Statins in the Media

March 4th, 2012

An article in the New York Times discussed safety alerts placed on “statins”, which are common cholesterol-lowering medications.  Such medications as Lipitor (atorvastatin) and Crestor (rosuvastatin) were implicated in causing diabetes and memory loss.   While I feel these findings are important, the risks far outweigh the benefits of these medications.  Statins have been revolutionary in preventing the progression and reducing the morbidity of coronary artery disease.  Ask any cardiologist which drug class is most responsible for reducing cardiac deaths in the past  20 years and statins will be the answer.

I think there are two messages we can learn from the safety alerts. One is that statins should not be prescribed indiscriminately.  People with minimal elevations of cholesterol based on their cardiac risk factors should consider diet and exercise before jumping to medication therapy.  Secondly, patients on statins should have their blood sugar monitored regularly, along with the usual monitoring of liver enzymes.

Not All Oatmeal Is Created Equal

February 4th, 2012

If you go to the grocery store, the oatmeal aisle is always puzzling even for the seasoned shopper. One finds the traditional giant cylinder with the words old fashioned or slow cooking, fast cooking oats, and boxes comtaining small instant packets. Here’s the deal. The reason why the oats cook quicker is because the surface area for cooking is increased. In other words, they mash up the oats. The quicker the oats, the finer the grain. Why is this important? Our digestive tracts are very efficient. But they have one big barrier, fiber. Fiber prevents us from absorbing all the sugars in oats. If you break the oats up into small pieces, you are destroying that barrier. In other words, the instant oats are like baby food- predigested nutrition. I tell all my patients to buy the slowest cooking oats possible. They may take more time, but they are worth it! If you are travelling, the instant is a good (but not equivalent) alternative.

The same rules apply to whole grain bread and brown rice. These are much better for you than their counterparts. Actually, once you switch over you will realize what amazing flavor these foods have. Brown rice has a nutty taste that is delicious.

Eating Out

February 4th, 2012

While cooking at home is important to good diet, we all enjoy a night out at a restaurant. I have friends who cook in restaurants and they say it is unfathomable how much butter and salt go into food. When you cook at home, you know what is in and what is not in your food.

Ordering from restaurant menus can be like walking on a minefield. You never know which item is going to be a healthy choice. Sometimes vegetables are fried in oil, sauces are thickened with copious starch, and MSG abounds. Let the waiter know about restricting the salt in the food. It’s easier to add salt than to take it out of the food.

Try to minimize condiments. Almost any condiment you can think of is unhealthy. Ketchup has loads of corn syrup and salt. Soy sauce, even the “Light” version is loaded with sodium. A trick you may want to try at your local sushi restaurant is to dilute the “Light” soy sauce with a little water from your drinking glass. Trust me, you will still be satisfied. In Japanese food culture, sushi is never “dunked” into soy sauce, just dabbed onto one area of the sushi. They know that soaking each piece till the rice starts to fall apart covers all the intricate flavors of the fish and rice.

Exercise and Physical Activity

February 3rd, 2012

With all the financial troubles, people working longer hours, and being overwhelmed with social networking, it’s tough to get in exercise. I think one of the big misconceptions is that good quality exercise can only be done in a gym. A better alternative is to incorporate exercise into your life. For example, take the subway to a stop that is one station away from your destination and walk the rest of the way. If you live in an elevator apartment, you could get off one floor below your floor and walk one flight up. You may feel out of breath the first few days as a result of being out of shape, but don’t be discouraged. The more exercise you do, the easier it gets. The following week, you can get off two floors below and walk two flights up. Before you know it, you will be burning many calories each day. Going downstairs is not as effective an exercise, because gravity does most of the work, but every bit counts.

Limit your time on the internet and watching TV. There are some programs that will shut down or lock your computer after a set time. You could also incorporate your TV watching with a gym regimen. For example, you could go to the gym and use the treadmill when the nightly news is on. The advantage is that you will be forced to do the exercise for the entire time.

While watching TV at home, try to use the commercial time in between to get in some workouts. Every woman I know has a few extra purses in their closet. Men can buy a small duffel bag or use one of those reuseable grocery bags. Place some cans of food (like soup cans) into the bag. Hold the bag in your hand and flex your arm, pulling the bag up. You can keep the bag next to your couch and use it during the commercials . You would be surprised at how much of a work out your arms get, and also how many commercials there are on TV!

Incorporate exercise into your daily routine. Cleaning the house is a chore, but is also great fat burning time. Put on some fun music and go at it! If you get rid of the housekeeper or maid, you save money!

When you travel, bring along resistance bands. They fit easily in any suitcase, and can be pretty good substitutes for weights.  Here are some other tips on how to get exercise while traveling.  Lunch break is a great time to get out and walk. Most people get one hour, but few people I know eat for the entire hour. Try brisk walking for half an hour then eat lunch afterward.