Category Archives: health & diet

The Rise of Apps to Monitor Chronic Disease

The Wall Street Journal has an interesting article about the increasing sophistication of personal apps on your electronic device to help monitor and treat conditions such as diabetes, COPD, CHF, and hypertension.  Although not a new idea by any means, the concept of self-monitoring with apps is getting more sophisticated.  Instead of simply entering data and tracking numbers, many of these apps are fusing with body sensors, directing linking with health care systems and doctors, and applying algorithms to optimize compliance with medications, and to produce early warning alerts prompting interventions that might ultimately keep people out of the hospital.

The WSJ cites developments in several disease models:

Diabetes – this condition exists along a continuum.  Type 1 diabetes requiring extremely vigilant monitoring and anticipation of insulin needs multiple times a day; whereas a mild case of adult Type 2 diabetes may require attention to lifestyle and diet alone, with monitoring of HBA1c levels every three to six months.   Apps are similarly available along a continuum of lifestyle coaching, from vital signs and activity monitoring, to intensive blood sugar monitoring with feedback to help determine insulin requirements.

Although the Wall Street Journal reports on several studies showing improved patient outcomes, it would be interesting to see if such intense monitoring of activities and diet leads to a reduction in quality of life.  Some people thrive on having their fitbit measure their daily activity.  But others feel such monitoring is intrusive, a burden, and down right depressing.  Other studies have shown the opposite, namely that monitoring blood glucose levels may improve mood scores, and add a sense of control.

Heart Disease : The WSJ reviews some programs such as one for patients undergoing cardiac rehabilitation after suffering a heart attack.  Once again, the results of vital signs, activity, and lifestyle monitoring seem positive in terms of better outcomes and functional status after a typical period of rehab.  The cardiologist quoted does bring up a sensible goal, that such intensive monitoring be used during an initial, educational and highly structured period to get people on the right track.  But then as their health improves and the conditions are better understood and accepted, the patients graduate to less structured self care and self-monitoring.

All of this does bring up important questions:

At what point does all this monitoring and surveillance become intrusive?

In the social media era, we have had a serious erosion of privacy and personal boundaries.  How much self awareness and self measurement and reporting do we tolerate before wanting to rip everything off and run wildly through open fields?

The “pill for every problem” assumption that guides the medical/pharma complex of today’s healthcare system may soon be joined by the “app for every problem.”  Is this more empowering than burdensome?   Does is lead to uniform dependence on one size fits all treatment approaches, or does it liberate more patients from dependence on doctors, pills, and a vast amount of knowledge they simply have to trust their doctors are relying upon.

With the anticipated ubiquitousness of sensors, penetrating, riding, and floating around the human body in the coming decades, what will the integrity of the human body amount to?  Are we simply phenomena like the weather to be tracked, predicted, and engineered?  Will the increasing alarms and whistles signaling problems and suboptimal statuses soon fill our minds like a the beeping of an open refrigerator door?

Answers to such questions will be different for each person, and I suspect that generational lines will define much of the degree of acceptance of health care apps.  With the future of mankind fusing with inorganic technologies, it seems the infrastructure for monitoring the cyborg machines future humans may become is already developing with these support tools for the still-organic, early 21st century human.

The companies developing such apps, linking them with healthcare systems and populations, figure to rise in the ranks of prominent corporations featured in the Wall Street Journal as well, as the one segment of our future economic model that seems sure to generate productivity of some sort will be tending to human health.

Until its all just robots.

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how read eyeglass prescription

How To Read a Prescription for Glasses (It’s Easy!)

I get asked how to read prescriptions all the time, including those for glasses. Reading a prescription for eyeglasses from your optometrist is simple, here’s how: (short video)

How to Read a Prescription for Eyeglasses / Common Abbreviations

Ordering prescription glasses online from somewhere like EyeBuyDirect or glasses.com? Be sure you know how to read your prescription!

  • OD = Right Eye (R)
  • OS = Left Eye (L)
  • SPH = “Sphere” or strength of your lens. A “+” positive number means you’re far-sighted while a “” negative number means you’re near-sighted
  • CYL & Axis will be filled in if you have astigmatism. That means your eye is not shaped spherical, but more like a football shape. The Axis is the angle of your astigmatism
  • ADD = Additional strength in your lenses like bifocal, progressive, etc.

Other EyeGlass Prescription Terms:

*PRISM = The prismatic power used to correct vision displacement. (When your eyes don’t align correctly)

*BASE = The way the base of the prism is facing: BU, BD, BI, BO

Pupillary Distance “PD” is the distance from one pupil to the other. PD is needed to order glasses online, but you can measure your own.

*Check out our coupons for EyeBuyDirect to save up to 50% on eyeglasses!  


More coupons: Check out today’s coupons for Scrubs & Beyond, or this deal for 50% off a WSJ subscription!

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trans fat restaurants

Banning Trans-Fatty Acids in Restaurants Saves Lives, Improves Mouth-Feel

Good news for supporters of trans-fatty acid bans: in New York State counties that implemented restrictions on their use in restaurants and eateries, there were significantly fewer admissions to local hospitals for heart attacks and cardiovascular events.

Specifically, researchers found a 6.2% decline in admission for hearts attacks and strokes combined, and an even greater drop of 7.8% for heart attacks alone. Both reductions were statistically significant.

Evidence has accumulated over the years that consuming trans-fatty acids is associated with increased risk of heart disease, stroke, and diabetes. The FDA plans to restrict the use of trans fats in foods nationwide in 2018, but some localities in New York State went ahead and banned TFA’s in restaurants and eateries starting between 2007-2011.

Processed foods, manufactured for long shelf lives, profit, and the creepy notion of “good mouth-feel,” have long been the biggest culprits using TFA’s.

Look for and avoid ingredients like “partially hydrogenated oil” found in many baked goods, cakes, piecrusts, crackers, cookies, biscuits, breakfast sandwiches, margarine, microwave popcorn, cream-filled candies, doughnuts, fried fast foods, and frozen pizza.

Unfortunately manufacturers are currently allowed to list trans fat content as 0 grams if the actual content is below 0.5 grams – kind of like rounding down, except that those small amounts can add up.

A legacy of the Obama administration will go into effect in 2018, when the complete phase-out of trans fatty acids in American foods is scheduled to be completed.  This happened despite intense lobbying by some companies and associations representing fast food and junk food interests.

The FDA estimated that up to 20,000 heart attacks and 7,000 premature deaths could be prevented each year with this phase-out, not to mention significant reductions in diabetes and cardiovascular disease prevalence.  Perhaps $140,000,000,000 will be saved in healthcare costs over 20 years.

New York City in 2006 under Mayor Bloomberg, and then California in 2008, pioneered the way with this enlightened TFA-banning legislation, but the early 1990’s Congress and then President H.W. Bush deserve some credit, too.

The original Nutrition Labeling and Education Act of 1990, sponsored by Democratic Rep. Henry Waxman, passed both houses of Congress and was signed into law by the first President Bush (H.W).

Ahhh… those nostalgic days of working together for the common good.  From Wikipedia:

The law gives the Food and Drug Administration (FDA) authority to require nutrition labeling of most foods regulated by the Agency; and to require that all nutrient content claims (for example, ‘high fiber’, ‘low fat’, etc.) and health claims meet FDA regulations.[2] The act did not require restaurants to comply with the same standards.

The regulations became effective for health claims, ingredient declarations, and percent juice labeling on May 8, 1993 (but percent juice labeling was exempted until May 8, 1994).[2]

Effective Jan. 1, 2006, the Nutrition Facts Labels on packaged food products are required by the FDA to list how many grams of trans fatty acid (trans fat) are contained within one serving of the product.[1]

So it is even more remarkable that a significant drop in heart attacks was seen with these more recent bans in New York, which really targeted the restaurant and eatery loopholes. Fast food and processed food companies had already decreased their use of TFA’s nationwide by some 85% over the past decades, as mounting evidence of harms and impending class action lawsuits loomed larger, and mandatory labeling of trans-fat content in foods increasingly drove educated consumers away from the products sitting on the shelves and lurking in the fryers.  Nationwide there has been a trend towards lower cardiovascular disease prevalence, but this is multifactorial.

The deep fried Twinkie as we know it will recede into the annals of history, conjured only by roving bands of post-apocalyptic freedom fighters raiding pre-WW3 bomb shelter pantries to find the archaic ingredients.

Humans will no longer be seduced by the Frankenstein mouth-feel of partially hydrogenated oils, which honestly, always tasted malicious somehow anyway.

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refined foods

The Inherent Badness of Refinement

sugar refiningI had an interesting conversation with a psychologist friend of mine who specializes in treating sexual addictions. She did not tell me anything interesting in terms of specific cases, practices, or titillating bedroom details, but rather piqued my awareness of the brave new world of dating and casual sex as facilitated by apps like Tinder.

I felt old and naïve as I learned that with a few swipes of the hand on an iPhone, people seeking a casual sexual partner in real time are able to search through profiles of other people, learn perhaps that this person is currently 100 yards away, trade photos for evaluation, and then basically get in on. For someone with a sexual addiction, this immediate gratification is as volatile and irresistible as one might witness placing a kid in front of a basket of Halloween candy. Which brought us to the corrupting notion of refinement in all things.

Take for example the refinement of carbohydrates and sugar in food. There is perhaps no more logical explanation for obesity and its attendant health problems than the free reign of sugar and starch as commodities, separated and refined from their original source.

Every day I hear the self-defeating arguments from people unable to lose weight as they cannot break a seeming addiction to starchy snacks, chips, bread, juices, soda, ice cream, and the like. The middle aisles of the grocery store, full of processed and refined inputs that have been reassembled into something complex enough to be called food, are really just barren wastelands of destroyed nutritional principles, forgotten cuisines, and corporate brand addiction. Freedom may be found in the simple, unwrapped harvest of the Earth.

Alcohol has also been refined to the point of absurdity. For thousands of years humans found health and pleasure in complex beers, ciders, wines, and other products of fermentation – a process which in some ways unlocked additional nutritional values. But over the past several hundred years the process of distilling has refined alcoholic drinks from the complex brews of the past into the simple, potent, hyper-concentrated alcohols and liquors that are often the source of addiction, accidents, and medical problems.

I personally appreciate gin and a good mixed drink, and I have a hard time preaching about the evils of alcohol, because in moderation even distilled spirits can be enjoyable and “healthy.” But for those with a predisposition to alcoholism, the concept of refinement applied in this realm has been lethal.

Which brings everything back to the conversation I had with my psychologist friend about sex, and the refinement of this realm that seems to be going on now. I am actually quite ignorant about what is actually happening out there, but as I learned more about specific websites, it seems that all the complex gratification of a relationship, or the challenging pursuit of another attractive individual – physically, emotionally, spiritually – is being reduced to a smartphone app that sorts available penises and vaginas.

This is of course just the latest development in a continuum that stretches from Playboy, through explicit internet content, and on past all the various distillations of a basic instinct for pleasure that can be satisfied in increasingly refined, uncomplicated ways. Especially for those with an addiction, this impersonal and freely available world in all its iterations is actually imprisoning.

I think that one way to achieve physical health, emotional wellness, and sexual satisfaction would be to paradoxically and intentionally seek the laborious, unrefined world.

Spend more money and time buying real foods, and cooking them, socially, in our own home kitchens, according to the traditions of a cuisine.

If you drink, seek out thoughtful, complex brews, wines and a few spirits, and revel in the magic of the process that brought this relaxing complexity to your lips, instead of enduring vehicle after vehicle of simple ethyl alcohol poisoning.

And beware of the reductionism and refinement of sex that occurs all around us, from the catalogs that arrive at our doors, to the shows on television, to the apps that would transform and enable our most primal urges. Otherwise we will continue to spoil of one of life’s greatest and most exhilaratingly complex pleasures – the physical expression of earned love.

Refinement is dehumanization.

Fight the Powder.

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hdl diet salmon

Low Carb Versus Low Fat Diets, and How My HDL Went Up 20 Points

fatsquirrelWhich is a healthier way of eating – low fat or low carb? Several recent studies have been published addressing this question, and the answer seems to be that lower carbohydrate diets, with moderate amounts of fat (yes, even some saturated fat), produce healthier cholesterol levels, reduced markers of inflammation, improved cognitive function, and greater weight loss.

My own experience in this regard may be helpful to consider.

25 year-old Dr. Charles used to work out 4 days a week, run about 10-15 miles a week, and eat very little fat but very high carbohydrates. The orthodoxy at that time was that a low fat diet was the best. I rarely ate any fat, forgot about things like nuts and avocados. I drank 1% milk fat. In an effort to gain weight, I would eat cereal or spaghetti before bed most nights of the week.

Approximate Stats:

  • Weight = 170
  • Total cholesterol 165
  • Good HDL only 38 (normal >40, optimal >60)
  • Bad LDL 103
  • Triglycerides 100
  • Energy levels fairly tired after most meals
  • Moderate adult acne

But then into my 30’s I started to incorporate more aspects of the Mediterranean diet, cooking with generous olive oil, eating nuts most days of the week, more fatty fish and shellfish, grass fed beef or bison, drinking whole milk and more wine with dinner, and substituting Greek yogurt and eggs (time permitting) for morning cereal. I stopped carb loading at night and figured I would just accept my thin body instead of trying to bulk up. I do eat carbs, maybe the equivalent of 2 servings a day, preferably whole grains or more exotic stuff like quinoa, spelt, and plant sources of starch like corn, squash, bean, sweet potatoes. Fruit, vegetables, berries. Unfortunately I found less time to exercise or run, and my time spent exercising was cut in half or more, with little to no running.

New stats on lower carb, higher fat, less active lifestyle:

  • Weight = 160
  • Total cholesterol 199
  • Good HDL 60 (most positive change)
  • Bad LDL 128
  • Triglycerides 75
  • Energy levels improved after most meals
  • Minimal adult acne

Eating more fat and losing weight?

Eating more fat, albeit mostly unsaturated healthy fats, and eating much less carbs produced 10 pounds of weight loss, boosted my HDL cholesterol over 20 points, and provided me with a subjective sense of more energy, and possibly cleared up some acne. This is consistent with the recent studies you may be hearing or reading about.

Fat is not the enemy. Even saturated fat in moderation seems to be ok. The French have known this for centuries, as have Mediterranean cuisines.

I believe in eating low carb/low sugar and low total calories, with very little processed foods from the middle aisles of the grocery store. I believe in drinking grass fed whole milk, limiting cereals in the morning in favor of eggs, whole grain toast with almond butter slathered on top, or full fat yogurt with berries. I believe in a glass of wine or beer with most dinners, because it relaxes me and my vascular tone as well. I snack on nuts, and eat saturated fats like cheese and animal fat in moderation. I pretty much never drink soda or juice, but I do like ice cream maybe once a week.

A few years ago there was a potential block buster drug being developed to boost people’s HDL cholesterol levels. This was considered the holy grail of cardiovascular risk reduction, as most studies consistently show a reduced risk of heart attack and stroke with good, high HDL levels. Unfortunately the clinical trials were halted after it became apparent that this artificial HDL engineering with a pill actually increased mortality rates.

Fortunately it seems we can turn things around with diet, perhaps as I was able to do.

Now I have to return to my very stressful job, which is going to give me a heart attack anyway.

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Food Truck Examining Room, an Evolving Concept

Given that our health care system has become a bloated carcass of once honorable intentions, I think a fundamental redesign of the examining room is in order.  For beyond the doctor and patient, the physical room which contains their ebullient repartee is the next logical target for improvement.  Here is one radical idea that may need only a few tweaks:

doctor food truck idea

Food Truck Family Practice Idea: click to view larger

The foodtruckexaminingroom will roam from town to town across the United States, stopping in major cities and small towns with main streets in order to provide excellent medical consultations.

The charge will be $25 per “visit”, with home made food gifts strongly encouraged. A medical “plan for your local doctor with malpractice coverage” will be generated from each visit, and will be thoroughly excellent.

The nerve center of the truck, and the heart and soul of this new concept, will be a very casual exam room inside the truck. There will be two chairs, a table, optional wine glasses, and a plush 1970’s style shag rug. A Norman Rockwell will be on the wall, a subtle and ironic nod to the midcentury demise of the “real” family doctor. Perhaps a bring-one-take-one-used-book-shelf will invite the free flow of subversive leftist literature.

A wine rack will be on the wall, highlighting the virtues of moderation and zinfandel.

Please rest assured there will be music gently streaming in the background, ranging from such therapeutic artists as Chopin, James Brown, and The Alabama Shakes. A nice, toothless, fluffy (and occasionally smelly dog) named Babaganoush will smile and purr gracefully at each patient, inviting intimacy and reducing anxiety from the start. For an additional 50 cents, “Baba” will roll around on your back, simulating a low cost sort of medical massage.

The truck will strive to park under shady trees in warm weather, and to maintain an alternate, open-air exam “area” with folding chairs. This area will have little to no privacy and so will be an optional, flagrant violation of HIPPA standards. A discretionary campfire, with a “Saturday Sausage Sizzle” (TM – trademark, all rights reserved) will mesh seamlessly with America’s entrenched tail-gating and RV culture.

On the top of the foodtruckexaminingroom will be perhaps the most important engineering feats – a mobile greenhouse growing organic kale, herbs, tomatoes, and mint for mojitos and tea. It will be fertilized periodically with excrement from the 500 pound, fully operational chicken coop. Free range chickens will be let out during the day to wander around eating local bugs, and will produce about a dozen organic eggs per day, which will be given to the first 12 patients of each session.

A beehive will be maintained on the roof as well, with honeybees diligently avoiding Bayer’s neonicotinoid pesticides, and Monsanto’s GMO crops, to bring us delicious honey, always on tap directly from the hive.

The rear of the truck will be retrofitted with a freezer for chocolate ice cream, the exclusive and happily restrictive diet that will be recommended for all willing nonagenarians.

The exercise zone will be fairly minimalistic, purposefully demonstrating that one really needs to just move around. The tai chi manual must be returned before sunset.

I am currently seeking investors and start up venture capital for this concept. I believe it to be scalable, yet inherently resistant to the mind-numbing, evil tendencies of big corporate paradigms and six sigma cannibalism. This concept will be “intuitive” and “quite natural” for patients willing to step inside the food truck and get some healing. Please allow me to clarify any questions you may have, and I would happily entertain suggestions for improvement.

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foods eat when sick

Best Food to Eat When Sick: 5 Foods to Beat the Common Cold

Best foods to beat the common cold: While catching a little case of the sniffles is, frankly, no big deal, it can be incredibly inconvenient. We all have busy lifestyles these days, which means that finding the time to take a few days to recover can be mission impossible. After all, no one particularly likes having to just lay around and do nothing. Not when there are far more exciting things that they could be getting on with in the meantime. When you get that first hint of a cold – whether it’s a sore throat or a headache – you know just what’s coming.

There are no two ways about it… You’re going to feel pretty darn awful for the next week or so. While bed rest and plenty of fluids are absolutely always advisable when you have a cold, there are some other things that you may want to try as well. You see, what you eat actually plays a rather major role in your overall recovery. If you’re hoping to speed up the process, changing your diet ever-so-slightly could be the answer you’ve been looking for.

So, what should you be eating? When you’re generally feeling a tad under the weather, it may be tempting to reach for the chips and chocolate to take your mind off things. Don’t do that. What you really need right now is all the right vitamins and minerals, which are certain to help you fight this cold off once and for all. If you’re not sure where to start, you’ve come to the right place.

We’ve put together a handy list of the five best foods to beat the common cold. Start eating these things, and you should feel better in no time at all:


1. Sweet potato

sweet potato healthy

Sweet potato is not just a delicious alternative to the standard baking potato; it can actually have some rather incredible health benefits as well. The reason is because these things are packed full of a little something called Vitamin A. That particular vitamin plays a huge part in keeping your mucosal surfaces, i.e. the inside of your nose and your skin, healthy.

What that means is that when you eat sweet potato, you’re boosting your intake of the vitamins you need to fight off your cold in a very real way. Try baking or frying these beauties for a tasty (and more importantly) healthy snack. You won’t regret it at all!


2. Garlic

grilled salmon healthy

When you’re all bunged up with a cold, the very last thing you’re going to want to do is going around kissing a bunch of people. That’s probably pretty handy really since you’re going to need to stock up on a whole load of garlic. We know all know that garlic is something of a wonder bulb.

Weight Watchers Online: get free registration coupon!

It’s well worth eating on a regular basis anyway since it’s surprisingly good for you. In fact, there have even been studies that show that taking garlic supplement can help you ward off the common cold. Simply including a clove of the stuff in your daily meals could be enough to make a serious impact on your health.

3. Chicken soup


chicken soup eat sick

Your mom was right – chicken soup is very good for you when you’re sick. It’s by far one of the best foods to beat the common cold. There are actually a few different reasons that this stuff is great for you when you happen to have a rather nasty cold. For one thing, drinking soup means that you’re boosting your intake of liquid; a well-known way to get rid of a cold.

The heat from the soup will also help to loosen your mucus (gross!) and raise the general temperature of your body. Both of these things will help you to cure your cold before you know it. Plus, chicken soup is so darn tasty, there’s no reason not to love it.


4. Salmon

grilled salmon healthy

Part of the reason that we end up getting colds during the colder, darker months is because we lack the Vitamin D that we usually get from sunlight. You absolutely need to make sure that you replenish this loss if you want to avoid getting too many colds. Luckily, there’s a strikingly simple. In truth, (wild-caught) salmon is one of the best foods to beat the common cold. For the healthiest results, it’s well worth grilling or roasting your salmon rather than frying it, and it can’t hurt to throw in some avocado (learn how to ripen avocados faster!) too!


5. Ginger

foods to eat when sick

Finally, it’s one of the spices that we all love the best. Eating this stuff as part of your daily balanced diet will help you to overcome your cold in no time. Spices like this one actually help you to sweat out the infection and unclog your pores. It really is that simple. Get yourself some ginger extract or even an entire root of the stuff and just go wild. Doing so is certain to give you the very best chance to warding off your illness!

These common foods are also easy to incorporate into most diets. In fact, the immune sytem-boosting vitamins and minerals in these foods can keep you from catching a cold in the first place, so don’t wait until you get sick to start eating them!

Written by Charlotte Cassidy

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