Low Fat Diet Does Not Prevent Breast Cancer

This very large study of the effects of diet on the incidence of breast cancer was just published today in The Journal of the American Medical Association and has received much media attention, including this article in the Los Angeles Times. The study is important because of its size (over 48,000 women were studied) and because it was one of the few studies of the effects of dietary change that actually involved randomizing women into the low fat or the standard diet group. This randomization makes the results much more reliable than studies in which the subjects decide themselves what to eat.

The results showed the same incidence of breast cancer in both groups of women. Approximately one in every 230 women in each group developed breast cancer.

Some are interpreting the study with caution, warning that the women in the low-fat diet group may have still had too much fat in their diets to decrease their risks, but if that’s the case, it’s probably not realistic to expect women to lower their dietary fat much further. The other possible interpretation is the obvious one: that there is no link between dietary fat and breast cancer.

Links between diet and cancer incidence have always been speculative, and in other diseases like heart disease and obesity dietary fat is being found to be less important than total calories consumed and exercise. Unfortunately, breast cancer prevention remains elusive, and the best we can do at this point is early detection.

More

Electronic Medical Records Improve Patient Care

In his State of the Union Address this week, the President specifically praised electronic medical records.

We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors.

Our office has had electronic medical records from the day we opened, three years ago. I believe that electronic records make possible improvements in patient care that are impossible with paper charts. Automatic checking for drug interactions and secure access from remote locations are just two examples. Our office has been such enthusiastic proponents of electronic records that the company that makes our medical records software, A4 Health Systems, published a case study of our practice.

More

A Single Episode of Exercise Can Improve Your Mood

This Washington Post article reviews a recent study in which depressed patients were randomized to either rest quietly for 30 minutes or to walk on a treadmill for 30 minutes at 60 to 70 percent of their maximum heart rate.  The people who exercised reported higher scores of well-being afterwards.

This post-exercise sense of accomplishment and vigor is familiar to anyone who does cardiovascular exercise regularly.  To put it simply, exercise feels good.

Cardiovascular exercise also has proven benefits in decreasing anxiety, reducing blood pressure, improving control of diabetes, and decreasing risk of stroke and heart attack.  Weight-bearing exercise, like walking, also improves bone density.  So get out there today and take a walk for 30 minutes, especially if you’re in a bad mood!

More

The Worst of the Flu Season May Be Over In California

The California Department of Health Services monitors influenza (flu) activity in the state. By all measures, the peak of activity in California was two or three weeks ago. Click here for their weekly report.

There are still new cases, and the season is by no means over, but each week has seen fewer new cases than the week before. The national Centers for Disease Control (CDC) still recommends having the flu vaccine if you are 50 years-old or older or are at high risk for complications from influenza. The vaccine should be given as early as possible in the season, but for those who are still unvaccinated, the CDC recommends giving the vaccine as late as May. You can review the CDC recommendations for the flu vaccine here. You can learn general information about flu prevention and what to do if you get sick here.

More

Hernia Repair May Be Optional

This Reuters UK article cites a study published in today’s Journal of the American Medical Association which has interesting implications about the management of men with hernias that are causing only minimal symptoms. The standard of care until now has been to repair hernias as soon as they are diagnosed, fearing that delay may result in complications or the need for an emergency repair later. The study demonstrates that there is no harm in waiting until a hernia becomes more bothersome, and then operating only on the men whose symptoms are worse. Dr. David R. Flum, from the University of Washington in Seattle, predicted in a related editorial

“If the results of this study are reproduced in other populations and for other types of hernia, then the era of preventive hernia repair should go the way of prophylactic tonsillectomy, cholecystectomy [gallbladder removal], and appendectomy.”

I see this as a part of a larger trend away from surgical procedures as our knowledge increases. Surgeries for bleeding ulcers were more common before the discovery that many ulcers could be treated with antibiotics. Heart bypass surgery is becoming less frequent as cholesterol lowering medications help slow the progression of heart disease. It’s exciting to hope that as our understanding improves, other surgeries for which there is currently no adequate alternative, like joint replacement or spine surgery, will also be replaced by less invasive therapies.

More

The Practice

Ready for a medical practice that values your time as much as the doctor’s – where you can easily arrange an appointment when you need it, and the physician offers personal, focused medical care?

By paying close attention to what patients need and want, I created a new kind of medical practice – designed around you.

Enjoy same-day appointments and predictable costs. Rest easy, knowing that you can reach your physician by phone directly at any hour. Feel confident that your doctor cares about you.

You have come to expect top-notch service in every part of your life. Why should your healthcare be any different?

More