A Succinct Review of the Top Medical Research Studies of 2018 for Family Physicians

By Natan Schleider, M.D.

May 19th 2019

SOURCE: AMERICAN FAMILY PHYSICIAN V.99 # 9 MAY 2019 P.565-573

Every year I try to some up the most important easy to understand studies for my patients, doing my best in eliminating fancy medical mumbo jumbo.

Here are the important points for 2018:

  1. Home blood pressures are more accurate than doctor’s office blood pressures. Sooo, if your blood pressure is high at the hospital or doctor’s office (which it should be unless you are super zen), check your blood pressure at home with any machine that measures above the elbow OR ask a friend who knows how to check blood pressure. If you find yourself surrounded by machines as in the above photo, you are doing something wrong…that photo is actually an old ECG machine.
  2. Lower blood pressures are almost always better EXCEPT in elderly patients 85 or older.
  3. Shorter courses of antibiotics are almost always as effective and have fewer side effects than longer courses. So, for example, if a Zpack usually helps your bronchitis or ear infection or sore throat, opt for the 3 day Zpack rather than the 5 day.
  4. For women who suffer from 3 or more UTIs annually, drinking an additional 1.5 liters of water daily reduces risk of future UTI by 50%.
  5. Several studies show that non-opiod pain medicines are as effective for relieving acute injury of arm or leg pain in the emergency room compared to opiods.
  6. Patients who exercise (at least 150 hours per week or more) have lower risk of depression.
  7. For patients being medically treated with anxiety who then stop their medicines, 1/3rd will have a relapse and require medication again. 1/6th of all patients with anxiety will have worsening anxiety despite treatment.
  8. Stool testing for colon cancer screening using DNA found in stool (called Fecal Immunochemical Tests or FIT) is better than standard stool testing for blood and an optional substitute for colon cancer screening other than colonoscopy.
  9. Type II diabetics should shoot for a HbA1c of 7-8 percent (and not lower as previously advised).
  10. If you are 60 or older, a blood pressure of 150/90 or lower is ok presuming you do not have other serious medical issues. Below 60 lower than 140/90 is ok.

Please contact me with any questions or comments.

Thx,

Natan Schleider, M.D.

Is Breakfast Really the Most Important Meal of the Day?

By Natan Schleider M.D.

SOURCE AND QUOTES FROM:
JAMA. Published online May 1, 2019. doi:10.1001/jama.2019.2927

‘Back in 1917, the same year that she cofounded the American Dietetic Association (now the Academy of Nutrition and Dietetics), Lenna Frances Cooper authored an article in Good Health magazine that noted “in many ways the breakfast is the most important meal of the day, because it is the meal that gets the day started.” Good Health was published by the Battle Creek Sanitarium, a Michigan health resort run by Cooper’s mentor, John Harvey Kellogg, MD, the coinventor of corn flakes (his brother started the cereal business that would become the Kellogg Company).’

Recent studies indicate that eating breakfast may NOT improve weight loss and nutrition, speaking to how the public’s medical knowledge that ‘everybody knows’ has no scientific support. Other fallacies that our parents told us include sitting too close to the TV will cause eye damage, for example–it will not.

One Meal A Day (commonly called OMAD) has been a recent diet trend where a person consumes all calories within an 8 hour window or fewer.

Bottom line for the patient with a normal metabolic system is that total calories consumed per 24 hours will best reflect weight loss outcomes, regardless when calories are eaten. That said, plenty of serious body builders and models eat no carbs after 12 noon .

If breakfast is integral to your nutrition, diet and lifestyle, great, don’t change a thing. I personally am not big on breakfast eating usually some egg whites sauteed with some onion and tomato and chipotle tabasco sauce (about 200-300 calories). If you have been forcing down breakfast and not particularly hungry, recent data shows this may kickstart metabolism and hunger later in the day leading to weight gain.

Thanks for reading,

Dr. Natan Schleider