American College of Physicians: Internal Medicine — Doctors for Adults ®

Tuesday, July 9, 2013

A gastroenterologist preaches healthy food choices for longevity and healthy living

It's morning and I'm imbibing a beverage that has no nutritive value. I only hope it won't cause me harm, as it's a beverage that slides down my gullet with regularity. Of course, today's poison may be tomorrow's panacea. This is one of the amusing ironies in the medical arena. Every 10 years or so, it seems that what was felt to be medical dogma gets tossed out by a new set of studies, which will be reversed a decade later.

Remember when every peri-menopausal woman was advised in the strongest terms to take hormone replacement to protect her bones? That was then.

As to our diet, these recommendations are also subject periodic mutations. Butter in. Butter out.

I am presently planted in what can safely be regarded as a fast food establishment, where in a single meal, one can exceed his daily caloric need. With my fidelity to personal responsibility, I don't blame the establishment for the free choices that its patrons make. Some years ago, Burger King was sued by parents who demanded justice (read: money) blaming Burger King for their kids' obesity. If you suspect embellishment on my part, open your browser in a new window and search for this judicial absurdity. Afterwards, take some antacids and return to this post.

I won't divulge the specific restaurant I am in presently, as I don't want this to serve as either as an endorsement of a specific restaurant by a gastroenterologist, or as repellent considering the politically incorrect food choices that I routinely make. I will only divulge that I am feeling rather McHappy at this moment, and trust that this opaque reference will not be sufficient to disclose my location, although discerning Whistleblower readers might be able to crack this enigma.

Meanwhile, Europeans are galloping off in anger as their precious beef has been horsed around with. Yes, their beef has been surreptitiously fortified with horse meat, which I'm told "does not taste like chicken." The silver lining here is that a horse pain reliever (phenylbutazone) has also been detected in European meat, which may bring some relief to arthritis sufferers who are eating shepherd's pie and beef lasagna.

A report was just released by the Hudson Institute that showed that restaurants that offered lower calorie options sold more food and beverages than competitors that continued serving lard-glazed delicacies. One of the study's points was that these establishments offered low-calorie delights, not as a promotion to create wellness buzz, but in response to market forces. In other words, menus were adjusted to conform to consumer desires. In other words, businesses will sell what we will buy.

I'm not against corporate societal responsibility, but their mission is to sell goods and services legally and to cash in. If we disagree with a particular corporate culture or deem a product to be frivolous or injurious, than we are free to hold on to our cash. I'd rather that the choice of what I can purchase be mine.

People often ask for personal references from folks who are insiders. Ask a chef which restaurants he likes. Ask an athlete which personal trainer can fashion a six-pack from jiggling and sagging abs. Ask a doctor who his doctor is. So, what does this gastroenterologist eat regularly? Surely this response will be a road toward nutritional nirvana.

Whistleblower Food Choices
Item: Frequency of Ingestion
Probiotics: Not deliberately
Diet Soda: Twice daily
Vitamin Supplements: Never
Red Meat: Mmmmm, say the word
French Fries: Never enough
Greasy French Fries: See above response
Ice Cream: Upon awakening
Seaweed: Only during ocean swim
Steamed anything: Never willingly
Fried anything: On call

What kind of nutritional example am I setting? Hard to say. Ten years from now, the nutritional standards may be a mirror image of what today's wellness playbook advises. A recent obesity study, for example, published in the Journal of the American Medical Association concluded that modestly obese individuals live longer than those with 'normal' body weights. Today's heresy may become tomorrow's gospel.

So, in 2023, when nutritional gurus are pushing fries, fast food, a doughnut a day and a milkshake chaser, will I be regarded as a pioneer who was ahead of his time, or a crackpot charlatan who drank diet pop and tried to serve up Kool Aid.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

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Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.

Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

Peter A. Lipson, MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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