April Showers Bring May _____________ (Ans: Flowers!)

What a difference a few weeks have made!  Spring (and pollen) are in the air! You can feel it on your skin (and in your sinuses)!  Walkers and joggers have returned to the Boardwalks (hurrah!) and the annual Northward migration of my Florida Snowbirds is well underway. The ocean temperature is rising and the surf beckons!  Here are some medical news items to help you stay healthy this Spring and every season of the year!

John A. Schmidt, Jr., MD

No Correlation Between Fat Intake and Cardiac Risk!

As shockingly reported in the March 18 issue of the Annals of Internal Medicine, studies conducted on more than half a million persons have failed to show that dietary fat poses a significant heart risk.  The study examined fats of all kinds including saturated and unsaturated fat, transfat, and popular supplements. This report flies in the face of longstanding recommendations by health authorities to reduce intake of fatty foods.  

I applaud this timely study because it shines a bright light on the real culprits - sugar and cholesterol rich foods. Please consider the following: 1) there is no consistent correlation between plasma triglycerides (fat) and cardiovascular disease; 2) expensive and aggressively advertised drugs that lower plasma fat (e.g., Lovaza�), have failed to show any reduction in cardiovascular disease; 3) fat is an essential fuel for skeletal and cardiac muscle; and 4) fat cannot be converted by blood into sugar.  On the other hand, as covered in a recent issue of this newsletter, those who derive a disproportionate percentage of their caloric intake from simple sugars have reduced life expectancy.  Some blame the advice to avoid fat as responsible for the steep rise in diabetes. They may well be right.

Do Not Confuse Fat with Cholesterol!

Cholesterol is not a fat or a fuel.  Whereas one can reduce body fat with regular, sustained, and vigorous exercise, the body has limited ability to eliminate cholesterol.  Exercise has a dramatic effect on blood fat levels but a small effect on cholesterol levels. Diet, on the other hand, has a major effect on plasma cholesterol.  Individuals, who, for genetic reasons, are unable to remove cholesterol from blood, die in their twenties and thirties of atherosclerosis. Statins such as atorvastatin reduce cholesterol levels (with minimal effects on fat levels) and unequivocally reduce the incidence of heart attack, stroke, and death due to cardiovascular causes. 

Thus cholesterol content, not fat content, is the most important element of the food label.  Unfortunately, food manufacturers have lumped cholesterol and fat together.  For example: "zero percent" Greek yogurt means zero cholesterol and zero fat.  What we need is low cholesterol, protein rich products. Nuts, which have a cardiovascular benefit, are in this category.  So is tuna fish.  The Mediterranean diet, which emphasizes nuts and fish, has been proven to reduce the incidence of death due to cardiovascular causes.

Caution!

My comments should not be taken as license to overdose on calorie rich fatty foods (for example, "fast" foods).  Calorie rich diets, including those with large amounts of fat, lead to obesity and increased abdominal girth, both of which are linked to increased cardiovascular risk.  As discussed in another newsletter, the notion of "healthy obese" is a myth.  We all need to maintain normal weight and girth and remain aerobically fit.

Changes in Diabetes-Related Complications 1990-2010

This is a good news-bad news story.  Good news: As reported in the April 17 issue of the New England Journal of Medicine, the incidence of diabetes related complications (heart attack, stroke, amputation, and end stage renal disease) has decreased dramatically over the past two decades.  Bad news: Even so, patients with diabetes still have ten times the risk of developing these complications as compared to those without diabetes.  Message: Type II diabetes is to be avoided at all cost.  How? 1) Reduce calorie rich, especially sugar-rich, high glycemic index foods (for example, cookies and candy); 2) Exercise aerobically at 80% of your age-adjusted maximum heart rate; and 3) Maintain normal weight and girth.

Cure for Hepatitis C

"Cure" is an unfamiliar word for an internist.  Most of the time, medicines help but do not cure.  However, as reported in the April 17 issue of the New England Journal of Medicine, there is now a genuine cure for Hepatitis C.  The side effects are tolerable and the treatment duration is short. The costs are high so we need to discuss treatment options with your insurance plan.  Let's work together to cure Hepatitis C! 

Now Hear This! New Patient Portal (Follow My Health) has been launched!                                                            

We're excited to offer a new online tool that provides anywhere, anytime access to your personal health records! With our new patient portal, you can manage your health, communicate with your providers and make more informed decisions about your care - 24/7 from any computer, smartphone or tablet. Benefits of the Patient Portal include:

• Saving Time: No more waiting on hold to speak to staff or schedule appointments.
• Convenience: Anywhere anytime access lets you communicate on your time.
• Privacy: Secure messaging ensures privacy between you and me.
• Goals: Use the portal to track your health conditions, wellness goals and chart progress.
• Patient Controlled: YOU own your portal, all of the data within it and control who sees what.

After many weeks of preparation, Valerie and I are now sending email invitations to our patients to establish their Patient Portal accounts. If you have not already received an invitation, please email Valerie at [email protected] and she will make sure you receive an invitation in your inbox.  

The new patient portal is powered by Follow My Health and will give you direct and secure access to your Personal Health Information.  You will also be able to collect and share it with multiple participating physicians. Call Valerie at (732) 282-8166 and sign up today!

Next issue: Stroke Victims: Time is of the essence! 

Valerie and I wish you an abundant Spring on the Boards and Beaches of greater Belmar!