60 Day Turnaround

As always we will have interns and Dr. Levi adjusting!

From CNN.com : http://www.edition.cnn.com/2013/01/14/health/coke-obesity/index.html?hpt=hp_mid

Coca-Cola weighs in on obesity fight:

STORY HIGHLIGHTS
In a new ad campaign, Coca-Cola calls obesity “the issue of this generation”
Coke has previously been a target in an anti-obesity campaign
The Center for Science in the Public Interest says the campaign is “damage control”

(CNN) — It’s a statistic we’ve been hearing far too often — and for far too long. Two-thirds of American adults are either overweight or obese — and the problem is only getting worse.

Even Coca-Cola, the world’s largest beverage company, is now calling obesity “the issue of this generation.”

The world’s most valuable brand took the last seat at a crowded table Monday, when it launched an ad campaign aimed at “reinforcing its efforts to work together with American communities, business and government leaders to find meaningful solutions to the complex challenge of obesity.”

The first commercial of the campaign, a two-minute video called “Coming Together,” begins with a voice-over: “For over 125 years, we’ve been bringing people together. Today, we’d like people to come together on something that concerns all of us: obesity.” The spots are scheduled to run on television, including CNN, beginning this week.

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Coca-Cola points out in the video it offers 180 low- and no-calorie beverages out of more than 650 beverage products.

Coke has come under increased fire over the past year as a predominant target of an anti-obesity crusade, led in large part by the Center for Science in the Public Interest, also known as the CSPI.

Appearing on CNN’s “Sanjay Gupta MD” in October, Michael Jacobson, executive director of the CSPI, conceded that sugar and soda consumption are, in fact, on the decline.

“But,” he said, “the scientific community has … reached a consensus that soft drinks are the one food or beverage that’s been demonstrated to cause weight gain and obesity. And if we’re going to deal with this obesity epidemic, that’s the place to start.”

Global report: Obesity bigger health crisis than hunger

The CSPI came out swinging in October, introducing “The Real Bears,” — “an animated short film that encourages Americans to pour out their sodas.” It stars “The Real Bears,” which resemble the iconic Coca-Cola polar bears.

The video was directed by Alex Bogusky, the man behind the anti-tobacco “Truth” campaign, and features an original song, “Sugar,” by Grammy award-winning artist Jason Mraz.

In response, Coca-Cola issued a statement that read: “This is irresponsible and the usual grandstanding from CSPI. It won’t help anyone understand energy balance, which is key according to recognized experts who’ve studied this issue — a group that doesn’t include CSPI. Enough said.”

In its new campaign, Coca-Cola drives home the sentiment that “beating obesity will take action by all of us, based on one simple, common-sense fact: All calories count, no matter where they come from. … And if you eat and drink more calories than you burn off, you’ll gain weight.”

The reason soda and other sugary drinks have found their way to the forefront of the so-called “war on sugar” is the harmful rate at which they are absorbed, said Dr. Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco, as well as the author of the new book, “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease.”

“The reason to eat your sugar as whole fruit and not juice (or soda) … is because the fiber helps reduce the rate of absorption from the gut into the bloodstream,” Lustig says. “When you juice it, it’s all going to you and your liver gets overwhelmed and you get sick.”

Opinion: Lustig: A fast-food, sugar fiasco

CSPI, in a statement Monday, said the new Coke ad campaign is “just a damage control exercise, and not a meaningful contribution toward addressing obesity.”

“What the industry is trying to do is forestall sensible policy approaches to reducing sugary drink consumption, including taxes, further exclusion from public facilities, and caps on serving sizes such as the measure proposed by Mayor (Michael) Bloomberg.”

On September 13, Bloomberg, the New York mayor, won health board approval of a proposal to ban the sale of sugary drinks in containers larger than 16 ounces in restaurants and other venues.

In an exclusive interview with Gupta after the board’s approval of the ban, Bloomberg stressed the importance of portion control.

“I can tell you — and I think I speak for almost everybody — if it’s in front of me, I eat it,” said Bloomberg. “I love Cheez-Its. If you put a 2-pound box of Cheez-Its in front of me, I’d probably eat them all. That’s not very good for you. But if you eat (almost) anything in moderation, there’s no harm.”

Jacobson told Gupta that the occasional soda could, of course, be a part of a healthy diet. “We don’t want to wipe out soft drinks,” he said. “But we would like to see soft drinks return to the dietary role they played in the ’50s, which was occasionally, and small portions, (as a) special treat. Now, people are guzzling huge containers of soda every day of their lives, practically.”

Opinion: Forget large sodas, how about banning French fries?

This is something even Coca-Cola can agree is a bad idea. The company is in the middle of a roll-out of smaller, portion-controlled sizes of its most popular drinks, and promises to have them in about 90% of the country by the end of the year.

“We’ve never been more committed to doing our part to help address the issue of obesity,” Coca-Cola spokesman Ben Scheidler said in an e-mail, adding that “2013 is going to be a landmark year in terms of expanding partnerships and efforts to educate consumers about energy balance.”

But perhaps most important is a move Coca-Cola has already made: the decision to add the calorie counts to the front of their bottles and cans, to make it even easier for consumers to make informed decisions.

As always, there will be interns and Dr. Levi here adjusting.

I have been following Dr. Katz some recently. He had some great quotes in this past month’s Men’s Health, and he has been citing his support of Juice Plus for some time now, and I am interested in his clinical approach, which is a research/evidenced based approach, vs the testimonial approach that is often observed in my world. Check it out:

David Katz, M.D.Director, Yale Prevention Research Center
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Do multivitamins cause breast cancer? An observational cohort study conducted in Sweden, recently published in the American Journal of Clinical Nutrition, suggests they may.

In such trials, people answer questions about their lives, and are then observed to see what happens to whom. These studies can be powerful when large — this one followed nearly 35,000 women for close to ten years — but they are never as definitive as intervention trials in which people are randomly assigned to treatment A or treatment B. People who decide to do ‘A’ may differ in a whole variety of ways from people who decide to do ‘B.’

In this case, they did. Women who took multivitamins also used oral contraceptives and hormone replacement therapy more, and exercised less, for example, than the women who did not take the supplements.

Roughly 25 percent of the women in the study routinely took a multivitamin, and were 19 percent more likely to be diagnosed with breast cancer after adjusting for other potential explanations.

There’s the headline, but let’s work those numbers over just a bit. That 19 percent risk increase, if real, is a “relative” risk increase. How big is the absolute risk?

A total of 681 cancers developed over roughly 10 years in 26,312 women not routinely taking multivitamins. The risk of breast cancer in these women in any given year was thus about 0.26 percent.

In the 9,017 women taking multis routinely, there were 293 breast cancers over that same decade. Among these women, then, the absolute risk of breast cancer in any given year was 0.32 percent.

The relative difference between a risk of 0.32 percent and 0.26 percent is, indeed, about 19 percent. But the absolute difference is 0.06 percent. In other words, if multivitamins are truly the cause of the apparent risk difference, they would increase your breast cancer risk by considerably less than one tenth of one percent; 1,667 women would need to take multivitamins for a year before one extra case of breast cancer occurred.

So, clearly, there is no cause for panic.

But there is cause for reflection, and perhaps reorientation. After all, we take multivitamins in the hope they will do us good, not in the hope they won’t do us harm. And while evidence is scant that they do us good, this study is not the first to hint of potential harm — other researchers have found a similar association between multis and breast cancer.

There are plausible mechanisms. Tumors grow less well when certain nutrients — folate prominent among them — are in rate-limiting supply. A multivitamin might “feed” cells in a tumor.

If folate is the relevant nutrient in Sweden, it may not be relevant in the U.S., since we fortify our food supply with folate (doing so dramatically reduces the occurrence of a congenital anomaly called ‘neaural tube defect’) and the Swedes do not. Even Americans NOT taking multivitamins are getting supplemental folate. Folate, however, is just one potential explanation for the findings.

Of course, if what prevents a tumor from growing is having too little of a nutrient to feed the tumor cells, it raises a question: is there enough of the nutrient to feed healthy cells optimally? Not getting cancer is important, but so is being vital and energetic. This study could not address that issue.

If we want optimal nutrients for healthy cells but don’t want to feed tumors, the source of nutrients may be crucial. The best source — the source strongly and consistently associated with lower risk of just about every disease — is wholesome foods. No supplement is a substitute for them.

But something called a “whole food based” supplement may come close. Products such as Juice Plus, currently under study in my lab, take all of the nutrients from plant foods and concentrate them into capsules for those who simply can’t or won’t eat the recommended servings of fruits and vegetables daily (that’s most Americans!). Unlike multivitamins which take nutrients out of context and repackage them, whole food supplements maintain the natural array and concentration of nutrients — thousands of them — found in the foods themselves. It may be that nutrients only work as they should in concert, like the various instruments in a symphony orchestra. There is both science and theory to support this notion, although no decisive evidence yet that whole food supplements promote health over the long-term while avoiding potential harms of standard multivitamins. But it seems plausible to me that this might be true, and further study is well justified.

Finally, not all nutrients are equal when it comes to breast cancer risk. Supplementation with calcium, and possibly vitamin D, in the Swedish study were actually associated with reduced risk. So along with “don’t panic,” let’s add: don’t toss out the baby with the bathwater. I favor vitamin D supplementation, vary my calcium recommendations depending on diet, and routinely encourage supplementation with omega-3 oils. I have not yet abandoned use of multivitamins, but am growing steadily less enthusiastic.

If multivitamins increase breast cancer risk, the increase is very, very small. While quite meaningful at the population level, it is very unlikely to make a difference in your life. Still, the association could be real — and there are other ways to optimize your nutrient intake. The best of these is to eat those fruits and vegetables Mom recommended all along.
Dr. David L. Katz; www.davidkatzmd.com

I am going to get away with a short post today. But one that is worth posting, and doing. A patient went in to a CrossFit gym this week for his first time, and he was given a workout from last years CrossFit Open.

The Open is a competition that runs worldwide, and seeks out the fittest members of our planet to compete in regional qualifiers. From there, regional winners make it to the CrossFit Games to battle for fittest on Earth!

The first workout (task or test as it were) was 7 minutes of burpees. In addition, the jump portion (see below) was to a target which if memory serves me right, was one foot over the highest point of your standing reach.

So this is your task now, 7 minutes of burpees. But don’t run off and do them now, you need to red your rules first.

Burpee – what in the world is that. For our purpose, you will start standing up, then drop to the ground in any fashion you choose, so that your chest is on the floor. From there push yourself back up and jump into a squat, then stand and jump while clapping your hands overhead.

You don’t need to jump down and up, you could slowly work your way down and up, the key is that you move from upright, to horizontal on the floor, to upright, then finish with a very slight jump and clap. As long as your feet are off the ground, your jump is good.

I think I did 119 or 121 of these last year with the 1′ jump overhead. Really annoying.

Have fun, be fit… oh, and did you see that they are using CrossFit with the Biggest Loser crew this series? Guess what… if they can do it, you can do it.

Be Blessed, Dr. E

Please call 770-517-2240 for an appointment.

Functionally Fit is what I am talking about, not culturally fit.  We’ll get to this difference momentarily, but the definition for the day.  To be able to accomplish all tasks that you could be called upon for, for the benefit of your quality of life, longevity, and enjoyment.

I made this definition up in the moment, and it took no more than a few seconds to come up with it.  Why is that pertinent?  Because it is important to understand that fitness is a living definition, as well as a living pursuit.  It is not static, it is dynamic.  As my life circumstances change, so does the need, thus I could go from fit to unfit in a minute.  Let me explain.

As a 30 year old hockey player, chiropractor and childless husband, my needs were to be able to move throughout my day with ease, adjusting patients without difficulty or pain.  This is functional fitness, fitness that serves a purpose, and it benefits the quality of my life.  My need for low cardiovascular risk, low bone weakness risk, and low cancer risk are ever present, and fitness levels have an impact on that according to more and more research.

And of course, enjoyment.  I was playing regularly in the Annual Adult National Chapionship Hockey Tournament in Florida in the spring.  I wanted to win, and I wanted to be a significantly positive impact on our teams chances to win.  My fitness needed to be enough to sustain a very high level of play.

At 36, the moment the hockey puck hit my eye and blinded me, my fitness needs changed, and over time it became evident that they had increased dramatically.  I went from being happy with my fitness if I could play high level hockey.  Which is a 40 second to 1 minute shift of high intensity, followed by 2-3 minutes of rest before going on the ice again.  In the weekly pickup game that I played, it was usually 5-8 minutes on the ice with a 2-4 minute rest.

It might sound like a significant requirement, but out of shape overweight guys with skills can carry on that kind of athletic effort, with a huge gap in potential fitness.  I was already crossfitting when the injury came, but it became a bit more of my passion, as my ability to see a puck coming and identify where it was, had gotten really bad.  Catching a football became nearly impossible for me, and all hand-eye coordination became difficult.  

I took up adventure racing, and ended up spending hours on these mountain bike running, canoeing races through the woods.  Suddenly, I found myself in two sports (CrossFit and Adventure Racing), that appeared to be complete dichotomies.  One required great endurance, the other great strength and short intense bursts of energy.  Both were important to me in my pursuit of fitness, but it would appear that the appropriate training for each would be totally different.  

However, that is not true.  First, before I cover that, I want to point out that my fitness needs for quality of life didn’t really change.  My need to be productive in life was the same, though increasing in its need as we ramped up from 100 adjustments a week, to 300, to 500, to 800.  The need to be fit has definitely increased over time.  Though many would think that their needs for fitness decrease as they age… I believe that for most of us, they actually stay the same, only subtly changing over time.

Back to the differing needs for my enjoyment.  I found out, that the crossover of short intense bouts of fitness are amazing.  I chose to pursue CrossFit as my method, and that method was providing me with the ability to test my fitness in the form of adventure races.  And we began to win these races.  

At 40 years old, I have been using CrossFit for my method of fitness for 7 years.  I am more fit than I was at 30, or at 20.  I am stronger, and I have much greater endurance.  I might not be quite as fast in a sprint, but I am not far behind.  

Fitness – the ability to do whatever might be called on of yourself for the most basic needs.  One of the greatest needs you will encounter as you age is balance.  Figure out how to balance yourself until you are dead, and your life will be much better off.  I have a friend who just flew off to Canada today to be with his 91 year old mother through pelvic surgery.  We can only pray that she handles it well and recovers.

Be well, be fit, and try out CrossFit.  We will be giving between 5 and 8 classes for free to our new CF Towne Lake, or The Garage in the upcoming Total Food Makeover.  Its your time!  

Be blessed – Dr. E