When most people awaken to see the after-effects of a mammoth blizzard, their thoughts don't drift to visions of physicians from long-ago, trudging through mountains of snow to see a sick patient or comfort those suffering from chronic illnesses. But that's what preoccupied me this morning after New York City was blanketed with a titanic storm that has since moved northward.
Such a country doctor was one of my role models, albeit a fictitious one: Dr. Astrov, the world-weary, philosophical character in Uncle Vanya by Anton Chekhov, himself a country doctor. When I looked out my West Village window and saw the entire street blockaded by snow in every direction, walled off to traffic, devoid of pathways for pedestrians, I thought of those heroic "primary-care physicians" in Czarist Russia whose never heard the words "co-payment", "deductible', or "referral."
They were men on a mission of mercy, and nothing would stand between them and human suffering. Dr. Astrov seemingly gives up his whole life for his professional responsibilities; he's unlucky in love and sometimes the patients can't pay. My first and best Dr, Astrov was the incredible George C. Scott, and Julie Christie was the girl that got away ! Talk about dedication ! Seeing those actors in 1973 and experiencing Chekhov's bittersweet musings gave me a taste of what it's like to be a physician, even 100 years and thousands of miles away.
Dr. Astrov might have carried his "little black bag" dozens of miles in sub-freezing temperatures, armed with what we would now consider primitive medications and tools. There were no antibiotics, X-rays, or blood tests. Although superficially understood, heart disease, diabetes, and
hypertension were decades away from adequate treatments. The rural doctor like Dr. Astrov was essentially a general practitioner with experience in orthopedics, surgery, internal medicine, and sometimes pediatrics--something utterly impossible today.
A very real general practitioner in my family, my only close relative who was also a physician, was my great-uncle Abe Fischer. He inspired me for many years, first as a frequent visitor to our home and then as an attendee at conferences at Maimonides Medical Center during the years of my internal medicine residency (1980-83). He looked like a character from a Chekhov play, with theatrical eyebrows and a Freudian goatee. Uncle Abe would immediately sit himself at the head of the table when he came for dinner--the doctor was an honored member of society and thus the immediate focus of attention at family gatherings. He would automatically become the principal conversationalist, and Uncle Abe had plenty of stories to tell.
Some of these stories were about various A-level patients he had treated, such as Al Capone, "Dutch" Schultz, and Maria Callas (during her childhood in Boro Park, Brooklyn). More often, the stories were about his difficult early years as a physician-in-training. In the 1920's, internships at Maimonides Medical Center (then Israel Zion Hospital) were a precious commodity; in contrast to my starting salary in 1980 of $25, 000 per year, Uncle Abe had a salary, as he put it, of -$110 per month----the fee he had to pay for room and board. I was on-call every three nights for a continuous 33 hours for three years. Uncle Abe was on-call every single night for three years. And when things were "slow" in the hospital, the medical residents had to ride the ambulance.
Such a schedule is unthinkable today. So is that type of dedication, empathy, "bedside manner," integrity, and love of humanity. Uncle Abe was perhaps my greatest inspiration, and I can only hope that I have done something analogous over my own 30-year career as a physician. Bad weather would never have slowed him down, and he would regularly make all-weather housecalls during the Great Depression (the fee was a chicken). I assume that Dr. Astrov--and Dr. Chekhov--would have done the same (and the fee would have been similar).
Wading through hip-high snow, scaling mini-mountains from one plowed street onto another, dodging icicles, braving frigid blasts of cold air---that's the least I can do to commune with the spirits of those sublimely inspired healers who forged a path for me. I thought of them as I bundled up this morning and headed for my office, one of very few souls in my neighborhood to even venture outside. And I thought about the life of world-weary Chekhovian physicians, those amazing role-models that captured my imagination decades ago. I remember them now. But who will remember me?
Monday, December 27, 2010
Monday, November 22, 2010
Notes on "The Park Avenue Diet Show: Inflammation: an Introduction"; November 21, 2010
The inflammatory response is the body's way of protecting us when infections or injuries threaten our health. The biochemistry is extremely complex, involving many different chemical mediators (prostaglandins, leukotrienes, thromboxanes) secreted by many different types of cells (granulocytes, macrophages, leukocytes).
In medical school we were taught the classic signs of inflammation along with their Latin names (which are redness/rubor, swelling/tumor, heat/calor, and pain/dolor). Of course, these are the signs of inflammation that you can see; a good example would be a skin infection like an infected cuticle.
But inflammation has a dark side. It may also be a destructive process on a microscopic level and might be so small that someone might feel entirely well yet may be perilously ill.
Remember our program called "Oil and Water" a few months ago? If not, you might want to listen again on my website http://www.parkavenuediet.com/. Here's a quick recap, but try to listen again to the entire program.
Cholesterol floats through your bloodstream isolated from water-soluble molecules. Being fat-soluble, cholesterol cannot dissolve and therefore is in somewhat of a state of suspension, like grease stains on a shirt or the fatty component of lamb stew, chicken soup, or spaghetti with meat sauce. Ever leave beef stew leftovers in a plastic container overnight in your refrigerator? In the morning you'll find an orange-yellowish wax that has floated to the top. Oil and water don't mix.
So when you're overeating and your triglyceride levels and LDL start overflowing, some of those fat droplets wind up in the walls of the larger arteries. And you know that oil and water don't mix. These fat droplets are very irritating to the surrounding tissues, and your body decides to try to get rid of them, or at least wall them off and neutralize their effect. This happens by the process of inflammation; those chemical mediators we mentioned are called into action and white blood cells swarm into the area.
But this process is totally counterproductive. The arterial wall, a most delicate organ, is now a battleground between oil and water.
The extent to which damage occurs depends on many factors: which arteries are affected (brain/heart/kidneys); if the individual decides to avoid further damage by making lifestyle changes (such as you will read in The Park Avenue Diet); and if the individual is wise enough to use the benevolent force of good nutrition to help save the day.
We've been discussing inflammation, which as you know is part of the human body's normal response to injury or infection. But when it occurs in an inappropriate way, such as when the arterial wall becomes a battleground between cholesterol droplets and white blood cells, the result is tissue destruction, circulatory impairment, and other self-inflicted wounds.
The abnormal inflammation in the walls of the heart's arteries is thus a form of "friendly fire." Instead of bullets, white blood cells release powerful chemical mediators that are forms of arachionic acid and its precursor, linoleic acid.
An enzyme called cyclo-oxygenase turns the arachionic acid into one of several possible potentially dangerous chemicals. These are named; prostaglandins, thromboxane, and leukotriene. Thromboxane A2 is a good - or rather a bad-example . This chemical mediator causes platelets, those sticky little cells that are part of the clotting system, to become even more sticky and start to clump together while circulation throughout the body.
You can see them at work, and even feel them, if you are a male medical student at Maimonides Medical Center shaving in the morning too quickly. Those teeny red "shaving-nicks" are in part made up of platelets. But Thromboxane A2, one of the prostaglandins made from arachidonic acid, turns this usually appropriate function into something altogether different.
In people with high levels of Thromboxane A2 (and by the way, this is a chemical that becomes excreted due to stress), platelets start to stick to those irritating cholesterol droplets inside the arterial wall. The more platelets that stick to the cholesterol droplet, the narrower the artery becomes. Then , the entire irritated area literally explodes-just like a pimple on the surface of your skin. Except this pimple is inside a coronary artery. And after it explodes, more platelets become stuck to the lesion.
I'm sure you have heard the medical term for this horrible cascade of biochemical events. It's called a coronary thrombosis. And you've heard about the illness that is the immediate and sometimes fatal result. It's called a heart attack. The end result of a heart attack might have severe pathological, psychological, and social repercussions. But it all began due to abnormal biochemistry...biochemistry that activated the body's inflammatory response in an inappropriate, painful, and sometimes tragic way.
And now for some really good news: there's a way to manipulate these chemical mediators in an extremely beneficial way. Nature has provided beneficial molecules called Eicosanoids that have the ability to offset the dangerous accumulation of thromboxanes, leukotrienes, and malevolent prostaglandins.
Eicosanoids are made from omega-3 or omega-6 essential fatty acids. And the more omega-3 oils one has circulationg through the body, the more healthy the overall picture. Omega-3 oils reduce the inflammatory effects of arachionic acid and its products.
Let's review this: Arachionic acid promotes inflammation. Omega 3 and 6 oils are much less inflammatory, or inactive, or even anti-inflammatory.
Tune in next week when we will continue with our discussion on inflammation.
In medical school we were taught the classic signs of inflammation along with their Latin names (which are redness/rubor, swelling/tumor, heat/calor, and pain/dolor). Of course, these are the signs of inflammation that you can see; a good example would be a skin infection like an infected cuticle.
But inflammation has a dark side. It may also be a destructive process on a microscopic level and might be so small that someone might feel entirely well yet may be perilously ill.
Remember our program called "Oil and Water" a few months ago? If not, you might want to listen again on my website http://www.parkavenuediet.com/. Here's a quick recap, but try to listen again to the entire program.
Cholesterol floats through your bloodstream isolated from water-soluble molecules. Being fat-soluble, cholesterol cannot dissolve and therefore is in somewhat of a state of suspension, like grease stains on a shirt or the fatty component of lamb stew, chicken soup, or spaghetti with meat sauce. Ever leave beef stew leftovers in a plastic container overnight in your refrigerator? In the morning you'll find an orange-yellowish wax that has floated to the top. Oil and water don't mix.
So when you're overeating and your triglyceride levels and LDL start overflowing, some of those fat droplets wind up in the walls of the larger arteries. And you know that oil and water don't mix. These fat droplets are very irritating to the surrounding tissues, and your body decides to try to get rid of them, or at least wall them off and neutralize their effect. This happens by the process of inflammation; those chemical mediators we mentioned are called into action and white blood cells swarm into the area.
But this process is totally counterproductive. The arterial wall, a most delicate organ, is now a battleground between oil and water.
The extent to which damage occurs depends on many factors: which arteries are affected (brain/heart/kidneys); if the individual decides to avoid further damage by making lifestyle changes (such as you will read in The Park Avenue Diet); and if the individual is wise enough to use the benevolent force of good nutrition to help save the day.
We've been discussing inflammation, which as you know is part of the human body's normal response to injury or infection. But when it occurs in an inappropriate way, such as when the arterial wall becomes a battleground between cholesterol droplets and white blood cells, the result is tissue destruction, circulatory impairment, and other self-inflicted wounds.
The abnormal inflammation in the walls of the heart's arteries is thus a form of "friendly fire." Instead of bullets, white blood cells release powerful chemical mediators that are forms of arachionic acid and its precursor, linoleic acid.
An enzyme called cyclo-oxygenase turns the arachionic acid into one of several possible potentially dangerous chemicals. These are named; prostaglandins, thromboxane, and leukotriene. Thromboxane A2 is a good - or rather a bad-example . This chemical mediator causes platelets, those sticky little cells that are part of the clotting system, to become even more sticky and start to clump together while circulation throughout the body.
You can see them at work, and even feel them, if you are a male medical student at Maimonides Medical Center shaving in the morning too quickly. Those teeny red "shaving-nicks" are in part made up of platelets. But Thromboxane A2, one of the prostaglandins made from arachidonic acid, turns this usually appropriate function into something altogether different.
In people with high levels of Thromboxane A2 (and by the way, this is a chemical that becomes excreted due to stress), platelets start to stick to those irritating cholesterol droplets inside the arterial wall. The more platelets that stick to the cholesterol droplet, the narrower the artery becomes. Then , the entire irritated area literally explodes-just like a pimple on the surface of your skin. Except this pimple is inside a coronary artery. And after it explodes, more platelets become stuck to the lesion.
I'm sure you have heard the medical term for this horrible cascade of biochemical events. It's called a coronary thrombosis. And you've heard about the illness that is the immediate and sometimes fatal result. It's called a heart attack. The end result of a heart attack might have severe pathological, psychological, and social repercussions. But it all began due to abnormal biochemistry...biochemistry that activated the body's inflammatory response in an inappropriate, painful, and sometimes tragic way.
And now for some really good news: there's a way to manipulate these chemical mediators in an extremely beneficial way. Nature has provided beneficial molecules called Eicosanoids that have the ability to offset the dangerous accumulation of thromboxanes, leukotrienes, and malevolent prostaglandins.
Eicosanoids are made from omega-3 or omega-6 essential fatty acids. And the more omega-3 oils one has circulationg through the body, the more healthy the overall picture. Omega-3 oils reduce the inflammatory effects of arachionic acid and its products.
Let's review this: Arachionic acid promotes inflammation. Omega 3 and 6 oils are much less inflammatory, or inactive, or even anti-inflammatory.
Tune in next week when we will continue with our discussion on inflammation.
Monday, November 15, 2010
Note on "The Park Avenue Diet Show: What Should I Have for a Snack?"; November 14, 2010
Snack foods have been around since the Paleolithic Era, when cave-dwellers first discovered berries, nuts, and certain vegetables right on their doorsteps--although they lacked doors and steps. These foods provided energy, nutrition, and enjoyment. Ten of thousands of years later, snacking has evolved, or rather devolved, thanks to prepackaged, unhealthy "foods" developed during the Industrial Revolution.
But enough of an anthropology lesson and pseudo-political commentary! Snacks foods, and there are literally thousands of them, need not be unhealthy, fattening, or carcinogenic, especially the ones you choose to sustain yourself between meals. Armed with a full understanding of insulin resistance, you now know that unstable blood sugar levels usually force people to choose unwisely--potato chips, salted peanuts, candy, pastries. Your choice of snack may be related to whatever you had for breakfast--the more sugar in your breakfast, the more likely you will be to pick a sweet snack.
The ideal snack food for people on a weight-loss diet is precisely the one Dr. Atkins taught me: a slice of turkey wrapped around a carrot stick or celery stalk...extremely low-calorie, extremely low-fat, and obviously very nutritious. The relative macronutrient balance (namely more protein, less carbs) keeps insulin stabilized, thus preventing another swing of blood sugar several hours later.
Think about this when you reach for "nutrition" bars at the grocery: these glorified candy bars, containing negligable amounts of vitamins, were primarliy designed for weight-lifters and exercise enthusiasts. Just because a candy bar has 30 grams of protein doesn't mean that you'll be more muscular tomorrow. Ya gotta exercise beforehand, otherwise the protein is metabolized as fuel, just like glucose is---a total waste of time, nutritionally speaking.
Read labels carefully, and avoid artificial sweeteners--these might also over-stimulate insulin even though no calories are involved or somehow attempt to trick one's brain into thinking that a huge amount of sugar has just been ingested--which the body overcorrects later on by doing just that!
Your grandmother told you (and mine told me) that breakfast is one of the most important meals of the day. She probably also knew that balancing your insulin levels was important so that you wouldn't overdo it at snack time and thereby jeopardize your weight and your health. People who pick the right snacks remove a tremendous obstacle to weight loss. They gain Enlightenment...and Lightenment !
But enough of an anthropology lesson and pseudo-political commentary! Snacks foods, and there are literally thousands of them, need not be unhealthy, fattening, or carcinogenic, especially the ones you choose to sustain yourself between meals. Armed with a full understanding of insulin resistance, you now know that unstable blood sugar levels usually force people to choose unwisely--potato chips, salted peanuts, candy, pastries. Your choice of snack may be related to whatever you had for breakfast--the more sugar in your breakfast, the more likely you will be to pick a sweet snack.
The ideal snack food for people on a weight-loss diet is precisely the one Dr. Atkins taught me: a slice of turkey wrapped around a carrot stick or celery stalk...extremely low-calorie, extremely low-fat, and obviously very nutritious. The relative macronutrient balance (namely more protein, less carbs) keeps insulin stabilized, thus preventing another swing of blood sugar several hours later.
Think about this when you reach for "nutrition" bars at the grocery: these glorified candy bars, containing negligable amounts of vitamins, were primarliy designed for weight-lifters and exercise enthusiasts. Just because a candy bar has 30 grams of protein doesn't mean that you'll be more muscular tomorrow. Ya gotta exercise beforehand, otherwise the protein is metabolized as fuel, just like glucose is---a total waste of time, nutritionally speaking.
Read labels carefully, and avoid artificial sweeteners--these might also over-stimulate insulin even though no calories are involved or somehow attempt to trick one's brain into thinking that a huge amount of sugar has just been ingested--which the body overcorrects later on by doing just that!
Your grandmother told you (and mine told me) that breakfast is one of the most important meals of the day. She probably also knew that balancing your insulin levels was important so that you wouldn't overdo it at snack time and thereby jeopardize your weight and your health. People who pick the right snacks remove a tremendous obstacle to weight loss. They gain Enlightenment...and Lightenment !
Monday, November 8, 2010
Notes on "The Park Avenue Diet Show: Diabetes Mellitus"; November 7, 2010
Diabetes Mellitus has been recognized throughout virtually all of recorded history. Scholars and physicians from ancient Greece, Rome, India, Japan, and China had their own names for the disease, explanations of its causes, and ineffective remedies.
Diabetes has had a tumultuous history even within the past forty years. I was taught about Adult Onset Diabetes Mellitus in medical school. This term no longer exists since the exact same problem occurs now in teenagers and young adults.
Even the more scientific-sounding term "non-insulin dependent diabetes" which replaced AODM is somewhat misleading. It is now thought that virtually 100% of diabetics will eventually need injections of this pancreatic hormone. Strictly speaking, NIDDM means that a given patient will not develop ketoacidosis within 48 hours if he or she does not take insulin.
"Juvenile diabetes", another antiquated term is an auto-immune disease that results in total and permanent absence of insulin. People with NIDDM may be taking insulin every day, but they will not die suddenly without it.
Most people who have diabetes in 2010 have the more "benign" form. And 95 or more percent of these individuals have overweight or obesity provoking or complicating this disease. As modern medical research shows, diabetes actually exists in a hidden form in these individuals for up to ten years before a blood sugar rise is noted by the patient or a physician.
I'm sure you would not like to have the flu for ten years in a hidden form before you start coughing and sneezing and realizing you are sick. Diabetes is hundreds of times worse than that and potentially debilitating or fatal.
While it is true that modern pharmaceuticals can immediately correct blood sugar abnormalities, they have little effect on pancreatic exhaustion and death of the beta cells of the Islets of Langerhans where insulin is produced. Simply put if you are a diabetic who has not corrected their diet or achieved a normal weight, your diabetes will worsen with the years, requiring even more medicine, repeated doctor visits, and protection against numerous emergencies.
The next time you go to the supermarket, take a peek at some of those diabetic cookbooks or magazines. They feature lascivious pictures of chocolate cake, creme brulee, brownies, cupcakes, cheesecake, etc. If you were a recovering alcoholic, would you want the newsletter for Alcoholics Anonymous to be strewn with ads for vodka, beer, or wine? If you are a member of PETA and idealistically are committed to protecting all living creatures, what would you think if the PETA journals featured pictures of shotguns, bows and arrows, or animal traps? This is how I view those horrid magazines that tempt diabetics with seemingly forbidden pleasures.
Diabetes is not an incurable illness like pancreatic cancer. Its prevalence reflects the prevalence of obesity, which is most certainly a self-inflicted wound. While obesity does not strike many as inherently unhealthy, diabetes has frightened scholars and physicians for over 2000 years. In an era where we are reminded often to treat "root causes", please consider diabetes a "clear and present danger", and do your best to erase it from your life.
Diabetes has had a tumultuous history even within the past forty years. I was taught about Adult Onset Diabetes Mellitus in medical school. This term no longer exists since the exact same problem occurs now in teenagers and young adults.
Even the more scientific-sounding term "non-insulin dependent diabetes" which replaced AODM is somewhat misleading. It is now thought that virtually 100% of diabetics will eventually need injections of this pancreatic hormone. Strictly speaking, NIDDM means that a given patient will not develop ketoacidosis within 48 hours if he or she does not take insulin.
"Juvenile diabetes", another antiquated term is an auto-immune disease that results in total and permanent absence of insulin. People with NIDDM may be taking insulin every day, but they will not die suddenly without it.
Most people who have diabetes in 2010 have the more "benign" form. And 95 or more percent of these individuals have overweight or obesity provoking or complicating this disease. As modern medical research shows, diabetes actually exists in a hidden form in these individuals for up to ten years before a blood sugar rise is noted by the patient or a physician.
I'm sure you would not like to have the flu for ten years in a hidden form before you start coughing and sneezing and realizing you are sick. Diabetes is hundreds of times worse than that and potentially debilitating or fatal.
While it is true that modern pharmaceuticals can immediately correct blood sugar abnormalities, they have little effect on pancreatic exhaustion and death of the beta cells of the Islets of Langerhans where insulin is produced. Simply put if you are a diabetic who has not corrected their diet or achieved a normal weight, your diabetes will worsen with the years, requiring even more medicine, repeated doctor visits, and protection against numerous emergencies.
The next time you go to the supermarket, take a peek at some of those diabetic cookbooks or magazines. They feature lascivious pictures of chocolate cake, creme brulee, brownies, cupcakes, cheesecake, etc. If you were a recovering alcoholic, would you want the newsletter for Alcoholics Anonymous to be strewn with ads for vodka, beer, or wine? If you are a member of PETA and idealistically are committed to protecting all living creatures, what would you think if the PETA journals featured pictures of shotguns, bows and arrows, or animal traps? This is how I view those horrid magazines that tempt diabetics with seemingly forbidden pleasures.
Diabetes is not an incurable illness like pancreatic cancer. Its prevalence reflects the prevalence of obesity, which is most certainly a self-inflicted wound. While obesity does not strike many as inherently unhealthy, diabetes has frightened scholars and physicians for over 2000 years. In an era where we are reminded often to treat "root causes", please consider diabetes a "clear and present danger", and do your best to erase it from your life.
Monday, November 1, 2010
Notes on "The Park Avenue Diet Show: Trick or Treat?"; October 31, 2010
"Trick or Treat?" is not usually a question applied to health topics. But there's a first time for everything. Last night was the world premiere of a one-time-only quiz show with that name as part of "The Park Avenue Diet Show".
Using the format of "You Bet Your Life", a legendary television program starring Groucho Marks, the choice was expanded to the areas of nutrition, obesity, personal myths, food additives, and even Hollywood monsters. Noah Fleischman, my fantastic broadcast associate, channeled the spirit of George Fenneman, a legendary 1950's announcer.
"Trick or Treat" could be rephrased very simply "is it good for you or bad for you?" Here are some examples of things that are bad for you: margarine, Olestra, sugar-free creme brulee, a bmi of 40, taenia solium (pork tapeworm, definitely not a recommended treatment for obesity), GM (genetically modified) foods and ayahuasca tea (a psychadelic).
Some of the "treats" included: branched-chain amino acids (leucine, isoleucine, valine), dandelion tea, a blood pressure of 90/60, and positive personal myths.
Here are a few questions that were not used in the quiz. What's your answer? Trick or Treat? Quinoa; Turducken; Christmas pudding; Scotch Egg; Bulgaricum; Alfalfa; Borjomi water; Ectoplasm; Fugu; "Muffin Top"; leptin.
Our final caller amazingly knew two out of the three medical questions in the category of Hollywood movie monsters. Boris Karloff modeled the Frankenstein monster's walk from knowledge of tabes dorsalis, a sign of neurosyphilis. This would have been especially frightening in a pre-antibiotic era. Victims walk with extremely stiff legs, their arms outstretched to achieve balance. Imagine my surprise when Dr. David Grob demonstrated this walk during a lecture on neurology while I was a medical student at Maimonides Medical Center.
Our caller from Freehold, New Jersey also knew that Dracula has type AB-+ blood and is thus protected against "transfusion reactions". Did you ever think that you can learn so much medical information on Halloween? Of course "The Park Avenue Diet Show" is entertaining and informative every week of the year!
Using the format of "You Bet Your Life", a legendary television program starring Groucho Marks, the choice was expanded to the areas of nutrition, obesity, personal myths, food additives, and even Hollywood monsters. Noah Fleischman, my fantastic broadcast associate, channeled the spirit of George Fenneman, a legendary 1950's announcer.
"Trick or Treat" could be rephrased very simply "is it good for you or bad for you?" Here are some examples of things that are bad for you: margarine, Olestra, sugar-free creme brulee, a bmi of 40, taenia solium (pork tapeworm, definitely not a recommended treatment for obesity), GM (genetically modified) foods and ayahuasca tea (a psychadelic).
Some of the "treats" included: branched-chain amino acids (leucine, isoleucine, valine), dandelion tea, a blood pressure of 90/60, and positive personal myths.
Here are a few questions that were not used in the quiz. What's your answer? Trick or Treat? Quinoa; Turducken; Christmas pudding; Scotch Egg; Bulgaricum; Alfalfa; Borjomi water; Ectoplasm; Fugu; "Muffin Top"; leptin.
Our final caller amazingly knew two out of the three medical questions in the category of Hollywood movie monsters. Boris Karloff modeled the Frankenstein monster's walk from knowledge of tabes dorsalis, a sign of neurosyphilis. This would have been especially frightening in a pre-antibiotic era. Victims walk with extremely stiff legs, their arms outstretched to achieve balance. Imagine my surprise when Dr. David Grob demonstrated this walk during a lecture on neurology while I was a medical student at Maimonides Medical Center.
Our caller from Freehold, New Jersey also knew that Dracula has type AB-+ blood and is thus protected against "transfusion reactions". Did you ever think that you can learn so much medical information on Halloween? Of course "The Park Avenue Diet Show" is entertaining and informative every week of the year!
Monday, October 25, 2010
Notes on "The Park Avenue Diet Show: The Only Thing Constant is Change"; October 24, 2010
“The only thing constant is change.”
This famous quotation attributed to Herakleitos (written 2500 years ago) has implications that are philosophical, existential, and medical. It appears in Lives of the Philosophers by Diogenes Laertius. Other translations: “Only change is unchanging”. “Nothing is permanent except change.”
We tend to think of our bodies almost as statues, impervious to outside influences and figuratively fixed in stone. You know however that virtually every component of human anatomy and biochemistry is renewable as growth and metabolism proceed.
Sometimes we cannot see change. If you look in the mirror every day, the person staring back at you always looks the same. But take a look at your photos from ten years ago and you’ll have to admit that things are different. I certainly hope they are better.
On the other hand, if the tensions of life and misplaced priorities have led you down the path of dietary indiscretion, you certainly need change—primarily a change in your personal mythology, your personalized rule book or code of behavior. Change occurs with every chronic illness, although the illnesses due to obesity change very quickly and seriously.
At a recent convention of the American College of Physicians, data was presented that shocked the world of endocrinologists: at the time of diagnosis of a typical type 2 diabetic, 60% of damage to the major blood vessels and the heart has already happened. In essence, the disease has been diagnosed at an advanced state and there are already potentially fatal complications.
Moreover even if the patient is taking prescription medication, diabetes is constantly worsening although blood sugar values may be deceptively normal. These findings provide a frightening view into the nature of some bodily disease processes, but unfortunately in diabetes the only thing constant is change.
http://www.ajmc.com/supplement/managed-care/2006/2006-11-vol12-n14Suppl/Nov06-2399ps369-s381
Here’s another quotation from Herakleitos: “One’s bearing shapes one’s fate” which can also be translated from the ancient Greek as “character is destiny.” This is reflected in The Park Avenue Diet by my own philosophy that your lifestyle is reflected not only by external and internal characteristics but also in your opportunities and relationships.
“You cannot step into the same river twice” as Herakleitos reminds us. This is certainly true because new waters are continuously flowing past your feet. It is also true because of the element of time. And for the human body, time means aging.
Knowing this, you need to be proactive in matters that concern your health. Just like diabetes having a long, silent “waiting period” before complications occur, so too do problems of physical, mental, or spiritual illness have a “calm before the storm.” Don’t wait therefore for problems to arise. Your vigilance and attention to health must be constants despite the ever-changing nature of our world, your environment, and the human body.
This famous quotation attributed to Herakleitos (written 2500 years ago) has implications that are philosophical, existential, and medical. It appears in Lives of the Philosophers by Diogenes Laertius. Other translations: “Only change is unchanging”. “Nothing is permanent except change.”
We tend to think of our bodies almost as statues, impervious to outside influences and figuratively fixed in stone. You know however that virtually every component of human anatomy and biochemistry is renewable as growth and metabolism proceed.
Sometimes we cannot see change. If you look in the mirror every day, the person staring back at you always looks the same. But take a look at your photos from ten years ago and you’ll have to admit that things are different. I certainly hope they are better.
On the other hand, if the tensions of life and misplaced priorities have led you down the path of dietary indiscretion, you certainly need change—primarily a change in your personal mythology, your personalized rule book or code of behavior. Change occurs with every chronic illness, although the illnesses due to obesity change very quickly and seriously.
At a recent convention of the American College of Physicians, data was presented that shocked the world of endocrinologists: at the time of diagnosis of a typical type 2 diabetic, 60% of damage to the major blood vessels and the heart has already happened. In essence, the disease has been diagnosed at an advanced state and there are already potentially fatal complications.
Moreover even if the patient is taking prescription medication, diabetes is constantly worsening although blood sugar values may be deceptively normal. These findings provide a frightening view into the nature of some bodily disease processes, but unfortunately in diabetes the only thing constant is change.
http://www.ajmc.com/supplement/managed-care/2006/2006-11-vol12-n14Suppl/Nov06-2399ps369-s381
Here’s another quotation from Herakleitos: “One’s bearing shapes one’s fate” which can also be translated from the ancient Greek as “character is destiny.” This is reflected in The Park Avenue Diet by my own philosophy that your lifestyle is reflected not only by external and internal characteristics but also in your opportunities and relationships.
“You cannot step into the same river twice” as Herakleitos reminds us. This is certainly true because new waters are continuously flowing past your feet. It is also true because of the element of time. And for the human body, time means aging.
Knowing this, you need to be proactive in matters that concern your health. Just like diabetes having a long, silent “waiting period” before complications occur, so too do problems of physical, mental, or spiritual illness have a “calm before the storm.” Don’t wait therefore for problems to arise. Your vigilance and attention to health must be constants despite the ever-changing nature of our world, your environment, and the human body.
Monday, October 18, 2010
Notes on "The Park Avenue Diet Show: All About the Abs"; October 17, 2010
The abdominal muscles are necessary parts of your anatomy. They are also featured in book titles, exercise routines, and vitamin advertisements. But for 67% of the adult American population, abdominal muscles are sandwiched between layers of subcutaneous and visceral fat, a most unhealthy sandwich indeed.
Epidemiologists have determined how to answer the most profound question of the 21st century: "How do you know if you're fat?" Here are several ways of answering this:
1. Waist circumference, where normal for men is under 40 inches and for women is under 35 inches.
2. Waist-to-hip ratio (abnormal is greater than 0.9 in women, greater than 1.0 in men). This measurement correlates strongly with the most significant complications of obesity because upper body fat (visceral fat) is more dangerous than leg or buttocks fat (subcutaneous fat).
3. Look at yourself sideways in the mirror.
The abdominal muscles support the front of the upper body, thus helping breathing, and also support the spine and lower back muscles, helping your posture. The abdominal muscles also help with balance and flexibility.
Since you are probably envious of people with well defined abdominal muscles, it might be motivating to learn their proper names. The innermost is the transverse abdominus, a band of muscles that totally encircles the lower body. Nearby are two internal oblique muscles and on top of these are two external oblique muscles. The latter can sometimes be seen in well developed athletes.
The most famous abdominal muscle of all is the rectus abdominus, a long, flat band of muscles that extends from the ribs to the pelvis. These muscles are crossed by three tendons called the linae transversae. This structure has the appearance, as you well know, of a "six-pack".
People who are physically fit know that there is no single exercise for the abdominal muscles. Quite the contrary, all exercises should utilize the abdominal muscles. For example curls with hand weights do not merely strengthen the biceps. The exerciser should also maintain a perfectly flat abdomen during biceps curls for stability and isolation of the arms. The abdominal muscles do not participate in the active movement of the weights but they certainly receive a workout.
What other exercises are good for the abdominal muscles? The plank, the "bicycle", the crunch, the extended-arm crunch, and "sit-ups" using an exercise ball. All of these are described in detail on various sites on the internet. Bernadette Penotti, my brilliant colleague and health expert, favors the plank for beginners and seasoned athletes.
Your abdominal muscles will not see the light of day until you lose weight, so make that your number one priority for shaping up in general. In "The Park Avenue Diet" is an entire 42 day exercise plan that takes you from beginner to expert. By the end of the book you will be able to duplicate, albeit slowly, the exact routine that Bernadette Penotti does herself.
It's all about the abs, so get started on improving yours today.
Epidemiologists have determined how to answer the most profound question of the 21st century: "How do you know if you're fat?" Here are several ways of answering this:
1. Waist circumference, where normal for men is under 40 inches and for women is under 35 inches.
2. Waist-to-hip ratio (abnormal is greater than 0.9 in women, greater than 1.0 in men). This measurement correlates strongly with the most significant complications of obesity because upper body fat (visceral fat) is more dangerous than leg or buttocks fat (subcutaneous fat).
3. Look at yourself sideways in the mirror.
The abdominal muscles support the front of the upper body, thus helping breathing, and also support the spine and lower back muscles, helping your posture. The abdominal muscles also help with balance and flexibility.
Since you are probably envious of people with well defined abdominal muscles, it might be motivating to learn their proper names. The innermost is the transverse abdominus, a band of muscles that totally encircles the lower body. Nearby are two internal oblique muscles and on top of these are two external oblique muscles. The latter can sometimes be seen in well developed athletes.
The most famous abdominal muscle of all is the rectus abdominus, a long, flat band of muscles that extends from the ribs to the pelvis. These muscles are crossed by three tendons called the linae transversae. This structure has the appearance, as you well know, of a "six-pack".
People who are physically fit know that there is no single exercise for the abdominal muscles. Quite the contrary, all exercises should utilize the abdominal muscles. For example curls with hand weights do not merely strengthen the biceps. The exerciser should also maintain a perfectly flat abdomen during biceps curls for stability and isolation of the arms. The abdominal muscles do not participate in the active movement of the weights but they certainly receive a workout.
What other exercises are good for the abdominal muscles? The plank, the "bicycle", the crunch, the extended-arm crunch, and "sit-ups" using an exercise ball. All of these are described in detail on various sites on the internet. Bernadette Penotti, my brilliant colleague and health expert, favors the plank for beginners and seasoned athletes.
Your abdominal muscles will not see the light of day until you lose weight, so make that your number one priority for shaping up in general. In "The Park Avenue Diet" is an entire 42 day exercise plan that takes you from beginner to expert. By the end of the book you will be able to duplicate, albeit slowly, the exact routine that Bernadette Penotti does herself.
It's all about the abs, so get started on improving yours today.
Monday, October 11, 2010
Notes on: "The Park Avenue Diet Show: Eggs-istentialism"; October 10, 2010
Misinformation and misunderstanding about eggs represent errors in thinking that confuse the American public and lead to poor nutritional recommendations. For several decades many people have been lead to believe that eggs cause hardening of the arteries, coronary artery disease, strokes and other cardiovascular abnormalities. The simplistic reason? Since eggs contain cholesterol, they are inherently unhealthy.
The truth is quite the opposite: cholesterol is not a poison but an important component of many crucial bodily hormones. Moreover, as has been determined from research on the metabolic syndrome, weight gain and high calorie diets trigger insulin resistance which in turn elevates dangerous lipoprotein levels in the bloodstream.
What do you eat for breakfast? If you check out the breakfast menu of your local fast food franchise, you will find numerous items whose caloric content may be seven to ten times more than that of a hard boiled egg. For people struggling with weight, a high protein, low calorie food is indeed the perfect choice, and that’s exactly what eggs are.
Here are several scholarly articles on the subject. Note that in no case do the researchers recommend egg-white omelets or avoiding eggs entirely.
The first article, dating from 1999, was a trailblazing study that upset the nutritional applecart. Egg consumption was found to have any impact on the risk of serious cardiovascular illnesses.
http://jama.ama-assn.org/cgi/content/abstract/281/15/1387
A more recent article in The American Journal of Clinical Nutrition came to the same exact conclusion. Here the blame for atherosclerotic disease is attributed to saturated fats and trans fats. The latter two are supplied in abundance in those 1,000 calorie breakfasts that many Americans unreservedly embrace.
http://www.ajcn.org/cgi/content/full/87/4/799
An article in Circulation in 2008 studied the effect of egg consumption on heart failure. Once again there was no causal relationship.
http://circ.ahajournals.org/cgi/content/full/117/4/512
Here is the most important study that we discussed this week, published in the journal Risk Analysis. Eating one egg per day is responsible for less than 1% of the risk of coronary heart disease in healthy adults. On the other hand, poor lifestyle choices (unhealthy diet, smoking, obesity, physical inactivity) contribute 30-40% of heart disease risk. The remaining 60-70% of heart disease risk is due to unavoidable factors (genetics) and potentially treatable risk factors (diabetes, high blood pressure). Next to those numbers, the 1% risk attributed to eggs seems extraordinarily small. Perhaps someone can explain why diabetes is treated so flippantly in some circles—on “diet” magazine covers that promote “healthy” chocolate cakes—yet eggs are still considered nutritional pariahs.
http://www.physorg.com/print148641987.html
The larger issue, once we accept the fact that eggs have a place in virtually everyone’s diet, is: where does the average American turn when there is so much misinformation in our media-cluttered society? Unfortunately, it is up to you to refer to trusted sources of health information exclusively, no easy task. Sorting through supposedly conflicting data and controversial issues—that’s my responsibility. Your responsibility? Eat a healthy breakfast!
The truth is quite the opposite: cholesterol is not a poison but an important component of many crucial bodily hormones. Moreover, as has been determined from research on the metabolic syndrome, weight gain and high calorie diets trigger insulin resistance which in turn elevates dangerous lipoprotein levels in the bloodstream.
What do you eat for breakfast? If you check out the breakfast menu of your local fast food franchise, you will find numerous items whose caloric content may be seven to ten times more than that of a hard boiled egg. For people struggling with weight, a high protein, low calorie food is indeed the perfect choice, and that’s exactly what eggs are.
Here are several scholarly articles on the subject. Note that in no case do the researchers recommend egg-white omelets or avoiding eggs entirely.
The first article, dating from 1999, was a trailblazing study that upset the nutritional applecart. Egg consumption was found to have any impact on the risk of serious cardiovascular illnesses.
http://jama.ama-assn.org/cgi/content/abstract/281/15/1387
A more recent article in The American Journal of Clinical Nutrition came to the same exact conclusion. Here the blame for atherosclerotic disease is attributed to saturated fats and trans fats. The latter two are supplied in abundance in those 1,000 calorie breakfasts that many Americans unreservedly embrace.
http://www.ajcn.org/cgi/content/full/87/4/799
An article in Circulation in 2008 studied the effect of egg consumption on heart failure. Once again there was no causal relationship.
http://circ.ahajournals.org/cgi/content/full/117/4/512
Here is the most important study that we discussed this week, published in the journal Risk Analysis. Eating one egg per day is responsible for less than 1% of the risk of coronary heart disease in healthy adults. On the other hand, poor lifestyle choices (unhealthy diet, smoking, obesity, physical inactivity) contribute 30-40% of heart disease risk. The remaining 60-70% of heart disease risk is due to unavoidable factors (genetics) and potentially treatable risk factors (diabetes, high blood pressure). Next to those numbers, the 1% risk attributed to eggs seems extraordinarily small. Perhaps someone can explain why diabetes is treated so flippantly in some circles—on “diet” magazine covers that promote “healthy” chocolate cakes—yet eggs are still considered nutritional pariahs.
http://www.physorg.com/print148641987.html
The larger issue, once we accept the fact that eggs have a place in virtually everyone’s diet, is: where does the average American turn when there is so much misinformation in our media-cluttered society? Unfortunately, it is up to you to refer to trusted sources of health information exclusively, no easy task. Sorting through supposedly conflicting data and controversial issues—that’s my responsibility. Your responsibility? Eat a healthy breakfast!
Monday, October 4, 2010
Notes on "The Park Avenue Diet Show: What Should I Have for Breakfast?"; October 3, 2010
My grandmother said it, and so did yours: “Breakfast is one of the most important meals of the day.” Although somewhat simplistic, this statement reflects not only old-world values but physiologic biochemistry.
People who begin their day with a breakfast that is nothing more than a junk heap of refined carbohydrates are truly starting off on the wrong foot. Carlton Fredricks, the famed nutritionist, was one of the first people to speak out against America’s overindulgence with sugar. Not only are most breakfast foods highly caloric, they have the ability to set into motion insulin resistance and a pattern of glucose instability throughout the day.
Donuts, pancakes, French toast, waffles, bagels, syrupy coffee concoctions all have in common an absolute lack of nutrition and a 100% composition of sugar. Take a look at the shape of people who start their day with these foods. Or better yet, take a look at yourself. “Saving money” by making a glazed donut your breakfast will be offset eventually by the high price of prescription medication for one or more of the illnesses caused by the metabolic syndrome.
A healthy breakfast should be a balanced one, namely one that includes good carbohydrates and protein. The caloric total should not exceed 500 calories, since this is 25% of one’s daily needs. A very healthy breakfast might even “weigh in” with 250 calories. Now take a look in person or online at the calorie content of breakfasts foisted on you by the fast food industry. Who needs 800 to 1100 calories upon waking up from a deep sleep? Perhaps a construction worker, an athlete, or a hiker in the Himalayas. Certainly not you or your children.
If you want to know if a friend or colleague has good nutritional insights, the easiest way is simply to ask him or her what was for breakfast. And if you are struggling with weight, changing your breakfast is probably the first thing you should do.
Here are some great ideas that can start you on the road to enlightenment. The longest journey begins with a single step. The pathway to better health should start with your next breakfast.
---------------------------------------------------------------------------------
And now here are some excellent breakfast tips from an honored colleague:
----------------------------------------------------------------------------------
Hi everyone, this is Jennifer, and you may have heard Dr. Fischer mention my name on this week’s show. I have been very fortunate to work with Dr. Fischer as his practice nurse for the past 2 ½ years.
I would like to share with you some of my favorite breakfast items. For starters I always enjoy a cup of Jasmine-Green tea without milk or sugar (this is such a flavorful tea that additives are unnecessary).
On mornings when I may not have much of an appetite I will have a vanilla yogurt with a few blueberries added in. This will run you anywhere from 150-200 calories.
There are other mornings that I wake up and require something a little more substantial. On these days I may have a frittata (a baked omelet) made with egg whites, tomatoes, spinach and feta cheese; about 230 calories. One of my other recommendations is actually my favorite of breakfast items and that is one poached egg over a bowl of steel-cut oatmeal. For a little extra flavor I sometimes sprinkle Parmigiao-Reggiano cheese right over the top; for a total calorie count of 230 calories. Besides being absolutely delicious, the combination of protein and carbohydrates will keep your appetite satiated right till lunchtime.
A healthy breakfast is exactly what you need to start your day off right.
People who begin their day with a breakfast that is nothing more than a junk heap of refined carbohydrates are truly starting off on the wrong foot. Carlton Fredricks, the famed nutritionist, was one of the first people to speak out against America’s overindulgence with sugar. Not only are most breakfast foods highly caloric, they have the ability to set into motion insulin resistance and a pattern of glucose instability throughout the day.
Donuts, pancakes, French toast, waffles, bagels, syrupy coffee concoctions all have in common an absolute lack of nutrition and a 100% composition of sugar. Take a look at the shape of people who start their day with these foods. Or better yet, take a look at yourself. “Saving money” by making a glazed donut your breakfast will be offset eventually by the high price of prescription medication for one or more of the illnesses caused by the metabolic syndrome.
A healthy breakfast should be a balanced one, namely one that includes good carbohydrates and protein. The caloric total should not exceed 500 calories, since this is 25% of one’s daily needs. A very healthy breakfast might even “weigh in” with 250 calories. Now take a look in person or online at the calorie content of breakfasts foisted on you by the fast food industry. Who needs 800 to 1100 calories upon waking up from a deep sleep? Perhaps a construction worker, an athlete, or a hiker in the Himalayas. Certainly not you or your children.
If you want to know if a friend or colleague has good nutritional insights, the easiest way is simply to ask him or her what was for breakfast. And if you are struggling with weight, changing your breakfast is probably the first thing you should do.
Here are some great ideas that can start you on the road to enlightenment. The longest journey begins with a single step. The pathway to better health should start with your next breakfast.
---------------------------------------------------------------------------------
And now here are some excellent breakfast tips from an honored colleague:
----------------------------------------------------------------------------------
Hi everyone, this is Jennifer, and you may have heard Dr. Fischer mention my name on this week’s show. I have been very fortunate to work with Dr. Fischer as his practice nurse for the past 2 ½ years.
I would like to share with you some of my favorite breakfast items. For starters I always enjoy a cup of Jasmine-Green tea without milk or sugar (this is such a flavorful tea that additives are unnecessary).
On mornings when I may not have much of an appetite I will have a vanilla yogurt with a few blueberries added in. This will run you anywhere from 150-200 calories.
There are other mornings that I wake up and require something a little more substantial. On these days I may have a frittata (a baked omelet) made with egg whites, tomatoes, spinach and feta cheese; about 230 calories. One of my other recommendations is actually my favorite of breakfast items and that is one poached egg over a bowl of steel-cut oatmeal. For a little extra flavor I sometimes sprinkle Parmigiao-Reggiano cheese right over the top; for a total calorie count of 230 calories. Besides being absolutely delicious, the combination of protein and carbohydrates will keep your appetite satiated right till lunchtime.
A healthy breakfast is exactly what you need to start your day off right.
Monday, September 27, 2010
Notes on "The Park Avenue Diet Show: The Little Book of Big Medical Emergencies"; September 26, 2010
This week’s show focused on medical emergencies, a topic reflecting my four years as an attending physician in the emergency room of Cabrini Medical Center. From 1983 to 1987 I worked three 12-hours shifts in a crowded, noisy, somewhat chaotic facility where people came around the clock for a wide variety of medical, surgical, psychological, and social ailments.
Although I had worked in the Maimonides Medical Center emergency room during my internal medicine residency, the Cabrini experience was quite different. I was figuratively and literally in charge of all of the patients simultaneously. For those with an artistic view of the health care experience, this is like conducting several orchestras at the same time.
The emergencies ranged from life-threatening accidents to panic attacks, as well as comforting social outcasts and unfortunate homeless people whose isolation and loneliness were truly painful. As you probably know from personal experience, medical emergencies are very frightening, and even doctors and nurses are not immune. Knowing what to do and recognizing the most serious warning signs can be life-saving, and that’s what impelled me to write The Little Book of Big Medical Emergencies.
The book was originally published by Lyle Stuart, the legendary literary figure, in 2002. Hatherleigh Press published a second edition in 2007, this one updated and reviewed by fourteen noted specialists in diverse medical and surgical fields.
Medical emergencies happen to everyone. I hope that yours have been minor and inconsequential. The statistics show that a given individual will have some type of medical emergency every three years, so being prepared with the proper information and tips on prioritization is absolutely essential.
What could medical emergencies possibly have in common with the usual recommendations of a diet doctor? I’ve answered that question dozens of times: it’s all about your health. Although emergency medicine is crisis intervention and lifestyle advice is preventative medicine, both are ways that you can take care of that most precious and delicate machine, the human body.
Even if you are the most glamorous, healthy, and happy individual, The Little Book of Big Medical Emergencies belongs in your home.
Although I had worked in the Maimonides Medical Center emergency room during my internal medicine residency, the Cabrini experience was quite different. I was figuratively and literally in charge of all of the patients simultaneously. For those with an artistic view of the health care experience, this is like conducting several orchestras at the same time.
The emergencies ranged from life-threatening accidents to panic attacks, as well as comforting social outcasts and unfortunate homeless people whose isolation and loneliness were truly painful. As you probably know from personal experience, medical emergencies are very frightening, and even doctors and nurses are not immune. Knowing what to do and recognizing the most serious warning signs can be life-saving, and that’s what impelled me to write The Little Book of Big Medical Emergencies.
The book was originally published by Lyle Stuart, the legendary literary figure, in 2002. Hatherleigh Press published a second edition in 2007, this one updated and reviewed by fourteen noted specialists in diverse medical and surgical fields.
Medical emergencies happen to everyone. I hope that yours have been minor and inconsequential. The statistics show that a given individual will have some type of medical emergency every three years, so being prepared with the proper information and tips on prioritization is absolutely essential.
What could medical emergencies possibly have in common with the usual recommendations of a diet doctor? I’ve answered that question dozens of times: it’s all about your health. Although emergency medicine is crisis intervention and lifestyle advice is preventative medicine, both are ways that you can take care of that most precious and delicate machine, the human body.
Even if you are the most glamorous, healthy, and happy individual, The Little Book of Big Medical Emergencies belongs in your home.
Monday, September 20, 2010
Notes on "The Park Avenue Diet Show: Butter and Apples"; September 19, 2010
Do you know what to order when you go to a restaurant? Our glamorous First Lady, Michelle Obama, thinks that you don’t. She recently addressed a meeting of the National Restaurant Association and asked them to change their menus in ways that improved nutrition and lower the risk of obesity.
Among the suggestions were smaller portions, substituting whole wheat pasta for white, less butter, and more carrots. Here’s one emblematic idea: serving apple slices as the side dish with hamburgers instead of French fries. Diners would have to be especially careful not to cover the fruit with ketchup and cheese.
Although Mrs. Obama has the best intentions, these recommendations are an unrealistic solution to an extremely serious problem. Do parents not know that macaroni and cheese is fattening? Do you know that salt raises blood pressure and causes fluid retention in cardiac patients almost immediately? Why are we pretending that it is the responsibility of a waiter, chef, or restaurant owner to take responsibility for your personal health?
Since health is not the number one priority for most people (and must be) we now have surrogates like the government interceding on your behalf with potentially disastrous social and financial consequences. It’s much easier for you to be your own nutritional “traffic cop”. Certainly you can police the caloric environment of any restaurant or fast food franchise and figure out what’s best for you in the long run. If you need a government official to tell you or force you to eat less macaroni and cheese, you obviously missed a few classes of high school science.
Another article focused on kids being bullied and humiliated about their weight and inability to compete athletically.
http://news.yahoo.com/s/livescience/20100910/sc_livescience/overweightkidsbodyimagetakespoundingfrombullies
This is definitely a real phenomenon but is nothing new. Kids have been mocked and teased since the dawn of time, and sometimes adults are no better. The way to avoid this is not through counseling and psychotherapy or anti-depressant medication. Why not solve the problem realistically and definitively by weight loss?
What do you think about when you see extremely overweight people on television? When they are featured in your favorite comedies or dramas, do they serve as role models the way some people might admire Derek Jeter or Halle Berry? Some psychologists think that “fat acceptance” is a compensatory reaction to a potentially serious health problem. The self-esteem of the overweight is more important (incorrectly) than their additional risk for 40 different illnesses in 9 organ systems.
http://www.foxnews.com/entertainment/2010/09/16/shows-focusing-overweight-characters-obesity-problem/
As a physician, I am more concerned with the health and wellness of the actors than their physical suitability for the roles. But if we are so paranoically concerned about showing people smoking cigarettes on television, how can we allow walking advertisements for an unhealthy lifestyle? 20% of American adults smoke cigarettes; 67% of American adults are overweight or obese. You do the math.
Do you think it would be helpful during the upcoming television show “Mike and Molly” for them to be eating apple slices with their cheeseburgers? If so, please direct your comments to 1600 Pennsylvania Avenue.
Among the suggestions were smaller portions, substituting whole wheat pasta for white, less butter, and more carrots. Here’s one emblematic idea: serving apple slices as the side dish with hamburgers instead of French fries. Diners would have to be especially careful not to cover the fruit with ketchup and cheese.
Although Mrs. Obama has the best intentions, these recommendations are an unrealistic solution to an extremely serious problem. Do parents not know that macaroni and cheese is fattening? Do you know that salt raises blood pressure and causes fluid retention in cardiac patients almost immediately? Why are we pretending that it is the responsibility of a waiter, chef, or restaurant owner to take responsibility for your personal health?
Since health is not the number one priority for most people (and must be) we now have surrogates like the government interceding on your behalf with potentially disastrous social and financial consequences. It’s much easier for you to be your own nutritional “traffic cop”. Certainly you can police the caloric environment of any restaurant or fast food franchise and figure out what’s best for you in the long run. If you need a government official to tell you or force you to eat less macaroni and cheese, you obviously missed a few classes of high school science.
Another article focused on kids being bullied and humiliated about their weight and inability to compete athletically.
http://news.yahoo.com/s/livescience/20100910/sc_livescience/overweightkidsbodyimagetakespoundingfrombullies
This is definitely a real phenomenon but is nothing new. Kids have been mocked and teased since the dawn of time, and sometimes adults are no better. The way to avoid this is not through counseling and psychotherapy or anti-depressant medication. Why not solve the problem realistically and definitively by weight loss?
What do you think about when you see extremely overweight people on television? When they are featured in your favorite comedies or dramas, do they serve as role models the way some people might admire Derek Jeter or Halle Berry? Some psychologists think that “fat acceptance” is a compensatory reaction to a potentially serious health problem. The self-esteem of the overweight is more important (incorrectly) than their additional risk for 40 different illnesses in 9 organ systems.
http://www.foxnews.com/entertainment/2010/09/16/shows-focusing-overweight-characters-obesity-problem/
As a physician, I am more concerned with the health and wellness of the actors than their physical suitability for the roles. But if we are so paranoically concerned about showing people smoking cigarettes on television, how can we allow walking advertisements for an unhealthy lifestyle? 20% of American adults smoke cigarettes; 67% of American adults are overweight or obese. You do the math.
Do you think it would be helpful during the upcoming television show “Mike and Molly” for them to be eating apple slices with their cheeseburgers? If so, please direct your comments to 1600 Pennsylvania Avenue.
Tuesday, September 14, 2010
Notes on "The Park Avenue Diet Show: September Song"; September 12, 2010
This week’s show, entitled “September Song”, heralded the arrival of the Fall Season. We tend to think of such landmarks in our datebooks in terms of school, the theatre season, autumn foliage, or something more personal. I’m a bit more monochromatic: for me, it’s all about health, mine and yours.
Every season, and in fact every day, is a good opportunity to reevaluate your health status. Don’t forget that I follow the World Health Organization definition of health: “Physical, mental, and social wellbeing, and not merely the absence of disease.” As the author of The Park Avenue Diet, I focus on image which I define as an amalgamation of seven different components of appearance and behavior. One of these is weight.
For the last forty years, The Dark Ages of Dieting, people have mistakenly gravitated towards weight loss programs that exist in a vacuum. Namely, they only address food choices as if all of the other components of image somehow improve by themselves (interpersonal skills, skin, hair, clothing, self-confidence). I do not blame the well-meaning and well-deserving American people for believing this utterly illogical hogwash. Pick up any supermarket tabloid or “health magazine” and you will see pseudo-science at its worst.
Now for some real science: here are a few articles from the bibliography of The Park Avenue Diet. At the most recent convention of The American College of Physicians, researchers asked that no more studies be done comparing the various mass-market “diets” since none has a success rate over ten percent. It is a thorough waste of time to see whether “low carb” or “macrobiotic” foods produce better results since experimental subjects do not follow either program consistently or successfully.
http://jama.ama-assn.org/cgi/content/full/293/1/43
http://cardiology.jwatch.org/cgi/content/citation/2005/211/6
http://www.annals.org/content/142/1/56.abstract
http://www.annals.org/content/147/1/41.abstract
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)16986-9/abstract
The above articles, as well as a monograph by the British Medical Journal, all result in the same scenario. The attrition rate (people who drop out of a study) is almost ninety percent no matter which article you read. This leads researchers to believe that weight loss in itself no matter what’s on the menu is not a sufficient reward.
Put another way, dropping a few pounds and staying the same in other ways is at best a tenuous state of affairs. This accounts for the fact that yo-yo dieting, temporary and ineffective attempts to be thinner, is the prevailing practice. As a result the overweight and obese percentages of our population are growing daily, and this unbelievably unhealthy practice is now being foisted on the next generation. The implications of this disastrous scenario are medical, social, and worst of all financial.
The Park Avenue Diet provides a truly comprehensive program for improving one’s physical, mental, and social health. As such it is realistic, holistic, and quite enjoyable. One measures success here by an improved lifestyle and better worldly opportunities, not merely poundage. In times such as these, only realistic solutions to our challenging problems should be discussed. It is time to emerge from The Dark Ages of Dieting into a physical, mental, and social renaissance.
Every season, and in fact every day, is a good opportunity to reevaluate your health status. Don’t forget that I follow the World Health Organization definition of health: “Physical, mental, and social wellbeing, and not merely the absence of disease.” As the author of The Park Avenue Diet, I focus on image which I define as an amalgamation of seven different components of appearance and behavior. One of these is weight.
For the last forty years, The Dark Ages of Dieting, people have mistakenly gravitated towards weight loss programs that exist in a vacuum. Namely, they only address food choices as if all of the other components of image somehow improve by themselves (interpersonal skills, skin, hair, clothing, self-confidence). I do not blame the well-meaning and well-deserving American people for believing this utterly illogical hogwash. Pick up any supermarket tabloid or “health magazine” and you will see pseudo-science at its worst.
Now for some real science: here are a few articles from the bibliography of The Park Avenue Diet. At the most recent convention of The American College of Physicians, researchers asked that no more studies be done comparing the various mass-market “diets” since none has a success rate over ten percent. It is a thorough waste of time to see whether “low carb” or “macrobiotic” foods produce better results since experimental subjects do not follow either program consistently or successfully.
http://jama.ama-assn.org/cgi/content/full/293/1/43
http://cardiology.jwatch.org/cgi/content/citation/2005/211/6
http://www.annals.org/content/142/1/56.abstract
http://www.annals.org/content/147/1/41.abstract
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)16986-9/abstract
The above articles, as well as a monograph by the British Medical Journal, all result in the same scenario. The attrition rate (people who drop out of a study) is almost ninety percent no matter which article you read. This leads researchers to believe that weight loss in itself no matter what’s on the menu is not a sufficient reward.
Put another way, dropping a few pounds and staying the same in other ways is at best a tenuous state of affairs. This accounts for the fact that yo-yo dieting, temporary and ineffective attempts to be thinner, is the prevailing practice. As a result the overweight and obese percentages of our population are growing daily, and this unbelievably unhealthy practice is now being foisted on the next generation. The implications of this disastrous scenario are medical, social, and worst of all financial.
The Park Avenue Diet provides a truly comprehensive program for improving one’s physical, mental, and social health. As such it is realistic, holistic, and quite enjoyable. One measures success here by an improved lifestyle and better worldly opportunities, not merely poundage. In times such as these, only realistic solutions to our challenging problems should be discussed. It is time to emerge from The Dark Ages of Dieting into a physical, mental, and social renaissance.
Monday, September 6, 2010
Notes on "The Park Avenue Diet Show: The Party's Over"; September 5, 2010
Remember those essays you had to write in your first weeks back at school? "How I Spent My Summer Vacation." I'd hope that your summer was devoted in part to taking care of your yourself healthwise. Summer's meant for fun...and so is the rest of your life. Did you make all the right food choices? Did you exercise every day? Were you as sociable as possible, challenging yourself with new opportunities and projects?
Whether you did or not, the summer's gone, the party's over, and many of us, far too many, have neglected our responsibilities to the upkeep and upgrading of that most remarkable piece of machinery, the human body. But that's what the Fall Season is ideal for, which will be the topic of next week's edition of "The Park Avenue Diet Show."
My summer was a most momentous one. I celebrated my 60th birthday with a spectacular party that featured my debut as a standup comedian. And I attended two amazing theater festivals, seeing the brilliant actor/director Everett Quinton in "Oh Dad, Poor Dad" as well as his moving, haunting production of "The Elephant Man" ...followed by 8 performances at the Salzburg Festival as a chaser.
This week's show cited three particularly upsetting articles in the news.
1) Many Americans Don't Even Know They're Fat'----
http://www.businessweek.com/lifestyle/content/healthday/642638.html
2)Parents Turn to Personal Trainers to Help Fight Obesity---
http://www.cbsnews.com/8301-504744_162-20015552-10391703.html
3) 40% of NYC Students are Too Fat----
http://www.nypost.com/p/news/local/your_kids_are_getting_so_big_p9iTxEeieCpuwUoj7OjWZJ
The latter is particularly upsetting, since these kids will grow up with very high risk of early cardiovascular disease and cancer. Obesity, as you know, is a risk factor for 40 different illnesses in 9 different organ systems.
So...how did you spend your summer vacation? And watcha gonna do about it? It's time to get in shape for the Fall Season, and your image--your appearance and behavior--is especially important in times of economic uncertainty. The new season of "The Park Avenue Diet Show" begins next week. Its only goal is to improve your health, which the World Health Organization defines as "physical. mental, and social well-being and not merely the absence of disease." And who will be the principal beneficiary? You !
==================================================
If you're looking for an terrific personal trainer, by the way, check out Stefan Aschan and his excellent website. He's a health-care professional of the first rank, an insightful and charismatic motivator with superlative credentials.
http://www.stefanaschan.com/welcome/
Whether you did or not, the summer's gone, the party's over, and many of us, far too many, have neglected our responsibilities to the upkeep and upgrading of that most remarkable piece of machinery, the human body. But that's what the Fall Season is ideal for, which will be the topic of next week's edition of "The Park Avenue Diet Show."
My summer was a most momentous one. I celebrated my 60th birthday with a spectacular party that featured my debut as a standup comedian. And I attended two amazing theater festivals, seeing the brilliant actor/director Everett Quinton in "Oh Dad, Poor Dad" as well as his moving, haunting production of "The Elephant Man" ...followed by 8 performances at the Salzburg Festival as a chaser.
This week's show cited three particularly upsetting articles in the news.
1) Many Americans Don't Even Know They're Fat'----
http://www.businessweek.com/lifestyle/content/healthday/642638.html
2)Parents Turn to Personal Trainers to Help Fight Obesity---
http://www.cbsnews.com/8301-504744_162-20015552-10391703.html
3) 40% of NYC Students are Too Fat----
http://www.nypost.com/p/news/local/your_kids_are_getting_so_big_p9iTxEeieCpuwUoj7OjWZJ
The latter is particularly upsetting, since these kids will grow up with very high risk of early cardiovascular disease and cancer. Obesity, as you know, is a risk factor for 40 different illnesses in 9 different organ systems.
So...how did you spend your summer vacation? And watcha gonna do about it? It's time to get in shape for the Fall Season, and your image--your appearance and behavior--is especially important in times of economic uncertainty. The new season of "The Park Avenue Diet Show" begins next week. Its only goal is to improve your health, which the World Health Organization defines as "physical. mental, and social well-being and not merely the absence of disease." And who will be the principal beneficiary? You !
==================================================
If you're looking for an terrific personal trainer, by the way, check out Stefan Aschan and his excellent website. He's a health-care professional of the first rank, an insightful and charismatic motivator with superlative credentials.
http://www.stefanaschan.com/welcome/
Monday, August 30, 2010
Notes on "The Park Avenue Diet Show: Big Business"; August 29, 2010
“The Park Avenue Diet Show” on August 29, 2010 discussed “Big Business”, namely the industry and products surrounding and helping people struggling with obesity. Most people do not appreciate how difficult and uncomfortable life can be for someone with excess weight. The sheer effort of moving as well as self-care can be extremely frustrating and painful, both physically and emotionally.
It is difficult to understand why someone would remain in a state of relative incapacitation rather than reduce their body size and take advantage of products utilized by healthier individuals. Nevertheless, American industry in its wisdom has invented dozens of products and devices that make life easier for obese individuals and may unknowingly keep them in that condition.
You can find the websites alluded to on your own. There is no need to provide links to show you the actual items mentioned on the radio program. Just to remind you, here are the 13 products discussed:
1. A 96” tape measure, not the conventional 60” one used by tailors.
2. A smaller-sized steering wheel.
3. Large chairs that can accommodate individuals weighing several hundred pounds.
4. Tools that aid in reaching things, such as dropped objects or objects on shelves. Some websites offer leg-lifters that help people get into cars more easily.
5. A zipper device that allows a woman to reach easily down the back of her own dress to pull the zipper up. The promotional material states “You don’t need a man to pull up that hard to reach zipper on the back of your dress!” The latter seems like a very depressing state of affairs.
6. A long-handled under and between toe washer.
7. A toilet paper holder. Which is more grotesque, the item itself or the mentality of an individual that allows this need to exist?
8. Tricycles for “exercise”, since people struggling with morbid obesity cannot balance properly on a two-wheeler.
9. A portable bidet with a two-quart tank, advertised as great for travel.
10. A scale that goes up to 1,000 pounds.
11. A large-sized bib that covers the entire body and lap. Why should obese people be more likely to stain their clothing than others? Is it because of the anatomical or psychological complications of their excessive weight? I have no idea.
12. A jumbo coffin, the ultimate indignity.
13. Iodine scrubs, usually used for sterilization in operating rooms, necessary in obese people because of more prevalent bacterial infections.
The above products were discussed at length, as was a reminder of the grim medical statistics about obesity. Namely, obesity (BMI 30-35) reduces life expectancy by approximately three years; morbid obesity (BMI greater than 40) reduces life expectancy by ten years. Also according to the American College of Physicians, obesity increases the risk of forty different illnesses in nine different organ systems. Although you now have access to conveniences such as the thirteen products listed above, obesity ain’t no picnic.
It is difficult to understand why someone would remain in a state of relative incapacitation rather than reduce their body size and take advantage of products utilized by healthier individuals. Nevertheless, American industry in its wisdom has invented dozens of products and devices that make life easier for obese individuals and may unknowingly keep them in that condition.
You can find the websites alluded to on your own. There is no need to provide links to show you the actual items mentioned on the radio program. Just to remind you, here are the 13 products discussed:
1. A 96” tape measure, not the conventional 60” one used by tailors.
2. A smaller-sized steering wheel.
3. Large chairs that can accommodate individuals weighing several hundred pounds.
4. Tools that aid in reaching things, such as dropped objects or objects on shelves. Some websites offer leg-lifters that help people get into cars more easily.
5. A zipper device that allows a woman to reach easily down the back of her own dress to pull the zipper up. The promotional material states “You don’t need a man to pull up that hard to reach zipper on the back of your dress!” The latter seems like a very depressing state of affairs.
6. A long-handled under and between toe washer.
7. A toilet paper holder. Which is more grotesque, the item itself or the mentality of an individual that allows this need to exist?
8. Tricycles for “exercise”, since people struggling with morbid obesity cannot balance properly on a two-wheeler.
9. A portable bidet with a two-quart tank, advertised as great for travel.
10. A scale that goes up to 1,000 pounds.
11. A large-sized bib that covers the entire body and lap. Why should obese people be more likely to stain their clothing than others? Is it because of the anatomical or psychological complications of their excessive weight? I have no idea.
12. A jumbo coffin, the ultimate indignity.
13. Iodine scrubs, usually used for sterilization in operating rooms, necessary in obese people because of more prevalent bacterial infections.
The above products were discussed at length, as was a reminder of the grim medical statistics about obesity. Namely, obesity (BMI 30-35) reduces life expectancy by approximately three years; morbid obesity (BMI greater than 40) reduces life expectancy by ten years. Also according to the American College of Physicians, obesity increases the risk of forty different illnesses in nine different organ systems. Although you now have access to conveniences such as the thirteen products listed above, obesity ain’t no picnic.
Monday, August 23, 2010
Notes on "The Park Avenue Diet Show: Why is Exercise Good For Me?"; August 22, 2010
The topic for this week was “Why is Exercise Good For Me?”, a rather straightforward question that apparently eludes 67% of adult Americans whose weight is problematic. Exercise provides a “sink”, namely a place for calories to be burned off just as a sink provides a conduit for emptying refuse.
Exercise can be either anabolic (weight lifting for example) or catabolic (jogging). Jeff Halevy was the guest for this show and an articulate spokesperson and example of the multiple benefits of regular exercise. Most people think of exercise as a chore, but he repeatedly reminds his clients to think of exercise as fun. From a strictly nutritional point of view, exercise seems like the ideal way to treat the various components of the metabolic syndrome. Elevated triglycerides, cholesterol, sugar, and blood pressure are almost immediately approved by regular exercise.
As people age the need for regular exercise becomes especially crucial. The goals here are increased flexibility and balance, so that an individual will sustain less serious injuries due to an accidental fall. Even short walks have been found to be beneficial in the elderly population. Activity promotes increased circulation and avoids venous stasis, particularly in the lower legs where phlebitis can evolve into a major medical emergency.
Your physique is an important component of your image. There’s no getting around the fact that how you look is extraordinarily important in diverse situations ranging from job interviews to dating. If you are foolish enough to neglect your own body, how would a prospective boss want to hire you to help improve his or her own business? If you do not care how you look, how could a prospective mate imagine that you would care about their wellbeing?
The quiz question was: Which “organ” in overweight or obese people is most helped by exercise? None of the callers got the right answer, which is visceral fat. As you remember from our discussion of this topic, visceral fat releases extremely dangerous hormones and chemicals into the circulation. These are directly responsible for additional risk to overweight or obese people for dozens of illnesses and cancers. Aerobic exercise seems to be fueled initially by visceral fat and therefore it is the perfect way both to lose weight and improve risk factors.
A recent article in the August 2010 issue of Harvard Woman’s Health Watch confirmed these exact points:
http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch.htm
Another interesting article discussed contraction-induced signaling. This is a process by which exercise stimulates glucose transport into the muscles of the body. What is most interesting is that it does not depend on insulin, and therefore exercise is especially helpful for people with insulin resistance. Somehow exercise helps the intracellular pathways leading to glucose transport:
http://www.news-medical.net/news/20100821/Study-supports-role-for-SNARK-protein-in-regulating-glucose-transport-during-muscle-contraction-and-exercise.aspx
These are new and rather complex biochemical findings but the message is the same. No matter what your weight is, exercise is extremely important for you.
---------------------------------------------------------------------------------------------
Here is Jeff Halevy's contact information. He is a superlative personal trainer and fitness expert whom I unhesitatingly recommend to everyone.
Halevy Life(212) 233-0633 www.HalevyLife.com
Exercise can be either anabolic (weight lifting for example) or catabolic (jogging). Jeff Halevy was the guest for this show and an articulate spokesperson and example of the multiple benefits of regular exercise. Most people think of exercise as a chore, but he repeatedly reminds his clients to think of exercise as fun. From a strictly nutritional point of view, exercise seems like the ideal way to treat the various components of the metabolic syndrome. Elevated triglycerides, cholesterol, sugar, and blood pressure are almost immediately approved by regular exercise.
As people age the need for regular exercise becomes especially crucial. The goals here are increased flexibility and balance, so that an individual will sustain less serious injuries due to an accidental fall. Even short walks have been found to be beneficial in the elderly population. Activity promotes increased circulation and avoids venous stasis, particularly in the lower legs where phlebitis can evolve into a major medical emergency.
Your physique is an important component of your image. There’s no getting around the fact that how you look is extraordinarily important in diverse situations ranging from job interviews to dating. If you are foolish enough to neglect your own body, how would a prospective boss want to hire you to help improve his or her own business? If you do not care how you look, how could a prospective mate imagine that you would care about their wellbeing?
The quiz question was: Which “organ” in overweight or obese people is most helped by exercise? None of the callers got the right answer, which is visceral fat. As you remember from our discussion of this topic, visceral fat releases extremely dangerous hormones and chemicals into the circulation. These are directly responsible for additional risk to overweight or obese people for dozens of illnesses and cancers. Aerobic exercise seems to be fueled initially by visceral fat and therefore it is the perfect way both to lose weight and improve risk factors.
A recent article in the August 2010 issue of Harvard Woman’s Health Watch confirmed these exact points:
http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch.htm
Another interesting article discussed contraction-induced signaling. This is a process by which exercise stimulates glucose transport into the muscles of the body. What is most interesting is that it does not depend on insulin, and therefore exercise is especially helpful for people with insulin resistance. Somehow exercise helps the intracellular pathways leading to glucose transport:
http://www.news-medical.net/news/20100821/Study-supports-role-for-SNARK-protein-in-regulating-glucose-transport-during-muscle-contraction-and-exercise.aspx
These are new and rather complex biochemical findings but the message is the same. No matter what your weight is, exercise is extremely important for you.
---------------------------------------------------------------------------------------------
Here is Jeff Halevy's contact information. He is a superlative personal trainer and fitness expert whom I unhesitatingly recommend to everyone.
Halevy Life(212) 233-0633 www.HalevyLife.com
Monday, August 16, 2010
Notes on "The Park Avenue Diet Show: What is the Metabolic Syndrome?"; August 15, 2010
This week’s WOR program centered on the metabolic syndrome, one of the most important discoveries in the past fifty years. Until recently it was not known how several seemingly disparate illnesses occurred simultaneously, for example hypertension and heart disease. None of the facts we are about to discuss were in any of my medical school text books and were totally unknown at the time of my internal medicine residency at Maimonides Medical Center.
The metabolic syndrome is quite simply a group of three blood tests and two physical findings. It has been defined slightly differently by different health organizations in various studies. One such definition (by the IDF) is as follows:
• 1. Abdominal (central) obesity: waist circumference >37 inches (men); >31.5 inches (women) [these are lower for South Asian/Chinese/Japanese].
Plus 2 of the following 4
• 2. Blood pressure > 130/85 mm Hg
• 3. Triglycerides > 150 mg
• 4. HDL: under 40 (men); under 50 (women)
• 5. Fasting glucose > 100 mg.
Other scientific papers may utilize different measurements but the overall significance remains the same, namely that the person has an extremely high chance of developing circulatory diseases prematurely as well as the other components of the metabolic syndrome. Note that two of the criteria are essentially “pre-diabetes” and “pre-hypertension.”
What is most interesting about the metabolic syndrome is how those seemingly unrelated components are actually interconnected. There was no “central unifying thesis” until recently. The missing link was insulin resistance.
Insulin resistance, as yet only partially understood, affects all aspects of the metabolic syndrome as well as virtually all aspects of an obese body. Simply put, insulin resistance means that a person’s insulin is not functioning up to its usual capacity. It is somehow weakened or ineffective. This begins to happen in the early stages of weight gain, particularly in those individuals from diabetic families.
Ineffective insulin is unable to allow circulating glucose to enter cells of the body, most notably those in skeletal muscle and the liver. The cells which are not receiving enough energy from glucose send out messages to the pancreas, which in turn overproduces even more ineffective insulin. Thus, paradoxically, a “pre-diabetic”, will actually be producing more insulin then his or her healthy friends.
Multiple abnormalities result thereafter, all somehow related to the overproduction of ineffective insulin. One result is excessive retention of sodium by the kidneys, especially dangerous in a “civilized” country like the U.S.A with our high salt diet. Another result is circulating fats (called free fatty acids) which have numerous potentially dangerous consequences. This can most readily be seen as elevated cholesterol and triglycerides. What is unseen is a possible destructive effect of free fatty acids on the pancreas, leading to its further weakening (and diabetes).
Can we mention two of the most dreaded complications? One is a “pro-inflammatory” state, namely having highly unstable lesions in the coronary/cerebral arteries that can literally explode at any time. The other is a “pro-coagulant” state, one in which blood can clot more easily, the usual scenario for a heart attack or stroke.
The biochemistry charts depicting the various interactions we have just described are unbelievably complex. The above discussion is extremely simplified, and a great deal is not known as yet. However we are dealing with an illness, obesity, that clearly has warning signs well in advance of potential disaster. If you have the metabolic syndrome, you have already developed insulin resistance. And if you have insulin resistance you may already have done serious damage to your heart, brain, and kidneys. The need to take weight off and keep it off would therefore be the most important item on your “to do” list.
Here’s a little more information for those who want bonus points and wish to demonstrate amazing scientific knowledge to their friends:
Metabolic abnormalities associated with insulin resistance
• Endothelial dysfunction (increased adhesion molecules, increased cellular proliferation, less vasodilatation)
• Dyslipidemia (increased free fatty acids, TG, small dense LDL; decreased HDL, adiponectin)
• Procoagulant state (increased PAI-1, fibrinogen)
• Inflammation (increased CRP, IL-6)
-European Journal of Pharmacology 2004
------------------------------------------------------------------------------------------------
• 1/3 of the USA population is insulin sensitive.
• 1/3 of the population is insulin resistant. These people have very high insulin levels and really need intervention.
• 1/3 is in the middle.
The metabolic syndrome is quite simply a group of three blood tests and two physical findings. It has been defined slightly differently by different health organizations in various studies. One such definition (by the IDF) is as follows:
• 1. Abdominal (central) obesity: waist circumference >37 inches (men); >31.5 inches (women) [these are lower for South Asian/Chinese/Japanese].
Plus 2 of the following 4
• 2. Blood pressure > 130/85 mm Hg
• 3. Triglycerides > 150 mg
• 4. HDL: under 40 (men); under 50 (women)
• 5. Fasting glucose > 100 mg.
Other scientific papers may utilize different measurements but the overall significance remains the same, namely that the person has an extremely high chance of developing circulatory diseases prematurely as well as the other components of the metabolic syndrome. Note that two of the criteria are essentially “pre-diabetes” and “pre-hypertension.”
What is most interesting about the metabolic syndrome is how those seemingly unrelated components are actually interconnected. There was no “central unifying thesis” until recently. The missing link was insulin resistance.
Insulin resistance, as yet only partially understood, affects all aspects of the metabolic syndrome as well as virtually all aspects of an obese body. Simply put, insulin resistance means that a person’s insulin is not functioning up to its usual capacity. It is somehow weakened or ineffective. This begins to happen in the early stages of weight gain, particularly in those individuals from diabetic families.
Ineffective insulin is unable to allow circulating glucose to enter cells of the body, most notably those in skeletal muscle and the liver. The cells which are not receiving enough energy from glucose send out messages to the pancreas, which in turn overproduces even more ineffective insulin. Thus, paradoxically, a “pre-diabetic”, will actually be producing more insulin then his or her healthy friends.
Multiple abnormalities result thereafter, all somehow related to the overproduction of ineffective insulin. One result is excessive retention of sodium by the kidneys, especially dangerous in a “civilized” country like the U.S.A with our high salt diet. Another result is circulating fats (called free fatty acids) which have numerous potentially dangerous consequences. This can most readily be seen as elevated cholesterol and triglycerides. What is unseen is a possible destructive effect of free fatty acids on the pancreas, leading to its further weakening (and diabetes).
Can we mention two of the most dreaded complications? One is a “pro-inflammatory” state, namely having highly unstable lesions in the coronary/cerebral arteries that can literally explode at any time. The other is a “pro-coagulant” state, one in which blood can clot more easily, the usual scenario for a heart attack or stroke.
The biochemistry charts depicting the various interactions we have just described are unbelievably complex. The above discussion is extremely simplified, and a great deal is not known as yet. However we are dealing with an illness, obesity, that clearly has warning signs well in advance of potential disaster. If you have the metabolic syndrome, you have already developed insulin resistance. And if you have insulin resistance you may already have done serious damage to your heart, brain, and kidneys. The need to take weight off and keep it off would therefore be the most important item on your “to do” list.
Here’s a little more information for those who want bonus points and wish to demonstrate amazing scientific knowledge to their friends:
Metabolic abnormalities associated with insulin resistance
• Endothelial dysfunction (increased adhesion molecules, increased cellular proliferation, less vasodilatation)
• Dyslipidemia (increased free fatty acids, TG, small dense LDL; decreased HDL, adiponectin)
• Procoagulant state (increased PAI-1, fibrinogen)
• Inflammation (increased CRP, IL-6)
-European Journal of Pharmacology 2004
------------------------------------------------------------------------------------------------
• 1/3 of the USA population is insulin sensitive.
• 1/3 of the population is insulin resistant. These people have very high insulin levels and really need intervention.
• 1/3 is in the middle.
Monday, August 9, 2010
Notes on "The Park Avenue Diet Show: Sweetness and Light"; August 8, 2010
The topic of artificial sweeteners is as controversial as they get. These miracles of modern chemistry have changed the palates of the American public since the mid-1960’s. But why were they invented in the first place? Surely there are enough natural substances to go around, for example cane sugar, stevia, fructose and lactose.
Artificial sweeteners however, earned their role in our culture since they purportedly are a useful tool for weight loss and weight control. But, as we also learned in the 1960’s, “everything you know is wrong.” Is it possible that the massive increase in the incidence of obesity that began in the 1970’s is not merely a correlation with the use of artificial sweeteners but a causative factor? Put another way, does the use of artificial sweeteners make people fatter?
This was a possible interpretation of a shocking study presented at the American Diabetes Association convention in 2005. A large-scale study showed that the more diet sodas a person drank, the more likely he or she would be obese. I appeared on CNN This Morning and was interviewed by Soledad O’Brien on this topic. You can actually see this interview on You Tube.
http://www.youtube.com/watch?v=yklNA6oE0DI
Several other journal articles have appeared since 2005 which seem to confirm the suspicions of those researchers. Take a look at these articles. You may not be able to understand the technical language or the statistics, but you certainly will be disturbed to know that the role of artificial sweeteners in your diet is by no means clear—or beneficial.
http://www.ajcn.org/cgi/content/short/ajcn.2008.26792v1
http://sci.tech-archive.net/Archive/sci.med.nutrition/2005-06/msg01172.html
http://www.foodnavigator.com/Science-Nutrition/JAMA-questions-sense-of-sweeteners-for-weight-loss
Non-nutritive (artificial) sweeteners are chemosensory signaling compounds. They tell your brain that you have just ingested many calories of an imaginary sugar, but there may be a backlash of sorts. The sweeteners may condition the body to no longer associate sweetness with calories, thereby disrupting its ability to accurately assess calorie intake. Practically speaking this means that after a diet soda or two, you may overeat dessert because it doesn’t seem as sweet as those chemicals (sucralose, aspartame, saccharin).
In summary, non-nutritive sweeteners:
(1) May increase appetite.
(2) May promote energy intake, not restrict it.
(3) May contribute to obesity.
The last of these three points is obviously the most controversial. This is a source of much back-and-forth arguing in the dietary community. The matter is hardly settled yet. Could overweight or obese people be easing their consciences by substituting an artificial sweetener for a packet of sugar (which only saves them 20 calories)?
Or could the aforementioned chemicals disrupt the feedback mechanism of satiation to such a degree that artificial sweeteners in fact cause the illness, obesity, which they are meant to cure? There is no answer as yet. What do you think?
Here are the two quiz questions explained:
How much swimming do you have to do to burn off the calories from one packet of sugar? Answer: A packet of sugar contains about 20 calories. Swimming burns off approximately 600 calories per hour. Therefore 20 calories would disappear in one thirtieth of that time period, namely two minutes.
If you switch to an artificial sweetener for your morning cup of coffee and do nothing else differently, in how long will you lose one pound? Answer: Since one pound of body fat requires a sacrifice of 3500 calories and there are 20 calories in a packet of table sugar, this process will take 175 days, about six months. Please note that if you are using artificial sweeteners at breakfast time but having a high-calorie meal (like a bagel with cream cheese or pancakes)…naughty, naughty.
Artificial sweeteners however, earned their role in our culture since they purportedly are a useful tool for weight loss and weight control. But, as we also learned in the 1960’s, “everything you know is wrong.” Is it possible that the massive increase in the incidence of obesity that began in the 1970’s is not merely a correlation with the use of artificial sweeteners but a causative factor? Put another way, does the use of artificial sweeteners make people fatter?
This was a possible interpretation of a shocking study presented at the American Diabetes Association convention in 2005. A large-scale study showed that the more diet sodas a person drank, the more likely he or she would be obese. I appeared on CNN This Morning and was interviewed by Soledad O’Brien on this topic. You can actually see this interview on You Tube.
http://www.youtube.com/watch?v=yklNA6oE0DI
Several other journal articles have appeared since 2005 which seem to confirm the suspicions of those researchers. Take a look at these articles. You may not be able to understand the technical language or the statistics, but you certainly will be disturbed to know that the role of artificial sweeteners in your diet is by no means clear—or beneficial.
http://www.ajcn.org/cgi/content/short/ajcn.2008.26792v1
http://sci.tech-archive.net/Archive/sci.med.nutrition/2005-06/msg01172.html
http://www.foodnavigator.com/Science-Nutrition/JAMA-questions-sense-of-sweeteners-for-weight-loss
Non-nutritive (artificial) sweeteners are chemosensory signaling compounds. They tell your brain that you have just ingested many calories of an imaginary sugar, but there may be a backlash of sorts. The sweeteners may condition the body to no longer associate sweetness with calories, thereby disrupting its ability to accurately assess calorie intake. Practically speaking this means that after a diet soda or two, you may overeat dessert because it doesn’t seem as sweet as those chemicals (sucralose, aspartame, saccharin).
In summary, non-nutritive sweeteners:
(1) May increase appetite.
(2) May promote energy intake, not restrict it.
(3) May contribute to obesity.
The last of these three points is obviously the most controversial. This is a source of much back-and-forth arguing in the dietary community. The matter is hardly settled yet. Could overweight or obese people be easing their consciences by substituting an artificial sweetener for a packet of sugar (which only saves them 20 calories)?
Or could the aforementioned chemicals disrupt the feedback mechanism of satiation to such a degree that artificial sweeteners in fact cause the illness, obesity, which they are meant to cure? There is no answer as yet. What do you think?
Here are the two quiz questions explained:
How much swimming do you have to do to burn off the calories from one packet of sugar? Answer: A packet of sugar contains about 20 calories. Swimming burns off approximately 600 calories per hour. Therefore 20 calories would disappear in one thirtieth of that time period, namely two minutes.
If you switch to an artificial sweetener for your morning cup of coffee and do nothing else differently, in how long will you lose one pound? Answer: Since one pound of body fat requires a sacrifice of 3500 calories and there are 20 calories in a packet of table sugar, this process will take 175 days, about six months. Please note that if you are using artificial sweeteners at breakfast time but having a high-calorie meal (like a bagel with cream cheese or pancakes)…naughty, naughty.
Tuesday, August 3, 2010
Notes on "The Park Avenue Diet Show: A Modest Weight-Loss Proposal"; August 1, 2010
What could be more controversial than an essay by Jonathan Swift? How about, "A Modest Weight-Loss Proposal", an essay reminiscent of his sardonic wit, describing an imaginary "diet" that would ensure near-total compliance? You'll be able to read the complete essay at the end of this brief introduction and judge for yourself. But please be seated and have smelling salts at hand !
It was only a matter of time before politicians and insurance companies decided to impose penalties on those whose weight is excessive. I wrote the my Swiftian essay about 7 years ago, and it was immediately deleted from the manuscript for "The Park Avenue Diet." Too incendiary, I guess.
But as listeners heard, there are now taxes proposed on soda, sodium, trans fats, and saturated fats. Germany is considering weighing obese schoolchildren daily, with severe repercussions for their parents should no action be taken.
http://www.telegraph.co.uk/news/worldnews/europe/germany/7904990/Overweight-people-should-pay-fat-tax-to-cover-healthcare-costs-German-MP-says.html
Use your favorite search engine to seek out other examples of a "fat tax." You'll have plenty of summer reading material...all of it Orwellian. Or watch the politicians of New York state argue about soda taxes (naturally, all of our elected officials are glamorously and radiantly healthy role-models.)
Whatever your opinion is, don't blame me. I wrote "A Modest Weight-Loss Proposal" as a satire. The April 15th Diet, described below, was only a joke when I thought it up. Will it become reality soon? Ask at your local post office.
------------------------------------------------------------------------------------------
A Modest Weight-Loss Proposal----------------------------------------------------------
------------------------------------------------------------------------------------------
It was only a matter of time before politicians and insurance companies decided to impose penalties on those whose weight is excessive. I wrote the my Swiftian essay about 7 years ago, and it was immediately deleted from the manuscript for "The Park Avenue Diet." Too incendiary, I guess.
But as listeners heard, there are now taxes proposed on soda, sodium, trans fats, and saturated fats. Germany is considering weighing obese schoolchildren daily, with severe repercussions for their parents should no action be taken.
http://www.telegraph.co.uk/news/worldnews/europe/germany/7904990/Overweight-people-should-pay-fat-tax-to-cover-healthcare-costs-German-MP-says.html
Use your favorite search engine to seek out other examples of a "fat tax." You'll have plenty of summer reading material...all of it Orwellian. Or watch the politicians of New York state argue about soda taxes (naturally, all of our elected officials are glamorously and radiantly healthy role-models.)
Whatever your opinion is, don't blame me. I wrote "A Modest Weight-Loss Proposal" as a satire. The April 15th Diet, described below, was only a joke when I thought it up. Will it become reality soon? Ask at your local post office.
------------------------------------------------------------------------------------------
A Modest Weight-Loss Proposal----------------------------------------------------------
------------------------------------------------------------------------------------------
As a practicing physician it never ceases to amaze me when an overweight patient doesn’t follow my advice. After a Yale University liberal-arts education, a degree in psychology, four years of medical school, an Internal Medicine residency, four years of emergency room work, and more…where did I go wrong?
Usually people respond positively to my gravitas and depth of knowledge. The recommendations I give can make an enormous difference…after all, we are talking about life-shortening, debilitating chronic illnesses, the ones precipitated and worsened by overweight.
Why don’t most of those 67% overweight or obese Americans slavishly follow the warnings of the medical community? It’s certainly not from lack of publicity: every newspaper and television show seems to have an article or segment devoted to health issues. Yet only 5-10% of dieters keep the pounds off permanently and never revert to their former bad habits. What’s wrong with the other 90%? Aren’t they afraid of death?
Somewhat sheepishly I have often posed to colleagues the hypothesis that there is only one diet that would really work wonders. I call it The April 15th Diet. Don’t bother to look for the recipe book, spin-off products, or in fact any nutritional information. On The April 15th Diet you can eat unlimited portions of anything that you want throughout the entire year. Sounds terrific, no?
Then on April 15th of every year you will report to the local post office. After your retina scan and DNA sample pass inspection, you will hand the clerk a notarized copy of your previous year’s income tax returns. You will then step onto a special scale that will measure height and weight, immediately calculating your Body Mass Index. A bar-code sticker will be printed and affixed to your tax return. Then you are done for the day.
Several months later you will receive an envelope from the Internal Revenue Service. They will have audited your tax return and calculated your refund. This amount, however, will be adjusted downwards for every unit of Body Mass Index higher than ideal. Only people who demonstrate sufficient personal responsibility, self-control, and successful results will qualify for a full refund. Incomplete efforts, “trying”, or total neglect will lead to incrementally increasing deduction from the funds. Parents are also penalized for the behavior and overweight of their children.
The money saved by instituting this program would be incalculable. Since overweight and obese American will eventually divert money from the health-care system to pay for their insulin injections, cardiac surgery, dialysis treatments and seeing-eye dogs, it is economically wiser to extract some sort of pre-payment beforehand.
Illnesses that affect all people equally (cancer, influenza, broken bones) should be “paid for” by all citizens since they are all more or less at identical risk. However, the concerned citizen of the future might ask his obese neighbor, “You pay for your own ice cream. Why should I share the cost of your medication, hospitalization, and nursing care?”
Illnesses that affect all people equally (cancer, influenza, broken bones) should be “paid for” by all citizens since they are all more or less at identical risk. However, the concerned citizen of the future might ask his obese neighbor, “You pay for your own ice cream. Why should I share the cost of your medication, hospitalization, and nursing care?”
Americans share only two things in common: death and taxes. The fear of early death is not sufficient to motivate people to lose weight. The possible loss of disposable income, on the other hand, would certainly change hearts, minds, and bellies very quickly.
Memberships in health clubs would sky-rocket, especially in March. Nutritionists, rather than accountants, would have to work around the clock in early April. Cobwebs and tumbleweeds would surround fast-food stores, and long lines would form at salad bars at the crack of dawn.
Memberships in health clubs would sky-rocket, especially in March. Nutritionists, rather than accountants, would have to work around the clock in early April. Cobwebs and tumbleweeds would surround fast-food stores, and long lines would form at salad bars at the crack of dawn.
Get angry, stamp your feet, write a Letter to the Editor! I know that The April 15th Diet is the worst diet that you ever heard of…but boy would it work!
Monday, July 26, 2010
Notes on "The Park Avenue Diet Show: Flab Food Nation"; July 25; 2010
This week's show, entitled "Flab Food Nation", posed the semi-theoretical question: "What is the #1 reason that so many Americans are overweight or obese?". Callers offered their views. providing remarkable insights into this profound issue.
But beforehand there was a tutorial in The Mathematics of Dieting. First off: the definition of a calorie more specifically than a unit of energy. A food calorie (kcal) is the amount of energy needed to increase the temperature of one kilogram of water (one liter) by one degree Celsius. Other useful figures: proteins and carbs, when burned off, produce 4 kcal per gram, whereas fats produce 9 kcal per gram. It's therefore twice as hard to burn off fats...so beware of fast food breakfast sandwiches such as [redacted] with 3 strips of bacon, a sausage patty, 4 slices of ham, an egg, and 2 slices of cheese....yes, it's real.
The recommended daily intake of calories for a young adult or a man is 2500 kcal per day----and for a woman, 2000 kcal per day.
3500 kcal equals one pound of body fat....in either direction, namely putting it on or taking it off. This translates into 5 hours of jumping rope, for example, if that's a favored pastime. On the other hand, the revolting "food" called "turducken" contains 3500 kcal. God Bless America !
Last interesting trivia for now---your weight multiplied by 15 is approximately the number of calories you are now eating in order to maintain your current weight. So if you weigh 200, you are taking in 3000 kcal per day.
These fascinating facts of biochemistry have no place in the world of supermarket tabloids, where thin celebrities "lose ten pounds" on a special food program unmentioned in medical textbooks. Does anyone wonder how far we've gotten off track in our Flab Food Nation?
Back to the question of the week: "What is the #1 reason that so many Americans are overweight or obese?" There were at least six excellent responses from callers, and there were many others who couldn't get through our switchboard. Your humble host, however, provided the correct answer: "Health is not the #1 priority of most Americans." Further amplification was provided, and the discussion will continue next week.
But beforehand there was a tutorial in The Mathematics of Dieting. First off: the definition of a calorie more specifically than a unit of energy. A food calorie (kcal) is the amount of energy needed to increase the temperature of one kilogram of water (one liter) by one degree Celsius. Other useful figures: proteins and carbs, when burned off, produce 4 kcal per gram, whereas fats produce 9 kcal per gram. It's therefore twice as hard to burn off fats...so beware of fast food breakfast sandwiches such as [redacted] with 3 strips of bacon, a sausage patty, 4 slices of ham, an egg, and 2 slices of cheese....yes, it's real.
The recommended daily intake of calories for a young adult or a man is 2500 kcal per day----and for a woman, 2000 kcal per day.
3500 kcal equals one pound of body fat....in either direction, namely putting it on or taking it off. This translates into 5 hours of jumping rope, for example, if that's a favored pastime. On the other hand, the revolting "food" called "turducken" contains 3500 kcal. God Bless America !
Last interesting trivia for now---your weight multiplied by 15 is approximately the number of calories you are now eating in order to maintain your current weight. So if you weigh 200, you are taking in 3000 kcal per day.
These fascinating facts of biochemistry have no place in the world of supermarket tabloids, where thin celebrities "lose ten pounds" on a special food program unmentioned in medical textbooks. Does anyone wonder how far we've gotten off track in our Flab Food Nation?
Back to the question of the week: "What is the #1 reason that so many Americans are overweight or obese?" There were at least six excellent responses from callers, and there were many others who couldn't get through our switchboard. Your humble host, however, provided the correct answer: "Health is not the #1 priority of most Americans." Further amplification was provided, and the discussion will continue next week.
Monday, July 19, 2010
Notes on "The Park Avenue Diet Show: Are My Friends Making Me Fat?"; July 18, 2010
Are you influenced by people around you, or do you primarily make decisions on your own?
Perhaps we all do a little of both, but for this week's edition of "The Park Avenue Diet Show" we explored how one's social circle may influence his or her foods choices. Those who have maintained a good weight for decades are on automatic pilot, having established a routine that favors nutrition and optimal health from which they rarely deviate. They have their own inner set of self-care priorities, so called positive personal myths.
Other people who are struggling with weight are encircled by individuals who may knowingly or unknowingly intimidate them into overeating. This can be done through a wide range of dysfunction behaviors. Here are some examples, and you can see the pattern--someone is being asked/cajoled/humiliated into eating to fulfill someone else's negative personal myths.
"What's wrong with having a second dessert? You worked hard today and deserve it."
"Let's not talk about unpleasant topics. Let's go have a pizza."
"You don't want seconds? Obviously you don't like my cooking."
"You may be on a diet, but not here. You''ll just have to go to the gym for a few extra hours."
"You're not fat. You look fine to me."
"Enablers" are people who may knowingly or unknowingly steer you in the direction of unhealthy food choices. They are not bad people, and they may actually feel that they are taking care of you. This particularly true with parents who overfeed their children in the mistaken belief that this represents the "comforts" of home. The classic "comfort foods", still promoted by supermarket magazines that promote crackpot weight-loss tips, are well known to you: macaroni and cheese, rice and beans, noodle pudding. Do they conjure up thoughts of childhood and happiness for you?
People who want you lose to weight, improve your image, and get healthier are your "support group." People who undercut your efforts, for whatever reasons, may be "co-dependents." They may not want you to change, possibly because it reflects badly on their inability to do so.
Needless to say, weight loss, an extremely challenging project on its own, is made even more difficult when close friends, family, or colleagues involve others in unhealthy behavior patterns. Part of the learning curve in weight loss is discovering for oneself where those influence lie...and reshaping one's thinking accordingly. This is a central premise in "The Park Avenue Diet", one eloquently elucidated by Dr. Stanley Krippner. He teaches the reader how to respond to enablers and co-dependents, something equally as important as eating low calorie food, perhaps even more so, since this facilitates lifelong lifestyle changes.
The guest discussant on this week's show was the eminent psychologist Debbie Joffe Ellis. You can hear her brilliant insights and mellifluous voice on the WOR section of parkavenuediet.com
She recently completed the last chapter of her late husband's autobiography, and the book is now available...and unmissable. He, of course, is Dr. Albert Ellis, perhaps the most important psychologist of the 20th century and certainly the most influential philosophically for me. What a thrill to have Debbie on my show, but don't take my word...listen for yourself.
Here's the new book:
http://www.amazon.com/All-Out-Autobiography-Albert-Ellis/dp/1591024528
Perhaps we all do a little of both, but for this week's edition of "The Park Avenue Diet Show" we explored how one's social circle may influence his or her foods choices. Those who have maintained a good weight for decades are on automatic pilot, having established a routine that favors nutrition and optimal health from which they rarely deviate. They have their own inner set of self-care priorities, so called positive personal myths.
Other people who are struggling with weight are encircled by individuals who may knowingly or unknowingly intimidate them into overeating. This can be done through a wide range of dysfunction behaviors. Here are some examples, and you can see the pattern--someone is being asked/cajoled/humiliated into eating to fulfill someone else's negative personal myths.
"What's wrong with having a second dessert? You worked hard today and deserve it."
"Let's not talk about unpleasant topics. Let's go have a pizza."
"You don't want seconds? Obviously you don't like my cooking."
"You may be on a diet, but not here. You''ll just have to go to the gym for a few extra hours."
"You're not fat. You look fine to me."
"Enablers" are people who may knowingly or unknowingly steer you in the direction of unhealthy food choices. They are not bad people, and they may actually feel that they are taking care of you. This particularly true with parents who overfeed their children in the mistaken belief that this represents the "comforts" of home. The classic "comfort foods", still promoted by supermarket magazines that promote crackpot weight-loss tips, are well known to you: macaroni and cheese, rice and beans, noodle pudding. Do they conjure up thoughts of childhood and happiness for you?
People who want you lose to weight, improve your image, and get healthier are your "support group." People who undercut your efforts, for whatever reasons, may be "co-dependents." They may not want you to change, possibly because it reflects badly on their inability to do so.
Needless to say, weight loss, an extremely challenging project on its own, is made even more difficult when close friends, family, or colleagues involve others in unhealthy behavior patterns. Part of the learning curve in weight loss is discovering for oneself where those influence lie...and reshaping one's thinking accordingly. This is a central premise in "The Park Avenue Diet", one eloquently elucidated by Dr. Stanley Krippner. He teaches the reader how to respond to enablers and co-dependents, something equally as important as eating low calorie food, perhaps even more so, since this facilitates lifelong lifestyle changes.
The guest discussant on this week's show was the eminent psychologist Debbie Joffe Ellis. You can hear her brilliant insights and mellifluous voice on the WOR section of parkavenuediet.com
She recently completed the last chapter of her late husband's autobiography, and the book is now available...and unmissable. He, of course, is Dr. Albert Ellis, perhaps the most important psychologist of the 20th century and certainly the most influential philosophically for me. What a thrill to have Debbie on my show, but don't take my word...listen for yourself.
Here's the new book:
http://www.amazon.com/All-Out-Autobiography-Albert-Ellis/dp/1591024528
Monday, July 12, 2010
Notes on "The Park Avenue Diet Show: Oil and Water"; July 11, 2010
My lecture on "Oil and Water" has been popular for many years. I first did it on "Vital Signs", my fondly remembered WEVD program sponsored by The Atkins Center, then recycled it for several lectures.
Oil and water don't mix (they are immiscible), as anyone who has repaired his or her own car knows very well. Oil and water don't mix in milk either, as it eventually separates into curds (fat) and whey (water-soluble protein). When you eat dietary "oils" (fats) like butter, cream, cheese, or salad oil, a separate liquid, bile (which is made in the liver and stored in the gall bladder), is needed to allow their byproducts to flow through the intestines and become absorbed into the circulation.
Once in your bloodstream, the oils take the form of cholesterol, triglycerides, and similar chemicals, and they travel as somewhat isolated molecules (for our convenience these are simplistically named HDL, LDL, VLDL etc...but the constituency of these is very complex.)
Oils have a place in the lungs..."lubricating" the air sacs (alveoli) so that they never collapse fully. We were taught at Maimonides Medical Center that this is partially why chicken soup is so soothing during flu season---the chicken fat makes the lung tissues more compliant, less "dehydrated."
But oil in the wrong place is a bad bad thing, just like butter staining your clothing when it squirts out of Chicken Kiev. Allergic reactions are usually due to oils--the most notorious, diet-wise, is peanut oil. The most notorious, skin-wise, is the plant that causes urushiol-induced contact dermatitis...poison ivy.
Overflow oil (triglycerides, particularly) in the liver causes what I used to refer to as "The Pate Syndrome"--"fatty liver", properly temed steatohepatitis. Oil inflames the tissues, just like "poisonous" plants inflame the skin, and the eventual result can be cirrhosis. Just as a reminder--- it is predicted that young obese diabetics who continue to neglect their diet and weight might need liver transplants in the future (in their 40's) for this entirely preventable condition.
And now, the piece de resistance...oil (cholesterol molecules) in the walls of coronary arteries--very similar to "pimples"--are hidden pockets of inflammation, calcium deposition, and blood clots. These can eventually rupture, just like a pimple, except that the rupture of a coronary artery is the initial event in most heart attacks. Oil in the walls of coronary arteries is "immiscible" in the water-based environment of bodily fluids and tissues. Here, the abnormal collision of oil and water can be fatal.
This is why anti-inflammatory agents (such as low-dose aspirin) are used to prevent strokes and heart attaks. They "soothe" the interface between oil and water...but if there are too many lesions, "something's got to give."
Oil and water----they need to get along somehow in many of your bodily organs. But if you're neglecting your weight and diet...and therefore your health...the collision between oil and water might be explosive !
Oil and water don't mix (they are immiscible), as anyone who has repaired his or her own car knows very well. Oil and water don't mix in milk either, as it eventually separates into curds (fat) and whey (water-soluble protein). When you eat dietary "oils" (fats) like butter, cream, cheese, or salad oil, a separate liquid, bile (which is made in the liver and stored in the gall bladder), is needed to allow their byproducts to flow through the intestines and become absorbed into the circulation.
Once in your bloodstream, the oils take the form of cholesterol, triglycerides, and similar chemicals, and they travel as somewhat isolated molecules (for our convenience these are simplistically named HDL, LDL, VLDL etc...but the constituency of these is very complex.)
Oils have a place in the lungs..."lubricating" the air sacs (alveoli) so that they never collapse fully. We were taught at Maimonides Medical Center that this is partially why chicken soup is so soothing during flu season---the chicken fat makes the lung tissues more compliant, less "dehydrated."
But oil in the wrong place is a bad bad thing, just like butter staining your clothing when it squirts out of Chicken Kiev. Allergic reactions are usually due to oils--the most notorious, diet-wise, is peanut oil. The most notorious, skin-wise, is the plant that causes urushiol-induced contact dermatitis...poison ivy.
Overflow oil (triglycerides, particularly) in the liver causes what I used to refer to as "The Pate Syndrome"--"fatty liver", properly temed steatohepatitis. Oil inflames the tissues, just like "poisonous" plants inflame the skin, and the eventual result can be cirrhosis. Just as a reminder--- it is predicted that young obese diabetics who continue to neglect their diet and weight might need liver transplants in the future (in their 40's) for this entirely preventable condition.
And now, the piece de resistance...oil (cholesterol molecules) in the walls of coronary arteries--very similar to "pimples"--are hidden pockets of inflammation, calcium deposition, and blood clots. These can eventually rupture, just like a pimple, except that the rupture of a coronary artery is the initial event in most heart attacks. Oil in the walls of coronary arteries is "immiscible" in the water-based environment of bodily fluids and tissues. Here, the abnormal collision of oil and water can be fatal.
This is why anti-inflammatory agents (such as low-dose aspirin) are used to prevent strokes and heart attaks. They "soothe" the interface between oil and water...but if there are too many lesions, "something's got to give."
Oil and water----they need to get along somehow in many of your bodily organs. But if you're neglecting your weight and diet...and therefore your health...the collision between oil and water might be explosive !
Monday, July 5, 2010
Notes on "The Park Avenue Diet Show: Weight Loss in Red, White, and Blue": July 4, 2010
The articles reviewed this week frame the subject of obesity in unusual ways, at least geographically speaking. First this news item:
http://www.theborneopost.com/?p=42767
Borneo and the surrounding islands of the Indonesian archipelago are not usually associated with obesity. How times have changed ! Sad to say, other emerging nations, formerly plagued by endemic malnutrition, are struggling with the same problem, namely China, India, and Mexico.
Leave it to the USA to spearhead the movement, albeit in the wrong ways:
http://www.nydailynews.com/lifestyle/2010/06/24/2010-06-24_open_wide_friendlys_burger_and_cheese_triple_decker_is_even_worse_for_you_than_k.html
I reviewed other fast-food franchise websites as we discussed what to eat during the summer and came up with new, depressing facts. Ice cream is no longer the single scoop treat or Eskimo Bar that your parents might remember. There are now even sweeter, thicker, and more artificial concoctions that pack hundreds of extra calories into swimwear that teeters on the brink of explosion. One such company, advertising a product whose caloric content ranges from 700 to 950 (!!!) has this slogan: "You only live once." If rewritten to utilize data from an article cited previously from The Lancet: "You only live once, and we're taking three years of that away from you."
"Weight Loss in Red, White, and Blue" can be expressed in pleasant and positive ways--like red snapper, egg white omelets, and blueberries. But that same show title can also remind us of the consequences of obesity: excess blood clotting, anemia due to chronic renal failure, and cyanosis due to sleep apnea. Which do you prefer for yourself and your family?
The average male requires about 2000 calories a day, the average woman 1800. With that in mind, please look at certain foods differently this summer: pecan pie (575), 4 ounce cheeseburger (525), giant soft pretzel (500), "club sandwich" (800),.....one carrot (30), papaya (less than 50), corn on the cob (100). Do you really need 500 calories of starch and fat as "popcorn" in order to sit through Eclipse? Send your extra calories to Robert Pattinson !
And what about burning off calories over the summer? I doubt you'll be waterskiing (400 calories/hour). Maybe your type of "exercise" is miniature golf (200 calories). Most likely, your weightlifting will be confined to your cellphone and "cardio" will be gossiping (68 calories/hour).
Want more shockingly high-calorie food stats? A 20 ounce T-bone steak (1500), potato salad (360), "funnel cake" (500) and a gigantic turkey leg (1100) might try to tempt you, overstimulate your insulin, and fill up thousands of lipocytes.
Or would you prefer something nutritious and tasty? Watermelon, papaya, and avocados are alkaline, raising your body's pH very healthfully at a low caloric cost. What's better for you than those grotesque colas, spiked with phenylalanine? Coconut water has the same osmolarity as human serum, perfect for those hot, sweaty days. It's actually better for dehydration than water or that "vitamin" liquid.
In an era when your own health, image, and self-care become increasingly important every day, how much longer can you afford to ignore The Mathematics of Dieting? 3500 calories= one pound of body fat, on or off your body. Summer is as good a time as any to do the math, come to your senses, and reinvent yourself entirely a la The Park Avenue Diet. You are the main beneficiary, and that's the best investment for the future anyone can make !
http://www.theborneopost.com/?p=42767
Borneo and the surrounding islands of the Indonesian archipelago are not usually associated with obesity. How times have changed ! Sad to say, other emerging nations, formerly plagued by endemic malnutrition, are struggling with the same problem, namely China, India, and Mexico.
Leave it to the USA to spearhead the movement, albeit in the wrong ways:
http://www.nydailynews.com/lifestyle/2010/06/24/2010-06-24_open_wide_friendlys_burger_and_cheese_triple_decker_is_even_worse_for_you_than_k.html
I reviewed other fast-food franchise websites as we discussed what to eat during the summer and came up with new, depressing facts. Ice cream is no longer the single scoop treat or Eskimo Bar that your parents might remember. There are now even sweeter, thicker, and more artificial concoctions that pack hundreds of extra calories into swimwear that teeters on the brink of explosion. One such company, advertising a product whose caloric content ranges from 700 to 950 (!!!) has this slogan: "You only live once." If rewritten to utilize data from an article cited previously from The Lancet: "You only live once, and we're taking three years of that away from you."
"Weight Loss in Red, White, and Blue" can be expressed in pleasant and positive ways--like red snapper, egg white omelets, and blueberries. But that same show title can also remind us of the consequences of obesity: excess blood clotting, anemia due to chronic renal failure, and cyanosis due to sleep apnea. Which do you prefer for yourself and your family?
The average male requires about 2000 calories a day, the average woman 1800. With that in mind, please look at certain foods differently this summer: pecan pie (575), 4 ounce cheeseburger (525), giant soft pretzel (500), "club sandwich" (800),.....one carrot (30), papaya (less than 50), corn on the cob (100). Do you really need 500 calories of starch and fat as "popcorn" in order to sit through Eclipse? Send your extra calories to Robert Pattinson !
And what about burning off calories over the summer? I doubt you'll be waterskiing (400 calories/hour). Maybe your type of "exercise" is miniature golf (200 calories). Most likely, your weightlifting will be confined to your cellphone and "cardio" will be gossiping (68 calories/hour).
Want more shockingly high-calorie food stats? A 20 ounce T-bone steak (1500), potato salad (360), "funnel cake" (500) and a gigantic turkey leg (1100) might try to tempt you, overstimulate your insulin, and fill up thousands of lipocytes.
Or would you prefer something nutritious and tasty? Watermelon, papaya, and avocados are alkaline, raising your body's pH very healthfully at a low caloric cost. What's better for you than those grotesque colas, spiked with phenylalanine? Coconut water has the same osmolarity as human serum, perfect for those hot, sweaty days. It's actually better for dehydration than water or that "vitamin" liquid.
In an era when your own health, image, and self-care become increasingly important every day, how much longer can you afford to ignore The Mathematics of Dieting? 3500 calories= one pound of body fat, on or off your body. Summer is as good a time as any to do the math, come to your senses, and reinvent yourself entirely a la The Park Avenue Diet. You are the main beneficiary, and that's the best investment for the future anyone can make !
Tuesday, June 29, 2010
Notes on "The Park Avenue Diet Show: What is a Personal Myth?"; June 27, 2010
The article cited this week comes from the current Journal of the American Medical Association. It discusses the link between obesity and the development of diabetes in older adults. Needless to say, the illness indeed develops insidiously, as with other age groups. There are no surprises here:
http://jama.ama-assn.org/cgi/content/abstract/303/24/2504
Much more interesting and sadly emblematic of our times is a cover article in a recent “health” magazine. Last week I saw a famed “nutritional” periodical tell its readers how to “eat more, weigh less”, a physical impossibility. But this week I stared at the cover of a well-known journal with the headline: “Lose 7 Pounds in 6 Days.”
Let’s explore the mathematics of dieting, a favorite topic. 3500 calories = one pound, whether calories are taken in or burned off. In order to lose 7 pounds, you need to incur a calorie deficit of 24, 500 calories. If this is divided among 6 days, that comes to about 4000 calories a day. Now remember, you need a deficit, so that means…no eating at all…as well of one of these “exercise programs”: swimming for 6 hours per day, taking eight aerobic classes in sequence daily, or mowing the lawn for 10 hours per day—a “green” alternative.
Therefore, that article I saw promised something physically impossible. The “weight” lost by any crash program is extracellular tissue fluid—water—which will promptly be regained. Did you get fooled by any similar articles today? I hope not.
The general topic for this evening’s broadcast was “What is a Personal Myth?” This topic has been explored for decades by my lifelong friend, mentor, and literary colleague Dr. Stanley Krippner. My own take on this complex and fascinating topic:
Personal myths make up our “rulebook”, the code of behavior that we have developed for ourselves over a lifetime. Many can be positive, for example: “I can best help the world during my life by being a physician.” [one of mine]
But all of us harbor negative personal myths, and sometimes these can undermine our best efforts at living. A distorted belief system can lead an individual into unrealistic viewpoints, self-deception, and self-validation. The latter is nicely expressed in French as soi disante…[self-styled, making the speaker an authority figure].
Here are typical negative personal myths that interfere with some individuals’ inability to stay on a weight loss diet.
1) It’s been a hard day at work so I’m having another piece of pie.
2) I’m allowed to have “cheat days” because overall I plan to lose weight.
3) I’m going to eat macrobiotic for the rest of my life.
4) I just worked out at the gym so now I can eat whatever I want.
5) Ordering a diet beverage offsets the high calories in the rest of my meal.
6) Buying cakes and muffins in bulk is the perfect way to save money in a recession.
7) My kids aren’t overweight. That’s baby fat.
And so on…
The remedy is to replace each of these incorrect statements with a productive and realistic thought that leads to a healthier lifestyle. That’s part of The Park Avenue Diet, by the way.
In coming shows, we’ll explore how to do this. Meanwhile, can you think of any of your own personal myths…and how I might “rewrite” them to send you off to a happier tomorrow? Give it a try.
Meanwhile, here’s a superlative classic book by Dr. Krippner that belongs in your library.
http://www.amazon.com/Personal-Mythology-Ritual-Imagination-Discover/dp/160415036X/ref=pd_sim_b_1
http://jama.ama-assn.org/cgi/content/abstract/303/24/2504
Much more interesting and sadly emblematic of our times is a cover article in a recent “health” magazine. Last week I saw a famed “nutritional” periodical tell its readers how to “eat more, weigh less”, a physical impossibility. But this week I stared at the cover of a well-known journal with the headline: “Lose 7 Pounds in 6 Days.”
Let’s explore the mathematics of dieting, a favorite topic. 3500 calories = one pound, whether calories are taken in or burned off. In order to lose 7 pounds, you need to incur a calorie deficit of 24, 500 calories. If this is divided among 6 days, that comes to about 4000 calories a day. Now remember, you need a deficit, so that means…no eating at all…as well of one of these “exercise programs”: swimming for 6 hours per day, taking eight aerobic classes in sequence daily, or mowing the lawn for 10 hours per day—a “green” alternative.
Therefore, that article I saw promised something physically impossible. The “weight” lost by any crash program is extracellular tissue fluid—water—which will promptly be regained. Did you get fooled by any similar articles today? I hope not.
The general topic for this evening’s broadcast was “What is a Personal Myth?” This topic has been explored for decades by my lifelong friend, mentor, and literary colleague Dr. Stanley Krippner. My own take on this complex and fascinating topic:
Personal myths make up our “rulebook”, the code of behavior that we have developed for ourselves over a lifetime. Many can be positive, for example: “I can best help the world during my life by being a physician.” [one of mine]
But all of us harbor negative personal myths, and sometimes these can undermine our best efforts at living. A distorted belief system can lead an individual into unrealistic viewpoints, self-deception, and self-validation. The latter is nicely expressed in French as soi disante…[self-styled, making the speaker an authority figure].
Here are typical negative personal myths that interfere with some individuals’ inability to stay on a weight loss diet.
1) It’s been a hard day at work so I’m having another piece of pie.
2) I’m allowed to have “cheat days” because overall I plan to lose weight.
3) I’m going to eat macrobiotic for the rest of my life.
4) I just worked out at the gym so now I can eat whatever I want.
5) Ordering a diet beverage offsets the high calories in the rest of my meal.
6) Buying cakes and muffins in bulk is the perfect way to save money in a recession.
7) My kids aren’t overweight. That’s baby fat.
And so on…
The remedy is to replace each of these incorrect statements with a productive and realistic thought that leads to a healthier lifestyle. That’s part of The Park Avenue Diet, by the way.
In coming shows, we’ll explore how to do this. Meanwhile, can you think of any of your own personal myths…and how I might “rewrite” them to send you off to a happier tomorrow? Give it a try.
Meanwhile, here’s a superlative classic book by Dr. Krippner that belongs in your library.
http://www.amazon.com/Personal-Mythology-Ritual-Imagination-Discover/dp/160415036X/ref=pd_sim_b_1
Monday, June 21, 2010
Notes on "The Park Avenue Diet Show"; June 20, 2010
A fascinating article was recently published in the British Medical Journal reporting the findings of a survey that found a correlation between obesity and adverse sexual health.
http://www.bmj.com/cgi/content/full/340/jun15_1/c2573
This article is certainly the first of its kind and sparked interesting discussion on many news blogs. A definite correlation was found between Body Mass Index and sexual behavior. Unfortunately, the findings were negative and unpleasant.
What is most interesting was this statement: “The relation between obesity and sexual ill health might be forged via physiological, social, and psychological mechanisms. It is in the social factors influencing sexual behavior, however, that we are most likely to find insights into these findings, particularly for women.”
The correlation between weight and impaired social behavior is addressed as a central premise in The Park Avenue Diet. No other weight loss book or philosophy works on these seemingly unrelated components of image simultaneously. Poor interpersonal skills, however, will lead people into the abyss of dietary excess; food provides the comfort and pleasant feelings that elude them in intimate relationships. Although a harsh reality, this must be addressed as part of a weight loss program. The researchers in the above scholarly article have obviously come to the same conclusion.
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The Ten Commandments of Dieting, as discussed on the 6/20/10 show:
1. Matter is neither created nor destroyed in a chemical equation. [This is The First Law of Thermodynamics which basically states for our purposes that weight gain or loss is totally dependent on calories. Any other explanation defies physics.]
2. No commercially available weight loss program has ever been shown to be better than another. There “success rate” is approximately 5-10% with success defined as 12-15 pounds in one year. These facts are shielded from the American public. They would not be if the issue was car safety, for example. [The studies that prove this can be readily accessed in the bibliography of The Park Avenue Diet. In fact, the AMA and ACP have asked that no further studies be done on this subject since the outcomes will always be the same.]
3. There is no single set of foods associated with normal weight. On the contrary, individuals throughout the world are able to avoid weight gain on hundreds of ethnically different diets. [The foods that magically produce weight loss are figments in the imagination of desperate magazine writers.]
4. A weight loss program that does not take into account other components of image will fail in the long and short run. [Please refer to the discussion above for an illustration of the relationship between BMI and “interpersonal skills.”]
5. Magazines whose cover articles describe “How to Lose Belly Fat” should not accept advertising revenue from products with “empty” calories. Why have we banned cigarette and liquor ads from magazines? [A currently available supermarket magazine tells gullible readers “Eat more, Weigh Less”—a physical impossibility]
6. “Hormonal” imbalances affect weight gain minimally, probably around 15 pounds, according to the American College of Physicians. [Obesity is not a “glandular condition.”]
7. “Yo-yo dieting” is an independent risk-factor for cardiovascular disease. [All the more reason to lose weight and keep it off!]
8. Human genetics do not account for any aspect of weight gain. The obesity epidemic began in the mid-70’s, and 30 years is too short a time for the human genome to be modified. [The idea that human DNA can change drastically in a few decades defies molecular biology and common sense, although not necessarily in that order.]
9. You can not lose weight without proper nutritional supplementation. You can not maintain a healthy weight without regular exercise. [Them’s the rules. I don’t make them.]
10. Do not look at the scale. Observant friends, family, and colleagues will notice any improvement. They, after all, are the ultimate judges of how you look. [This is another central premise of The Park Avenue Diet. If you truly look and act much differently, everyone will notice and be impressed.]
http://www.bmj.com/cgi/content/full/340/jun15_1/c2573
This article is certainly the first of its kind and sparked interesting discussion on many news blogs. A definite correlation was found between Body Mass Index and sexual behavior. Unfortunately, the findings were negative and unpleasant.
What is most interesting was this statement: “The relation between obesity and sexual ill health might be forged via physiological, social, and psychological mechanisms. It is in the social factors influencing sexual behavior, however, that we are most likely to find insights into these findings, particularly for women.”
The correlation between weight and impaired social behavior is addressed as a central premise in The Park Avenue Diet. No other weight loss book or philosophy works on these seemingly unrelated components of image simultaneously. Poor interpersonal skills, however, will lead people into the abyss of dietary excess; food provides the comfort and pleasant feelings that elude them in intimate relationships. Although a harsh reality, this must be addressed as part of a weight loss program. The researchers in the above scholarly article have obviously come to the same conclusion.
------------------------------------------------------------------------------------------------
The Ten Commandments of Dieting, as discussed on the 6/20/10 show:
1. Matter is neither created nor destroyed in a chemical equation. [This is The First Law of Thermodynamics which basically states for our purposes that weight gain or loss is totally dependent on calories. Any other explanation defies physics.]
2. No commercially available weight loss program has ever been shown to be better than another. There “success rate” is approximately 5-10% with success defined as 12-15 pounds in one year. These facts are shielded from the American public. They would not be if the issue was car safety, for example. [The studies that prove this can be readily accessed in the bibliography of The Park Avenue Diet. In fact, the AMA and ACP have asked that no further studies be done on this subject since the outcomes will always be the same.]
3. There is no single set of foods associated with normal weight. On the contrary, individuals throughout the world are able to avoid weight gain on hundreds of ethnically different diets. [The foods that magically produce weight loss are figments in the imagination of desperate magazine writers.]
4. A weight loss program that does not take into account other components of image will fail in the long and short run. [Please refer to the discussion above for an illustration of the relationship between BMI and “interpersonal skills.”]
5. Magazines whose cover articles describe “How to Lose Belly Fat” should not accept advertising revenue from products with “empty” calories. Why have we banned cigarette and liquor ads from magazines? [A currently available supermarket magazine tells gullible readers “Eat more, Weigh Less”—a physical impossibility]
6. “Hormonal” imbalances affect weight gain minimally, probably around 15 pounds, according to the American College of Physicians. [Obesity is not a “glandular condition.”]
7. “Yo-yo dieting” is an independent risk-factor for cardiovascular disease. [All the more reason to lose weight and keep it off!]
8. Human genetics do not account for any aspect of weight gain. The obesity epidemic began in the mid-70’s, and 30 years is too short a time for the human genome to be modified. [The idea that human DNA can change drastically in a few decades defies molecular biology and common sense, although not necessarily in that order.]
9. You can not lose weight without proper nutritional supplementation. You can not maintain a healthy weight without regular exercise. [Them’s the rules. I don’t make them.]
10. Do not look at the scale. Observant friends, family, and colleagues will notice any improvement. They, after all, are the ultimate judges of how you look. [This is another central premise of The Park Avenue Diet. If you truly look and act much differently, everyone will notice and be impressed.]
Monday, June 14, 2010
Notes on "The Park Avenue Diet Show"--June 13th, 2010
Here are a few comments regarding the points covered in the show entitled" The Top Ten Weight-Loss Myths".
The Medical Riddle of the Day was: "What is it called when overflowing oil gushes out into natural surroundings and pollutes everything it touches?" The answer is not you-know-what in the Gulf of Mexico. It's visceral fat, that toxic accumulation of hormonally active, potentially carcinogenic, and thus extremely dangerous "oil"....which "pollutes" millions of American bodies internally. No tell-tale oil slick, since these chemicals (free fatty acids) do their mischief via the circulation.
And here are the Top Ten Weight-Loss Myths
1) Those mass-market diets are very successful. That's why they've been around for years. (See The Park Avenue Diet bibliography for medical articles on this topic----and be prepared to be horrified).
2) "I'm from the government and I'm here to help your weight" (This paraphrase of Ronald Reagan is meant as a warning that no elected official, government agency, or political party is particularly interested in your health...and therefore it's up to you. This will be even more true in future years.)
3) There are foods that can help you lose weight (This is conceptually impossible and defies the first law of thermodynamics).
4) There's nothing wrong with being overweight (Lifespan is reduced by one year in the overweight, 3 years in the obese, and 10 years in the massively obese....please complain to "The Lancet" if this seems unpleasant).
5) Exercise is more important than eating correctly if you want to lose weight (Many 'exercisers' overeat after a workout...conversely, exercise is mandatory for maintenance of a good weight.
6) All health information is equally valid, especially those magazines at the supermarket checkout counter.
7) Weight-loss depends on carbohydrate content and/or glycemic index. (see: the first law of thermodynamics)
8) Diabetes and high blood pressure are benign conditions like athlete's foot.
9) I feel okay so my weight isn't a problem.
10) "Weight loss has magical transformative properties." (This error in thinking is discussed at length in The Park Avenue Diet).
Next week: The Ten Commandments of Weight-Loss (June 20, 2010).
The Medical Riddle of the Day was: "What is it called when overflowing oil gushes out into natural surroundings and pollutes everything it touches?" The answer is not you-know-what in the Gulf of Mexico. It's visceral fat, that toxic accumulation of hormonally active, potentially carcinogenic, and thus extremely dangerous "oil"....which "pollutes" millions of American bodies internally. No tell-tale oil slick, since these chemicals (free fatty acids) do their mischief via the circulation.
And here are the Top Ten Weight-Loss Myths
1) Those mass-market diets are very successful. That's why they've been around for years. (See The Park Avenue Diet bibliography for medical articles on this topic----and be prepared to be horrified).
2) "I'm from the government and I'm here to help your weight" (This paraphrase of Ronald Reagan is meant as a warning that no elected official, government agency, or political party is particularly interested in your health...and therefore it's up to you. This will be even more true in future years.)
3) There are foods that can help you lose weight (This is conceptually impossible and defies the first law of thermodynamics).
4) There's nothing wrong with being overweight (Lifespan is reduced by one year in the overweight, 3 years in the obese, and 10 years in the massively obese....please complain to "The Lancet" if this seems unpleasant).
5) Exercise is more important than eating correctly if you want to lose weight (Many 'exercisers' overeat after a workout...conversely, exercise is mandatory for maintenance of a good weight.
6) All health information is equally valid, especially those magazines at the supermarket checkout counter.
7) Weight-loss depends on carbohydrate content and/or glycemic index. (see: the first law of thermodynamics)
8) Diabetes and high blood pressure are benign conditions like athlete's foot.
9) I feel okay so my weight isn't a problem.
10) "Weight loss has magical transformative properties." (This error in thinking is discussed at length in The Park Avenue Diet).
Next week: The Ten Commandments of Weight-Loss (June 20, 2010).
Tuesday, February 16, 2010
The Greatest Blessing of Life
At designated times of the year like Easter, Passover and other holidays, we are often asked to count our blessings. Maybe you’ve been reminded of this somewhat hypothetical activity when confronted with someone else’s problems. “There but for the Grace of God go I” seemed an archaic rumination until I had emergency ulcer surgery in 1991—feeling sorry for myself until I realized that my room at St. Claire’s Hospital was on a ward of people with terminal illnesses. All my intravenous lines, electrodes, and tubes seemingly vanished when I pondered the depth of those patients’ despair and suffering. It was an epiphany of sorts, but one arrived at through transformation of selfishness into empathy for others less fortunate.
Are you conscious of how seamlessly the human body works? Think about the organs over which you have no control: your spleen, ureters, ciliary muscles, alveoli, pons, and portal triad (among dozens of other body parts) are actively engaged in highly specific tasks beyond the scope of human understanding, let alone noticeable feelings. Put another way, the parts of your body that you actually notice—your brain (via self-talk and voluntary actions)…your muscles (via your conscious movements)…your digestive tract (via hunger and subsequent satiation)—are a tiny component of the entire machine. The part of you that’s unique (your thoughts, your memories, your knowledge base, your appearance) is really very small when compared with the dazzling molecular structure, biochemical interrelationships, and mechanical intricacies of the musculoskeletal infrastructure. Shakespeare called the human body “the beauty of the Earth, the paragon of animals.”
Yet there is something even more beautiful than the human body, and that is the mysterious set of emotions that draws people together. While we share these unknowable forces with every member of the animal kingdom, we humans seem to do it more poetically. From earliest childhood when we are taught social behavior, we can develop a need to share, a special pleasure in the attention and affection of others, and perhaps even an inner calm and contentment when we find ourselves in intimate relationships.
Like optimal health, personal contentment is an evanescent pleasure, one subject to the whims of fortune, the inexorable forces of nature, and the ultimate fragility of the human body. The people we are closest to will eventually vanish from our lives, even under the best circumstances. The loss will be magnified exponentially the closer and more intense the relationship was. That cannot dissuade us from trying to reach out to others, hoping by some strange twist of fate, or perhaps just good luck, or even the kind intervention of a friend, to find someone who can give a meaning to life that eludes all of medical science.
The greatest blessing of life is the one that transcends the ravages of time, aging, disease, despair, loneliness, and fear. It is the force that ennobles us, makes us capable of being more than ourselves, more than complex biochemical machines, more than a collection of organ systems. Like the human body, it is magical, powerful, uncontrollable, and all-enveloping. It is ample reason for life itself. It is love.
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