Supplementing Mediterranean Diet with Olive Oil or Nuts Decreases Stroke Risk

What is a Mediterranean diet? I had always believed that it involves eating shawarma three times a day while sitting on a beach in Tel Aviv, just because that’s my diet when I visit the Mediterranean. I was astounded to learn that this is not the case. A Mediterranean diet includes a lot of fruits, nuts, vegetables, olive oil, and cereals. It includes moderate intake of fish and poultry, and very little dairy, red meat, and sweets. Wine is included in moderation and consumed with meal...
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Still No Evidence that Organic Food is Healthier

“It’s not what you don’t know that hurts you, it’s what you know that isn't so.” -- attributed variously to Mark Twain and to Will Rogers

Many popular ideas are popular not because they're right but because of a widespread failure of skepticism. For example, in the 1970s the idea that wide lapels really make you look great was widely adopted without rigorous testing. Organic food has grown to a $26 billion industry in the last couple of decades largely on publ...
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Weight-Loss Surgery More Effective for Diabetes than Medication

About 20 million Americans currently have type 2 diabetes, three times more than in 1980. Diabetes is a major risk factor for stroke and heart attack, is the leading cause of new cases of blindness, and is the largest cause of the need for dialysis. Diabetes is also usually progressive, meaning that on the same medications and on the same diet and exercise regimen, the blood sugar of a patient with diabetes will slowly increase, necessitating constantly increasing amounts of medications. So des...
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Epidemiology is Much Worse For You Than Red Meat

"Red meat is not bad for you. Now blue-green meat, that's bad for you!” -- Tommy Smothers

I generally try to avoid writing about meaningless studies that should be ignored. First, there are a lot of them. Second, I don’t want to attract more attention to them than they already get in the media. But sometimes a meaningless study seems to perfectly confirm what we already wanted to believe. Then a feedback loop of reader gullibility and media misunderstanding ...
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Reflections on Gratitude

For each new morning with its light, For rest and shelter of the night, For health and food, For love and friends, For everything Thy goodness sends

Thanksgiving By Ralph Waldo Emerson

It’s been a difficult year for many of my patients. S...
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Difficult to Digest Carbohydrates Implicated in Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a chronic condition marked by abdominal pain, bloating, and alternating constipation and diarrhea. There is no specific test for IBS and other more serious diseases like celiac disease and inflammatory bowel disease can cause similar symptoms. The good news is that when a doctor has ruled out these more serious diseases and diagnosed IBS the patient can be assured that her illness is chronic but not progressive or life-threatening. The bad news is that IBS sympt...
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Vitamin E Increases Risk of Prostate Cancer

Lots of my patients take vitamin supplements. I don’t recommend them. My patients don’t ask me about it, they just tell me. In the absence of a specific vitamin deficiency or medical condition, there is absolutely no evidence that any vitamin improves any health outcome. I’ve always assumed that vitamins are generally ineffective, but harmless. Some patients are very eager to feel like they’re doing everything they can to be healthy, and I usually decide not to say anything and instead save my...
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