15 Questions to Ask When Your Doctor Prescribes a Drug
As you probably know by now, I am a huge proponent of becoming an active participant in your healthcare. This can begin with asking the following questions when your doctor recommends a drug:
WHAT DOES THIS MEDICATION DO?
HOW, WHEN AND FOR HOW LONG SHOULD I TAKE IT?
IS THIS DRUG INTENDED TO CURE MY UNDERLYING CONDITION OR IS IT INTENDED TO GIVE ME RELIEF FROM MY SYMPTOMS?
WHAT ARE THE SIDE EFFECTS? ARE THEY MINOR OR MAJOR? COMMON OR RARE?
IS IT SAFE TAKE WHILE PREGNANT OR BREASTFEEDING? (IF APPROPRIATE TO YOU.)
HAVE LONG-TERM STUDIES BEEN DONE ON THIS DRUG? HAVE STUDIES BEEN DONE FOR THIS DRUG ON THE ELDERLY OR WOMEN? (IF APPROPRIATE TO YOU.) ASK THIS ESPECIALLY IF YOU ARE GOING TO TAKE THE DRUG LONG-TERM.
DO THE BENEFITS OUTWEIGH THE RISKS?
IS THIS DOSAGE INDIVIDUALIZED FOR ME, OR IS THIS A ONE-DOSE-FITS-ALL DOSAGE?
WOULD IT BE POSSIBLE TO START ME AT A LOWER DOSE AND ADJUST IT ACCORDING TO MY RESPONSE?
WHAT HERBS, SUPPLEMENTS, FOODS, DRINKS, OR ACTIVITIES SHOULD I AVOID WHILE TAKING THIS MEDICATION?
IS IT SAFE FOR ME TO TAKE THIS MEDICATION WITH OTHER DRUGS OR SUPPLEMENTS I AM TAKING?
WILL ANY TESTS BE NECESSARY WHILE I AM TAKING THIS MEDICATION?
WHAT SHOULD I DO IF I MISS A DOSE OF THIS MEDICATION? TAKE IT IMMEDIATELY WHEN I REMEMBER, OR WAIT UNTIL MY NEXT REGULARLY SCHEDULED DOSE?
IS THERE A GENERIC VERSION OF THE MEDICATION?
WHAT ARE MY NON-DRUG ALTERNATIVES?
Health and Wellness Associates
Dr Anne Sullivan
Integrative-medicine pioneer Andrew Weil, MD, talks about why Americans are taking too many drugs.
When Andrew Weil, MD, was growing up in the 1940s and 1950s, doctors wrote prescriptions in Latin. To fill that prescription, “you had to hand it to a pharmacist who stood behind a high counter intended to prevent you from seeing what he did,” Weil writes in his new book, Mind Over Meds: Know When Drugs Are Necessary, When Alternatives Are Better — and When to Let Your Body Heal on Its Own.” The upshot? Patients had no idea what medications they were taking.
Although times have changed and the Internet has made health information widely available, Weil notes, people still do not ask enough questions about the medicine they’re prescribed. That’s just one reason, he says, why prescription drug use in the United States has increased tenfold in the past 50 years, and over-the-counter drug use has skyrocketed as well.
Drugs are certainly life-saving in critical and acute illnesses, Weil notes, but when it comes to chronic illnesses such as diabetes, high blood pressure, heart disease, and GERD, lifestyle changes such as dietary change, exercise, and stress relief are critical. “Taking a drug just because a doctor says so is not necessarily a good idea,” he counsels. “Always try to understand why you need it.”
To get a better sense of when to take drugs — and when to look for alternatives — we spoke to Dr. Weil. Here’s what he had to say:
Dr. Weil, you’ve spent the majority of your career in integrative medicine, using lifestyle-based approaches such as nutrition, movement, and mind-body medicine to tackle the chronic-disease epidemic. Why do you think prescription drug use in the United States has increased so dramatically in the past 50 years?
Andrew Weil | Drug makers have had a profound influence on both physicians and the general public. The information that doctors rely on when prescribing typically comes from industry rather than objective sources. For example, pharmaceutical companies commonly fund research. In these studies, drugs are typically pitted against a placebo, almost never against diet and lifestyle changes that may work as well or better. The results drive clinical practice.
Advertisements paid for by Big Pharma are the major revenue source for medical journals, a situation that compromises editorial objectivity. The current medical school curriculum and the influence of Big Pharma condition doctors from their first days of training and throughout years of practice to have more faith in the power of prescription drugs than in the healing power of nature.
Regarding the public, direct-to-consumer marketing by drug companies has increased demand for their products. Due in part to this type of advertising, people have a strong desire to be medicated, believing it to be the only or the best way to effectively treat disease. Direct-to-consumer marketing by Big Pharma should be banned.
Lastly, many people prefer the “quick fix” of popping a pill. Nondrug therapies, such as lifestyle modification, require motivation and active participation on the part of patients and may take time to produce desired results. And the pill, as opposed to safe and effective nondrug approaches, is usually covered by insurance.
AS | When it comes to chronic disease, why do so many doctors prescribe drugs as a first-line treatment instead of using lifestyle modifications?
AW | Current medical training is heavy on high-tech treatment options, including drug therapy, and neglects the power of prevention, the impact of positive diet and lifestyle changes, and evidence for the safe and effective use of natural remedies and complementary therapies. With little or no background in these areas, healthcare providers are left to rely almost solely on medication. The circumstances outlined in question No. 1 further complicate matters.
My colleagues and I at the University of Arizona Center for Integrative Medicine are working to improve medical education so that future healthcare providers enter practice with an understanding of how to support and optimize a patient’s innate healing capacity. Of course, drug therapy is an important method for maintaining health and treating disease — but it’s not the only method.
AS | What are the consequences of overmedication?
AW | Safety is the biggest concern – polypharmacy (being on multiple medications) increases the odds for adverse reactions, drug interactions, and the unintended worsening of health problems.
Another worry is cost — the markup on pharmaceutical drugs is greater than on any other commodity in the marketplace. Big Pharma justifies this by citing the high cost of research, but that represents a small fraction of what they spend on advertising and promotion.
There are also environmental concerns — we get exposed to drugs that are excreted from the body or thrown out because they accumulate in our water supplies, in the soil, and in the foods we eat.
Overmedication also contributes to the pervasive notion that drugs are the only answer, but drug therapy is often best at hiding symptoms. Drugs alone do not address the root cause of disease.
AS| You have a very evocative statement in your book: “No difference exists between a drug and a poison except dose.” What do you mean by that?
AW | All drugs become toxic as the dose is increased. Doctors generally believe that the best medications are those that are powerful and work quickly. Unfortunately, concentration of pharmaceutical power inevitably concentrates toxicity. These potent agents are necessary in cases of severe illness, where benefit outweighs risk, but they are now used for almost every disease condition, even mild ones.
Strong reliance on these isolated, purified chemical compounds produces a high incidence of adverse reactions, ranging from mild discomfort to multisystem failure and death, even when the drug has been prescribed appropriately. Herbal remedies are far safer because the active components are present in a complex natural balance and in low concentrations.
AS | You write in your book that you want people to become wise consumers when it comes to medicine — to know when pharmaceutical products are really needed. So when are they needed?
AW | Use of pharmaceuticals should be limited to those situations where they are clearly indicated — critical care, terminal care, and the management of severe disease. I would like to see them play a smaller role in the treatment of common conditions where the risks are not justified. For chronic disease management, drug therapy should be offered in the context of comprehensive care that also includes lifestyle modification and nondrug therapies. Both doctors and patients need to become knowledgeable about less expensive and less dangerous interventions that are safe and effective.
AS | Are there any heartening trends afoot? What will it take, in your opinion, for more doctors to adopt a lifestyle-first strategy to tackle the chronic disease epidemic?
AW | We are faced with the growing realization that over-reliance on prescription-drug therapy has come at a terrible price — worsening antibiotic resistance and an unprecedented opioid addiction and an epidemic of serious adverse drug reactions are some of the most disturbing developments. Doctors are responding by prescribing fewer antibiotics for viral illnesses such as colds and the flu (antibiotics do not work against viruses), and by recognizing that narcotic medications are only indicated for short-term pain management following acute injury or surgery — they are not effective for the relief of chronic pain. In contrast, positive lifestyle changes such as an anti-inflammatory diet and healthy stress-management practices, as well as complementary therapies including acupuncture and mind-body techniques, are safe and effective ways of managing chronic pain.
Crisis offers opportunity. In these challenging times, my hope is that as a country we see the wisdom of integrative medicine and the lifestyle habits it encourages as part of the solution to our healthcare crisis.
Health and Wellness Associates
Dr Anne Sullivan
Frequent Nut Consumption Can Help to Prevent Diabetes and Improve Blood Glucose Control
This year, the WHO, ( World Health Organization) is focusing on diabetes in order to increase awareness about its rise and staggering burden and consequences, in particular in low-and middle-income countries. The International Nut & Dried Fruit Council (INC) wants to raise awareness about the importance of nuts in the treatment and prevention of this disease.
Cyril Kendall, PhD at the department of Nutritional Sciences at the University of Toronto, explains that this increase of prevalence is linked to our changing lifestyle. “We are becoming less active and our diet is becoming overly processed. This unhealthy diet not only increases blood glucose levels but it also leads to an increase in body weight which further increases the risk of developing diabetes”. Kendall, who has been studying the relation of nut consumption and diabetes, says that “based on the current scientific evidence, nuts may play an important role in improving the risk factors for this disease. Population studies have shown that frequent nut consumption is inversely associated to diabetes development and clinical studies indicate that nuts can help to improve blood glucose control in diabetes”.
In fact, nut consumption has been associated with beneficial effects on glucose and insulin levels, according to the latest studies about the relationship between nut intake and type 2 diabetes (T2D). The PREDIMED study concluded that the results of two Mediterranean Diet groups which added extra virgin olive oil and nuts reduced the risk to suffer diabetes by 52%. In addition, researchers at the Human Nutrition Unit, from Rovira i Virgili University, have proven that the intake of two ounces (57 g) of pistachios per day has a significant effect: it decreases fasting glucose, and favors insulin and the homeostasis model assessment of insulin resistance. Also, researchers at the Shih-Chien University and the Chang Gung University of Science and Tech (Taiwan), have shown that 60 g/day almond consumption improved glycemic control in patients with T2D.
Currently, about 400 million people (more than 5% of the world’s population) have T2D. It is estimated that by 2035 there will be almost 600 million people living with T2D and almost 900 million people with pre-diabetes, a silent state associated with a high risk of several deadly conditions including T2D, heart disease, hypertension, strokes and early death.
Health and Wellness Associates
Dr Anne Sullivan
Get up for Pulled Muscles and Sprains
If you’ve really injured yourself (with shin splints, a pulled muscle, or a sprain, for example), you need downtime to heal; otherwise it’s important to keep moving.
“Activating a sore muscle is better than resting it,” says Stephen P. Sayers, PhD, an assistant professor of physical therapy at the University of Missouri Columbia. ”
Getting the blood flowing to those muscles will reduce inflammation and help them heal.
Choose a less strenuous exercise to do for a few days; then gradually work your way back up to a harder routine.”
Health and Wellness Associates
Dr. J. Jaranson
Risk of Stroke with Nexium, Prilosec, Other Heart Burn Drugs Seen in New Study
The findings of new research raise additional concerns about the potential side effects of Nexium, Prilosec and other heart burn drugs, suggesting that certain users of the popular medications may face an increased risk of stroke.
According to preliminary findings of a study presented this week at the American Heart Association’s Scientific Sessions 2016, researchers from the Danish Heart Foundation indicate that the overall stroke risk with Nexium, Prilosec and other proton pump inhibitors (PPI) increased 21%, especially among users of higher doses, which is a strong indicator that the drugs are likely causing the strokes.
Proton pump inhibitors (PPIs) are a class of heartburn medications used by millions of Americans, including blockbuster brands like Nexium, Prilosec, Prevacid, Protonix, Dexilant, AcipHex and others, many of which have over-the-counter versions available without a prescription.
Although most users assume the drugs carry few serious side effects, often continuing to use Nexium or other PPIs for years, without any attempt to discontinue the drugs, the medications have been linked to a number of possible health risks in recent years, including heart attacks, dementia, kidney disease and kidney failure. However, some experts suggest that the link between Nexium and strokes may be most worrying, if confirmed.
“At one time, PPIs were thought to be safe, without major side effects,” Dr. Thomas Sehested, the study’s lead author, said in an American Heart Association press release. “This study further questions the cardiovascular safety of these drugs.”
The study, which has not yet been completed or peer-reviewed, looked at the records of nearly 250,000 Danish patients, with an average age of 57, who underwent an endoscopy procedure to seek out causes of stomach problems. Nearly 9,500 of those patients suffered an ischemic stroke during the six year follow up period of the study. The researchers looked to see which of those patients were taking either Nexium, Prilosec, Protonix, or Prevacid.
Researchers found that the overall stroke risk with Nexium, Prilosec, Protonix and Prevacid increased by 21% for patients taking the drugs. The risk increased at higher doses for some, with high doses of Prevacid increasing the risk of stroke to 30%, and high doses of Protonix carrying the most risk of stroke with a 94% increased risk.
The study also looked at another class of heartburn drugs, known as H2 blockers, which includes Pepcid and Zantac. However, no increased risk of stroke was seen with those other drugs.
The researchers said their findings should inspire doctors to be more cautious in prescribing PPIs, and suggested that they should carefully consider if a PPI prescription is necessary and for how long to keep the patient on the drugs.
Other Nexium, Prilosec, Prevacid, and Protonix Health Risks
Over the past year, a growing number of Nexium lawsuits, Prilosec lawsuits ,Prevacid lawsuits, Protonix lawsuits, Dexilant lawsuits and other claims have been brought against the makers of proton pump inhibitors, alleging that users and the medical community were not adequately warned about the risk of serious and potentially life-threatening injuries.
The litigation has emerged over the past year, after a series of independent studies suggested there is a link between Nexium and kidney risks, including acute interstitial nephritis, acute kidney injury, chronic kidney disease and end-stage kidney failure. This has raised questions in recent months about whether the drugs may be overused.
Earlier this year, a study published in the medical journal JAMA Internal Medicine also found an increased risk of chronic kidney disease with the heartburn medications, indicating that users of Nexium, Prilosec and other PPI may be 50% more likely when compared to non-users.
In 2014, a study published by researchers from the University of Findlay College of Pharmacy noted that not only was overuse and abuse of heartburn drugs widespread, but many who take the drugs do so for longer than four years. The study noted that this increases the risk of any side effects associated with the drugs, but it also has a large economic impact as well.
Plaintiffs claim that drug makers placed their desire for profits before consumer’s safety by withholding important safety information, alleging that if warnings had been provided about the risk of acute interstitial nephritis, kidney injury, kidney disease and kidney failure, many individuals may have been able to avoid these severe and potentially life-threatening injuries.
Given the large number of users throughout the United States, it is expected that thousands of cases may be filed in the coming months as heartburn drug injury lawyers continue to review and file cases.
We here at Health and Wellness Associates have mentioned this many times over the past few years. Luckily, we have helped many of you get off these drugs safely. If you are on any of these medications and you wish help in getting off them, please call us, or write to us, and we will be happy to get back with you.
Please share with family and loved ones.
Health and Wellness Associates
Director of Personal Healthcare and Preventative Medicine
When it comes to the first and last meals of the day, it can be extremely difficult to find something that is both healthy and delicious. This challenge becomes increasingly difficult if you are attempting to eat a vegan diet. The answer to the breakfast and dessert dilemma is this delightful healthy twist on traditional rice pudding.
Traditional rice pudding is high in fat and heavily processed foods. By replacing regular milk with coconut milk, white rice with brown and removing the egg, the dish becomes an altogether healthier prospect.
This is a healthy, animal-friendly and tasty recipe for early mornings and late nights. So get out the slow cooker and start cooking!
The replacement of regular dairy milk with coconut milk not only makes this recipe a great choice for vegans, but it also provides a significant boost to your health. Coconut milk has a high copper content. Elevated levels of copper in the body have been shown to boost your immune system to fight off illness and infections.
Additionally, coconut milk has been proven to contain high levels of niacin (also known as Vitamin B-3). One of the significant benefits of increasing the level of niacin in your body is that it helps with a healthy increase of sex hormones and stress relieving hormones. Niacin is crucial to your reproductive and mental health.
Coconut Brown Rice Pudding
Prep time: 5 minutes
Cook time: 3 hours 35 minutes (slow cooker)
1 cup short grain brown rice
1 can light coconut milk
2 cups water
2 tablespoons maple syrup
1 teaspoon vanilla
2 teaspoons cinnamon
1/2 cup raisins
Put the coconut milk, brown rice, syrup, vanilla and water into the slow cooker and cook for three and a half hours on low heat.
Stir in the cinnamon and raisins.
Sarah’s RA (Rheumatoid Arthritis ) Treatment
When I first saw Sarah, we discussed her diet, and I suggested there might be a genetic influence involved as she’s Scottish-Irish. Many of her family members also had autoimmune problems, including multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS). Her genetic background suggested she may have an intolerance of wheat and gluten.
“You said I should eliminate that out of my diet as well as processed foods and sugar. You also did a metabolic typing. I did a very thorough questionnaire about how I metabolize food, about my energy levels, and about the stress in my life.
Along with my blood type, I was given a very special protocol of which foods would help me heal… I did a lot of vegetable juicing, which really helped me. I juiced probably 48 ounces a day of green juice.
I also ate a lot of organic grass-fed beef, ostrich, bison, free-range chicken and raw dairy. You even recommended raw eggs and raw egg yolks. Because I was in Wisconsin, I found an organic farm close to me. I got most of my meat, raw milk and my eggs from there. I bought all my fresh vegetables from local farmers markets. I got to know area farmers and learn about their farming practices.
I would buy a variety of vegetables and meats from them because I knew how they grew their food and raised their animals. I even used to meet the ostrich farmer in a parking lot across from the co-op where she used to sell her meats and buy it direct at a lower price. I also incorporated a lot of probiotics in my diet, and increased my vitamin D levels. Instead of suppressing my immune system with drugs to control my disease, I was using food to redesign my immune system and make it as strong as possible.
Apart from diet, the other important issue you advised me to address was the level of stress in my life. At that time, I was a teacher, new and passionate about the field. I worked very long hours, beyond what was healthy. Additionally, I dedicated several hours per week to triathlon training, and had some emotional stress in my life is well.
You, emphasized how stress and emotions impact immunity and now that I am studying Eastern medicine I have learned it is one of the primary causes of disease. I still question whether it was the amount of work and stress in my life which triggered the onset of my disease.
I cut back on the amount I was working and doing, and made more time for rest and enjoyment. You, also taught me Emotional Freedom Technique, a method of tapping along traditional energetic acupuncture meridians to help relieve emotional issues. I began incorporating EFT into my daily life, which was a simple and time-effective method to help me better deal with everyday stress and anxiety.
The Importance of Vitamin D
Vitamin D is a really important component. It stimulates 200 to 300 anti-microbial peptides that are even more powerful than antibiotics, which help improve and regulate your immune system and fight infections. Sarah, as many others with RA, noticed her symptoms were at their worst during the winter, and would often dissipate during the summer. This is what you call a giant clue that vitamin D is at work…
Invariably, unless you’re aggressively addressing your vitamin D level with sun exposure or supplementation, your blood levels of vitamin D will drop to dangerously low levels sometime in January, February, or March, when sun exposure is at its lowest. Optimizing your vitamin D is extremely important.
Essentially, if you’re using a supplement, you need to take whatever dosage is required to reach and maintain a therapeutic level, which can only be done by a healthcare worker that understands this.
Nourishing your gut microbiome is another important component. In addition to eating more fermented foods, it’s equally important to cut out sugar from your diet as it will feed pathogenic microbes and decimate your immune system, leaving you susceptible to autoimmune diseases of all kinds.
“I learned how to ferment my own vegetables and dairy products. I made my own kombucha, yogurt, cultured butters, milk kefir and coconut kefir. It took almost two years to get my system in balance, but right away, I noticed a difference.
In about two weeks my cravings for wheat, breads, and sugar diminished… My healthcare worker also told me that I had leaky gut and digestive proteins in my bloodstream.
I talked to my healthcare team, and after three months after being very strict with the diet. I felt better; I’d lost about 10 pounds. I had so much more energy and felt lighter. But when they did my analysis and showed me was — that I had completely changed — that’s when I really believed that food was medicine…
I was able to resume my regular activities… I was able to return to racing. That year, after following your protocol for about a year, I actually won an entire triathlon… So I went from being told I’d never run again to winning a race. Slowly, slowly the symptoms diminished. After two years of being very strict [with my diet], my symptoms went to complete remission, and they’ve stayed that way. It’s been over 10 years.
I still work out. Right now, I train Brazilian capoeira, which incorporates martial arts, dance, and acrobatics. I’m still able to do gymnastics. I can still do back flips at age 43. I still run occasionally. I still swim and bike. I do yoga and cross-country skiing when I’m in the north. So, I’m very active and very healthy. In fact, I feel that by you helping me, it really extended my life. I feel much younger than my age.”
I just want to wish Sarah the best, and her testimony we hope is helpful for others.
Sarah did go through more steps than she had wrote about, but
There IS Hope for RA Patients!
Health and Wellness Associates
Best and Worst Nuts for Your Health
Should you go nuts?
Nuts are nature’s way of showing us that good things come in small packages. These bite-size nutritional powerhouses are packed with heart-healthy fats, protein, vitamins, and minerals.
Here’s a look at the pros and cons of different nuts, as well as the best and worst products on supermarket shelves today. Of course, you can get too much of these good things: Nuts are high in fat and calories, so while a handful can hold you over until dinner, a few more handfuls can ruin your appetite altogether. And although nuts are a healthy choice by themselves, they’ll quickly become detrimental to any diet when paired with sugary or salty toppings or mixes.
Best nuts for your diet
Almonds, Cashews, Pistachios
All nuts are about equal in terms of calories per ounce, and in moderation, are all healthy additions to any diet. “Their mix of omega-3 fatty acids, protein, and fiber will help you feel full and suppress your appetite,” says Judy Caplan, RD, a spokesperson for the Academy of Nutrition and Dietetics.
The lowest-calorie nuts at 160 per ounce are almonds (23 nuts; 6 grams protein, 14 grams fat); cashews (16 to 18 nuts; 5 grams protein, 13 grams fat); and pistachios (49 nuts; 6 grams protein, 13 grams fat). Avoid nuts packaged or roasted in oil; instead, eat them raw or dry roasted, says Caplan. (Roasted nuts may have been heated in hydrogenated or omega-6 unhealthy fats, she adds, or to high temperatures that can destroy their nutrients.)
Worst nuts for your diet
Macadamia Nuts, Pecans
Ounce for ounce, macadamia nuts (10 to 12 nuts; 2 grams protein, 21 grams fat) and pecans (18 to 20 halves; 3 grams protein, 20 grams fat) have the most calories—200 each—along with the lowest amounts of protein and the highest amounts of fats.
However, they’re still good nuts: The difference between these and the lowest calorie nuts is only 40 calories an ounce. As long as you’re practicing proper portion control and not downing handfuls at a time, says Caplan, any kind of raw, plain nut will give you a good dose of healthy fats and nutrients.
Best nuts for your heart
While all nuts contain eart-healthy monounsaturated fats, walnuts (14 halves contain 185 calories, 18 grams fat, 4 grams protein) have high amounts of heart-healthy alpha linoleic acid (ALA), a type of omega-3 fatty acid found in plants. Research has suggested that ALA may help heart arrhythmias, and a 2006 Spanish study suggested that walnuts were as effective as olive oil at reducing inflammation and oxidation in the arteries after eating a fatty meal. The authors of this study, funded in part by the California Walnut Commission, recommended eating around eight walnuts a day to achieve similar benefits.
Best nuts for your brain
Technically legumes but generally referred to as nuts, peanuts are high in folate—a mineral essential for brain development that may protect against cognitive decline. (It also makes peanuts a great choice for vegetarians, who can come up short on folate, and pregnant women, who need folate to protect their unborn babies from birth defects, says Caplan.) Like most other nuts, peanuts are also full of brain-boosting healthy fats and vitamin E, as well. One ounce of peanuts (about 28 unshelled nuts) contains about 170 calories, 7 grams protein, and 14 grams fat.
Best nuts for men
Brazil Nuts, Pecans
Creamy Brazil nuts are packed with selenium, a mineral that may protect against prostate cancer and other diseases. Just one nut contains more than a day’s worth, so eat these sparingly: Recent research has hinted that too much selenium may be linked to type 2 diabetes risk. One ounce of Brazil nuts (6 nuts) contains about 190 calories, 19 grams fat, and 4 grams protein.
Pecans are also good for men’s health: They’re loaded with beta-sitosterol, a plant steroid that may help relieve symptoms of benign prostatic hyperplasia (BPH), or enlarged prostate. One ounce of pecans (18 to 20 halves) contains about 200 calories, 21 grams fat, and 3 grams protein.
Best nuts for disease prevention
Relatively low in calories, almonds have more calcium than any other nut, making them a great food for overall health. Plus, they are rich in fiber and vitamin E, an antioxidant that helps fight dangerous inflammation and possibly health conditions such as lung cancer and age-related cognitive decline.
Because they’re so versatile, almonds are often a favorite among nut eaters: You can buy them raw, toasted, slivered, or coated with a variety of fun flavors.
Best snack packaging for nuts
Choose 100- to 200-calorie packs
Because nuts are so high in calories (and so tasty, to boot!), it’s important to practice portion control when eating them as a snack. We love Blue Diamond Almonds 100-calorie snack packs, available in six flavors, including Cinnamon Brown Sugar and Dark Chocolate. Want more variety? Pick up Planters Nutrition Wholesome Nut Mix on-the-go packs, each containing a 200-calorie mix of cashews, almonds, and macadamia nuts.
Worst snack packaging for nuts
Avoid anything in a tub
We’re all for buying in bulk to save money and packaging, but it’s important not to snack straight from the box (or in this case, the giant tub) when a craving hits. Beer Nuts’ “original” formula—peanuts coated with a sweet and salty glaze—aren’t a bad choice themselves (170 calories, 14 grams fat, and 2 grams sugar per ounce), but if you’re munching on them at a party or during a “long day of game watching,” as the company’s website suggests, you’ll likely be eating more than the recommended serving size. Not to mention, the Party Mix variety also includes M&Ms and sugary yogurt-covered raisins, for an extra calorie boost. A better bet is Beer Nuts’ Original Teaser Peanut Sized bags, each containing just half an ounce of nuts.
Best nuts for chocolate lovers
Go for cocoa-dusted almonds
Rather than hiding your nuts under a thick layer of sugary chocolate candy—think Jordan almonds or peanut M&Ms—keep it simple with Emerald’s Cocoa Roast Almonds. These nuts are lightly dusted with cocoa powder and sweetened with Sucralose, and have 150 calories, 13 grams fat, and 1 gram of sugar per ounce.
We’d give you a “worst” nuts for chocolate lovers, but the possibilities are practically endless. Just think of it this way, says Caplan: Anything that’s more chocolate than nut really should be considered candy—not as a way to get your daily quota of healthy fats.
Best nuts for your sweet tooth
Try all-natural glazed nuts
Want something sweet and satisfying but without the extra calories and high-fructose corn syrup? Look no further than Sahale Snacks glazed nuts, in flavors like Almonds with Cranberries, Honey, and Sea Salt (160 calories, 11 grams fat, 5 grams protein per ounce) or Cashews with Pomegranate and Vanilla (150 calories, 10 grams fat, 4 grams protein per ounce). They’re sweetened with organic cane juice and tapioca syrup, and each contains only 6 grams of sugar per ounce. Just be careful not to eat the whole bag!
Worst nuts for your sweet tooth
Check labels for sugar content
Just because something has nuts in it doesn’t make it good for you, says Caplan: “Don’t justify eating a Snickers because it’s got peanuts in it.” Anything coated with or tucked inside layers of sugar, toffee, chocolate, or ice cream isn’t going to give you much nutritional benefit, and the calories can quickly add up, she says.
It’s not just candy, though: Beware of seemingly healthful varieties, like Planters Sweet ‘N Crunchy Peanuts. Although they still have just 140 calories and 8 grams fat per ounce, the second and third ingredients after peanuts are sugar and butter. In fact, one ounce contains 13 grams of sugar (in just a 28-gram serving size). Considering peanuts only have about 2 grams of sugar naturally, that’s 11 grams of added sugar in just one handful, out of a recommended 25 for the whole day!
Best nuts for a salt craving
Look for ‘lightly salted’
If you don’t have high blood pressure or haven’t been warned away from salt by your doctor for other reasons, a handful or two of salted nuts a day won’t hurt you, says Caplan, who has a private nutrition practice in Vienna, Va.
Nuts are, of course, available unsalted. But to satisfy a salty craving without going overboard, look for in-between varieties like Planters Lightly Salted peanuts, almonds, and cashews (45-55 mg sodium), or Wonderful Pistachios Lightly Salted (80 mg). Check ingredient labels, too: Some brands, like Back to Nature Salted Almonds (75 mg sodium), contain less salt than others.
Worst nuts for a salt craving
Steer clear of BBQ or boiled nuts
If you’re watching your sodium intake, watch out for hot and spicy or barbecue flavors too. Kar’s Nuts Blazin’ Hot Peanuts, for example, contain 370 mg of sodium per ounce (along with 160 calories and 14 grams fat)—a whopping 15% of your daily recommended value, in just one handful!
Beware boiled peanuts, as well: This Southern treat is made by soaking fresh, raw peanuts, in their shells, in a salty brine. Sodium amounts will vary based on the exact preparation, but Margaret Holmes Peanut Patch boiled peanuts, for example, contain 390 mg per ounce.
Best trail mix
Raw nuts, seeds, and dried fruit
Trail mix is available in countless varieties and from countless brands. “Look for trail mix with raw nuts,” suggests Caplan. “Or if the nuts are roasted, look for the words ‘dry roasted’ rather than ‘oil roasted.'”
Nuts pair great with fruit, seeds, and perhaps even a little dark chocolate, Caplan adds; just pay attention to the calorie count and serving size. We love Eden Foods’ “All Mixed Up” blend (160 calories, 12 grams fat, 8 grams protein per ounce) of organic almonds, pumpkin seeds, and dried tart cherries. If you’re more of a granola guy or gal, treat yourself to a quarter cup of Bear Naked’s Banana Nut mix (140 calories, 7 grams fat, 3 grams protein) with almonds and walnuts.
Worst trail mix
Save high-calorie mixes for the trail
High-calorie trail mix is fine when you’ve got a long hike ahead of you, but too often we eat these store-bought blends while sitting at our desks or driving in our cars. Don’t make that mistake with Planter’s Energy Go-Packs, a 1.5-ounce mix of nuts, semisweet chocolate, oil roasted soynuts, and sesame seeds: With 250 calories and 20 grams of fat a pop, they fall slightly above our healthy snacking guidelines.
Also check labels for sky-high sugar contents: Some trail mixes—especially those with raisins, dried cranberries, and/or candy-covered chocolate pieces—can contain up to 18 grams of sugar per serving.
Best nut butter
Keep ingredients simple
When choosing a nut butter, look for spreads with the fewest ingredients possible: Just nuts (and salt, if you want). Arrowhead Mills Organic Peanut Butter, for example, contains 100% dry-roasted peanuts, and has 190 calories, 17 grams fat, and 8 grams protein per 2 tbsp serving. (We also like their creamy cashew and almond butters, which do contain some natural canola oil.) Keep natural peanut butter in the fridge, advises Caplan, to keep it from going rancid and to prevent oily separation.
Worst nut butter
Skip added oils and sugars
Major brands have eliminated trans fats from their nut butters, but most still contain hydrogenated oils (high in saturated fat) to increase spreadability and prevent separation. Some “natural” product lines swap hydrogenated oils for palm oil, also high in saturated fat. Skippy Natural with Honey, for example, contains 200 calories, 16 grams fat (3.5 grams saturated), and 5 grams sugar per 2-tablespoon serving.
Nutella’s creamy chocolate-hazelnut combo is terrific for an occasional treat—but it’s hardly part of a “balanced breakfast,” as its commercials say. Two tablespoons contain just 200 calories, yes, but 21 grams of sugar. In fact, sugar and palm oil are the product’s first ingredients, even before hazelnuts.
Best way to eat nuts
Pair them with a healthy carb
Now you know all about which nuts are good for what—but to get the most health benefits, it’s also important to pay attention to how you eat them. “Nuts are a great thing to eat when you’re having a carbohydrate like fruit or juice, because it helps slow down digestion and the breakdown of sugar,” says Caplan.
A few winning nut-and-carb combos: Sprinkle them on salads, add them to low- or nonfat yogurt, or spread nut butter on slices of apple or pear. On the go? Pick up a 150-calorie pack of Earthbound Farms Dippin’ Doubles Apples & Peanut Butter (11 grams fat, 5 grams protein).
Best nuts overall
A mixed bag!
So which is the healthiest nut overall? A 2004 review in the Harvard Medical School Family Health Guide tackled this tough question. Luckily, they concluded, we don’t have to pick just one. Mixed nuts, ideally raw and unsalted, provide the best variety of nutrients and antioxidants.
Health and Wellness Associates
Archived: Dr. J Jaranson
312 972 WELL
Are Sleeping Problems a Warning for Alzheimer’s?
Trouble getting enough sleep may be linked to a bigger risk of Alzheimer’s disease for some people, new research suggests.
The results of the small study hint that people with a higher-than-normal risk of Alzheimer’s disease who had worse sleep quality, more sleep problems and daytime sleepiness had more markers for Alzheimer’s disease in their spinal fluid than those who didn’t have sleep issues.
The markers found by researchers included signs of the proteins amyloid and tau, and brain cell damage and inflammation, all linked to potential Alzheimer’s.
Amyloid is a protein that folds and forms plaques. Tau is a protein that forms tangles. Plaques and tangles are found in the brains of those with Alzheimer’s disease and are considered a hallmark of the disease.
“This study and others in the field suggest that sleep may be a modifiable risk factor for Alzheimer’s disease,” said senior researcher Barbara Bendlin. She’s an associate professor of medicine at the University of Wisconsin School of Medicine and Public Health.
“This will require studies that directly test whether modifying sleep has a beneficial effect on the brain,” Bendlin said.
So, if you’re someone who’s always tossing and turning at night, does that mean you’re destined to a future with Alzheimer’s disease?
Not necessarily. Bendlin said these findings cannot prove that poor sleep causes Alzheimer’s disease. “We found an association,” she said. “But that does not mean cause and effect.”
It’s possible changes in the brain associated with Alzheimer’s could affect sleep, as opposed to the other way around, Bendlin added.
People with markers — signs — of Alzheimer’s in their spinal fluid aren’t necessarily predestined to develop the condition either, she said.
“We found relationships between sleep and levels of proteins related to Alzheimer’s disease, but the proteins that we were measuring haven’t yet been shown to predict future dementia when measured in cognitively healthy people,” Bendlin said.
The study included 101 people and their average age was 63. At the time of testing, all of the study volunteers had normal thinking and memory skills. But they were considered at risk for Alzheimer’s either because they had a parent with the disease or they carried a gene that increases the risk for Alzheimer’s called apolipoprotein E, or APOE.
The study volunteers gave a sample of spinal fluid to be tested for markers of Alzheimer’s disease.
They also answered questions to judge the quality of their sleep. Examples included: “During the past four weeks, how often did you get the amount of sleep you needed?” Or “Did you get enough sleep to feel rested upon waking in the morning?” Bendlin said.
Although a strong association between sleep problems and Alzheimer’s markers was seen in most people, not everyone with sleep difficulty had these markers in their spinal fluid, Bendlin said.
For example, there was no association seen between people who had sleep apnea and markers for Alzheimer’s in their spinal fluid.
Other factors — such as the use of drugs to aid sleep, education, depression and weight — didn’t change the association between poor sleep and markers for Alzheimer’s disease, the researchers found.
One thing that could have thrown the findings off is that the participants reported their own sleep problems. It’s possible that people misreported their sleep issues or didn’t remember them correctly, the researchers said.
One specialist said that the association between sleep and amyloid has been seen in mice, but its effect on people isn’t clear.
“There is a positive feedback loop involving sleep and amyloid,” said Dr. Sam Gandy, director of the Center for Cognitive Health at Mount Sinai Hospital in New York City.
In mice, the worse the sleep, the more amyloid builds up. The more amyloid builds up, the worse the sleep, he said.
It’s not known if this occurs in the same way in humans, Gandy said.
“Since our ability to slow progression of Alzheimer’s is still quite limited, this is an important area for research so that we might be able to exploit sleep regulation therapeutically,” he said.
Bendlin said it’s important to identify modifiable risk factors for Alzheimer’s because delaying Alzheimer’s disease in people by as little as five years could reduce the number of cases in the next 30 years by nearly 6 million and save $367 billion in health care costs.
Health and Wellness Associates
Dr P Carrothers
Home Brewing Kombucha
What is all the hype about this funky tea known as Kombucha? Kombucha most likely started in China and spread to Russian over 100 years ago. It is often called mushroom tea because if the scoby that forms on the top, resembling a mushroom. Scoby is actually an acronym for symbiotic culture of bacteria and yeast.
Kombucha contains multiple species of yeast and bacteria along with the organic acids, active enzymes, amino acids, and vitamin C. According to the American Cancer Society “Kombucha tea has been promoted as a cure-all for a wide range of conditions including baldness, insomnia, intestinal disorders, arthritis, chronic fatigue syndrome, multiple sclerosis, AIDS, and cancer. Supporters say that Kombucha tea can boost the immune system and reverse the aging process.” I will caution you however that there is little scientific evidence to support such strong claims.
For us Kombucha is fun to make, and is highly recommended among many of my holistic friends. It is naturally fermented with a living colony of bacteria and yeast, which is helpful for digestive health. I think it smells a little strong, but is actually pleasant tasting.
Instructions for Making Kombucha Tea
- 14 cups water
- 1 cup sugar
- 8 tea bags
- 1 cupstarter tea or vinegar
- kombucha culture
- Combine hot water (14 cups for 1 gallon) and sugar (1 cup) in the glass jar you intend on using to brew the tea. Stir until the sugar dissolves. The water should be hot enough to steep the tea but does not have to be boiling.
- Place the tea or tea bags in the sugar water to steep. Use 8 tea bags for a gallon of tea. I prefer the flavor of green tea, but you can also use black tea. Try to find an organic tea. If you use loose tea leaves use 4 tbsp for a gallon of tea.
- Cool the mixture to room temperature. The tea may be left in the liquid as it cools. Once cooled remove the tea bags.
- Add starter tea from a previous batch to the liquid. If you do not have starter tea, distilled white vinegar may be substituted. If using vinegar use 2 cups for a gallon of tea.
- Add an active kombucha scoby (culture).
- Cover the jar with a towel or coffee filter and secure with a rubber band. Ants can smell sweet tea a mile away.
- Allow the mixture to sit undisturbed at 68-85°F, out of direct sunlight, for 7-30 days, or to taste. The longer the kombucha ferments, the less sweet and more vinegary it will taste.
Keep the scoby and about 1 cup of the liquid from the bottom of the jar to use as starter tea for the next batch. You will have the “mother scoby” that you added and a new “baby scoby” that will have formed on the top. You can reuse your mother scoby, and gift your baby.
The finished kombucha can be flavored, or enjoyed plain. Keep sealed with an airtight lid at room temp for an additional 7 days with added fruit if you like a fizzy drink like soda. Otherwise store in the fridge to stop the fermentation process. These little bottles of “hippy tea” have been popping up all over grocery stores for about $3 a bottle, but you can make it at home for about $1 a gallon. I’m not sure that it’s a cure-all, but at worst you have a delightful and affordable probiotic.
Health and Wellness Associates
Dr S. Siewert