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Latest Posts

Calcium Supplements: Good For Your Bones But Bad For Your Heart?

Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently.

In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calcium supplements that are raising concerns. Two studies published in the past two years suggest that calcium supplements are associated with a significantly increased risk of heart attacks. Could the risks of calcium supplements outweigh any benefits they offer? Read more »

*This blog post was originally published at Science-Based Medicine*

New Recommendations For Vitamin D

Vitamin D has been talked about as the vitamin — the one that might help fend off everything from cancer to heart disease to autoimmune disorders, if only we were to get enough of it.

“Whoa!” is the message from a committee of experts assembled by the Institute of Medicine (IOM) to update recommendations for vitamin D (and for calcium).

The IOM committee’s report, released this morning, says evidence for many of  the health claims for vitamin D is “inconsistent and/or conflicting or did not demonstrate causality.” The exception is the vitamin’s well-documented (and noncontroversial) benefits on bone growth and maintenance.

The IOM panel’s report also says most North Americans (Canadians as well as Americans) have more than enough vitamin D in their blood to achieve the desired effect on bone. The committee said a blood level of 20 nanograms per milliliter (ng/mL) is sufficient for most people.

The panel set 600 International Units (IU) as the recommended daily intake for children and for adults ages 19 to 70. People ages 71 and older are supposed to get an additional 200 IU, or 800 IU a day.

That’s a fairly sizable increase over the previous recommendations of 200 IU per day through age 50, 400 IU for people ages 51 to 70, and 600 IU for people ages 71 and older. Read more »

*This blog post was originally published at Harvard Health Blog*

Life Line Screening Promotes Unnecessary Medical Tests

A patient brought in a flyer for Life Line Screening, where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, their abdominal aorta screened for aneurysm (swelling), and be tested for osteoporosis. The advertisement claims that “we can help you avoid a stroke,” and their logo notes “Life Line Screening: The Power of Prevention.”

Are these tests worth your money? Short answer: No.

Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), exercising regularly, and eating a low-sodium diet. Their is no mention of an ultrasound test. Why? Because there is NO evidence that it helps save lives in individuals who are healthy and have no symptoms (except for the following situations). Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

McDonald’s Vs. DASH: Two Days, Two Diets

This week I’ve been trying to eat according to the DASH guidelines for lowering blood pressure. It actually hasn’t been too difficult — partly because I’m not following their strictest guidelines, which call for just 1,300 milligrams of sodium and 16 grams of saturated fat a day. I’ve been shooting for 2,300 milligrams of sodium and 22 grams of saturated fat.

In 2003, I tried a somewhat different “diet,” which in some ways was more difficult to follow, even though it only lasted one day. My son Jim (then age 11) and I ate every meal at McDonald’s for an entire day (yes, this was before Super Size Me). We recorded the experience on the Web. I thought it would be interesting to compare my day at McDonald’s to a typical day on DASH. Read more »

*This blog post was originally published at The Daily Monthly*

Vitamins In A Nut Shell

Some patients love their vitamins, spending hundreds to thousands of dollars annually. At times, they will even forgo proven medical therapy. As more Americans go without health insurance coverage while others face higher office visits and copays, increasing numbers of patients are seeking alternative, natural therapies instead of medical care. Are vitamins really the scientific breakthrough and secret that doctors refuse to recommend or are they simply marketing hype? As any medical school student will tell you, the correct answer to any question is: it depends.

For certain groups, pregnant women, patients with macular degeneration, and vegetarians, vitamins and minerals may be recommended as research finds them helpful. Prenatal vitamins have more folic acid which has been found to decrease the risk of neural tube defects in the fetus. Vegetarians may need to supplement their diet with vitamin B12, iron, and vitamin D, which are absent in their food choices. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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