The Doctor Weighs In

[Credits:  Advertisement from the German Olympic Sport Federation.  http://adsoftheworld.com/
media/print/german_olympic_sport_federation_david] 

By Dov Michaeli MD, Ph.D

Some of the health advice we come across in the media and the internet is so outrageous it borders on quackery; no, it is quackery. If it wasn’t so dangerous it would be hilarious. So I thought we should all share in the hilarity. But before we proceed, a disclaimer: the following is based on actual Q and A, but the author took  literary license to highlight their innaneness (there, I finally got to use this word). So here goes:

HEALTH QUESTION & ANSWER SESSION
Q: I've heard that cardiovascular exercise can prolong life; is this true?
A: Your heart is only good for so many beats, and that's it... don't waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that's like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?
A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

Q: Should I reduce my alcohol intake?
A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. Bottoms up!

Q: How can I calculate my body/fat ratio?
A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?
A: Can't think of a single one, sorry. My philosophy is: No Pain...Good!

Q: Aren't fried foods bad for you?
A: YOU'RE NOT LISTENING!!! ... Foods are fried these days in vegetable oil. In fact, they're permeated in it. How could getting more vegetables be bad for you?

Q: Will sit-ups help prevent me from getting a little soft around the middle?
A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?
A: Are you crazy? HELLO . Cocoa beans! Another vegetable!!! It's the best feel-good food around!

Q: Is swimming good for your figure?
A: If swimming is good for your figure, explain whales to me.


Q: Is getting in-shape important for my lifestyle?
A: Hey! 'Round' is a shape!


Well, I hope this has cleared up any misconceptions you may have had about food and diets.

Finally, an exercise regimen I found in a Man's Health magazine. I have been following it religiously:

You have to give this a try, it really works.

This exercise is suggested for mature adults, to build muscle strength in the arms and shoulders. It seems so easy, so I thought I'd pass it on. I suggest doing it three days a week.
Begin by standing on a comfortable surface, where you have plenty of room at each side. With a 5-lb potato sack in each hand, extend your arms straight out from your sides and hold them there as long as you can.

Try to reach a full minute, and then relax.

Each day, you'll find that you can hold this position for just a bit longer. After a couple of weeks, move up to 10-lb potato sacks. Then try 50-lb potato sacks and then eventually try to get to where you can lift a 100-lb potato sack in each hand and hold your arms straight for more than a full minute. (I'm at this level)

After you feel confident at that level, put a potato in each of the sacks.

And remember:

"Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways - beer in one hand - chocolate in the other - body thoroughly used up, totally worn out and screaming "WOO HOO, What a Ride"

Dov Michaeli MD, Ph.D is in the biotech industry and is a nut when it comes to diet and exercise.

By Dov Michaeli MD, Ph.D

The last two posts dealt with 'end-of-life' and 'life after death' issues. Pretty grave...

I thought it would be appropriate to see what America's quintessential humorist had to say about it. Fortunately, Twain was an avid collector of scraps, newspaper clips, photos, and his own musings. Here are some notes he wrote about death and the afterworld during the period of declining health, just before his death.

As he approached the end of his life, Clemens grew more lonely and melancholic. He took on a biographer, a personal assistant, and a dozen or so surrogate grandchildren. He traveled to Bermuda for health and relaxation. He played billiards with friends. He also built a house in Redding, CT. and called it Stormfield, after one of his characters who makes a trip to heaven.

Clemens approached death stoically, but in a sense it had always been a familiar friend, providing him a rich field for humor and a hope for release from what had often been a difficult life.

When he died on April 21, 1910, newspapers around the country declared, “The whole world is mourning.” By then, Sam Clemens had long since ceased to be a private citizen. He had become Mark Twain, a proud possession of the American nation.

When I found myself perched on a cloud, with a million other people, I never felt so good in my life. Says I, “Now this is according to the promises; I’ve been having my doubts, but now I am in heaven, sure enough.” I gave my palm branch a wave or two, for luck, and then I tautened up my harp-strings and struck in. Well, Peters, you can’t imagine anything like the row we made. It was grand to listen to, and made a body thrill all over, but there was considerable many tunes going on at once, and that was a drawback to the harmony, you understand; and then there was a lot of Injun tribes, and they kept up such another war-whooping that they kind of took the tuck out of the music. By and by I quit performing, and judged I’d take a rest. There was quite a nice mild old gentleman sitting next me, and I noticed he didn’t take a hand; I encouraged him, but he said he was naturally bashful, and was afraid to try before so many people.... Him and I had a considerable long silence, then, but of course it warn’t noticeable in that place.... Finally, says he—

“Don’t you know any tune but the one you’ve been pegging at all day?”

“Not another blessed one,” says I.                                                                                        

“Don’t you reckon you could learn another one?” says he.                             

“Never,” says I; “I’ve tried to, but I couldn’t manage it.”

“It’s a long time to hang to the one—eternity, you know.”

“Don’t break my heart,” says I; “I’m getting low-spirited enough already.”                                                                                                                  

After another long silence, says he -

“Are you glad to be here?”

Says I, “Old man, I’ll be frank with you. This AIN’T just as near my idea of bliss as I thought it was going to be, when I used to go to church.”

Says he, “What do you say to knocking off and calling it half a day?”

“That’s me,” says I. “I never wanted to get off watch so bad in my life.”                     Somerfield, 1908.

Mark Twain, “Extract from Captain Stormfield’s Visit to Heaven,” 1909

“Now, I have known so many burglars—not exactly known, but so many of them have come near me in my various dwelling-places, that I am disposed to allow them credit for whatever good qualities they possess. Chief among these, and, indeed, the only one I just now think of, is their great care while doing their business to avoid disturbing people’s sleep. Noiseless as they may be, however, the effect of their visitation is to murder sleep later on.”—Mark Twain, “Of books and burglars” speech, 1908

From one of Twain’s last letters, when he was trying to get home from Bermuda.

“I don’t want to die here for this is an unkind place for a person in that condition. I should have to lie in the undertaker’s cellar until the ship would remove me and it is dark down there and unpleasant.”—Mark Twain, Letter to Albert Bigelow Paine, 1910
Returning Home from Bermuda, 1910.

What a great way to go: stoically, whimsically, with his ever present twinkle in the eye.

Dov Michaeli, MD, Ph.D is in the Biotech industry.

There are a bunch of little things I have wanted to share…but they are all pretty brief, really not enough to justify a “whole post.” So, I am now inaugurating a new, occasional TDWI post (you get to do that when you are “in charge”). This post will give me a chance to capture some great, but brief, unrelated ditties, for your reading pleasure. Many of these postlets have been sent to TDWI by readers who will be credited for enriching our collective reading experience.

These posts will be called “This and That” or T&T, for short.

Here is the first TDWI T&T post (enjoy):

· Email from Skip McGinty: Why Ellen DeGeneris says she can’t quite get around to exercise:

“I gotta work out. I keep saying it all the time. I keep saying I gotta start working out. It's been about two months since I've worked out. And I just don't have the time. Which uh..is odd. Because I have the time to go out to dinner. And uh..and watch tv. And get a bone density test. And uh.. try to figure out what my phone number spells in words.” Ellen DeGeneres

· Snack tips from Fitness magazine (my plane reading Houston to SF):

Cracker snacks, how do they stack up:

Ritz crackers Serving size = 5 crackers Calories/serving = 80

Wheatables Serving size = 17 crackers Calories/serving = 140

Multi-grain Wheat Thins Serving size = 17 crackers Calories/serving = 130

Triscuits (I love ‘em) Serving size =6 crackers Calories/serving =120*

Kavli Thin Crispbread Serving size =3 “sheets” Calories/serving= 60

Wasa Fiber Rye Crispbread Serving size = 1 sheet Calories/serving = 30**

*120 calories and I only get to eat six small Triscuit crackers…this is why I don’t eat them anymore

**Wasa Fiber Rye crackers are the perfect snack food. You can eat two (comparatively gigantic crackers) and only ingest 60 calories. Try dipping them in Haig’s hummous. Now there is a snack that is satisfying, filling, and modest in term of calorie contribution

· Are you a runner or walker? Got lots of old running shoes lying around?

Of course you do. If you are never going to use them again, here’s how you can put them to good use. Box them up and send them to Ana Weir at www.oneworldrunning.com. She will wash them, spiff them up, and then send them to folks in the developing world so that they can run, hike,or just plain get around in shoes. Thanks, Ana.

· Finally, Barry Messersmith sent this to TDWI to help readers recognize and respond to stroke-in-progress (Thanks, Barry!):

“A stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke. This test is recommended by physicians. Ask the person these 4 things:
1. Ask the individual to SMILE.
2. Ask the person to SPEAK A SIMPLE SENTENCE
(Coherently, i.e. . . It is sunny out today)
3. Ask him or her to RAISE BOTH ARMS.
4. Ask the person to 'STICK' OUT THEIR TONGUE.
If the tongue is 'crooked', if it goes to one side or the other,
this is another sign of a stroke.
If he or she has trouble with ANY ONE of these tasks, call 911 immediately and describe the symptoms to the dispatcher.”

OK, a bit of a disjointed post, but fun, huh? Let me know if you like this new feature. If so, T&T will be a keeper…if not, this could be the first and last This and That.

If you like the idea of sharing short, but substantiated, health tips, email them to me @ psalber@comcast.net. You could find your name in the bright lights of TDWI, cool huh?

Pat Salber, MD

I have been thinking about aging recently. I am not getting any younger, my loved ones are not young either; for heaven's sake--my little kids are in their forties (well, very very early forties). So where do you turn for sage advice? my favorites are the ten commandments. No, not THE Ten Commandments. I am talking about George Carlin's infinite empathy and wisdom-cum- smile. So here they are:

HOW TO STAY YOUNG

by George Carlin

1. Throw out nonessential numbers. This includes age, weight and height. Let the doctor worry about them. That is why you pay him/her.

2. Keep only cheerful friends. The grouches pull you down.

3. Keep learning. Learn more about the computer, crafts, gardening, whatever. Never let the brain idle. " An idle mind is the devil's workshop." And the devil's name is Alzheimer's.

4. Enjoy the simple things.

5. Laugh often, long and loud. Laugh until you gasp for breath.

6. The tears happen. Endure, grieve, and move on. The only person who is with us our entire life, is ourselves. Be ALIVE while you are alive.

7. Surround yourself with what you love, whether it's family, pets, keepsakes, music, plants, hobbies, whatever. Your home is your refuge.

8. Cherish your health: If it is good, preserve it. If it is unstable, improve it. If it is beyond what you can improve, get help.

9. Don't take guilt trips. Take a trip to the mall, to the next county, to a foreign country, but NOT to where the guilt is.

10. Tell the people you love that you love them, at every opportunity.

AND ALWAYS REMEMBER:

Life is not measured by the number of breaths we take, but by the moments that take our breath away.


Woopdeedo, who cares ..

nobody couldn't have said it better.

Thanks, George; I already feel younger.

Dov Michaeli

It isn’t often that you get a good chuckle while reading a medical journal. But today I did. I am on a plane again (not United Airlines, thank heavens) .  I am flipping through some recent issues of the Journal of the American Medical Association (JAMA). One article catches my eye. It describes the case of a woman with polycystic ovary syndrome (PCOS).   I decided to read it in detail to see if there was anything new in the cause, diagnosis, or treatment of women PCOS since I last wrote about it – there wasn’t.

PCOS is one of the most common causes of anovulatory infertility. Women with the condition have irregular periods, and cycles where they don’t ovulate. They also have physical findings related to hyperandrogenism (excess hair growth, acne), and they are frequently overweight or obese. Many are insulin resistant and some will go on to develop Type 2 diabetes. PCOS is risk factor for that condition.

As I read through this case study, I found that I didn’t really agree with the physician expert’s take on the case. The patient, “Ms R,” was worried because she had gained weight despite a pretty rigorous exercise regimen (she bikes 20 miles a day and swims regularly). She was described as 59 inches and 122 pounds with a BMI of 25. Did I do the math right? That means she is quite short to be packing around 122 pounds. She says she eats the same as she always has, but at the ripe old age of 27, she finds that she has gained weight.

The doctor discussing this case kept saying it was good that Ms R was “normal” weight, but we never learn whether she is slender or. in fact, is “abdominally” obese. And, he doesn’t mention whether he actually assessed how much she eats in a typical day or if he just believed her uncritical self-assessment. Before I started logging my food intake, I probably would have told you that I ate the same amount of calories as I did when I was thirty and thin. But once I started weighing and measuring and counting and recording my intake, surprise, surprise, I was actually quite an oink-oink. The weight started dropping when I decreased my intake to a caloric amount more appropriate for my height.

This article also does not mention Ms R’s ethnic background. Asians and South Asians can have abdominal obesity (and associated insulin resistance) at BMIs that are considered “normal.” It isn’t the BMI that is the problem, it is the abdominal, and in particular, intraabdominal or visceral fat – that is the problem. (I am willing to bet Ms R has plenty of fat around her middle.

Although her most recent fasting glucose level is normal, this woman is at risk for Type 2 diabetes because her father had it. And, as the doctor discussant pointed out he didn’t test her to see if she was glucose intolerant. You have to do a glucose tolerance test (drink a sugary substance and have blood drawn at regular intervals after that) to detect this type of insulin-resistance-related abnormality in glucose metabolism.

So I am already a little annoyed by the way this case is being discussed, but then, on the last page, this doctor says that he would counsel the patient that she appears to have a mild case of PCOS (not sure if this is the equivalent of doctors who tell their patients that they have a “touch of sugar.”) He recommends she keep on taking birth control pills that help her have regular periods and counteract the hair growth and acne cause by the increased androgen levels characteristic of PCOS (I agree). He enthuses that Ms R has “done an admirable job at weight control.” Yeah? But he did say he would refer her to a dietitian for further counseling on diet.

And then, comes the comic bombshell: He says, “I would counsel her against excessive “Googling” of PCOS on the web. I kid you not…I can hear it now, “No excessive googling, dear, you might learn something I don’t agree with?”

I have already written about Google’s ability to diagnose. This doctor has taken “Googling” to a new level by including this admonition in his case discussion in a respected medical journal. What a hoot.

Pat Salber, MD, MBA

A friend forwarded this really good advice to me.  I am compelled to share....enjoy

Q: I've heard that cardiovascular exercise can prolong life; is this true?

A: Your heart is only good for so many beats, and that's it... don't waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that's like saying you can extend the life of your car by driving it faster. Want to live longer?

Take a nap.

--------

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables.  So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass  (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

--------

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. Bottoms up!

--------

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

--------

Q: What are some of the advantages of participating in a regular

exercise program?

A: Can't think of a single one, sorry. My philosophy is: No pain...good!

--------

Q: Aren't fried foods bad for you?

A: YOU'RE NOT LISTENING!!! ... Foods are fried these days in vegetable oil. In fact, they're permeated in it. How could getting more vegetables be bad for you?

--------

Q: Will sit-ups help prevent me from getting a little soft around the

middle?

A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

--------

Q: Is chocolate bad for me?

A: Are you crazy? HELLO Cocoa beans! Another vegetable!!! It's the best feel-good food around!

--------

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

--------

Q: Is getting in-shape important for my lifestyle?

A: Hey! 'Round' is a shape!

--------

Well, I hope this has cleared up any misconceptions you may have had

about food and diets.

_______________________________________________________________________

Forwarded to you by Dov Michaeli, MD, PhD

My local newspaper, the San Francisco Chronicle, has a hysterical article about a restaurant in Arizona named “The Heart Attack Grill.”

The restaurant specializes in serving food that is really, really bad for you. Here’s what’s on the menu:

• The Quadruple Bypass Burger (also available in a Single, Double or Triple Bypass version)
• Flatliner Fries (the restaurant’s website boasts that these are fried in pure lard!)

They also sell beer and soda as well as cigarettes. Cigarettes? Yep, cigarettes are on the menu being promoted with the tagline: “When you’re in the mood to be bad, add cigarettes to your meal.

If you are able to finish a Triple or a Quadruple Bypass Burger, you can get pushed to your car in a wheelchair. Squadnillion calories burgers, lard-fried fries and cigarettes: no wonder the registered tagline for the restaurant is

“A Taste Worth Dying For”

The waitresses, designated as “nurses,” are dressed in Hooter-like cleavage and bun-baring outfits. Although the owner, Jon Basso, calls his food “nutritional pornography,” the controversy surrounding this restaurant is not the food, but the sexy imitation nurses. Basso and his restaurant are evidently under threat of a lawsuit by the Arizona Board of Nursing for using the word “nurse” at his restaurant and on his website.

BTW, the Heart Attack Grill concept is available for franshising if you are "Man Enough."  As the website states, a Heart Attack Grill could be coming soon to an artery near you!

This is truly an “only in America story.” Enjoy.

Here's a fun article about giving out healthy things for Halloween instead of candy.  Although I am often accused of being a party pooper when it comes to junk food, even I wouldn't have thought of giving the little ones a toothbrush for Halloween!

Here's the link to the article:  http://www.wikihow.com/Give-Healthy-Treats-for-Halloween

Pat Salber