Monthly Archives: April 2012

Dough is the Devil

We love things made of wheat…bread,rice,pasta, cakes, cookies and of course, PIZZA!!!  This is what our bodies love or at least like an awful lot.  However, what our body’s need is boring…protein and vegetables.  There in lies the battle.  What we want versus what we need.  The interesting thing about wheat, according to Dr. Davis in is current book, Wheat Belly, it that wheat has been genetically altered starting in the 1950’s.  Before this time, wheat came in only about 25 varieties and was not too unlike the wheat of Moses and the bible.  When Jesus said to ask our Father to “Give us this day our daily bread” he was talking about this ancient type wheat that even appears in our patriotic American songs with the phrase, “Amber waves of grain”. 

         The worry about food shortages and population explosion changed all that.  To improve the yield of an acre of wheat ten fold took enormous genetic changes to the wheat, creating something called “dwarf wheat”.  To get dwarf wheat took the varieties of wheat from the original 25 varieties to 25,000 varieties.  While we now get ten times the amount of wheat per acre, no body took the time to see what this new, franken-wheat did to humans. It turns out that this new wheat actually increases our appetites to the point that giving free bread in a restaurant before a meal raises our appetites so we order more wheat.  This is through a protein called glyiden that has a morphine like effect on our brains so we eat more food.  We are essentially addicted to wheat containing products.  This causes us to over eat and gain excess weight.  Hence the term, Wheat-Belly very analogous to the good old Beer Belly of old (since beer hops are made of wheat).

         So dough is a nutritional devil.  Now if a guy exercises a lot ( over two hours a day of cardio exercise like running, cycling, swimming) then nutritionally you can  earn dough.   In fact, to prevent bonking while distance road cycling you actually must eat dough type products to keep riding for hours.  But if  we guys don’t exercise that much, it is best to stick to mostly proteins and vegetables.  Fruit really spikes the blood sugar, similar to wheat so it should also be avoided on most days.  There is an inverse relationship between vegetables and weight. The more vegetable you eat the less you weight. Conversely, the more wheat you eat, the more you weight.  Simple in concept, hard to follow.  Tim Ferriss recommend in his great book, The Four Hour Body, to be good six days a week, then one day a week have a “DGW”…diet gone wild!  This will allow you to not feel deprived, stay true to the nutrition program the other six days, and tell your body you are not starving so keep loosing weight.  On this cheat day (the DGW) I truly believe that Hostess does not make a bad product ( especially their cupcakes).  If you only cheat on one day a week, it really doesn’t seem to wreck a weight loss program. Provided you are good the other six days a week. 

        So if you want to get to your ideal weight my mantra to my patients is to “Say NO to Dough”! but cheat once a week to stay sane.  This is a great way to get lean.   (And beware of waitress baring gifts…like bread!)


Colon Cancer Kills, here’s how to beat it

With guys especially, there are certain sensitive areas of the body.  Unfortunately, the large intestine known as the colon is an area that causes  many  cancers.  Cancer is a very scary word.  According to Dr. Agus in his new book, End of Illness, someone does not so much “have cancer” as the person’s body is “cancering”.   The normal tissues of the body go rogue and start growing in a dangerous way.  Since this takes some time, the sooner any cancer is picked up, the greater the chance to cure it.  One step better is to get rid of abnormal tissue before it changes into cancer.  Colon polyps almost always change to colon cancer. By taking out polyps in the colon you prevent (not just cure) cancer.  Colon cancer is especially common after the age of 50 years old.   Also, any bleeding from that area can also be a sign of early cancer.  To get your colon checked requires looking up the colon with a camera scope appley  called a colonoscopy.  They put you to sleep to check the colon and also will take out any polyps that they find. Early screening is best. Below are the top ten reasons to get screened:

10.   You enjoy getting your picture taken!-why not see if this Really Is Your Good End?

9. You heard about the prep-a perfect time to contemplate that bathroom renovation!

8.  Your over 50. or you have a family history. It’s Time!

7.  Colon  cancer  is  the second deadliest cancer, so you’re taking a stand to fight it.

6.  You got over juvenile phobias by the age of 12-Your’re ready to start acting like a grown up.

5.  Doctors recommend this method way more than “Just waiting to see what happens”.

4.  You’ve had symptoms and decided that embarrassment is not an excuse.

3.   You’d actually like to be around to see your grandkids.

2.   If something is found during your screening, it can be removed during the procedure.

and the number 1 reason to get screened is…’s your best chance to stop colon cancer before it stops you.

No butts about it.  Colonoscopy saves lives.

Motion is Medicine, especially for men

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease”.
~Thomas Edison

There is something magical about motion (walking,running, cycling, swimming,etc) .  We adults like to think we know more than kids.  We have our important things to do and even spend many hours essentially motionless in our work and daily activities.  Children, if left to themselves, move for the sake of moving. There is much to be learned from the young.

Currently the bane of modern health is a term called, “Cardiometabolic Syndrome”. In brief, it is the epidemic of obesity, diabetes, heart disease and strokes. Over half of all adults will die of heart disease. In spite of all our diet foods, artificial sweeteners and spending billions on healthcare, the increasing rate of cardiometabolic syndrome is dramatic.

Part of the cure for all this is motion.  We try to complicate it by calling it exercise, aerobics, plates, crossfit, etc.  But to our bodies, motion is truly medicine. The newest research brings us back to what every grade school child knows instinctively, recess is wonderful!

Let’s start with arthritis: As many of us over 50 years old know, “Arthur-itis” likes to visit first thing in the morning. The pain keeps us up at night and makes it hard to get going in the morning.  The problem is in the cushioning of our joints called cartilage. It is usually a white, firm, smooth substance that is also what makes up the structure of the tops of our ears.  Cartilage is white because it does not get it’s nutrition from blood but from something called, imbibement.  The best way to explain it is to think of a two inch sponge sitting in one inch of water.  If the sponge does not get squished or massaged, the top of the sponge will dry out and become brittle and flake off. This is what happens to our cartilage when we don”t use it. I have patients say, “I don’t understand why I have osteoarthritis, I just sit on the couch”. I have to tactfully inform them that the reason they have osteoarthritis is BECAUSE they sit on the couch.

You see, our joints are self-lubricating. That is to say, motion is lotion to our joints. Gentle, continuous motion will keep the cartilage (think sponge) moist, supple and smooth.  While hitting the sponge with a sledge hammer will get the fluid/water to move into the sponge, it beats up and destroys the sponge. This is what jogging to lose weight does. As we age and become above our ideal weight, it is not good for our cartilage to run/jog to get into shape. In fact, I turn it around for my patients and say,” you need to be in shape to run when you’re older”.  It is not fair to our cartilage to pound on it like the sledge hammer.  While it is America, and we can do anything we want… just because you can take the pain, does not mean it is good for you. While running/jogging can be good for your heart/engine, it beats up the wheels if we are over our ideal weight.

But I thought you said motion is good? It is, but “pain is a blessing” in terms of damage to our knees, hips and other joints. If you ignore pain, it is like ignoring the red light on our car’s dash board. Oh, you could but a piece of tape over the red light, but the car will suffer. Just like you could take a pill to mask the pain in your knees and run the marathon, ultimately your knees will suffer.  So, what kind of motion is good for my heart and my joints?  In my opinion, some form of cycling seems to be best. Having run six marathons (with 3 hours 5 min PR), I had to undergo arthroscopic surgery in both knees and cannot run even a mile now. But, I can ride over a hundred miles on my bike. For most of us, we can only run until we are into our forties, but frankly, we can ride until we are 100 years old.

Cycling, both indoor and/or outdoors is wonderful for cartilage. In my exam rooms, where I see many patients everyday complaining of severe, constant pain to their joints—especially their knees and hips—I have several river rocks on the counters. You know what “river rocks” are; they are the rocks people love to place in their gardens because they are smooth and round and pretty. But how did they get like that? Did someone take a grinder to each one (read, arthroscopic surgery)? No. They gently tumbled down the river, becoming amazingly smooth just by spinning in the water. In essence, a well fitted bike will do the same thing to your knees and hips. By spinning on a bike, gently smoothing and massaging your cartilage, it gives nutrition to the cartilage and mechanically smooths the surface eliminating most, if not all, the popping and snapping most people have in their knees. In short, cycling IS surgery.

So, for your cartilage sake, for your hearts sake and even for your mind’s sake, gentle motion is just want the doctor(this doctor) orders!


Why Men Die Younger than women

Except for birds, it has said that all male species die sooner than women.  It was noted as far back as 1750 that woman lived longer than men. Why is this? There are many theories. A trend in nature seems to be that larger animals, in general, do not live as long as smaller animals. In my medical practice we note that there are some old guys and some large guys but there seems to be few old-large guys.  If men want to live  long, fun lives the mantra to follow is “lean-fit-flexible”.  Put in a more practical term I tell them to be more like “Lance than Arnold”.ie  more endurance type activity versus only performing heavy resistance training. In a perfect world men do both cardio and resistence training. Cardio for the heart and head, the resistence exercise for bones and muscles.  There is something almost magical about an hour of cardio-type exercise everyday.  The NFL has a program for kids that is called “Play 60”, meaning every child should attempt to get 60 minutes of exercise a day.  I think this applies to adults as well, especially guys.

Besides body size, men die younger than women of just about all diseases. The latest data from the Center for Disease and Control (commonly known as the CDC) has women living at least five years longer than men in the United States.  Just about everyone has an opinion for this phenomenon .  Men seem to take more risks, especially when they are younger. When you search on youtube to see why men die before women there are some pretty funny video clips offered :

My contention for another reason why men die sooner than woman has to do with access to appropriate medical care.  Prevention is better than treatment.  I think a first step is for guys, especially after the age of forty years  to see a doctor or other health care professional yearly.  The “big three” that kills men is heart disease, cancers and stroke.  These are preventable.  Unfortunately most guys are reluctant to see a doc.  I think this contributes to their early death rate compared with women.  Using business terms, what get measured gets managed.  Guys love data so getting checked will let them know their own personal medical “scoreboard”.  Once they know the right numbers (blood pressure, weight, cholesterol, psa etc) to check they have a better chance to be successful.  In this case, knowledge can be power in the health battle.

Men are symptom minimizers

Men are tough.  They pride themselves in doing their job well and don’t complain. We doctors call them ” symptom minimizers”, meaning that they attempt to lessen any pain they have.  At an early age they are encouraged to be tough and then are usually given the best sports medicine advice in the history of sports medicine advice.  When they are injured playing sports, all of their buddies and coaches say, almost in unison these three exact words, ” Walk It Off”.  Yeah, get up, brush yourself off the limp/walk on the injury until it feels better. For minor ankle and knee sprains this sometimes works, but for heart,head and more serious illnesses this universal advice fails miserably.

When guys are young and feel bulletproof they can get away with minimal health care. In most high schools, if a guy plays sports they are required to have an annual preparticipation sports physical exam. This sports “physical” is really just a  “screening” examination for various diseases that could but them at risk if they play sports.   It really is not a preventive medical examination.  Decades ago the pre-sports test was very superficial.   Of note, the latest preparticipation physical exams are getting more in dept and this year we will perform 12 lead ECG’s on all high school athletes that agree to have this performed.  For many men, this is their last physical exam until they get a serious problem later in life.

Given all the different pains that a guy could suffer when should he actually see a doctor?  Especially as a guy nears the age of 40 years old, certain pains need to see doctor. Chest pain is a very important symptom to get checked out.   Especially if a guy has a family history of heart disease, any chest pain should be taken seriously.   Chest pains can be a sign that the heart is not getting enough blood flow due to a blockage to the blood vessels to the heart.  It should be noted that the pains in the chest associated with heart disease is difficult for the patient to describe. In fact,  a common first response to heart disease chest pain is denial of the pain by the patient. We quip that “de-nial” is not just a “river in Egypt”. (yes, doctors are horrible with puns).   Chest pain is not to be taken lightly and is not the time to try tough it out.  Unfortunately, it seems the the toughest of men are the ones who get early heart disease.

Men Die Young, Women Don’t Care: Introduction

Hello and welcome to  the Men Die Young Blog.  As a family and sports medicine doctor in southern california I take care of many types of patients.  While I like to treat illness I think it is far better to prevent disease and death if possible.  One segment of the population that I feel is woefully under treated and at risk for disease are men.   As almost everyone knows, men don’t live as long as women.   In my practice I see many middle-aged men (I use 40 years + as my start of middle age…harsh but true) that show up with advanced disease and when I ask when their last physical exam was, many times it was way back in high school over 20 years ago.

Women do a better job of going to the doctors and getting preventive care.  For various reasons, they usually get almost annual check ups.  I think this is a significant reason they live longer.  Guys are guys. We are told at an early age, especially if you played any sports to:  not complain, suck-it-up, do-your-job and don’t be a wimp.   Men don’t like going to the doctors, so they don’t.  I think this is significant reason they don’t live as long as women.

What strikes me funny is that while, essentially, everyone knows that men die young, there just doesn’t seem to be any alarm about this.  I kiddingly think that if women died younger than men that women would do something about it. There would most likely be an Avon-type fund raiser walk that would be promoted, a special colored ribbon to wear and maybe, if Oprah was still on TV, that she would do a special about how women need as good a medical care as men so they would live as long.  Guys die younger than women and frankly even the guys don’t seem alarmed.

While I am a big advocate to excellent healthcare for women, I do think that there should be some movement to get guys to start getting annual physical exams after the age of forty years old to minimize the risk of heart disease, cancers and stroke.  It breaks my heart when you hear of another middle aged man dying suddenly of a heart attack or getting an essentially preventable cancer.   While there has been some improvement in cardiovascular disease treatment, there is much work to be done.

While guys don’t want to go to the doctors, because I specialize in primary care sports medicine, they will see me without a stigma.  Since I am board certified in both sports medicine and family medicine, I wear two hats and “sneak in” preventive primary care medicine whenever I see a man for his latest injury as a weekend warrior.  There are gynecologist for women but there are no “guyologist” for men. I consider myself a “guyologist”.  My hope for this book is to break down the barriers to care for guys.  I am obviously kidding when I say that women don’t care. We have a rule in the locker room that we can tease about stuff that is not more than 10% true. So women really do care, but sometimes it doesn’t seem like they do.  Guys are even worse.

So the first step to solving a problem is always recognizing that there is a problem.  I think we as doctors need to do a better job at meeting the needs of men who are at significant risk for heart disease, cancer and stroke. The best way to treat disease is to prevent disease and do it in away that encouraged men to become lean,fit and flexible.

Gerardo “Jerry” Hizon,MD,