Archive for the 'Progress Notes' Category



Oats: Junk Food or Health Food? Ingredients are Only the Beginning

(I guess I’ll still post something new here now and then, but I’m not holding myself to any set schedule.)

The American view of which foods are healthy is much too simplified to be of any use for people who want to avoid or reverse lifestyle related illness.

Take “grains”, for example – for a long time promoted as the foundation of a healthy diet. There are still dietitians who make their living promoting this unfortunate unnuanced myth.

First, it helps to consider that humans just might not be well equipped to digest and utilize large amounts of any foods that haven’t been around for as long as we have. Farming grains is a relatively new invention. They do grow wild, but not in the quantities we are now exposing ourselves to.

Second, whether we chew, crush, cook or ferment foods makes a difference in their nutritional value. Some items in our diets are poisonous in one form and nutritional in another. For example, kidney and Lima beans, potatoes and cassava are poisonous uncooked. And this is where oats can be junk food or a reasonable, if not downright healthy, dietary choice.

There is a lot of talk these days about highly processed foods, and it conjures up images of cheese curls, and chips that aren’t made from thin slices of potatoes but baked from some type of flour. But boxed breakfast cereals, including those made from oats, and instant oatmeal belong here, too. Instant oatmeal is basically oat flour.

Why is powdered oatmeal unhealthy? Because it turns into glucose faster than eating table sugar.

So, if you eat uncooked rolled oats, you first have to chew them, then the acid in your stomach has to break them down into smaller pieces that you can digest. This process causes a slow, modest rise in blood glucose. We call this a low glycemic index food.

Notice I say blood glucose. That is what the body uses for energy. The term blood sugar is incorrect. Sugar, or table sugar, which comes from sugar beet or sugar cane, consists of one molecule of glucose and one of fructose. The enzyme sucrase splits these two molecules, just like lactase splits milk sugar into glucose and galactose. Both these breakdown processes happen in the small intestine.

Instant oatmeal actually turns into sugar right in your mouth, from the action of amylase, an enzyme in your saliva. There is also amylase in the pancreatic digestive juices that act in the small intestine, but because instant oatmeal is in powder form, there is no chewing or stomach acid required before your salivary amylase can go to work.

We call instant oatmeal a high glycemic index food: Your blood glucose starts to climb and you release insulin to get the glucose out of the bloodstream and into your cells. Then, unless you’re splitting wood or running a marathon (in which case the glucose turns into carbon dioxide and water after you’ve used up its energy), your cells turn this sudden sugar load into fat (called triglycerides, which can be stored in the liver, for example – think fatty liver disease) and possibly worse than that, the glucose spike triggers inflammation, which we now know is at the root of many of the lifestyle related diseases we didn’t see back in the days when overconsumption was not so common.

Back to the oats: Instant oatmeal is a junk food, uncooked oats, the main ingredient in Swiss muesli, are quite healthy. Consequently, cooked oats fall somewhere in between, depending on just how long you cook them. So, merely looking at the ingredients of foods we consider eating isn’t enough.

The key word is PROCESSED. If cavemen couldn’t have served it to themselves or their families, it might just be plain bad for you.

July 4 Book Release Update

The eBook is now available on Amazon. The paperback edition of A Country Doctor Writes: CONDITIONS – Diseases and Other Life Circumstances should soon also be available on Amazon and will be available through the usual bookseller distribution channels. There is a slight delay because Amazon has suddenly found many of the essays elsewhere on the Internet, so I have to prove that I published them first on my own blog. I’ve always been flattered that so many sites all over the world have republished my work, but at the moment this has (briefly) turned into a negative. Have no fear, I have the proof that my words are my own.

I am also taking the opportunity to announce that my second book in the series, PROGRESS NOTES – Starting, Growing and Staying in the Medical Profession, will be released on September 7. Notice the Holiday release schedule I’m setting for myself (Labor Day in the US)?

My next holiday release book is tentatively planned for Veterans Day or Thanksgiving, and a fourth one might turn out to be lighthearted, inexpensive stocking stuffer for Christmas.

https://amazon.com/Country-Doctor-Writes-CONDITIONS-Circumstances-ebook/dp/B08B67NR7K

When a diagnosis leads to sadness instead of triumph – KevinMD

Early in our careers, doctors have a tendency to triumph over serious or rare diagnoses we make as we marvel over our newfound skills and the logical complexity of the human body.

At this stage of mine, I often feel sadness when a patient I care for, and care about, develops a symptom that signals the possibility of a serious disease.

— Read on www.kevinmd.com/blog/2020/07/when-a-diagnosis-leads-to-sadness-instead-of-triumph.html

A Country Doctor Talks – KevinMD

Tuesday’s podcast by Kevin Pho features yours truly and the topic is the recent blog post I wrote exclusively for him, “Will Telemedicine Make Us Better Diagnosticians?” We also talk about my upcoming book, which Kevin was kind enough to provide an official Amazon and paperback cover endorsement for.

Here’s the podcast link:

https://www.kevinmd.com/blog/2020/06/will-telemedicine-make-us-better-diagnosticians-podcast.html

A favor to Kevin:

“If you enjoy the show, please leave a 5-star rating and review on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-podcast-by-kevinmd/id1515033137

Please share the podcast on your social networks, and invite your friends to subscribe: https://www.kevinmd.com/podcast

Participating in the greatest miracle a physician is privileged to be part of – KevinMD

Today, on Father’s Day, KevinMD posted a plug for my new book with an excerpt that is close to my heart, describing my emotions when hearing fetal heart tones with the office Doppler and the flashbacks that brought from my residency training and my first ever delivery – a double footling breech – and from watching my children and my granddaughter in neonatal intensive care.

“Thirty years ago, I saw more births than deaths. Now I only attend departures. For a minute or two that morning, I was again participating, ever so briefly, in the greatest miracle a physician is privileged to be part of.”

— Read on www.kevinmd.com/blog/2020/06/participating-in-the-greatest-miracle-a-physician-is-privileged-to-be-part-of.html


I just realized none of the posts show on an iPad or a computer, but they do show on an iPhone. WordPress is working on this. In the meantime, please visit my Substack.

 

 

Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.

 

BOOKS BY HANS DUVEFELT, MD

CONDITIONS, Chapter 1: An Old, New Diagnosis

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