So are eggs an amazing super food or a cholesterol bomb? Looking at the evidence

Few foods are as controversial as the egg. It feels like one minute it is being hailed as the next super health food, and the next minute, a cholesterol-laden bomb to be avoided at all costs. This back and forth gives me-and my patients- some serious whiplash when we’re trying to figure out the answer to the simple question ” should I eat eggs or shouldn’t I???”

So you know me, I’m all about the evidence.  As much as I like Google and social media, there can be lots of biased misinformation out there. As a physician, I seek the results of  clinical studies to help guide me in my answer. So let me help summarize the latest research for you!

Long-story short: in people without underlying medical conditions, an egg a day is an excellent source of protein, vitamins, lutein, choline and some fats (mainly mono and poly-unsaturated fats ). Interestingly, the data suggests that people with diabetes and other CVD risk may have higher risk of heart disease if consuming more than 3 eggs a week. {link} (It seems like more research is needed to determine exactly why).

To break that summary down a bit more, here are the key points:

-Eggs are extremely delicious (this is totally anecdotal from my taste buds, not from clinical studies)

-One egg contains about 200 mg of cholesterol a day, found in the yolk, but that type of cholesterol isn’t NECESSARILY the bad type

-Most studies don’t prove that eating eggs are BETTER for you than not eating them, but some studies show that you’re not WORSE OFF if you eat eggs (in moderation) than if you didn’t

-If you’re at higher risk for heart disease (especially if you have diabetes) then it seems that you can only get away with fewer eggs a week than the average person.

So what would I tell my patients after reading these studies? If they are generally healthy, I’d say eat up to 7 eggs a week without guilt! And watch what you’re eating those eggs with; we tend to sabotage a healthy meal with the accompaniments (bacon, sausage), or the way that we prepare that meal (ie: frying eggs )…and these things are worse than the actual egg itself. Want some healthy options to complement your egg? Avocado, whole wheat toast, tomatoes and other veggies in an omelette come to mind ! And one tip I like to give: if you use one whole egg and 1 or 2 egg whites you still get the benefit of that delicious yolky taste without as much cholesterol.

Have an Egg-cellent day ! (sorry, couldn’t resist 🙂 )

Dr Kim

 

So is coconut oil good or not??

So today I read an article where a Harvard professor declared coconut oil is “pure poison”. Say what now?

A few days ago, a couple of my blog readers asked me to talk about the health benefits of coconut oil. So I decided this was a perfect time to write this post I’ve been meaning to for a while now!

Over 70% people think that coconut oil is healthy, based on polls. Everywhere you look it is being hailed as a wonderful super food, and some fanatics go so far as to suggest that coconut oil is the cure for almost any disease if used in sufficient quantity.  Maybe it’s because coconut oil is made from coconut, which is a fruit (yup it’s a fruit I looked it up). Maybe it’s all the beautiful recipes on Pinterest and Instagram which  feature coconut oil as a healthy ingredient in your baked goods , smoothies and sautes. So then how could it possibly be poison?

My head hurts, you guys.

I’ll be honest, there’s so much contradictory information out there, which just goes to show how controversial the topic is. I had to really analyze the quality of the evidence, and threw out any literature that didn’t have strong studies to back the claims. I also realized that although there are many studies out there, most of them are pretty small (sometimes they only analyzed a few dozen people for example), and everyone knows that the best studies are the ones that include a large population size.

So anyway, based on what I’ve researched, here is a quick summary with some links for your viewing pleasure.

  • Coconut oil is 82% saturated fat, composed of 2/3 Medium Chain Fatty Acids (MCFA) like lauric acid, which might POSSIBLY reduce cardiovascular risk and improve brain health. It is not clear if the potential benefit of the MCFAs outweighs the known risk of the other types of saturated fat in coconut oil
  • Coconut oil does increase LDL cholesterol (in some studies, not all). LDL cholesterol is a known cause of heart disease; however, recent evidence is showing that there are actually different TYPES of LDL particles (the small dense type which is bad, and a larger fluffy particles which may actually be good). This is relatively new research which is still evolving
  • Coconut oil also increases HDL cholesterol (the “good” type which has been said to be protective for your heart-although now they’re not so sure about that either? Omg!)
  • Coconut oil is touted as a weight loss agent but the actual evidence is very small
  • Virgin coconut oil has the same fat content as the refined kind (but refined has a higher smoking point so is better for cooking)

Based on the current literature, the American Heart Association came out with a statement against use of coconut oil. Tell that to the #coconutoilforeverything crowd!

Many coconut oil advocates argue that some studies actually don’t show that high-saturated fat diet is worse for heart health than a low-saturated fat one. However,  some of those studies have been criticized, because they don’t account for the fact that when people in the studies followed a diet LOW in saturated fat, they potentially had increased the amount of refined carbohydrates in their diet to compensate (which is bad for your heart, thus messing up the overall result).

Right now, I’m not comfortable recommending a diet high in coconut oil to anyone. More research needs to be done to determine if the type of LDL particles that coconut oil increases are the “good” or “bad” type, and basically just more studies need to be done and combined to get a larger population size.

So, what do I recommend to patients? Don’t go diving headfirst into a vat of coconut oil anytime soon. Small amounts are probably ok if you don’t have underlying risk factors but for those with heart disease or at high risk, I’d probably focus on the oils widely known to be heart healthy, like olive oil.

Hope I didn’t give you too much of a headache with that one!

Dr Kim

 

I know soda’s bad but 100% fruit juice is ok….right?

The food advertising industry is amazing. The way certain foods are marketed and labeled provides false reassurance that they are healthy. We’ve been conditioned to equate the certain words and phrases with health, like “all-natural”, “made with real fruit/vegetables “, “cane sugar”. When in many cases, it couldn’t be further from the truth!

One example I come across again and again is the juice vs soda debate. By now, EVERYONE knows that soda is not a healthy food (and if this is news to you, honey we have A LOT of work to do). But sometimes, people make the mistake of swapping coke or sprite for fruit juice, patting themselves on the back that they’re making a healthier decision.

As a doctor I’m used to giving bad news, so here’s another one for you: juice is barely any better nutritionally than soda. Even if it’s actual real fruit juice (and not those other flavored sugary drinks that pose as fruit juice but have no actual fruit listed in the ingredients)

So let’s talk about (real) fruit juice. Here are the facts:

  • Fruit juice doesn’t contain as many vitamins and nutrients -like fiber- as the actual fruit since much of it is lost during processing
  • Fruit juice usually has sugar added to it to enhance the taste
  • Even the types of juice that state proudly “no added sugars!” still has lots of sugar in it, even though it is the sugar naturally found in fruit.

The reason why this is bad is that juice is a CONCENTRATED form of sugar water with little fiber and nutrients, that quickly raises your blood sugar and provides LOTS OF CALORIES. Example, 1 orange = 60 calories. 1 8oz glass of OJ= 112 calories. In fact, some types of juice even have more sugar than soda! (Don’t believe me, CLICK HERE)

So, my common-sense tip to patients is; stay away from liquid calories as much as possible. Juice isn’t much better than soda. If you MUST drink juice “for the taste” try to dilute with water and drink it less often. And it’s  ALWAYS better to eat the actual fruit than the juice.

Hope that helps to clear things up. Stay healthy, my friends!

Dr K

Multigrain/honey wheat/rye bread: How we’re being tricked that they are healthy

The bread aisle in the grocery store can be a headache. You know that “white bread” is a huge no-no, and that whole wheat is supposedly healthy….but there’s lots of other types of bread out there. Multigrain, honey wheat, rye…and look at that healthy looking multi-grain bread with the seeds sprinkled on the top of the loaf! And they’re a nice brown color, ie not white. So, good….right?

Not necessarily.

Most of us by now know that whole grains are healthy. But why, and how do all the other non-white breads stack up?

Firstly, WHOLE GRAIN means that the product contains all the parts of the grain. So using wheat for example: the product contains the bran, endosperm and germ . These are the parts that contain the nutrients, fiber etc and this is why these things are healthy. Also, very importantly, whole grains are more slowly digested in the body which causes less of a blood sugar spike and help keep us full longer.

However, some whole wheat bread may be processed in a way that it doesn’t contain all the germ. So its not whole GRAIN, but still whole wheat.

So how do you know what type of bread to eat? Simple simple tip. Avoid anything where the word “WHOLE” is not in the first ingredient.

Look at the ingredients, if the first ingredient is whole grain flour that’s the best. Whole wheat flour and you’re still in good shape. You might see enriched wheat flour- that’s REFINED = not WHOLE. This simple tip will help you navigate the bread aisle, and help you to see that most rye bread, raisin bread, honey wheat bread etc, are actually NOT whole grain/wheat bread. Sorry!

So now we can navigate the bread aisle with confidence! Happy, healthy eating 🙂

 

Dr K

Sinus congestion

If I were to charge friends and family for all the medical advice I give, I’d be able to shop at Sephora a lot more often (which, in retrospect, probably is not a good thing). My last medical question went something like this “so this sinus infection has my face and teeth hurting for a week. What do I do? ”

When our nasal passages and sinuses get congested, all of a sudden you have a greater appreciation for your sense of smell, don’t you?  And now you’re a mouth breather, you have a headache, your nasal passages are taking turns being blocked…UGH.

Usually around this time of year, congestion can be caused by a number of things:
1. An upper respiratory infection (90% of the time viral, not bacterial btw)
2. Irritation from dry, cold air
3. Seasonal allergies

Figuring out the underlying cause of congestion is important to be able to target underlying problem, but in general the regimen for clearing up your sinuses is the same:

1. Saline irrigation (either from OTC spray, or an irritation system like a neti-pot). P.S only use purified or distilled water!
2. Oral or topical (spray)  decongestant – some of these may not be safe for those with cardiac issues so ask your doc.
3. Humidifier – if dry air is exacerbating symptoms

A Word on Antibiotics

Often when patients come to the office complaining of congestion, the conversation inevitably leads to the “do I need an antibiotic for this?”.  And the answer 90% of the time is “you definitely do not”. As I mentioned before, congestion can be caused by things other than infection, and  only 10% of actual sinus infections are bacterial. However, there IS a time and place for antibiotics in some cases.  Based on the guidelines; I may break out the prescription pad if someone has:
– Fever
-Facial pain
-Symptoms ongoing > 2 weeks despite conservative treatment, or initially improved then suddenly worsened again (which can suggest a superimposed bacterial infection).

So for example, for my friend I mentioned in the beginning, since she was experiencing a lot of facial pain ,she might be an appropriate candidate for an antibiotic, in addition to the other methods for decongestion.

When your “cold” is actually allergies

Around this time last year, mommy dearest started getting frequent colds. She would feel like she was coming down with something; malaise, cough congestion, sneezing. She was treated a few times by her PCP for an “upper respiratory infection”, and when she described her symptoms to me, I agreed with the diagnosis. However, after feeling better for a few days,  poor mom would come down with yet another “cold”.

Then her PCP then decided to try another approach, and prescribed my mother an antihistamine… and ta-da! All cured. I’m surprised it took so long to figure out she might have been suffering from allergies. Probably because she’d never had seasonal allergies before, and so many of the symptoms overlap.

So how do you know if it’s allergies or a cold? Actually, I was going to write a whole article on this, but my friend who is also a blogger and ALLERGIST, already wrote a great article about this (click HERE). Thanks, Dr Gupta!

But to give a one-liner: if your symptoms seem worse depending on the environment, if you are experiencing itchy or runny eyes, and seems to occur around the same time every year…it may be allergies! Be cautious about self-diagnosing and treating with OTC allergy meds, especially if you are elderly. Talk to your doctor about what treatment is right for you!

In the next post we’ll overview how to treat sinus congestion/ congestion…stay tuned 🙂