Decoding Diets

•March 15, 2009 • Leave a Comment

There are millions of diets in existence, with new fad approaches to weight loss popping up each month.  From theApple a Day ever popular South Beach Diet, a high-protein, low-carbohydrate approach, to the very entertaining Cayenne Pepper and Water diet, essentially a starvation diet, it’s hard to sort through the myriad of approaches to weight loss.  Additionally, there is little scientific evidence to support the effectiveness of any of these plans.  Why punish yourself with cayenne pepper water three times a day if it doesn’t even help you lose weight?

This month, the New England Journal of Medicine, one of the most reputable journals in medicine, published the study, Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates,” to help dieters decode the plethora of diets peppering society.  The study examined 811 overweight adults (people with a Body Mass Index between 25 and 40) who were assigned to 4 different diets.  The participants received regular, personalized diet training during the entire study encouraging diets with less saturated fat, at least 20 g of dietary fiber per day, and low cholesterol.  The four diets studied were classified by the amount of fat, protein, and carbohydrates that each diet consisted of:

1.      Low-Fat, Average Protein: 20% Fat, 15% Protein, 65% Carbohydrates

2.      Low-Fat, High Protein: 20% Fat, 25% Protein, and 55% Carbohydrates

3.      High Fat, Average Protein: 40% Fat, 15% Protein, and 45% Carbohydrates

4.      High-Fat, High Protein: 40% Fat, 25% Protein, and 35% Carbohydrates

The target number of calories consumed per person was calculated as a 750 calorie deficit per day (meaning that if your body consumes 3000 calories per diet, which we call your Basal Metabolic Rate, your target diet would consist of 2250 calories per day).  You’re saying to yourself, “How on earth am I supposed to know what my Basal Metabolic Rate (BMR) is?”  There are a series of formulas that calculate this value for you based on age, height, weight, and amount of exercise you complete each day.  Follow this link to a convenient BMR Calculator (Click on BMR & RMR Calculator…and don’t forget to adjust your caloric need based on your daily physical activity).

Big KidAfter 2 years of monitoring participants weight loss, the study concluded that “reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.” Essentially, it doesn’t matter which diet you choose.  The most important factor in creating a diet is calculating the number of calories your body needs to consume, making sure that the diet you design consists of 750 calories less than your BMR per day. The study found that the majority of weight loss occurred in the first 6 months of the diet (i.e. if you haven’t lost any weight after 6 months, you aren’t on the right diet).  Additionally, all of the diets reduced risk factors for cardiovascular disease and diabetes (a definite bonus).

The Take Home Message: The amount of food you consume is just as important, if not more so, than the types of food your diet consists of.  Whichever diet you choose, be sure to calculate your individual caloric needs based on your age, height, weight, and physical activity and are eating the appropriate number of calories per day based on that number.

Diet Results

The Incredible Growing Baby

•March 5, 2009 • Leave a Comment

A newborn baby consumes approximately 100 calories per kilogram per day…which tranlates into a 500 calorie per day diet for an 11 pound baby.  If your average adult had the same metabolic needs as a newborn, we would need to consume 7,000 calories per day (here’s looking at you, Michael Phelps) to survive!  Don’t we all wish we still had a metabolism like that…

The Stink on Gas

•March 2, 2009 • Leave a Comment

Whatever you choose to call it – gas, farts, and flatulence – it’s a fact of life. Our body produces gas continually regardless of where we are or the company we are in (as we all have inevitably experienced). In case you feel alone inThe Human Fart Machine your flatulence-producing universe, most people produce between 1 to 4 pints of gas per day, causing an average of 14 gas-passing events daily!

At some point you have probably wondered, “Where in the heck does all that gas comes from?” There are two possible sources:

1. Swallowed Air: Aerophagia, or swallowed air, usually occurs unconsciously and is increased during activities such as chewing gum, sucking on hard candy, drinking too fast, smoking tobacco (another excellent reason to quit) or drinking carbonated beverages. The majority of this gas is expelled via belching, however, a portion of it is passed into the small intestine and eventually be passed per rectum (i.e. a fart).

2. Byproduct of the Breakdown of Carbohydrates: The remainder of gas is produced by bacteria in our gut which break down carbohydrates that our bodies cannot digest independently. Undigested carbohydrates, which are contained in higher concentrations in certain foods (for example, beans the “musical fruit”), are the primary source of gases produced in our own digestive tract. These hard-to-digest carbs are passed into the large intestine, which harbors a more extensive selection of bacteria. While these relatively harmless bacteria will not make you sick, they will devour these carbohydrates, releasing gas as they munch on your leftovers.

Gas in the Digestive Tract

Gas in the Digestive Tract

So what can you do to reduce your natural gas-producing predisposition? First, and most importantly, remember that everyone produces and releases gas on a daily basis…it cannot be avoided altogether. Also know that each person harbors a different cocktail of bacteria which responds uniquely to varying diets. Which brings us to the question: Which foods can I avoid to keep myself from another embarrassing predicament? If it was possible to recommend a 100% gas-free diet, we would, but you now realize such a diet does not exist. However, there are specific foods that are rich in hard-to-digest carbs which will undoubtedly escalate your gas output. Here’s a lineup of the usual suspects:

· Raffinose: A carbohydrate found in beans, cabbage, brussel sprouts, asparagus and broccoli

· Lactose: Found in all dairy products

· Fructose: A simple sugar found in onions, artichokes, pears, melons and wheat

· Sorbitol: A sugar substitute found in apples, peaches, prunes, artificial sweetener and sugar-free candy

If your gas is particularly inhibiting, try starting a food diary to look for patterns or particular foods that seem to create Flaming Fartthe biggest stink, and avoid those before your important meetings and hot dates. But if all else fails and you’re stuck with some particularly noxious flatulence, take advantage of the one truly productive aspect of gas (it has its name for a reason). Cancel your date, find yourself a lighter, and make some fireworks!

For more information about your natural gas-producing abilities visit The National Digestive Diseases Information Clearinghouse (NDDIC)

Auto-Cleaning Ear Wax

•March 2, 2009 • Leave a Comment

How many times did your mom tell you to clean your ears growing up?  If you’re like most of us, it was part of a daily mantra chanted by our parents.  Walk into any personal bathroom in America and there’s a 75% chance you’ll find a fancy little container of Q-Tips sitting on the counter reminding you to clean your ears.  The only problem is that your ears don’t actually need cleaning.Q-Tip Cleaning

The architect of the human body was brilliant and built an auto-cleaning function into our ears. Our bodies naturally produce ear wax (what doctors call cerumen) to trap dust particles that find their way into the ear canal.  Ear wax also collects all the dead cells from your ear canal that naturally desquamate (the doctor word for “die and slough off”) each day as well as some antibacterial properties.  Without this wax, your ears would have been completely blocked with dirt and cells by about age 3.  So how does the wax get out?  The portion of your ear canal where wax is produced (the outer 1/3 of the canal) is lined by tiny hair cells (cilia) which are constantly brushing in the outward direction.  The repetitive movement of these hair cells pushes the wax and dust particles out of your ears all by themselves…no Q-Tips needed.  When left alone, your ears are an amazing self-cleaning wonder.  So what’s the problem with using a Q-Tip to help this process along (perhaps before a hot date or your next yearly check up)?

There are two hazards to using Q-Tips:

1. Ear Drum PerforationYou could perforate (i.e. poke a hole in) your eardrum.  We’re all aware of this danger and have adjusted our ear cleaning techniques appropriately after the one time we dug a bit too deep and couldn’t hear for the rest of the morning.  Luckily your ear drum (called the tympanic membrane) is one of the fastest regenerating tissues in your body.  Thus, a perforation will be able to heal itself relatively quickly and you will regain normal hearing.

2. When you use a Q-Tip, the wax that you aren’t able to sweep out gets pushed deeper into the ear canal, beyond the region of the canal where the hair cells are able to push it out.  This wax remains in your ear and slowly accumulates with each successive Q-Tip “ear cleaning.”  Over time, you will build up your own Great Wall of ear wax and begin to notice a change in your hearing as you occlude the canal and coat the ear drum.  This is the point at which you go see your doctor to find out what’s going on with your hearing, resulting in a vigorous in-office ear flushing (yes, we realize this is both gross and uncomfortable).  If you’re already at the point of auditory-impairing wax build-up, you don’t necessarily need to go to the doctor to have it cleaned out.  The American Academy of Otolaryngology (i.e. Ear Doctors) recommends mineral oil or hydrogen peroxide treatments in the ear combined with rinsing in the shower to help soften up the wax and wash it out.  If the problem persists, go see your doctor for some cleaning assistance.  If you  insist that something be done on a regular basis for your wax, feel free to continue the mineral oil regimen at your leisure.  No harm in helping the natural cleaning process in a clinically-proven way!

Because of both of these dangers, Q-Tips are not actually intended for use when cleaning the ear canal.  The marketers of Q-Tip are aware of this and will never show a person cleaning their ear canal with Q-Tips during their commercials.  Instead, you’ll find lots of clips of women removing their makeup, wiping away the gunk around babies eyes, and people cleaning the outside portion of their ear (called the pinna)…but no deep ear cleaning.  For more information about earwax, visit The American Academy of Otolaryngology

Medical Mythology: The Bloody Nose

•February 22, 2009 • Leave a Comment

Medical Myth: To stop a nosebleed, tilt your head back while pinching your nose.

Fifty percent of this medical myth is true, while 50% can actually be relatively dangerous. Think of a nosebleed like a cut on your finger. What would you do to stop the bleeding? Pressure, pressure, pressure! The key to stopping any bleeding is pressure over the wound. The same theory applies in your nose. The bleed is caused by injury to an exposed blood vessel inside your nose as a result of trauma (i.e. the ever-sexy nose picking we all try to hide). To apply pressure, squeeze your nose firmly over the cartilaginous part (the softer part more towards the tip of your nose rather than the bony part closest to your face) and hold it for 5 minutes. Do not scrape away your newly-formed scab in your nose because this will simply restart your bleed. Now the myth: Tipping your head back does NOT stop the bleeding. All it does is allow the blood to flow down the back of your throat causing an upset stomach and an increased risk of choking on blood going down the wrong pipe…not a good idea. In children, the risk of aspiration (getting fluid, in this case blood, in your lungs) is even higher. The take home: Keep your head level or lean forward. Some people argue that applying an ice pack over your nose and brow helps constrict the blood vessels and slow down the bleed as well but this has never been proven Unlike tipping your head back, this can’t hurt so if you’re fond of the forehead icepack, there’s no harm in trying.

Welcome to House Call, MD

•February 14, 2009 • Leave a Comment

With the purpose of perpetuating medical knowledge for everyday living, I hope to translate medical fact and research learned in the clinic, laboraroty, and classroom into concise take home messages for your day to day life.  Stay tuned for weekly articles about current issues in medicine, remedies for the common cold, and much more.  Send in comments and questions if you’re interested in a particular topic, otherwise sit back and enjoy as the medical world is delivered to your doorstep in a simple and straightforward style designed for a modern lifestyle.