Realistic Resolutions for 2011

Welcome to the first Monday of 2011! Have you set any New Year's resolutions yet? Broken any yet? Let me encourage you to pick one or two HEALTHY resolutions that you can stick to-not just for 2011, but for your entire future.
Weight loss is a priority for the majority of Americans. However, often that means a strict, very low calorie diet (and the emotional misery that arrives as a side dish). Not surprisingly, this method rarely works. What might be a better choice?

How about committing to one of these simple changes:

1. Substitute a GLASS OF WATER for one other beverage (soda, coffee, etc.)
2. ADD one piece of fruit to your breakfast (a banana, or a handful of berries)
3. Eat FISH for at least one meal per week
4. Take a fruit or vegetable SNACK with you to work each day- and EAT IT (instead of vending food fare)

I realize these seem simple, but making these changes a HABIT will lead to a lifetime of benefit! For example, if you drink one can of soda per day, then swapping water for that can will create a caloric deficit that equals 14 POUNDS in one year! Now that is something to toast!

BOTTOM LINE: Set yourself up for success and make at least one CONCRETE HEALTHY CHANGE in 2011!

Amazing Weight Loss & the Acai Berry

Happy 2011! I hope your New Year's Resolutions include steps towards GOOD HEALTH this year! I am enjoying a snowy vacation in gorgeous Crested Butte, Colorado, this week. As I checked the weather report to decide on layers of clothing this morning, my attention was caught by a news headline by a Crested Butte health reporter.

The report was part of a series about effective weight loss strategies. I was immediately sucked in by the reporter's frank style and her admission that she was skeptical about different weight loss claims. She and the News 5 team decided to do their own trial, and guess what? She LOST 25 POUNDS in a MONTH, and looks slim and sexy with NO CHANGE in her diet! WOW!

Okay, wake up and smell the coffee! Of course, this is a SCAM and and AD to buy the berries. Unfortunately, it is SO CONVINCING that despite knowing the numbers and facts couldn't add up, I initially thought it was real, and that the reporter was simply exaggerating. The site looks amazingly valid, and she appears to be a legitimate health reporter. If you start to research the reporter, however, you quickly discover that no such reporter exists-ANYWHERE. This ACAI berry distributor simply created multiple websites under the names News5Health.com (and News6, and News7, etc.)

What is the truth?
1. You need a deficit of 3600 calories to lose a pound. Period. At burning (or not consuming) 500 calories per day, that is a pound of weight loss per week, which is terrific weight loss.
2. We do NOT have "gunk" lining our guts and creating "toxins". If we did, everyone who has a colonoscopy would be "cured" of obesity!
3. It's CALORIES IN vs. CALORIES OUT that creates weight loss or gain!

BOTTOM LINE: BEWARE OF WEIGHT LOSS SCAMS POSING AS NEWS REPORTS, especially the ACAI berry. Eat more fruits and vegetables and start moving more to lose weight in 2011!

MORE Losing Holiday Weight

Tip number two for losing that holiday weight is another common sense solution- GET SOME REST! A study published in the Annals of Internal Medicine this year compared weight loss between a group that followed a low calorie diet and had only an average of 5.5 hours of sleep per night versus a group that followed the same diet and averaged 8.5 hours of nightly sleep.
It may surprise you that not only did the people with more sleep had more weight loss, but they also had greater reduction in body fat and in HUNGER.

Scientists are not sure of exactly how more sleep resets your hunger thermostat or changes your metabolism, but we certainly know that less sleep stresses your body, which is not conducive to better health. If you struggle with INSOMNIA as the reason for your lack of sleep, make sure you are having good sleep hygiene (keeping a regular bed time, not watching tv or doing computer right before bed, etc.) and limiting or avoiding caffeine and alcohol. Check out my blog on covering the clock, and make an appointment with your doctor if you cannot restore good sleep on your own.

BOTTOM LINE: Make sure you are getting at least 8 hours of sleep to maximize your success with losing those extra holiday pounds!

Calcium: Adequate serum calcium is needed for fecal fat excretion. Observational data has shown that those who supplement their diet with calcium have lower levels of body fat. This systematic review found supplementation of about 1,200 mg of calcium per day leads to an increase in fecal fat excretion. Obes Rev 2009; 10(4): 475-86



Sleep: A very small pilot study compared a low calorie diet and either 5.5 hours of sleep vs 8.5 hours over 14 days. Those who slept more had greater loss of weight and body fat, and, among other things, less hunger. The authors postulate it was due to the neuroendocrine changes decreased sleep induces. Ann Intern Med 2010; 153: 435-441

Chronic PPIs: When used chronically, PPIs are associated with pneumonia, C. diff infection and other problems. This case control study found obesity developed in patients with GERD who were treated chronically with PPIs vs other treatments World J Gastro 2009; 15(38): 4794-4798.

Losing that Holiday Weight

Borrowing from my editor-in-chief's blog (Dr. Frank Domino) at the 5-Minute Consult, I'd like to share some tips this week to help you lose that extra weight you picked up over the holidays. Remember, the average American unfortunately gains close to 10 pounds between Thanksgiving and New Year's, so if your pants are fitting a bit tootight, you are not alone!

First of all, a simple trick models have known for years: DRINK WATER!! A trial of obese adults (published in the journal Obesity this year) showed that people who drank 16 oz of water before each meal along with following a low calorie diet lost >4 pounds MORE than the group that simply followed the same low calorie diet.

Often, we think we are hungry when we are really thirsty, so focusing on this simple tip of drinking a couple glasses of water with each meal will help you recognize what your body is really craving.

BOTTOM LINE: Add TWO 8 oz glasses of water to breakfast, lunch and dinner to help lose some of that holiday waistline!

Skier's Toe

Ever been skiing and noticed your toenail had turned black and incredibly painful at the end of the day? Was it black in part or all of the nail? This is a very common injury from skiing, and in fact, is often referred to as a "skier's toe".

The medical term is a subungual hematoma, which simply means bleeding under the nail. This can occur from a single instance of trauma like dropping something on your toe, or from small, repetitive trauma like a too-small or too-big (so your foot slams back and forth) ski boot.

The good news is that this can be quickly remedied in a clinic if you head in within hours or a day of noticing the black nail. If you wait several days trying to tough it out, we have less success treating the nail. The doctor typically burns a tiny hole in the nail, which allows the drop or two of blood to come out. (Sorry for the yucky description, but that's what we do.)

The BETTER news is that again, PREVENTION is key! Make sure your ski boots fit properly- don't cram your foot into a friend's boots- and be sure your socks are not bunched up. This painful injury does NOT occur if your shoes/boots fit correctly!

BOTTOM LINE: Make sure your ski boots and socks fit properly, and avoid getting skier's toe!

Going Skiing?

Are you headed to the mountains for some skiing this winter? The powder is definitely calling, especially after the huge storms we've had this week! One unexpected and unhappy surprise of a mountain vacation can be the development of symptoms of altitude sickness.

When does it start?
-usually within the first 24 hours, and often as early as the first few hours after arrival.

What are the common signs?
-MIld to moderate:Headache, decreased appetite or nausea, insomnia, and lightheadedness
-Severe: All of the above plus vomiting and shortness of breath

Treatment?
Ultimately, going to a lower elevation will relieve symptoms, but rest and hydration will alleviate most mild symptoms. For persistent or worsening symptoms, head to a clinic for possible oxygen and medications.

PREVENTION:
Hydration and avoidance of diuretics like CAFFEINE and ALCOHOL, especially the first few days.
SLOW ASCENT if possible (driving up to the mountains is lower risk than flying).
If you have had altitude sickness previously, see your doctor and consider prophylactic medications (acetazolamide or steroids).

BOTTOM LINE: Don't let the mountains take your breath away- plan ahead to prevent altitude sickness!

Mixing Drinks & Medications?

People have become increasingly cavalier about mixing medications. In our age of polypharmacy, we think nothing of taking this pill for our heartburn, plus this one for ADD, and that one for anxiety and depression. In fact, our doctors prescribe these combinations all the time, usually with good reasons and positive effects.

Why am I writing about this? Because there are (at least) two major problems that result from this mindset.

1. People like to SHARE. We want to help our friends, and often people share their PRESCRIPTION medications-from saved up antibiotics, to cough suppressants, pain pills and anxiety medications. When you remove the medical professionals (both providers and the pharmacy team) from the equation, there are no checks and balances to watch out for drug interactions.

2. People forget ALCOHOL is a drug. Especially this time of year, alcohol is offered and consumed without a second thought to whether or not it might interact with prescription medications. The most DANGEROUS combinations are ALCOHOL, NARCOTICS (pain pills and cough suppressants) and ANXIETY MEDICATIONS (like Xanax/Valium, etc.) Please note- your SLEEPING PILL falls into this category as well!
In this case, 1 +1= 3 or more, as the additive effects are much greater than the individual effects simply combined. In particular, you can STOP BREATHING when you combine these drugs. And BREATHING is good, right?

PLEASE, before you toast the season, picture your prescription bottles sitting in your drink. Is this MIXED DRINK safe?

BOTTOM LINE: PLEASE, do NOT share prescription medications, and do not COMBINE alcohol, narcotics, and/or other sedatives!