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How Much Water Are You Supposed To Drink? Your Urine Will Tell You

Perhaps you’ve heard that increasing your water intake is part of a healthy lifestyle – and that you should drink at least 8 glasses of a day. This “rule of thumb” is actually not based on scientific evidence. Although for many people it’s not harmful advice, you may not need to work so hard at getting enough water every day.

The amount of water that your body needs depends on three main variables (yes, needs can vary with different illnesses and conditions, but let’s talk about the average American):

1. Your body’s size

2. Your activity level

3. Your environment (weather and humidity conditions)

The larger you are, the more water you lose from sweat (be it from physical activity or hot weather conditions), the more water you need to replace. The amount you need can vary a lot – and in most cases there are two tricks you can use to stay properly hydrated: Read more »

The Seven Golden Rules For Kidneys

In the better-late-than-never category comes my shout out for World Kidney Day, which was March 10th.

I love their slogan: “Protect your Kidneys, Save your Heart.”

As an organ, the kidneys are a lot like offensive lineman in football; they do all the hard work but remain mostly anonymous. They sit motionless in the back of the body,quietly and humbly filtering salt, water and toxins from our bodies. Though some may think that pee smells bad, or is gross, not having “healthy” pee is a real problem.  No one ever thinks of their kidneys until they malfunction.

Though the inner workings of the kidney–with all its convoluted loops, capsules and ion exchangers–are more complicated to understand than the heart, keeping your kidneys healthy is simple: just make heart-healthy choices. Read more »

*This blog post was originally published at Dr John M*

We’re Overdosing On Sodium: Whose Responsibility Is It?

I confess to loving Campbell’s tomato bisque soup. I mix it with 1 percent-fat milk and it’s hot and delicious and comforting, but one of the worst food choices I could make because one cup contains more sodium than I should have in a day. Knowing this, I have already relegated it to an occasional treat. But by the end of this blog post I will do more.

We are overdosing on sodium and it is killing us. We need to cut the sodium we eat daily by more than half. The guidelines keep coming. The U.S. government has handed out dietary guidelines telling Americans who are over 50, all African Americans, people with high blood pressure, diabetes, or chronic kidney disease to have no more than 1,500 milligrams (mg) — or two thirds of a teaspoon — of sodium daily. That’s the majority of us — 69 percent. Five years ago the government said that this group would benefit from the lower sodium and now it made this its recommendation. The other 31 percent of the country can have up to 2,300 mg a day, say the guidelines from the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS).

Or should they? The American Heart Association (AHA) recommends that all Americans lower sodium to less than 1,500 mg a day. Excessive sodium, mostly found in salt, is bad for us because it causes high blood pressure which often leads to heart disease, stroke, and kidney disease and can also cause gastric problems. People with heart failure are taught to restrict salt because water follows salt into the blood and causes swelling of the ankles, legs, and abdomen and lung congestion that makes it difficult to breathe.

I saw one recommendation by an individual on the Internet to just drink a lot of water to flush the sodium out of your body rather than worry about eating foods that have less sodium. BAD idea, especially for people with heart problems who need to restrict fluids to help prevent fluid accumulation in their bodies. The salt will draw the water to it.

But cutting our salt consumption by half is quite a tall order for an individual consumer because Americans have been conditioned from childhood to love salt and we on average consume 3,436 mg — nearly one and a half teaspoons — a day. Sodium is pervasive in our food supply. We get most of our sodium from processed foods and restaurant and takeout food, sometime in unexpected places. Read more »

*This blog post was originally published at HeartSense*

Potassium And Exercise: Sports Drink Or Orange Juice?

As I stutter through recovery from LungMutiny2010, I’m paying more attention to my diet. So as I try to go out for my 10-minute walk everyday, I still drink some sports drink — usually Gatorade made from the massive vat of powder you can buy at Costco.

We tend to get plenty of sodium in our diet — far too much in the U.S. actually — but I always worry about potassium when I’m sweating (Disclaimer: I am not an exercise physiologist or a cardiovascular or nephrology physician.)

I always thought that the widely-sold sports drinks were the best sources of potassium outside of eating bananas or some dried fruits. I was surprised to learn that an 8-ounce serving of orange juice contains 18-fold more potassium than an 8-ounce serving of Gatorade® (450 mg vs. 25 mg). Who knew? Read more »

*This blog post was originally published at Terra Sigillata*

A Gene For Surviving Dialysis

As a hospitalist physician of seven years and taking care of dialysis patients, I’ve come to the conclusion that a dialysis survival gene exists. I talked with a nephrologist the other day about dialysis survival. Here’s what he said:

“If you take all dialysis comers, every year 25% of them will die.”

There is a broad range of dialysis survival. A 94-year-old with severe COPD, CHF, and dementia will not have the same survival statistics as a healthy 27-year-old with acute interstitial nephritis. The protoplasm from which you begin with often times determines the dialysis survival.

There are many factors that determine dialysis survival statistics. Some of them include, age, race, weight, and even the length of the dialysis treatments. But no where have I seen reported the association of dialysis survival with Happy’s presumed dialysis surivival gene. Read more »

*This blog post was originally published at The Happy Hospitalist*

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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