Clear Health Trends with Your Doctor

In the 1800s, nearly 200,000 Chinese immigrants came to the U.S. to work on the railroads. They brought with them Eastern medicine practices that dated back thousands of years including oil made from a Chinese water snake. The oil was used to treat the sore joints of workers after a long, grueling day of laying track and leveling grades.

This is the origin of the term “Snake Oil,” which is often applied to miracle cures in the form of secret elixirs. In my 40 years as a doctor, I’ve had lots of patients ask me about health trends – some safe and reasonable and some that sound a lot like snake oil.

Of course, as the Internet and social media have come to dominate how we receive information, I’ve heard about a lot more:

• Cure-alls
• Miracle diets
• Legitimate medical therapies

As these digital tools have replaced doctors as trusted sources of medical information, I’ve spent time discussing useful approaches to health, marginally scientific trends, folk remedies and, frankly, crazy, dangerous ideas.

I’m not complaining though. I’d rather my patients have a conversation with me before jumping on a health bandwagon. Whether it’s a diet or nutrition fad, a new supplement or even a new therapy or prescription drug, talking to your doctor is key. Your doctor can help you sort through which claims are real and which ones don’t hold water. More importantly, your doctor can help you determine if the latest trend is actually safe for you.

Nutrition and Diet Trends

The most popular health trends are often weight-loss related. Just as fad diets dominated magazine covers for decades, they now overwhelm our social feeds — with one major caveat: Instead of being pushed by celebrities, they’re also being endorsed by our friends. But just because a friend has had success losing weight doing one thing doesn’t mean that approach is proven to work, will work for you or is even safe. Let’s dive in here.

A lot of my patients have tried a Keto diet. While it may be safe for some, I’m concerned any time one of my patients with diabetes (type 1 or type 2) says they’re thinking of trying keto. Why? Keto diets may cause hypoglycemia (low blood sugar) because patients eat fewer carbohydrates, requiring an adjustment to medications. Keto diets tend to be high in fats and often saturated fats which can also impact your lipid (cholesterol) profile. If you have diabetes, you’re already at higher risk for heart disease.

This diet also affects the kidneys. Even if you have perfectly functioning kidneys, keto diets can put extra pressure on them. Diets high in fat and protein can promote kidney stones and, more seriously, albuminuria. Album is a protein in your blood that helps build muscle. That’s where it belongs, in your blood, not in your urine. When your kidneys filter your blood, they remove waste products which go into your urine. Album is not a waste product. And too much of it in your urine could indicate that your kidneys aren’t functioning correctly. Although I’m definitely a fan of minimizing sweets and simple starches in the diet, I want to make sure they’re replaced with HEALTHY fats and lean proteins. 

Intermittent fasting is another popular trend in diet and nutrition, and while there’s evidence it may help you lose or maintain weight, as well as improve health conditions such as diabetes and pre-diabetes, it’s impact on older people is not well known. Most of the studies we have on intermittent fasting focus on small groups of young or middle-aged adults. And if you’re on medications, intermittent fasting can wreak some havoc, especially for people who take heart and blood pressure medications. Fasting can also affect medications for people with diabetes.

Keto and intermittent fasting are both mainstream trends that have proven benefits for some people – but not everyone. This is why you should always talk to your primary care physician before you change the way you eat.

Supplements 

Between 60 and 80% of Americans take at least one supplement, usually in the form of a multivitamin. The supplements they take range from:

• vitamins (like D and C)
• Minerals (like potassium and calcium)
• Protein powders
• Green tea extract

Not surprisingly, supplements often get endorsed by celebrities, athletes (many of whom also make money from selling them) and health gurus.

So, what’s wrong with taking supplements? Nothing -- if you and your doctor agree you need them. But supplements – even simple vitamins – may cause health issues if you’re not careful. Too much vitamin D, for example, can cause:

• Muscle and abdominal pain
• Kidney stones
• Mood disorders.

The popular herb St. John’s Wort can interfere with antidepressants, anxiety medications, blood thinners, statins and even birth control. Vitamin K can interfere with blood thinners. And vitamins E and C can reduce the effectiveness of some chemotherapy drugs.

Unlike prescription and over-the-counter medications, supplements are not heavily regulated by the Food and Drug Administration. The FDA does periodically inspect manufacturing facilities and has established guidelines for manufacturing supplements, but it does not test to see if a supplement is properly manufactured, contains the ingredients listed or contains harmful ingredients.

These factors do not make all supplements bad. Quite the contrary, some supplements your doctor may ask you to take are essential for good health. Just make sure you let your doctor know what you’re taking or considering taking. That way he or she has a clear picture of how those supplements may interact with medications you may be taking or how they can impact your health.

Fitness Trends

Generally, exercise is good for you at every age. It helps manage stress, builds bones, lung and cardiovascular capacity and helps us manage our weight. It’s even good for your mental health. But some exercise trends popularized on social media and TV can be dangerous, even if you’re in good health.

Ever wanted to chase after a friend who has just run a marathon? Their Facebook pictures tell a story of triumph, but it’s a story of triumph after months and months of training. Even if you take part in a couch-to-marathon-type program, there’s a lot to consider from a health perspective. Is the plan you’re following appropriate for you? Will running a marathon exacerbate old injuries? Does your trainer know you and any pertinent health concerns? Have you spoken to your primary care doctor?

People get injured all the time during marathons: stress fractures, muscle pulls and heart issues. Why? Because they aren’t physically prepared for a marathon. In a study of 720 first-time marathoners, researchers found that half had a minor injury and 10 percent had a major one. Most of the injuries were related to overuse. The runners did too much too soon and suffered for it.

Wanting to run a marathon is hardly “new,” but it’s a good example of how people sometimes dive in headfirst into fitness trends and the outcomes aren’t quite what they expected. The same types of overuse injuries can also happen on spin bikes and other popular pieces of exercise equipment. In the marathon study, researchers found that simple strength training along with running could have blunted many of the injuries.

Even a seemingly benign fitness trend like yoga can be challenging for some people, especially its more extreme forms. Ever heard of Hot Yoga? If you haven’t, it’s exactly what it’s advertised to be — yoga in a room that’s heated to between 80 and 105 degrees. You’ll do more than stretch during a hot or Bikram Yoga. You’ll sweat. You may also raise your core body temperature.

Hot yoga is okay for healthy practitioners — and a few small studies have even shown cardiovascular benefits beyond flexibility, strength and balance which you can get from traditional yoga. But Bikram yoga may be dangerous for people with diabetes, back pain, heart disease or asthma.

Look, exercise is good for you. You should exercise regularly, and if trying new things helps motivate you to do more exercise, then mix in new things. Just talk to your doctor first before elevating your intensity or trying something new.

Good Health Isn’t About Following Trends

One of the cornerstones of my primary care practice was helping patients make changes to their exercise or dietary regimes they could sustain over the long haul. A life-long pattern of healthy eating and exercise prevents a lot of ills that will never be cured by a few weeks of following a popular health trend.

Trends are short term. While it may be fun to try out new things – and even good for you — just make sure you include your doctor in the conversation.