Also, Julie and Hollie made some pretty tremendous progress during the time from the last episode to the finale.  At the last episode, I wasn't all that impressed with them....but they certainly put the pedal to the metal those last 3 months.

    Although I've been critical of the show in past blogs, I'm going to say some good things for once.  I do admire the fact that it shows that significant weight loss is possible with lifestyle changes, no matter how heavy you are.  Many people think, once they've gotten that heavy, that there's no way they can lose a significant amount of weight...that they will be destined to be that way.  Some people resort to surgery or drugs to try to lose weight...often solutions that don't work very well over the long-term.  But this show proves to the nation that, if you really put the effort into changing your lifestyle, you can make significant changes to your weight and your life.

     

    Posted Dec 20 2007, 08:56 AM by jkrieger with no comments
  • Antioxidant Wars

    Happy Holidays, everyone!

    Last month I came across an article on FoodNavigator talking about a new antioxidant test.  For those of you who don't know, antioxidants are substances that help prevent the process of oxidation.  Oxidation is where things called free radicals go around your body and take electrons from various molecules in your cells.  Oxidation has been implicated in many diseases, such as heart disease.  Oxidation also contributes to the aging process.  For example, oxidation (which can be caused by the environment, sun exposure, and tobacco smoke) accelerates the aging of your skin.

    But let's get back to this new antioxidant test.  In the past, scientists have used a variety of tests to determine a substance's antioxidant capacity.  Names of these tests include the FRAP, ORAC, and TEAC tests.  Yes, all of those acronyms stand for something, but I'm not going to bother you with a bunch of long-winded technical terms.

    The thing with these tests is that they're usually done in a test tube.  The problem with that is that, just because something is a good antioxidant in a test-tube, doesn't mean it's a good antioxidant in the body.

    Well, this new test, called the CAA, tests a substance's antioxidant activity inside cells.  This makes it more relevant to how an antioxidant works in the body.

    Some scientists recently used the CAA to test some fruit extracts.

    And the winner is....

    Blueberries!

    Out of the fruit extracts tested, wild blueberries had the highest antioxidant activity.  The tested fruits ranked as follows:

    1. Blueberries
    2. Cranberries
    3. Apples
    4. Red grapes
    5. Green grapes

    So, if you're putting berries in your 20/20 shakes, you're getting a nice dose of antioxidants.  Really, you can't go wrong with any type of fruit, but berries are going to top the list if it's antioxidants you're after. 

    On a side note, make sure you watch the final episode of the Biggest Loser tonight!  I'll write about it later in the week.

    Posted Dec 18 2007, 09:31 AM by jkrieger with 2 comment(s)
  • More BL and TV ramblings...

    Tuesday night was the second to last episode of this season's Biggest Loser.

    Neil, the last remaining member of the blue team, was eliminated.

    Looks like karma finally came back to haunt Neil.  Remember, he's the one who resorted to gaining weight to avoid elimination in an earlier episode.

    I thought the challenge they did was cool.  They had to drag giant scales carrying the amount of weight they had lost to a giant pit and throw it all inside.

    It sure helps put things in perspective of how much weight these people had been carrying on their bodies.

    Also, is it just me, or is the list of competitors remaining not all that impressive?  With the exception of Bill, I'm not all that impressed by the remaining competitors.  The more impressive, hard-working competitors like Kae and others are all gone.

    Speaking of television, I caught a commercial for Alli, the only OTC weight loss drug.  Alli is basically a half-dose of the prescription weight loss drug orlistat (Xenical), which I wrote about in a previous blog.

    In the commercial, they said that people taking Alli lost twice as much weight as people who were just on a diet.  Well, people who usually just diet with no other lifestyle change don't lose much weight...so it doesn't sound like Alli is anything to get excited about.

    In the previous blog, I mentioned that people taking the full dose of orlistat only lost 6.6 pounds over a 1-4 year period.  Alli is only half the dose, which means you're only getting maybe an extra 3 pounds over the same period.  Alli costs about $2 per day.  So, for $730 a year, you get to lose 3 pounds.  That's $243 per pound.

    And for that money, you get these awesome side effects:

    • Gas with oily discharge
    • Loose stools or diarrhea
    • More frequent bowel movements
    • Hard-to-control bowel movements

    Not only that, but to keep those 3 pounds from coming back, you have to stay on the drug indefinitely.

    Sounds like a great deal!  Sign me up :)

     

    Posted Dec 14 2007, 10:34 AM by jkrieger with no comments
  • Sugar is still sugar

    Take a good look at the ingredients of any can of non-diet soda, or any juice that is not "100%" fruit juice.  You'll usually see the ingredient high-fructose corn syrup (HFCS). 

     

    HFCS is basically a type of sugar.  In fact, it is a mixture of sugars...glucose and fructose, specifically.  HFCS consumption increased dramatically in the U.S. from the late 1970's to the early 1980's.

    Obesity also increased during this time period, tracking the increase in HFCS.

    This has led a lot of people to blame HFCS on the explosion of obesity in the U.S.

    However, remember in a previous blog where I talked about the *** hoc, ergo propter hoc ("with this, therefore because of this") fallacy.  Just because ice cream intake goes up in the summer, and drowning incidence goes up in the summer, doesn't mean that eating ice cream makes you drown.  Likewise, just because HFCS consumption goes up, and obesity goes up, does not mean one caused the other.  Household income has increased just like obesity has....so does that mean making more money makes you fat?

     

    So what am I getting at here?  Well, a study was just published in the December issue of the American Journal of Clinical Nutrition, comparing the effects of drinks sweetened with HFCS to drinks sweetened with sucrose (regular table sugar).  The researchers had subjects consume a 360 calorie drink sweetened with either HFCS or sucrose.  The subjects then rated their appetite an hour later, and ate a test meal.  The researchers measured how much the people ate at the test meal.  They found no differences between the sugars in their effects on appetite or on how much the subjects ate.

    I'm bringing this up because some people have tried to argue that HFCS is somehow worse than plain table sugar.  Not only will they point out the data above, they'll also point out how research shows fructose to disrupt appetite regulation more than other sugars.  But here's the problem....a lot of this research compares pure fructose to other sugars.  HFCS is not pure fructose.  The HFCS you find in drinks is 55% fructose and the rest glucose.  By comparison, sucrose is 50% glucose and 50% fructose.  So there really isn't much difference between the two.  In fact, the only real difference is that the glucose and fructose in normal table sugar are bound together, while the glucose and fructose in HFCS are not.  However, there is no difference in the way the two are metabolized by the body.  Also, when you put sucrose in an acidic solution like in a soft drink, it is broken down into glucose and fructose, making it no different from HFCS.

    Now, I'm not saying that HFCS is healthy for you.  I'm only saying that it is no worse than plain table sugar.  Too much of either one will have negative effects on your health.  But it is clear that the increase in HFCS in our food supply is not causing obesity.  In fact, HFCS consumption plateaued from 1997 to 2004, while obesity continued to grow.  If HFCS had never replaced sugar in our food supply, our society would still be just as obese as it is now.  Sugar is still sugar, whether it's HFCS, table sugar, evaporated cane juice, honey, or the various other forms you'll find it in.

     

     

     

     

    Posted Dec 10 2007, 01:00 PM by jkrieger with 2 comment(s)
  • Not-so-miracle Pills

    Wouldn't it be nice if we could all just pop a pill and we could lose weight?

    In the never-ending search for lose-weight-quick schemes, both people and drug companies have been looking for that pill that will take off the pounds.

    There are currently three prescription drugs on the market that are marketed weight loss:  orlistat,sibutramine, and rimonabant.  Orlistat (Xenical) prevents fat digestion.  Sibutramine (Meridia) and rimonabant (Accomplia) reduce appetite by interfering with signals that go to the brain to make us hungry.  In fact, rimonabant works by blocking the receptors in the brain that are responsible for the marijuana-induced munchies.

    A big meta-analysis (a study of studies) was recently published in the British Medical Journal, evaluating the effects of these drugs.  After using these drugs for a period of 1-4 years, people lost an average of 11 pounds.  That's not much for a 1-4 year period.  People on 20/20 lose that much in 1-4 weeks...without the side effects.

    The average weight loss for orlistat was 6.6 pounds, while 30% of the patients on the drug had unpleasant intestinal side effects, like incontinence.  People on sibutramine lost an average of 20 pounds, and 20% of patients had side effects such as elevated blood pressure and heart rates, insomnia, and nausea.  People on rimonabant lost an average of 11 pounds, but also had an increased risk of psychiatric problems.

    The drop-out rates in the studies on these drugs was huge....30-40%.

    To be fair, the study did find that improvements in diabetes incidence, as well as improvements in blood lipids, blood pressure, blood sugar control, and cardiovascular disease risk.  But unfortunately, those improvements came with a price...in side effects, and in money.

    These drugs are a big industry.  In 2005, global sales totaled $1.2 billion.  That's a lot of money for a little weight loss. 

    You can't trick your body into losing weight with a drug.  Your body has dozens of mechanisms for regulating appetite and body weight.  If you try to alter one mechanism, other mechanisms will take over.  This is why drugs don't work very well.  You would have to take dozens of drugs to take care of all the mechanisms your body has for regulating your weight.  And then, you would have to take more drugs to take care of the side effects from the drugs you are already on.

    We'll never win the war on obesity with drugs.  The only winners will be drug companies.  The losers will be us, because we will be spending a lot of money for modest weight loss at best, and we will be paying for side effects.  And this myth that we can successfully battle obesity with drugs will be perpetuated.

    You can't fool mother nature with a drug.  The answer to obesity always has been, and always will be lifestyle change.  There is no other way.

    I will step off my soapbox now....err, I mean soap-blog.

     

    Posted Dec 07 2007, 03:28 PM by jkrieger with 3 comment(s)
  • Pedometer Plug

    Hey, everyone!  For you Northwest readers, I hope you're not getting too wet today with the record rainfall we're getting right now. 

    In a previous blog I mentioned the importance of walking, and how total daily activity (not just formal exercise) is very important in your quest to lose weight and keep it off.

    Well, pedometers are a good way to track how much you're walking per day. 

    An article was just published in the November 21st issue of the Journal of the American Medical Association, showing the benefits of pedometers.  The article was a meta-analysis, meaning that the researchers took a big group of past studies and analyzed them together, getting an idea of what the general consensus was among all the studies.

    The researchers found that, when people wore a pedometer, they walked an extra 2,491 steps per day on average as compared to people that didn't wear a pedometer.  Basically, just wearing a pedometer encourages you to walk around more.

    Let's look at how much extra calories you'll expend with an extra 2,491 steps per day.  If you take about 2 feet per step, that's close to 5,000 feet per day, or about a mile.  If you're 200 pounds, that's an extra 120 calories per day to cover that extra mile.  Over a year's time, that's 120 x 365 days = 43,800 calories.  If we assume 3,500 calories in a pound of fat, that's 12.5 pounds of weight loss per year by just wearing a pedometer and walking those extra 2,500 steps per day.

    The researchers also found that people who had a specific step goal (like 10,000 steps per day) were more likely to increase their physical activity than people who did not have a goal.  Also, people who wore pedometers decreased their body mass index (BMI) by 0.38, and their systolic blood pressure by 3.8 mm Hg.

    So, pedometers are a cheap and easy way to help you increase your overall walking each day.  Not all pedometers are created equal.  Some are more accurate than others.  I highly recommend Omron pedometers, as they've been shown in both research studies and Consumer Reports to be among the most accurate.

     

    Posted Dec 03 2007, 02:52 PM by jkrieger with 2 comment(s)
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