So Easy A Caveman Can Do It ???

May 27, 2009

So easy a caveman can do it??

No that is not my college yearbook picture !!! Although I would not mind the hair ; )

It is the popular caveman from the Geico commercials. In the commercials, the caveman acts like a normal everyday 21st century individual, until he sees the Geico slogan, "So easy a caveman can do it". Then he gets annoyed and I don't blame him.

But what does this have to do with your health?

Let me explain.

It is now 2009, and it goes without saying that we are more technologically advanced than our caveman ancestors. We have hospitals, doctors, surgeons and antibiotics. We have nurses, therapists, and a whole host of other healthcare providers, (just look at our Wellness Network), to help treat and cure disease. Our healthcare choices are plentiful. That may change if the federal government passes new healthcare legislation, but let me get back on topic.

So are we healthier than the caveman?

NOPE !!!!

Let me explain.

While we are more technologically advanced than our caveman ancestors, we still share over 99% of their DNA. So in essence, we are not that different, just more civilized? I know, another off-topic conversation.

Our 21st century diet and lifestyle are much different than our ancestors and not necessarily for the better!

Today I will focus on diet.

Our caveman ancestors lived off the earth and were known as hunter-gatherers. They did not go to Wegmans for their produce, Papa Johns for their pizza, or make reservations for dinner. They hunted and gathered for all their food on a daily basis. Their diet is said to have consisted of fresh fruits and vegetables, greens, nuts and seeds, as well as hunted wild game. They ate fish and foraged for eggs. Their nutritional status was heads and tails above present day man. Their foods contained no preservatives or added hormones. Today's processed foods, while having a long shelf life, easy to read nutritional labels and easy to prepare microwave instructions, has far less nutritional value than fresh food. Less nutrients in today's diet set us up for many Diet Related Diseases or DRD's. I am sure you have heard of the following DRD's:

Obesity
High Blood Pressure
High Cholesterol
Diabetes
Arthritis

There are many others but I think I made my point.

Oh well, I am on a roll so I'll make another point!

Did cavemen eat Cheerios? Bagels? Ice Cream? Pepsi? Pizza? ............. NO!

How bout eggs? apples? tomatoes? fish? chicken? .............. YES !!

Pearl of the day:

If you want to improve on, or prevent your Diet Related Diseases,

the solution may be,

"So easy a caveman can do it".

Steven Horvitz, D.O.
Board Certified Family Medicine
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/

To celebrate the end of the school year, for the month of June, all schoolteachers can receive $10 off a 1 hour massage, or $15 off a 1.5 hour massage from Julie Fischer, our certified massage therapist at The Institute For Medical Wellness. And if you refer a friend for a massage, you both will receive $5 off your next massage.

To view previous newsletters
To view Insitute For Medical Wellness Network events

Cheers or Jeers for Cheerios??

Excerpts From Yahoo News

Popular cereal is a drug, US food watchdog says

Tue May 12, 10:05 pm ET

WASHINGTON (AFP) – Popular US breakfast cereal Cheerios is a drug, at least if the claims made on the label by its manufacturer General Mills are anything to go by, the US Food and Drug Administration (FDA) has said.

"Based on claims made on your product's label, we have determined that your Cheerios Toasted Whole Grain Oat Cereal is promoted for conditions that cause it to be a drug," the FDA said in a letter to General Mills which was posted on the federal agency's website Tuesday.
Cheerios labels claim that eating the cereal can help lower bad cholesterol, a risk factor for coronary heart disease, by four percent in six weeks.

Citing a clinical study, the product labels also claim that eating two servings a day of Cheerios helps to reduce bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol, the FDA letter says.

Those claims indicate that Cheerios -- said by General Mills to be the best-selling cereal in the United States -- is intended to be used to lower cholesterol and prevent, lessen or treat the disease hypercholesterolemia, and to treat and prevent coronary heart disease.

The rest of the Yahoo News article can be found here.

Now how silly is this?

Doesn't the FDA have anything better to do than go after the number one sold cereal in the country?

Is accusing Cheerios of being an illegally marketed drug just a little bit over the top?

I can see the news headlines.

Just Say No to Cheerios !!!!

Let us look at how silly this is on many levels, as Cheerios claims and the FDA's claims are both inaccurate.

Cholesterol, by itself, does not cause heart disease, although it can be used as a marker for heart disease. Taking cholesterol lowering drugs makes it more difficult to stratify your level of heart disease risk by masking your true cholesterol levels. If you knock out a radar station, does that mean that incoming missiles will be prevented? Just because you do not see the missiles coming in (high cholesterol levels on your bloodwork), does not mean they are not there. I use cholesterol levels taken off of medication to be a truer reading of risk.

Cheerios, being a processed carbohydrate, will raise your sugar levels, thereby raising your insulin levels, which leads to an increase in vascular inflammation in your arteries. This will increase your risk of heart disease. Not exactly what Cheerios advertises!!

Lowering bad cholesterol (LDL) without knowing your good cholesterol (HDL), triglycerides, and total cholesterol is not helpful. So any statement about lowering your bad cholesterol, without mentioning the effects on your good cholesterol, is misleading. Don't believe what you see advertised on food, especially if approved of by the FDA. Approvals are based more on politics and profits than health.

I have found the lowest heart disease risk in patient's whose Total Cholesterol divided by their Good Cholesterol (HDL) is below 4. The higher risk individuals have this ratio above 5. I have also seen many people lower their bad cholesterol, but also lower their good cholesterol and actually increase their heart disease risk. This can happen more frequently when on a low fat diet.

Who do you think has the lower risk of heart disease based on cholesterol levels alone?

Patient #1) Total Cholesterol = 240
HDL Cholesterol = 60
LDL Cholesterol = 145
Triglycerides = 110

Patient #2) Total Cholesterol = 180
HDL Cholesterol = 30
LDL Cholesterol = 115
Triglycerides = 100

Answers will appear later.

My opinion....

The FDA is playing games with the food industry and the public and I am not sure of their intentions. In the past, the FDA almost always tended to side with big business to promote sales of their products. In fact, the FDA food pyramid, which was formulated by our federal government with backing from all the major food industries, has for years encouraged an abundance of carbohydrates in the diet, with cereals produced by American industry at the forefront. This is not my view of the healthiest way to eat, and it has contributed to an increase in heart disease. But things are now changing in Washington. The FDA appears to be going after certain industries that were previously immune. When I figure out why the change of heart, I will be sure to let you know.

As for the purported health claims that Cheerios will lower your risk of heart disease, if you believe that I have a bridge in Brooklyn I would like to sell you!! Cheerios is a processed man-made breakfast food product, made up primarily of processed carbohydrates. As previously mentioned, processed carbohydrates, when eaten in abundance has been linked to an increase in heart disease, as well as obesity and diabetes. My suggestion is to pass on Cheerios, as well as most processed cereals.

OK, so getting back to my cholesterol quiz, which patient has a lower risk of heart disease based solely on cholesterol measurements?

Patient #1 has higher levels of all the cholesterol components and triglycerides. Patient #1 also has a ratio of 240/60 = 4.0

Patient #2 has lower levels of all the cholesterol components and triglycerides. Patient #1 has a ratio of 180/30 = 6.0

The envelope please.............

Patient #1 has a lower risk of heart disease based on the ratio of 4.0 . Why??The HDL or good cholesterol, in theory goes through the body and scavenges up or cleans up after the bad cholesterol or LDL. The best way to improve your ratio is too lower your processed carbohydrate intake, increase your healthy fat, protein and fiber intake, increase your exercise, and if able supplement with fish oils. This will raise the amount of good cholesterol (HDL) and lower your ratio to healthier levels.

For more information, or too develop a personalized wellness plan to include tips on healthy eating, please schedule your annual wellness exam.

As Ben Franklin once said, " An ounce of prevention is worth a pound of cure! "

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

For more information about Dr. Horvitz and The Institute for Medical Wellness.
To view upcoming Wellness Network Events.
For previous newsletters.

High Blood Pressure- What treatments are best for you?

May 2, 2009

High Blood Pressure, also known as Hypertension is said to affect 1 in 3 U.S. adults, or about 73 million Americans over the age of 20. It has been called the "silent killer" as many people have this condition for years without ever knowing it. So what is the problem?? Well, untreated high blood pressure leads to an increased risk for heart disease, stroke, congestive heart failure, kidney failure, peripheral artery disease, and aortic aneurysms.

So, just what is blood pressure and what do the numbers mean? When we measure blood pressure we record two readings. The top number is the systolic pressure. This is the pressure generated when the heart contracts (pumps). It reflects the pressure of the blood against arterial walls. The bottom number is the diastolic pressure. This is the pressure when the heart is filling and relaxing between beats. The so called average blood pressure for an adult is 120/80, but each adult may have a different "normal" blood pressure. High blood pressure in adults is defined as a consistently elevated blood pressure of 140 mm Hg systolic and 90 mm Hg diastolic or higher.

It is important that your blood pressure be taken accurately. Improper size cuffs, calcified arteries and arm positioning can give false readings. If your blood pressure is elevated on 3 consecutive readings on different days or if your systolic pressure is 160 or above, or your diastolic pressure is 105 or above, treatment is indicated.

OK, so what treatment or approach is right for you?


There are many different treatments available and medications that can be used, but I prefer to use medications only after lifestyle changes are explained, taught and implemented. One of the reasons I started the Institute For Medical Wellness was to give my patient's more choice in the treatments available. Medications when used properly are safe and effective. But exercise, lifestyle changes and proper diet can also bring many high blood pressure readings back to normal.
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For a Naturopathic perspective on high blood pressue, Dr Jennifer Phillips, affiliate of The Institute For Medical Wellness has prepared the following:

Naturopathic approach to hypertension

High blood pressure (hypertension) is one of the leading causes of disability or death due to stroke, heart attack, heart failure and kidney failure. It's also the most common chronic illness Americans face. Despite the importance of these observations, blood pressure is poorly controlled in the United States. An estimated 25% of all American adults have high blood pressure, and only 27% have it under control. Conventional drug therapy consists of Diuretics, ACE inhibitors, Beta-blockers, Vasodilators, and Calcium-channel blockers. Side effects of these meds can include fatigue, depression, weight gain, and bone loss, so many patients are eager to find alternatives. If you are one of these patients, read on!
Diet Priniciples

Diet should be low in sugar, high in complex-carbohydrates (such as whole fruits and vegetables). Grains should only be eaten in moderation (3 or fewer servings daily, and only whole grains), nuts, seeds, legumes (beans), fish. Meat and poultry should be limited to free-range and/or organic varieties to avoid chemicals and hormones. Increase foods rich in potassium, calcium and magnesium (carrots, spinach, celery, alfalfa, mushrooms, lima beans, potatoes, avocados, broccoli, and most fruits). Salt restriction may be indicated for some types of hypertension, but not all types. I recommend salting food to taste after cooking, and use only natural sea salt. A diet rich in garlic and onion is as important as any other supplements, so be prepared to smell like an Italian restaurant!

Life-style Changes
Weight loss -- The United States is in the midst of an epidemic of obesity involving more than one-third of the adult population. Weight gain is very high risk in determination of hypertension. It is very critical to lose weight in a slow fashion to control hypertension. Rapid weight loss is not advised. Many studies have shown those overweight-hypertensive patients can reduce their medication with weight loss.

Exercise -- Sedentary people have a 35% greater risk of developing hypertension than athletes do. Keep in mind that people with hypertension should always consult with their physician (ie Dr. Horvitz or a cardiologist) before starting a new exercise program.

Good Sleep Habits -- Insufficient sleep can contribute to high blood pressure in hypertensive people. Are you getting your 8-10 hours each night?

Stress reduction - Stress management and relaxation techniques such as meditation can help in controlling high blood pressure. I feel that hypertension is similar to a pressure cooker- but a pressure cooker always has a valve to let off steam. If we don’t have a valve to "let off steam" or a way to prevent the pressure from rising, then our internal blood pressure goes up!

Specific Supplements
Supplements that have been clinically studied and shown to reduce blood pressure include: Magnesium, Potassium, Coenzyme Q10, Omega-3 Oils, Vitamins C and E; amino acids L-arginine and Taurine; herbs such as Hawthorn, Arjuna, Olive leaf, and Garlic.

You are advised to consult with a naturopathic physician to check for interactions between supplements and medication before embarking on any supplement plan that may reduce blood pressure, especially if you are currently taking medication. In my own practice I have helped many patients reduce or eliminate medication through natural means. The changes also help to reduce other cardiovascular disease risk factors, so the benefit is not just limited to blood pressure.
Jennifer Phillips, ND

If you would like to consult with Dr. Jennifer Phillips, she evaluates patients at my office on Thursdays.

For more information about Dr. Jenn.
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Have you ever had a massage and felt rejuvenated after? Julie Fischer, our massage therapist has the following thoughts on the benefits of massage on high blood pressure.

The lasting health benefits of massage are many, and yet it is often thought of as a luxury. In fact, studies have confirmed that one of the most effective ways of lowering high blood pressure is through receiving massage on a consistent basis. After a few weeks of regular massage, profound effects are found in groups of people who had been struggling to improve their heart's health. Blood Pressure levels are significantly lowered, levels of stress hormones decrease, and feelings of general well being return. As is the intent with all massage programs, the ultimate goal lies in a pain free and relaxing lifestyle. Controlling blood pressure is just one of the many benefits of massage therapy.

As a way to introduce Julie's massage skills, and hopefully bring or keep your blood pressure to a healthier level, she is now offering the following promotions:

Mini Massage! No time for a full session? Come by for a 15 or 30 minute refresher for your back, neck and shoulders! Feel the tension and stress release during your lunch break or between appointments in your busy day. Return to your schedule energized and renewed after this fully clothed, oil free mini massage. Be sure to call ahead to check time availability.

$20 - 15 minutes
$40 - 30 minutes

Relax Packages:
5 massage package 10% off
10 massage package 15% off
*must be used within 6 months

Healthy glow plan:
1 hour session per week - $250 monthly rate

Referral special:
Refer a friend for a first time visit, and receive $5 off of your next massage!
*Make sure your friend lets us know you are the referral source so that we can thank you!

Mothers Day Gift Certificates available!
What better way to show your appreciation than with a gift of renewal! Whether she chooses Thai, Hot Stone, Deep Tissue or Swedish, she will receive a healing treatment that will feel like absolute pampering.

Lockheed Martin employees -
Show your corporate ID and receive $5 off a 1 hour massage and $10 off a 2 hour massage!

For more information about Julie's sevices.
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Proper exercise can also play a key roll in controlling blood pressure. Andy Dick of Optimum Fitness has prepared the following:

Regular exercise is a great way to naturally lower your blood pressure and keep it regulated and nearly any form of regular exercise is proven to help. Both cardiovascular (running, biking, etc…) and strength training has been proven effective in controlling blood pressure. While diet alone can accomplish this, exercise has the added advantage of getting your heart involved in the work. Plus, while you are burning calories, your are also maintaining and/or improving your muscle tone. Regular exercise improves your circulation and allows your body to more efficiently use oxygen in the bloodstream. Sweating out excess amounts of stored water and sodium in the body during exercise can help regulate some of the important components in the body that contribute to high blood pressure. Exercise forces the body to release insulin, which lowers sodium, which helps to lower blood pressure naturally. Any exercise is good, so my advice would be start on any program that you will enjoy and that fits your lifestyle and personality.

Andy Dick

Please feel free to take advantage of a special offer available only to patients in Dr. Horvitz's Wellness Programs at The Institute for Medical Wellness: Enjoy a free initial consultation that will include body composition analysis, goal setting, program planning, and a comprehensive question and answer session to go over all of your concerns. After this, members of Dr. Horvitz’ Wellness Program are able to take advantage of an introductory 2 for 1 training package to get started. This is a $120 value for only $60 to get you on your way to a better, more rounded lifestyle.

For more information on Andy's services.
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High Blood Pressure has many different causes, and many different treatments. You should never feel forced or coerced into any one treatment plan. At The Institute For Medical Wellness, we will work with you to find the treatment plan that meets the following criteria:

It is Safe, Healthy, and will make you Happy!!

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

For more information about Dr. Horvitz and The Institute for Medical Wellness.

To view upcoming Wellness Network Events.

For previous newsletters.

www.DrHorvitz.com

Institute For Medical Wellness Vision

April 27, 2009

I have often been asked how and why I developed The Institute For Medical Wellness.

So here goes.

It all came down to following my vision of what makes a true Family Physician and developing a practice with this mission. This vision has been shaped and reshaped over the past 18 years. Upon graduation from medical school in 1991, and completing an internship and residency in Family Practice in 1994, I felt very well trained to begin my career. My first four years were spent working for another family physician with two offices. One was based in Cherry Hill and the other in North Camden. During those years I matured alot as an individual and as a physician. I learned that being a physician is not just about diagnosis and treatments. It is about building relationships based on trust and mutual respect.

My goal since childhood has always been to have a private practice. So in 1998 I started my own solo private practice in Moorestown. At the time I was told by a majority of physicians that I would never succeed. The prevailing thought in 1998 was that independent medical practices were too risky. In 1998, hospitals were buying up independent practices and physicians became employees of large hospital orgaizations. Well, if you do not know me well yet, I have my own views, many of them contrarian. I do not believe that the majority opinion is always correct. I also do not always play well with others, so an independent practice was my best career decision and I have never looked back and never regretted it.

Now starting a practice from scratch was not easy, but it was the right thing for me. It was slow the first year, but by the second and third year, things were moving along nicely. I was busy enough to be happy, but not so busy that I couldn't take the time necessary for each patient, as well as have enough time for my own family. Health insurance companies were strong, but they were not yet planting themselves between me and my patient's. But year after year insurance companies started requiring more and more bureaucratic nonsense in order for the proper delivery of care. Back in 2004-5 I stopped participating with 2 health plans due to their nonsense. My practice grew nonetheless. But again, each year brought more bureaucratic and governmental regulations that hindered the proper delivery of care. Referalls, preauthorizations, precertifications, electronic billing, HIPPA, and many others were not part of running an efficient and effective medical office when I started medical school. But this is what happens when Big Business and Big Government takes control of your healthcare.

In 2007, I was at a crossroads. My career goal was not to be the richest or poorest physician, but to be the best physician I could be. I explored two opportunities. One would have meant joining a large group practice that would deal with all the bureaucratic nonsense for me. The other was to convert my practice to a Concierge model. Both had many advantages, but also came with one big disadvantage, that being loss of control of how my practice is run. And as I stated before, I do not play well with others. So I needed another direction. I needed a practice model that fit my views of proper patient care and yet still remain viable in the community. So I brainstormed and put together the vision of The Institute For Medical Wellness. Special thanks to my wife, my daughter Nori, and great friend Ivy for all your help with bringing a name to my vision.

So in January 2008, The Institute For Medical Wellness was born and has been growing and evolving every day. It has not been all smooth sailing, and I have hit some bumps along the way, but overall I am moving in the right direction. Being in practice for 18 years, I have become more realistic in my views on medical care. I have learned that traditional medical care does not have all the answers. So while I received a traditional medical school education, my views now also include holistic approaches. In the treatment or prevention of illness, we need first to do it safely and effectively. I do not like to order tests just to order tests. I do not prescribe medications just for the sake of medications or expediency. I do not like calling in a prescription over the phone without a proper evaluation. That is not the best care I can provide. When I do prescribe medications or order tests, it will be the least amount necessary to do the job right. More is not necessarily better when it comes to medical treatment. My views are also that most disease can be classified as mild, moderate or severe. A holistic approach may work very well for prevention of disease as well as for mild disease. But when we get to moderate to severe disease, a traditional approach may be necessary. That being said, nothing makes me happier than lowering medication use by way of a healthier and more holistic lifestyle. Treatment without medications is always the number one goal.

So it is now the Spring of 2009. The Institute For Medical Wellness is 16 months old and is still in its infancy. But like all infants learning to walk, our legs are getting stronger each day. We are learning what our patients want and expect and are doing our best to accomodate in the safest and most effective way possible. The most frequent question has been about offering a closer integration of holistic approaches to treatment. So in future newsletters I will be introducing some holistic integrations available to improve your overall health and wellness. Many of our affiliates listed on my wellness network page will become more visible and available for your care.

So please stay tuned and be certain that The Institute For Medical Wellness is focused not on Big Business or Big Government, but instead on each and every individual who steps through our door. Our focus has always and will always be focused on you!

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

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

Your Metabolism and You- Part Two

April 8, 2009

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

Your Metabolism and You- Part Two

As mentioned in my previous newsletter, You and Your Metabolism - Part One, your weight is a result of a balance between anabolism-the storing of energy, and catabolism- the burning of energy. If you are overweight you tend to store more energy than you burn. If you are underweight, you tend to burn more energy than you store. During your yearly wellness exam, I take the time to review your diet and food choices. It also tends to be the time when my patient's eye contact starts drifting away. But back to your metabolism. The most common discussion if you are overweight is about becoming more of a burner than a storer of energy. While we all know that exercise increases the burning of energy, all the exercise in the world will not make you lose a whole lot of weight if you still store too much energy as fat. So how can you tip the balance towards becoming a burner as opposed to a storer?

Let me explain by bringing insulin into the equation via carbohydrates and sugar.

When you eat carbohydrates, and that includes both simple and complex carbohydrates, they are digested and broken down into glucose which enters your bloodstream. Elevated concentrations of glucose in blood stimulate the release of insulin, and insulin acts on cells thoughout your body to stimulate uptake, utilization and storage of glucose. When glucose is overabundant, it gets converted into triglycerides and stored as fat.

See the diagram below:

Excess carbohydrates---> increased glucose (sugar) ---> increased insulin---> increased storage of fat ---> increase in bad cholesterol ---> increase in weight.

So if you want to lose weight, and have that weight loss come from loss of fat, then by decreasing your carbohydrates the following occurs:

Low carbohydrates---> normal glucose---> normal to low insulin---> decrease in storage of fat---> decrease in bad cholesterol --->burning of fat for energy--->decrease in weight.

Let us look at this another way. When we need energy to burn, our body first uses glycogen (liver glucose store), followed by glucose available from our bloodstream. When these are used up, the next most available energy source is from our fat cells. So if we keep our carbohydrates low, thereby lowering the amount of glucose available for use, our bodies become better at burning our fat cells for fuel. Our metabolism shifts to burning more fat than we store, and weight loss comes predominantly from our fat stores. In men this is usually a decrease of weight around the abdomen. In women the weight loss occurs from the hip, legs and buttocks.

Now, if we want to build muscle, insulin as an anabolic hormone helps. When we eat abundant protein, this is digested into amino acids. Insulin acts upon the amino acids to form proteins. Proteins are the building blocks of muscle. To increase your muscle tone, start a good exercise program, to stimulate insulin to build muscle. This is why body builders can eat a whole lot of calories, put on a lot of muscle, but keep their body fat low. This is opposite to sumo wrestlers. Sumo wrestlers eat a high carbohydrate diet, thereby increasing their fat storage, and thus increasing their weight.

So take your pick.

Low carbohydrate diet with moderate exercise:

Or,

High carbohydrate with minimal exercise:

Any questions???

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

To view previous newsletters, please click here.

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

http://www.drhorvitz.com/

Your Metabolism and You- Part One

April 4, 2009

Your Metabolism and You- Part One

The most common health complaint I hear in my practice deals with weight management. Upon visiting my office. my patient's often get grumpy when asked to step on the evil scale.

When the evil, vile scale is read, I often hear the phrase, "It must be that I have a slow metabolism". But we should all remember that evil spelled backwards is live, so a scale is not always such a bad thing, but a necessary part of my job, and helps to keep you a-live!

Overall, metabolism is not just about being overweight, but is also responsible for being underweight. How can this be? Let us take a look at metabolism, and its definition.

Metabolism is the set of chemical reactions that occur in living organisms in order to maintain life. These "metabolic" processes allow us to grow and reproduce, maintain our organs, and respond to our environments. Metabolism is actually a balance between anabolism-the storing of energy, and catabolism- the burning of energy.

If you store more energy than you burn, you gain weight and may look like the figure on the right in the above cartoon. If you burn more energy than you store, you lose weight, and may look like the figure on the left.

How we maintain balance to get to a healthy weight is where the fun, or pain begins, and has been the subject of numerous diet books, of which, I have read a great many. Some have made me laugh out loud, while others have changed the way I eat and the way I practice. The first book I read was Protein Power, by Dr Eades. This book went over the metabolic processes of how we store and burn energy. It advocated we lower carbohydrates in our diet along while increasing both proteins and fats. It went against most of the lessons I was taught in medical school, yet it made tremendous sense. But I was not yet convinced and was not about to change my views based on one book. So I continued to research. Dr Atkins diet revolution, The Schwarzbein Principle, and Life Without Bread were all books that had similar concepts to Protein Power, but with their own distinct flavor. These books all based their theories on real human physiology. But just like life and politics, theories are one thing and reality can be another.

Would the theory of eating a low carbohydrate diet help the overweight and obese to lose weight? The only true way to know would be to test it out. But try convincing anyone to go against what all the so called experts on television and radio say about a healthy diet.

Well, the stars must have all been aligned, as a patient came to my office who had recently read Protein Power and wanted to try out the diet. I agreed to help and to monitor their progress by watching their weight, blood pressure, cholesterol and sugar levels. The low carbohydrate diet was a huge success. Weight loss with normal sugars and a much improved cholesterol profile. Blood pressure dropped so much that we had to stop blood pressure medications, and energy levels rose. How did this happen while eating more protein and fat, and less carbohydrates? Could all I was taught in medical school, and all the "media pundits" be wrong? More on this later. But if you want a sneek peek, check out the books mentioned above. It may open your eyes, slim your waistline, improve energy levels and balance out your metabolism!

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

Steven Horvitz, D.O.

Board Certified Family Medicine

Founder of The Institute for Medical Wellness

128 Borton Landing Road, Suite Two

Moorestown, NJ 08057

Phone: 856-231-0590

Fax: 856-294-0311

Please visit http://www.drhorvitz.com/ for more information about Dr. Horvitz and The Institute for Medical Wellness.

To view upcoming Wellness Network Events, please click here.

Prostate Cancer Screening. Is it Worthwhile?

March 28, 2009

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

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There has been a recent hubbub about prostate cancer screening. For many years, men over the age of 40 have been advised to have an annual PSA (prostate specific antigen) blood test along with a digital rectal exam.

In theory, PSA screening would detect prostate cancer at an early and more treatable stage. If the PSA level was above normal, or increasing quicker than expected, further evaluation for prostate cancer was begun. Ask any man who has undergone further evaluation. It is neither fun, nor pleasant.

Yet screening for prostate cancer via the PSA test seems worthwhile, if the alternative is a higher risk of prostate cancer. But two recent studies raise questions concerning the PSA tests effectiveness.

The first involved over 76,000 men. These men were divided into two groups. The first group had annual PSA and digital rectal exams for six years, while the second group had usual care. Although more prostate cancer was diagnosed in the first group, they did not have more prostate cancer related deaths after both seven and ten years.

The second study, involved 182,000 men followed over nine years. The first group had PSA screening every four years, while the second group did not. There were 20% more prostate cancers diagnosed, and slightly fewer prostate cancer deaths in the first group. But as we look closer at the studies statistics, for every 1,410 men screened with the PSA test, only 48 would be treated, or just over 3%. Of the 48 men treated only one cancer death would be prevented, or just over 2%. Of the 1,410 men screened, prostate cancer death would be decreased by less than 1/10 of one percent. There was no difference in overall death rates between the two groups.

So let us analyze this conundrum by going from point A to point B.

Point A is PSA testing. We want to get to Point B, which is prevention of prostate cancer deaths, while causing little or no harm. Yet, neither of these studies showed a significant decrease in prostate cancer or other causes of death.

A (PSA testing) -----XXX------>>>> B ( Decreased Prostate Cancer Deaths)

Most men identified as having abnormal tests will probably never develop a prostate cancer that will kill them. Some will say that the risk is worth it, and that is a valid opinion. But tell that to the men who had an abnormal PSA test, underwent further testing, biopsy and/or treatment, ended up impotent or incontinent, and were found not to have prostate cancer. Sometimes the investigation and treatment of a disease is worse than the disease itself.

Now, by sending out this newsletter, I am not advocating for the end of the use of PSA testing. PSA testing is especially useful in men with a family history of prostate cancer. It may also be useful for men between the ages of 40-60, as prostate cancer at a younger age tends to be more aggressive. But we need to further understand who and how often we need to screen. Should we screen yearly, every 2-3 years or every 5 years? Should we screen men over 70 or 80 years of age, when their risk of dying from other causes is higher than their risk from prostate cancer? The decision to screen should be left to each individual. Diagnosis of any disease at an early stage is a worthwhile goal and is something I strive for in my medical practice. But it must be accomplished without causing harm. The two studies mentioned above indicate that a harmful outcome is just as likely as a good outcome in PSA screening for prostate cancer. So what do we do to improve our odds of not having a bad outcome from prostate cancer without causing harmful side effects? How about teaching lifestyle modifications that can decrease your overall risk. Let me point to another recent study. In this study, intake of 500mg of omega-3 fatty acids daily, like those found in dark fish like salmon, reduced the death rate from advanced prostate cancer by up to 63%. Eating salmon sounds a bit more pleasant than a prostate biopsy ; ) I, for one, will eat more salmon and continue with my omega-3 fatty acid supplementation.

On another note, our politicians are debating about an overhaul of our healthcare system. My fear is that they will try to change the system to a cookbook style that is more concerned with costs than on good health outcomes. If that turns out to be the case, a less expensive alternative for prostate cancer screenings may soon look like the picture below.

I can hear it now.

Attention Wal*Mart shoppers.

Please head over to aisle four for your free prostate check ; )

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Please note that next week, Julie Fischer will begin performing massage therapy in my office on Tuesdays and Thursdays. She performs Thai, swedish and deep tissue massage, as well as hot stone massage. For the month of April, Julie's massage services will be offered at a 10% discount. Wellness Plan members get even better pricing. Please click on the above link for more information.

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

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

For more information about Dr. Horvitz and The Institute for Medical Wellness, please visit our website at http://www.drhorvitz.com/

To view upcoming Wellness Network Events, please click here.

Anniversary Newsletter

March 25, 2009

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

It has been just over a year since my initial email newsletter, all of which are archived at my blog site located at http://drhorvitz.blogspot.com/ . What started out as a whim, has become enjoyable and fun. Being a science major in college, I never enjoyed writing. But I guess when you find the right topics, it can end up being fun. Thank you to everyone who has encouraged me to continue.

My newsletters are an easy 21st century segway to promoting a healthy lifestyle and serves as an extension of my practice, and of my philosophy of family medical care. A physicians duty is not just about treating the ill, but more importantly preventing illness from occurring. This takes planning and lots and lots of time. The majority of physicians in today's insurance and government dominated healthcare system do not have the luxury of time for prevention and wellness counseling. They are too busy "running the health insurance mill". I have overheard patient's say they were treated less like a number at the deli counter, than at their doctor's office. This is not a criticism of other doctors, but more of a criticism of the system in which they work. This dysfunctional system was the strongest motivating factor towards the evolution of the Institute for Medical Wellness.

On average, individuals visit their doctor's office about 3-4 times a year. During these visits, they are lucky to have 10-15 minutes in the exam room before the doctor is running to the next patient. Do you think this is adequate for healthy lifestyle promotion? I do not! Fifteen minutes is barely enough time to "put out the fires", let alone teach and encourage healthy behaviors. These time stressors made my transition away from health insurance contracts towards an individual patient-centered practice much easier. This style of practice puts the emphasis back on the doctor-patient relationship, and makes certain that this relationship is paramount. It limits the ability of any third party involvement in the decision making pertaining to your care. The strong doctor-patient relationship was the hallmark of medical care that past generations enjoyed, and is the practice style that I prefer.

To help promote wellness, I have continued to network with other like minded professionals. My website has a Wellness Network page that can serve as an introduction to their specialties, which includes a Naturopathic physician, personal trainer, yoga instructor, and Physical therapist. I am pleased to announce starting in April, Julie Fischer will begin performing massage therapy in my office on Tuesdays and Thursdays. As the need expands, so will Julie's availability. For the month of April, Julie's massage services will be offered at a 10% discount. Wellness Plan members get even better pricing.

I hope you will look to the wellness network within the Institute for Medical Wellness for more of your healthcare needs. If there are other areas of wellness that you feel would be a good addition, please let me know. As for the newsletters, I plan on continuing to write them as long as useful information pops up in the news. So it looks like you are stuck with them for quite a while! At the bottom of each newsletter is a "manage your subscription" link where you can opt out of receiving the newsletter if you choose. But then you would be missing out on a whole lot of my unbiased medical opinions ; )

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

To Good Health!!

Steven Horvitz, D.O.
Board Certified Family Medicine

Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone: 856-231-0590
Fax: 856-294-0311

To view previous newsletters, please click here.

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

http://www.drhorvitz.com/

Are you ready for Spring ???

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!


It's almost spring. And after sitting around more during the cold weather season, we need to make sure we start our springtime exercise wisely. The most common visits to my office in the spring are for overuse athletic injuries. In other words, people overdoing exercise.

To help prevent this common malady. Andy Dick of Optimum Fitness has prepared the following.
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As warmer weather approaches, all of us in the Northeast get excited for a return to outdoor activities. Whether this means taking the dog for a walk, or training for a triathlon, it is important to approach this extra exercise sensibly.

First off, if you plan on trying something new, make sure it is something that you will enjoy and that it will help you accomplish your personal goals. You should also be careful not to pick a new activity that could aggravate an old injury. Someone with bad knees should not set out to run a marathon!

If you plan on picking up an old exercise that you know you enjoy, be sure to ease into the activity slowly. Your body is very good at learning your routine. This is why you tend to be very sore after your first workout in a long time, but someone who works out daily is rarely sore. However, your body learns specifics; therefore if you have been keeping active on an elliptical all winter, you need to let your body get used to running outdoors slowly. Otherwise, it could be uncomfortable for the days following your first few runs! Not only do we want to avoid being uncomfortable due to the soreness, but we don’t want to have to skip future workouts because you can’t get up off the couch! Although it doesn’t feel like it now, there will be plenty of nice days to get outside and enjoy the weather, so take it slow to start!

Although I will always preach the importance of a good warm-up, cool-down, and post-exercise stretch, it is especially important on the days you are starting something new.

· Always start off exercise with a 5 minute warm-up. This means that you start off slowly and slowly ramp up to your exercise pace over the warm-up time. This is important to get the heart pumping the right amount of blood to the right muscles. Otherwise, you may feel weak to start and you could be unfairly stressing your heart.
· Always end exercise with a 5 minute cool-down period. Slowly ramp your pace from what you have been exercising at to a moderate walking pace. This will allow your heart to slow down at a natural pace (which avoids blood pooling in your lower extremities due to the heart pumping too fast for your pace) as well as allow your body to rid the bloodstream and muscles of some of the waste products that build up during exercise. These waste products are a main cause of muscle soreness.
· Always stretch at the end of exercise! It is important to note not to stretch at the beginning unless you are loosening up an injured area. Muscles should not be too lax (or loose) before exercising. This can weaken them significantly, sometimes leading to injuries of the tendons, ligaments, or muscles surrounding the area.

Choose something that you enjoy! I cannot stress this enough. If you do not enjoy something, you will not stick with it and you will end up mad at yourself for quitting. Also, if you really can’t enjoy an activity for whatever reason, you will find yourself taking shortcuts to finish. Shortcuts are the easiest way to accidental injury.

Finally, don’t push too hard. Remember, most of us are not training for the Olympics. If you get out there with someone who is faster than you that is OK. Keep your eyes on your specific goals and don’t worry about trying to “win.”''

Andy DickOwner, Optimum Results(609) 304-7598
http://www.optimumresults.net/
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Good points Andy.

Thanks again!!

So I hope everyone starts thinking of how to get more exercise as the weather warms up. But if anyone is unsure of their ability to exercise, or has a sudden decrease in exercise stamina, trouble with chest discomfort, or shortness of breath, please stop exercising and give my office a call for evaluation.


Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057

Phone: 856-231-0590
Fax: 856-294-0311

For more information about Dr. Horvitz and The Institute for Medical Wellness, please click here.

To view upcoming Wellness Network Events, please click here.

http://www.drhorvitz.com/

Medical Studies- We can't live with them, and We can't live without them?

March 6, 2009


Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

Medical Studies- We can't live with them, and We can't live without them?

I graduated from medical school in 1991 and completed my family practice training in 1994. At that time, I was just embarking on my medical career. I was still idealistic. I believed what I was taught in school to be 100% the truth. Part of our training involves keeping up with all the newest and latest treatments of disease. We were taught to believe in peer reviewed placebo controlled medical studies. These studies shaped the way I practiced my new profession.

Fast forward to March 2009. I am 15 years older, and no longer in the early part of my career. I have come to realize that my hairline will continue to recede, and I have also become more realistic about the diagnosis and treatment of disease. With these realizations, I have become more realistic about what it means to be a family physician. Being a family physician means treating each patient as an individual, and to treat these individuals as you would treat your own family member. Please note I am assuming that we all love our family members. If you do not, please insert your favorite pet or your best friend wherever you see the words "family member".

So what does this have to do with medical studies?

As mentioned earlier, by practicing for 15+ years, I realize that medical care is far from idealistic. There is a tremendous amount of bias, especially as it involves medical studies and guidelines. My problem is with how medical studies are performed, who funds the studies, how they find their conclusions, how they promote their results and how they are used for propaganda and profit. One of the biggest offenders are the pharmaceutical companies. They have a tremendous knack for transforming mediocre medical studies into billion dollar drug sales. The two biggest culprits are the statin cholesterol medications and the bisphosphonate osteoporosis medications. Both of these medication classes have been marketed as the best thing since sliced bread. As a low carb proponent, you know how I feel about sliced bread. But if you truly look at the study statistics, you will find the conclusions and recommendations to be heavily biased.

Example: a statin cholesterol medication is advertised to lower your cholesterol by 30-50%. And then they tell us that further studies show a 20% relative decrease in heart disease. Wow!!! I should run and start taking that pill. But if you look closely at the numbers you find out that the 20% relative decrease is a marketing ploy. So I look at it differently. The number that I like to look at is what is called the NNT, or the number needed to treat. It goes like this. If 11 people have strep throat, and I give an antibiotic to all 11, 10 people will be cured and 1 will not. The NNT is 10/11, or a 91% success rate. Pretty good!!! Now, let us look at statins. A Business Week article examined the NNT for a poplular statin drug Lipitor. The NNT of Lipitor to prevent a cardiac event was 1/100 or a 1% success rate. You need to treat 100 people with Lipitor to prevent 1 cardiac event. Wonderful for the one individual, but what about the other 99.

So as I grew older and balder, there is hope. Not for my hairline but the tremendous amount of bias in medical studies that is finally getting some press. A recent article in JAMA, the Journal of the American Medical Association, (2.25.09. vol 301. No.8), wrote about guidelines that cardiologists propose as evidence based, is actually based on weak evidence. I even read in other blogs how these guidelines have been used to increase the need for cardiologists. How is that for self-referral??

So in my practice, I trust less of what the so-called experts propose, and more on common sense, and personal professional experience. I still use guidelines, but not as the holy grail of medical care and treatment. As many of the standards of care that I used 10 years ago, are now obsolete, or even dangerous, I am not close-minded to believe that the treatments proposed today by the "experts" will still be around ten years from now. Instead, I look for the causes and triggers of disease. I look for treatments that work with the bodies normal activities and not against it. I treat each patient as an individual, and I do not use population based medical studies as the determining factor in treatment. I consider these studies as options, but I always try to understand how this treatment will affect the individual sitting across from me. I look for bias in all studies, and all marketing that comes before me. The only way to be true as a doctor is to be true to your patients. And that means not drinking the medical study kool-aid that others in my profession drink. Besides, I prefer water. It tastes better, has no artificial ingredients, and has been around forever.

I will end with one of my favorite quotes:

"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute for Medical Wellness
http://www.drhorvitz.com/
http://drhorvitz.blogspot.com/
856-231-0590

Mental exhaustion makes workouts harder: study

By Reuters - Tue Feb 24, 3:06 PM PST
CHICAGO (Reuters) - Being mentally exhausted can impair a person's exercise performance, a finding that may help explain why it is sometimes so hard to work out, British researchers said on Tuesday. They said people who did a mentally tiresome task just before exercising reached exhaustion much more quickly than when they had been mentally rested.

Mental fatigue did not affect the performance of the heart or muscles, but it did affect their "perceived effort," Samuele Marcora, Walter Staiano and Victoria Manning of Bangor University in Wales wrote in the Journal of Applied Physiology. "Our study provides experimental evidence that mental fatigue limits exercise tolerance in humans through higher perception of effort," the team wrote. For the study, the researchers had 16 people take a demanding, 90-minute test that required close attention, memory, and left participants feeling tired and listless. Next, they rode a stationary bicycle to exhaustion, while the researchers tracked their heart rate and other vital signs. On a different day, the same group simply watched a 90-minute documentary film before riding the bike. The researchers found participants stopped exercising 15 percent earlier on average when they were mentally exhausted, even though there was little difference in their cardio respiratory or muscle function. "It provides strong evidence that brain function can limit short-term endurance performance," the team wrote. The researchers said the next step is to look at the brain to find out exactly why people with mental fatigue perceive exercise to be more difficult.
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Interesting study. I wonder if the authors wrote this article before or after exercising.

Q1: Does this mean that poor exercise performance can be "all in our heads?"

Q2: Is any other performance decreased due to mental fatigue, such as work or parenting?

I believe the answers are yes, yes and yes, but, a better question would be:

How do we get past the mental fatigue and continue to perform optimally?

As it pertains to exercise, Andy Dick of Optimal Fitness, has the following thoughts on getting past the exhaustion, or as some athletes call it, "getting past the wall".

I believe that this research points out an important point. You can (and should) only focus on so much without breaking down in one aspect or the other. Just like multi-tasking and juggling too many things at work can lead to reduced production in all of your work goals, exercise can suffer as a result of a long day at work. If one can focus on exercise as a method to relieve the day’s stress rather than as a an all-out He-Man workout, it can and should help break up the tightness in your mood. Rather than skipping the workout, re-focus on why you hit the gym!

Andy Dick
Owner, Optimum Results
(609) 304-7598
http://www.optimumresults.net/

Check out Optimum Results - Personal Training for this month's healthy tip!
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Thanks Andy!!

As I mentioned earlier, I believe mental fatigue, or as we should call it "STRESS", decreases our performance in many daily activities which then leads to phrases like "I woulda, I coulda and I shoulda." These phrases only perpetuate the stress and do not help in finding a way to release it.

My favorite stress release methods include reading a favorite book or magazine, or cooking a favorite meal, low carb of course ; )

If you have any favorite methods to reduce your mental fatigue, please visit my blog and post your annonymous methods in the comments section. This is where I hope we can all learn from each other. And I hope they are better than this next cartoon.

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

www.DrHorvitz.com

http://drhorvitz.blogspot.com

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

Colds and Sleep

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

February 17, 2009

I often get asked, "Hey Doc, Why do I always get sick. It seems like I am in here for a cold all the time."

A new study from the Archives of Internal Medicine on Sleep habits and the susceptibility to the common cold may give us a little clue.

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Colds and Sleep

Sleep habits and susceptibility to the common cold.
Arch Intern Med. 2009; 169(1):62-7 (ISSN: 1538-3679)

Cohen S; Doyle WJ; Alper CM; Janicki-Deverts D; Turner RBDepartment of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA. scohen@cmu.edu

BACKGROUND: Sleep quality is thought to be an important predictor of immunity and, in turn, susceptibility to the common cold. This article examines whether sleep duration and efficiency in the weeks preceding viral exposure are associated with cold susceptibility.

METHODS: A total of 153 healthy men and women (age range, 21-55 years) volunteered to participate in the study. For 14 consecutive days, they reported their sleep duration and sleep efficiency (percentage of time in bed actually asleep) for the previous night and whether they felt rested. Average scores for each sleep variable were calculated over the 14-day baseline. Subsequently, participants were quarantined, administered nasal drops containing a rhinovirus, and monitored for the development of a clinical cold (infection in the presence of objective signs of illness) on the day before and for 5 days after exposure.

RESULTS: There was a graded association with average sleep duration: participants with less than 7 hours of sleep were 2.94 times (95% confidence interval [CI], 1.18-7.30) more likely to develop a cold than those with 8 hours or more of sleep. The association with sleep efficiency was also graded: participants with less than 92% efficiency were 5.50 times (95% CI, 2.08-14.48) more likely to develop a cold than those with 98% or more efficiency. These relationships could not be explained by differences in prechallenge virus-specific antibody titers, demographics, season of the year, body mass, socioeconomic status, psychological variables, or health practices. The percentage of days feeling rested was not associated with colds.

CONCLUSION: Poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated with lower resistance to illness

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ZZZZZZZZZZZZ ........

ZZZZZZZZZZZZZZZZZZZ....................






Sorry, sometimes reading medical studies makes me sleepy ; )

To rephrase this study in a language we can all understand, individuals who achieved less than 7 hours of refreshing sleep a night had an almost 3x greater likelihood of "catching a cold".

So in today's rush-rush hectic world, where we do not have time to do all the things we feel are needed, it seems like a good time to adjust our schedules back to include time for a good 8 hours or more of sleep. And sleep should be something we look forward to at the end of the day, not something to dread because " I don't have time for sleep. I am too busy!"










The better we sleep, the better we function during our waking hours, which means better production at work, or at least better than the guy pictured below.










Here are some suggestions to try if you are having issues with sleep:
1) Avoid all products with caffeine after 4 PM.
2) Follow a routine at bedtime-- with consistent adherance to the routine: Example: warm bath and warm decaffeinated drink
3) TV off the same time every night.
4) Save bed for sleep and intimacy. DO NOT read or watch TV in bed.
5) If you are unable to sleep after 30 minutes in bed then get up and do something constructive in another room such as housework, a hobby, or watch TV. The idea is that this will avoid frustration with not being able to get to sleep and tell your brain/body: that if your are going to be awake then you will do "waking hours activities". Should you become sleepy then return to bed.
6) Learn yoga, Tai Chi, or other meditative breathing exercises to help you "turn off your brain" at night. The Mount Laurel Library is offering a one hour class the First Friday of every month, from 7-8 pm, in the ancient healing art of Tai Chi. For more info on this class or Tai Chi please click here.
For further sleep tips, please follow this link to the National Sleep Foundation, http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.4813227/k.2F67/Sleep_Tips.htm

If you have any sleep tips that you would like to share, please visit my blog at http://drhorvitz.blogspot.com/ and leave your annonymous tips in the comments section. The blog also contains all the previous newsletters with an easier search feature.

Good night and I hope you sleep well !!!

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