Health Notes

Avocados resurrected

One of the most difficult things to get across to most people is that FAT DOES NOT MAKE YOU FAT. The tragic misconception that it does was actually started by a psychiatrist turned “nutritionist.” David Reuben garnered a little fame back in the ’60s from his book, Everything You Always Wanted to Know About Sex but Were Afraid to Ask. The book sold for $25 back then, which was a heavy price in those days. Forty-year-old books, if they are of significance, will often sell for many times the original price. You can now pick up a copy of Reuben’s book for 75 cents, which doesn’t say much for its holding power. But, hey, 75 cents is 75 cents, and, besides, he probably made 75 zillion on the original.

It takes approximately zero knowledge in biochemistry, or any other hard science for that matter, to become a psychiatrist. So how did he become an expert in nutrition-a highly complex field of science-with no training and manage to shape the thinking of millions of Americans on the subject of fat metabolism? Only in gullible America could Reuben have metamorphosed into a nutritional expert.

All it took was one simple question: “Fat makes you fat, right?” he asked his readers in his next book, Everything You Always Wanted to Know About Nutrition. Well, that did it. Since the public sees the title “Dr.” and equates it with science (regardless of actual training), anything containing fat, including butter, bacon, and hundreds of other noble foods, went down the pig chute. Even the avocado was vilified.

Slowly, we are working our way out of this morass of misinformation. Avocados, for example, have been discovered not to make you fat, because they contain monounsaturated fatty acids, which are actually good for you.

The avocado’s image first took on some polish with a 1996 study in Mexico that looked at the health benefits of daily avocado consumption. Researchers found that volunteers who ate avocados every day for a week experienced an average 17 percent drop in total blood cholesterol. This included an improvement in all the ratios of HDL and LDL associated with heart disease. Beta-sitosterol, a natural substance shown to significantly lower blood-cholesterol levels, is found in high concentration in avocados. At the conclusion of the study, the 45 participants experienced a decrease in LDL (bad) cholesterol levels and an increase in HDL (good) cholesterol levels.

The U.S. government recently revised its official nutrition guidelines to urge Americans to eat more avocados. There were no apologies for the years of misinformation, however. Who needs this kind of expert advice? You might as well get your nutritional advice from a psychiatrist.

Archives of Medical Research, Winter 1996
American Journal of Medicine, 12/99
Michele Bloomquist, “The Avocado Advantage,” WebMD Medical News, 8/14/00

St. John’s wort depresses drug sales

When the remarkable effectiveness of St. John’s wort (Hypericum) for treatment of depression made the news a few years ago, I didn’t think anybody was listening or, if they were listening, I didn’t think they would believe it. But when I saw 5-foot display cases of St. John’s wort a year later in Wal-Mart, I knew someone was listening.

One of the most amusing-and unintended-compliments to the herb came from cancer chemotherapy experts. They warned that “this unregulated compound” (notice they never refer to aspirin or Coca Cola as unregulated compounds) can “interfere” with HIV drug therapy and immune suppression needed for transplant patients.

“Two studies published in the Lancet medical journal found that St. John’s wort dulls the effectiveness of both the HIV medicine indinavir and the transplant drug cyclosporin, used to suppress transplant patients’ immune systems so their bodies don’t reject the new organs,” reported the Associated Press [emphasis added].

St. John, bless his immortal soul, is preventing the suppression of the immune system? Except for certain patients, isn’t that a good thing?

It’s just a new spin on an old story: Vitamin C is “bad” because it protects the body from the immune-suppressing effects of radiation and chemotherapy. Now, St. John’s wort is “bad” for the same reason. Since immune-suppressing HIV treatments are ineffective anyway, I don’t think the suppression of their “effect” by St. John’s wort is a bad thing. In the case of immune suppression for transplant patients, it’s a different story. These patients will have to live constantly on the razor’s edge of immune suppression, so St. John’s wort should be avoided.

But if you are not a transplant patient, and you are down in the dumps, St. John’s wort is an excellent alternative to addictive drugs like Paxil.

Which brings me to the study done by German researchers, which actually states that St. John’s wort “offers the same benefits as the antidepressant imipramine, with fewer side effects.” Can you believe it? The German doctors go on to say that Hypericum should be the first treatment tried!

As with any effective medication, natural or man-made, there may be some side effects. But which would you prefer to take: an effective pharmaceutical with severe side effects (dry mouth, sweating, dizziness, nausea, weakness, and headache) or an effective herb with minor, if any, side effects?

Associated Press, 2/11/00
British Medical Journal, 9/2/00

Save your own life-recognize heart attack symptoms

The “golden period” for saving lives following a heart attack is the first hour. You need to know the following warning signs, so you can get help right away, either for yourself or someone close to you.

  1. Uncomfortable heaviness, pressure, pain, or squeezing in the center of the chest
  2. Pain that goes to the shoulders, neck, or arms–usually the left arm but it can be to the right
  3. Discomfort in the chest, along with a lightheadedness, fainting, sweating, nausea, or shortness of breath

America’s No. 1 killer is still heart and blood vessel diseases-with 490,000 deaths a year. So get help fast if you feel any of the above symptoms. Many lives can be saved by acting quickly and being aware of the signals your body is sending you.

Nursing nurses’ reputations back to health

I have always had a great respect for nurses. I listen carefully to what they have to say about the patient; I ask their opinion on difficult cases. I learned early in the practice of hospital medicine that a doctor’s best ally in avoiding mistakes is a good nurse. Nurses spend most of their time with patients; doctors only visit for brief periods. Most doctors under-utilize nurses, usually because of an overinflated ego-”I’m a doctor; she’s only a nurse.”

In the high-intensity atmosphere of the emergency room, the situation is different. Neither the doctor nor the nurse knows the patient. However, the nurse may still save the day by noting, say, a lab report that was missed, or a significant change in the patient’s condition that may have been overlooked.

Now comes a depressing article in the Chicago Tribune revealing that nurses are being sabotaged and degraded just as doctors have been trashed in the past:

“Overwhelmed and inadequately trained nurses kill and injure thousands of patients every year as hospitals sacrifice safety for an improved bottom line,” the Tribune reports. “Since 1995, at least 1,720 hospital patients have been accidentally killed and 9,584 others injured from the actions or inaction of registered nurses across the country, who have seen their daily routine radically altered by cuts in staff and other belt-tightening in U.S. hospitals.”
Sad, very sad.

Action to take:

If you or a member of your family are severely ill or scheduled for surgery, hire a private nurse. This is your watchman, who will protect you from the bureaucratic maze that medicine has become. She can check medications, see to it that you get pain relief, and call for help if you start heading south. The bottom line: She can save your life.


Michael J. Berens. “Danger: Overwhelmed Nurses,” Chicago Tribune, 9/12/00