Monday, January 12, 2015

Here is my first post...from August, 2013:

     I've been asking a lot of questions lately...questions of myself, of my profession, of the health care industry. I guess this is par for the course. As an eye doctor, it's my job to ask a lot of questions. In fact, the better I am at this, the easier it is to do my job. It's said that careful history-taking ( i.e., questioning) can determine the diagnosis most of the time. This 1975 study reported a correct diagnosis made by case history alone in 80% of the cases (physical examination wasn't needed!):

     So, each workday, I ask a lot of questions. Whether it be to determine which prescription is the right one for my patient ("which lens is better, 1 or 2?") or to help in the assessment of a patient's health ("do you have hypertension?" or "do you smoke?" or "do you have any family history of glaucoma?"), I try to ask the right questions and listen effectively to what my patient tells me. If I see diabetes or hypertension in the eyes, I generally have a game plan. If I see macular degeneration or glaucoma, I know what I am supposed to do. But, what do I do when I see cholesterol in the eye?

     From the front of the eye (corneal arcus)...

     ...and surrounding tissue (xanthelasma)... the back of the eye in the retina (emboli; Hollenhorst plaque),

it seems I am seeing, more and more each new year, evidence of cholesterol in the eyes of my patients. Indeed, even if there truly is more cholesterol seen nowadays in peoples' eyes (i.e., five years ago an eye doctor would see only 1 patient a day with cholesterol in their eyes, now they would see 3-5 patients a day with cholesterol in their eyes), what would that mean? What would it matter? Sure, if an embolism is present in a retinal artery, this can have a disastrous effect on ocular health and vision. But, if cholesterol is building up in the cornea ( arcus), does it mean anything? Does it matter?

Lastly, one more group of related questions- and this is probably where I'm trying to go- do I believe in the cholesterol-heart disease hypothesis or the lipid hypothesis? Do I follow along with the health, food and political industries (among others, these last few decades) that say we all need to eat low-fat, high-carb diets to keep heart-healthy? Do I really agree with these same industries that say we are fat or obese because we are lazy (don't exercise enough) and we have no self-control (eat too much)? Is "a calorie a calorie" and is saturated fat to blame for everything un-"healthy"?

Well, I think there are many more questions to ask ( and much deeper ones as well) but let's start there. Maybe we in the health care field are too busy to talk about eating REAL FOOD while cutting down on or eliminating processed foods and sugars......too busy to discuss the possibility that maybe what we feed our bodies-what we eat- does have a tremendous affect on our health. Let's continue the discussion and continue asking questions...

CAUTION = POST UNDER CONSTRUCTION (more questions to ask)!!!

Thursday, December 11, 2014

From an article "Cardiology's Top 10 Stories of 2014" Medscape. 

John M. Mandrola, M.D. Clinical Electrophysiologist


#10. The Blind Spot of Cardiology

Four in five heart attacks are preventable. These were the beautiful findings of Swedish researchers who studied the effects of five modifiable health measures in 20,721 men from 1997 to 2009.[35] No, lipoprotein(a) levels were not among them. Instead, this group measured the benefits of eating a healthy diet, drinking two (or fewer) alcoholic drinks daily, exercising regularly, having a small belt size, and not smoking. Each factor incrementally lowered the risk for first myocardial infarction, and those men who achieved all five measures were 79% less likely to have a heart attack than those who accomplished none.
Women, too, can prevent heart disease. American researchers performed a similar analysis of data from the Women's Health Initiative.[36] In this study, basic health parameters predicted heart failure
. Over the 11-year follow-up, including 1826 incident cases of heart failure, women who ate well, exercised regularly, maintained a healthy body mass index, and did not smoke enjoyed a 77% lower risk of having heart failure.
Perhaps the strongest support that simple lifestyle factors are potent elixirs for health came from data on AF ablation results. In the ARREST-AF trial, [37] a team of scientists from Australia showed that patients enrolled in an aggressive risk-factor modification clinic increased their chance of ablation success fivefold.
These studies, which yield utterly expected findings, should alarm this generation of caregivers. While we perseverate over statin drugs, or ezetimibe with statin drugs, or cholesterol-efflux capacity, we are witnessing the first group of adults who can expect to live shorter and sicker lives than their parents. This, on our watch. Doctors can't change society alone, but we are health professionals, right? We can start by assessing the right health measures. The word that comes to mind is leadership.
That's it for 2014. Please feel free to agree or disagree with my choices in the comments section.

Tuesday, August 19, 2014

Athletes in the news:

Tim Howard Goalie Soccer: paleo

NBA Stars: LeBron James, Kobe Bryant, Steve Nash...Low Carb High Fat / Paleo

Ketogenic couple rows across Pacific. Sami Inkinen (Co-founder Trulia) and Meredith Long
#antisugar #highfat #sugarfree #ketogenic #LCHF #paleo

78 year old Ironman Triathlete High Fat Low Carb Paleo-Ketogenic Diet  Dr. Jay Lehr

Tuesday, August 5, 2014

Nutritional Lipdology

Dr. William Davis, Cardiologist, Author of Wheat Belly

#EatRealFood #LowCarb #WheatBelly #cholesterol #RealFoodOptometrist #LowCarbHighFat #LCHF #AncestralDiet #PrimalDiet #PaleoDiet #Paleo #AncestralHealth #Primal #GlutenFree

Monday, May 12, 2014

Friday, May 9, 2014

Dr. Oz was wrong about saturated fat.

Dr. Peter Attia was 40 lbs overweight and insulin-resistant, following a low-fat diet and exercising more...