How many steps per day to stay fit?

Over the past several years, many individuals have started to count their steps as a way of adding exercise to their daily routines.  Most use a device known as a pedometer to see how many steps they walk in a day and then adjust their routines accordingly.  The question is, how many steps are needed to produce a beneficial health effect?  5,000? 10,000?

I recently attended the American College of Sports Medicine's Annual Meeting in San Francisco and was able to attend a clinical lecture that discussed just that.  Dr. Catrine Tudor-Locke and Dr. Michael D. Schmidt explained their detailed studies by presenting some intricate data that I will try to summarize.  The average individual takes about 5,000 steps per day with their normal activities, with men taking more than that.  If you think about it, that sounds like quite a few steps, and it is.  That amounts to about 2.5 miles.  You would think that this is surely enough to account for a healthy lifestyle but those individuals that take that many steps are typically classified as "sedentary" or "inactive."  I know that sounds unreasonable, but it is actually a valid statement.  This is because exercise should be considered an activity that takes place outside of an individual's normal routine.  Unless an individual runs or walks for a living, they are unlikely to get enough steps to be considered exercise.

That's all fine and dandy, but what is the magical number of steps that you should take?  A good rule of thumb is that you should add 3,000 steps to your daily routine.  The best way to figure out your total number needed is to use a pedometer to see how many steps you normally take.  Do this for a week and get your average steps.  You can now add 3,000 steps to this to get your goal number of steps.  For some individuals this may be 6,000 steps and for others it may be 11,000 steps.  Another good general rule of thumb to follow is that you should take 8,000 to 11,000 steps per day.  The more you take, the better off you are.

Here are some easy ways to increase your steps:
-Take the stairs at work instead of the elevator or escalator
-Park at a further spot in the parking lot (you know they are available!)
-Go for an actual walk around your neighborhood.  This is the best because your steps are concentrated within a time frame and can be considered true exercise
-Walk to lunch or to the local store
-Take your kids to the park and walk while they bike
-Window shop at the mall (I know this is sensitive territory for some), but avoid the pretzel store
-Hop on a treadmill or go for a run
-Walk your dog even if it runs around the yard all day
-If none of the above do the trick, walk in place at home while you watch TV.

If anybody already uses a pedometer, I would love to get some feedback on your success, challenges, or tips.  Now get up and go for a walk!  It's as easy as taking a few steps.

Interval Training to Burn Calories

If you enjoy running on a treadmill, then High Intensity Interval Training (HIIT) is something you might want to try.  This mode of running was previously used only by high-level athletes but has now become increasingly popular amongst the general public.  It consists of running at an average pace and adding bursts of high intensity running in between.

The benefits of interval training are multifold.  The most popular benefit is the ability to burn more calories.  With interval training, not only do you burn more calories during your workout, but you continue to burn calories for several hours after.  Some studies claim that this burn can last for up to 24 hours.  In addition, you will attain a higher level of cardiovascular fitness due to these intense bursts.  This means that your body will learn to exercise more intensely and likely for even longer periods of time.

So how does High Intensity Interval Training work?  Here is a sample treadmill workout:

• 5 minute warm-up at a moderate pace
• Alternate 1 minute of a very hard interval with 1 minute of a moderate interval for 20 minutes.  Example: 1 minute at a speed of 7 mph, then 1 minute at a speed of 5 mph.
• 5 minute cool-down at a slow pace

If you're like me and not a big fan of the treadmill, then try this on a stationary bike by alternating resistance levels.  Most individuals should start off at slower paces and gradually increase as your body adjusts to the intensity. If you are persistent with this form of exercise, you should find yourself losing some inches around the waist.  Remember to not give up too soon as most exercise forms will likely take 6 to 8 weeks to start producing noticeable results.  Good luck and HIIT the ground running!

How do you buy the right Sunscreen?

Summer is right around the corner and I'm sure most people are ready to spend some time enjoying the outdoors.  When hitting the beach or going on your favorite hike, you will hopefully apply sunscreen to protect yourself from the dangers of the sun.  However, when you walk down the sunscreen aisle, you may find yourself trying to figure out which one offers the most protection and the best price.  Suddenly, you will be lost in a jungle of SPF numbers and wonder if one is really better than the other.  You then walk out with an SPF 50 bottle that costs you $12 and hit the beach to tackle those nasty UV rays.  But does an SPF 50 offer any more protection than SPF 30?

SPF stands for the Sun Protection Factor.  An SPF of 15 basically means that if your skin burns in 10 minutes without sunscreen, you can go 15 times that without burning.  This is obviously not a hard and fast rule because if it was, then you could use SPF 50 and stay out in the sun for about 8 hours.  I definitely would not recommend that unless you are looking to come home looking extra crispy.  So which SPF should you buy?  The American Melanoma Foundation and the American Academy of Dermatology advises buying an SPF of 30 or greater.  A sunscreen of SPF 30 absorbs about 97% of ultraviolet radiation, whereas an SPF 50+ absorbs about 98%.  Additionally, you still have to apply both of those as frequently as the other.  If you're a perfectionist and looking for 100% protection, you will be disappointed because there are no sunscreens that offer total protection.

When buying sunscreen, make sure you buy one that offers "broad-spectrum protection."  This protects you against UVA and UVB rays.  Both can cause skin cancer, but UVA in particular can also prematurely age your skin.  New FDA regulations in June will require manufacturers to list the types of rays that you are protected against.  They will also eliminate words such as "waterproof" or "sweatproof" since all sunscreen will eventually wash off.  Instead, you will see "water resistant" as a common label.  Regardless of what you buy, you have to apply it early, generously, and often.  Sunscreen should be applied 30 minutes before you go out in the sun and should amount to about 1 ounce (the size of one shot glass!).  It must also be reapplied every 2 hours or in 80 minutes if you go into the water.

Sunscreen is important on sunny days, on warm and cloudy days, and even in the snow.  The sun has the capability to harm you through clouds or while you're hitting the slopes in cold temperatures.  The most commonly missed spots are the temples, the back of the ears, the top of your feet, and under your eyes.  So the next time you're out and about on a warm summer day, remember to apply that sunscreen.    Just remember, it's you against the sun.  You can fight the battle, but one of you is sure to get burned.

Optimizing your doctor visit

Going to the doctor is not the highlight of your week, and it probably never will be.  You don't want to be there.  We get it.  But there are ways to optimize your visit so that you can convey your message, receive your advice, and leave with minimal confusion.  Besides arriving on time (I know, I know...doctors run late), there are some steps to improving your visit:

1.  Be a good historian.  You have a medical issue and we are trying to diagnose it.  Before any of us ever spoke to a "real" patient, we were taught to obtain the best history possible.  While patients believe that a physical exam is the most important part of a diagnosis, most physicians agree that there is nothing as important as an accurate history.  This is the reason we ask so many questions.  Some of the most common questions are:  How long have you had this?  What have you tried for it?  Does anything make this better or worse?  Has this ever happened before?  What symptoms are associated with it (fever, chills, cough, congestion, sweating, bowel changes)?  The point is, the more information you can give us, the easier it is for us to diagnose it.  We don't need an hourly log for the past six days, but an accurate and concise description is crucial.

2.  Know your medications.  If you're taking medications, know what they are and how often you take them.  If you take a bag full of medications, bring them with you or bring an active list.  Medications and their interactions with each other can be responsible for many medical problems.  This includes over the counter medications, vitamins, supplements, herbal/natural drugs, and cultural home remedies.

3.  Read up, but don't self-diagnose.  A lot of times, a physician will ask a patient what brings them in today and the response they get is "I have bronchitis" or "I have tonsillitis."  This can bias the physician's history-taking, diagnosis, and treatment.  Report your symptoms, have your physical exam, and then ask if it can be a possible diagnosis that you read about.  Most physicians are open to discuss your ideas because in many cases, you may be very well informed of certain medical conditions and can provide valuable insight.

4.  Limit your list of chief complaints.  This one is hard to do, but it is one of the most important.  Most physician visits are limited to a 20 minute time slot.  This includes the process of having your vitals taken by the nurse, the visit, and any paperwork that needs to be done after.  Believe it or not, one chief complaint can take more than 5 minutes to address.  Something like chest pain can take longer due to the many things that can cause chest pain, the most important being heart disease.  If you have a list of 5 or 6 things to talk about, you can bet some things will be brushed off lightly due to time constraints.  If you do indeed have multiple concerns, schedule a follow-up appointment to have your needs adequately addressed.  Trust me on this one, walking in with a list of problems will lead to a disappointing visit for you both.

5.  Be patient.  Medicine is an ever-evolving art.  It does not have a cook book and it will never be mastered.  Sometimes patients and physicians alike want an answer and they want it immediately.  We live in a world of drive-thrus, delivery service, and online everything.  This doesn't work in medicine.  Many office visits are only a starting point, not the finish line.  Medicine requires testing, thinking, formulating, and sometimes guessing.  We as physicians and patients may not get our answer today, tomorrow, or ever.  A 150 years ago, Charles Darwin was trying to figure out genetics by mating pea plants.  Today we have the human genome mapped out.  Some things just take a while.

The ways in which medical care is administered has come a long way.  Long gone are the days of home visits by your neighborhood doctor.  They are replaced by double-booked office visits and self-diagnosing internet sites.  This isn't so much a problem of the patient or the physician, but more likely a product of a distressed health system.  Whether we like it or not, it is here to stay.  So the next time you visit your doctor, empower yourself and have a worthwhile visit.  Your clock starts...now.

Chicken Soup for the...Common Cold

This past weekend in Los Angeles was a reminder of what beautiful California sunshine is all about.  The birds were out chirping, the kids were out running, and my friends were out soaking in some sun at the beach.  I was home.  Coughing.

Catching a cold every year is expected, especially while working in the medical field where dodging a patient's precisely-guided cough is an essential skill.  Unfortunately, most of us have to accept defeat after a direct hit while trying to examine the throat with a tongue depressor.  (Note: when asked to say "aahh," it is entirely possible to do so without coughing.)  After my latest date with the common cold or sinus infection, I found myself bed bound and hopped up on Sudafed and Mucinex.  I'm sure most people can attest to the bad taste medication leaves in your mouth after a couple of days, and I was willing to try anything different.  I had heard a lot about chicken soup as a possible home remedy and the great taste was surely a huge plus as well.  So I tried to find out what was so special about chicken soup, and here it is.

When chicken is cooked into soup, it releases an amino acid called Cysteine.  This amino acid is actually a part of a medication known as N-acetylcysteine that is used to help break down secretions or mucus in the lungs.  Therefore, the cysteine from chicken soup is thought to aid in the process of mucus breakdown during the common cold or sinus infection.  I would say that the whole concept of cysteine seems theoretical but in reality it is actually manufactured into a medication.  This gives it significantly more credibility.

While there probably won't be any studies to back up the finding of chicken soup for the common cold, there also aren't any studies for many home remedies.  At the end of the day, we all know that a viral illness has to play itself out and there isn't much we can do to expedite it.  However, we have to try to treat the symptoms to maintain our own sanity.  So the next time you have a cold and want to keep it natural, head over to the poultry aisle and make some broth.  Cattle and pigs...carry on.

Is 5-Hour Energy the real deal?

When 5-Hour Energy was first introduced, it was primarily in specialty stores and certain grocery stores.  Last week I saw 5-Hour Energy next to the gas station cash register, sandwiched between the Slim Jims and Skittles.  The popular energy shot is now so popular that most people can recognize the small shot-sized bottle.  I assumed that 5-Hour Energy contained some sort of vitamin and herb mixture but I wasn't sure if it was effective.

It turns out that 5-Hour Energy contains some amino acids, B Vitamins, Citicholine (thought to help with memory), and caffeine.  I know, caffeine is the kicker and you probably forgot all the other ingredients after you read that one.  Some people are shocked that 5-Hour Energy contains caffeine and some people are not the least bit surprised.  So how much caffeine are we talking?  ConsumerLab.com did an independent analysis of the product and found one shot to contain 207 milligrams of caffeine.  Putting that in perspective, an 8 oz. cup of Starbucks coffee contains 160 milligrams of caffeine according to cspinet.org.

Okay so 5-Hour Energy contains caffeine and a bunch of other stuff, but does it actually work?  The producer of 5-Hour energy did its own study with 90 participants and obviously found individuals who took 5-Hour "significantly outperformed" those that did not.  There have been no outside studies to date but Consumer Reports states that "5-Hour Energy will probably chase away grogginess at least as well as a cup of coffee."  They also found little if any research that proves to support that Vitamin B and that other stuff give the average person a boost.

The bottom line from all that is that the caffeine content of 5-Hour Energy is likely about the only thing you would be getting to boost your day.  So unless we find out 10 years from now that Citicholine is the difference between appearing on Jeopardy and Wheel of Fortune, I'll stick to my cup of overpriced Starbucks!

The 10 most common reasons for visiting a doctor

Ever wonder why the doctor's office or urgent care is always so busy?  I thought it would be interesting to look at the most common chief complaints that patients present with at their doctor's visit.  I left out things such as "physical exam" and "prenatal exam" because those will obviously be significantly more common than medical problems.  According to the CDC, the most common chief complaints for which individuals saw a physician in 2008 were:

• Cough
• Symptoms referable to sore throat
• High blood pressure
• Knee symptoms
• Fever
• Skin Rash
• Abdominal pain
• Back symptoms
• Visual problems
• Earaches

To put the first two symptoms in perspective, it's interesting to look at the total number of visits for those complaints.  Cough accounted for over 26 million visits and sore throat accounted for over 17 million visits.  Of course these two conditions can also be attributed to things such as acid reflux, emphysema, smoker's cough, etc.  However, the majority of them are due to the common cold.  We also know that 90% of all colds are caused by viruses and resolve by themselves with symptomatic treatment that does not involve antibiotics.  So the next time you catch a cold, give it some time to resolve.  The guy with high blood pressure and knee pain thanks you.

Soccer player "Dead" for 78 minutes.

Fabrice Muamba is a soccer player who recently collapsed during a soccer match.  He suffered cardiac arrest on the field and CPR was begun immediately.  The medical staff worked on him for 48 minutes before he reached the hospital.  Resuscitation at the hospital continued for another 30 minutes until his heart began to beat independently.  This was also 15 shocks later from a defibrillator.  Fabrice is now in the ICU and has spoken his first words.  If you didn't believe in miracles or medical marvels, now is the time to think again.

This healthy and fit athlete is one of many that have suddenly collapsed during a sporting event, but his story of survival is certainly not the norm.  I assume he has hypertrophic cardiomyopathy (an enlargement of a portion of the heart) or one of several other conditions that can lead to sudden collapse.  With increased knowledge and improved response protocols, some of these athletes do survive this type of collapse.  The fact that Fabrice was shocked 15 times suggests that his heart did not necessarily stop completely for 78 minutes.  This is because the shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia.  Without getting into the details of these, they both imply that the heart is pumping irregularly and ineffectively.  They do not indicate that the heart completely stopped.  Regardless of the details and actual events that took place, the story of Fabrice Muamba is pretty amazing.

Fabrice's survival was dependent on two things: his willpower and that of the medical team.  For a team to  perform CPR and resuscitation for 78 minutes is remarkable.  Even if individuals are switching off on CPR, those of us that have done chest compressions will tell you that it is exhausting!  It is also mentally challenging to continue when the outlook for resuscitation is dismal.  At the same time, I don't believe this type of resuscitation would have been successful in most individuals.  Whether Fabrice survived due to his level of fitness or due to his willpower or simply by luck, his story is one of encouragement.

With all the bad publicity that athletes and the medical field receive these days, this is an example of why we each do what we do.  Whether you believe in modern medicine or miraculous feats of survival, there is no denying the intentions of the medical team and that of a young man who refused to give up.  I'm not sure Fabrice will ever play soccer again or what his mental capacity will be, but at least he will have the opportunity to see another day.  He may not be Kobe Bryant and the Black Mamba, but he is Fabrice Muamba...and he has the heart of a champion.

Color Blind St. Patty's Day: I hope this is green!

If you can read the number "45" in the image on the right, you belong to the approximately 93% of the world that is not color blind.  For the rare 7% of us, that image is nothing but a circle of scattered, colored dots.  I know, it's hard to believe that some of us cannot see a number that is clearly sitting smack in the middle of that circle.  Welcome to the world of color blindness.

When those with color blindness tell their friends about their unique dilemma, the first two questions are: 1) "So you can't see any colors?" and 2) "What color is that over there?"  Color blindness is somewhat of a misnomer because true color blindness, the inability to see anything but black and white, is almost non-existent.  Instead, most people are red-green color blind.  This usually means that when the colors red and green are held together closely or presented in certain shades, an individual may be unable to differentiate between them.  I know that sounds ridiculous to those with normal color vision, but the problem is actually biologic.  Those with color blindness have defects in photopigments in their retina and are therefore unable to perceive certain colors correctly.  Furthermore, it is actually a genetic issue since the genes for these photopigments are on the X chromosome.  Without getting into the the mechanism of gene transmission, just know that this makes color blindness predominantly a male condition.  It is inherited from mothers that function as carriers but don't actually have the condition.

You might be wondering how people with color blindness can actually function normally.  After all, how do they know when to stop at a stop light?  Rest assured, there is a reason we pass our driver's tests and don't run into intersections on a daily basis.  The reason is that a stop light "red" actually does look red and the "green" does look green.  These shades are generally very easy to differentiate as are those of roses, plants, strawberries, blood, spinach, and apples.  The trouble arises with man-made objects: clothes, Google Maps traffic (come on Google, help us out!), confetti, school mascots, and TV.  So on this day, St. Patrick's day, don't discriminate against the guy at the bar and his brown t-shirt.  He just didn't have the luck of the Irish.

Wish you were a little bit taller? Hold that thought.

Limb-lengthening is a complicated procedure that is performed by various surgeons around the world, and now by several in the US.  It was initially intended for those with short stature or dwarfism, but it has now developed a cosmetic niche as well.  That's right, for $85,000 you can grow 6 inches in 3 months.  Sounds too good to be true?   That's because it probably is.

The process of limb-lengthening begins with a surgeon breaking your lower leg (shin) bones and then inserting telescoping rods into the space.  The rods then extend by about a millimeter a day, allowing new bone, nerves, and tissue to regenerate around it.  If that sounds reasonable, just think about it one more time.  Another individual actually breaks your bones and hopes that equally sturdy bone will form in its place.  While the procedure does work, it is not without complications.  A study in the journal International Orthopaedics found there to be frequent complications with this procedure (2006 study) including nerve damage, unequal lengthening, paralysis, and hip problems.  That does not include the possibility of weaker bone formation and possible fractures in the future.

If that didn't sound bad enough, how about the inability to use anti-inflammatory medications because they may suppress bone growth?  As a result, patient's end up on high doses of narcotics such as Vicodin, Morphine, etc.  I assume a portion of them now have to deal with addiction issues and withdrawals.  Not only that, but some individuals that travel overseas for the procedure return home and have to adjust these rods themselves by some sort of leg maneuver.  Tell me THAT doesn't sound painful!

I think cosmetic surgery has come a long way and has become very mainstream.  While no procedures are entirely safe, some are safer than others.  When someone undergoes rhinoplasty (a nose job), the surgeon has to break their nose and readjust it.   This is clearly not on the level of having your legs broken for 3 months and having to undergo strenuous physical therapy to try to get your function back.  I can understand the medical uses of the procedure, but the cosmetic use is certainly extreme.  The obsession with cosmetic surgery continues to grow, but its complications are often overshadowed by its glamour.  In the case of limb-lengthening, it's hard to imagine the benefits outweighing the risks, some of which are unknown.  Besides, longer pants are so much harder to find.

Core Exercise: Your body is asking for it!

What is your core and why is it so important?  The core is a group of muscles that functions to provide you stability, strength, and balance.  It is made up of your abdominal muscles, your back, and your pelvis (buttocks, etc.).  It seems like the term is thrown around by those that work out regularly and are in tune with their fitness, but the general public remains largely unaware of its importance.  You don't get a solid core by curling the biggest weights at the gym or running 3 marathons in 4 days.  They don't necessarily show up as the glamour muscles (biceps, triceps, chest, shoulders), but they may be the key to avoiding physical ailments in the future.

Think of your core as the foundation of a building.  You can build nice stairwells, add fancy windows, and throw on a ton of marble. However, if your foundation is weak, it is only a matter of time before everything falls apart.  This is essentially what happens as we age or fail to maintain a strong core.  Most people will develop arthritis in their back, have their back go out on them, become hunched over, or have trouble strengthening other parts of their body.  Even the most highly trained athletes work on their core because it allows them to lift heavier, be more flexible, and avoid long-term injuries.  This is the reason you'll notice some of the most popular workout videos now include core stability.  So pick something you like, whether it is cardio core, pilates, or even just planks to get started.  Here is a website that shows you basic core positions:

Basic Core Demonstrations

If you're looking for a fun cardio core workout, this one is free, fun, and intense:

Cardio Core Home Workout 101

It doesn't matter where you start, but it is important to include a Core workout in your routine.  Most of it can be done at home without any equipment so there is no reason to procrastinate.  And hey, if in the process you end up with a flat stomach or a 6-pack, so be it!

Smoking Hookah: Harmless or Toxic?

I frequently get asked if smoking hookah is harmless or just as detrimental as smoking cigarettes.  Hookahs have become increasingly popular in the United States and worldwide because of their social implications.  It usually involves sitting together with a group of friends, sharing one mouthpiece, and finding the best hookah bar or hookah party.  Unlike cigarettes, the tobacco used in hookahs comes in various flavors such a strawberry, mango, cappuccino, etc.  This flavor appeal has made it popular and given the impression that it is entirely harmless.  Its easy to see that cigarettes are harmful, but how can something that taste like watermelon be a bad thing?

So here are the facts, directly from the CDC (Centers for Disease Control) website.  They site various studies on their fact sheet (CDC Hookah Fact Sheet) and can be summarized as follows:

• Hookah smokers may absorb higher doses of the toxins found in cigarette smoke.
• A 1-hour long hookah smoking session involves inhaling 100-200 times the volume of smoke inhaled from a single cigarette.
• Charcoal used to heat the tobacco in a hookah produces high levels of carbon monoxide, metals, and cancer-causing chemicals.
• Hookah smoking can cause the same medical conditions and cancers as cigarette smoke.
• Second-hand smoke from hookahs contains smoke from the hookah and charcoal, posing an even higher risk for nonsmokers.

Before I read up about hookah smoking, I also figured that it couldn't be as harmful as cigarette smoking because hookah is smoked much less frequently than cigarettes.  However, doing the math suggests otherwise.  If smoking hookah for an hour involves inhaling 150 times the smoke from a cigarette and you only smoke it once a month, that is still equivalent to about a 150 cigarettes per month.  Thats about 3 cigarettes per day.  Then I think about the smoke from the charcoal that is used to heat the tobacco.  Would anybody sit and inhale the charcoal smoke from their barbecue for an hour?  Would you also share the same straw as 8 other people in one sitting?  I highly doubt it.  

It looks like Washington has taken note of the facts laid out by the CDC because hookahs are now receiving the same treatment as cigarettes.  There are many proposals to ban hookah bars and limit its use in public establishments.  We know one thing, and that is that hookahs will never become as popular as cigarette smoking.  Afterall, its not often that you see a person driving and smoking their hookah.  Driving while eating a bowl of cereal?  That's for another day.

P90X vs. Insanity: Are either of them worth doing?

When P90X first came out, it was known by only a select few.  Today it is probably one of the most widely advertised home workouts and most people have at least heard of it.  A lesser known home workout called Insanity was created by the same people that released P90X.  Now that these programs are out, the internet is littered with people who post their before and after pictures which the trainer asks you to take during the program.  So what is the difference between the two and are either of them right for you? 

P90X is named as such because it is a 90 day program.  Insanity is named as such simply for marketing purposes, but it is a 60 day program.  P90X generally has one hour workouts per day (Yoga is an hour and 30 minutes), 6 days per week, and a special Ab Ripper X that is 15 minutes every other day.  Insanity has 45 minute workouts, 6 days a week, and requires no special equipment such as resistance bands, pullup bars, or weights that P90X does.  Both workouts are also different in the ways they work.  Insanity focuses much more on cardio/jump training and P90X focuses on muscle confusion for muscle strength/toning.  Both are on several DVDs and will run you about $120 (plus additional equipment). 

Now that the facts are laid out, lets take a look at which one is better for you, if any.  If you're looking to bulk up or tone down, P90X is the obvious choice.  Composed of pushups and pullups along with intense cardio, this will get you ripped.  If you're interested, you can find thousands of before and after pictures on the internet so I'll spare you.  Conversely, if you're looking for weight loss and cardio-fitness, then Insanity may be a better choice.  Using your own body's weight, it likely won't bulk you up as much but it will shed the pounds and provide toning if thats what you're looking for.  So before choosing either, it's important to really figure out not only what your goals are, but also which one you think you would enjoy more.

You're probably wondering, "If these two exercise programs are so great, why isn't everybody on board and why aren't we all walking around with beach bodies?"  The answer to that is simple yet complicated.  The first and foremost characteristic that you must possess in order to start these programs is the motivation and will power to stick with them.  These are incredibly challenging workouts and it is very easy to jump ship after the first week or even the first day.  You have to know that it will get easier, but it will never be easy.  You may start the program and realize that you can only do one pullup but the trainer wants you to do 15 to 25 of them.  Again, your one pullup will eventually become five, and so on.  Next, these workouts are meant to be solo workouts since they're done in the privacy of your own home.  Of course you can invite your buddies to do the workout with you but finding schedules that coincide 6 days a week is not very practical.  Therefore, if you do not enjoy working out by yourself, this is not the thing for you.  Lastly, and probably most importantly, do you have the time 6 days a week?  This is where I had trouble myself and I think many people would share my concern.  Depending on your school/work/diaper-changing schedule, you may not be able to find an hour or more 6 days a week for working out.  It's not as if you can just go for a 30 minute run or do some pushups and jump rope because the programs do not offer that flexibility.  If you're going to make the committment, you need to have the time to do so.

I think both of these workouts are top notch and for those that can stick with them, they produce incredible results.  For those of us who don't have the time or motivation to committ, there may be better choices.  Perhaps a better option would be to incorporate some of the workouts into your routine.  For instance, if you enjoy Kenpo-X from P90X, why not pop in the DVD for your next cardio workout?  You can always lift weights or Zumba on the other days and switch things up from time to time.  In the end, the perfect workout is the one that works perfectly for you.  If that means running on the treadmill twice a week and lifting weights on the days in between, then that's your workout.  Your results will obviously vary but at least you have found something that works for you.  So before you run to the store to buy one of these programs, find out if they are really right for you.  Enjoy your workout, make it part of your daily life, and never give up on your fitness goals!

Qnexa: "Miracle" Weight Loss Pill gets FDA backing

Obesity affects 35% of this nation, approximately 70 million Americans.  Drug companies have been looking for a way to cash in on this epidemic, and one such company is on the brink of pharmaceutical gold.  California-based Vivius is on the verge of FDA approval for their weight loss drug, Qnexa.  In clinical trials involving 4,323 individuals, there was a 10% average weight loss amongst participants.  Based on this study, 20 out of 22 FDA physicians are backing the new drug and it will likely receive full FDA approval.  Sounds great, sign me up!  Not so fast.

Qnexa is composed of Phentermine and Topiramate, two individual drugs.  If Phentermine sounds familiar, it's probably because it was a part of the popular drug Fen-phen which was withdrawn from the market after having to settle for legal damages of $13 billion.  Fen-phen was found to cause heart valve disease, and while Phentermine by itself does not, it is not entirely safe either.  Phentermine is similar to amphetamines and is known to elevate blood pressure and increase heart rate.  Topiramate (Topamax) is an anti-seizure medication that can cause nausea and fatigue.  Combine those side effects and the product sounds like a real winner right?  The truth is that most physicians will likely feel uncomfortable prescribing Qnexa to their patients because most already have underlying medication conditions such as high blood pressure, heart disease, irregular heart rhythms, etc.  Patient's, however, will likely be willing to tolerate any of those side effects to attain weight loss.

Weight loss drugs, much like trendy weight loss diets, are merely shortcuts and are usually not sustainable in the long run.  Just look at the Atkins company that went bankrupt after their diet plan was intially a huge hit.  The same goes for Fen-phen which may have actually ruined the lives of many consumers.  The real road to weight loss is through exercise and healthy choices.  While that may sound like the "doctor thing to say", it is the only proven long-term choice.  Eating well and exercise generally does not have any side effects, the FDA never recalls it, and nobody will ever win a lawsuit against it.  The choice is clear, and it doesn't require a prescription.

The Triple Bypass Burger? Stop it.

Earlier this week, a man ate at a restaurant called "The Heart Attack Grill" in Arizona and found himself in an ambulance shortly after.  His menu selection was the Triple Bypass Burger which is now estimated to contain 6,000 calories.  I guess you really get what you ask for at this place because the man had a heart attack while eating that lovely burger.  While the staff there is dressed as nurses and doctors and you are given a surgical gown to eat in, there wasn't much medical attention available on the spot.  The owner defended his restaurant on Twitter and also said "I am here to tell you straight out I am here to make a buck."

I know this may come off as a big joke to the owner, but I'll tell you something that isn't very funny...a triple bypass.  We're talking life and death here, not burgers and milkshakes.  While doctors tell their patients to eat better and exercise, here we have a guy who thinks making a buck off of someone's lack of self control is perfectly acceptable.  Unfortunately, there is no way to realistically shut this establishment down because there is nothing "illegal" about it.  There are also no laws in Arizona or most states that require restaurants to publish their nutritional information.  This is where I think California has done well. Nobody wants to go out for a nice dinner to see the nutritional facts guide sitting there, but I like knowing its there if I want to take a peek.

This story should shed light on the uphill battle we face everyday in striving to become a healthier nation. I'm not saying you can never have a burger because trust me, I enjoy my burger once in a while too.  All I'm saying is lets be smart about avoiding the obvious heart attack and pick up a sandwich or salad once in a while.  The choice is yours.

What's the point?

The point of this blog is to share medical news and knowledge that you may not know.  Medicine is changing constantly and I always come across questions that I think other people may have as well.  My goal isn't to bore everyone with intricate physiology or lengthy studies.  I just wan't to get to the point.  Hopefully I'm able to shed light on things that matter to most people and if not, I can at least babble to myself and hope someone else cares about what I say.  If there's anything you wan't me to talk about, let me know and I'll try my best.  Enjoy!