What fruits are high in sugar?

December 9th, 2017

Not all fruits are created equal.  While most guidelines for good health say “eat 5 fruits or vegetables per day”, we should understand that they do not mean it is ok to eat 5 bananas which are very high in sugar to meet this requirement.  These fruits also are lower in fiber and contain certain types of sugar which may contribute to weight gain.  In general, you want to avoid these fruits in juices or dried forms as it would be easy to overindulge and consume too many calories at once.

Here is a list of fruits and the amount of calories they contain.  You want to limit if you are trying to lose weight or if you have diabetes.  However any of these fruits in moderation would be an ok substitute for any desserts (cookies, cupcakes, ice cream) if you need a “sweet treat”.  As a frame of reference, a typical person needs 2000 calories per day and one can of soda is about 140 calories:

  • Banana or plantains:  9 inch=135 calories (ALMOST 1 can of soda!), 7 inch=105 calories
  • Grapes:  (30 small grapes)=100 calories
  • Raisins:  1 single serve box=129 calories
  • Mangoes:  1 medium sized mango=200 calories (more than 1 can of soda!)
  • Pineapple:  1 cup=100 calories
  • Watermelon:  1 slice=140 calories
  • Dried dates:  1 cup=400 calories!!!!

Here are some fruits/vegetables that may be better choices.  Some may be higher in calories, but due to their higher fiber content, you will actually absorb less of the calories.

  • Apples:  medium=70 calories
  • Carrots:  medium=25 calories
  • Blueberries:  1 cup=85 calories
  • Strawberries:  1 cup=40 calories
  • Blackberries:  1 cup=60 calories
  • Pears: 1 small=85 calories (4.6 grams of fiber)


How can I avoid getting foot pain/foot injuries?

September 30th, 2017

Our feet are amazing.  These two parts of our body support over 100 pounds almost every minute of the day!  Here are tips to reduce your chances of foot injuries and pain:

  • Wear appropriate shoes.  Shoes that are ill-fitting (too tight) can cause toes to be cramped and over long periods of time can cause bunions.  Your shoes should also have a slight arch support (this is the area in the middle of the foot).  If not, you can end up with pain in this area.
  • For long walks (more than 30 minutes), try to wear sneakers or comfortable shoes.  Whenever I go to museums (where I could easily walk over 10,000 steps) I always wear sneakers.
  • Do not wear “flip-flop” sandals.  These are often made without any support and can cause all types of injuries ranging from twisted ankles to foot infections.  They do not protect your feet from any pieces of glass on streets.
  • Wear appropriate socks.  Socks can provide additional cushioning and support and can wick sweat away from the surface of your feet.  I recommend wearing thicker socks when you are exercising.  Try to avoid synthetic fibers, as they can trap heat and do not breath as well as cotton.
  • Cut your toenails straight across.  It’s tempting to use the toenail clippers to create a rounded edge on top, but resist the temptation.  Cutting the toenails too short at either end of the nail can result in ingrown toenails which can be extremely painful and difficult to treat.
  • Elevate your feet at the end of the day.  The circulation to the feet is not the best since gravity pulls the water in our body downward towards the lowest part.  As a result, you may notice that your feet get swollen.  Elevating the feet with an ottoman or an extra pillow under your ankles while you are sleeping can help improve circulation.
  • If you get pedicures, avoid having your cuticles cut.  Any small nicks to the skin at the base of the nail can cause a nasty bacterial infection called “paronychia” which is very painful and often requires antibiotics and drainage at a podiatrist or primary care provider office.
  • Wash your feet regularly.  Fungus can grow easily if we do not clean our feet.  One key sign of fungal infection is a “yeasty” smell when your remove your shoes.  I recommend soaking your feet in and Epsom salt bath at least once a week and washing your feet with soapy water between the toes at least every other day.  If you do have a fungus problem, you can use an antifungal spray or powder on your feet and in your shoes.  Also, make sure you allow your shoes to dry out in between uses.  I recommend keeping shoes out in a hallway (rather than a cabinet or shoebox) for at least 3 hours after you wear them.
  • If you have diabetes, inspect your feet at least once a week.  Look for rashes, bleeding, or any painful areas.  You will also need to see a podiatrist (foot doctor) at least once a year.


What’s the best diet to follow?

May 21st, 2017

There are many “diets” and eating plans recommended for good health these days.  Almost everyone has heard about Atkins, Weight Watchers, Zone, South Beach, and many others.  I always get asked, “which diet is the best for me?”  Here is the simple answer:  the best diet for you is one that you will be able to stick with for the rest of your life and fits in with your needs.  I often call this diet with a lowercase “d” and not a capital “D”, because it should be unique and specific to you.

Most fad diets are very restrictive and tell you “eat this, and none of that”, imposed over a short period of time.  We are all creatures of habit.  If you are used to eating a donut every morning, Atkins (which strictly prohibits complex carbs), would probably make you miserable.  Sure, you could probably replace that donut with eggs every morning, but how would your body and mind react?  Instead, I recommend slow, gradual changes (SMART goals) that would allow you to adapt to a healthier way of eating over a long period of time.  How about for the first few weeks, you change the donut to a plain cake donut without icing.  The following weeks, you could change the donut for white toast with jelly.  Maybe the next it could be whole wheat toast with jelly.  See where I’m going with this?

In my own life, it’s taken a few years but I’ve adopted many features of eating in the Mediterranean diet.  I’ve reduced my intake of red meat and replaced it with fish and vegetarian protein (such as beans).  It hasn’t been an easy process, but I’ve noticed many positive changes in my mood, energy level, and overall health.

When is the best time to take my multivitamin?

April 20th, 2017

shutterstock_623537957I get this question all the time in my practice.  You should take a multivitamin or pre-natal vitamin with food in the morning or noontime.  Why?  Certain vitamins such as vitamins A, D, E and K require fat in your stomach to become absorbed.  If you take them with an empty stomach and do not eat anything with fat afterwards, you will absorb very little or none of these vitamins.

Why during the daytime and not with dinner?  Vitamin D requires the sun to become activated in the body, otherwise it is not as beneficial.  You’re more likely to be exposed to the sun outdoors at some point if you take the multivitamin in the morning.

As a side note, I recommend avoiding the popular “gummy” vitamins or anything that says it can be both a candy and a vitamin.  Many of these are filled with sugar, starch, gelatin, and preservatives.  Moreover, several vitamins can degrade easily when they are incorporated into with these fillers.  You will be getting less of the vitamin being absorbed than you pay for.  Also, if you have kids, they can easily confuse the gummy vitamins with candy and can easily overdose on them.  Vitamin overdoses can be life threatening, particularly related to vitamin A and iron.  With children, the danger is magnified since their bodies are smaller and they cannot excrete extra vitamins as quickly as an adult.

Get your flu shots!

January 15th, 2017

shutterstock_221544541According to the CDC, we are in the middle of this year’s flu season with many states reporting record numbers of flu cases.  The good news is that the flu vaccine is well matched to the flu strains that are spreading around.  Essentially, this means if you get the flu shot you will have better protection with this year’s formulation.  The bad news is that this is predicted to be a pretty bad flu season because the predominant flu strain is an H3 subtype, which often leads to more hospitalizations and death than other strains.

Protect yourself and your family!  Get your flu shot today.  Fortunately, the flu vaccine is in plentiful supply and is available at medical offices and pharmacies.  For 2 weeks after getting the flu shot, be sure to stay away from anyone who has the flu.  The flu vaccine is effective starting 2 weeks after you get the shot.  The pain of the shot is well worth the risk of having to stay in bed for a week or more!  Need more reasons, here are a list of 7 reasons!