How Doctors Practice What They Preach With Diet And Exercise

Everyone has heard a doctor explain how daily exercise and healthy eating make a difference in your overall physical well-being. But it’s hard to listen to your physician prescribe exercise if he or she doesn’t model the advice being dispensed.

Some local doctors don’t just talk about it. They work out daily, maintain busy practices and stay actively involved in family life. They make exercise a daily priority that doesn’t get eclipsed by work, family or other obligations. It’s scheduled; it’s not optional.

“If everyone could eat right and exercise, we wouldn’t have an epidemic of obesity and diabetes,” says Dr. David Balis, 43, of Plano, an internal medicine specialist at UT Southwestern Medical Center and Parkland Health & Hospital System who is also a triathlete. “Physicians definitely need to be role models. If a doctor is overweight and smokes, are the patients going to listen and take it to heart, or laugh in their face?”

His is a local response to a national issue.

In 2003, the president of the American Academy of Family Physicians, Dr. Michael Fleming, issued a personal challenge to the group’s 94,000 members to “walk the talk” by improving their own health. At the time, an e-mail survey of approximately 2,000 members indicated that 60 percent had problems with their own weight, and 69 percent worked out regularly and considered themselves to be healthy role models.

The group has since launchedan initiative to support doctors trying to improve their health and the health of their families, employees and patients.

“The premise behind it is that fitness needs to be the treatment of choice for preventing and treating medical problems,” said Dr. Vance Blackburn of Birmingham, Ala., who is participating in the program. “So much of what we treat is due to poor lifestyle choices, leading to obesity, high blood pressure, diabetes and heart attacks. We need to prevent it.”

Last year, 24 AAFP member practices across the country participated in a pilot program. The program is now being evaluated to see, in part, how patients responded when more emphasis was placed on their physical activity, nutrition and emotional well-being.

“If you’re going to try to make an impact on [patients'] lifestyles, you need to look at your own lifestyle, what you can and can’t do, to try to make the changes you’re recommending to your patients,” said Dr. Wilson Pace, a professor in family medicine with the University of Colorado and a facilitator with the AAFP’s National Research Network, which is evaluating the program.

“There’s a push to recognize that we’re not going to solve our crisis with another drug or another surgery. We need to start rethinking: how you eat, how you exercise. This isn’t an afterthought. It needs to be a central component to help people stay healthy.”

Leading by example

Dr. Michele Kettles, 45, medical director of the Cooper Clinic in Dallas, shows what kind of influence a healthy doctor can have.

Her patient Pat Allen, 73, credits Kettles with inspiring and guiding her through a lifestyle change. Kettles explained to Allen that her rising blood-sugar numbers could lead to a pre-diabetic condition. Allen, who comes to Dallas from Bryan to see Kettles, said she had never exercised and had grown up eating unhealthy fried foods.

“I could see Dr. Kettles’ vitality and the energy she had,” Allen said. “I knew it was because she ate right, and she exercised. I could tell she really believed in what she was talking about. It made a difference that she did it herself.”

Allen said she lost more than 40 pounds, and her blood work returned to normal ranges over the course of a year.

“I reached the point where I felt so much better,” she said. “I wanted to keep doing it. I didn’t say it was easy.”

Finding time

Physicians also have to work hard to fit exercise into their schedules.

Kettles, who specializes in preventive medicine, knows that a low fitness level is an indicator of poor health. She says it helps that she can show her patients it’s possible to schedule fitness into your life. She tells patients it matters how you set up your life, and that you have to schedule healthy behaviors and make them convenient.

Her workday ends at 5:30 p.m., when her husband brings their two children to her office. She and her family walk around the Cooper Institute campus most days. They sometimes swim or use the gym during family time.

“I have a stressful job,” said Kettles, who also runs at least three miles three times a week. “I need to burn the stress at the end of the day. I’m a much better wife and mother if I’m destressed than if I worked another 30 minutes.”

Kettles said she’s shocked at how often people comment about her family exercising together. “They think it’s an anomaly. People should do this.”

Both Balis and Dr. Bradley Weprin, 43, a Dallas pediatric neurosurgeon, get their workouts in before daybreak. Weprin, a marathon runner, trains at 5 a.m.

“I have to get my workouts in extremely early, or I wouldn’t get it done,” he said. “It helps my mind open. I’m probably a much better person, in a much better mood, when I’m active.”

He has his share of aches but says the benefits far outweigh the pains.

Balis cycles, swims, runs or lifts weights at the gym. He then showers and heads straight to work, eating a couple pieces of fruit and an energy bar en route.

Balis said he encourages his patients to do something and to gradually push themselves to do more. When they say they don’t have time, he counsels them to prioritize and to manage their time, even if it means cutting back on watching television or playing on the computer. He says there has to be some point in the day you can work out.

“You have to figure out when that time is for you and block it out,” he said. “You have to do it every day.” By Debbis Fetterman, The Dallas Morning News

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Study: Magnesium Improves Memory

Those who live in industrialized countries have easy access to healthy food and nutritional supplements, but magnesium deficiencies are still common. That’s a problem because new research from Tel Aviv University suggests that magnesium, a key nutrient for the functioning of memory, may be even more critical than previously thought for the neurons of children and healthy brain cells in adults.

Begun at MIT, the research started as a part of a post-doctoral project by Dr. Inna Slutsky of TAU’s Sackler School of Medicine and evolved to become a multi-center experiment focused on a new magnesium supplement, magnesium-L-theronate (MgT), that effectively crosses the blood-brain barrier to inhibit calcium flux in brain neurons.

Published recently in the scientific journal Neuron, the new study found that the synthetic magnesium compound works on both young and aging animals to enhance memory or prevent its impairment. The research was carried out over a five-year period and has significant implications for the use of over-the-counter magnesium supplements.

In the study, two groups of rats ate normal diets containing a healthy amount of magnesium from natural sources. The first group was given a supplement of MgT, while the control group had only its regular diet. Behavioral tests showed that cognitive functioning improved in the rats in the first group and also demonstrated an increase of synapses in the brain — connective nerve endings that carry memories in the form of electrical impulses from one part of the brain to the other.

Bad news for today’s magnesium supplements

“We are really pleased with the positive results of our studies,” says Dr. Slutsky. “But on the negative side, we’ve also been able to show that today’s over-the-counter magnesium supplements don’t really work. They do not get into the brain.

“We’ve developed a promising new compound which has now taken the first important step towards clinical trials by Prof. Guosong Liu, Director of the Center for Learning and Memory at Tsinghua University and cofounder of Magceutics company,” she says.

While the effects were not immediate, the researchers in the study — from Tel Aviv University, MIT, the University of Toronto, and Tsighua University in Beijing — were able to assess that the new compound shows improved permeability of the blood-brain barrier. After two weeks of oral administration of the compound in mice, magnesium levels in the cerebral-spinal fluid increased.

Toward a more “plastic” brain

“It seems counterintuitive to use magnesium for memory improvement because magnesium is a natural blocker of the NMDA receptor, a molecule critical for memory function. But our compound blocks the receptor only during background neuronal activity. As a result, it enhances the brain’s ‘plasticity’ and increases the number of brain synapses that can be switched on,” says Dr. Slutsky.

“Our results suggest that commercially available magnesium supplements are not effective in boosting magnesium in cerebro-spinal fluid,” she says. “Magnesium is the fourth most abundant mineral in the body, but today half of all people in industrialized countries are living with magnesium deficiencies that may generally impair human health, including cognitive functioning.”

Before the new compound becomes commercially available, Dr. Slutsky advises people to get their magnesium the old-fashioned way — by eating lots of green leaves, broccoli, almonds, cashews and fruit. The effects on memory won’t appear overnight, she cautions, but with this persistent change in diet, memory should improve, and the effects of dementia and other cognitive impairment diseases related to aging may be considerably delayed. redOrbit