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Thursday, December 25, 2014

Happy Holidays!

Wishing you and your family a healthy and happy holiday season!
Dr. Cruz, Dr. Jakob and the entire staff of Total Family Healthcare.

Friday, December 19, 2014

Healthy Menu Item May Not Be All That Healthy

Just because a restaurant bills itself as healthy doesn’t mean that everything on the menu is that great for you. Here are a few things to look out for when eating out:

It’s labeled gluten-free. Unless you have celiac disease or you’re sensitive to gluten, gluten-free foods are no safer for your diet or your body than the regular stuff. Look out for calorie bombs like gluten-free mac and cheese, and flourless cakes.

A component of the dish is maple- or honey-glazed. These natural sugars may sound appealing and less refined than white sugar, but they still contain unnecessary calories that give sugar-sweetened candy and soda a bad rep. Instead, look for caramelized foods. They’re cooked slowly, which creates a chemical reaction that breaks down natural sugars to develop a deep, nutty flavor.

“Creamy” is used to describe something on the plate. While this could describe a frothy sauce or dressing that is blended for an extra-smooth mouth feel, it probably refers to an item made with milk or cream, which means it could contains a lot of saturated fat. Just ask what’s in the item and request sauce on the side so you can monitor your portions.

It’s vegan! Vegetarian proteins like tofu, tempeh, and seitan may be naturally low in calories, and high in protein and fiber, but they’re also low in flavor. To compensate, chefs add sodium and sauces that contribute fat. Beware of menu items modeled after classic pub foods (like wings and nachos), which tend to be highly processed. And remember that your vegan “bacon” “cheese” “burger” could easily contain just as many calories as the real version.

It’s dairy-free. It’s true that dairy-free items tend to contain less saturated fat than cheesy, creamy dishes. But if a chef swaps out regular cheese for vegan cheese, your dairy-free dish might contain just as many calories as a dish that contains cow’s  milk. Also, dairy-free foods tend to be full of fillers and foreign-sounding additives like carrageenan, maltodextrin, and mono and diglycerides. If you’re lactose intolerant and crave some gooey goodness, dig in, but watch your portions.
The same warnings go for dairy-free desserts and coffee drinks made with flavored dairy alternatives like vanilla soy milk, which tend to contain added sugars that bump up the total amount of calories. Opt for unsweetened, unflavored alternatives, and remember that foods made with low-cal options like almond milk have less protein than regular cow’s milk, so they won’t really satisfy your appetite.

It’s made with whole grains. You know that whole grains like brown rice are better for you than refined carbs like white rice, which cause a blood sugar spike that can stoke your appetite shortly after you eat. But rice is rice — it’s not free of calories or carbs. Look out for meals that feature starchy carbs like pasta as the main event — even if it’s whole wheat pasta, you’ll end up with a dish that’s extra high in carbs. And if you do go with the pasta; opt for the seafood special, which will contain lean protein and healthy fats to balance out your meal.

It’s fat-free. Unfortunately, low-fat often means low-flavor. To compensate, chefs add sugar, which is no better (and probably worse) than the healthy fats found in options like balsamic vinaigrette.

It’s organic. Organic foods aren’t always healthier than non-organic foods, according to the Food and Drug Administration. The term itself refers to how a food is grown or produced: without chemical fertilizers, insecticides, herbicides, and antibiotics (in the case of livestock). In other words, organic foods might be cleaner when they enter the kitchen, but there’s no saying whether they’ll be healthier (i.e., richer in nutrients and lower in fat) than regular foods by the time they make it to your plate.

It’s 100-percent natural. "Natural" meat, poultry, and eggs are minimally processed and contain no artificial ingredients, according to the USDA. But natural doesn’t mean low-calorie or low-fat. So you know that 100-percent of your natural bacon, egg, and cheese sandwich has no artificial ingredients, but It’s probably still dripping in unhealthy fats.

It’s raw. Because raw foods are minimally processed, they may seem like your best bet. But because cooking can kill dangerous bacteria found in food, a dish made with raw meat, eggs, or unpasteurized milk products can actually make you sick. While raw food advocates claim that cooking kills enzymes in food and reduces the food’s nutrients, science suggests that cooking some foods (like tomatoes) can actually help your body absorb more of that food’s nutrients. One last thing to remember, raw vegan meals tend to contain fewer calories and less protein than cooked dishes, so they might leave you hungry and craving some serious dessert.

Wednesday, December 3, 2014

Holiday Depression

Christmas time is the most likely time of the year to experience depression. The suicide rate is higher during December than any other month, which tells us that Christmas depression should be taken quite seriously. Depression at Christmas time can be triggered by a multitude of things, such as losses, failures, and loneliness. These elements are exacerbated this time of year. People who have had deaths in the family or have experienced divorce or the loss of a child are more prone to depression, especially during the holiday season.

It can be especially difficult to cope with a Christmas depression because everyone else seems so joyous, so reaching out feels more awkward and more remote. We don’t want to bring down those around us, we don’t want to feel “different” or alienate ourselves, and we don’t want to draw attention to ourselves either. We tend to disassociate ourselves from our own feelings and ask ourselves self defeating questions. We wonder what’s wrong with us and why we can’t just jump right on into the holiday cheer. This is supposed to be the happiest time of the year and yet we can barely drag ourselves out of bed and become functional human beings. On top of feeling sad and dysfunctional, we feel out of place, and somehow illegitimate in our feelings.

 Not all holiday depression has anything to do with loss or failure or death, or even anything obvious. Sometimes people tend to just get depressed around the holidays. Yet those without an obvious “reason” feel that they really shouldn’t be depressed and are least likely to reach out for help. It’s as though people who have experienced trauma have more of a “right” to experience holiday depression than those who appear to have everything that could need or want.

People fail to recognize that holidays are stressful enough to trigger a depression. Sometimes the hustle and bustle and the need to produce (food, presents, parties, and the lot) are enough to seriously frustrate a person right into a depression. Feeling disconnected with the holidays can easily lead to a mild to moderate depression.

Whether dealing with a loss or change or simply feeling overwhelmed by holiday sadness, the number one most important thing anyone can do is to tell someone. Asking for help is a sign of strength, not weakness. Over the past ten years there has been a great awakening, so to speak, that has illuminated the issue of Christmas depression. People have become more educated and more understanding about the phenomenon and often already know that someone they love is suffering from depression before there is any actual confession.

If you are alone at Christmastime and you realize that you are coming down with holiday depression, reach out to someone by phone, whether it is a friend, a relative, or a professional, just call someone. This is so important. There is nothing to be ashamed of and there are plenty of people willing and able to assist you. A bad moment (even a really long one that last several weeks) does not have to ruin a future. Unfortunately people who find themselves depressed and do nothing about it are prone to staying depressed. Depression can interfere with job performance, friendships, romantic relationships, parenting ability, self care, and even the ability to take care of the dog. It can lead to losses of these very important things if the depression becomes serious enough.

The onset of Christmas depression can sneak up on you in numerous forms. You may simply start to feel more tired than normal or start sleeping through the alarm. You may procrastinate on holiday shopping, even when those events that require your participation are only a few days away. You may start to feel randomly irritable, or snap at people without provocation. You may start to feel disconnected with the world and withdraw from those around you, even children. These are all signs that you are experiencing at least some form of holiday depression, and warning signs that you may need help in dealing with whatever is making you feel this way.

Dealing with a holiday depression once you are able to recognize it is a vital step in returning to a better state of health. Naturally, my first recommendation is that you find a good counselor to speak with. The onset of holiday depression doesn’t have to mean that you require long term counseling or even medication. It may just mean you have to learn to set better boundaries or learn to let go of the past or learn better coping skills when it comes to dealing with a tragedy. Nothing that you are experiencing is so terribly abnormal, and no one is going to react terribly to you if you ask for help.

A good counselor can help you learn to set “holiday boundaries” while you are coping with holiday depression. “Holiday boundaries” include things like limiting the number of holiday party invitations you and your family accept, scaling down Christmas to a level that feels more reasonable to everyone, asking for help in the Christmas preparations, and perhaps dealing a little differently with the specific tasks that tend to depress you more. If wrapping presents creates a huge sadness in you because it triggers and emotion or a memory, then perhaps you can get a significant other, an older child, or another relative to help you so that you don’t have to wrap nearly as many. Sometimes just doing it with someone is enough to help keep your depression away.

A Christmas depression is usually more than just a simple case of the holiday blues, and it really should be treated with more respect than that. It is better to go to a counselor and have them tell you that you just have the “blues” and it will pass than to sit on a serious depression and slowly watch your world around you disassemble. A holiday depression requires attention, especially one that develops annually. While it may seem logical to believe that because it happens every year that it will just keep leaving every year.

Wednesday, October 15, 2014

Stretching For Back Pain Relief

Almost everyone can benefit from stretching the soft tissues - the muscles, ligaments and tendons - in the back, legs, buttocks, and around the spine. The spinal column and its contiguous muscles, ligaments, and tendons are all designed to move, and limitations in this motion can make back pain worse. Patients with ongoing back pain may find it takes weeks or months of stretching and other back exercises to mobilize the spine and soft tissues, but will find that meaningful and sustained relief of back pain will usually follow the increase in motion.

General Tips for Stretching to Relieve Back Pain
Keep the following in mind when starting a stretching routine as part of a program of back exercises:

  • Stretching should be pain free; do not force the body into difficult positions
  • Move into the stretch slowly and avoid bouncing, which may actually tear muscles
  • Stretch on a clean, flat surface that is large enough to move freely
  • Hold stretches long enough (20-30 seconds) to allow muscles or joints to become loose
  • Repeat the stretch, generally 5-10 times

If one already has low back pain or neck pain, it is best to check with a physician or physical therapist to discuss whether the following neck, shoulder, and lower back pain exercises should be done.

Back, Hip & Gluteus Stretches
Many back pain patients know the feeling of tension in the back, especially first thing in the morning. These stretching back exercises can help bring back some suppleness and increase mobility, decreasing back pain and discomfort.

Back Flexion Exercise
While lying on one's back, pull both knees to the chest while simultaneously flexing the head forward until a comfortable stretch is felt in a balled-up position.

Knee to Chest Stretch
While lying on the back with the knees bent and both heels on the floor, place both hands behind one knee and bring it to the chest.
The hips and buttocks (where the gluteus muscles are) support the lower back, and stretching these muscle groups plays a pivotal role in maintaining spine flexibility.

Hip Stretch
While standing with feet shoulder-width apart, take a half-step back with the right foot, bend the left knee and shift weight back to the right hip. While keeping the right leg straight, bend forward more and reach down the right leg until a stretch in the outer hip is felt.

Piriformis Muscle Stretch
The piriformis muscle runs through the buttocks and can contribute to back pain or leg pain. To stretch the this muscle, lie on the back and cross one leg over the other and gently pull the other knee toward the chest until a stretch is felt in the buttocks area.

Friday, October 3, 2014

High Blood Pressure! What is it & Why You Should Care.....

Cara Jakob, MD
We have all likely heard of high blood pressure, or "hypertension", at some point in our lives. Our grandmother may have been taking blood pressure medicines. We may have checked our own blood pressures out of curiosity at those little machines at our local pharmacy.  Or, perhaps our own doctor has mentioned high blood pressure to us.

  But, what exactly is high blood pressure, and why such a big deal about it?  Let's start with some numbers. High blood pressure, or "hypertension," is defined as repeated blood pressure above 140/90mmHg. Normal blood pressure is blood pressure up to 120/80mmHg.  The blood pressures in between 120/80-140/90mmHg are considered "pre-hypertension."

  How do these numbers affect our health?  According to the Centers for Disease Control, heart disease is the current leading cause of death in the United States.  About one third of all deaths above age 35 is due to heart disease, and hypertension is a major risk factor in the development of heart disease. Hypertension also increases risk for stroke, heart failure, and kidney disease.

  Just imagine trying to water your lawn using a garden hose that has a kink in it. You'll be working harder and struggling to push the water past the high pressure in the hose, and those flowers in your garden will suffer from the poor supply of water coming through. That is a simplified version of the way our hearts are working to pump blood through our arteries to feed our body's organs like the brain, eyes, kidneys, etc. With hypertension, our vital organs are suffering the damages of a high pressure system.

   The good news is that healthy lifestyle changes like regular exercise, lower sodium diet, and weight loss can significantly lower blood pressure, thereby decreasing the risk for stroke, heart attack, heart disease, etc. 

 Aerobic exercise regularly can lower blood pressure by 5-15mmHg, and the intensity of the workout is more important than its duration. An easy way to improve our diet to a lower sodium diet is to limit or cut out the processed foods and canned foods. Eating fresh foods, and preparing your own meals can help reduce that excess salt in our diet. As for weight loss, there are many benefits to reaching a healthy weight, and better blood pressure is one major benefit. Every few pounds we lose can improve our blood pressure by as many points. Some people may also need medications to treat their hypertension and its risks.

Now that we know more about hypertension, let's be on the lookout for it, and take healthy steps to help combat it. Talk with your doctor about your blood pressures and whether you have hypertension. Together, you can develop an individual health plan to keep you at your best.


Tuesday, September 30, 2014

Different Types of the Flu

Edgar Cruz, MD
Influenza (the flu) is a virus that infects the nose, throat, airways and the lungs. It is very contagious and is transmitted from person to person during coughing, sneezing, and even while speaking at a very close distance. The infection with the influenza virus occurs during the period from October through April.

The typical symptoms of the flu include fever, chills, muscle aches, nasal congestion, runny nose and difficulty breathing. In some instances, in vulnerable people like young children and older adults, it can even cause fulminant pneumonia. Every year in the United States approximately 200,000 people are hospitalized and 36,000 die from complications of the infection. Because of the fact that the infection is caused by a virus, it cannot be successfully treated with antibiotics.

Since the 1940’s a flu vaccine has been available to reduce or eliminate the symptoms of the flu. There are two types of vaccines. The vaccine with inactivated virus is developed in eggs. It is purified and it is administered as an injection. The vaccine with attenuated (debilitated) virus ”Flu Mist”, is also produced in eggs. This vaccine is administered as a nasal spray. Because the virus is attenuated, it cannot grow in the lungs but it can grow in the nasal cavity were it produces an excellent protective immune response. Both vaccines include the 3 most frequent types of virus that cause the infection during that year. The flu vaccine is administered each year because the circulating virus are different each year.

For the most part the flu vaccines are safe. There is a secondary effect that could be very serious. Because the vaccines are produced in eggs there might be a small amount of egg protein. The people that are allergic to eggs might develop an allergic reaction that is rarely fatal but that it can be very severe. For this reason people that are allergic to eggs should not receive the flu vaccine unless they are in a very high risk population and that the benefits of receiving the vaccine outweighs the risk of getting a severe flu infection.

The flu vaccine is usually administered right before the flu season starts during September and November. The vaccine can be administered during the flu season even through March. In a phone conversation with CDC (centers for Disease Control) personnel we were informed that as long the vaccine has not expired there is no definite time limit to administer the vaccine.

The vaccine could protect 70 to 90 of every 100 people from contracting a moderate to severe infection. Talk to your doctor and try to get the vaccine this year.

Friday, September 26, 2014

How the Flu Spreads

Edgar Cruz, MD
All three flu viruses are spread in the same way: they leave an infected person’s body in droplets whenever that person coughs, sneezes, or puts their mouth on another object. If you’re in close contact with an infected person, you may end up inhaling infected droplets immediately, but you can also pick up the virus later from touching an infected object like a door handle or a pencil, and then touching your eyes, nose, or mouth.

This is why it is essential to maintain vigorous personal hygiene, especially during flu season. Simple steps like using antibacterial liquid to clean your hands after getting off a bus, or washing your hands extra carefully before eating, can go a long way in avoiding the flu and preventing its spread. 

Tuesday, September 23, 2014

Why it is Important to Bring Your Prescription Bottles to Your Office Appointment?

Edgar Cruz, MD
The best way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.
Make sure that all of your doctors know about every medicine you are taking. This includes prescription and over-the-counter medicines and dietary supplements, such as vitamins and herbs.  Do not assume that everyone has all the information they need. Bring all of your medicines and supplements to your doctor visits. "Brown bagging" your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date and help you get better quality care. Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you to avoid getting a medicine that could harm you.
Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you get them:

What is the medicine for?

How am I supposed to take it and for how long?

What side effects are likely? What do I do if they occur?

Is this medicine safe to take with other medicines or dietary supplements I am taking?

What food, drink, or activities should I avoid while taking this medicine?

When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?

Ask for written information about the side effects your medicine could cause. If you know what might happen,  you will be better prepared if it does or if something unexpected happens.


Monday, May 26, 2014

Remembering Memorial Day

We would like to thank all those who have and are protecting us here at home. Your sacrifices should always be remembered not just today, but every day! Happy Memorial Day from the staff of Total Family Healthcare.

Wednesday, May 21, 2014

What To Look For In A Weight Loss Program


Some people lose weight on their own; others like the support of a structured program. Overweight people who are successful at losing weight, and keeping it off, can reduce their risk factors for heart disease. If you decide to join any kind of weight-control program, here are some questions to ask before you join.
  • Does the program provide counseling to help you change your eating activity and personal habits?
    The program should teach you how to change permanently those eating habits and lifestyle factors, such as lack of physical activity, that have contributed to weight gain.
  • Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?
    You need to be evaluated by a physician if you have any health problems, are currently taking any medicine or plan on taking any medicine, or plan to lose more than 15 to 20 pounds. If your weight-control plan uses a very low-calorie diet (a special liquid formula that replaces all food for 1 to 4 months), an exam and follow-up visits by a doctor also are needed.
  • Is training available on how to deal with times when you may feel stressed and slip back to old habits?
    The program should provide long-term strategies to deal with weight problems you may have in the future. These strategies might include things like setting up a support system and establishing a physical activity routine.
  • Is attention paid to keeping the weight off? How long is this phase?
    Choose a program that teaches skills and techniques to make permanent changes in eating habits and levels of physical activity to prevent weight gain.
  • Are food choices flexible and suitable? Are weight goals set by the client and the health professional?
    The program should consider your food likes and dislikes and your lifestyle when your weight-loss goals are planned.
There are other questions you can ask about how well a weight-loss program works. Because many programs don't gather this information, you may not get answers. But it's still important to ask them:
  • What percentage of people complete the program?
  • What is the average weight loss among people who finish the program?
  • What percentage of people have problems or side effects? What are they?
  • Are there fees or costs for additional items, such as dietary supplements?
Remember, quick weight loss methods don't provide lasting results. Weight-loss methods that rely on diet aids like drinks, prepackaged foods, or diet pills don't work in the long run. Whether you lose weight on your own or with a group, remember that the most important changes are long term. No matter how much weight you have to lose, modest goals and a slow course will increase your chances of both losing the weight and keeping it off.

Monday, May 19, 2014

How to Change Your Behavior About Food

Your Weight Is Important

Over the past few years it has become clear that weight is an important health issue. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health care encounters in which they felt blamed, but not helped. Successful weight management is a long-term challenge.
Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who carry the excess weight. The amount of weight loss needed to improve your health may be much less than you wish to lose, when you consider how you evaluate your weight. Research has shown that your health can be greatly improved by a loss of 5–10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5–10 percent of your starting weight is both realistic and valuable.

Behaviors That Will Help You Lose Weight and Maintain It

Set the Right Goals
Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and physical activity changes that will lead to long-term weight change. Successful weight managers are those who select two or three goals at a time that are manageable.
Useful goals should be (1) specific; (2) attainable (doable); and (3) forgiving (less than perfect). "Exercise more" is a great goal, but it's not specific. "Walk 5 miles every day" is specific and measurable, but is it doable if you're just starting out? "Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, 5 days each week" is specific, doable, and forgiving. In short, a great goal!

Nothing Succeeds Like Success

Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: (1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and (2) consecutive rewards keep the overall effort invigorated.

Reward Success (But Not With Food)

An effective reward is something that is desirable, timely, and dependent on meeting your goal. The rewards you choose may be material (e.g., a movie or music CD, or a payment toward buying a more costly item) or an act of self-kindness (e.g., an afternoon off from work or just an hour of quiet time away from family). Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort.

Balance Your Food Checkbook

"Self-monitoring" refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, amount of physical activity, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually moves you closer to the desired direction and can produce "real-time" records for review by you and your health care provider. For example, keeping a record of your physical activity can let you and your provider know quickly how you're doing. When the record shows that your activity is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.
While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change from day to day, and water changes are often the result of things that have nothing to do with your weight-management efforts.

Avoid a Chain Reaction

Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to change the situation, such as by separating the association of eating from the cue (don't eat while watching television), avoiding or eliminating the cue (leave the coffee room immediately after pouring coffee), or changing the circumstances surrounding the cue (plan to meet your friend in a nonfood setting). In general, visible and reachable food items are often cues for unplanned eating.

Get the Fullness Message

Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message that you've been fed. Eating slowly will help you feel satisfied. Eating lots of vegetables and fruits can make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear too small. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.
From The National Institute of Health

Monday, March 17, 2014

Happy St. Patrick's Day

May there always be work for your hands to do
May your purse always hold a coin or two;
May the sun always shine on your windowpane;
May a rainbow be certain to follow each rain;
May the hand of a friend always be near you;
May God fill your heart with gladness to cheer you.

Wednesday, March 5, 2014

Increased Red Meat Consumption Linked to Higher Diabetes Risk

According to a new long-term observational study from researchers at the Harvard School of Public Health and the National       University of Singapore, increasing the number of servings of red meat over time increases the risk of getting type 2 diabetes, while cutting back reduces the danger. The study is published in JAMA Internal Medicine.
Using food questionnaires, researchers tracked the eating habits of almost 150,000 people every four years for an average of 20 years of follow-up. Their analysis took into account age, family history, race, smoking status, initial red meat consumption and  lifestyle factors such as physical activity, alcohol intake and diet quality.

The study found that among those who ate more red meat as the study progressed showed higher rates of diabetes than those whose red meat consumption didn’t change.

Consuming 3.5 more servings of red meat per week during a four-year period increased a person’s chance of developing diabetes by almost 50 percent in the subsequent four years.
Those who consumed 3.5 less servings of red meat per week during a four-year period didn’t have a short-term reduced risk of developing the disease, but over the subsequent 10 years, reduced their risk of developing type 2 diabetes by 14 percent.

The findings apply to both processed red meats, such as lunch meat and hot dogs, and unprocessed red meat, such as hamburger, steak and pork. The association was stronger for processed meat.
Some experts suggest that the high calories and fat in red meat are to blame for the association between increased consumption and higher risk of diabetes. Indeed, people who are overweight are more likely to develop the condition. However, even after the  researchers controlled for body mass index and weight gain, the linkage between increased red meat consumption and  type 2 diabetes remained.

In an invited commentary in the journal , William J. Evans, Ph.D., head of the Muscle Metabolism Discovery Performance Unit at GlaxoSmithKline, and an adjunct professor of geriatric medicine at Duke University, suggests that the problem isn’t red meat, but the amount of saturated fat in the meat.
According to lead author An Pan, Ph.D.:

“The public-health message is to try to limit red meat consumption (particularly processed red meat) and switch to plant-based food choices and more fish or poultry. While there is no cutoff point or recommendation regarding how many servings per week, the current evidence suggests the less, the better.”
The study is the first to look at red meat consumption changes over time and how it affects diabetes risk.


Monday, March 3, 2014



For Release: Immediate
CHICAGO - The American Academy of Pediatrics (AAP) has issued a new policy statement opposing the use of Retail-Based Clinics (RBCs) - limited, lower-cost services at walk-in facilities located in supermarkets, pharmacies and large retail stores - as a source for medical care of infants, children and adolescents. These clinics do not support the AAP's commitment to the medical home model that provides accessible, family-centered, comprehensive, continuous, coordinated, compassionate and culturally effective care for which the pediatrician shares responsibility with the family.
The AAP is particularly concerned with the following aspects of RBC care:
  • Fragmentation and possible lower quality of care
  • Care for children with special health care needs
  • Lack of access to a central health record
  • Use of tests and diagnosis without proper follow-up
  • Public health issues surrounding exposure to contagious diseases in a retail environment
While the AAP is opposed to the use of RBCs, it does acknowledge that these clinics will likely continue to exist. To help ensure the best care possible through these outlets, the AAP has issued the following guidelines:
  • RBCs should support the medical home model by referring patients back to primary care physicians for future care. A medical home ensures a main source for a child's health care and medical records
  • RBCs should communicate with the patient's pediatrician or other primary care physician within 24 hours of the visit.
  • All those providing care to children should follow AAP clinical guidelines as well as those developed by other medical organizations.
  • RBCs should be subject to health facility standards and precautions should be taken to avoid the spread of contagious diseases.
In addition, the AAP is opposed to waiving or lowering co-pays or offering financial incentives for visits to RBCs in lieu of pediatricians or primary care providers. These types of incentives would further promote the fragmentation of care.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.

Saturday, March 1, 2014

Remember Your New Year's Resolution!

So it has been nearly 2 months since you made that New Year’s Resolution, but do you even remember what it was?  We all have good intentions when we make them, but let’s face it, life just gets in the way! Only 8% of those who make a New Year’s resolution end up keeping it; the rest of us are done with them by the end of March.  We tend to fail, not for lack of trying, but for setting unrealistic expectations and time frames.

Stop thinking “New Year’s Resolution” and start thinking “my goals for this year”.  It is important for you to make your goals specific, attainable, relevant, measurable, and set to a time limit.  Losing weight is always in the top 5 resolutions, and one of the first to be broken.  Instead of thinking “losing weight”, make a goal to eat healthier (eat 4 servings of fruit and veggies a day), limit desserts to 1 per week and eat a normal portion size.  These changes will help you lose the weight you want by establishing easy, achievable daily goals.  Fall off the wagon one day?  Don’t worry about it, just start again!  Think of getting healthy like the stock market.  Your goal in investing is not to get rich quick, but to secure long term wealth, or, in this case health.

If you need help achieving your goal of obtaining a healthy lifestyle, we are here to help!  Our patients lose thousands of pounds each month, and best of all they keep them off.  Our doctors and staff can help you identify the physical and emotional triggers that have stopped you in the past and give you a personalized wellness plan to get you on your way to better health once and for all.  For the month of March we will be running a “New Goals for a New Me” promotion where you can get a free wellness consultation and begin your personalized wellness plan for only $50.00, when you "Like Us" on Facebook. (offer ends 03/31/14)

Friday, February 7, 2014

A Valentine's Day Dinner That Will Blow Your Mind Not Your Waistline!

Check out our latest patient handout, "A Valentine's Dinner That Will Blow Your Mind Not Your Waist Line" on our Facebook page. We put together a Romantic, 3 course dinner that is less than 500 calories including dessert!

Be sure to like our page while your are there!


Thursday, January 23, 2014

Low Testosterone?

Many of my male patients have questions about testosterone. Specifically, do they need more of it?
Just as women go through hormonal changes with aging, men’s bodies change in important ways, too. Testosterone is known as the primary male hormone, and it is responsible for development of the male sex characteristics and the male sex organs. Normal testosterone levels impact virtually every organ in the body, including the brain where it influences libido (sex drive) and mood, and the muscles, where it leads to increased size and strength. Testosterone also plays a critical role in our metabolism, including our risk of diabetes. Low testosterone is defined as a clinical syndrome characterized by low testosterone levels in the blood coupled with symptoms that doctors think are attributable to those low blood levels.

Some of the specific signs of low testosterone that may be easier to identify include low libido, erectile dysfunction (ED), reduced genital stimulation or orgasm, hot flashes, osteoporosis, and reduced male pattern hair growth. Less specific signs of low testosterone include decreased energy, depression, reduced muscle strength, poor concentration or memory, sleep disturbance, and increased body fat. Sometimes these latter symptoms are the key to early identification of a problem.

Low blood levels of testosterone—defined by a blood test showing a value less than 300 nanograms per deciliter of blood (ng/dL)—are believed to be quite common and under-diagnosed. In one study, researchers estimated that low testosterone affects 39 percent of men ages 45 and older who present for primary care checkups. Low testosterone becomes more common with age as well as with other medical conditions like obesity, diabetes, high blood pressure, and dyslipidemia (high triglycerides, low HDL cholesterol). Exercise may increase testosterone a little bit. Men who have the symptoms we discussed should have a testosterone blood test. I also believe that men age 35 and older should probably have a baseline testosterone with their cholesterol profile. I think this is important, because studies show that men with undiagnosed low testosterone tend to die earlier than those with normal values. It is better to identify this early. Doctors can help patients decide if treating low testosterone is the right thing to do.

Low testosterone has been linked to cardiovascular disease. A recent study showed that low testosterone in men with high blood pressure was associated with a higher likelihood of heart attack and stroke. Low testosterone may also signal a need to improve lifestyle habits, particularly by exercising more and losing weight. The experts in the field agree that a normal testosterone level is an integral part of good overall sexual, metabolic, and cardiovascular health.

Saturday, January 4, 2014

Congratulations Maria!

Everyone did a great job decorating for this years Holiday Door Decorating Contest and we would like to thanks all our patients who voted. Congratulations to Maria  for winning this year's contest!

Wednesday, January 1, 2014

Happy New Year!

May the New Year Bring Health, Happiness and Joy

to You and Your Family

Clermont Office
3115 Citrus Tower Blvd., Suite A
Clermont, Florida 34711
Toll-free: (866) 212-2943
Orlando / MetroWest Office
1507 Park Center Drive, Unit 1H
Orlando, Florida 32835
Toll-free: (866) 212-2943