01/01/06 NEWSLETTER carlstonmd.com
Dear Patients HOME

Happy New Year!

Typical of holiday gatherings, this newsletter contains leftovers as the main course. Before moving on to those bits and pieces, I would like to thank you for our time together. Although patients seek medical care for their own benefit, all health care providers learn the most about how to help patients from the patients themselves. Sure, I do spend hours every day studying research and other informational sources to improve my work for you, but none of that data is meaningful if it does not work in clinical practice. So, in a very real way, you all help each other. My job is to function as the intermediary.

Best, Michael Carlston, M.D.
www.carlstonmd.com 
707-545-1554
In This Issue: INDEX
  • SLEEP AND WEIGHT LOSS
  • PEDOMETERS
  • BOOK CHAPTER
  • VITAMIN D
  • MEDICARE PART D MEETING WITH LYNNE WOOLSEY
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    SLEEP AND WEIGHT LOSS TOP

    Last time I wrote about the connection between insufficient sleep and weight, including new understanding of the hormone changes that mediate those effects. I neglected to mention the lifestyle change which is quite probably one of the factors driving our obesity epidemic. In the last 40 years the percentage of young American adults who sleep less than eight hours has nearly doubled. That is a big change.

    If you add this to our consumption of highly refined grains, sugars like high fructose corn syrup, lowered calcium consumption, reduced level of physical activity and potential effects of environmental hormone mimicking chemicals, it is not at all surprising that we are dealing with this problem.
    PEDOMETERS TOP

    Many of you know that in keeping with a number of medical organizations (American College of Sports Medicine and American Academy of Family Physicians, among them), I advocate the 10,000 Steps a Day program to increase physical activity. Using a pedometer is a great way to learn how much/little we are currently moving around. It is also a great way to help yourself reach the targeted activity level. Most importantly to me, though, is that you can use the pedometer to GRADUALLY increase movement so that you don’t get hurt by trying to do too much too fast.

    Patients to whom I have recommended a pedometer have expressed frustration about finding them, or spending $20 to buy one. To help remove this obstacle, I bought a box of decent but simple ones that we have in the office for $5.
    BOOK CHAPTER TOP
    Due to my peculiar mix of interests, I do quite a bit beyond my clinical practice. One part of that is my work for the publishers of medical journals and textbooks. The third edition of one of the standard medical texts in the field (Fundamentals of Complementary and Integrative Medicine - Sanders, Elsevier) just came out, which includes my chapter on homeopathy. It is a good book with comprehensive coverage of a very broad subject matter. Although aimed at health sciences students and practitioners, if you are interested in a solid overview I strongly recommend it.

    VITAMIN D

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    As those in our area not displaced by flooding huddle indoors, this is a good time to talk a bit about vitamin D. This vitamin has been hanging at the top of the scientific hot list for the past year or more. There are many reasons for this.

    A recent meta-analysis of 63 studies published over the past 40 years showed marked reduction in the risk of several forms of cancer among those with higher levels of vitamin D. The risk of breast and ovarian cancer was cut by 35% and colon cancer by 50%. The authors of this study concluded that a daily dose of 1,000 iu/day might be ideal.

    Other data show that low blood levels of vitamin D are very common (over 50% in some populations). Even in areas of the world were the combination of people with light skin and high sunshine create the expectation that vitamin D levels should be fine, we are finding that this is not the case. In addition to the production of vitamin D in the skin from sunlight exposure, we can get it from eating eggs, meat and oily fish.

    This unexpected finding of insufficiency intrigues me because of my questions about dietary calcium intake. It is clear that Americans suffer many consequences from inadequate calcium metabolism. At the same time, the RDIs for calcium are uncomfortably high for me. I accept the problem, but philosophically rebel against numbers that are nearly impossible to achieve through a good diet. Certainly this gap can be narrowed by consuming highly absorbable forms of calcium in association with magnesium and, massively important, getting sufficient physical activity so that your body makes new healthy bone. Adding vitamin D to the equation may get us to a sensible balance.

    MEDICARE PART D MEETING WITH LYNNE WOOLSEY

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    For consumers, the Medicare Drug program is confusing, disastrous, or both, depending upon your perspective. Those of you who want to try to make sense of it or complain about it can attend a dialog session with Congresswoman Lynn Woolsey on Monday, January 9 from 10-11 at Finley Community Center in Santa Rosa, or from 2-3 pm the same day in Olney Hall at the College of Marin. For more information contact Emmie Morgan at 707-542-7182.
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