Get a physician's perspective on modern medicine... Internal and Respiratory Medicine
House Calls
House Calls Started This Year
House calls are meant for patients who are temporarily or permanently home bound, or for other good reasons can't make it into the office.
To schedule a house call: Tel (203) 853-1919; email istaw@drstaw.com
Sunday, January 5, 2014
Wednesday, December 18, 2013
Holiday Weight Gain
We used to believe that the average American adult gained 5 or more pounds during the holiday season, between Thanksgiving and New Year. But a study published in the New England Journal of Medicine (NEJM) in 2000 changed all that. It concluded that the average Holiday Season weight gain was "only" 1 pound.
But this just didn't sound right. As many of you know, my practice had a weight management division for over 25 years, known as Health Extenders, where we followed a large number of patients for their weight and behavior over long periods of time, including the holiday period. We never believed the 1 pound weight gain, and I still believe it's much higher than that.
Friday, November 15, 2013
Statins – To Take or Not to Take?
And the controversy rages on. If you followed the article Experts
Reshape Treatment Guide for Cholesterol and the editorial Don’t Give
More Patients Statins in the New York Times in the last two days, you’d see
the breadth of the issue.
The problem is that, while heart disease is the number one
cause of death in the US ,
most heart disease is not necessarily caused by an elevated cholesterol or
abnormal cholesterol pattern. The number one cause of premature heart attacks (and
overall mortality) is smoking!
It is quite clear that people who have already had a heart
attack are at a high risk for a subsequent heart attack, and those with type 2 diabetes
carry a similar risk. These people should be treated with statins, if possible.
Most experts agree.
But...
Tuesday, November 12, 2013
Low Glycemic Index Foods – Why Bother?
After a meal blood sugar levels usually rise. To keep the blood
sugar in check, insulin levels rise, and then return to normal, in order to bring
blood sugar levels back to normal.. There are many reasons to keep both blood
sugar and insulin levels within acceptable limits, but most important are the control
of diabetes, cholesterol, and weight.
Keeping you sugar under control helps curb appetite- that’s
how it helps you lose weight.
The foods that raise your blood sugar the most, the
culprits, are “simple carbohydrates” (or simple carb’s): Sugar, high fructose corn
syrup, and highly processed wheat products (mainly white flour).
The “good carbohydrates” are complex carbohydrates such as whole
wheat products and a host of vegetables, legumes and some fruits (don’t forget
the grapefruit, the season is approaching…).
The Glycemic Index (GI)is a measure of the blood sugar rise
after a test amount of a given food is ingested. The Glycemic Load (GL) is
a measure of the sugar level rise after a regular portion size amount of
the same food is ingested. The lower the
numbers, the better the food.
You can find many GI and GL tables on the internet. A
reliable source is the one by Berkeley
Labs. Use it.
Any question? You know where I am.
Friday, November 8, 2013
Curb Your Sweets
I need not tell you the dangers of dietary sweets/sugars,
especially if you have, or are at risk for, diabetes. Here are some hints for
curbing your sweet-craving:
- Start the day with a balanced meal of protein, vegetables (yes, vegetables for breakfast) and complex carbohydrates. This will allow your blood sugar to rise slowly and gradually, as it should, and avoid a “sugar rush.”
- Avoid eating “light bread” made of wheat flour, which is made of simple carbohydrates. Have whole wheat bread instead of light bread, sweetened crackers, white rice, or potatoes.
- Incorporate
into your meals complex carbohydrates: whole wheat products, corn, beans,
peas, lentils, whole grain rice.
- Try to
eat something as frequently as every three hours, in order to not deplete
your energy stores, and to avoid sugar craving. A piece of fruit or whole
wheat cracker may do.
- Get
enough sleep. Tired bodies demand immediate energy in the form of simple
carb’s.
- Have
some sun exposure. Avoid staying in dark environments most day (as you may
do in the office). Lack of sun exposure causes a decrease in serum
serotonin, which causes relative depression and an increase in sugar
craving. A little bit of Chocolate (70% cocoa, please) will increase
serotonin level, and may elevate the mood.
- A
boring lifestyle, associated with low serotonin, drives sweet craving. So
keep busy. Exercise, yoga, or spending
quality time with someone will help a lot.
- You don’t have to totally abstain from sweets. Have a measured amount of your favorite candy periodically – every day, two days, or a week. Don’t eat it all at once, leave some for tomorrow.
Have a great day, without the sweets...
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