Friday, November 21, 2014

New Cholesterol Drug Questions Raised

A new study of cholesterol treatment, called IMPROVE_IT, has raised a question about the choice of medications to use, and whether or not physicians should embrace the new data.  I was asked to comment on this on the MedPageToday website:

Friday Feedback: Will IMPROVE-IT Trial Affect Primary Care?

Sunday, November 9, 2014

Bad food choices we all make

Our diets are littered with foods that taste good, but are hardly good for us.  Part of that is due to our craving for certain foods, and part of the problem is manufacturers who have learned to tailor foods to our liking, and that encourage us to buy more and more.  Here are a few examples that I have come across, and my thoughts about these products:

DIET SWEETENERS: Just about anyone who has “gone on a diet” has used one of the several products out there to provide sweetness.  The problem is that many put the sweetener in their beverage, while eating a high calorie meal.  The 16 calories that the teaspoon of sugar may have supplied is more than offset by the hundreds or thousands of calories in the food eaten alongside.  Further, that the artificial sweeteners taste “sweeter” than sugar promotes continued sweet seeking behavior, which only leads to further calorie gain.  Better to avoid the artificial sweeteners altogether, use a modest amount of sugar, and eat sensibly.  And, by the way, there is no advantage to “raw” or “turbido” sugar, it is just marketing.

FRUIT FLAVORED YOGURT:   These taste so yummy not because of the fruit, but the added calories with sweetener that accompany the processed fruit.  Studies have suggested that adding your own fresh fruit to fat free yogurt is healthier, lower in calories, and does not promote overeating.

SALADS:   Whether a Caesar salad at a restaurant, or a fast food green salad with chicken or such, just because it is a salad does not mean it is low in calories or fat.  Some of these dishes pack more than 1000 calories, about half a day’s requirement, in one salad.  Added cheese, croutons, meats, and oils can quickly escalate the calorie count into the unhealthy range.  Better to have a garden salad, if it does not grow from the ground you can’t have it on the salad, with some light dressing.  That’s a healthy alternative!

GRANOLA and TRAIL MIX:   With a wonderful healthy facade, these two seemingly natural snacks share one thing, calories.  Most granola is laden with fat and sugar, even if it is honey.  And trail mix may have all kinds of calorie bombs in the mix.  There are many simple home recipes for granola that are low in sugar and calories and high in nutritional value, ditto for trail mixes.  Make it yourself, save some money, and end up with a better product.

SUSHI:   Here’s a food that is popular among the beautiful people, and again, perceived as a healthy alternative to older hors d’oeuvres.  But with the added sauces with mayonnaise or cream cheese, and the wrapping of white rice, or maybe tempura fried, these can reach 500 calories a piece.  Better to forgo the white rice for sashimi, or brown rice, and avoid the sauces and frier.

MUFFINS:   How about a nice bran muffin for breakfast, rather than the eggs and meats so often consumed?  Okay, but you still will get about the same number of calories.  Just because it is made with bran, or granola, or blueberries, does not mean that it is healthy.  An English muffin with jam, or toast and a little Nutella may be a better alternative.  Even that big bagel and cream cheese is problematic, and needs to be downsized from its usual opulence.  

DRIED FRUIT:   These are just little calorie bombs.  When you dry fruit, you remove the water, not the sugar.  So one cup of raisins, dried grapes, contains almost 500 calories, compared to a cup of grapes, at about 60.  You figure this one out on your own!

WHOLE MILK AND MILK PRODUCTS:    The only difference between whole milk, 2% milk, 1% milk, and skim or fat-free milk is the fat content and its resultant fat calories.  That’s it.  Same protein, same Vitamin D, same calcium – just the fat.  And foods made with low or fat-free milk carry that attribute.  So low fat cheese, fat free yogurt, fat free pudding, and such are all good alternatives to the whole fat variety.  Yes, sometimes there is a taste difference, but life is like that.

WRAPS:    What could be better than a wrap, and who needs all that bread?  Turns out that the amount of “stuff” in the tortilla or other dough used for the wrap is often more than two full slices of bread.  And with extra area to spread the mayonnaise, butter, and fillings, that fancy wrap can easily surpass a plain old sandwich for calorie count.  That is not something to be proud of.  Sometimes a sandwich is really what you need, make it with thin bread to keep it under control.