Quackery

Did you know that you can make just about any claim about a supplement and get away with it? As long as you don't say it's medicine, you can say ANYTHING!

I see a table with juice samples at my local Whole Foods, and wander on up for a sample. It is a supplement mixed in juice, with vitamins and amino acids, which are intended to boost energy. As I am a huge fan of free samples, I try some.

"This will boost your energy, if you take it with our vitamin B complex," the woman tells me.

No one expects that a woman with long hair wearing a tie-dye shirt, blue jeans, and big sunglasses wandering her local Whole Foods at 4 pm on a weekday is a cardiologist (we were done for the day in the cath lab, and I was out early). So, I ask: "Do you have proof?"

Her: "It has amino acids."

Me: "Okay, but do you have any scientific data that shows that ingesting amino acids will increase energy?" I know that the answer is no, but I'd love to hear what they have to say.

Her: "They're amino acids. The building blocks to proteins."

I'm realizing, not surprisingly, that this woman has no idea what she's talking about. Me: "What I am asking is, do you know of any trials from the scientific literature that prove that taking this supplement will provide more energy?"

Her (looking uncomfortable): "Ummm... no, I'm sorry, I don't think we have any of that here."

Her boss or co-worker overhears the exchange and offers me a brochure entitled "Energy", written by a physician who has written and researched on chronic fatigue syndrome and fibromyalgia. I'm offered brochures on chronic fatigue syndrome and on stress, but decline.

This brochure is interestingly done -- it talks about what various vitamins do, in a chart form that I've seen in a few medical textbooks, and the heading above the "what it does" column is changed to "effect on vitality and energy". Very fancy. The physician then claims that "most Americans are chronically dehydrated", which is completely untrue, and while he has over 100 references, not one to support that claim of chronic dehydration.

Another doozy: He talks about how stress will "...exhaust the adrenal reserve" and that "...it is important to supplement your adrenals with a glandular therapy regimen to ensure healthy cortisol levels and adrenal function." He has two references for his claim: one is his book, the other a study on sodium deficiency in guinea pigs!

The problem is, people actually believe this nonsense. A man with an "MD" after his name prints it. And even though most of his references are to books (as opposed to actual studies), including frequently his own "From Fatigued to Fantastic" book, it all looks quite scientific to the lay person.

All in all, this is a very expensive multivitamin. A multivitamin is okay to take, because we don't get everything every day in our diet in spite of our best efforts. This one is no better than any other one. Oh, and the amino acids? You get plenty of those in a balanced, varied diet. And if you want more energy, do more, exercise, push yourself.

Bottom line: If something sounds too good to be true, it probably is. Don't be afraid to ask your doctor before you spend lots of money on a seemingly magical cure to your ailments.

Animal-Friendly Accessories

The Today Show had a feature on eco-friendly accessories, featuring vegan accessories!

It's nice to see a mainstream media outlet talking about vegan products. If only they would discuss the cruelty involved in producing leather and fur, but this is a good start.

I was a little surprised at the mention of bboheme.com, which is a site based out of the UK, when there are plenty of companies here in the US that offer vegan accessories, such as Alternative Outfitters and MooShoes.

What I've Learned Since Going Vegan

-- It took me 16 years in life to go vegetarian, and another 13 to go vegan. As passionate as I am about veganism, I'm not going to convince anyone overnight.

-- When people say, "I could never be a vegetarian", it means the gears in their brain are churning.

-- As years pass, you'll find that friends and coworkers become vegetarian, and you can be proud that you were an influence in their decision.

-- Just because that 450-calorie chocolate chip cookie is vegan, that doesn't mean I have to eat it.

-- So many foods are vegan, including Oreos, Laffy Taffy, Cracker Jacks, Twizzlers, potato chips, and soda pop.

-- Simply being a vegan doesn't mean that I am healthy.

-- It's best to just eat the bread that might have a trace of egg or whey, rather than annoy the waiter with endless vegan questions. That trace amount won't harm me, barely harms even one hundredth of an animal, and the waiter and other diners won't think of veganism as insanely complicated.

-- Make it look easy to follow a vegan diet, even the few times when it's not.

-- Over dinner, when asked "So why are you a vegan?", it's best to avoid details of cholesterol-laden arteries, tethered veal cows, and unanesthetized branding and castration. A simple answer like, "I learned what the animals go through, and I was very disturbed and don't want to be part of that. And, it's much healthier and better for the environment," will suffice. A reference to look at later, like meat.org, will help them understand.

-- It's best to just laugh at questions about whether plants have feelings too.

-- I still don't have the perfect answer to, "Do you mind if I eat this steak in front of you?" My best response: "It's an omnivore's world, I'm just living in it."

How's the Training?

It's good. I'm swimming with a masters swim group 1-2 mornings per week, spinning 2 times per week, running when I can, and doing a little weight training and an occasional kickboxing class.

Running is a challenge right now, because every so often my iliotibial band gets inflamed -- that's the injury I've been dealing with since December. I'd love to do speed workouts, but our running coach says I should take it easy, and I think she's right.

Another bonus of getting back into training is that I'm finally taking off the 12 or so pounds I gained during the cold weather. I always gain weight in the fall and lose in the spring. It's not a good habit, I know.

My first triathlon is June 9, the Hyannis Sprint Triathlon. I think a couple of coworkers will be doing it too, which will be fun.

Spinach

This is my own version of the indian dish palak paneer, but without the cream or cheese. Sautee spinach in a little canola oil, with mustard seeds, cumin, coriander, salt, pepper, paprika, and a little Earth Balance margarine. Toward the end of cooking, add cubes of firm tofu. I ate this with Stacy's Simply Naked Pita Chips.

Marathon City

The Boston Marathon is on Monday. As a result, Boston is full of tourists this weekend, carrying their orange marathon bags or wearing their blue marathon jackets. It's exciting, yet a little bittersweet -- I had a marathon number through a charity and had to give it up because of an iliotibial band injury, which still intermittently nags me.

I attended a conference for work this week at the Hynes Convention Center, which conveniently is also where the marathon Expo is taking place. During breaks, I sneaked down to the expo, had my running gait analyzed, saw Katherine Switzer (the first woman to officially run the Boston Marathon), got free socks, and sampled many goodies.

It's all so exciting. If things are quiet at work on Monday, I might try to sneak out for a bit to watch the runners finish.

Tomato Matza Farfel with Veggies

Whole wheat matza farfel (crumbled up matzah into small pieces) cooked in tomato sauce, topped with fresh broccoli and mushrooms sauteed in olive oil, salt, and pepper.

Passover Pancakes

The pre-mix box of Passover pancakes has always been a big hit for my family. While the mix itself is vegan, the recipe on the box calls for a cup of milk and one egg to be added to one cup of mix.
I made these pancakes with one cup of mix, one cup of applesauce, one tablespoon of oil, and three tablespoons of water. Mmmm.... pancakes for breakfast....

Passover Seder, Vegan Style!!

I visited my family this weekend for Passover and contributed a few vegan dishes for our seder, the festive dinner where we tell the story of Passover. The recipes are all from Roberta Kalechofsky's The Vegetarian Pesach Cookbook.

This is the Sweet Potato Orange Pudding, which was good but I found to be too sweet.


This is a Vegetable Nut Loaf. It's time-consuming, with lots of vegetable chopping and peeling, but quite filling. It's a bit dry, like most Passover foods, as real flour can't be used, but it goes well with an apricot marinade.

And now for the best of the three: Multi-National Potato Casserole. It's a dish with a layer of mashed potatoes on the bottom and top, and in the middle a layer of sauteed onions and portobello mushrooms. This came out quite good. The pictures are staggered to show you the different layers.




Finally, what's a meal without dessert? And, better yet, a Passover dessert that doesn't have twelve eggs in it? Can it be done? The answer is a resounding YES! This is the No Bake Chocolate Matzoh Roll. Kind of an interesting concept -- melted chocolate, a little bit of coffee, sugar, margarine, and moist matzah, rolled up with chocolate glaze and strawberries on top. My 92 year-old grandmother, the ultimate food critic, enjoyed it, and I thought it was pretty decent too.
So, that was seder. Proof that you can be vegan and eat well on Passover.

I'm Back...

....and some food posts are coming. I cooked some stuff for Passover. Some of it was good, some of it was so-so, but all of it was edible. That is an accomplishment for Passover.

In the meantime, here's a little humor.

Staying Busy

There are no recent posts because things have been very busy. This past weekend, I was at the American College of Cardiology conference in New Orleans, learning about new trials, innovative ways to intervene on coronary arteries, and of course having a little bit of fun -- can't give you any bull about that!

So, with two busy days in the cath lab behind me, I am off to spend the holiday of Passover with my family.

Saving the Environment, One Burping Cow at a Time

This is about the most absurd thing I've heard in a while: A pill to decrease methane production from livestock cows.

Yet more evidence that a plant-based diet is better for the environment.

Calcium and Vegan Diets

There's new data about calcium, fractures, and vegan diets. This study showed that vegans overall are 30% more likely to have a bone fracture than lacto-ovo vegetarians, fish-eaters, or meat-eaters:

Appleby P et al. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr, Feb 7, 2007.

Jack Norris of Vegan Outreach has an excellent discussion of the results.

However, those vegans who consumed over 525 mg/day of calcium had the same risk of fracture as the other populations in the study.

When calcium is consumed with large amounts of protein, such as in milk, calcium excretion in the urine increases. Therefore, it has been suggested that vegans have lower dietary calcium requirements.

I think that this study suggests that perhaps we do need to be more diligent with our calcium consumption. Most people need 1000 mg/day of calcium; pregnant women, the elderly, and children may have higher requirements.

Also, be mindful of getting enough Vitamin D, which regulates calcium absorption. Fifteen minutes of sunlight a day will give you enough. But, if you are in a northern climate or do not get that much sunlight, make sure you are consuming either a multivitamin with Vitamin D or Vitamin-D fortified soy or rice milk.

My Talk at Boston Vegetarian Society

I gave my talk on "Vegetarian Diets and Heart Disease" to the Boston Vegetarian Society yesterday. The feedback that I've gotten is good. It's a good thing I did some reading in advance because there were some very challenging questions from the audience.

So, thanks for the suggestions of things you would want to hear about -- I did incorporate some ideas into the talk.

Back in the Pool

Master Swim is at 6:30 am. And I am not a morning person. So when the alarm went off at 5:30, I almost slammed it down, until I remembered that I had packed everything the night before.

I found a spot in the slowest lane, me and two other women. Having not swam in 2 months, I was apprehensive. The first 200 meters were tough; I wanted to just die about 150 meters into the warm-up. But then, somehow, it all came back. I think I swam about 1600 meters in an hour.

I was halfway through any given set, and I'd look over and the other lane swimmers were done, eagerly standing at the edge of the pool ready to do the next set. And here I'd have another 100 meters or so to swim.

I like our coach. She has lots of good feedback, even for us in the slow lane. For me, I guess I keep my arms straight under the water. I'll work on fixing that.

Tri training has begun.... Hyannis Sprint in June, here I come!

Rollerblading and the Law

It was a beautiful New England day, partly sunny and in the high 60's. Not typical for mid-March. I felt the urge to rollerblade.

So, I grabbed my bag with my rollerblades and pads and walked the mile or so up to the Esplanade, the paths that run along the Charles River. I put on my rollerblades and padding and headed down the path, leaving my bag with my shoes and other rollerblade equipment behind a tree.

A half an hour and an awesome workout later, I return to see that my bag is gone. There is a State Trooper vehicle parked nearby, with my bag sitting on top of it. I rollerblade over, and the trooper gets out of the car.

Trooper: Is this your bag?
Me: Yes.
Trooper: You know, you shouldn't be leaving bags out here.
Me: There's nothing valuable. It's just shoes...
Trooper: We don't know what's in it. What if it was stolen? You'd be calling us up. In fact, I could be calling out the bomb squad.

Oh my... a big deal over a bag! Next time I'll just have to carry my blades and tuck my shoes behind a tree, without a bag of course.

But seriously, I hate to be equated to the guys who paralyzed the city with their Cartoon Network advertisement devices. After all, there is real crime in this city to be fought too. People are getting stabbed on the orange line, among other things.

Leave me alone. Go fight crime, and let me rollerblade.

Getting Serious about Training

It's time to start triathlon training again......

I've taken the first step by joining the triathlon club at my gym. It's serious business -- there's a coach for each discipline, several group workouts a week, and they come up with a tailored workout plan toward our individual goals.

I have a ways to go. The iliotibial band is getting better, but isn't 100%. I can run 15 minutes at a time pain-free. I haven't swam in over a month, because I just don't like swimming by myself. It's the whole rat on a wheel feeling of swimming laps in a pool without external stimulation. However, I've been training my weakness, which is biking, by doing a few spin classes each week.

It's going to be tough, but I'm ready. I need the structure, and I'm excited for the challenge.

Advice for Doctors

My friend Dr. Krupali Tejura, a radiation oncology resident, submitted a question to Leroy Sievers, an NPR journalist who blogs about his fight against cancer. She asks what patients want from their doctors. The answers she gets are interesting. Read on.

It's great food for thought. If you don't know the answer to a question, you can always look it up. But personal interaction can't be replaced.

Spinach and Potstickers

Sometimes it's all about convenience... tonight's one of those nights. We just finished a complicated case in the lab, and I'm hungry and tired.

So, I sauteed some frozen spinach in olive oil, with sea salt, ground pepper, garam masala, garlic, and a little chili powder. The potstickers are Ling Ling brand, and easily heated in boiling water. The whole thing took ten minutes. Easy, filling, and delicious.

Bold Ideas for NYC Restaurants

The New York City Department of Health has made two recent proposals. The first is to eliminate trans fats from all NYC restaurants. Second, restaurants would be required to list the number of calories in each meun item clearly on the menu next to each item.

I think these are great ideas. Trans fats are more atherogenic, in other words are more likely to lead to plaque buildup in the arteries. I'm especially excited about listing calorie content of menu items -- I think that even the simplest of consumers would be wary of a menu item with 1,500 calories. Or, those who think they're having a "light dinner" by ordering an appetizer with 2,500 calories might think again.

Last night I was at a dinner with a few interventional cardiology fellows, and we were discussing this topic. One was particularly adamant that Americans could care less about the calorie content of what they're eating and would make no changes based on that information.

I disagree -- I think that with this information, people for the most part would make wiser choices. As a result, restaurants would have to think twice about how they're preparing food and consider changing their menues to include healthier items.