Banana or Avocado a Day Keeps Hardening Arteries Away

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Banana or Avocado a Day Keeps Hardening Arteries Away

Laurence T. Gayao, MD

Early on in my career I heard someone said, “You are only as old as your arteries.” After thinking about it, really made sense. It has been observed that ones’ arteries hardens as we get older, the medical folks refer to this as pathogenic vascular calcification or arteriosclerosis. This hardening of arteries causes high blood pressure, heart attacks, strokes and circulation problems especially of the lower extremities which may result in limb amputation. A new study shows how low dietary potassium is associated with development of arteriosclerosis. So now we could say, Banana or avocado a day keeps hardening arteries away.

University of Alabama of Birmingham Study

The University of Alabama at Birmingham (UAB) did a study that shows for the first time that reduced dietary potassium is associated with the development  hardening arteries in mice as compared with normal potassium feed mice. This is an important in the prevention of diseases related hardening of arteries. It also raises a red flag for those taking medications that potentially lowers potassium in the blood.

The study was lead Yabing Chen, Ph. D. UAB professor of pathology and a research career scientist. They found that that a high potassium diet inhibited vascular calcification. Cell culture showed low potassium enhanced calcification in smooth muscles cells in the walls of blood vessels which leads to its hardening. It is postulated that when the potassium in the smooth muscle is low, calcium another essential substance in the blood builds up in the smooth muscle of the blood vessels and permanently binds to it to stiffen it thus it losses its elasticity. This process is called calcification. Remember calcium is important for body function and it only does that when our blood potassium is low.

Function of potassium in the body

Potassium is an electrolyte “a substance that conducts electricity in the body, along with sodium, chloride, calcium, and magnesium. Potassium is crucial to heart functionand plays a key role in skeletal and smooth muscle contraction, making it important for normal digestive and muscular function.”

Low potassium symptoms

Symptoms of low potassium are usually mild. At times the effects of low potassium can be vague. There may be more than one symptom involving the gastrointestinal (GI) tract, kidneys, muscles, heart and nerves.

What are some common foods rich in potassium:

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Foods rich in potassium

Sweet potato

A medium baked sweet potato has 542 mg (12% DV) of potassium. These tubers are also rich in vitamin A

White potato

Surprise, surprise: A single medium baked potato has 941 mg (20% DV) of potassium.

Tomato sauce

This plain old pasta topper is a secret source of potassium, with 728 mg (15% DV) in each cup. Look for a low-sugar variety sold in BPA-free packaging.


A cup of cooked, sliced beets delivers 518 mg (11% DV) of potassium, while a 1-oz serving of beet chips has an impressive 90 mg.

White beans

White beans might be the best source of potassium in the grocery store: A single cup has 1189 mg. That’s a full quarter of what you need every day


A cup of cooked, sliced beets delivers 518 mg (11% DV) of potassium, while a 1-oz serving of beet chips has an impressive 90 mg.


I cup, sliced (146 g) has 708 mg. It is also rich in polyunsaturated and monounsaturated fats which also prevents arteriosclerosis.


One medium banana has 422 mg. It is also is rich in multi vitamins and source of many other nutrients.

More foods with high potassium go to the website (click)

Watch this video on potassium rich foods.

Warning for those with kidney disease

Please note, if you have kidney disease please consult your physician for advice on potassium rich food intake because in kidney disease may increase your blood potassium level because of impaired excretion by the kidneys. With the retention of the potassium in the blood it may get elevated to dangerously life threatening levels.

Diet best medicine

This study highlights diet low in potassium is a major contributor  to the development arteriosclerosis and the importance of additional dietary modification to fight its progress. Again this re-enforces the idea that the right diet is the best medicine. Remember you are only as old as your arteries.

Your fitness Doc.






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Clearing The Confusion About Fats

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Fats part of a healthy diet.

Clearing the Confusion About Fats

Laurence T. Gayao, MD

A few weeks ago, I had a 57-year-old friend suddenly died of a heart attack while driving his pickup. Then I was having lunch the other day with my two sons, and one of them asked me if a 44-year-old could have a heart attack. He added that he just got news of friend who was said to have had a heart attack and was currently unconscious on life support. I said yes, and told him the youngest patient I had encountered that had heart attack was 27 years of age. All these victims had no previous known heart problems. These premature deaths underscores the importance of preventing heart disease.

Lately nutritional news releases have created confusion about role of fats in the causation of coronary heart disease. You may have heard “butter is back.” Eating fat has no bearing on coronary heart disease (CHD).  On the  other extreme fear of fats still affects many of us. Many of us may still have the mistaken notion that if we get off fats in our diets we would solve our weight problems and get rid of heart disease, because we have been constantly being told that “Fats are bad”. To add to this confusion many articles have come up with the idea that fats after all has no bearing on increasing of deaths from coronary heart disease, which of course has been repudiated by multiple studies. Lately the British Medical Journal affirmed that there is reduction of coronary heart disease by replacing bad fats with good fats in the diet.

Fats Part of Healthy Diet

The truths is, we need fats in our diet. The United States Department of Agriculture’s 2005 Guidelines recommends that adults get 20-30% of their calories from fats.  The American diet has about 34-40% calories are from fats because it tastes good and it is part of many favorite foods.

It is important at the outset to clear the confusion on dietary fats. What is its role in cardiovascular disease which is global leading cause of death, accounting for 17.3 million deaths a year.

 Types of Fats

First, we need to know there are good and bad fats and it is recommended  to swap good fats for bad fats in our diets.

Fats we need to stay away from are the trans fats and saturated fats. These fats you find in packaged and manufactured food. Manufacturers use trans fat, partially hydrogenated oil, because it is less likely to spoil, so foods made with it have a longer shelf life. Trans fat is formed through an industrial process that adds hydrogen to vegetable oil, which causes the oil to become solid at room temperature.

Saturated fats: “Examples of foods containing a high proportion of saturated fat include animal fat products such as:

  • cream
  • cheese
  • butter
  • other whole milk dairy products
  • fatty meats which also contain dietary cholesterol.
  • Certain vegetable products have high saturated fatcontent, such as coconut oil and palm kernel oil.”

Is saturated fat bad for you? A diet rich in saturated fats can drive up total cholesterol, and tip the balance toward more harmful LDL cholesterol, which prompts blockages to form in arteries in the heart and elsewhere in the body by causing inflammation in the wall of blood vessels. For that reason, most nutrition experts recommend limiting saturated fat to under 10% of calories a day.

Monounsaturated fat: From a chemical standpoint, monounsaturated fats are simply fat molecules that have one unsaturated carbon bond in the molecule, this is also called a double bond. Oils that contain monounsaturated fats are typically liquid at room temperature but start to turn solid when chilled.

Polyunsaturated fats. “Polyunsaturated fats are essential fats. That means they’re required for normal body functions but your body can’t make them. So you must get them from food. Polyunsaturated fats are used to build cell membranes and the covering of nerves. They are needed for blood clotting, muscle movement, and inflammation.” A polyunsaturated fat has two or more double bonds in its carbon chain. There are two main types of polyunsaturated fats: omega-3 fatty acids and omega-6 fatty acids. The numbers refer to the distance between the beginning of the carbon chain and the first double bond.”

What should you eat?

Foods with Monounsaturated fat — found in

  • Nuts, such as almonds, cashews, pecans and macadamias.
  • Canola oil
  • Nut butters
  • Peanut oil

— is a healthier option than is saturated fat. Nuts, fish and other foods containing unsaturated omega-3 fatty acids are other good choices of foods with healthy fats.

Polyunsaturated fats. When you pour liquid cooking oil into a pan, there’s a good chance you’re using polyunsaturated fat – common examples

  • Corn oil,
  • sunflower oil
  • safflower oil
  • Sunflower seeds
  • Flax seeds or flax oil
  • Fish, such as salmon, mackerel, herring, albacore tuna, and trout
  • Soybean oil

Eating polyunsaturated fats instead of saturated fats or highly refined carbohydrates reduces harmful LDL cholesterol and improves the blood cholesterol profile. A good cholesterol profile is when your high density cholesterol is high and the low density is low. It also lowers triglycerides. Good sources of omega-3 fatty acids include fatty fish such as salmon, mackerel, and sardines, flaxseeds, walnuts, canola oil, and unhydrogenated soybean oil. Omega-3 fatty acids may help prevent and even treat heart disease and stroke.

In all these discussions about fats, let us not forget eating a higher percentage of calories from added sugar is associated with significantly increased risk of cardio vascular disease deaths and if combined that with eating more bad fats it puts the individual in greater danger of premature death.

So eating healthy fats, fresh fruits and vegetables, grains, legumes all in moderation and staying away from manufacture foods is the key to healthy eating. Hope this helps in Clearing the Confusion About Fats.

Bon appetite,

Your fitness Doc

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Sugar Is Nutritional Public Enemy #1

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Sugar Is Nutritional Public Enemy #1


Laurence T. Gayao, MD


Sugar is nutritional public enemy #1. Sugar has now displaced fatty foods which use to occupy that position. For years nutritionists had blamed fats and cholesterol as the main cause of obesity, diabetes, heart disease that plagues western society. In recent years however multiple research results have scientists and nutritionists now pointing their fingers to sugar as  real villain causing these problems.

sugar poison Sugar Is Nutritional Public Enemy #1
Enjoy now die later

Lately you may have heard of cities imposing tax on sugary drinks to promote health among its citizens, just like they do on tobacco products. Many school districts have removed vending machines selling these drinks. They too don’t serve them in their cafeterias.  All these in an attempt to control childhood obesity which in recent years has been on the rise at an alarming rate.

There are 62 calories in two teaspoons of sugar. That is not really much. However if you consider the amount of sugar in a 12 ounce soda is about 13 teaspoons so on average the total calorie for just one drink would be about 403 calories. Add to that sugar in  cakes, cookies, ice cream, processed foods and other sources, it does not take rocket scientist to figure out why many of us have weight problems.

The US government has released Dietary Guidelines For Americans for 2015-2020. The title of their introduction is ‘Nutrition and Health Are Closely Related.’ It states that “About half of all American adults—117 million individuals—have one or more preventable chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. In 2008, the medical costs associated with obesity were estimated to be $147 billion. In 2012, the total estimated cost of diagnosed diabetes was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity.”

You have heard the US president and congress talk about working on healthcare reform to curve spending. If you listen to their discourse not one of them are talking about addressing controlling preventable causes of illnesses in order to control the sky rocketing rise in health care spending through promoting  healthy diet and lifestyle. Someone has said the right diet is the best medicine.


Sugar intake and Obesity

In the last three decades the amount sugar consumption per capita have increased by 30% and there has been also a proportionately increase in the percentage of  overweight individuals.

Sugar is a simple carbohydrate is naturally found in vegetables and fruits. These foods however use by food manufactures in their products where they add refined sugar to enhance their taste and preservatives to extend shelf life. The end being unhealthy and dangerous for human consumption. Even bottled fruit juice in you read the amount of sugar per serving is just as high as a sugary soda pop. Fresh vegetables and fruits contains sugar that provides the energy fuel for our bodies and along with nutrients in the right proportion.

OW Added Sugar Infographic smaller 1024x791 Sugar Is Nutritional Public Enemy #1Increase per capital sugar intake past decades


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Obesity increase past decades in US


 Glucose is a single sugar molecule. Refined sugar is a pure form of sugar, when ingested it needs no digestion,  it is absorbed as is and goes straight to your blood stream and cause an immediate spike in your blood sugar level.



Sucrose may be more familiar to you as table sugar. Sucrose is made when a glucose and a fructose molecule combine together. It is derived from the refinement of a sugar beet. When taken in its refined from it too does not need digestion and is absorbed straight to your blood stream.  Sucrose also occurs as a natural sugar in many vegetables, such as peas, sweet potatoes and carrots.


 Starch are Is a complex carbohydrate or polysaccharide. These long chains of glucose molecules which is the form that plants store sugar. This required digestion before they are absorbed into the blood stream, thus they don’t cause spikes in the blood sugar when ingested.



Dietary fiber is a naturally occurring carbohydrate found in many vegetables and fruits. In most vegetables, fiber is made of cellulose, a non-digestible complex sugar. This does not cause increase in your blood sugar. Your body’s digestive system can break down cellulose using the bacteria of the digestive system, but cellulose does not get absorbed by the small intestine. Instead, cellulose is useful to your body to promote the health of your digestive tract. Food manufactures usually remove much of the fiber so the sugar is more concentrated and their products tend to have more calories and may be constipating.

Cellulose fibers help keep your digestive system clean and running smoothly, by preventing constipation. This is known as natures laxative. If you have trouble with regularity of bowel movement and hard stools it is recommended that you increase fiber in your diet and water intake. Manufactures sells it as purified form of over the counter bulk laxative. Another benefit of fiber is it gives one the feeling of fullness preventing over eating.


I hope after going through this you would know about the different carbohydrates to help you choose which foods are healthy for you. Try to stay away from manufactured foods and refined sugars. You may have heard people say, ‘ I am on a low carb diet’ which In actuality is not a really a healthy diet because there are healthy carbs that are essential for body function. Stay away from empty calories like refined sugars which are high in calories with no nutrients and fiber . The best rule,  get your sugar in its natural state from fresh vegetables and fruits.

Happy healthy eating, Chow.

Your Fitness Doc.

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Do You Have Sleep Apnea

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Do You Have Sleep Apnea

Laurence T. Gayao MD, Fitness Doc

Do you have sleep apnea or know of someone who has it? How do you know if you have sleep apnea?  Apnea is defined as a disorder that causes you to stop breathing briefly, often while you’re asleep.

Symptoms of Possible Sleep Anea

 Do you have these problems?

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How could I sleep? He sounds like a freight train.

Sleepiness or lack of energy during the day

  • Forgetfulness, mood changes, and a decreased sex drive
  • Sleepiness while driving
  • Waking up with a very sore or dry throat
  • Loud snoring
  • Occasionally waking up with a choking or gasping sensation
  • Morning headaches
  • Restless sleep
  • Recurrent awakenings or insomnia

If you have these symptoms you may have sleep apnea.

What is sleep apnea video/ courtesy of Mayo Clinic

Sleep apnea is characterized by repetitive episodes during sleep where there is repetitive pauses of breathing for an abnormal period during sleep. There are two causes of sleep apnea first is obstructive sleep apnea and second is central sleep apnea.


Types of Sleep Apnea

Obstructive sleep apnea is secondary due to narrowing upper airway and often pause in breathing lasts for 10 to 30 seconds. On the other had central sleep apnea is cause by periods of luck of signal from the brain to breath and it my last any were from 10 to 90 second.


In both cases the abnormal breathing of sleep apnea periods of inability to get air to the lungs during sleep. This decrease the oxygen level to the brain. Usually the sleep partner usually reports that the patient would have these pauses of breathing when patient would gasp of air or repeatedly wakeup or not even remembering waking up.


These episodes result in giving the body large amount of stress. It may cause day time fatigue or sleepiness, irritability, mode changes, inability to focus and memory problems.


Health Problems Associated with Sleep Apnea


There is associated increased risk for obesity, diabetes, high blood pressure, heart attack, stroke, dementia and premature death. These are reasons to diagnose and treat the problem early on before complications develop.


Sleep apnea may run in families because certain disorders that maybe inherited may predispose one to have sleep apnea. These disorders are:

  • breathing problems due defect in signals from the brain
  • due to floppy upper airway tissue
  • family history of obesity
  • irregular sleeping pattern
  • certain ethic groups people of African decent


 How Is Sleep Apnea Diagnosed?

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.

Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

Medical and Family Histories

If you think you have a sleep problem, consider keeping a sleep diary for 1 to 2 weeks. Bring the diary with you to your next medical appointment.

Write down when you go to sleep, wake up, and take naps. Also write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel at various times during the day. This information can help your doctor figure out whether you have a sleep disorder.

You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”

At your appointment, your doctor will ask you questions about how you sleep and how you function during the day.

Your doctor also will want to know how loudly and often you snore or make gasping or choking sounds during sleep. Often you’re not aware of such symptoms and must ask a family member or bed partner to report them.

Let your doctor know if anyone in your family has been diagnosed with sleep apnea or has had symptoms of the disorder.

Many people aren’t aware of their symptoms and aren’t diagnosed.

If you’re a parent of a child who may have sleep apnea, tell your child’s doctor about your child’s signs and symptoms.

Physical Exam

Your doctor will check your mouth, nose, and throat for extra or large tissues. Children who have sleep apnea might have enlarged tonsils. Doctors may need only a physical exam and medical history to diagnose sleep apnea in children.

Adults who have sleep apnea may have an enlarged uvula (U-vu-luh) or soft palate. The uvula is the tissue that hangs from the middle of the back of your mouth. The soft palate is the roof of your mouth in the back of your throat.

Sleep Studies

Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea.

There are different kinds of sleep studies. If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor.


A PSG is the most common sleep study for diagnosing sleep apnea. This study records brain activity, eye movements, heart rate, and blood pressure.

A PSG also records the amount of oxygen in your blood (oxygen saturation), air movement through your nose while you breathe, snoring, and chest movements. The chest movements show whether you’re making an effort to breathe.

PSGs often are done at sleep centers or sleep labs. The test is painless. You’ll go to sleep as usual, except you’ll have sensors attached to your scalp, face, chest, limbs, and a finger. The staff at the sleep center will use the sensors to check on you throughout the night.

A sleep specialist will review the results of your PSG to see whether you have sleep apnea and how severe it is. He or she will use the results to plan your treatment.

Your doctor also may use a PSG to find the best setting for you on a CPAP (continuous positive airway pressure) machine. CPAP is the most common treatment for sleep apnea. A CPAP machine uses mild air pressure to keep your airway open while you sleep.

If your doctor thinks that you have sleep apnea, he or she may schedule a split-night sleep study. During the first half of the night, your sleep will be checked without a CPAP machine. This will show whether you have sleep apnea and how severe it is.

If the PSG shows that you have sleep apnea, you’ll use a CPAP machine during the second half of the split-night study. The staff at the sleep center will adjust the flow of air from the CPAP machine to find the setting that works best for you.

Home-Based Portable Monitor

Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:

  • The amount of oxygen in your blood
  • Air movement through your nose while you breathe
  • Your heart rate
  • Chest movements that show whether you’re making an effort to breathe

A sleep specialist may use the results from a home-based sleep test to help diagnose sleep apnea. He or she also may use the results to decide whether you need a full PSG study in a sleep center.”


 Treatment of Sleep Apnea

Sleep apnea treatments is depends on the under lying cause of the problem. It may be lifestyle changes, such as losing weight or changing sleeppositions, to CPAP therapy, to ever surgery to correct the specific problem.

Treating Sleep Apnea at Home

You may be able to treat mild cases of sleep apnea by lifestyle changes, for example:

  • Losing weight.
  • Avoiding alcohol and sleeping pills.
  • Changing sleep positions to improve breathing.
  • Stopping smoking. Because smoking increases the swelling in the lining of the upper airway, which may worsen both snoring and apnea.
  • Avoiding sleeping on your back.

Continuous positive airway pressure therapy (CPAP ) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway doesn’t collapse when you breathe in.” This is usually prescribed by a pulmonologist physician specialist.

If you suspect you or some you know has sleep apnea it is important to have it check you a physician before any permanent side effects set in.

Your Fitness Doc

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Conflicting Dietary Advise

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Conflicting Dietary Advise

 Laurence T. Gayao MD

For the last few years we have received conflicting dietary advise from the American Heart Association, American Cancer Society, American Diabetic Association and U.S. Department of Health and Human Services and U.S. Department of Agriculture.

Don’t we have enough studies on nutrition to establish guidelines for good nutrition? What causes the conflicting information regarding good nutrition guidelines? A closer look at   these studies shows there are a good number these studies that have been sponsored by different sectors of the food industries are skewed to promote their business interests and not that of us the consumers.

Major Health Organizations With Conflict of Interest

I googled for example the company sponsors of the American Dietetic Association and found among them are Coca-Cola, PepsiCo, Abbott Nutrition, General Mills, kellogg’s, Mars,  SoyJoy, Turivia, Subway, Jamba Juice, Monsanto Funds and many different pharmaceutical companies. These are large multibillion corporate food manufacturers. Pharmaceutical companies sponsors who produce antibiotics, growth enhancing products for animals and other chemicals used in pesticides. Event sponsors for meetings were American Beverage Association, ConAgra Foods (producers of and assortment of processed foods for stores, restaurants and food service establishments), Post Cereal (cereal manufacturer) and Safeway (a grocery retailer).

food politics Conflicting Dietary Advise
Marion Nestles book showing the influences in the US nutritional government policies and guidelines. Image from Amazon

I checked  American Cancer Society, among their sponsors are: Tyson Foods (the largest supplier of poultry meat, Redners (retail food company), Walmart, Kroger and several large pharmaceutical companies.

Influence of Pharmaceutical Industry

to Barbara Roberts, M.D. and Martha Rosenberg “The American Heart Association (AHA) and the American College of Cardiology (ACC) released new cardiovascular disease prevention guidelines. They are a gross example of much that is wrong with medicine today.

The new guidelines propose a vast expansion of the use of statins in healthy people, recommending them for about 44 percent of men and 22 percent of healthy women between the ages of 40 and 75. According to calculations by John Abramson, lecturer at Harvard Medical School, 13,598,000 healthy people for whom statins were not recommended based on the 2001 guidelines now fall into the category of being advised to take moderate or high intensity statin therapy.

The American Heart Association (AHA) is a nonprofit organization with a mission to “build healthier lives free of cardiovascular disease and stroke.” Yet in its 2011-2012 financial statement, the AHA noted $521 million in donations from non-government and non-membership sources and many well-known large drug companies, including those who make and market statins, contribute amounts in the $1 million range.”

Instead of recommending lifestyle changes in diet and exercise they recommend the use of pharmaceuticals for heart disease prevention. In short, support pharmaceutical products of their sponsors on bases studies that were sponsored by the same companies.


Influence of Food Industry Lobby

U.S. Department of Health and Human Services and U.S. Department of Agriculture has an advisory committee that releases nutritional guidelines every five years. The latest released was in 2015.  But a number of leading nutrition experts—including some tasked by the government to advise it on the latest research—say the guidelines are influenced too much by food manufacturers, food producers, and special interest groups.

“It’s upsetting to see cycles of misinformation coming back over and over again,” says Dr. David Heber, founding director of the University of California, Los Angeles, Center for Human Nutrition. “The public has been confused and will remain confused by these guidelines.”

Dr. Frank Hu one of members of the committee says the food industry has a very strong influence especially in the advice on red meat consumption, which lobbied not to especially strongly advice from staying away from eating processed meats (hotdogs and salami) which has been known to be linked to high incidence of cancer, and  the heavy eating of red meat which repeatedly in studies shows a higher incidence of cardiovascular disease and cancer. The committee instead recommended eating process meats, but to just cut down on the amount. It is just like saying it alright to smoke just cut down on the amount

See this documentary that exposes food politics causing misleading information 

The guidelines still recommends high intake of carbohydrates and avoid fats. “This advice to eat more carbs and avoid fat is exactly backwards if you want to improve health and lower body weight,” says Dr. Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco. He and other nutrition researchers say the popularity of anti-fat, pro-carb guidelines helped fuel a rise in diet-related health problems. The fats that need to be avoided are the trans-fats. A recent report from Harvard School of Public Health lists lower trans fat consumption as one of the major reasons rates of premature death and disease fell among Americans adults from 1999 to 2012.

The guidelines also say’s the average American don’t consume enough dairy products and recommended the increase their intake of dairy products. “There’s just no scientific evidence to support such large amounts of dairy consumption,” Harvard’s Dr. Walter Willett says, adding that dairy industry influence may have played a role in that as well.

On closer examination of these guidelines reveals the evidence of the underlying food politics. The Department of Agriculture supports the meat and dairy industries with subsidies on one side and there is the scientific knowledge on the other. The the advisory committee are under pressure by the business interests of the food industry which undermines public interests for their advantage.

Consumer Beware

There is indeed conflicting nutritional advise out there. A Canadian study found that government-run sites were consistently accurate in the Canadian system in their health advice, but news sites were right only 55 per cent of the time and those that were sponsored by a product or service gave no helpful advice. The Canadians offer free universal healthcare to its citizens, so there is greater incentive for the government to keep its citizen as hearth as posible. This just shows us to be discriminating on the source of our information. Total Fitness Medicine try’s to bring you as accurate information to avoid conflicting dietary advice that is promoted by those primarily to create more profits for their businesses but to the detriment of the consumers.

Your fitness Doc


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Moderate Drinking Damages the Brain

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Moderate Drinking Damages the Brain


Laurence T. Gayao, MD


The use of alcoholic beverages is an integral part of the American social scene. Advertisers gives the impression that no social activity is complete without it. Recent studies however has shown that even moderate drinking damages the brain

alcohol Moderate Drinking Damages the Brain
Different forms of alcohol beverages


Alcoholics Shrunken Brains Impaired function

I have observed among alcoholics their CAT scans or MRI of their brains showed less tissue mass compared patients of the same age who were non-drinkers. A study just released showed that even moderate drinking showed associated changes in the brain structure and associated deteriorating brain function. This study was published in the June, 2017 issue of the British Medical Journal.


Everybody knows that heavy drinking damages the brain, we know this without doing a CAT or MRI scan of the brain. We may have alcoholic relatives (jolly old fellow uncle or cousin) or acquaintances that even in their sober state behaves in a goofy manner, with some degree of subtle mental dysfunction. I know of fellows in the family who succumbed to early dementia who abused alcohol.


Associated Changes in the Brain with Moderate Drinking

The study compared teetotalers, moderate drinkers in a total of 550 subjects who were middle-age. It was found that the more alcohol consumed the greater risk of shrinkage brain hippocampus. Damage to this structure is associated with memory dysfunction.


While working as an emergency room physician, through the years I have observed various levels intoxication. The funny thing we observed was in spite of how intoxicated these people were, they usually would admit to drinking only two beers.  How do we quantify moderate and heavy drinking? In the US the recommended guideline suggests that 24.5 units per week is safe for men and half of that amount for women. “A unit is defined as 10 ml (2 teaspoons} of pure alcohol. There are roughly two in a large beer, nine in a bottle of wine and one in a 25 ml (5 teaspoons) spirit shot.”


The study showed that those who drunk more than 30 units a week were prone to greater hippocampal injury, but even those who took only 14-24 units per week showed some significant damage. The study showed that the more one drinks resulted in a greater deterioration in memory function.

What is the difference between alcoholism and alcohol abuse? (CDC)

There two classes of alcohol disorders or alcoholism, alcohol abuse and alcohol dependency.

Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. Manifestations of alcohol abuse include the following:

  • Failure to fulfill major responsibilities at work, school, or home.
  • Drinking in dangerous situations, such as drinking while driving or operating machinery.
  • Legal problems related to alcohol, such as being arrested for drinking while driving or for physically hurting someone while drunk.
  • Continued drinking despite on going relationship problems that are caused or worsened by drinking.
  • Long-term alcohol abuse can turn into alcohol dependence.

Dependency on alcohol, also known as alcohol addiction and alcoholism, is a chronic disease. The signs and symptoms of alcohol dependence include—

  • A strong craving for alcohol.
  • Continued use despite repeated physical, psychological, or interpersonal problems.
  • The inability to limit drinking.
Long Term and Short term side effects.

There are short-term and long-term side effects of alcohol intake. We know that immediate effect of too much intake of alcohol results acute mental and physical dysfunction proportionate to alcohol intake (commonly called Intoxication), which gets better as soon as the blood alcohol level goes down. Depending of blood alcohol level (mg/dl) symptoms could vary. This scale would apply to a typical social drinker: 

  • 50 mg/dL: Loss of emotional restraint, vivaciousness, feeling of warmth, flushing of skin, mild impairment of judgment
  • 100 mg/dL: Slight slurring of speech, loss of control of fine motor movements (such as writing), confusion when faced with tasks requiring thinking, emotionally unstable, inappropriate laughter
  • 200 mg/dL: Very slurred speech, staggering gait, double vision, lethargic but able to be aroused by voice, difficulty sitting upright in a chair, memory loss
  • 300 mg/dL: Stuporous, able to be aroused only briefly by strong physical stimulus (such as a face slap or deep pinch), deep snoring
  • 400 mg/dL: Comatose, not able to be aroused, incontinent(wets self), low blood pressure, irregular breathing
  • 500 mg/dL: Death possible, either from cessation of breathing, excessively low blood pressure, or vomit entering the lungs without the presence of the protective reflex to coughit out

The long-term effects of repeated consumption is associated with permanent damage to certain brain cells resulting in deterioration of function. There are numerous brain disorders associated with chronic alcohol abuse. For example, research shows that up to 80 percent of chronic alcohol users have a thiamine deficiency, and some in this group will progress to a serious brain disorder known as Wernicke-Korsakoff syndrome (WKS). Symptoms of WKS include confusion, paralysis of eye nerves, impaired muscle coordination, and persistent problems with memory and learning ability.


Most Abused Drug

Alcohol though legal, is the most commonly abused drug in the United States. Over 50% of individuals 12 years and older in the US are alcohol users. “Approximately 8.7 million Americans under the legal drinking age (12-20 years of age) are current alcohol users. This statistic includes 5.4 million binge drinkers and 1.4 million heavy drinkers.” In this age group the highest cause of deaths are accidents and suicides which maybe both related to alcohol abuse. It is a well-accepted fact that alcohol abuse can exacerbate an underlying mental problem.

Video: Alcohol and Your Brain, Produced by: Australian Lions Drug Awareness Foundation

The effects of alcohol on someone who has just barely learned how to drive and on an emotionally disturbed teenager who has hot developed enough coping skills could lead to devastating consequences. This explains why motor vehicular accidents and suicides are the highest cause of deaths in this age group.

The developing brain of a fetus during pregnancy could be retarded or damaged by the mothers’ abuse of alcohol during that period, most especially in the first three months of pregnancy. In fact there are facial features and characteristics resulting from such toxic exposure that has been called fetal alcohol syndrome Disorder (FASD).

Fetalalcohol Moderate Drinking Damages the Brain
Facial feature of fetal alcohol syndrome. Image: Alcohol Self-Help News

A person with an FASD might have:

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school (especially with math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones

“The brain is arguably the most important organ in the human body. It controls and coordinates actions and reactions, allows us to think and feel, and enables us to have memories and feelings – all the things that make us human.” So, whatever we eat drinking or do we need to make sure that this three-pound organ, protected by the skull is not harmed in any way. Remember the saying, “The mind is a terrible to waste.”

Your Fitness Doc

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Forgiveness Really Heals

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Forgiveness Really Heals
Few days ago, I read an article written by Dr. Honesto Pascual Jr. which to me was so touching. He wrote about the emotional journey he had to take from losing his father at young age in the hands of the brutal Japanese Kempeitai (Imperial Secret Police). For years, he lived harboring hate for the Japanese people and how circumstances lead to his change of heart. A testament to the fact that Yes, Forgiveness Really Heals.
I was born after World War II, a year after my father was released as prisoner war from the Japanese who occupied the Philippines. He was a member of the US Armed Forces of the Far East. Through the GI bill he was then able to go to school at Philippine Union College (now Adventist University of the Philippines) and was employed by the college after his graduation in 1949 as a high school teacher. We lived in the college campus, were Mrs. Pascual also taught, till I was eight years old .
As a child I heard many stories first hand from victims of the atrocities of Japanese soldiers during the war. I also heard bits and pieces of the story of Honesto Pascual a faculty member of the college that did not survive such atrocity. In fact, I remember his wife Josefina Pascual and her three boys Deleo, Jomey and Honesto Jr. I later made short tribute video about Honesto Pascual, who is the composer of the Philippine Union College school song, Shine On Forever.
“On soldiers, forgiveness, and friends”


By: Honesto C. Pascual, MD
And forgive us our debts As we forgive our debtors… For if you forgive men their trespasses, your heavenly Father will also forgive you. But if you do not forgive men their trespasses, neither will your Father forgive your trespasses.” Matthew 6:12, 14-15 [NKJV]
“Yesterday, December 7, 1941—a date which will live in infamy—the United States of America was suddenly and deliberately attacked by naval and air forces of the Empire of Japan.” Thus started President F. D. Roosevelt’s speech to the joint session of Congress.
The United States was drawn into World War II. Ten hours after the Pearl Harbor attack, Japanese forces bombed Manila; and the Philippines was drawn into that war which lasted until 1945.
October 12, 1944 when I was almost two, was our family’s day of infamy. That was the day my father was taken by Japanese soldiers under pretense of just needing to ask him and the president of Philippine Union College [PUC] a few questions. The American missionaries who had been running the school were interned, and so that responsibility was assigned to two Filipinos who were in their early 30s. My father was the business manager
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Honesto Pascual
The college president, my father, and three students were incarcerated at Fort Santiago in Manila, where they were repeatedly tortured and starved. And for what? For being pro-American, working under Americans at the missionary college. Miraculously, the president was released; but not my father nor the students. Japanese soldiers continued to torture and starve them until they were killed. They were murdered, really.
So, growing up, I always hated all Japanese people. I felt I was justified to hate them. They viciously robbed me of my right to grow up under the guidance and tutelage of my father. I was too young to remember him when they murdered him. So, I hated them all . As a boy playing soldiers with my older brother and our friends, I made sure I was among those who shot and killed the enemy, the Japanese.


An American missionary who spoke Japanese was the president of PUC when my mother was a student and started teaching there.

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Dr. Andrew Nelson baptizing Japanese prisoners.
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Japanese Baptized Prisoners

One of his personal missions in the Philippines was to give Bible studies to Japanese POWs who were incarcerated at the National Penitentiary.

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Josephina C. Pascual


My mother was among those who assisted him on Sabbath afternoons. A dozen or so of those POWs were eventually baptized in the baptistry at PUC. I witnessed that event. I was about 8 years old. It was my first time to see Japanese men live and in person. They came in a prison bus escorted by Filipino soldiers. Not one of them was attacked by anyone from within and outside the college campus. But I still hated them.

In May 1954, Asian Games II were held in Manila. We watched the basketball game between the Philippines and Japan. Philippines won the gold. The team and their coaches had to be escorted to and from the court by Filipino soldiers. They were booed and pelted with soda bottles and other debris causing the game to be stopped briefly a few times for the maintenance crew to clear the floor. No athlete was injured, but I was elated they lost to “my team”. Oh, how I hated them!
After the war, my mother, widowed at age 25, with three boys to raise, returned to college. She became a teacher at PUC, so we resided in one of the houses in campus. In the 1950s, Adventist Japanese students were sent to study at PUC. She had those Japanese students in her history classes. I noticed how my mother treated them fairly and decently. At times, she would help them with their English. She even had them for Sabbath lunch. I never observed any hint of animosity from her towards them. Her kindness slowly began to mellow my hatred.


Also during that decade, the Seventh-day Adventist Seminary held a summer session at PUC. Pastors and Bible teachers from the Philippines and all over Asia convened in campus. Naturally, Japanese ministers were in the group. Among them was a pastor who was a student at PUC when the war broke out. He was drafted by the Japanese Imperial Army and was assigned to Fort Santiago.


His duties there included English translator. It turns out that he was the one who wrote my mother the letter confirming my father’s torture, starvation, and death at Fort Santiago. He saw my father’s remains.

Until receiving that letter, my mother had hoped that my father survived, had amnesia, and was somewhere in the Philippines or even Japan as a POW. I can still remember being four or five years old and seeing my mother crying, holding that letter, which confirmed the unthinkable.

In 1959, one of the Japanese students who studied at PUC, was our tour guide in Tokyo

Yet here was my mother, inviting him and his fellow Japanese pastors to join us for Sabbath lunch. Again, I never observed any hint of animosity from her towards them.
In 1959, one of the Japanese students who studied at PUC, was our tour guide in Tokyo when my older brother and I stopped over en route by ship from Manila to San Francisco.
In 1962, one of my friends at Pacific Union College [the “other” PUC] was Japanese, the son of the very pastor who wrote the letter to my mother.
In 1964, I made friends with a Japanese student when I returned to PUC in the Philippines. We played softball together. He taught me a Japanese phrase: “Watashi wa anata o tomadachi,” I am your friend.
During my fellowship in 1975 to 1977, the chief of allergy and clinical immunology at the medical center I trained in was Japanese. Not only was he my mentor, he was my friend.
Over the last 35 years, every time I go back to the Philippines, I visit Fort Santiago. We visited there last month. There is a cross mounted on a pedestal. Engraved on marble are the words:
I learned forgiveness from my mother. She had more reason than I to hate the Japanese people. But she forgave them. I can do no less. I too, forgive them. Today, I can go to Fort Santiago with no feeling of animosity towards them. They are my tomadachis.
When you embrace forgiveness, you release all the pain, negative vibes, distress, and baggage that, if left unchecked, interferes with your emotional, spiritual, and even physical wellbeing. There’s another saying that says “refusing to forgive someone is like drinking poison and waiting for the other person to die.” Yes, Forgiveness Really Heals, yurushi ga hotoni iyasu.
Your Fitness Doc.
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Weight Gain and Weight Loss

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Laurence T. Gayao, MD

Most of us know the struggles of Weight Gain and Weight Loss. Let me share with you my own recent journey.

Earlier this year my wife Edith and I took a vacation to the beautiful islands of the Philippines the country of our birth. As always, these vacations were filled with fun and the five weeks just went by so fast and before we realized we had to head back home to Texas. You know how it is, vacation seems always just too short.

Weight Gain

Our vacation schedule was packed with activities, we visited three different islands. First ten days we were in the island of Luzon to attend the 100th founding anniversary of our undergraduate university, Adventist University of the Philippines. We stayed in a budget motel called Microtel by Wyndham South Forbes in Silang, Cavite. The stay included a good continental breakfast and the rest of the day we ate in restaurants and banquets. We visited several resorts and friends invited us to their homes.

We then went to the island of Mindanao to go to Iligan City home town of my wife where we maintain an apartment. There we had a hired cook and house keep. Much of dinners were in restaurants with relatives and friends. You see, when fifty dollars in a restaurant could feed 8-10 people you don’t have second thoughts treating them and not have to worry about cleaning up after is definitely a plus.

With my 97 year old aunt Genia, in the town of Moalboal, Cebu. (Also in picture Edith my wife and Virginia my first cousin)

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With my 97 year old aunt, in the town of Moalboal, Cebu. (In the picture Edith my wife and Virgie my first cousin from Badian, Cebu)

Our next stop was the island of Cebu to visit relatives in my mother side of the family. We stayed in a luxury hotel called Waterfront Cebu & Casino‎. Part of the package was free breakfast buffet that offered a wide variety choices. The atmosphere was relaxed and we took our time enjoying each breakfast. Lunch and dinner were usually spent with relatives in different restaurants. We then went back to Iligan City for a few days before we headed back home to Texas.

Breakfast Buffet at Water Front Cebu & Casino

During that vacation I only worked out in the gym only twice, that was when I stayed at Edsa Shangri-La Hotel for two nights to attend my medical school reunion gala. The only other exercise I did was doing pushups

Weigh Loss

You see, back home I make my own breakfast and supper and my wife prepares our lunch which is a full meal. For breakfast, I usually have avocado, dates, grapes or an orange fruit salad. For supper, I may have vegetable soup, fruit and a protein shake. When I make my drinks I put in vegetable for fiber and nutrients, but just in enough fruits for flavor because some of these sweet fruits may have a high glycemic index and may raise your blood sugar. Another thing we often overlook is the amount of salt in commercially prepared food in restaurant. The higher salt intake  makes you retain more water. The old adage ‘breakfast like a king, lunch like a prince and dine like a pauper’ could be the best way to lose weight and stay healthy, Kings College scientists say.

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What about a plate of this followed by glass of plant proteins shake?

After getting home I was glad I get back to my physical fitness routine which help burn some of the calories I stored. Cardio and light weights exercise three or four times a week. Brisk walking or treadmill thirty minutes at time for cardio.

After ten weeks I am glad to report that I have gone back to my pre vacation weight of 155 lbs. I don’t claim to have used a magic formula, such a miracle pill or a drink. Basically, if you want to lose weight eat lesser calories than what you use. Ear more fresh foods, fiber, lots of water to stay full and of course exercise to burn more of them calories.  I is just that simple.

Purpose Driven Life

Yes, it is that simple in principle, but to apply it is the big part of the problem. In his book Purpose Driven Life, Rick Warren asked the profound question, “What on Earth Am I Here For?” Personally, for me it is an easy answer.  I enjoy a healthy life. serving others and my family, that is what am on earth for. I love my family and I want to see my grandchildren grow up to be useful citizens. God gifted me with this life and I would like to be well and healthy for as long as I can. Wouldn’t you want to do the same my friend?

Your Fitness Doc.







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Chronic Anger

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Chronic Anger

Laurence T. Gayao MD

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Prisoner of Chronic Anger

I was checking my tweets to today and I was attracted to this quotation “Holding onto anger is like drinking poison and expecting the other person to die.” I searched to see who was responsible for this quotation and could not find any but found several variations. One variation is “By doing this (holding onto anger) you are like a man who wants to hit another and picks up a burning ember or excrement in his hand and so first burns himself or makes himself stink.”Visuddhimagga IX, 23. Is there anything good on holding onto anger or chronic anger?

I have come across a lady who was a victim of rape that occurred several decades back and she has not seen the perpetrator for long time, but all these years she harbored anger at this individual to the point that she was miserable and could not trust people. Anything that reminded her of the individual or incident triggered severe emotional response.

At one point of my career I had to cover at times for a psychiatrist in a drug and alcohol rehab center. I noticed many of the patients harbored long standing anger or animosity for people in their remote past due to being sexually, physically or mentally abused by parents or other people in their past. I also happened work as physician for a short period of time at a Texas state penitentiary and noticed many prisoners had a lot of grudge and anger directed to people in their past too.

To be abused by one’s parents, someone you love, respect or even by a stranger must be traumatic and to many of us who have never been victims it would have hard comprehending the difficulty in coping up after incident and pain one bears as a result of the such trauma. That being said, one becomes a long-term victim if he or she holds on to that anger, as the quotation says, “Holding onto anger is like drinking poison and expecting the other person to die.”

Anger is normal emotional reaction that we experience from time to time. We know in acute situations when there is a perceive a threat it evokes the fight or flight response. The blood adrenaline goes up, the heart rate goes up, there is a  increased tone of your muscles, the pupils get bigger making you ready physically and mentally to face the threat and in many instances that extra burst of energy could be life-saving.

In acute situations the feeling of anger may actually help you make better choices — even if you are normally not great at making rational decisions — because anger can make you focus on that which is important, and ignore things that are irrelevant to the task of making a decision.

On the other-hand chronic or prolong anger is harmful mentally and physically to the individual. It weakens your immune system and leads to a variety of health and mental disorders such as:

  •        Headaches, tension or migraine headaches
  •       Problems with digestion like peptic ulcers or irritable bowel
  •       Insomnia and sleep disorders
  •       Increased anxiety and poor concentration
  •       Depression and may even lead to suicide, must seek medical help right away. 
  •       High blood pressure
  •       Skin problems, such as eczema
  •       Heart attack
  •       Stroke
  •       Eating disorders, overeating or poor appetite.
  •       Alcoholism and drug abuse (both legal and illegal drugs).
  •       Marriage problems and difficulty in relationships
  •      It may create a feeling inferiority complex, that you are not good enough until you   make your revenge.
  •       Chronic fatigue syndrome

You see, chronic anger creates attitude of bitterness, hopelessness and sense of futility resulting in a life of unhappiness. The truth is, it is hard to be happy or have a good time if are holding on to anger.
Fortunately, our minds functions in a way that in a given moment we could process only one thought at a time. You could either have a good time or be angry but not both.

This is the basis of positive thinking. Not everybody may accept the Bible to be divinely inspired but there is a lot to truth to this verse in Philippians 4:8:

“Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things.

In the Buddhist teaching they emphasize meditating on positive things. A good example is being thankful that you are not the rapist and sympathize that the perpetrator who is miserable individual that needs help. So, you refuse being a perpetual victim that gives another individual control over your life and happiness. In other words, there is nothing wrong with you and you feel sorry him or her for being wrong or being that kind of an individual. When you forgive, you quit punishing yourself by not harboring the burden of chronic anger which is self-destructive.   

A few years ago my eldest daughter gave me a copy of the book the Art of Happiness co-written by the Dalai Lama and Howard C. Cutler, MD. I read the whole book in just one setting. The book in a way enlightens it readers of the basic tenets of Buddhism which emphasizes the need for a positive attitude. When I was in undergraduate school I had the privileged to have read motivational books like, “The Power of Positive Thinking” by Dr. Noman Vincent Peel, “See You At the Top,” by Zig Ziglar and “How to Stop Worrying and Start Living,” by Dale Carnegie. Let me tell you, personally these books have help direct my life to where I am today and over decades gave me ability to help others along the way. The price of all these books combine is cheaper than an initial visit to a psychiatrist but the lesions they blessed me with could not be measured in terms money.

Still harboring chronic anger? Give it up, free yourself of that unnecessary luggage you have been carrying all this years. Quit being a victim.

Your Fitness Doc

“Our worst fault is our preoccupation with the faults of others.” Kahlil Gibran

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High Cost of Medical Care, Not Quality

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High Cost of Medical Care, Not Quality

Laurence T. Gayao, MD


USA spends the most per capita on medical care but is dead last in quality among the ten most advanced nations. Why US have high cost of medical care, not quality?


totalfinessMedicingTp High Cost of Medical Care, Not Quality
President Donald Trump attempt to repeal Obamacare

During the most recent presidential election US President Donald Trump repeatedly said in his campaign, “I will fix the broken US health care system and repeal Obamacare.” Early on in his young administration with the Republican congress, together they tried to introduce legislation to make that change, but failed to do so.  The problem was, they did not have the right diagnosis of what the problem was and they went ahead gave a prescription to fix it. There is no question our healthcare delivery system is broken, but we have to know first what is fundamentally wrong with it in order to make the right changes. They need to go beyond political rhetoric to make the significant changes.


Public health refers to “the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals.”


Medicine “is the science and practice of the diagnosistreatment, and prevention of disease.[1][2] The word “medicine” is derived from Latin medicus, meaning “a physician.” Too often in our present healthcare system the emphasis is more in the diagnosis and treatment and not prevention of diseases.


Public health care initiatives have to a large extent impacted populations’ health in a great way. Vaccinations have almost eliminated many of the common child hood illnesses, we no longer have to deal with polio, smallpox and have prevented influenza pandemics. The in the US we hardly hear of tuberculosis, diphtheria, tetanus and there have been a consistent decline of lung cancer, and cervical cancer as a result of public health measures.


There is no question that medicine in the US is more advanced from a technological aspect compared to most other nations. We have the latest technology to aid health care providers in diagnosis and care of ill patients. This however comes at a significant cost. As a nation US is the highest spender per capita. We spend $8,233 per capita per year and the next closest is Norway that spends $5,388. Averaging all nations US spends 2 ½ times per capita. However in terms of quality of medical care among 10 most advanced nations US is dead last among them.

Key findings related to the U.S. include:

Healthy lives: The U.S. does poorly, ranking last on infant mortality and on deaths that were potentially preventable with timely access to effective health care and second-to-last on healthy life expectancy at age 60.

Access to care: People in the U.S. have the hardest time affording the health care they need. The U.S. ranks last on every measure of cost-related access. More than one-third (37%) of U.S. adults reported forgoing a recommended test, treatment, or follow-up care because of cost.

Health care quality: The U.S ranks in the middleOn two of four measures of quality—effective care and patient-centered care—the U.S. ranks near the top (3rd and 4th of 11 countries, respectively), but it does not perform as well providing safe or coordinated care.

Efficiency: The U.S ranks last, due to low marks on the time and dollars spent dealing with insurance administration, lack of communication among health care providers, and duplicative medical testing. Forty percent of U.S. adults who had visited an emergency room reported they could have been treated by a regular doctor, had one been available. This is more than double the rate of patients in the U.K. (16%).” We have basically a fragmented health system.

“Equity: The U.S. ranks last. About four of 10 (39%) adults with below-average incomes in the U.S. reported a medical problem but did not visit a doctor in the past year because of costs, compared with less than one of 10 in the U.K., Sweden, Canada, and Norway. There were also large discrepancies between the length of time U.S. adults waited for specialist, emergency, and after-hours care compared with higher-income adults.”

“Now that millions more Americans have good coverage, we have to invest in our health care delivery system to be sure all patients—and especially those with the greatest need and whose care is the most costly—can get the high-quality, well-coordinated health care they need,” said Commonwealth Fund President David Blumenthal, M.D. “Those kinds of improvements will go a long way toward improving peoples’ health while making efficient use of our precious health care dollars.”

Use of Computers to Aid in Medical Care

I have have been going to University of Texas Southwestern Medical Center for over eleven years for medical care since I have been treated of thyroid cancer. I have access to my medical records and able to communicate with my providers through their website called My Chart. I could review my test results, appointments, billing information by logging into it. I get email reminders for up and coming appointments.

Many primary physicians have not yet integrated technology in their practices in the care of their patients. In emergency medicine, I have had the privilege of using computerized medical records for over 15 years. It helps physicians have instant access to old records when available, keeps from giving medicines that the patient maybe allergic to or is contraindicated in that patient due his conditions or other medications he is currently taking. It also guide the physician on the proper dosage.

The use of computers could also aids in health maintenance of patients by keeping track of their vaccination status, whether they need colonoscopy, breast cancer screening, pap smear, follow-up on their triglycerides and cholesterol. It also helps keep track of the general patient’s progress. No matter how good the memory of your physician is, he could not remember all these details. Besides, it has been shown that properly used computers may increase the productivity of the healthcare provider. Some of these practice programs subscribe to virtual medical libraries that the physician may access help and the latest information to aid in patient care.

Hope as health care providers and consumers we could help promote the development of a more efficient, comprehensive health care system that blends preventive lifestyle medicine and medical care in the care of patients.

Your Fitness Doc

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