Someone taking Coumadin wanted to know why her INR was so different every time she had it checked at her doctor’s office. It is probably because she ate different amounts of green leafy vegetables from day-to-day, and week-to-week. The Vitamin K in green vegetables counteracts the effect of the medication. Green leafy vegetables are an important part of a healthy diet, but doctors frequently tell their patients taking Coumadin to avoid greens.  That is one way to deal with the problem. Or, you can eat greens, but you need to take in the same amount of Vitamin K every day so that the dose of Coumadin can be adjusted.  Well, even people who love spinach will get tired of eating spinach every day. They might like to eat kale instead of spinach every once in a while!

It is not easy, but it is possible, to  eat the same amount of Vitamin K every day.  It just takes a bit of extra thought when you are preparing your meals. The USDA web site has a list of the Vitamin K content of foods, so that you can estimate the amount of greens you can eat from day to day, and still keep your Vitamin K intake level. This first link is sorted by Vitamin K content , and this second link is sorted alphabetically.

If you do choose to eats greens every day, take it seriously and be careful. There is a very, very good reason why you are on Coumadin, and it is simply not worth the risk if you cannot be consistent.

For those of you interested in Vitamin D, there is an interview with a physician, Dr. Soran, who specializes in Integrative Medicine, and recently wrote a book called the Vitamin D Revolution.  You can listen to the interview on http://blog.VitaminDRevolution.com.  Scroll down to the bottom of the page to find the audio buttons. The first few minutes of the show consists of another physician discussing the Influenza vaccine, then Dr. Soran (as he prefers to be called) begins. He discusses the risks of Vitamin D deficiency beyond osteoporosis (cancer, infections) but he also discusses how he supplements his deficient patients. It is well worth the time to listen.

Along those same lines, a scientific study* that looked at once-a-year high dose Vitamin D supplementation in older women was recently published.  The intervention group of the study received 500,000 international units of cholecalciferol (D3) once a year, and actually experienced more falls and fractures than the placebo group that received no supplementation.  The lesson to be learned is Vitamin D is important, but don’t take it all at once, once a year.

* Sanders, K. M., A.L. Stuart, E.J. Williamson, J. A. Simpson, M. A. Kotowicz, D. Young, G. C. Nicholson “Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women: A Randomized Controlled Trial” JAMA 2010;303(18):1815-1822

Grapes, wine and resveratrol have received a lot of press, although wine to prevent heart attacks is old news. So, for a longer life, should you eat grapes, drink red wine, or buy resveratrol supplements at the health food store?

To answer this question, we need to backtrack a bit first. No one is sure whether it is the alcohol or the antioxidants in wine that protect our hearts. For a time, people believed it was the resveratrol in wine that accounted for the French Paradox: the paradox being that the French people eat a high-fat diet but don’t have high rates of heart disease.  But, not all wines are created equally: some have more resveratrol than others. Grape vines under stress (for example, when under attack by fungus) produce resveratrol. As such, wines from upstate New York have high levels of this antioxidant because of the cold, damp climate. Red wine has more resveratrol than white wine, because this antioxidant is found in the skin. Red wine is fermented with the skins, but white wine is not. But, whether red or white, from California or New York, there simply is not much resveratrol in wine.  So, should we buy resveratrol supplements at the health food store for a longer healthier, life? Read more…

Calories are  calories, but is high fructose  corn syrup (HFCS) any worse for us than other kinds of sweets? There is the camp that believes calories are calories and it doesn’t make a difference whether the calories are from regular table sugar or HFCS. Then, there is the opposing camp that believes HFCS is of horse of a different color. But are there any data from scientific studies? In a study done in mice, researchers showed that mice given a soft drink sweetened with HFCS gained far more weight than mice given a soft drink sweetened with table sugar. Read more…

The Skinny Is Overrated web site, despite the silly name, brings important new scientific information to those interested in improving their health. Dedicated to those who are overweight or obese, this scientific information on health and wellness is translated into a readable form. So many times, when a new study is published, the news media distorts the results in order to have a more sensational headline. Other more important studies are ignored. By giving a synopsis of important studies, I hope to give people information so they can make their own decisions.

As a physician practicing in East Harlem, the majority of my patients are overweight or obese. My patients ask: “Tell me what to eat.” It’s not that simple. Health is more than a number on a scale. The diet I support is a Mediterranean Diet, although, other types of diets can certainly be healthy. With information and knowledge, you can make intelligent choices for yourself to improve your health, and thus, your happiness.