Clinical Nutrition Center
 
HealthStyles e-Newsletter
Ethan Lazarus, M.D.               Heather Thomas, P.A. -C
7555 E. Hampden Ave, Ste 301
phone:  303-750-9454
fax:  303-750-1996
Denver, CO  80231
HealthStyles
March, 2009
 
Greetings HealthStyles subscribers.  All of us at Clinical Nutrition Center want to wish you a happy and healthy Spring!  We hope that 2009 is getting off to a great start.  We are proud to bring you the following news, tips and updates to help get your spring started.
 
Obesity:  A Disease with Systemic Consequences
National Jewish Hospital is hosting a free educational event for Obese Patients and Their Families.  To register, visit their web site at www.njhealth.org/ObesityCME
 
Date:  Saturday, April 4th
Time:  1:30 pm - 4:00 pm
Place:  National Jewish Hospital
 
Wanting a healthier lifestyle for you and your entire family? Need help in controlling your diabetes?

Please join us for an afternoon of free education on the family approach to weight management by top National Jewish Health healthcare professionals!

Agenda

Time
Topic
Speaker
1:30-2:00pm Registration  
2:00-2:30pm Management of Metabolic Syndrome and Diabetes Daniel Bessesen, MD
2:30-3:00pm Nutrition and Weight Loss Lacy Smith, RD
3:00-3:30pm Psychological Aspects of Obesity: The Pediatric Perspective Natalie Walders Abramson, PhD
3:30-4:00pm Panel Discussion All Faculty

 

New Technology at CNC
Have you noticed the new systems at CNC?  For 2009, we are working hard to get all of our technology cutting-edge.  Here are just a few of the upgrades to watch for:
1)  Computer system upgrades.  Investigating options for becoming a paperless office.
2)  Phone system upgrades
3)  MedGem Analyzes Software:  The MedGem analyzes your breathing to determine your resting metabolism.  This information can aid your dietitian in figuring out how many calories you need from food, and how many additional calories should be burned with exercise.  Have you had your resting metabolic rate checked in the last 6 months?  Our MedGem can now interface with the new computer system to provide a detailed report of your unique metabolism.  Call us at 303-750-9454 if you'd like to set up an appointment with your Registered Dietitian for this important test!
4)  Digital Electrocardiogram:  Our state-of-the-art EKG machine interfaces directly to the new computer system, providing us with a fully-digital transfer and interpretation.  These tests are now stored on a server and repeat tests can be overlaid and compared with the help of computer-based analyzer software. 
When was the last time you had an electrocardiogram performed?  We perform this important test on every new patient at CNC because it gives us important information regarding your heart.  If it has been over 5 years since you had an EKG, if there have been changes to your health status (new medical diagnoses like Diabetes, Hypertension, High Cholesterol, etc), or if you have lost over 50 pounds since having your last EKG, we strongly recommend having this test repeated.
Although having an EKG performed at most physician's offices commonly costs well over $100, we are currently performing an EKG including my interpretation for only $25.  Remember, this test take only minutes to perform and is completely non-invasive.  Please talk to the front office staff if you'd like to schedule a follow-up exam.
We are hopeful that this latest series of upgrades will set the stage and help us serve our patients' needs better for the foreseeable future.
Ethan Lazarus, MD
A Picture is Worth 1000 words!

A new study shows that taking photos of what you eat with your cell phone (or digital camera) can help you lose weight!

A group of 43 men and women - who perceived themselves to be healthy eaters - contracted with researchers at the University of Wisconsin-Madison to take a before photo of everything they ate and drank for a week (in addition to writing it down). At the end of the week, the photographers discovered that not only were their portions too large, but their meals lacked recommended servings of vegetables and fruit and snacks were calorie-dense.

It seems that the act of taking a photo made everyone much more aware of the reality of their portions and food choices. Using a camera also made it possible to review several days worth of meals and snack. This really helped those who tended to overdo on weekends. Consensus of both the researchers and the participants was that a photo food journal could be a quick, easy and more effective way of keeping a food journal.

"The act of taking a photo made them so much more aware of what they were eating," says lead researcher Lydia Zepeda, PhD, a professor of consumer science at the university. "They weren't trying to lose weight, but many said they didn't want an unhealthy snack or a second helping at a meal if they had to take a picture of it."

As reported by Sari Harrar, a health writer, in "0" magazine, April '09.
Mickey Berry
 
Tainted Over The Counter Diet Drugs
The US FDA is warning consumers not to use nearly 70 over-the-counter diet products that may contain dangerous undeclared drugs.
The products were sold on Web sites and at retail stores, often marketed as "natural" or "herbal."  The FDA said that analyses of the drugs revealed that they contain undeclared active pharmaceutical ingredients, such as a prescription weight-loss drug (sibutramine), an antiseizure drug (phenytoin), a diuretic (bumetanide), and a laxative that is a suspected carcinogen (phenolphthalein).  Some of these compounds were present in doses that far exceed those recommended by the agency for approved uses.
The agency also found products containing rimonabant, a diet drug that is sold in Europe but for which the FDA has denied approval for sale in the US.  This drug is associated with an increased risk of depression and suicide.  Over the past 2 years, European authorities have received reports of more than 700 adverse reactions among patients taking this drug, including 5 deaths, according to the FDA.
Patients unwittingly taking products containing these compounds may face serious health consequences, according to the agency, which advises patients who have taken these drugs to see a physician.  A complete list of the products and their respective undeclared ingredients is available on the FDA's Web site (http://www.fda.gov/cder/consumerinfo/weight_loss_products.htm)
JAMA, February 25, 2009 - Vol 301, No. 8, page 817
 
Phentermine:  Still a Safe Prescription Medication For Over 50 Years
 
Don't you find it interesting that even in the face of the obesity epidemic this country faces, there have been no new medications approved for obesity management in 12 years?  And, to this date, there are only 5 options that physicians commonly use.  I am excited that the coming years will bring new and innovative pharmaceutical approaches.  However, for now, Phentermine and Tenuate remain preferred treatment options.
In the Winter edition of The Bariatrician, Dr. Michael Anchors, MD, writes that there is much skepticism in the medical community towards current weight loss medications, despite the fact that they are proven, time-tested, and effective.  I agree with these statements.  At Clinical Nutrition Center, we have been using Phentermine and Tenuate for over 35 years, and have not encountered any serious adverse events, nor had trouble with addiction. 
In 1992, Michael Weintraub discovered that when fenfluramine was added to phentermine, the appetite-control action was enhanced.  The Mayo clinic in 1997 reported that this so-called "Phen-fen" combination was responsible for 24 cases of heart valve disease.  None of these cases were in patients on Phentermine alone.  In fact, to date, there have been no reported instances of heart valve damage with Phentermine when used alone (Rader A, Steelman GM, Westman E.  Clinical experience using appetite suppressants and SSRIs.  J Okla State Medical Assoc 2008; 101(8))
It is interesting to note that there is a new long-term clinical trial being performed by a company in California called Vivus.  The new investigational drug, Qnexa, is a combination pill including Phentermine and Topomax, a drug commonly used to treat seizures, and for migraine headache prevention.  Perhaps, if approved, these studies will further help alleviate suspicion regarding long-term Phentermine use.
In summary, if you are struggling with keeping weight off, don't forget that we have several safe, effective choices.  Schedule an appointment with Dr. Lazarus or Heather at the office if you'd like to discuss your treatment options.
Ethan Lazarus, MD
 


The Worst 'Healthy' Foods

If you want to lose weight, it may seem like a good idea to trade candy bars for granola bars or to swap bacon and eggs at breakfast for the classic bagel (it’s shaped like a zero; how bad could it be?).

Sadly, it’s just not that simple. Customers’ nutrition knowledge is rising, so food marketers are desperate to attract the right kind of attention from the eating public. So they’re twisting nutritional buzzwords to trick us into eating the kinds of foods that can actually help make us fat. We need to be more careful than ever to make sure we’re feeding ourselves and our families the very best real health foods — not sugar-infused calorie bombs disguised as weight-loss foods.

Read up for our latest batch of dietary phonies. They may look good on the front label, but they’ll get you in the end if you're not careful.
 
Granola Bar                                                  Eat this instead!
200 calories                                                     1 oz cheddar cheese with Triscuits
15 g sugars                                                      150 calories, 5 g sugars
 
Ever wonder what keeps a granola bar together? The answer: high-fructose corn syrup, which quickly raises blood sugar and cancels out most of the potential benefits the granola almonds and oats might give you. Switch over to good old-fashioned cheese and crackers and you trade sugar and calories for protein and
fiber. It's a big deal that will make you smaller as will steering clear of the sugar bombs. By the way, these are the most sugar-packed foods in America.

Yogurt with Fruit, sweetened                      Eat this instead!
190 calories                          1 cup fat-free Plain yogurt with ½ cup fresh berries
30 g sugars                                                      110 calories, 15 g sugar
 
Pass on these over-sweetened yogurt cups; they contain as much sugar as a soft drink. Almost all of that comes directly from the “fruit,” which is swimming in high-fructose corn syrup. Yogurt and fruit can be a great way to start your day, but do it yourself by mixing a cup of nonfat plain yogurt with a half cup of mixed berries.

Bagel with Cream Cheese                            Eat this instead!
700 calories                          Cheese omelet (3 whole eggs, 2 oz low-fat cheese)
40 g fat                                                            425 calories
13 g saturated                                                 18 g, 6 g saturated
 
Bagels are bogus. The bread is bad enough, containing 300 calories and 60 grams of carbohydrates, but tack on the liberal cream cheese schmear (by our survey of popular breakfast chains, up to 4 ounces for a single bagel!) and your "harmless" breakfast sandwich weighs in as worse than a Whopper. The omelet swap will save you nearly 300 calories, plus provide a surge of metabolism-boosting protein. And a recent study from the University of Connecticut found that eating eggs can help raise
HDL (good) cholesterol.

Dried Fruit                                                     Eat this instead!
175 calories                                             Fresh fruit, like a small apple or peach
45 g sugars                                                      70 calories, 15 g sugars
 
OK, so dried fruit won’t totally derail a day of good eating (unless you down the whole bag of banana chips), but it’s far from being a harmless snack. First, because the dehydrating process sucks most of the volume from the fruit, you can eat cups of the stuff and 600 calories later, still not feel any fuller. More troubling, though, is the fact that Sun-Maid and Ocean Spray add sugar to the fruit, making Craisins closer to candy than Mother Nature’s original intention. The choice is clear: Stick to the original, straight from the tree.
 
Fried Fish Sandwich                                     Eat this instead!
600 calories                                                  3 oz Grilled chicken on a plain bun
30 g fat                                                            300 calories
11 g saturated                                                 13 g fat, 4 g saturated
 
Fish is good for you, except when it’s battered, fried, robed in cheese and bathed in tartar sauce. The lesson? Even the biggest star can be sabotaged by the supporting cast. To this end, avoid any menu item with the word "crispy," the restaurant industry’s favorite euphemism for “fried.” Make sure your next fish or chicken sandwich is grilled, dressed with fresh produce, and topped with a low-cal barbecue sauce, or even ketchup and mustard.

Stick margarine (1 Tbsp)                              Eat this instead!
100 calories                                                     Whipped butter (1 Tbsp)
11 g fat                                                            50 calories
2.5 g saturated                                                 6 g fat
2.5 g trans fat                                                  1.5 g saturated
 

In their haste to remove saturated fat from butter, margarine makers created the margarine monster — a dangerous lipid called trans fat, with more dangerous links to heart disease than saturated fat. Pick up whipped butter instead; by whipping air into the spread, manufacturers decrease the caloric density of a tablespoon of butter and they make it easier to top your toast. If you buy margarine, make sure it’s the type found in the tub, hopefully with an added bonus like omega-3s folded into the mix.

 

*Adapted from David Zinczenko, with Matt Goulding - http://health.yahoo.com/experts/eatthis/15442/the-worst-healthy-foods/

 
 
Thank you!

 

Sincerely,

 

Dr. Lazarus, and the Staff at CNC

 

 
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Ethan Lazarus, M.D.     Heather Thomas, P.A. -C
 
Clinical Nutrition Center
7555 E. Hampden Ave Ste 301,
Denver, CO  80231, Tel: (303) 750-9454

http://www.clinicalnutritioncenter.com