Saturday, August 16, 2014


Do you know what 168 stands for?
For those who do not know that number, let me give you some hints. 168 represents something very valuable, yet often taken for granted. It's also represents something that most people would think is far less. Ready for the answer?
Drum-roll, please.
168 represents the number of hours in a week.
When I ask this question to many people, the answer surprises them. I often ask the question in response to someone inquiring about how I spend my time these days. When they hear what 168 represents, they first smile to themselves as they do their own silent calculations -- 7 days times 24 hours a day equals 168.
But the best part is when they look again at me and grin. For in that moment, they realize that 168 is a pivotal number for me and that I am transmitting a message with my question. Before they can speak, I do a little more math for them. I start by stating that if I sleep 7 hours a day, which is my target, I will use 49 hours of the 168 a week. That leaves 119 hours at my disposal.
That also leaves 119 hours at anyone's disposal that sleeps 7 hours a night. If you work, subtract at least another 40 to 60 hours that includes transportation time and you are left with a neat 59 to 79 hours to eat, shop, bathe, toilet, have sex, and generally meet human needs. That may knock of another 25 to 30 hours off a week leaving you with a sum total of a low of 29 to a high of 54 hours.
Depending on the speed at which you do life, you should have time left over for more pleasant activities such as parenting (both to children and your own parents; yes, I know that it's not always pleasant), enjoying hobbies, reading, exercising, watching (may not actually be better), and socializing.
I suggest you do your own tally and figure out how you spend each week.
Why bother?
Two reasons.
First, as you only go around once, don't you want to figure out if you are making the best use of your time? It seems that many people don't appreciate the value of their current time and instead 'plan' to make good use of time only when they retire.
That's a shame. You never know what life may bring when you retire, such a state of health, and you shouldn't wait for it.
Second, and far more personal to me, retirement for most people doesn't appear to be all that great. What, you may say? Are you crazy? You may feel that when you retire, you won't have to set your alarm clock, get ready for work, travel to work, work all day to make a living, go home, and repeat the same regiment the next day. Wouldn't that be great? I know I felt that way.
Then I retired. I like to read, watch, socialize, eat, have sex, shower, sleep, exercise, etc. The problem is that even when I'm done, I'm still left with too much time to spend. (No speedy sex jokes, please)
Okay, you may say, how about some charitable or volunteer work? I've tried that by getting involved in community, non-profit work. It just wasn't all that satisfying for me because there always seemed to be more talking than action. In fact, it almost seemed like people joined these boards to hear themselves speak. (By the way, I'm not saying that such organizations don't play an important role--just that they weren't my cup of tea.)
So what's my point here?
Stop wasting your time because you never know what you will find at the end of the rainbow. Find work that you enjoy if that is possible. Work is for most people a necessity, but that doesn't always mean you have to spend spend your life doing unpleasant work in the hope that retirement, even an early one, will make it all worth it. A terminally ill cancer patient once told me that no one states on their death bed that they wished they had spent more time at the office.
So back to 168 hours a week. It's actually plenty; so make sure you are using them all well. If not, maybe it's time you started.
My last piece of advice is never retire. Keep working until you can't physically or intellectually work any more. If you work because you are trying to save for retirement or to put food on the table then keep doing what you must until you are financially comfortable (whatever that means for you), then switch to work you enjoy so it won't feel much like work.
Finally, always find a reason to get out of bed every day. It sure beats the alternative.

Friday, August 8, 2014

No Really, It's All About You.

I’ve been as guilty as anyone who tries to give the best health advice to family, friends and even strangers. I’ve answered countless questions and initiated endless discussions about food, nutrition, dietary supplements, exercise, and many other facets of presumed healthy living. This advice has always been based on the weight of the evidence of the available science. But in my heart, I always knew that my recommendations were based on statistical significance. In other words, the evidence would show that there was a statistical advantage to following one approach over another based on the conclusions of any number of studies.
These studies may have nothing to do with you at all. The problem with basing recommendations on such studies ignores the fact that they don't ultimately account for YOU as an individual.
For example, although smoking is strongly linked to lung cancer and other lung related diseases, it doesn’t equally affect all smokers. That doesn’t mean smoking is ever good for you, but for some it actually is harmless. (Today, as there is no way to know if you are at real risk, it’s still best to avoid.)
While some people have a disease (Celiac) that absolutely requires them to avoid gluten and others have an intolerance to it, there are still many that are not affected, whether it’s genetically modified or not. The same can be said for sugar and simple carbohydrates. There is no doubt that for some the consumption of sugar is lethal as it leads to deadly weight gain, diabetes, heart disease, etc., while there are others completely unfazed by consumption of large amounts. I have a friend Steve that consumes it non-stop with no apparent consequence. He has no family history of diabetes and his blood sugar is not elevated above normal levels despite his relentless consumption. He is also very physically active and that may explain his apparent immunity.
Now I’m not saying that just because you don’t know for sure whether or not something is bad for you it’s okay to throw caution to the wind and ignore the statistics. Rather, I’m saying that you really have to pull together all the clues your body is giving you to try to make sense of what is and is not right for you.
Those clues include family history, genetic testing, blood work, the mirror, how you feel, etc.
None of these clues in and of themselves carry absolute weight.
You are not your parents or your siblings. First, you inherit two sets of genes, one from each parent. Second, factors such as mutations and environmental exposures affect if these genes turn on or off. At this point, science cannot predict except in very rare circumstances how one’s genes will ultimately affect your overall health. That’s because it’s a complex, multifaceted hormonal and transcriptional system that’s at play.
Complicating the matter further, over the span of one’s lifetime, genes can change the way they act or even actually change in what are called somatic mutations. That may explain why something that was never a problem suddenly becomes one and vice a versa. The science of how the environment affects our genes is called epigenetics and it is still a fledgling field.
What about genetic tests? They have yet to become mainstream and for good reason. Genetic tests only identify the genes we know and understand and potentially ignore many other genes that we don’t fully understand their roles and how they may affect the genes we do seem to understand. More importantly, gene therapy is still in its early stages and so identifying a gene problem for which there is no practical solution today could best be described as a frustrating exercise in futility for the current sufferer. While there is great promise in what lies ahead, genetic testing today plays at best a marginal role. Yes, it may induce a woman with a family history of breast cancer and a known BRCA gene mutation to undergo mastectomy, but it may not have been necessary if we had a better grasp of what other factors, such as the presence or absence of other genes or gene mutations, would change the risk profile and eliminate the need for surgery.
Blood tests provide good, but also imperfect information. Their results are generally markers, rather than causes of diseases. I generally favor them as more information is usually better than less, but even that’s not always the case. The Prostate Specific Antigen test for prostate cancer is a case in point. Reasonable doctors can disagree if and when having such a test is indicated as so many men pursue further expensive, invasive, and unnecessary testing based on misleading results.
The mirror is my favorite clue. How do you look? The most specific clue is do you look your age. Again, not the perfect clue because you can look great and still have underlying disease or even trouble pending. That’s also true for how do you feel. Feeling good is obviously better than the alternative, but it’s no guarantee of good health.
My point is that although no clue in isolation should give one complete peace of mind, taken collectively they offer a decent roadmap when reviewed by someone capable of properly making such a determination.
Now you may say that all this concern about clues about health is much ado about nothing because there is actually very little you can do to change anything--and you may actually be right. Until we know more, no one can answer that question with certainty, or what is certain today may not be tomorrow
However, to the extent that you continue to seek advice about the best foods to eat, what supplements you need, what form your exercise should take, etc., please be aware that unless the person giving you such advice knows a lot about you such as your family history, your blood results, your genetic profile, your state of mind and body, such advice is merely general and generic. That’s because at the end of the day it’s all about what does/will affect you as an individual and not some statistic. Don’t chase or accept unsolicited advice from people who don’t know YOU or your history. Such advice is usually not meaningful and may lead to bad results.
By the way, this does not apply to medical advice given by a health professional following a proper consultation. That’s more a question if you trust the professional’s knowledge and judgment (a whole topic on its own).
Nevertheless, you don’t need to be a narcissist to realize that when it comes to your health and the best approach, it really is all about YOU.

Tuesday, July 1, 2014

Next Stop: Stanford University

In 1955, Albert Einstein was quoted that one should "learn from yesterday, live for today, hope for tomorrow. The important thing is to not stop questioning. Curiosity has its own reason for existing." Like Einstein, I have always believed in lifelong learning and satisfying my ever curious mind.
You may think that at the age of 55, with a medical school education, surgical training, a business degree, and a career that included founding, building, and eventually retiring from HealthDrive, a national health care company serving the extended care industry, my learning days and quest for more knowledge might be done. You might also think that after the shutdown of MDPrevent, (see my other post on what happened), my full throttle, but unsuccessful foray into life extension and disease prevention by lifestyle modification, my interests in longevity and preventive medicine would have waned. If you thought so, you would be incorrect on both accounts. That's because I believe if you don't succeed at first, try again.
About two months ago, I learned about a new program starting up at Stanford University called the Distinguished Careers Institute or DCI. The DCI, the brainchild of Philip Pizzo, MD, the former dean of Stanford’s Medical School, offers people who have had successful careers, but are eager to discover what comes next, an opportunity to expand their minds at Stanford by pursuing a scholarly pathway under the guidance of faculty mentors and advisers. When I read about the program in a press release, which I accessed through my daily Google alert on the keyword ‘longevity,’ the idea so excited me that I suspect I was the first person to apply online.
I am excited to announce that my application was accepted and I received an invitation to join the inaugural group (20 individuals) of Fellows to start the program in January 2015. Yesterday, I made the decision to accept the invitation after consulting with a number of professors at the Stanford Center for Longevity and the Stanford Prevention Research Center, including Doctors Pizzo and Kathy Gillam, the executive director of the DCI program, who all impressed me with their knowledge, friendliness, and willingness to help me identify my next career. Although I have always believed that success is the byproduct of one’s own hard work (and good luck), I have also learned the value of getting help from others. 
As a believer in making the most of one’s life until you can’t do no more and in doing well by doing good, I can’t believe there can be a better place for me than Stanford as the next stop on my life journey. Wish me luck.

Wednesday, June 11, 2014

Caveat Lector -- Let The Reader Beware!

A new study shows…

How many times have you heard that phrase followed by some new big revelation? It’s usually a new discovery because few scientists want to study and merely confirm what is already known. If they do, the confirmed results often don’t see the light of day. However, if they discover something new then watch out.

More importantly, the media doesn’t grab attention by generating headlines about widely accepted knowledge.  Often times, the new information creates a buzz because it conflicts with previously accepted science; not surprisingly, often these types of studies grab the most headlines. 

The problem with such studies and the headlines they generate is that no single study proves anything—it merely adds to our knowledge. That’s why people are cautioned to not accept any media science headlines at face value without knowing the full scope of the study reported and how its conclusions fit in with the greater body of evidence surrounding the topic.

At a recent wedding, three of my cousins approached me to ask nutritional questions. One even asked me during the meal if what he was eating was healthy.  Another commented that they should watch me to see what I eat to determine what was good for them.  That approach would be a horrible mistake.  A healthy diet should never be judged by one meal alone; healthy food should never be judged on the basis of isolated nutrients.

One would think that it is well understood that a healthy diet should be viewed holistically (in its entirety), but you could be forgiven for thinking otherwise when studies like the one recently published by the CDC hits the media circuit. The study, titled Defining Powerhouse Fruits and Vegetables: A Nutrient Density Approach attempts to clarify the value of consuming certain fruits and vegetables over others based on the levels of certain nutrients they contain.

As part of the study, Jennifer Di Noia, an associate professor of sociology at William Paterson University in Wayne, N.J., crafted a list based on the nutritional density of fruits and vegetables, using data from the U.S. Department of Agriculture. As the basis of determining nutritional value, she used 17 nutrients including potassium, fiber, protein, calcium, iron, thiamin, riboflavin, niacin, folate, zinc, and vitamins A, B6, B12, C, D, E, and K.
By her own admission, because she felt that since it was not possible “to include phytochemical data in the calculation of nutrient density scores, the scores do not reflect all of the constituents of a fruit and vegetable that may confer health benefits.” By phytochemicals, Dr. Noia is referring to all the antioxidants, like anthocyanins, polyphenols, carotenoids, etc., and other nutrients that naturally occur in fruits and vegetables; the same antioxidants that are believed to work synergistically with all the other nutrients in the fruits and vegetables to deliver the full nutritional value of a food item; the same naturally occurring antioxidants that are believed to play a role in neutralizing free radicals.

In addition, her qualification list only includes 17 nutrients while there are 13 vitamins, 15 minerals, two fatty acids, nine amino acids (she did include proteins, but did not clarify if they were complete proteins that by definition contain all 9 essential amino acids), and water, all of which are considered essential to human functioning. So even though there are 49 absolutely essential (as identified by current science—of course subject to future revision) nutrients, her list was based on only 17. Nevertheless, she concluded that they were apparently the most important.

What were her conclusions? Leafy green vegetables are good.  No big surprise. Raspberries, tangerines, cranberries, garlic, onions, and blueberries are essentially a waste of time when it comes to their nutritional soundness. Why? Because they didn’t have enough of the 17 nutrients she deemed important. Forget about what else they have in them; they just don’t make the cut. That’s just plain absurd.

An essential nutrient is an essential nutrient.  None is more important than another. Further, it’s renders her study meaningless when she leaves out phytochemicals.  If you followed Noia’s logic, you shouldn’t bother eating fruits and vegetables at all. Just pop a pill that includes the same amounts of her 17 key nutrients and call it a “Powerhouse Pill.” Shameless.

Nevertheless, I am very surprised, given the study’s limited utility, that the CDC published it in the CDC’s journal, Preventing Chronic Disease.  More importantly, until I read the actual study, I was baffled by its reported conclusions. Once I knew what criteria had been used, I also knew its true value—zero.  I disdain the use of “powerhouse” to describe any food as being more important than other foods contributing to an overall healthy diet. Using such a word is nothing more than an attempt at hype to grab more media attention. Uch.

For me it invoked once again the saying, Caveat Lector—let the reader beware!

Friday, June 6, 2014

Dr. Oz Show Canceled???

New York, NY. June 6, 2017 --After riot police were summoned, Harpoon Productions, the producers of the Dr. Oz Show bowed to public outcry and the rapidly growing crowd outside it’s studios that stretched down Manhattan’s Sixth Avenue, blocking traffic for miles in any direction, by announcing today the immediate cancellation of the syndicated television show that ran for ten years featuring Dr. Melvin Oz.    

The problems with the show had been steadily increasing due to mounting scandals plaguing Oz such as a lawsuit concerning burnt diabetic toes.  Another scandal involved Dr. Oz denying the fact that he and his family take no supplements and never have despite stating the opposite on many episodes.  In the face of incontrovertible evidence, Oz has continued to claim that he consumes dozens of supplements a day to prevent colds, hair loss and fungal infected toenails. However, the most troublesome revelation about Oz was the discovery that he is paid $1 every time he endorses a supplement. It is believed that Oz has joined the Forbes 300.
Problems for Oz and his show escalated on Wednesday when a group of several hundred morbidly obese women and men gathered outside the studio at Rockefeller Plaza in New York.  They came to protest against the show and its star. Waving banners that read, “You Did This To Us” and “Stop Feeding Fat Lies To Skinny People,” the protesters were presumably reacting to Oz’s now almost daily proclamations of new ways to lose weight, including his most recently touted  “One-Minute Rapid Weight Loss Plan” and “How To Lose Ten Pounds By Donating An Organ.“
These newfangled, unscientific, and radical plans were touted by Dr. Oz pursuant to what he declared was “recent research that showed they worked.”  In addition, these “quickie” weight loss plans, described by Oz as “miracles” had joined a long list of his other rapid weight loss schemes like Raspberry Ketones, Garcinia Cambogia, and Glucomannan.
One hefty protester by the name of Pop Goestheweasel, a 64 year old construction worker from Yonkers  said that he had enjoyed a 34 inch waist before watching the show based on his wife’s advice.  Goestheweasel,, who now appears to have ballooned to at least four hundred pounds, cut the interview short to snack on a pizza and milkshake Oz had recommended on a recent show as “a magical weight loss elixir.”  He also admitted that he was a sucker for Oz’s medical persona and until today continued to hope that the next Oz advice would be the one that finally restores his waistline.
Events really started to get out of hand when the original protesters were joined by thousands of once happy, but now neurotic women who joined the fray waving medical bills.  These bills estimated to total in the millions of dollars were the result of faithful viewers seeking immediate medical attention after Dr. Oz aired multiple episodes about the dangers of ignoring warning signs, such as sneezing once may indicate breast cancer, and an eye sty may be a sign of a heart attack.  
One woman in the crowd identified as Gota Migraine, a 47 years old housewife from Queens, revealed that she had seen five internists and thirteen specialists after hearing Dr. Oz tell his TV audience that fatigue may be due to Overexertion, a newly discovered illness.  After researching Overexertion on the internet, this lady was determined to seek appropriate medical attention to combat her life-altering condition. Despite numerous medical exams and tests, alternative medicine doctors she sought out after seeing them repeatedly featured on The Dr. Oz Show who had been unable to pinpoint why Overexertion was causing her fatigue. After being told to take no less than three thousand different supplement pills and nutritional foods, many of which had been emphatically endorsed on the Dr. Oz Show, Mrs. Migraine realized that her fatigue was due to carrying around hundreds of bottles containing her daily supplements.
The final straw for the Dr. Oz Show’s producers was when the crowd expanded to include hundreds of thousands of scalpel wielding doctors who traveled from all over the world to beg Oz to stop spewing pseudoscience to their patients.  In fact, it was noted that some doctors were actually breathing heavily from the burden of listening to their patients for years tell them that “Dr. Oz said this…and Dr. Oz said that.”  
The crowd, including the panic-stricken doctors, went into a frenzy when an announcement was made that Dr. Oz had issued a message for the crowd that “protesting against the Dr. Oz Show was bad for their health.”  Fortunately, the crowd quieted and was noted to have uttered a collective deep sigh of relief when news of the show’s cancellation reached them.  Even as the crowd began to dissipate, some doctors were noted to be tending to the morbidly obese men that had overdosed on Glucamannan and were suffering from intestinal blockage, while other doctors were seen comforting the neurotic women that everything would be okay now.
As for Melvin Oz, who could not be reached for comment, authorities report that he was taken into protective custody pending resolution of the incident. At the same time, it’s been announced that all his ubiquitous images on TV, magazines, internet, newspapers, and billboards have been removed to avoid inciting another mass protest.  It is clear the good doctor is no longer in.
This parody is meant as good fun. It is completely fictitious, as are all the characters and none of it has happened (at least not yet.) 
In addition, no real people were harmed in the writing of this parody, but it’s not certain that the same can be said for the viewers of the Dr. Oz Show.