Friday, September 12, 2014
Thursday, September 11, 2014
Tuesday, September 9, 2014
Dr. Patrick Roth pens book 'The End of Back Pain'
His new book may be titled "The End of Back Pain," but Dr. Patrick Roth, chairman of neurosurgery at Hackensack University Medical Center, said that his prescription has much more to do with managing it.
"Poll the people at any place in the world, at any time," he said, "and the percentages will be the same: 20 percent will have back pain at that moment, 40 percent have had it in the last year, and 80 percent have had it over the course of a lifetime. And that's not going to change."
So why buy his book?
Because even if you can't eliminate that dreadful discomfort that can make walking, standing, sitting and lying down difficult, you can manage it effectively — as long as you're willing to give his method a shot, Roth said.
"There's a big difference between treating a disease and building health," he said. "This is about building health. People come to me and say, 'Take away my pain.' But there's a better way."
That "better way" relies on about a dozen exercises that, when done in a progressively more difficult workout, should reduce the frequency, duration, and intensity of the participant's back pain.
Roth's program requires a kettlebell (a piece of equipment that looks like a cannonball with a handle) and a Swiss ball, and can be done as easily in a living room as in a gym, he said.
"What's beautiful about a kettlebell is the convenience. They take up no room, and you can literally put it in a closet."
All of the exercises, from the cat stretch and back twist to the kettlebell squat and Turkish get-up, aim to strengthen each part of a person's core, including the smaller muscles of the back that are often neglected in traditional routines, Roth said.
"Everyone will do sit-ups, but they won't work the back muscles. And that's the key. It's the muscles that you don't see that are the most important part of mitigating back pain."
It has worked for him. With two herniated disks and a stress fracture in his L5 vertebrae, thanks to his high school football days, he practices what he preaches. "I went through it. I lived it. My whole life has been back pain," he said.
Roth's ideas might not be for everyone: His advice to work out even when in pain will turn some off, and his opinion that back surgery is "terribly overdone" because it's profitable for the surgeons will likely raise hackles. But he argues that most patients who get surgery don't need it, and could, with a little work, take control of the pain themselves.
"You have to try it," he said. "People don't feel confident that they can do it on their own, but they can."
Email: janoski@northjersey.com
--
- See more at: http://www.northjersey.com/news/health-news/doctor-s-rx-for-managing-back-pain-1.1082180?page=all#sthash.ta1oo6Qy.dpuf
"Poll the people at any place in the world, at any time," he said, "and the percentages will be the same: 20 percent will have back pain at that moment, 40 percent have had it in the last year, and 80 percent have had it over the course of a lifetime. And that's not going to change."
So why buy his book?
Because even if you can't eliminate that dreadful discomfort that can make walking, standing, sitting and lying down difficult, you can manage it effectively — as long as you're willing to give his method a shot, Roth said.
"There's a big difference between treating a disease and building health," he said. "This is about building health. People come to me and say, 'Take away my pain.' But there's a better way."
That "better way" relies on about a dozen exercises that, when done in a progressively more difficult workout, should reduce the frequency, duration, and intensity of the participant's back pain.
Roth's program requires a kettlebell (a piece of equipment that looks like a cannonball with a handle) and a Swiss ball, and can be done as easily in a living room as in a gym, he said.
"What's beautiful about a kettlebell is the convenience. They take up no room, and you can literally put it in a closet."
All of the exercises, from the cat stretch and back twist to the kettlebell squat and Turkish get-up, aim to strengthen each part of a person's core, including the smaller muscles of the back that are often neglected in traditional routines, Roth said.
"Everyone will do sit-ups, but they won't work the back muscles. And that's the key. It's the muscles that you don't see that are the most important part of mitigating back pain."
It has worked for him. With two herniated disks and a stress fracture in his L5 vertebrae, thanks to his high school football days, he practices what he preaches. "I went through it. I lived it. My whole life has been back pain," he said.
Roth's ideas might not be for everyone: His advice to work out even when in pain will turn some off, and his opinion that back surgery is "terribly overdone" because it's profitable for the surgeons will likely raise hackles. But he argues that most patients who get surgery don't need it, and could, with a little work, take control of the pain themselves.
"You have to try it," he said. "People don't feel confident that they can do it on their own, but they can."
Email: janoski@northjersey.com
--
- See more at: http://www.northjersey.com/news/health-news/doctor-s-rx-for-managing-back-pain-1.1082180?page=all#sthash.ta1oo6Qy.dpuf
Monday, September 8, 2014
Why do we still eat so poorly?
Drive down most highways in North Jersey, and you’re guaranteed to come across one of two things: a curbside fast food restaurant trying to lure motorists into its drive-thru with promises of salt-, sugar-, and fat-laden goodness, or a big metal sign advertising that such a place lies just off the next exit.
Their food is awful for us — we all know this — but many of us pull in anyway.
Take a lunch made up of an offering from McDonald’s dollar menu, such as the McDouble. That burger has 380 calories, 17 grams of fat, 34 grams of carbohydrates, and 840 milligrams of sodium. Add a "medium" order of fries for another 340 calories, 16 grams of fat, 44 grams of carbohydrates, and 190 milligrams of sodium, and a large Coke at 280 calories and 76 grams of carbohydrates, and you’ve got a meal packing a whopping 1,000 calories, 33 grams of fat (10.5 grams of which is saturated), 154 grams of carbohydrates, and 1,030 milligrams of sodium. That’s 58 percent of the recommended daily fat intake, 51 percent of carbs, 43 percent of sodium and about half of our recommended daily intake of calories, all in one heart-clogging, gut-busting meal.
And what’s the reward? Feelings of guilt and a waistline that never shrinks: According to the Center for Disease Control and Prevention, 70 percent of American adults now qualify as overweight, and of those, 35 percent are considered obese.
So why do we keep eating this way?
The problem, said Dr. Diego Coira, chairman of the Department of Psychiatry and Behavioral Medicine at Hackensack University Medical Center (HUMC), begins with one of the medical field’s favorite culprits: stress. When we’re under physical or emotional stress — not uncommon for our fast-paced lives — the body releases cortisol, a hormone that causes our appetite to increase (even if we ate a short time ago) and causes "stress eating." And the combination of salt, sugar, and fat that’s found in many of the worst foods is, unfortunately, psychologically and physically comforting, even if it’s unhealthy.
"They’re called ‘comfort foods’ because they help when you’re stressed — they calm you down, the brain releases endorphins and dopamine after you eat them, and you’re good," Coira said
And there’s more: Many of us don’t even know how much we’re consuming. Menus in most restaurants don’t have calorie or carbohydrate counts, and over time, those counts have risen as portion sizes have increased. The size of a bagel, for example, has doubled from 3 inches in diameter to 6 over the past 20 years, said Katie Day, clinical dietitian at HUMC at Pascack Valley, adding 200 calories to the breakfast meal.
Burgers are bigger, fries are more numerous, and we don’t feel like we’re getting a good "bang for our buck" unless we’re inundated with victuals. That line of thinking has allowed meals’ caloric values to wander into the realm of the ridiculous.
One example is the Cheesecake Factory’s "Brulee French Toast," which was recently awarded an "Xtreme Eating" award by the Center for Science in the Public Interest. Served at brunch and topped with powdered sugar and maple-butter syrup, it packs a heart-attack-inducing 2,780 calories, 93 grams of saturated fat, 2,230 milligrams of sodium, and 24 teaspoons of sugar. To burn that off, you’d have to run 21 miles.
Dealing with temptation
Even a regular steak dinner, said Chesney Blue, a registered dietitian for the Green Hill Senior Living community in West Orange, is probably twice as large as it should be: Instead of the 3 to 4 ounces that’s recommended, most restaurants give patrons at least 6 or 8.
So what can we do?
"If you know you’re going on a long trip, take stuff with you: granola bars, unsalted nuts, baby carrots, cheese cubes, etc.," Day advised. "That way, if you’re tempted, you at least have something there."
If stopping is an absolute necessity, order grilled or baked food over fried things, include a salad, and drink water instead of soda or other sugar-sweetened beverages that are typically standard fare.
At restaurants, practice portion control to avoid overeating, which two-thirds of Americans admit to doing.
"Your hand is a very good tool — if the amount of meat doesn’t fit in the palm of your hand, it may be too much for you," said Blue.
Day also suggested sharing an entrée, or having the waiter wrap up half of the plate before it’s even brought to the table.
Coira, however, said that going to dinner with friends may actually help us eat less: Not only does that sort of socialization alleviate stress, it forces us to do more talking than chewing. This slower pace means that our brain, which doesn’t register us as "full" until 20 minutes after we begin eating, has more time to figure out that the body doesn’t really need that rich, sugar-laden dessert.
But no matter how large the portion is, Coira said the most helpful thing we can do for ourselves is focus on the actual act of eating.
"Be mindful," he said.
"Smell the food, look at the colors, taste it, and take your time. That’s when you experience pleasure with a meal."
Email: janoski@northjersey.com
--
- See more at: http://www.northjersey.com/news/health-news/why-do-we-still-eat-so-poorly-1.1082177?page=all#sthash.k0SW3Bjd.dpuf
Their food is awful for us — we all know this — but many of us pull in anyway.
Take a lunch made up of an offering from McDonald’s dollar menu, such as the McDouble. That burger has 380 calories, 17 grams of fat, 34 grams of carbohydrates, and 840 milligrams of sodium. Add a "medium" order of fries for another 340 calories, 16 grams of fat, 44 grams of carbohydrates, and 190 milligrams of sodium, and a large Coke at 280 calories and 76 grams of carbohydrates, and you’ve got a meal packing a whopping 1,000 calories, 33 grams of fat (10.5 grams of which is saturated), 154 grams of carbohydrates, and 1,030 milligrams of sodium. That’s 58 percent of the recommended daily fat intake, 51 percent of carbs, 43 percent of sodium and about half of our recommended daily intake of calories, all in one heart-clogging, gut-busting meal.
And what’s the reward? Feelings of guilt and a waistline that never shrinks: According to the Center for Disease Control and Prevention, 70 percent of American adults now qualify as overweight, and of those, 35 percent are considered obese.
So why do we keep eating this way?
The problem, said Dr. Diego Coira, chairman of the Department of Psychiatry and Behavioral Medicine at Hackensack University Medical Center (HUMC), begins with one of the medical field’s favorite culprits: stress. When we’re under physical or emotional stress — not uncommon for our fast-paced lives — the body releases cortisol, a hormone that causes our appetite to increase (even if we ate a short time ago) and causes "stress eating." And the combination of salt, sugar, and fat that’s found in many of the worst foods is, unfortunately, psychologically and physically comforting, even if it’s unhealthy.
"They’re called ‘comfort foods’ because they help when you’re stressed — they calm you down, the brain releases endorphins and dopamine after you eat them, and you’re good," Coira said
And there’s more: Many of us don’t even know how much we’re consuming. Menus in most restaurants don’t have calorie or carbohydrate counts, and over time, those counts have risen as portion sizes have increased. The size of a bagel, for example, has doubled from 3 inches in diameter to 6 over the past 20 years, said Katie Day, clinical dietitian at HUMC at Pascack Valley, adding 200 calories to the breakfast meal.
Burgers are bigger, fries are more numerous, and we don’t feel like we’re getting a good "bang for our buck" unless we’re inundated with victuals. That line of thinking has allowed meals’ caloric values to wander into the realm of the ridiculous.
One example is the Cheesecake Factory’s "Brulee French Toast," which was recently awarded an "Xtreme Eating" award by the Center for Science in the Public Interest. Served at brunch and topped with powdered sugar and maple-butter syrup, it packs a heart-attack-inducing 2,780 calories, 93 grams of saturated fat, 2,230 milligrams of sodium, and 24 teaspoons of sugar. To burn that off, you’d have to run 21 miles.
Dealing with temptation
Even a regular steak dinner, said Chesney Blue, a registered dietitian for the Green Hill Senior Living community in West Orange, is probably twice as large as it should be: Instead of the 3 to 4 ounces that’s recommended, most restaurants give patrons at least 6 or 8.
So what can we do?
"If you know you’re going on a long trip, take stuff with you: granola bars, unsalted nuts, baby carrots, cheese cubes, etc.," Day advised. "That way, if you’re tempted, you at least have something there."
If stopping is an absolute necessity, order grilled or baked food over fried things, include a salad, and drink water instead of soda or other sugar-sweetened beverages that are typically standard fare.
At restaurants, practice portion control to avoid overeating, which two-thirds of Americans admit to doing.
"Your hand is a very good tool — if the amount of meat doesn’t fit in the palm of your hand, it may be too much for you," said Blue.
Day also suggested sharing an entrée, or having the waiter wrap up half of the plate before it’s even brought to the table.
Coira, however, said that going to dinner with friends may actually help us eat less: Not only does that sort of socialization alleviate stress, it forces us to do more talking than chewing. This slower pace means that our brain, which doesn’t register us as "full" until 20 minutes after we begin eating, has more time to figure out that the body doesn’t really need that rich, sugar-laden dessert.
But no matter how large the portion is, Coira said the most helpful thing we can do for ourselves is focus on the actual act of eating.
"Be mindful," he said.
"Smell the food, look at the colors, taste it, and take your time. That’s when you experience pleasure with a meal."
Email: janoski@northjersey.com
--
- See more at: http://www.northjersey.com/news/health-news/why-do-we-still-eat-so-poorly-1.1082177?page=all#sthash.k0SW3Bjd.dpuf
Wednesday, September 3, 2014
So, should you avoid eating carbs?
Yes, a new study has found that a low-carbohydrate diet helped participants drop weight faster over 12 months than a low-fat one, but let's not toss the rye bread and start frying up the eggs just yet.
Look past the headlines that the study, led by Tulane University's Dr. Lydia Bazzano and published this week in the Annals of Internal Medicine, has generated, and you will find that the message is not, in fact, about the importance of really cutting back on carbohydrates — it's yet another heads up to be more careful about what we're eating.
The study found that a group following a low-carb diet lost more weight — an average of 7.7 pounds worth — and their levels of HDL ("good") cholesterol had increased "significantly more" than a group following a low-fat diet over a year's time. Their triglycerides also fell sharply, and their Framingham scores, which predict how likely a patient is to have a heart attack within 10 years, also dropped.
Many see the results as an endorsement of an Atkins-like high-protein, high-fat diet, but Sharon R. Akabas, Ph.D., director of the M.S. in nutrition program at the Institute of Human Nutrition for Columbia University, said that we may be missing the point.
"The message that may be lost in translation is that eating unprocessed foods is very important," she said.
America has made a "big mistake" in making fat out to be villainous, she said, and the foods we developed in the wake of the "low-fat" craze may be low in fat but high in sugar and really low in nutrients. So while there's nothing inherently wrong with using a low-fat diet to keep your weight down, it's difficult to do without eventually eating processed foods. The reason? We've got to get our calories somehow. Low-carb diets, on the other hand, may not be as difficult to maintain; dieters may eat more fat, but if it's healthy fat – from nuts and olive oil, for example – that's OK.
"The higher-fat diet seems to allow us to select less processed foods, and that allows people to manage their weight better," Akabas said. "That ultimately affects their health in a positive way." In other words, she noted, this study reinforces what scores of previous studies have found: "People should reduce their simple sugars and processed foods while moving to a more plant-based diet."
The study took a group of 148 obese people and divided them into two groups: one that followed a traditional low-fat diet that restricted them to getting no more than 30 percent of their daily energy intake from fat, and another that followed a low-carbohydrate approach and limited participants to no more than 40 grams a day (an average diet allows for around 300 grams). The subjects ranged from 22 to 75 years old, had a body mass index of between 30 and 45 (doctors prefer it to be between 18 and 25), and had no reported history of cardiovascular problems. The diets included no specific calorie goal, and both groups were asked not to change their physical activity levels.
Cardiologist Benita Burke, M.D., medical director of Valley Medical Group's Heart Care for Women, said that the study had flaws, such as a limited scope, short timeline and a reliance on participants reporting what they ate. And while triglycerides and other inflammation markers fell among the low-carb eaters, blood pressure readings didn't, and levels of LDL cholesterol — (the "bad" cholesterol) — didn't change with either group. Larger studies with final tallies of how many patients later suffered heart attacks or strokes are necessary before a final judgment is made, she said.
The one benefit, Burke said, was the insinuation that sugar is a no-no. "It's a good thing to say, 'Keep people away from the bagels and the muffins,' because we have to stay away from them. We know it turns into sugar, and we're already on sugar overload," she said.
"It all comes back to these processed foods and these sugars … everything we eat that's 'white' should be out."
Email: janoski@northjersey.com
- See more at: http://www.northjersey.com/news/health-news/so-should-you-avoid-eating-carbs-1.1079786#sthash.aarU1yy6.dpuf
Look past the headlines that the study, led by Tulane University's Dr. Lydia Bazzano and published this week in the Annals of Internal Medicine, has generated, and you will find that the message is not, in fact, about the importance of really cutting back on carbohydrates — it's yet another heads up to be more careful about what we're eating.
The study found that a group following a low-carb diet lost more weight — an average of 7.7 pounds worth — and their levels of HDL ("good") cholesterol had increased "significantly more" than a group following a low-fat diet over a year's time. Their triglycerides also fell sharply, and their Framingham scores, which predict how likely a patient is to have a heart attack within 10 years, also dropped.
Many see the results as an endorsement of an Atkins-like high-protein, high-fat diet, but Sharon R. Akabas, Ph.D., director of the M.S. in nutrition program at the Institute of Human Nutrition for Columbia University, said that we may be missing the point.
"The message that may be lost in translation is that eating unprocessed foods is very important," she said.
America has made a "big mistake" in making fat out to be villainous, she said, and the foods we developed in the wake of the "low-fat" craze may be low in fat but high in sugar and really low in nutrients. So while there's nothing inherently wrong with using a low-fat diet to keep your weight down, it's difficult to do without eventually eating processed foods. The reason? We've got to get our calories somehow. Low-carb diets, on the other hand, may not be as difficult to maintain; dieters may eat more fat, but if it's healthy fat – from nuts and olive oil, for example – that's OK.
"The higher-fat diet seems to allow us to select less processed foods, and that allows people to manage their weight better," Akabas said. "That ultimately affects their health in a positive way." In other words, she noted, this study reinforces what scores of previous studies have found: "People should reduce their simple sugars and processed foods while moving to a more plant-based diet."
The study took a group of 148 obese people and divided them into two groups: one that followed a traditional low-fat diet that restricted them to getting no more than 30 percent of their daily energy intake from fat, and another that followed a low-carbohydrate approach and limited participants to no more than 40 grams a day (an average diet allows for around 300 grams). The subjects ranged from 22 to 75 years old, had a body mass index of between 30 and 45 (doctors prefer it to be between 18 and 25), and had no reported history of cardiovascular problems. The diets included no specific calorie goal, and both groups were asked not to change their physical activity levels.
Cardiologist Benita Burke, M.D., medical director of Valley Medical Group's Heart Care for Women, said that the study had flaws, such as a limited scope, short timeline and a reliance on participants reporting what they ate. And while triglycerides and other inflammation markers fell among the low-carb eaters, blood pressure readings didn't, and levels of LDL cholesterol — (the "bad" cholesterol) — didn't change with either group. Larger studies with final tallies of how many patients later suffered heart attacks or strokes are necessary before a final judgment is made, she said.
The one benefit, Burke said, was the insinuation that sugar is a no-no. "It's a good thing to say, 'Keep people away from the bagels and the muffins,' because we have to stay away from them. We know it turns into sugar, and we're already on sugar overload," she said.
"It all comes back to these processed foods and these sugars … everything we eat that's 'white' should be out."
Email: janoski@northjersey.com
- See more at: http://www.northjersey.com/news/health-news/so-should-you-avoid-eating-carbs-1.1079786#sthash.aarU1yy6.dpuf
Monday, September 1, 2014
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