What Do Habits Have to Do With Health?

Bad habits can drive us nuts…

But they can also be at the bottom of health problems too.

It’s no secret that there is an epidemic of overweight, diabetes and stress.  Yet, if we know about these things, which almost all of us do - and we know at least some of the things we should do to make them better - then why, oh why, aren’t the problems going away?

Because a lot of the solution has to do with changing our habits!  And that can be hard to do.

Feel free to weigh in on your biggest bad habits and the roadblocks to changing them.

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Are GERD and Allergies Connected?

Someone asked me the other day about their really horrible allergies and GERD.

The question went like this:

I have horrible allergies and nothing seems to work.  I have GERD and it is hard to find a food that does not affect me.  I am very frustrated and just want to get the allergies and GERD under control.

This was such a problem that they actually went for a heart stress test and was told their heart was healthy but they were unfit.  But…they did the test when their allergies were flaring up.  Otherwise, they can walk a mile in 10 to 12 minutes without getting out of breath in the least.

Let’s start with a question.  What is GERD?  OK, yes, it is gastroesophageal reflux disease.  Disease? Huh?  Do you catch it on the bus or something?

Let’s try that again.  GERD is a problem with the digestive system up where the esophagus meets the stomach.  The problem is that gasses and acids, and sometimes food, in various stages of digestion, reflux back up the esophagus.

Here’s the problem.  We are used to treating this “disease” with acid blockers, not eating large meals or late meals, and sleeping with the head of the bed raised.  Bad idea, good idea and good idea in a pinch.

But did you know that reducing starchy carbohydrates is one of the most useful things you can do for GERD?  Which isn’t such a bad thing to be doing anyway, because most of us eat waaayyyy to many of them to begin with!

Let’s throw in another thought.  The upper part of the digestive system is normally pretty low in bacteria and is relatively higher in acid, which helps kill off bacteria that come in on food and also helps digest food.  And the bacteria that are there tend to be the “good” bacteria, like Lactobacillus acidophilus (think probiotics).

But, what if you’ve been taking acid blockers?  Oops.  Potentially more bacteria and less digestion.  What if you are eating meals that are too big and tend to just “sit” in the upper bowel?  Or what if you have diabetes or low thyroid, conditions that can slow down the forward movement of the intestine?

What if you are actually sensitive to gluten, the protein found in wheat and most of the other grains we commonly eat?  That adds an immune and inflammatory problem.

Pretty soon the upper intestine can have a lot of bacteria, a lot of inflammation, and actually, some damage to it’s one cell thick lining (yes, really, only one cell thick).

Then you’ve got potential for “allergies” (actually better described as “reactions”) from almost any food you eat and you’ve got a little fermentation plant producing, guess what, lot’s of gasses from small bowel bacterial overgrowth. These gasses can cause the usual reflux symptoms, but also throat and sinus symptoms, and even asthma like symptoms and chest pain.

The GERD and allergies become a vicious circle.

So what’s the answer?

In general, the best plan is to get to the root of the problem.  Remove the insults and strengthen the system.

Different people are different, but I usually start with removing all of the starchy carbs, and even all gluten foods for about 6 weeks and adding some digestive enzymes.  If fruits, vegetables or probiotics are difficult to tolerate, I start thinking about bacterial overgrowth.  There are tests to help sort that out, and a special non-absorbable antibiotic called Rifaximin can sometimes be useful.

And, if the things you can do yourself don’t solve the problem, hunt around for a doc that will look into some of these other things.  Don’t just settle for acid blockers as the “solution”.

You need your acid.  It just needs to stay in your stomach where it belongs.

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Is Raw Milk Good or Bad?

Is raw milk and dairy a good thing or a bad thing?

When I was a little kid, I used to go to my grandma’s house, which was on a farm.  It was a little family farm, mostly retired by that time.  But there were still some milking cows.  They used to milk the cows in the afternoon and put the milk in the fridge over night.  First thing in the morning there was nothing better than fresh milk with a rich creamy layer on top.

Raw milk.

Some people won’t drink any think else.  The question, of course is whether or not raw milk is better for you or if pasteurization really is needed to kill bacteria.

Personally, I don’t think there is a good answer to this question.

On the one hand, I certainly like foods as close to whole and natural as possible.  Raw milk fits that bill.

On the other hand, bacteria can be deadly.  Literally.  Back in my grandmother’s day, children died pretty routinely and people died early deaths because of things like a simple bacterial infection.  Two of the greatest advances in health and avoiding early death are sanitation and antibiotics.

So, the raw milk products issue is a trade off.  It’s a trade off between keeping a food more whole and keeping a food safe.  You can live with a less whole milk product, but you can’t live with a bacteria that is stronger than you and all of our antibiotics.  It can kill you.  The chances may be low, but the unlucky folks that end up with an infection, it’s 100%.

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Know What’s In A Pesticide On This Earth Day

I just got back from Sacramento, the Capitol of California.  I was there to testify in favor of a bill, SB 759, to make sure that ALL of the ingredients in pesticides, including the “inert” ones, are disclosed before they are sprayed.

The bill was authored by California State Senator Mark Leno and sponsored by Pesticide Watch.

What a great way to spend earth day!

It’s a great idea, actually (at least I think), for everyone to go to their state capitol and sit in on some sessions.  You get to see how government works.  Who knows, you might even decide you want to make your own voice heard.

I went there today to make my voice heard on something that’s very important to me - taking the most control we can over our health by asking for the right to know what chemicals are in the pesticides that might be sprayed over our communities.

Here’s what I had to say:

TESTIMONY TO CALIFORNIA SENATE HEALTH COMMITTEE - 4/22/09
Chairwoman Elaine Alquist
ANN HAIDEN D.O.

Good afternoon committee members.  My name is Dr. Ann Haiden.  I am an internist practicing in the Bay Area with a focus on preventive and environmental medicine.  Thank you for allowing me to speak to you today.

I am concerned that we, as citizens and health care providers, be able to know what is in the environmental chemicals we are exposed to. We need and deserve to have this information to be able to prevent harm and to be better able to help people who develop symptoms after exposure.

I would like to highlight 3 main points:

1) First, we know from body burden studies that we all have the chemicals from our everyday environment within us.  We need to know what exactly we are being exposed to because these substances, both active and inert,  affect our health.

The effects of environmental pesticide exposures can manifest as endocrine disruption, inflammation, neurologic and immune problems, detoxification system problems and epigenetic alteration of our DNA.  Fetuses have the highest burden levels, but children, the elderly and those who are already health challenged or with less powerful chemical detoxification systems are also at higher risk.

Evidence increasingly implicates environmental chemical exposures to a wide variety of illnesses and syndromes.  For instance: hypospadias, the male genital feminization birth defect, asthma, autism, cancers, Parkinson’s disease and Alzheimer’s dementia and many of the ill defined chronic immune and nervous system disorders.

We also know that through epigenetics, a person’s actual genetics can be changed in response to various exposures, including environmental.

2)  Secondly, we know that inert ingredients can be every bit as active as the “active” ingredients of a chemical product. The delivery vehicle that the formula is delivered by can have it’s own set of consequences.  And the effects of the individual pieces can add up to be more harmful than they would be all by themselves.

3)  Finally, if we are to do a better job of helping, we have got to have more information to work with.

Exposures of chemicals and pesticides can have acute and prolonged symptom effects for real people in our communities.  Not numbers in a study, but real people.  These folks present to physicians in a bind, looking for help.  As health care providers, we are working with our hands tied when we do not know what exactly has been applied to a community or the procedure for reporting.  We saw this after the LBAM spraying in Monterey and Santa Cruz counties,  most profoundly in an infant with severe respiratory arrest that has resulted in a permanent respiratory condition, but also many other people with other symptoms

I urge you to vote for SB 759 to give us full disclosure of pesticide ingredients, both inert and active, better reporting systems and better health care training so that we can better help our citizens.

Have a great earth day!  By the way, the bill passed the committee!

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Losing Weight Smartly, not Hardly…

Weight loss is not as easy, for some, as eat less and exercise more.

It makes a lot more sense to lose weight the smart way.  Because trying to lose weight the hard way hardly ever really works.

For a lot of people, eating right and exercising is exactly the ticket.  The trick there is just knowing how to eat, and the right kind and amount of exercise.

But for other folks, it’s more complicated.  Chances are good that if you are one of those folks, you may intuitively know that there has got to be something else going on, because you have tried so hard and so many times to lose weight without long lasting results.  That can be disheartening and too many of us end up feeling like we just don’t have enough will power.

By looking at how the system works, our vision opens up about what other things might be going on to have us saying “why can’t I lose weight”?

Take this survey to see if there are other things that may be hijacking your weight loss efforts.

.

• Do you feel gassy after eating

• Do milk and dairy products make you feel very relaxed?

• Do you crave baked goods or sugars?

• Do you exercise but no weight loss results?

• Do you have constipation or diarrhea?

• Do you have skin rashes?

• Do you have mood swings?

• Are you always cold?

• Does your social or emotional life revolve around food?

• Are your friends and family overweight?

• Is it hard for you to exercise because of fatigue or extreme muscle soreness?

• Does more than about 1/4 or your diet consist of grains?

Notice that there is no question here about willpower!!!

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How many positive responses do you have?  The more yes responses, the more likely it is you have other contributing factors that make it hard to lose weight.

2 - likely to have some contributing factor
4 - likely to have a couple contributing factors
>6 -  likely to have several contributing factors

Does this sound like you?  What are your challenges around weight loss? Would you like to get beyond willpower?

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Sugar In, High-Fructose Corn Syrup Out…

Who are we kidding?

Sugar is back in packaged foods and drinks, and HFCS is out, as the NYT reports.  But do we really think switching from high-fructose corn syrup to sugar is going to solve all of our sweet tooth induced problems?

High fructose corn syrup may be the evil product of corn subsidies and high tech food manipulation in all of it’s sugary madness, but thinking a switch from one sugar to another is the answer to our problems is just a silly mind game.

Take a walk into almost any grocery store.  Walk down the middle isles which, in most stores, is most of the store.

There lives the sugar coated cereal, the sugary soft drinks, the sugar laden “vitamin” drinks, the sugar coated pastries, the sugar spiked frozen dinners, salad dressing, etc, etc, etc.  The variety is mind boggling.

It’s hard to find yogurt without sugar for Pete sake.  Yogurt!

In all reality, if we didn’t buy this stuff, the stores wouldn’t stock it.  Supply and demand.

It is time to get a national grip!

I do apologize for the rant, but we are drowning in sugar, regardless of the form it comes in.  Our bodies and their million of years of accumulated know-how are beside themselves trying to figure out what to do with it all the sugar we are dumping into them.

How many of us need to struggle with obesity and overweight?  How many of us need to struggle with diabetes?  How many of us need to struggle with heart disease?  What do we have to suffer with before we get it?  Our kids are dealing with adult onset diabetes and hyperactivity.  What is the future we are giving them?  Especially when it doesn’t have to be that way.

We are like a country of addicts for sugar!

Ah.  Bingo.  Actually, the brain is hard wired to covet sugar.  That makes it easier to fool ourselves into making it o.k. to sweeten almost every food we can.  That has a way of making foods irresistible too.  That’s a boon to repeat sales.

But we get to pay with our health…and our medical bills.  That’s not so sweet.  And there is no health care restructuring plan that can make that better either.

It’s funny though.  Once you break the habit of sugar, the craving goes away.  And, you feel better.  And you discover that other healthier things taste good.  Really good.

Then, when you want to have something once in a while, with real sugar, it’s o.k.  No guilt.  Nada. Zip.  Zilch.

So, give me real sugar, yes, but not so much, and not very often.

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Eating Away The Cholesterol

Guess what?  Guess what?  “My cholesterol was down 90 points and I passed my treadmill!!”

Wait.  Slow down.  What?

Bob, my friend, had burst in the door and stood there with his arms open wide and a little kid grin, just beckoning me to come receive a hug.

He was so darn proud and somehow, I had something to do with it.

So, never one to decline a hug, I collected my hug and got down to the business of finding out why I was so honored.

Well, it turns out that I had been giving Bob some advice about diet over the last year or two and he had gradually started doing it.  He had become frustrated with going to the doctor and getting the recommendation for pills so he had decided to take action.

I had made a simple eating suggestion.  I call it the “plate rule”.  At least one half of the plate should be vegetables and fruits.  Mix up the colors and easy on the starchy ones.  1/4 should be whole grains and legumes, sometimes less depending on the person, and sometimes excluding gluten. And, about 1/4 should be protein like lean chicken and fish, though there are other options for vegetarians. Hold the frying and the fat laden sauces.  Eat whole grains and hold the baked goods for special occasions. He was already getting regular exercise by walking.

He gradually added in the changes more and more consistently, and much to his amazement, it worked!  It really worked.

His LDL cholesterol dropped by 90 points, his good  HDL cholesterol improved, he lost some weight, and he exercised like a champ on that treadmill…

Nothing brings joy to my heart like the look of a ten year olds’ happiness in a middle aged man…

…just walking on cloud nine.  Because he took charge, and it worked.

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Can Gene Testing Help Diabetes & Heart Disease?

Are diabetes, heart disease and cancer risk determined by our genes?

The other night I went to a little presentation by Navigenics, where the topic of the evening centered around predictive genomics testing, genetic predisposition and the idea of personalized medicine.

To my mind, the subject is not so easy to discuss because how genes behave is heavily influenced by the environment you put them in, from what we eat to what we live in.  Personally, I’m happy about that, because self direction is empowering.

But, nevertheless, we talked about how the evolution of genomics is upon us.  Coming to a doctors office near you.  Knowledge never more to be an unattainable mystery…

And, perhaps useful in actually helping people achieve better health.

We’ve been seeing predictive genomics testing companies, like 23andMe, cropping up all over the place.  What is different about the Navigenics plan?

As opposed to companies that offer large numbers of SNP’s , as these  little “snippets” of genetic information are called, Navigenics offers a core group of SNP’s that correlate best with chronic diseases like diabetes and heart disease, as well as some cancers.  The idea being that it is most useful to test for things that you can then institute preventive intervention for.  And, to do that through your doctor, who is in a position to help, whether it be through behavioral change, a medication regimen or screening tests.  In the case of functional and integrative medicine, the preventive strategy is even broader and more holistic.

Ahhhh.  But shouldn’t we all be doing all that preventive stuff anyway?

Yes.  We should.  With should being the key word here.

But a funny thing happens when people are actually presented with their genetic proclivities.  Like a very seductive behavioral carrot stick…it actually gets people to behave better.  To take action.

OK.  Well, how much out of pocket health care money is it worth?  Because, it’s not covered by health insurance.  Who will benefit the most and who will be interested?

Good questions.

Stay tuned.

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Sensible Progressive Medicine

Have you ever been frustrated by health problems that don’t ever seem to have an answer or recommendations to take more and more medications?

As a physician, I heard your frustration. And, I was just as frustrated as you! But, I have come a long way. I am now happy to say that for many problems, there IS a better way: a new way of thinking about health care and the practice of medicine. I call it sensible progressive medicine. It is prevention based and is not about “curing” disease, but rather, it is about optimizing how the body functions so that it can best take care of itself.

In my fourteen years of internal medicine and spine care experience, I have discovered that conventional medicine is great at many things, particularly acute care and symptom control, but it is often not always good at getting to the root of problems – or prevention.

Scientific studies are showing increasingly that there are a handful of things that are at the root of a diverse number of health problems. First, we all have a particular genetic makeup that can predispose us to different types of problems. We call that genomic predisposition. Layered on top of that is the environment that we live in. That includes everything from the air we breathe and the chemicals we are exposed to, to the food we eat; the stress we are exposed to and medicines we take. Sometimes we are overweight, have chronic allergic situations, chronic low grade infections or chronic nutritional problems. When all of these factors combine in an unhealthy way, several things can happen. Inflammation, oxidation (the “exhaust” of burning oxygen) and overload of the natural enzyme and detoxification systems can produce the “symptoms” that make us uncomfortable and have us running to the doctor.

I have become dedicated to looking at health from this new perspective. Using the best of conventional thinking in combination with the most sensible of progressive new thinking. The wonderful thing about this is that much of it can be accomplished by taking steps to achieve wellness, rather than focusing only on treating symptoms.

My mission is to provide both information and medical care, so you will find both on this web site.

Imagine medical care based on restoring health and preventing future problems. Imagine infinite horizons and sustainable wellness.

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