What’s New! – A Healthy Living Newsletter

September, 2002
My patients frequently ask my opinion about new health books on the market. And there's certainly no shortage of experts peddling their advice! While many of these books are excellent, others are written by people who don't have a clinical background in the subject. Simply put - they're inaccurate.

The people writing the books either don't regularly use the medicines they write about or they're presenting theories as if they are facts. Others can be valuable tools for improving the quality of your life.

If you find this newsletter useful, please forward it to a friend!

Get Skinny The Smart Way A Revolutionary Approach to Winning the Diet War Forever By Annette B. Natow, Ph.D., R.D. and Jo-Ann Heslin, M.A., R.D. I've read so many diet books, I know the formula by heart. First start with the dangers of obesity, then explain why the other diets don't work, and finally come up with a "revolutionary" variation of a diet popular about 50 years ago that is "new" for everyone under 60. Does Get Skinny The Smart Way fall into this mold? Almost.

Written by two dietitians, Get Skinny The Smart Way is simple and direct. Natow and Heslin base their diet on a few premises: 1) no food is forbidden and 2) eating should be fun. Is their diet fun? Actually, they do try to make interesting, flavorful and low-cal foods. And even better, they help the dieter along with little "tricks" such as eating pectin, drinking water and taking a calcium supplement to curb the appetite and burn calories.

A great feature of this book is the 28-day menu plan. The dieter knows just what to eat and in what proportions for the first month. And Natow and Heslin try to cover all the difficult-to-diet situations such as holidays, eating out, and traveling. When discussing eating out, the authors suggest looking for these words: au jus, baked, boiled, grilled, cooked with lemon juice, cooked with wine, garden fresh, steamed, roasted, poached, marinara, lean, without skin and fresh. Try to avoid the following: au gratin, battered, buttered, breaded, casserole, hash, hollandaise, creamed, deep fried, gravy, scalloped, rich, prime, Kiev, etc.

Without delving into the psychology of obesity, the authors discuss eating "triggers" or emotional situations which cause people to overeat - and how to cope with them. For example, "When I can't sleep, I eat. How do I stop this?", "Whenever I fight with my husband, I bury my sorrow in a bag of potato chips which destroys all my dieting efforts. Any suggestions?", or "Any ideas on how to avoid the office vending machines?" Their answers were again, simple, useful and direct.

Like any good diet book, Get Skinny The Smart Way emphasizes exercise. The exercises are nothing special - just a basic free weight program with stretching thrown in for good measure. But I actually like that better than encouraging dieters to join a gym knowing that most people stop going to gyms after 1 month - and feel guilty about the money they wasted. Instead, the free weights are a minimal financial investment and will sit there on your closet floor as a daily reminder to use them.

I have a few reservations about this book. First, the authors are a bit anal about calories. I'm more focused on the quality of food, how it improves you health and eating in moderation. So, it was disconcerting to see page after page of foods listed by their caloric content. For example, a toasted plain white flour bagel has 195 calories, while a fresh avocado has 324. For a calorie counter, the bagel would be the wiser choice. For the health conscious, the avocado would be better. It's rich in vitamins, minerals and natural fats that, among other things, support your skin and a healthy immune system. The white flour bagel is vitamin depleted and metabolizes into glucose. If eaten alone, the bagel forces your body to work harder to keep your blood sugar stable.

Another small objection I have with the book is the too-generalized calcium recommendation. Cheap calcium supplements often contain lead and are poorly absorbed. I also question the whole idea of calcium as a fat burner. The authors state that when calcium levels are low, hormones tell the body to hold on to and store extra fat. As I mentioned in another review, people in the West and in the United States in particular, have higher levels of calcium than their Eastern counterparts. That means Americans should weigh-in less than the other countries. (Anyone who has visited Disney World in Orlando, Florida, knows that's just not the case.)

"On any given day, 45% of women and 24% of men in the U.S. are either trying to lose weight or maintain the weight they lost." For these folks in-the-dieting-trenches, Get Skinny The Smart Way is a useful book. It's not particularly slick or sophisticated. Instead, it's a practical way for the average person to lose some weight and gain healthier eating habits.

Overdose The Case Against the Drug Companies By Jay S. Cohen, M.D. In the United States today, there are approximately 300 medication-related deaths every day. That's about 106,000 people a year. This means 300 times a day, some medically authorized prescription drug causes someone not just to get sick, lose kidney function, develop arthritis or diabetes - but to die.

I had to reread these statistics several times because I simply couldn't believe it. Americans fear losing our young men in a potential war thousands of miles away and yet we passively lose 300 people a day right here from legitimately-prescribed drugs causing fatal side-effects or overdoses.

Compare this to the 300 deaths a year from U.S. airline crashes or the 85 people who died over several years from accidents linked to faulty Firestone tires. There's something wrong here! And that's why author and medical doctor Jay Cohen wrote Overdose. In Overdose, he methodically, almost tediously looks at the drug industry and the over-drugging of U.S. citizens. I say methodical because it's not the easiest book to read. He footnotes everything and inundates the reader with detailed explanations defending his points. But then, if you were writing something potentially libelous, you would do the same.

Cohen is a man with a 3-part agenda. First, educate medical physicians as to the lowest, safest and most effective drug doses for their patients as to eliminate side-effects. Second, establish an independent drug testing and research program that confirms or refutes the drug companies' claims for their products. And third, develop an Independent Medication Safety Board that investigates prescription drug-related deaths.

Educating physicians is tougher than it sounds. Most physicians, and laypeople rely on the Physicians Desk Reference (PDR) for their drug information. But who writes the PDR? The drug companies. And are they going to include ways to use less of their products and therefore decrease their revenues? Except in a few circumstances, you can guess the answer. Interestingly enough, most of the independently written drug reference books failed. Perhaps, because they charged for the book instead of delivering it free, like the PDR, to roughly 700,000 medical physicians in the United States.

Cohen suggests that the cholesterol-lowering drug Zocor is safer and equally as effective in most people in doses of 5 and 10mg a day in comparison to the 20mg dosage generally given. Celebrex, a popular drug for arthritis, works well at the Mayo clinic in 50mg dosages rather than the typical 100mg. And Prozac can be effective in many people at ½ and ¼ strength of its usually recommended prescription. To help physicians, Overdose includes a list of top selling drugs and their safer, lower doses.

All too frequently, well-meaning physicians dismiss age when they discuss drug side-effects. This is especially disheartening because the elderly metabolize drugs more slowly and need lower dosages, but all too often drug side-effects are ignored or misinterpreted as normal signs of aging.

Addressing his second point of an independent review of all new medications, Cohen reminds us that drugs are big business. "It would disappoint the patients and the profession to realize how truly little of the important medical consequences is known about a new drug at the time it becomes a salable product."

In the struggling US economy, the prescription drug industry is one of the few business sectors that has held its own, but there is an ugly side. And it's about this side that Cohen writes. The medical research on new drugs is too short and is slanted to make the drug look more effective than it actually is. The pharmaceutical companies do this by conducting multiple studies and publishing only the most favorable results, while ignoring the less favorable or damaging results. Or they may compare the new drug with a very low dose of a similar but older and less expensive drug. This gives the new drug dramatically better results. In addition, drug companies influence the medical research in the U.S. by underwriting 70% of it. And if you think that these medical researchers can print unfavorable results, think again. Who are the major advertising contributors to the journals? Yup - drug companies. Do I think that every medical researcher and journal is compromised? No, but I think there is a strong potential for abuse. Cohen suggests that all medical studies publish the identity of the underwriters of the research. This is a great, but not an original idea.

As you are reading the book, it's not hard to think that Cohen is over-doing the "cloak and dagger" routine. However, when he refers to "researchers who pushed to publish unfavorable findings in order to warn the public..(and found themselves) either threatened" or removed from the study or from the medical journal staff, you get a sense that what he writes is just the tip of the iceberg.

His third point demonstrates clearly how the U.S. closes their eyes to the overdosing of its citizens. Two hundred and thirty deaths occurred in seven months from Viagra. Eighty-five over several years from Firestone tires. Which made the evening news headlines night after night? The British government recognized the dangers of birth control pills after 9 years; the U.S. doctors, after 25 years of overwhelming research, finally stepped in and decreased the dosage of both birth control and other hormonal therapies. Why not follow Cohen's advice and develop an Independent Safety Board to investigate why 300 U.S. citizens die each day and how to decrease that number?

Forty-six percent of U.S. citizens take at least one prescription drug daily. Maybe it's time to think about how safe that practice is. Americans march on Washington for AIDs and breast cancer, but we quietly bury 300 people a day from often avoidable prescription drug reactions. If you take a prescription drug and get a side-effect(s) from it, read this book - and show it to your medical physician. It just might save your life. And, even better, consider natural treatments for the condition.

Health tip: Splitting Pills can be safe for your health
A recent study led by Dr. Randall Stafford, assistant professor of medicine at Stanford Univerity's Center for Research in Disease and Prevention determined that some prescription drugs, especially drugs for cholesterol, high blood pressure and depression are still frequently effective when the pill is split in half. The particular drugs mentioned in the article were Zocor, Lipitor, Viagra, Paxil, Celexa, Prinivil and Zestril(ACE inhibitor lisinopril). If you are interested to know about whether other prescription drugs can be split in half and still be effective, please consult your physician.

Herb tip: Don't split herb pills
Gingko biloba is a well-researched herb commonly used, among other things to enhance memory function. Recently, I read an article in the Wall Street Journal questioning the effectiveness of Gingko in a scientific study. After looking at that study, I saw that the dosage used was 120mg. The scores of successful scientific studies used doses of 240 and 360mg of the herb. With some prescription drugs, taking half the recommended dosage can still be effective. However, with herbs, the two most important factors in the effectiveness of the herb are the quality and quantity. If you want consistent results, don't compromise on either.

To all the local readers, our office is located at 11825 SW Greenburg Rd., Ste A2, Tigard, Or. 97223.