June 18, 2008 by Avery Jenkins.

And, not surprisingly, it comes from the American Medical Association.

The AMA has proposed a resolution which would call upon state and federal legislatures to restrict the use of the term “Doctor” to only those who have an MD, DO, DDS, or DPM degree.

That’s right. According to the AMA, it should be illegal to call me Dr. Jenkins, even though I posess a valid doctor’s degree from a federally and state accredited university with permission to offer that degree.

Even though getting my doctor degree required more hours than required to get a medical degree.

Even though I posess not one, but two post-graduate board certifications, each requiring hundreds of hours of education.

And certainly, there couldn’t be a single psychologist in the country worthy of being called doctor. Nor should anyone holding a PhD be worthy of the term.

I don’t know whether to attribute this  brand-spanking-new medical folly to a bad case of acute arrogance or simply institutional dementia.

Or, it could be that  the fear is starting to set in.

The fear that the medical “doctors” will continue to lose patients to professions like mine, real doctors who know how to create health, not just dress illness up in a drug and call it healthy.

The fear that people will start to realize that yes, according to the CDC’s own statistics, medical “doctors” kill as many people as 5 jumbo jets crashing every day.

The fear that the curtain of concealment is starting to tear, and patients are beginning to recognize that the wizards of health — those so-called medical “doctors” — are little more than Kansan hucksters selling cartloads of high-tech snake oil.

Frankly, I’m livid. Can you tell?

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June 13, 2008 by Avery Jenkins.

As a primary care physician preaching the gospel of nutrition and exercise, I have always tried to follow my own advice. Particularly this year, with my overseas adventure rapidly approaching, I have been ramping up the fitness quota, and am now pushing six training days weekly.

Nobody as yet has mistaken me for Thor, God of Thunder. There’s always hope, though; after all, myopia is a common disorder. Nonetheless, despite the general public’s oversight in this regard, I think I’m in pretty good shape. At least, I did until yesterday.

Marilyn Gansel, a personal trainer with studios in Stamford and Kent, CT, graciously invited me for a one-on-one with her in her Kent facility. Marilyn is multi-degreed and is currently working on her PhD in sports psychology. Marilyn and I have talked with each other on many occasions about her functional approach to training, and she offered me the chance to experience it first-hand.

A Different Path to Fitness

Before we get to the embarrassing parts, first a word about functional exercise. Traditionally, strength training has been performed by isolated muscles, using benches, barbells, dumbells or machines. The exercises will work one set of muscles at a time; for example, the classic bench press, which is used to strengthen the muscles of the chest.

Functional exercise, on the other hand, uses more complex motions with weights in a variety of forms when additional resistance is needed. For example, at one point Marilyn had me doing lunges off of a step, while at the same time raising a medicine ball above my head and in front of my chest.

For fairly obvious reasons, these exercises, and the benefits they give you, translate much more readily into our day to day activities and the sports in which we participate.

And for the majority of my patients, it is these exercises, not the leg-curl machine at the gym or the physical therapist’s office, that will provide the greatest benefit.

Sure, following orthopedic surgery, the isolated, single-joint, single-muscle approach is the way to go. But most of my patients with musculoskeletal complaints suffer from more chronic soft-tissue injuries. In these cases, functional exercises are leaps and bounds ahead of traditional techniques.

And for people whose disorders affect their sense of balance or coordination, training such as this can be especially helpful.

Indeed, as I found out, functional exercise training can provide benefits for those seeking to improve their overall fitness, a goal I try to impress on all of my patients, regardless of disorder.

Finding the Weak Spots

It took Marilyn all of 15 minutes to isolate some extraordinarily weak areas of which I was utterly oblivious. Because my strength training routine has focused on the larger muscle groups, some of the smaller muscles used to control posture and stabilize movement have gone somewhat neglected. Strengthening them will only improve my performance in my two primary activities, Aikido and cycling.

But as with any weak area, the path to improvement is by incorporating those exercises into my workout routine.

To this end, Marilyn showed me proper form and timing for the exercises. Although her studio is equipped with high-end exercise equipment, many functional exercises can be performed with low-tech aids. Form, posture and timing are key, however, which makes her one-on-one instruction imperative.

And even working at the slower pace required by my introduction to these exercises, I could tell that the possibilities for cardiovascular conditioning are clearly present, making Marilyn’s methodology a very balanced approach.

At the end of my hour with Marilyn, I could feel that I had gotten a good, solid workout. More than that, I had discovered new ways to boost my fitness, not necessarily in a win-the-swimsuit-contest way, but in an improve-my-overall-health way.

And that’s something we could all use. Regardless of your fitness level, I highly recommend you get in touch with Marilyn. Her website is www.fitnessmatters.com.

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June 10, 2008 by Avery Jenkins.

Patients often come see me because they are confused about all of the conflicting information they are getting about nutrition. Last week, tomatoes were good. This week, they will make your pancreas explode. Last week, fish were full of mercury and should be eaten only every third Sunday in months with the letter “t” in them. This week, damn the mercury, get those omega 3 fatty acids!

It seems that every day there is a new study coming out that conflicts with last week’s study.

There are two sources of this confusion. The first is the demands of mainstream news processing and distribution. By the time the media is finished with a useful news item, it has usually been stripped of any valuable content, much like what happens to an ear of corn on its way to becoming a Doritos chip. It is then unsurprising that conflicting information should appear, sometimes stemming from the same study.

The second source of confusion is the frequent poor quality of the research itself. If you have a background in the sciences, and you actually read the articles themselves, rather than the abstract, you often begin to wonder how on earth the authors reached the conclusions that they did.

It is a little bit like looking at a painting and thinking to yourself, “what a beautiful study in yellow I see here,” then having the artist walk up and tell you how red the whole thing is. You just have to shake your head and wonder.

Which is exactly what I did when I came across this little gem of an article, “A High-Fat Meal Increases Cardiovascular Reactivity to Psychological Stress in Healthy Young Adults.” (Article here.)

At first blush, this is right up my alley. Nutrition, mind/body interaction, cardiovascular disease, gee, I couldn’t ask for more out of a journal. And the conclusion was very interesting. “The consumption of high levels of saturated fat over the course of several weeks may lead to exaggerated cardiovascular reactivity,” the authors wrote. In fact, “the consumption of a single high-fat meal has been associated with a transient impairment of vascular function.”

Translation: A high-fat meal is bad for your heart and arteries.

It would seem to be common wisdom, after all, that’s the party line that has been thrown at the public over the past 20 years. But the party line, as we know all too well, is rarely the whole truth.

Comparing junk to junk

Which it turns out, is the case here. The high fat meal consisted of 2 McDonald’s hash brown patties, a Sausage McMuffin and an Egg McMuffin. Holy Toledo! But wait — the “healthy” meal included Kellog’s Frosted Flakes, skim milk, Source fat-free yogurt, a Kellogs Fruit Loops Fruit Bar and Sunny Delight orange juice.

In short, both meals were nutritionally unsound. The low-fat meal turns out to be a high-sugar meal, also accompanied by hormones, antibiotics and a cornucopia of chemical additives, most of which have unknown effects on physiology.

Perhaps that did not matter to these investigators. However, were I conducting nutritional research, I would choose a nutritionally balanced and healthy meal as my baseline. All we are doing here is comparing junk to junk.

“All well and good,” some might say, “but it still tells us about the effects of fat on the heart.”

It actually tells us nothing of the kind. There were no controls in place for any of the following:

1. Hormones, which are known to exist in physiologically effective concentrations in the meat sources used by McDonald’s and other fast-food chains;

2. Antibiotics, also present in physiologically effective concentrations;

3. Trans fats and unsaturated fats, which have significantly different cardiovascular effects;

4. Sugar. Although the long-term ingestion of high amounts of sugar eventually lead to ongoing high blood pressure, the immediate effect of eating sugar is to temporarily lower blood pressure.

So not only were the researchers comparing junk to junk, they also failed to control for significantly important nutrients which could influence the outcome, and in particular, chose a baseline meal that would have the effects of exaggerating the outcome of the experiment.

In short, in addition to using junk nutrition, these researchers produced junk science.

Nonetheless, it  will be cited in yet other journal articles as yet more proof that high-fat diets are bad for your health.

When, actually, this research said much and proved nothing.

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