Sunday, May 11, 2008

Six Nutrition Questions

Take a short quiz and test your nutrition knowledge. These are not trick questions, and they all have information important to your health. I have selected these from the UC Berkeley Wellness Letter, March 2008, as part of a larger Nutrition Quiz. I have modied the questions and answers with my own comments. There may be more than one correct answer. Here goes:

1. Fish is a good source of:
a. vitamin C
b. protein
c. beta carotene
d. omega-3 fatty acids

2. Nuts are high in:
a. calories
b. fat
c. cholesterol
d. all of the above

3. Rank the following foods for potassium, from the most to the least:
a. a cup of orange juice
b. a cup of yogurt
c. 3 ounces of halibut
d. a medium banana
e. a cup of broccoli

4. True or False:
Olive oil has more calories than butter

5. True or False:
Honey and brown sugar are healthier for you than white table sugar

6. To lower blood pressure, you should
a. eat more fruits and vegetables
b. eat low fat or nonfat dairy foods
c. use less salt
d. take a potassium supplement


1. b and d. Fish has as much protein as meat, and is a good source of omega-3 fatty acids. Fish does not contain significant vitamin C or beta carotene, found in vegetables and fruits.

2. a and b. Nuts have 160-200 calories per ounce, with macademia nuts being the highest. Nuts are high in fat, but fortunately this is the healthy monounsaturated type of fat. Only animal foods have cholesterol.

3. b, a, c, e, d. While bananas are well known for their potassium (420 milligrams per medium sized banana), other foods are even higher. A cup of yogurt has 530 milligrams, and orange juice 500. The halibut has 490 milligrams and the broccoli 460.

4. True. Olive oil has 120 calories and 13.5 grams of fat per tablespoon, while butter has 100 calories and 11.5 grams of fat. However, the fat in butter is not the healthy type since it is saturated, while olive oil is rich in healthy monounsaturated fat. However, use it sparingly because of the calories and total fat content.

5. False. Sugar is sugar. Brown sugar is white sugar with a little molasses for coloring. The sugar in honey is similar to white sugar, and any other nutritional ingredients are insignificant. All sugars are ok in moderation and best if combined with other foods containing protein.

6. a, b, c. The DASH diet (see my Blog on this) for lowering blood pressure emphasizes fruits, vegetables and low fat or nonfat dairy products. Salt raises blood pressure in most people and should be avoided in any excess. No one should take potassium supplements unless prescribed by a physician. Potassium in foods, such as fruits and vegetables, are helpful, but not as supplements.

Wednesday, May 7, 2008

Doctor Patient e Mail: Stuck in First Gear

This article appeared recently describing the current state of doctor patient e mail. Although a few of us "committed souls" are modeling this as a great tool to improve access to health care, keep patients out of the office unless they really have to be there, and efficiently pass information back and forth, most US Health professionals are still unwilling to follow suit.

With few exceptions, most insurance companies don't reimburse for online office visits, so doctors are understandably reluctant to give their time away to e mail patients when they can bill for their time in the office. There are other barriers too, including lack of comfort or skill with internet/e mail, malpractice concerns, privacy concerns, and medical record documentation concerns.

These barriers need to be addressed and removed. Through widespread use of e mail, many office visits can be eliminated, greatly reducing the cost of care. Furthermore, one of the most frustrating aspects of the health care system is difficulty with physician access. With use of e mail, patients can get a timely response to many questions. They can also request prescription refills, appointments and review lab data. All of these are currently difficult to do, require playing phone tag and lead to tremendous frustration on the part of patients and physicians alike.

At eDocAmerica, we have seen, first hand, the enormous benefits of connecting patients with doctors via e mail. Connecting with your own doctor will be even more valuable. The eDoc staff developed a pilot project with a clinic in Portland, OR a few years ago and is now working on another one with the Family Medicine Clinic at the University of Arkansas in Little Rock, AR. We are hopeful that, as more and more of these pilot projects spring up, and more and more insurance companies begin to reimburse for e-visits, that e mailing your doctor will become routine before too long.

Your comments and opinions are always welcome...