J Clin Endocrinol Metab

A study from Copenhagen has shown a 53% increased risk of getting diabetes and taking antibiotics. For years, antibiotics have been over prescribed and we are not only seeing resistance to current antibiotics but there are not a lot of new antibiotics in the pipeline.. Most outpatient infections that we see in the office are caused by viruses which will resolve on their own. Even some common bacterial infections, like sinusitis and ear infections do not require antibiotics. Antibiotics do have side effects and can adversely affect the bacteria microbiome in the intestines.

“Martin J Blaser, MD, the Muriel and George Singer Professor of Medicine, professor of microbiology, and director of the Human Microbiome Program at New York University Langone Medical Center, New York, called this an “important paper” and a “very well-conducted large-scale study” that provides further evidence of the importance of gut microbiota in human health and disease”

When you come in to see us (or any doctor, for that matter) try not to get upset when we do not prescribe antibiotics for your cold.



Abnormalities in the bacteria in the gut has now been linked to obesity, high triglycerides and low HDL (good cholesterol). Since lipid lowering medications and antibiotics can affect the  gut microbiome, patients on these types of medications were excluded from this study. Using new sequencing technology, the researchers found that healthy lipid levels were associated with increased microbial diversity, and 34 microbial taxonomies associated with BMI and blood lipids were identified. Since the microbiome is affected by diet and drugs,  an individual’s microbiome may modulate diet and drug pharmacokinetics and as such is considered a key element in designing personalized medicine and precision medicine.

More research needs to be done, but it is clear to me, from reading multiple articles from varied sources that this will play an important role in our health in the future.

I am recommending probiotics for everyone but we should be aware that not all probiotics are equal and there are no standard formulations.


Studies were recently done to see if eating fruits and vegetables really prolonged life. Included in these categories were also nuts and beans. According to the American Journal of Nutrition, people who ate 5 servings/day actually increased their lifespan by 3 years. Extending their research, they showed that, over time, those who ate 4 servings daily lost 1 month, 3 servings lost 3 months, 2 servings lost 7 month,  those who only ate their fruits and veggies lost 1 ½ years and those who did not eat any servings lost 2 years off their lifespan.

Most of the subjects were in their 50’s and 60’s. However, there was a group of women in their 70’s who added 5 years just by eating 5 servings daily (compared to the cohorts who did not eat healthy).


Mannion AF, et al. Paper #2. Presented at: EuroSpine Annual Meeting; Sept. 2-4, 2015; Copenhagen, Denmark

I have been recommending books by John Sarno, MD for the last 20 years. The improvement in patient pain is truly astounding considering the only treatment is reading a book!

Now, a study from Denmark looked at the relationship between chronic pain and pessimistic people. 2,500 patients filled out a questionnaire about “back beliefs” and those who were pessimistic and inactive were more likely to suffer from back and neck pain when compared to those who were more optimistic and exercised regularly.

These findings correlate very nicely with Dr. Sarno’s beliefs dating back from the 1970’s!


Tests from Consumers Reports show that beef cooked under 160 degrees (rare, medium rare) can make you sick. At least 28% of Americans eat undercooked meat. All meat contains bacteria, including chicken, pork and turkey but these meats are rarely undercooked. Ground beef appears to be much more tainted then steaks. The problem with ground beef is that bacteria gets inside of the meat during processing as opposed to steaks where the bacteria remain on the surface-So when cooked, the outside gets hot enough to kill the bugs whereas in ground beef, bacteria remain alive on the inside if not cooked long enough. Another problem is that your burger may not be 100% beef, but rather from multiple animals of different species.

Consumer Reports bought 458 pounds of ground beef and found deadly bacteria in every sample!

Most of the beef in the US is processed by just 4 companies, so if the food gets contaminates, large outbreaks could occur.

There are 3 take home messages”

1.       Consider all beef to be contaminated

2.       Only  eat meat that is 160 degrees internally (at least medium)

3.       Try to buy grass fed organic meat if possible since these appear to be healthier to eat.



The FDA has taken action against over 1,000 websites that sell unapproved medications and medical devices to US consumers.

Operation Pangea VIII is aimed to identify and eliminate these products with the help of regulatory authorities from 115 countries. As part of the operation, warning letters were sent to almost 400 website operators, whose sites sell unapproved or misbranded prescription medications, along with nine firms offering unapproved or uncleared medical devices to U.S. consumers. The FDA warned that in addition to the health consequences these sites and products pose, accessing the sites could also lead to computer viruses, credit card fraud and identity thefts.

Please buy your medications from approved pharmacies. If the price is too good to be true……..



Gass MLS et al. Menopause 2015 Jul


At one time it was thought that the side effects of hormone replacement therapy (blood clots, heart disease, strokes) far outweighed the benefits in women over 65. This was published in JAMA in 2002. In 2012, the North American Menopause Society noted several studies that showed that low dose hormonal replacement can be safe for older women. So, the question is: Should otherwise healthy women over 65 who are still symptomatic from menopausal symptoms be denied treatment totally based on age?

According to more recent studies, it looks like it may be continued for selected women over 65 who are given counseling and frequent follow up care when benefits outweigh risks



All restaurants in Florida are subject to periodic health inspections. There is a free app for your phone called “WHAT THE HEALTH” that will let you view the health inspection score for any restaurant in Florida. In some other states, like California, their inspection grades must be posted on the front door of the restaurant( not a bad idea for Florida!).

The app is very easy to use and actually shows you what the infractions are.

The only problem that I have found is that it only populates restaurants in your current area. There is a search engine but it does not work. So, if you live in Lakewood Ranch and want to search a restaurant on Main Street-Sarasota, it will only show up if you are near that location.

Nevertheless, this is an app well worth looking into.



It is known that Alzheimer’s disease originates in the part of the brain that senses smell, before spreading to other areas. The “olfactory vector hypothesis” suggests that there may be an environmental agent that could enter the brain through the nose.

It is known that changes in smell may pre-date cognitive decline. So, the theory is: Could changes in smell be used to predict Alzheimer’s disease?

Researchers at the University of Florida designed a test based on the fact that the left side of the brain processes what we smell from the left nostril and the right side processes smells from the right nostril. The experiment involved elderly people and peanut butter. People in the control (non-Alzheimer’s group) were able to smell the peanut butter from 7 inches away through either nostril. Patients with Alzheimer’s could smell the peanut butter on the right side from 7 inches but could only detect in from 2 inches away on the left side. This was only seen in Alzheimer’s disease but NOT in other causes of dementia.


Probiotics are very popular, not only in patients who have GI problems, but they have also have been found to help prevent inflammation and heart disease as well as possibly improving mood and stress.

A lot of people try to avoid gluten (wheat, rye, and barley) if they are allergic to gluten but many people, especially athletes find they just feel better when going  gluten free even though they have no sensitivities to it.

A new report states that gluten is found in as many as 50% OF ALL PROBIOTICS-so gluten free may be meaningless when choosing a probiotic –and could potentially make celiac disease worse.

Yes, I do believe that probiotics can be a great supplement for everyone (refer to my recent blog about the “MICROBIOME”). The only problem is that there are so many choices and we really don’t have any standardizations. So once again, it’s buyer beware.


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