Monday, December 26, 2011

Doctors Bust Medical Myths and Lies

The information has been passed on through the generations – but is it accurate? A panel of experts and MDs speak up on the common myths that affect your health.
Today's blog is very long, but the information is very valuable and important to know. 

MYTH: Muscle weighs more than fat.
FACT: One pound of muscle actually weighs the same as one pound of fat: They each weigh one pound! There are, however, two important differences between muscle tissue and fat tissue that are important to recognize. 

For one, fat tissue is more bulky than muscle tissue, so it occupies more space under the skin. Thus, one pound of fat tissue actually has more volume (and will appear larger) than one pound of muscle tissue. For this reason, a 170-pound woman whose body is composed of 25% fat tissue will appear much leaner than a woman weighing the same but whose body fat percentage is 45%. Therefore, individuals need to assess their weight management efforts using a wide variety of body measurements and health parameters – focusing solely on the number on the scale can conceal real and important improvements in body composition. Aim for the look and the feel – not just a number.

Secondly, muscle tissue utilizes more calories than fat tissue. What does that mean? Let’s take the two 170-pound women mentioned above. The woman with 25% body fat has more muscle tissue, so her body needs more calories to keep its systems running.  Thus, she burns more calories – even when she is just sitting around – than does her 45% body fat counterpart. As a result, the leaner woman can actually eat more calories each day and maintain her weight as compared to the woman with more fat tissue. 

If you want to appear leaner and be able to consume more calories without gaining weight, be sure to incorporate regular strength training into your exercise program to promote muscle development.

MYTH: Carbohydrates are bad for your health and can make you gain weight.
FACT: In the recent past, no-carb and low-carb diets have demonized carbohydrates in the eyes of the public. It’s time to take a new look at carbs! First of all, carbohydrates are the primary source of fuel for the body. Without them, we would have a very difficult time functioning and moving about our day-to-day activities.

In their simplest form, carbohydrates break down into glucose, or sugar, which our cells use for energy. But, not all carbs are created equal. There is a big difference between refined carbohydrates, such as pastries, cookies, white pasta – and those that are not processed, like whole grains, fruits and starchy vegetables.

Whole grains contain multiple vitamins and minerals. They are also rich in fiber, which can help maintain healthy cholesterol levels, support optimal digestion, and stabilize blood sugar levels. Fiber helps prevent constipation, while also creating a feeling of fullness, which prevents us from overeating – good news for anyone who is looking to drop some pounds in a healthy way. Some examples of whole grains are oatmeal, wild rice, buckwheat, corn, quinoa, barley, as well as whole wheat breads, crackers, pastas and cereals. Also, whole grains are low in fat and have been linked to lower risks of cancer, diabetes and heart disease.

Refined grains and added sugars, however, are stripped of their nutrients and fiber; not only are they missing key nutrition, but these foods can spike our blood sugar and make us crave more food, while putting us at risk for developing diabetes. Refined carbs and added sugars to avoid: white flour, baked goods, white rice, white bread, soda, juice and candy.

Starchy vegetables like sweet potatoes and carrots are also rich in numerous health-boosting minerals and vitamins. Fruit is an excellent source of fiber, phytochemicals and antioxidants; keep in mind, fruit does contain natural sugar, so should still be eaten in moderation.

MYTH: Frozen fruits and veggies are never as good as their fresh counterparts.
FACT: Frozen fruit and veggies are frozen at peak ripeness so it all depends on when you are purchasing and what season we are in. For example, in northeast Ohio in the summer, we can easily get blackberries locally, but in the winter, our options if we eat fresh are to purchase berries that have traveled from far away to reach us. Each day of traveling means loss of nutrients. In the summer, fresh blackberries are the best, but in the winter, frozen rules. You’ll get more nutrients from the frozen versions.

MYTH: Eating at night will make you gain weight.
FACT: While eating later in the day means you don’t have as much time to burn off excess calories, what dieters really want to do is focus on how many calories are consumed throughout the entire day. Eating 3500 more calories per week than what you can burn will cause you to gain 1 pound and it really does not matter when these calories enter your body during the day.

MYTH: Twelve-grain breads or multigrain breads are the best bread options for fiber and healthfulness.
FACT: Just because the label says it has lots of grains does not mean they are all 100% whole. Whenever shopping for bread, you want to make sure that all ingredients constitute a whole grain source. That will provide the best bang for your nutritional buck when it comes to fiber intake and lowering your risk for metabolic syndrome. Look for a percentage of 100% on the bread label and find breads that provide ideally 3 grams of fiber per serving.

MYTH: Compounded "bioidentical" hormones are identical to the hormones in our bodies.
FACT: Plant-derived estrogen from soybeans is molecularly very similar, but not identical to human hormones. That’s why I prefer the term “bio-mimetic” to “bio-identical.”

Furthermore, what you get from the compounding pharmacy (where a compounding pharmacist custom mixes drugs to fit the unique needs of a patient) is not “more human-like” than what you get in an FDA-approved product. In fact, you are actually getting the IDENTICAL estradiol molecule whether you get your hormones from a compounding pharmacy or your mega-pharmacy.

How can that be? This is the interesting part. Compounding pharmacies don’t manufacture hormones – they just mix them. Manufacturing factories are the ones that extract estrogen from plants, synthesize it to a useable form, and then sell the same active ingredients to both commercial pharmaceutical companies and compounding pharmacies. It is then that the active ingredient is used to make lotions, pills, sprays or patches.

It’s basically all the same stuff. In fact, many compounding pharmacies mass produce hormone preparations that are copies of those produced commercially.

MYTH: Ice is better than heat to treat pain.
FACT: There are tons of myths about hot and cold packs. But, the truth is – it depends. The reason it depends is that heat and cold do different things to your body.

Heat causes the temperature in your tissues to increase which relaxes your muscles and also allows the blood vessels to expand (this is called vasodilation) and deliver more oxygen and nutrients to an injured area. Since heat increases blood and lymph flow, warmer tissues may have more swelling (inflammation). 

On the other hand, cold works by decreasing the temperature of the tissues. This causes the area to become numb (cold acts as a local anesthetic, which can be very helpful in relieving pain) and blood vessels to narrow (vasoconstriction), thereby lessening swelling and inflammation. 

For a new injury – especially in the first 24-48 hours – the goal is often to limit swelling and inflammation, so icing is used in the common sports medicine pneumonic “PRICE” (Protect, Rest, Ice, Compress, Elevate). Moreover, if there are cuts, lacerations, open wounds or the risk of internal bleeding, then heat isn’t a good idea as it promotes more bleeding. Keeping ice on for too long (more than 20 minutes or so) can cause tissue damage or “burns.” Also, it’s important to avoid using ice on fingers and toes in people who have circulation problems as the ice causes even less blood to flow and may permanently injure these parts of the body.

After the first day or two, the muscles around the injury may get very tight (this happens a lot in whiplash injuries after a car accident). Then, heat can really be helpful. For chronic injuries, heat is often the best modality to use to relax the muscles and improve flexibility. However, in chronic joint pain, such as arthritis, then cold may be better because it numbs the area and reduces inflammation. 

For a new injury, if you aren’t sure whether to use hot or cold packs, talk to your doctor. If you have a chronic injury, consider which one of these has helped you the most in the past – that’s probably the one to use regularly for the best relief. 

MYTH: If a low-fat diet is good, a no-fat diet is even better.
FACT: While most Americans consume way too much fat, we actually need a certain amount of fat in our diet for good health. Fat is an essential part of every cell in our bodies. Certain fats contain fatty acids such as omega-3 and 6 which are necessary for brain and heart health. Additionally, fats must be present in our digestive tract to help the body absorb and utilize vitamins A, D, E and K, and keep us from becoming malnourished!

Fats are an important energy source for the body. They also provide padding under the skin for warmth, protection for internal organs and bones, and coat nerve fibers so nerve impulses can be transmitted. Fat also makes food more enjoyable and stay in our stomachs longer, helping to stave off hunger and cravings.

Insufficient fat in your diet can cause hair loss, depression, bruising, lack of energy, dry, flaky skin, weak muscles and bones, hormonal imbalances, and a weakened immune system, to name a few.

Fat should make up between 20-35% of your daily calories (depending on age, height, gender and activity level), the majority of which should be unsaturated fats. Include some healthy fats in every meal, such as olive oil, avocado, low-fat dairy, nuts, fatty fish (salmon, tuna, sardines, herring), peanut butter and soy products.

MYTH: People can just "tough out" depression and get better on their own.  
FACT: Clinical depression is an illness characterized by clear diagnostic criteria – sad mood or anhedonia for two weeks or longer and then 5 or more symptoms ranging from loss of appetite to sleep disturbance to feelings of worthlessness.

Sadly, we still view this as something that a person can "control" – and they often get feedback like "Get over it,” “Cheer up," "Toughen up," or "Man up." A person with depression often already feels ineffectual; hearing this can often just push them deeper into the shadows and less willing or able to seek help.

Can you imagine if someone just got a diagnosis of cancer, or MS, or diabetes and were told to "Get over it”?

The research is clear that untreated depression can lead to significant worsening of symptoms, greater occupational and social impairment, and poorer treatment outcomes. The stigma a person feels when they are told they should "Just get over it" may hamper them from seeking therapy. Depression is a very real condition, and while therapy is hard work for the client, it is not just about getting over it, but often taking medications, engaging in the work of therapy, and being prepared for future symptomatology.

MYTH: The more sugar you consume the more cavities you will get.
FACT: This is not true! It’s more about the length of time the sugar sits in your mouth – not the amount of sugar you consume. For example, if you have all your kids’ Halloween candy in an hour versus eating it over the course of the day or several days in a row, you are less likely to get decay. However, I’m not suggesting you eat that much candy in an hour!

Sugar is broken down by the bacteria that cause decay, and the byproduct of the bacteria is an acidic environment that promotes enamel (tooth) breakdown. The pH of the mouth is taken to an acidic level that causes decay. The pH usually stays at this level for about an hour. During this hour, teeth are more susceptible to cavities. Afterward, saliva, other foods or water help to bring the pH back to normal, neutralizing the acidic environment. 

If you keep reintroducing sugar to your mouth on a hourly basis, you increase your chances of decay! So if you pop a hard candy in your mouth at every break, or sip your sugary soda all day long instead of at one sitting, you could be in trouble.

I recommend having your soda or sweets at once, then rinsing with water or chewing gum to neutralize the acidic environment in your mouth. This will greatly reduce your chances of decay.

MYTH: Eating eggs will raise your cholesterol.
FACT: You can enjoy eggs in moderation as part of a healthy diet. Chances are, if you tuned into nutrition advice in the ‘80s and ‘90s, you remember caveats to steer clear from eggs because they are “high in cholesterol and could trigger high cholesterol and heart disease.” And while people with existing heart disease are still advised to limit dietary cholesterol to 200 milligrams a day (one egg has about 185 milligrams), if your cholesterol levels are normal, eggs may be something you can welcome back to your shopping list.

The reason for the confusion? The cholesterol molecules found in eggs are not the primary driver of higher LDL (bad) cholesterol in your own bloodstream. Rather, the real dietary culprits that can raise our body’s own cholesterol production are certain saturated fats and trans fats that we eat (in things like fried and baked foods, red meat or that side of bacon), leading to higher cholesterol levels and heart disease.

In my opinion, eggs are hands down one of the best values in the grocery store: 1 egg has just 70 calories, but packs 6 grams of high quality protein, more than a dozen vitamins, minerals, and nutrients like choline (important for a healthy brain and nervous system). Plus, the latest 2010 USDA nutrition data found that the average egg in America now contains 64% more vitamin D than it did in 2002, likely due to differences in the diet of the chickens.

Fire up the skillet from time to time, but skip the butter and sauté eggs in olive oil or canola oil for a heart healthy boost. For zero added fat, enjoy poached eggs on whole grain toast or hard boiled eggs with some fresh fruit for a delicious snack.

MYTH: Crossing your legs causes varicose veins.
FACT: Varicose veins affect more than half of all women in the US (55%). Causes include increasing age, genetics, pregnancy, obesity, gender (women develop varicose veins far more than men), high blood pressure and standing for long periods of time. Crossing your legs, however, will not cause varicose veins to form.

Complications are fortunately rare and include the development of ulcers and blood clots. If you are prone to varicose veins, have a strong family history, are pregnant, or stand for long periods of time, consider wearing support hose. There are now fashionable versions that no longer resemble your grandmother’s stockings.

Avoid wearing high heels for prolonged periods of time; this will aggravate the condition. Raise your legs when sitting down. Many treatments exist, including sclerotherapy, vein stripping, embolization, laser therapy and radio frequency ablation.

MYTH: All butter products are bad for your health. 
FACT: Ghee, which is clarified butter, actually has positive health benefits. Ghee has been successfully used for medicinal purposes in ayurveda, the traditional medical system of India, for millennia.

Ghee can be prescribed as cooking oil as part of an ayurvedic diet, in skin creams for rashes or just as an anti-aging regimen, and as part of an herbal mixture to remedy a multitude of conditions from digestive disorders to neurological conditions. 

Ghee is also known for its ability to remove toxins and is used to remove deeply seeded impurities in the organs as a preparation for the ayurvedic seasonal detox program, Panchakarma.

Animal studies have shown that ghee can have a beneficial impact on cholesterol, unlike traditional butter. Of course, it is still recommended that ghee be used in moderation.

Just switching your stick of butter for a jar of ghee could make you healthier while you continue to enjoy that buttery taste.

MYTH: The more you exercise, the more weight you lose.
FACT: This is totally a myth! In fact, most people who over-exercise and exercise intensely stall weight loss because they are so ravenous when they are done that they overeat!

The truth is diet is responsible for 80% of your weight loss and exercise makes up the other 20%. If you’re serious about losing weight, make eating for weight loss your top priority before you begin exercising.

Don’t worry about eating to support your workout if you need to lose weight; your body has plenty of stored energy inside each fat cell and that’s what we want to burn when we step into the gym – not the last meal we ate! Keep your exercise intensity moderate so you can simply resume normal eating when you’re finished.

If you’re so ravenous after your workout that you can’t stop, you pushed too hard or worked out too long. Start slow. Try drinking a whey protein shake that’s less than 155 calories and low in fat and sugar, and watch the weight fall off. Did you know that whey boosts your metabolism by 25%?

The truth is that people who change their diet without working out lose more weight because they don’t feel like they get a free pass to eat whatever they want!

MYTH: No pain, no gain.  
FACT: Often, I see athletes and patients who are pushed by coaches that use the motto, “No pain, no gain.” While we know people can sustain additional injuries by “pushing through injury,” knowing the right time to push through and when to rest is key to a fast recovery.

Pain causes you to move, think and behave differently. Recent studies show that knowing how to use your body and muscles when you’re in pain can significantly reduce injury time. Therefore, my motto of choice is, “Know pain and gain.”

As we age, our bodies often communicate to us via pain. Pain is the body’s protective mechanism that helps motivate us to protect the injured area from getting worse. Many people try to fight pain rather than take it as a sign to slow down and address the issue. Fighting pain only creates a series of compensating movements that puts you at risk of aggravating the injury and lengthening the time needed to heal. Because of this, it’s important to listen to what your body is telling you.

With an acute injury, pain is a good warning sign that can help prevent additional complications while allowing the healing process to begin sooner. If you have a mild sprain or strain, putting the old acronym RICE – rest, ice, compression and elevation – to use will usually relieve some of the natural inflammatory response and lessen the pain.

Tending to your body may keep you off your feet for a while, but you will save time in the long run as it can prevent your injuries from becoming chronic.