Jeff Benabio, M.D., a dermatologist with Kaiser Permanente in San Diego, talks about the history and future of medicine and how physicians will once again reinvent how we deliver healthcare to our patients at TEDx last October.

Dr Michael Evans talks about the single best thing someone can do for their health and in only 30 minutes a day…

NPR has a story today on how groceries stores are trying to promote their fresh produce sales.

Today, November 2nd, is Election Day in the United States, where approximately a third of the U.S. Senate and all of the House of Representatives are up for re-election. Additionally, state and local electoral races can have a large impact on the direction and level of government involvement iin developing public policy for diabetes prevention and treatment.

One aspect of the recent health care reform bill (Health Care and Education Reconciliation Act of 2010) signed into law by President Obama will help lower the barrier to treatment for elderly Americians with diabetes by including preventative care such as blood sugar testing and cholesterol screening as a covered benefit under Medicare.

Another benefit of the new law is the mandate that requires health insurance companies to extend insurance coverage to child with pre-existing conditions such as diabetes.

Senior citizens that found themselves caught in the “donut hole” coverage and having to pay for a significant portion of their prescription drugs under the Medicare Part D plans will find that the “donut hole” will disappear by 2020. This change in policy is an important component for effective diabetic care and management since many diabetics require prescription medications to control their diabetes and that approxiamately 15% of patients stopped taking their medications once they reached the Medicare “donut hole” based on a Kaiser Foundation research paper and were required to pay the full cost of their medications until their catastrophic coverage kicked in.

In case you were wondering what disease followed October’s Breast Cancer Awareness Month, November is the American Diabetes Month (as well as “Movember” – a prostate cancer awareness campaign where guys get to grow really cool mustaches in order to raise money for prostate cancer). We’ll be highlighting both diabetes and prostate cancer awareness for this month, primarily focusing on…prevention, since I feel that is the most important aspect of medicine. If we can prevent it, then I don’t have to talk to you as a patient about how to treat it or attempt to cure it.

And how cool would that be?

Want more info on American Diabetes Month? Check out the American Diabetes Association

Find out more about “Movember” and raising awareness for prostate cancer.

Very interesting lecture by Robert H. Lustig, MD from University of California San Francisco on “Sugar: The Bitter Truth”

View San Diego Area Farmers Markets in a larger map

An April 2010 article in the Journal of the American Medical Association details research from Emory University that shows how people that have a higher amount of added sugar in their diet have worse cholesterol profiles that patients that limit the amount of added sugar in their diets.

The research on the effect of added sugar on cholesterol levels looked at over 6000 adults in the US that were part of the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006. The study looked at cholesterol levels (HDL, LDL and triglycerides) in men and women when grouped by their intake of added sugars in their diet. The study found that as daily added sugar intake increased, there was a statistically significant decrease in the high-density lipoprotein cholesterol or HDL-C, (typically referred to as the “good” cholesterol) and an increase in the triglyceride levels of both men and women. Only women were also found to have a significant increase in their low-density lipoprotein cholesterol or LDL-C levels (considered the “bad” cholesterol) as seen in the table below.

The President’s Cancer Panel has released ther 2008-2009 Annual Report on Reducing Environmental Cancer Risk: What We Can Do Now.

The 150 page report details environmental and chemical exposure as it may increase Americans risk of developing cancer as a result of long-term exposures. Study raises interesting questions regarding the efficacy of government regulation and oversight in United States.

I have some other patients that have asked about the benefits of a raw food diet, and while there are many benefits, there are a few drawbacks to a completely raw food diet.

Cooked tomatoes have higher antioxidant levels

The reality is that some foods actually have higher nutritional value if they are cooked versus eaten raw. Tomatoes are a prime example of this feature. Cooked tomatoes actually have higher levels of antioxidants and lycopene when compared to raw tomatoes.

One reason that raw food diet advocates give for their eating habits is that cooking most foods decreases the amount of vitamin C in the food. However, it’s important to look at the entire anti-oxidant properties of the vegetable or fruit and not just the Vitamin C levels. This focus on a solitary vitamin or nutrient may be why many studies that look at supplementation do not show significant impact on a variety diseases, but diets high in foods that contain those nutrients do demonstrate a positive effect.

One study that clearly demonstrates this is a 2002 study in the Journal of Agriculture Food Chemistry by researchers from Cornell University. The researchers compared to vitamin C,  lycopene, and total antioxidant activity between raw tomatoes and tomatoes that were cooked for various times ranging from 2 minutes to 30 minutes. The results are summarized below but basically demonstrate just a slight decrease in vitamin C concentration between the raw tomato and  cooked tomatoes, while there was a significant increase in the lycopene and total antioxidant concentrations.

Nutritional Qualities Of Raw Versus Cooked Tomatoes

My take on this study is that there is no one correct type of diet or method of eating. While there are benefits of raw food, there also are measurable benefits for some foods that are cooked. Please pass spaghetti sauce.