Chocolate and Depression

May 3, 2010

Institute For Medical Wellness Healthy Living Report

First things first.

Did everyone enjoy their peek at summer weather?

I hope it put a smile on everyone's face, especially after our brutal winter.

If it did not, maybe you need a mood enhancer?

How bout some chocolate ?

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Chocolate and Depression

Yep!

I am back to chocolate yet again.

I wrote a previous post about chocolate that can be found here.

The definition of a chocoholic is: a person who loves/is addicted to chocolate.

I really have a taste for chocolate, but I am not convinced that I meet enough criteria to be labeled a "chocoholic".

You see, there are many days that I turn down a Hershey's kiss.

But today is not looking good! And tomorrow is not looking much better ; )

Oh well!!

Now let's look at the study.

First they screened 1018 individuals for depression. Of these, 694 were men, and 314 were women.

First question: How did they get twice as many men as women for a chocolate study???

The study allowed 931 of the 1018 into the study, as these individuals were not presently on any antidepressant medication. These 931 subjects tracked their chocolate consumption as well as being tested for mood using a depression screening scale.

The study results were as follows.

There were three patterns which were grouped according to the depression scales.

The individuals who scored high on the depression scales consumed 55% more chocolate than those not positive for depression.

Even more interesting was that the individuals who scored the highest on the depression scales consumed over twice the amount of chocolate as those who scored not positive for depression.

There was no statistical difference between men and women.

These results can be viewed a few different ways.

1) Since depressed individuals eat more chocolate, maybe the chocolate is causing the depression.

I sure hope this is not the case, as I do not want to give up my chocolate ; )

2) Depressed individuals self medicate by eating chocolate, as chocolate is high in polyphenols which can raise serotonin levels in the brain. The prescription drug Prozac also works by raising brain serotonin levels. Here is a link to more information on why chocolate may help with mood.

I can see the slogan now.

"Feeling down or depressed? Eat a Hershey's Kiss. It's natures Prozac !"

I guess that could be good or bad for Hershey's chocolate sales???

And the third reason,

Drum roll please ...................

3) Some people just enjoy the taste of chocolate!!!

Being in the medical field, my personal theory agrees with both #2 and #3. I am a firm believer that you are what you eat. I also believe that we have subconscious cravings for different foods dependent upon their nutritional value. This is very evident in the diets of pregnant women, but occurs in everyone, just to different degrees. In that vein, here is a link to the top ten scientific reasons why chocolate is the world's perfect food, and why you may also crave chocolate.

P.S.

Don't tell Jessica, my medical assistant, that I ratted her out, but I think she is a chocoholic !!!!
So if you want to get on her good side, you know, to get that script called in quickly, or to get a copy of your recent test mailed to you, chocolate goes a long way ; )

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Institute For Medical Wellness New Offers:

I came across a very interesting blog article. The article discussed how our gut flora, the billions of bacteria that live in our digestive tract, get out of balance. This can occur with natural aging, as well as a result of our lifestyle choices which include diets, stress, and use of prescription medications, among others. I will not go further into this theory here, other than to say that to slow down aging, I agree with the blog author that we need to decrease inflammation in our body. As lifestyle accommodations can take years of trial and error to perfect, I like to focus on supplements that help our bodies immune system to properly control inflammation.

Soooooo........................

My supplement of the month offer for May 2010, includes two supplements that help with decreasing inflammation and maintaining proper gut flora.

For May 2010,

Vitamin D3- Liquid 2000iu per drop, 900 drops per bottle- regularly $20

plus

Probiotic Pearls- ProFlora Immune- 30 pearls, regularly $20.

Purchase these two supplements together for $30, a 25% savings.

This offer can be used with other Institute For Medical Wellness supplement discount offers!!

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Don't forget that a massage makes a wonderful Mother's Day Gift.

For more information on our massage services please click here.
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And now for an important announcement.

I have added an Announcement page to our website.

This page will include recent and new happenings concerning the Institute For Medical Wellness, including new programs and special offers, which sometimes may be good discounts. So please check out the Announcement page every so often.
Other Institute For Medical Wellness Programs and Events:

1) Healthy Heart Program
2) Healthy Weight Program- Lite Edition
3) Traditional Wellness Plan

4) I am pleased to announce that the Institute For Medical Wellness is a Silver Sponsor of Moorestown Day 2010.


Please look for our booth on Main Street in Moorestown on Saturday June 5, 2010, between 9AM-3PM.

I hope to see you there, and please wish for good weather, that is, no rain!

It is no fun being outside in the rain!!

To Good Health!
Steven Horvitz, D.O,
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

http://www.drhorvitz.com/

Kidney Stones - Part Two

Institute For Medical Wellness Healthy Living Report January 18, 2010

Today's topic is once again kidney stones.

For those of you who read my last newsletter, you learned I had the unfortunate luck to experience a kidney stone. Tried as I may, I was unable to avoid a short hospital stay. I have always known that hospitals are not wonderful places to be, and they can really put a crimp on your normal activities. All kidding aside, my hospital stay was uneventful, and the nursing staff was superb. But still, my job is too help you avoid hospitals as much as possible.

So how can you avoid kidney stones?

The most common type of stone is one made of calcium oxalate, and this is the type I will focus on today. In general, when we have too much calcium going through the kidneys, or not enough water to keep our urine dilute, calcium can crystallize in the kidney by precipitating out as a solid stone. If we can drink plenty of fluids at this point, we can still pass these small stones without ever knowing we had one. But if we do not drink enough, the stone can increase in size to a point where passage of the stone can be quite painful.

But calcium does not act alone. In calcium oxalate stones, oxalic acid forms around the stone and increases its size. So another good dietary tip, if you are a calcium oxalate stone former, is to keep your dietary oxalates very low. A good list on dietary oxalates can be found here.

Please do not lower your calcium intake. Medical studies disagree on calcium restriction as a means of preventing kidney stones. Also calcium in your diet is needed for many other important functions. If your body does not get enough calcium in its diet, it will take calcium out of your bones. This may lead to an increased risk of osteoporosis later in life.

My number one recommendation to prevent calcium oxalate kidney stones remains:

Drink, drink and drink some more. Drink until your urine is clear with just a hint of yellow.

But what do I do if I have a known kidney stone, of a size that can pass spontaneously, other than drink , drink and drink some more?

I followed the recommendations from a website that uses an interesting method to move a stone from your kidney, down your ureter, into your bladder. It is called the jump and bump method and it can be found here.

While this method may not work for everyone, it may have worked for me. When my stone began causing bad pain, I used this method and within 3 hours, my pain went from my left kidney area to my groin, which usually indicates the stone has moved down to almost the level of the bladder. Once the stone is in the bladder, the horrible pain of renal colic is gone, and passage of the stone out of the bladder is the next step. While this last step may not be very comfortable, it pales in comparison to renal colic.

But remember, the best medicine is still prevention!!
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Healthcare Reform Update:

On Tuesday January 19th, 2010, Massachusetts will be holding a special election to fill the Senate seat once occupied by the late Ted Kennedy. For healthcare reform, the stakes are high. The Democrat in the race, Martha Coakely, has vowed to vote for the present healthcare reforms making their way through private closed door meetings. Her opponent, Scott Brown, a Republican, has vowed to vote against the present reforms. In fact, if he is elected, he would be the 41st No vote in the Senate, which would hopefully put a stop to this massive healthcare scheme.

I am a registered independent, and will vote for the best person for the job. As healthcare is my life's chosen profession, my hope in this race is for Scott Brown. A No vote on the Obama healthcare scheme would hopefully allow us to reboot the entire reform approach and start over again. However I have one caveat. If the present healthcare scheme is defeated, I do not want healthcare reform on the back burner. I want it front and center! However this time, I want the following players around the negotiating table who are likely to care more about individuals than profits:

• Individuals- both insured and uninsured. At present we seem to be more focused on the uninsured than those presently insured.
• Independent physicians- Independent physicians represent only two parties, patient's and themselves. There is little group-think or corporate interests.
• Community based hospitals- large hospital systems tend to be run with their corporate interests at heart, while smaller community based hospitals tend to be closer to their patient's.
• Independent pharmacies- similar concept to hospitals mentioned above.
• Other independently owned healthcare providing organizations
• C-SPAN - at least for transparency
  

Who do I not want at the table. Well, that answer is simple. Everyone that is there now. The following players care more about their corporations, organizations and profits than patient's.

The following should be barred from further negotiations:

• Health Insurers- care more about profits and control than individuals
• AMA (American Medical Association)- they no longer represent the majority of physicians views. They are more interested in continuing the status quo to increase revenues to their corporation.
• AARP - stands to make many millions in revenues if Obamacare passes. They are in Obama's back pocket.
• Big Pharma - they need to be cleaned up and they need to end all dealings with the government and insurers and once again deal directly with individuals. Cutting out the bureaucratic middleman would not only drop the cost of medications dramatically, but most likely increase their bottom lines, allowing more investment in research and development.
• Medical Device Manufacturers- ditto above comments about Big Pharma.
• Any large corporation- Do they actually have individuals best interests at heart??
• Politicians- they got us into this mess, and they will only make things worse. If you want your senator or congressman treating you in the hospital, then by all means support Obamacare. But if you prefer your doctor, then get the politicians out of the way.
• Any and every special interest that I neglected to mention. There should be no special interest when a patient is obtaining medical care. The only and supreme interest should be the care of the individual!
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  Institute For Medical Wellness Happenings:
  
  At The Institute For Medical Wellness, we combine dietary advice with medical management to help you achieve a healthier weight. That is why our Healthy Weight Program is off to a good start. One thing that sets us apart from other programs is our use of private internet communication, in the form of a shared document that is individualized to you! That means that no two programs are the same.
  
  And due to popular demand, we will be extending our $100 discount through the end of January. So there is no better time than now to let us help you achieve that healthy weight. More information on the Healthy Weight Program can be found here.
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  Wellness Network:
  
  This month I would like to introduce you one of our network affiliates, Paula Andersen, who has an acupuncture practice located in Moorestown. Paula is offering Wellness Programs through the Institute For Medical Wellness in the following categories.

Package 1: Stress Reduction and Immune Building

Package 2: Pain Reduction

Package 3: Hormone Balancing

More information on Paula's Wellness Programs can be found here.
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New offers:

We are now able to offer a supplement of the month. For the remainder of January, we will be offering our Vitamin D3 drops, for $15, a savings of $5 each. This offer starts January 18th, and will continue while present supplies last.
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Quote of the day and one of my favorite signs in the office:

" Indecision, may or may not be my problem ."


To Good Health!


Steven Horvitz, D.O,
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
www.drhorvitz.com
To follow The Institute For Medical Wellness on Twitter.

More on H1N1

The "Swine Flu" or H1N1 virus is here and still spreading.

The H1N1 vaccine is slowly becoming available as distributors have started shipping out the vaccine.

The question still stands: Should I get the vaccine and should I have my kids get the vaccine?

I had a call today from the mother of a family I have known for quite a while.

Here is a little of the conversation we had:

Mom: Thanks Doc for taking my call !

DrH: No problem! What can I do for you?

Mom: My child's school has been hit with the swine flu. Six (6) kids have already contracted the flu and the school will now be offering the vaccine to all student's, with parent's permission. What is your opinion doc?

DrH: Would you like the short or the long version?

Mom: I would like your answer as a parent first.

Wow!!

Score One for Mom!!!

Right to the point!

BTW, I try to make all my medical decisions as if I were treating my own family. I would not give you any treatment or medication that I would not take if I were sitting in your seat.

But back to the H1N1 question.

The H1N1 virus is here and spreading. So far, this virus has not been any worse than traditional seasonal influenza virus. In fact it seems to be less harmful. Unfortunately, any influenza illness will still cause hospitalizations and some deaths. But the H1N1 flu seems to cause more problems for children as opposed to adults. The theory behind this is that the H1N1 virus causes our immune systems to overcompensate. This overcompensation contributes greatly to the severe illness that can lead to bad outcomes. Children's immune systems appear more prone to overcompensation than adults.

That being said, I am not ready to give this vaccine to my child. This vaccine was rushed into production before proper testing. While I understand the "Why's" of it being rushed, that does not mean that I should recommend the vaccination to my family and my practice. If this vaccination program is a nationwide test of the vaccines ability to prevent H1N1 infection, I prefer not to be a "testee". Please, no puns intended!!

There are a few variables that can change my opinion.

1) If the H1N1 vaccine makes it through proper testing showing both effectiveness against contracting the virus and safety equivalent to or better than the seasonal flu vaccine, then I will advocate for vaccination.

2) If the H1N1 virus does morph or change into a deadlier strain, causing increased hospitalization and death, then the pros and cons of getting the vaccine may tilt towards receiving the vaccine.

As of today, neither of the above have occurred.

But, I do not expect everyone to agree with my views.

As George Patton once said, "If everyone is thinking alike, someone is not thinking!"

So if you want to receive the H1N1 vaccine, please click on the link to a Burlington County Health Department update on the H1N1 Vaccine distribution. It will indicate where you can go to receive the vaccine.

There are other options to help prevent contracting the H1N1 flu.

While not proven by large medical studies, Vitamin D has been shown anecdotally to help prevent and treat influenza.

We do have Vitamin D in the office for those that want to try this method.

We use RX Vitamins Liqui-D3, which is an oil based supplement that contains olive oil and Vitamin D3.

The usual dose is between 1-5 drops a day, equivalent to 2,000 to 10,000 iu per day. It is helpful to obtain a blood test to monitor Vitamin D levels if on this supplement, although I have not yet had anyone have harmfully high levels on the above doses.

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Vitamin D 'is mental health aid'

February 21, 2009

Dr. Steven Horvitz- Reading between the Lines:

Bringing you healthcare information you can trust!

As many of you already know, I am a big proponent of prevention of medical illness through easy lifestyle changes. The key to prevention is understanding how the different parts of your day impacts on your health.

The diet you follow is of utmost importance, especially when it comes to getting the proper amount of vitamins and nutrients to not only sustain your energy levels, but also to optimize your body to run efficiently.

While not a believer in megadoses of vitamins, I am a strong believer in getting optimal amounts, which in many cases is very different from the governments RDA, or recommended daily allowance.

Vitamin D is one vitamin that we are learning more and more about, especially with prevention of disease. My belief is that the RDA is much too low for optimum health.

The following article is from BBC online and discusses Vitamin D as a preventive for cognitive decline as we age.

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Vitamin D 'is mental health aid'

From the BBC news online: Jan 23, 2009

Vitamin D, found in fish and produced by sun exposure, can help stave off the mental decline that can affect people in old age, a study has suggested.

UK and US researchers looked at 2,000 people aged 65 and over.

They found that compared to those with the highest vitamin D levels, those with the lowest were more than twice as likely to have impaired understanding.

Alzheimer's charities said the research was interesting, but more work was needed to understand vitamin D's role.

Vitamin D is important in maintaining bone health, in the absorption of calcium and phosphorus, and in helping the immune system.

The body makes vitamin D when it is exposed to the sun, or it can be obtained from foods such as oily fish, and those fortified with vitamin D, such as milk, cereals, and soya drinks.

But older people's skin is less able to absorb vitamin D from sunlight so they are more reliant on obtaining it from other sources.

Supplements

Animal and lab studies have previously suggested that the vitamin can have a beneficial effect on cognitive function.

The team from the Peninsula Medical School in Exeter, the University of Cambridge and the University of Michigan, assessed people's cognition, or comprehension skills.

People who have impaired cognitive function are more likely to develop dementia.

The researchers looked at people who had taken part in the Health Survey for England in 2000.

Just over 200 had significant cognitive impairment, assessed by looking at people's attention, orientation in time and space and memory.

The study found that as levels of vitamin D went down, levels of cognitive impairment went up.

The paper will appear in a forthcoming issue of the Journal of Geriatric Psychology and Neurology.

Dr Iain Lang from the Peninsula Medical School, who worked on the study, said: "For those of us who live in countries where there are dark winters without much sunlight, like the UK, getting enough vitamin D can be a real problem - particularly for older people, who absorb less vitamin D from sunlight.

"One way to address this might be to provide older adults with vitamin D supplements.

"This has been proposed in the past as a way of improving bone health in older people, but our results suggest it might also have other benefits.

"We need to investigate whether vitamin D supplementation is a cost-effective and low-risk way of reducing older people's risks of developing cognitive impairment and dementia."

Risk factor?

Rebecca Wood, chief executive of the Alzheimer's Research Trust, said: "Many foods that contain vitamin D, such as oily fish, eggs and breakfast cereals, are also good sources of vitamin B12, which, as previous studies have shown, can help protect the brain.

"Diet is known to influence dementia risk. The best way of reducing your risk of developing dementia is to maintain a balanced diet with regular exercise and frequent social interactions."

She added: "These findings may be significant, but much more research is needed."

Dr Susanne Sorensen, head of research at the Alzheimer's Society, added: "One in three people over 65 will die with dementia so research into how we can reduce risk is to be encouraged.

"There was some previous evidence to suggest that people with dementia may have a lower level of vitamin D in their blood but it was not clear if this happened after the onset of disease.

"It would be interesting if a low level of vitamin D was found to be a risk factor for cognitive problems as it is cheap and easy to remedy.

"We look forward to seeing the published results of this new research to help us better understand the potential role of vitamin D in reducing risk."

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So, yet more information on the potential benefits of Vitamin D. Naysayers will argue that the "studies" were not run properly, or that the study was too small. Instead of focusing on statistics, let's use a little logic. We have found out that Vitamin D has many functions other than calcium and bone development. Please refer to the Vitamin D council website for a long list of other beneficial effects. I like to look at how our body would naturally obtain a nutrient both in today's world and a thousand years ago, before we had vitamin supplements. As our bodies are able to manufacture Vitamin D from sunlight, in amounts of 10,000 - 15,000 units from a good summertime sun exposure, the RDA of 400-800 units seems pretty low.

Question: Why do many retirees first head south for the winter, and then eventually move south for good?

Is it the warmer weather, lower taxes, lower cost of living, OR possibly they feel better due to more sunshine naturally increasing their Vitamin D?

If you have any comments or questions about this newsletter please visit my blog and post it for discussion.

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness

www.DrHorvitz.com

http://drhorvitz.blogspot.com/

A few of my past newsletters on Vitamin D are listed below.

The Flu: Vitamin D's use in prevention and treatment

Vitamin D may help curb breast cancer, study finds

The Flu

The Flu, otherwise known as Influenza. Influenza usually occurs during the winter and can cause disease among all age groups. Some believe it is just a bad cold. That is a big understatement. Influenza is a serious contagious viral illness that hospitalizes an average of 200,000 people each year, 20,000 of them being children under five years of age. Luckily, most healthy people recover from the flu without complications. Serious illness and death are highest among people 65 years and older and children less than 2 years old. As many as 36,000 people in the United States die from the flu each year.


Now, Do I have your attention??

Influenza usually starts suddenly and may include the following symptoms:

• Fever (usually high)- can average 102-104 for 3-5 days.
  
• Headache
• Tiredness (can be extreme)- inability to get out of bed
  
• Cough- can be severe at times
  
• Sore throat
• Runny or stuffy nose
• Body aches- makes it unable to function normally
  
• Diarrhea and vomiting (more common among children than adults)

So how is Influenza spread?

Influenza is spread primarily through sneezing and coughing. Contaminated objects (hands, phones, shared eating utensils) can also spread the flu. Close contact (within 3 feet) is usually required for transmission. You can spread the virus for up to two days before showing symptoms. Once ill, you'll be contagious for about 5 days. The flu usually lasts 3-7 days for most people, although some symptoms can last for up to 2 weeks.

How can I prevent catching Influenza?



Traditionally, we offer the "flu shot" for prevention. The flu shot contains portions of dead flu virus to which your body forms an antibody response. These antibodies are what give you protection from the flu. You can not contract the flu from the flu shot. Some people do get a reaction the the flu shot, such as low grade fever, headache and mild body aches. This is usually an indication of a good antibody response to the flu shot. Do not get a flu shot if you are allergic to eggs or any other ingredient contained in the flu shot. Most flu shots contain a preservative called thimerosal. Do not get a flu shot if you are allergic to thimerosal. There is a small supply of thimerosal free flu vaccines available. If you are in need of this version please call our office and we will try to obtain it for you.

Other preventative techniques include:

• Wash your hands often with soap and warm water
• Use tissue when you cough, sneeze or spit and dispose of the tissue in a covered trash bin

• Keep your hands away from your face-The flu virus enters your body through the eyes, nose, mouth, and possibly even the ears.
• Clean shared space more often such as phone receivers, keyboards, steering wheels and office equipment
• Do not share personal items such as, forks, spoons, toothbrushes and towels
• Avoid crowds
• Avoid people who are sick with respiratory illnesses

Are there any natural ways to prevent Influenza?

There are many other options that are available for prevention and are listed below:

1. Get enough sleep. Your immune system functions much better when you get enough sleep. Most people really need about 8 hours per night for optimal health. If you're body is fatigued, it simply won't be able to fight off the flu virus (or any other infection) very well.

2. Exercise regularly. Exercise helps keep your immune system strong. In fact, a recent study showed that mice who performed mild exercise as soon as they were exposed to the flu virus had much lower death rates. Read about the study here.

3. Avoid sugar. Even small amounts of sugar can significantly impair your immune function, making you more susceptible to a flu infection. A large amount of sugar, such as the amount found in a normal can of soda, hurts your immune function for hours.

4. Drink lots of pure water. Keeping your mucous membranes well-hydrated is a key to helping them fight off viruses. Shoot for about eight 8-ounce glasses per day.

5. Reduce stress. Too much stress has a highly negative impact on your overall health and, over time, it will make you much more susceptible to a flu infection. Studies show that prolonged stress is at least partially responsible for 90% of all illness and disease. Regular exercise and sufficient sleep both help reduce stress levels. Also, meditation is a proven stress-buster that is easy, enjoyable and can be used on a daily basis.

6. Get fresh air every day. During the winter the dry heat from indoor heating systems dries out your mucous membranes and makes you more susceptible to viruses. If you can, during the day, crack open a window or two to give your body some relief.

7. Drink little or no alcohol during flu season. Too much alcohol impairs liver and immune function, which leaves you open to all kinds of infections. Heavy drinkers are especially susceptible to flu infections. Also, alcohol dehydrates your body which is always bad during flu season.

8. Don't smoke... and avoid smoke-filled places. First and second-hand smoke significantly impairs your immune system. It also dries out your nasal passages and paralyzes cilia, the small hairs in your nose and lungs that help keep out viruses.

Once you contract the flu, do not expect to function normally. You should stay home and definitely not try to attend school or go to work. You will put yourself at risk of further complications, and also help to spread the flu throughout your school and work. Your best options are to stay home, drink lots of fluids, water or tea is best. try to keep your fever below 101 with tylenol or ibuprofen, if you are not allergic or sensitive to the medications. Antibiotics are not effective against the flu because the flu is caused by a virus. There is a prescription drug called Tamiflu, that if started within 12-24 hours of flu symptoms, can decrease the length and severity of the flu by a few days.

My personal favorite for preventing Influenza is a combination of the flu vaccine and adequate Vitamin D. My goal is to get Vitamin D3 levels to an optimal range of between 50-70. If you have not yet had your levels checked, please call our office. Here are a few recommended links to articles on how Vitamin D helps to prevent contracting and possibly lessening the duration of Influenza.

http://www.vitamindcouncil.org/newsletter/2006-apr.shtml

http://www.vitamindcouncil.org/newsletter/2005-nov.shtml

Finally, we never know when the flu will hit, yet it almost always hits in the winter months. Interestingly, our winter is the southern hemispheres summer. When we are battling the flu, our southern hemisphere neighbors are enjoying the sunshine and good health. Makes you think more about the Sunshine-Vitamin D link and flu prevention theory.

This year, Google launched a flu symptom tracker called Google Flu Trends that it hopes will predict and show when the flu is hitting. It will be interesting to see if they can spot Flu cases before the traditional medical establishment.

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness