MORE BITE SIZED TIPS FOR YOUR WEEKEND

As I do every four years, I've been watching the Olympics fairly religiously. This one in Beijing is the best summer Olympics I can recall. I have to commend China, whatever you might feel about them: they have done a hell of a job building facilities and running a fantastic sports extravaganza. I personally could care less how old their gymnasts are. In watching these sports, it's interesting to see the athletes and what sort of shape they are in. I've come to some conclusions about the relative health of athletes, and these conclusions are not just opinions. They are well substantiated by studies of athletes as they age.


THE HEALTHIEST OLYMPIC SPORT: SWIMMING
Why? Simple. Swimming provides good cardiovascular training, the involvement of most if not all muscle groups, and is very low-impact. Swimming injuries are few, far between, and generally minor. Drawbacks: requires a pool and silly clothing. Michael Phelps may be dull as a post, but you can't deny that dude is in good shape.



THE LEAST HEALTHY OLYMPIC SPORT: GYMNASTICS
Why? Gymnastics is not exercise, it's torture. The constant impact on the joints, especially in young girls, combined with anatomically harsh angles and hard falls, is a recipe for poor health. In the best of cases, gymnastics can lead to Olympic medals. In most cases, it leads to recurrent severe injuries and chronic pain. Don't believe me? Consider this: the age range of our Olympic women's gymnastics team is 16-20 years. All of them, with the exception of 1, have already had orthopedic surgery. Ask Mary Lou Retton (my childhood hero) about her hip replacement. Nobody as young as Mary Lou should need a hip replacement. If you have a young daughter who wants to do gymnastics, I suggest you gently but firmly tell them to take up something safer, such as motorcycle racing or BASE jumping.

READER QUESTION: FLOURIDE?
A friend of mine recently blew me away by getting a letter published in The Economist, then stumped me with a question about flouride in kids' toothpaste. I'm a big fan of flouride, and I get pissed when I see toothpaste in health food stores marketed as "flouride free." Turns out that it's DIFFERENT FOR KIDS. While flouride is in most toothpaste for school-aged kids, younger kids are supposed to brush their teeth with FLOURIDE FREE toothpaste. This is because flouride hardens the teeth and makes the tooth enamel more permanent. But when kids are still growing their permanent teeth, they don't have hard, permanent enamel established. When you use flouride toothpaste in young kids, especially before age 2, the enamel hardens prematurely on the new teeth as they grow in. The results are not awful, but they can get abnormally bright white spots on otherwise "cream colored" new teeth, and these spots are both noticeable and permanent.
Close to age 2, kids are supposed to have their first dental checkup. That makes it easy to decide when to use flouride. The bottom line is: DON'T use toothpaste with flouride on your kids UNTIL they have had an exam with a dentist and the dentist has told you to start using flouride.
Adults: you need flouride, even if you've never had cavities. That's because it prevents bacteria from infecting the gums, which leads to gum disease and root canals. If you've never had a root canal, you're lucky. The only thing I liked about mine is that I ended up with a sweet gold tooth that only cost $4500!

ORGANIC? PESTICIDE FREE?
If you can afford it, organic produce is probably worth buying. Today, I found a website I just have to tell you about, because it helps you spend your money wisely. This site actually quantifies the amount of pesticide residue on common commercial fruits and vegetables, so that you can choose WHICH to buy organic, if your grocery store or your pocketbook limit your choices. Kudos to: www.foodnews.org for good research and a great website- you can even download a wallet-size list of commercial produce to buy (and to avoid), so that you can take it to the market with you. And the list is surprising.

THE PINNACLE OF FASHION: CAMO

Last night as I sat around the airport for 6 hours waiting for another delayed flight (I can't recall the last time I flew on a flight that was on time), there was a kid sitting across from me and another kid sitting next to me; both were dressed head-to-toe in green camouflage outfits. My first thought was, "right on!" I myself was wearing a more subtle, "mossy oak desert sagebrush" camo shirt in tan, black, and hints of sage green. As I sat around the airport, pretending to read and making mental notes of passengers' poor fashion choices, I counted at least half a dozen people with camouflage clothing. None of them were soldiers, and none of them appeared to be going hunting.

If you haven't purchased camo clothing lately, you should know that the world of camouflage has exploded, much like the world of portable electronics. There are literally hundreds of camo patterns for various uses, and almost all stores, from high-fashion to variety to Army surplus, carry some camo items. You can buy camo sunglasses, watchbands, hats, towels, coolers, dinnerware, tents, shoes, socks, and infant pajamas- and that's just at the Super Target in north Denver. I personally think this is a wonderful thing. Camo, like many great things, was invented for military use (as was the Internet), and I think it's a triumph of civilization when a military invention becomes "demilitarized," and co-opted into peaceful civilian uses.

WHY YOU SHOULD WEAR CAMOUFLAGE CLOTHING

1. If you get a food or wine stain on camo clothing, no one will notice-not even you.

2. If you're into "supporting the troops," you can show your solidarity without all that "sacrificing your life for your country" business.

3. If you're opposed to the military, you can rebel by wearing camo at a peace rally or knitting circle.

4. If you like bird-watching, hunting, or fishing, camo potentially allows you to get closer to wildlife (hint: neon orange is not the best pattern for this use)

5. With all those earth-tones blended together, camo matches almost any other color or fashion accessory.

6. Children everywhere will think you're cool, or at least into dressing like they do.

7. Camo is not "stuck up." It's available everywhere- thus, it's the true "clothing of the people."

8. Camo compels complete strangers to ask you amazingly interesting questions, such as: "bagged any rutting elk on the Western Slope lately?"

9. Matching shoes are readily available. Can you say, "camo Crocs?"

10. Doesn't it sound fun to buy your new fall wardrobe at a store called "Bass Pro Shops?"

IN SUMMARY: Camo has nothing to do with your health. But my friends seem to love it so much when I wear it, that it must just make people happy somehow. Try it: you'll find it strangely compelling.

SUPERFOODS TO MAKE YOU LIVE LONG TIME

Last night I was watching PBS and there were some shows featuring Gary Null, PhD. For those of you who don't know Gary Null, he's basically a health food guru who believes that aging, cancer, heart disease, depression, and most other ailments are caused in part by unhealthy food; and that these processes can be reversed by changing the diet.
I think you have to take Gary Null with a grain of salt, or spirulina, to some degree- some of his statements, or rather about 50% of them, are conjecture, and not supported by science. But overall, I think he's still a positive force, because the other 50% of what Gary Null says is pretty accurate. What impresses me is that he's been talking about the wonders of nuts, honey, berries, peppers, and other nutrients for over 30 years- and every year there are more studies in the medical literature showing benefits of these food. If Gary Null is 50% correct today, he might be 60% correct next year, and so on. On balance, I think he is worth checking out.
Last night's show was on Gary Null's 15 "Superfoods for Optimum Health." Let's see if I can remember them all:
GARY NULL'S SUPERFOODS FOR OPTIMUM HEALTH:
1. Garlic
2. Onions
3. Carrots
4. Shitake Mushrooms
5. Whole grains
6. Beans and legumes
7. Oranges
8. Peppers
9. Ginger
10. Blueberries
11. Apples
12. Bananas
13. Leafy greens such as kale, collards, and spinach
14. Almonds
15. Soy products
Damn, I have a good memory. That's Gary Null's list of what are, in his opinion, the healthiest foods out there for reversing aging and preventing disease. I have to agree, it's a fairly good list. I just think it needs a few additions. So let's increase Gary Null's list up to a combined list of 20 foods, to provide a bit more variety:
DR. TOFUHEAD'S ADDITIONAL SUPERFOODS
16. Walnuts
17. Small fishes (sardines, anchovies, herring)
18. Grapes, including wine
19. Olive oil
20. Fresh herbs, such as: oregano, thyme, sage, rosemary, marjoram, parsley, cilantro, tarragon, etc.
Are you seeing a pattern here? I am. You can distill this food list down a bit to a more simple concept: A HEALTHY DIET IS PRIMARILY VEGETARIAN, WITH AN EMPHASIS ON FRESH FRUITS AND VEGETABLES. Think "Mediterranean." Gary Null waxes poetic on how healthy the food is in coastal Italy. I'd have to add Greece as the country I've been to with the healthiest food. Everything you've seen above is abundant in Mediterranean diets.
OTHER RELATED ISSUES AND QUESTIONS:
1. To cook or not to cook? Contrary to what you might hear from "raw food" experts, Gary Null and I are in agreement that you can cook these superfoods with little impact on their nutritional value. And if you cook them in healthy oils such as olive, canola, safflower, or walnut, you can enhance their nutritional impact.
2. What about meat? I personally don't think a healthy diet has to be devoid of meat. I do agree with Gary that commercial meats are full of preservatives, hormones, antibiotics, and pathogenic bacteria, as well as fat. But nowadays, there are great alternatives. In short,
HOW TO MAKE YOUR MEAT HEALTHY:
-Buy free range, hormone-free meat when possible.
-Stick to lean meats. These include skinless chicken breasts, turkey "white meat," and lean cuts of "the other white meat," i.e. pork. Lean pork cuts include pork tenderloin, pork chops, and ham. Some beef cuts like flank steak, strip steak, and beef tenderloin are fairly lean as well. Buffalo is another good choice.
-Avoid preserved meat with sodium nitrates, nitrites, and sodium benzoate. Even if you like salami and sausage, you can get these without the preservatives. But you might need to go to a health food store.
-Keep your portions small. Avoid the 22-ounce T-bone steak.
3. What about dairy? Gary Null is just plain wrong when he states that dairy products cause "mucus." He should know better- that myth was debunked years ago. I think dairy is fine, just keep your cheese portions on the small side and choose less fatty cheeses such as mozzarella, feta, and goat cheeses when possible. If you drink milk, choose hormone-free organic milk if you can afford it.
4. Should I get a juicer? I think juicers are wonderful, and they are a great way to get many servings of fruits and vegetables at one time. You lose some of the fiber, but few of the nutrients, when you have juice as opposed to whole fruits and veggies. I'm going to do a whole blog on juice and juicers soon, so more on that later-
Any questions?

HOMEOPATHY: HEALTH CARE OR VOODOO?

    Aren't you lucky, dear reader: 2 new posts in one day!   The truth is, I have a ton of new topics to cover, because I have been out of touch with the blog and have left my readers hanging for weeks without a new entry.   I apologize for this.    I think in return for the wonderful support and interest I've gotten from my readers, I owe it to you to put up a new entry at least a couple times per week- even if it's a quick note about fashion that my friends will riducule.

READER QUESTION: WHAT IS HOMEOPATHY?

     Homeopathy is a branch of medicine which started in Europe not long ago- hundreds of years ago, not thousands of years ago like acupuncture or some other modalities.   It gained wide acceptance in Europe and America starting in the 1800s and going well into the early 1900s, until the American Medical Association (the AMA) launched a concerted effort to discredit homeopathy and ostracize its practitioners.   As a result, homeopathy really fell to the wayside as a "fringe" practice, offered by clinicians that the AMA widely ridiculed as "quacks."

      Without getting too political or straying from the subject, let me first give you Dr. Tofuhead's take on the AMA: this is one of the dirtiest, most corrupt organizations in the history of medicine.    Never afraid of taking huge amounts of money from tobacco and firearms companies, the AMA until very recently spent much of this money trying to increase the power and prestige of high-paid, private medical specialists, at the expense of all and sundry alternative medical practitioners.   Even primary care doctors like your beloved Dr. Tofuhead have suffered from the malignant antics of the AMA.   So when the AMA widely comes out AGAINST something like homeopathy, it makes me think: THERE MUST BE SOMETHING TO HOMEOPATHY!

HOMEOPATHY: BASIC CONCEPTS

1. Toxic or disease causing entities, in very small amounts that do not cause harm, can be introduced into the human body and actually compel the body to fight those entities and overcome disease.

2. Toxic entities must be serially diluted in a very specific and time-consuming way in order to produce effective homeopathic remedies.

3. The homeopathic serial dilution method not only yields a remedy with a tiny amount of a toxic substance, but the chemical makeup of the solution itself (in which the toxin is dissolved), is itself altered in the process, in a clinically significant way.  This point has been supported by some very complex and surprising experiments, done by physical chemists in recent years.

HOMEOPATHY: DOES IT WORK?

      The most honest answer is: we don't really know.   To date, there have not been many good scientific studies looking at homeopathic remedies and whether or not they really work.   My own opinion is that homeopathy, like any branch of health practice, will turn out to work for some things, and to not work for others.   What I hope to see in future research is studies that will help us pinpoint just what homeopathy can treat.   For the time being, I would not rely on homeopathic remedies to treat conditions for which their are proven treatments: for example, strep throat (which is treated with antibiotic drugs).    

       However: small studies have been compelling when it comes to treating viral respiratory illnesses with homeopathic remedies.    For example, there is a homeopathic medication called "Occillococcinum" which many of my patients swear by, for fighting colds and flus.   Years ago, when I worked in an acupuncture and homeopathic practice, I had access to this medication for free.   My own experience here is not worth much, but I do believe that if I took occillococcinum at the onset of a cold, it either disappeared completely or the duration of the cold was shortened.   It's worth looking into; after all, traditional western medicine or "allopathic medicine" has nothing that can cure or prevent a cold.   If any of my readers have had experience with this or another homeopathy remedy, please share.

WHERE CAN I FIND HOMEOPATHIC REMEDIES?

     You can find popular homeopathic medicines such as Occillococcinum at health food stores, vitamin shops, and even some grocery stores.   My optometrist even gave me a homeopathic eye drop recently, which really worked for me.   But keep in mind that there are thousands of homeopathic remedies with odd names; names that don't really reflect the condition they are designed to treat.   So except for a few exceptions, see someone who knows what they are doing.   I recommend seeing a homeopathic doctor for advice and for remedies if you want to treat something other than a cold or flu.   And if you're taking a homeopathic remedy for an illness and it's not working, please: see your allopathic primary care doctor!

BOTTOM LINE: My take on homeopathy is that there IS something to it.   I also think it's an exciting field, in which we will see some compelling new research in our lifetimes.   So watch these pages- I'll return to the topic again in the future.

RECENT READER QUESTIONS ON FASCINATING TOPICS

     To all my friends who pointed out my own fashion mistakes when I posted my last blog choc-full of essential fashion tips, I just want to give this reasonable feedback: dress as I say you should dress, not as I do dress. I'll admit- I take a special pleasure in occasionally wearing hideous or outdated clothes, just to elicit reactions. That doesn't mean you should, unless you enjoy people laughing at you.

READER QUESTION: WHAT IS HYPOCHONDRIASIS?

Or more specifically, "what causes someone to be a hypochondriac?"

     This was a tough question for me to answer. In fact, it took me weeks to find information that I felt was reliable. Essentially, being a hypochondriac means that you have an "exxagerated concern or worry about having a health problem or health problems, despite evidence to the contrary." This actually used to be classified in the psychiatric literature as a form of a "personality disorder," in other words a mental illness all its own. That was probably both innaccurate and unhelpful, since personality disorders are not often treatable. Currently, hypochondriasis is generally seen as a symptom of a treatable mental illness, the most common illnesses being depression, anxiety disorders, and post-traumatic stress disorder (PTSD). Hypochondriasis can also be seen in other mental illnesses such as obsessive-compulsive disorder (OCD), and psychotic syndromes.

     By far the most common underlying illness in someone who is a hypochondriac is depression. Part of that is because we are recognizing, with increasing frequency, that major depression can cause physical symptoms, which are often ill defined. Another factor is that a majority of depressed patients are very resistant to being diagnosed as having depression, and depressed patients are often hard to convince that their physical symptoms are coming from a psychological rather than a physical source.  Hypochondriacs  who are depressed and are treated for depression do very well, and are able to overcome their hypochondriasis is most cases.

    This is also true for patients who have hypochondriasis in the context of an anxiety disorder, PTSD, or other mental illnesses.

MORE QUESTIONS AND ANSWERS ABOUT HYPOCHONDRIASIS

1. DOES EVERYONE WITH HYPOCHONDRIASIS HAVE A MENTAL ILLNESS?

No.   Honestly, I think many hypochondriacs just have too much time on their hands, or they're too focused on their own needs.   In these folks, it tends to be a temporary problem.   After a few doctor's visits and normal tests, and hopefully some encouragement from a doctor, they realize that they are wasting their time- and that rather than worrying about non-existent health problems, they should use their mental energy to work, have fun, and pursue more productive hobbies.  

     There are also hypochondriacs who are justified in their hypochondria, in my opinion.   For example, cancer survivors often become hypochondriacs, and for good reason.   The last time they thought they had a serious illness, they did!   I don't even think it's fair to call cancer survivors hypochondriacs.    It's better just to offer them the tests they want, whenever they want, to help reassure them that they don't have cancer again.   At least, that's what I do.

2. WHAT'S WRONG WITH BEING A HYPOCHONDRIAC?

I think the biggest problem for hypochondriacs is that they are unhappy, and their hypochondria keeps them that way.   It's really no fun to think you have an undiscovered illness.   Not only does the hypochondriac worry about his or her health, but he or she wastes a lot of time- time in doctor's appointments, getting tests, searching for health information on the internet, and seeing various health practitioners.   Hypochondriacs put a big time and financial burden on themselves, and they also can make their loved ones and family members unhappy or frustrated with them.

3. WHAT IF OTHER PEOPLE THINK I'M A HYPOCHONDRIAC, BUT I REALLY HAVE A SERIOUS HEALTH PROBLEM?

See a doctor.   If your doctor treats you with annoyance or insults you, get another doctor.   If there are tests that are reasonable to do, ask your doctor to run them.   But you should trust your doctor's judgement to some degree- demanding complex tests that your doctor doesn't think you need will generally get you nowhere.    And keep in mind the most important fact here: there are very few health conditions out there that "no one can detect" or "multiple doctors can't diagnose."   A recent book on the subject reviewed a number of studies of patients with "hard to diagnose, undiscovered health problems."   The studies revealed that only a tiny fraction of these patients turned out to have a real physical ailment; most had either stress-related conditions or depression.    So if you've been to a few doctors, had a number of tests, and "no one can figure out what's wrong with you," the painful truth is this: there probably is nothing wrong with you, physically.   You might do yourself a favor and seek a therapist.

EASILY DIGESTIBLE FASHION TIPS FOR MEN

Here's another short, easy-to-read, digestible blog. Don't worry if you've submitted a reader question this week; I assure you, I'm working on those. I will be blogging on those only after I've done the comprehensive research required. I don't answer any question "off the top of my head." But I can comment on men's fashion off the top of my head. That's because "men's fashion" is an oxymoron. It's like talking about "Mormon cocktails" or "fun skin rashes." Men's fashion leaves much to be desired. Here's how you can avoid making it even worse. All you have to do is avoid making the following common men's fashion mistakes.

LAME MEN'S FASHION HABITS TO AVOID:

1. Oakley blades. In fact, just because they invented Oakley blades, I recommend that you avoid purchasing any Oakley product, unless it's BMX bike grips, which Oakley actually made exclusively when the company started, before they started making ugly sunglasses.

2. Pants without a belt. Only wear these if they are sweats. But do yourself a favor: don't wear sweats. There are much nicer sloppy clothes to wear.

3. Brown belt with black shoes or vice versa. You can wear this combination if you're colorblind and you have a large sign around your neck that says, "HI, I'M COLORBLIND."

4. The upside-down visor. In case it's not obvious, this simply sends the message, "My I.Q. is lower than yours."j

5. Puffy white shoes with jeans. In fact, if you have white shoes you should be:

-a nurse

-a guest at a disco party

-working out at the gym

6. Socks with sandals. You can wear socks with sandals if you have a broken foot and you're wearing an "orthopedic sandal," which is basically a shoe that makes it obvious that you have a broken foot. Make sure you have at least one crutch with you at all times.

7. Dress slacks with black athletic shoes or hiking shoes. Do you really want people to mistake you for a primary care doctor? If you do, go for it! Also, consider wearing a plaid shirt with a knit tie.

8. Pants with flip-flops. See my earlier blog on this subject.

9. Short running shorts. Why do men still wear these to Safeway? These are of questionable integrity even if you're actually running. Opt for something more aesthetically pleasing, like a Swedish thong or a Spandex body suit.

10. Windbreakers. Is there even any such thing as a "windbreaker" anymore? Unfortunately, yes. Feel free to wear one if you live in the Wyoming plains or if you're at a 70's party. In short, you should wear a windbreaker in any situation in which you might normally wear a "Members Only" jacket, or a plastic "poncho."

11. Flannel shirts with the sleeves cut off. I know it's shocking, but people in Denver still wear these, believe it or not. NOTE: these are still cool if you're a gay lumberjack with nice arms.

12. No underwear. There is a reason underwear was invented. It's called "civilization." If you don't wear underwear, consider adult diapers or checking yourself into a mental facility.

Sorry to be so harsh. I don't know why men's clothing concerns me so much. Women are just better dressers, at least most of them are.

HOW DO I KNOW I DON'T HAVE CANCER?

I see new patients every day, and some of them ask me to be "tested to make sure I don't have cancer." The truth is, there is really no test that can do this. The problems are:
1. There are too many cancers, and one test can't evaluate for all of them.
2. Most cancers are diagnosed by complicated imaging tests and biopsies, both of which are not completely safe. So it's generally not a good idea to do these tests unless your doctor has a high suspicion that you have cancer.
3. Some of the tests for cancer, particularly CT or CAT scans, can actually cause cancer. So again, you shouldn't get one unless you really need it.
However, there are "screening tests" for cancer- these are tests that are performed on healthy people to try to detect certain cancers early. There are only a few of them, because only a few tests have been shown to save lives by providing reliable information about cancer at an early stage. All people should get cancer screening tests, starting at various ages depending on the test. Please note: IF YOU HAVE A FAMILY HISTORY of cancer, your doctor may want to start doing screening tests on you at an early age. The below applies only to people who do not have a family history of cancer. Also: FAMILY HISTORY of an illness like cancer, in most cases, means that you have a parent or sibling with the disease in question, usually at a certain age. I know it sounds complicated. For example, if your mother had breast cancer before age 50, you have a family history of breast cancer. If your aunt had breast cancer at age 70, you don't have a family history of breast cancer. You really need to talk to your doctor about your family history to know what's relevant.
CANCER SCREENING TESTS YOU SHOULD HAVE:
1. Pap smears: this may actually be the single best cancer screening test in terms of lives saved. You need to start getting this test:
-if you're a woman
-at age 19
-at an earlier age if you're sexually active (within the year of becoming sexually active)
-how often? Yearly at first, but if you have 3 normal pap smears in a row and you're monogamous, you can then change to every 2-3 years.
2. Mammograms: there is controversy over whether to start these for women at age 40 or 50. I get them every 2-3 years in women 40-50, and yearly after that. If you want to make it easy to remember, just do one at the same time every year starting at age 40. All women should get mammograms, even if no one they even remotely know has ever gotten breast cancer!
3. Colon cancer screening. There are actually 3 total tests and you need at least 2 of them at various intervals. It works like this:
-start getting colon cancer tests at age 50.
-EVERY YEAR you should do a "stool card test", which detects blood in your stool.
-HAVE YOUR FIRST COLON SCOPE AT AGE 50. This may be what's called a "flexible sigmoidoscopy," a "colonoscopy," or a "virtual colonoscopy." Ask your doctor which is right for you, but do it at age 50.
-After your first colon scope, you need to do it again every 5 to 10 years, depending on what they found on the first scope. If you have any precancerous "colon polyps," you'll need to get a scope every 5 years.
-People seem terrified of colon scopes. But the whole thing takes 20-30 minutes and you can be sedated for the procedure. It's easy to do!
FOR THE GENERAL POPULATION, that's it, believe it or not. There are other cancer screening tests, and some of them are worth doing if you have a family history of cancer. But these 3 are the only ones in wide use for the general population. Beating cancer is not easy. But as you can see, getting your cancer screening done is.