Monday, May 30, 2011
Time for Medicare to Quit Ignoring Primary Care
An article by Brian Klepper and Paul Fischer at Health Affairs has me all fired up. Finally these two health experts are calling it like it is. The Wall Street Journal, New York Times and EverythingHealth have written before about the way primary care is undervalued and underpayed in this country and how it is harming the health and economics of the United States. A secretive,
Sunday, May 29, 2011
Divorce rates higher in couples with long commutes
Researchers at Umea University in Sweden found that divorce rates are 40% higher in people who have commutes greater than 45 minutes. The study looked at 2 million households and found that long commutes were even more difficult for women. The risk for divorce was highest during the first few years of commuting.
We have been a commuting culture for decades...especially in large urban areas
We have been a commuting culture for decades...especially in large urban areas
Thursday, May 26, 2011
Food Reward: a Dominant Factor in Obesity, Part IV
What is Food Reward?
After reading comments on my recent posts, I realized I need to do a better job of defining the term "food reward". I'm going to take a moment to do that here. Reward is a psychology term with a specific definition: "a process that reinforces behavior" (1). Rewarding food is not the same thing as food that tastes good, although they often occur together.
Read more »
After reading comments on my recent posts, I realized I need to do a better job of defining the term "food reward". I'm going to take a moment to do that here. Reward is a psychology term with a specific definition: "a process that reinforces behavior" (1). Rewarding food is not the same thing as food that tastes good, although they often occur together.
Read more »
Why Health Care Costs So Much
It is my job at EverythingHealth to steer the reader to great information. For this reason I am providing you with a Link to The New England Journal of Medicine article titled "The $650 Billion Dollar question - why does cost effective care diffuse so slowly?" I have retitled it "Why Health Care Costs So Much".
The United States spends much more on health care than other industrialized nations
The United States spends much more on health care than other industrialized nations
Tuesday, May 24, 2011
Healthy Skeptic Podcast
Chris Kresser has just posted our recent interview/discussion on his blog The Healthy Skeptic. You can listen to it on Chris's blog here. The discussion mostly centered around body fat and food reward. I also answered a few reader questions. Here are some highlights:
- How does the food reward system work? Why did it evolve?
- Why do certain flavors we don’t initially like become appealing over time?
- How does industrially processed food affect the food reward system?
- What’s the most effective diet used to make rats obese in a research setting? What does this tell us about human diet and weight regulation?
- Do we know why highly rewarding food increases the set point in some people but not in others?
- How does the food reward theory explain the effectiveness of popular fat loss diets?
- Does the food reward theory tell us anything about why traditional cultures are generally lean?
- What does cooking temperature have to do with health?
- Reader question: How does one lose fat?
- Reader question: What do I (Stephan) eat?
- Reader question: Why do many people gain fat with age, especially postmenopausal women?
Monday, May 23, 2011
Top Ten Greatest Public Health Achievements of this Century
The Center for Disease Control published the top ten public health achievements from 2001-2010, the first decade of the 21st century. In no order they are:
Vaccine-preventable Diseases - new vaccines for herpes zoster, pneumonia, HPV and rotavirus have saved thousands of lives When you add in the older vaccines for diptheria, pertussus, tetanus and measles/mumps millions of lives have been
Vaccine-preventable Diseases - new vaccines for herpes zoster, pneumonia, HPV and rotavirus have saved thousands of lives When you add in the older vaccines for diptheria, pertussus, tetanus and measles/mumps millions of lives have been
Sunday, May 22, 2011
Fast Food, Weight Gain and Insulin Resistance
CarbSane just posted an interesting new study that fits in nicely with what we're discussing here. It's part of the US Coronary Artery Risk Development in Young Adults (CARDIA) study, which is a long-term observational study that is publishing many interesting findings. The new study is titled "Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis" (1). The results speak for themselves, loud and clear (I've edited some numbers out of the quote for clarity):
Read more »
Read more »
Saturday, May 21, 2011
Answer to Medical Challenge
This is a really good one and several of you got it right. The answer is #1. Endometrioma. (scroll to post on 5/19/2011 for the image)
The woman's medical history was significant for dysmenorrhea (painful periods) and two recent laparoscopic resections of endometriomas. Histologic examination after resection of the nodule revealed the presence of endometrial glands and stroma. Endometriosis of
The woman's medical history was significant for dysmenorrhea (painful periods) and two recent laparoscopic resections of endometriomas. Histologic examination after resection of the nodule revealed the presence of endometrial glands and stroma. Endometriosis of
Thursday, May 19, 2011
California will release expensive medical prisoners
I wrote previously about the Governor from Mississippi who released two sisters from prison because the cost of providing dialysis was more than the prison system could bear. This seems to be a nationwide trend. Under a state law signed by Gov. Arnold Schwarzenegger in September, prisoners who are in a highly incapacitated state and deemed to pose no threat to society can be released if the
This Weeks Medical Challenge
It's time again to test your diagnostic skill with the New England Journal of Medicine image challenge. (click on the image to see up close) The nodule formed in this young woman in the umbilical (naval) area and bled intermittently. What is the diagnosis?
1. Endometrioma
2. Metastatic adenocarcinoma
3. Omphalith
4. Umbilical hernia
5. Urachal cyst
Give me your best answer as a comment
1. Endometrioma
2. Metastatic adenocarcinoma
3. Omphalith
4. Umbilical hernia
5. Urachal cyst
Give me your best answer as a comment
Wednesday, May 18, 2011
Food Reward: a Dominant Factor in Obesity, Part III
Low-Fat Diets
In 2000, the International Journal of Obesity published a nice review article of low-fat diet trials. It included data from 16 controlled trials lasting from 2-12 months and enrolling 1,910 participants (1). What sets this review apart is it only covered studies that did not include instructions to restrict calorie intake (ad libitum diets). On average, low-fat dieters reduced their fat intake from 37.7 to 27.5 percent of calories. Here's what they found:
Read more »
In 2000, the International Journal of Obesity published a nice review article of low-fat diet trials. It included data from 16 controlled trials lasting from 2-12 months and enrolling 1,910 participants (1). What sets this review apart is it only covered studies that did not include instructions to restrict calorie intake (ad libitum diets). On average, low-fat dieters reduced their fat intake from 37.7 to 27.5 percent of calories. Here's what they found:
Read more »
Tuesday, May 17, 2011
Clarifications About Carbohydrate and Insulin
My statements about carbohydrate and insulin in the previous post seem to have kicked up some dust! Some people are even suggesting I've gone low-fat! I'm going to take this opportunity to be more specific about my positions.
I do not think that post-meal insulin spikes contribute to obesity, and they may even oppose it. Elevated fasting insulin is a separate issue-- that's a marker of insulin resistance. It's important not to confuse the two. Does insulin resistance contribute to obesity? I don't know, but it's hypothetically possible since insulin acts like leptin's kid brother in some ways. As far as I can tell, starch per se and post-meal insulin spikes do not lead to insulin resistance.
Read more »
I do not think that post-meal insulin spikes contribute to obesity, and they may even oppose it. Elevated fasting insulin is a separate issue-- that's a marker of insulin resistance. It's important not to confuse the two. Does insulin resistance contribute to obesity? I don't know, but it's hypothetically possible since insulin acts like leptin's kid brother in some ways. As far as I can tell, starch per se and post-meal insulin spikes do not lead to insulin resistance.
Read more »
Labels:
archaeology,
fats,
Food reward,
low-carb,
overweight
Powerful Men with Powerful Flaws
aArnold Schwarzenegger's revelation about his long-term affair with his household employee that involved a child being born is the latest in a string of powerful men with career ending flaws. Add to that the shocking arrest this week of powerful Dominique Strauss-Kahn for allegedly raping a hotel maid and we must ask, "What the heck is going on with these guys?"
I can't count the number of
I can't count the number of
Sunday, May 15, 2011
Real Food Doesn't Need Hype
The article from The New York Times about "Foods with Benefits" is a great read. (Don't click now...read this post first and then read the article). It talks about what consumers are seeing at the grocery aisles as well as in advertising. Food is being packaged and advertised as a miracle for good health. They say certain foods can lower cholesterol, fix irritable bowel, cause weight loss or
Friday, May 13, 2011
Healthy Skeptic Podcast and Reader Questions
Chris Kresser, Danny Roddy and I just finished recording the podcast that will be released on May 24th. It went really well, and we think you'll find it informative and maybe even practical!
Unfortunately, we only got around to answering three of the questions I had selected:
Read more »
Unfortunately, we only got around to answering three of the questions I had selected:
- How does one lose fat?
- What do I (Stephan) eat?
- Why do many people gain fat with age, especially postmenopausal women?
Read more »
Tuesday, May 10, 2011
NSAIDs are a problem for Cardiac Patients
New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack. These over-the-counter drugs are commonly used like Advil, Aleeve, Diclofenac, Ibuprofen. Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI). The researchers
Administrative Note
My blog is being mercilessly ripped off by cheesy feed aggregators that are using my material for commercial gain, often without attribution. I was able to ignore them when there were only one or two, and when they appeared far down the list on Google searches. But at this point, there are 20+ rip-off sites that ride my coattails under questionable circumstances, and are getting decent Google rankings, so I've had enough. I'm changing my feed settings so that I only partially syndicate my posts, and I'm adding a short plagiarism warning to each post.
What that means is that if you're using an RSS reader, you'll have to click through to my blog to read my material in full. I apologize for the inconvenience, but I don't see any other solution.
Read more »
What that means is that if you're using an RSS reader, you'll have to click through to my blog to read my material in full. I apologize for the inconvenience, but I don't see any other solution.
Read more »
Sunday, May 8, 2011
Ask Me a Question
On May 13th, I'll be recording a podcast with Chris Kresser of The Healthy Skeptic. Chris interviewed me about a year ago, and I thought it went well. Chris is a good host and asks interesting questions.
This time around, we're going to do things a bit differently. I'll start with a little overview of my current thoughts on obesity, then we'll answer reader questions. The show is going to be mostly about obesity and related matters, but I may answer a couple of questions that aren't related to obesity if they're especially interesting. There are two ways to leave questions: either in the comments section of this post, or the comments section of Chris's post. The show will air on May 24th.
Read more »
This time around, we're going to do things a bit differently. I'll start with a little overview of my current thoughts on obesity, then we'll answer reader questions. The show is going to be mostly about obesity and related matters, but I may answer a couple of questions that aren't related to obesity if they're especially interesting. There are two ways to leave questions: either in the comments section of this post, or the comments section of Chris's post. The show will air on May 24th.
Read more »
Saturday, May 7, 2011
Best and Worst Place to be a Mother in the World
Happy Mothers Day to mothers everywhere. It is an important day for us to honor women and acknowledge the incredible hard work of mothering. There are some places in the world where being a mother is positively life threatening. The worst place to be a mother is Afghanistan.
Childbirth in Afghanistan is primeval. One in 8 women in Afghanistan die during pregnancy or childbirth, more than any
Childbirth in Afghanistan is primeval. One in 8 women in Afghanistan die during pregnancy or childbirth, more than any
Friday, May 6, 2011
Answer to Medical Challenge
The answer to yesterday's medical challenge is....drumroll.....
#4 - Sugar
Plain granulated sugar can be applied to the mucosa of the prolapsed structure (such as the ileum in this case) to promote the osmotic shift of fluid out of the edematous tissue. In this case, within 2 minutes, the edema had diminished sufficiently to allow spontaneous reduction of the prolapse.
Thanks to all who made
#4 - Sugar
Plain granulated sugar can be applied to the mucosa of the prolapsed structure (such as the ileum in this case) to promote the osmotic shift of fluid out of the edematous tissue. In this case, within 2 minutes, the edema had diminished sufficiently to allow spontaneous reduction of the prolapse.
Thanks to all who made
Wednesday, May 4, 2011
The Hardest Image Challenge
Q: A prolapse such as this can be effectively reduced by applying what common household substance to the tissue?
1. Baking powder
2. Flour
3. Salt
4. Sugar
5. Tea
This is the hardest image challenge from the New England Journal Of Medicine that I have seen. Fellow physicians, and EverythingHealth readers, I want you to go out on a limb and give me the answer.
For you non-physicians,
1. Baking powder
2. Flour
3. Salt
4. Sugar
5. Tea
This is the hardest image challenge from the New England Journal Of Medicine that I have seen. Fellow physicians, and EverythingHealth readers, I want you to go out on a limb and give me the answer.
For you non-physicians,
Monday, May 2, 2011
Pay It Forward With Organ Donations
With all of the news focus on Osama Bin Laden's death and memories of 9-11, it is time for a feel good story. We have one compliments of Loyola University Medical Center in Illinois. A total of 7 kidneys have been donated by perfect strangers and 5 of them were from hospital employees. Loyola has set up a "Pay it Forward" program to inspire others to do the same. When a person gets a good
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