Monday, 26 September 2011
Living the Sweet Life--How Sugar Bites Back

Added sugar is a big concern; Here is what you can do to cut back and ramp up your health 

Most Americans get more than 22 teaspoons — or 355 calories — of added sugar a day, which far exceeds USDA guidelines and American Heart Association recommendations.

 Lots of people are eating and drinking more sugar than ever because it is added to so many foods and beverages. Added sugar is most likely a major factor in the rise in obesity and other health problems.

What exactly is added sugar, what makes it so dangerous and what can we do about it? It does not mean you have to avoid sugar at all costs. Sugar occurs naturally in some healthy foods, including fruits. However, it is added to many other foods and beverages. Desserts, sodas and energy/sports drinks are the top sources of added sugar in most American diets. Foods high in added sugar do nothing to help your health. In face they do little more than add extra calories to your diet. And they pave the way for potential health problems. With a little knowledge, these health problems can be avoided.

Reasons added sugar is in so many foods
All sugar, whether natural or processed, is a simple carbohydrate your body uses for energy. Sugar occurs naturally in some unprocessed foods that are staples of a healthy diet — fruits, vegetables, milk and some grains. Sugar that is added to foods and beverages is known as added sugar. Sugar is added to processed foods because it:

Enhances flavor
Provides texture and color to baked goods
Preserves foods and fuels fermentation
Acts as a bulking agent in baked goods and ice cream
Neutralizes the acidity of foods containing vinegar and tomatoes

Why Added Sugar is Dangerous

Added sugar is often found in foods that also contain solid fats. Together solid fats and added sugars — called SoFAS — make up a whopping 35 percent of total calories in a typical American diet. When you get so many calories from foods containing SoFAS, it's a bad sign. Chances are you are getting too many calories, causing excess weight and obesity

Too much added sugar can lead to such health problems as:

Tooth decay. All forms of sugar promote tooth decay by allowing bacteria to grow. The more often and longer you snack on foods and beverages with either natural sugar or added sugar, the more likely you are to develop cavities, especially if you don't practice good oral hygiene.

Poor nutrition. If you fill up on foods laden with added sugar, you may skimp on nutritious foods, which means you could miss out on important nutrients, vitamins and minerals. Regular soda plays an especially big role. It's easy to fill up on sweetened soft drinks and skip low-fat milk and even water — giving you lots of extra sugar and calories and no nutritional value.

Weight gain. There's usually no single cause for being overweight or obese. But added sugar likely contributes to the problem. Sugar adds calories to food and beverages making them more calorie-dense. When you eat foods that are sugar sweetened, it is easier to consume more calories than if the foods are unsweetened.

Increased triglycerides. Eating an excessive amount of added sugar can increase triglyceride levels, which may increase your risk of heart disease.

Recommendations regarding added sugar
In the 2010 Dietary Guidelines for Americans, the U.S. Department of Agriculture (USDA) recommends cutting back on calories from SoFAS. For most people, that means no more than about 5 to 15 percent of total daily calories should come from SoFAS.

The American Heart Association has specific guidelines for added sugar — no more than 100 calories a day from added sugar for most women and no more than 150 calories a day for most men. That's about 6 teaspoons of added sugar for women and 9 for men.


To reduce the added sugar in your diet, follow these tips:

  • Cut out sugary, nondiet sodas.
  • Limit candy, gum and other sweets that are high in added sugar.
  • Choose breakfast cereals carefully. Although healthy breakfast cereals can contain added sugar to make them more appealing to children, skip the non-nutritious, sugary and frosted cereals.
  • Have fresh fruit for dessert instead of cakes, cookies, pies and other sweets.
  • If you choose canned fruit, make sure it's packed in water or juice, not syrup.
  • Have your children drink more milk or water and less fruit juice and fruit drinks — and yourself, too. Even though 100 percent fruit juice has a high concentration of natural sugar, drinking too much juice can add unwanted calories.
  • Eat fewer added-sugar processed foods, such as sweetened grains like honey-nut waffles and some microwaveable meals.
  • Go easy on the condiments — sugar is added to salad dressings and ketchup.
  • Opt for reduced-sugar varieties of syrups, jams, jellies and preserves.
  • Be aware that dairy-based desserts and processed milk products, such as ice cream and sweetened yogurt, can contain lots of added sugar.
  • Avoid sugar-sweetened tea and blended coffee drinks with flavored syrup, sugar and sweet toppings.
  • Snack on vegetables, fruit, low-fat cheese, whole-grain crackers, and low-fat, low-calorie yogurt instead of candy, pastries and cookies.
  • Recognizing added sugar

If you're not sure which foods and beverages contain added sugar, do not worry.The biggest culprits behind excessive amounts of added sugar are soft drinks and sugary fruit drinks.

Ways to spot added sugar:

  • Check the list of ingredients. Ingredients are listed in descending order by weight. So if you see sugar listed among the first few ingredients, the product might be high in added sugar. Know that sugar goes by many different names, though — it may not be easy to spot added sugar even in the ingredient list. And natural sugars generally aren't included in the ingredient list.
  • Sugar goes by many different names, depending on its source and how it was made. This can make it confusing to identify added sugar, even when you read ingredient lists and food labels. One easy way: Check for ingredients ending in "ose" — that's the chemical name for many types of sugar, such as fructose. There's no nutritional advantage for honey, brown sugar, fruit juice concentrate, or other type of sugar over white sugar.

Common types of sugar and added sugar:

  • Brown sugar. Granulated white sugar with added molasses for flavor and color, commonly used in baking.


  • Cane juice and cane syrup. Sugar from processed sugar cane. Further processing produces brown or white solid cane sugar.


  • Confectioners' sugar. Granulated white sugar that has been ground into a fine powder, sometimes with a small amount of cornstarch. Commonly used in icings and whipped toppings.


  • Corn sweeteners and corn syrup. Corn sugars and corn syrups made from corn and processed cornstarch.


  • Dextrose. Another name for glucose.


  • Fructose. Sugar that occurs naturally in fruits, vegetables and honey.


  • Fruit juice concentrate. A form of sugar made when water is removed from whole juice to make it more concentrated.


  • Glucose. A simple sugar that provides your body's main source of energy. Also called blood sugar because it circulates in your blood.


  • Granulated white sugar. This is table sugar, or pure crystallized sucrose, made by processing raw sugar from sugar cane or sugar beets. It's commonly used in baking or to sweeten tea or coffee.


  • High fructose corn syrup. The most common sweetener in processed foods and beverages, this is a combination of fructose and glucose made by processing corn syrup.


  • Honey. A mix of glucose, fructose and sucrose created from nectar made by bees.


  • Invert sugar. Used as a food additive to preserve freshness and prevent shrinkage, this is a mix of fructose and glucose made by processing sucrose.


  • Lactose. Sugar that occurs naturally in milk.


  • Maltose. Starch and malt broken down into simple sugars and used commonly in beer, bread and baby food.


  • Malt syrup. A grain syrup made from evaporated corn mash and sprouted barley.


  • Molasses. The thick, dark syrup that's left after sugar beets or sugar cane is processed for table sugar.


  • Sucrose. The chemical name for granulated white sugar (table sugar).


  • Syrup. Sugar comes in many forms of syrup, a thick, sweet liquid that can be made from the processing of sugar or from sugar cane, grains such as corn or rice, maple sap, and other sources.


  • White sugar. Same as granulated white sugar (table sugar).


From my experience as a family doctor, I have seen that sugar can have an addictive quality. Have you ever noticed when you eat sugary or salty snacks it is not long until you crave them again? You can break the cycle. It only takes about two weeks to end the craving for sugar. So the next time you're tempted to reach for a sugary drink, grab a glass of water instead.

Talk to your family doctor about tips to change your health for the better. At Leavitt Family Medicine, we are here for you, for all your medical needs. Please let us know how we can help you today!

(Information Source:Mayo Clinic)

Posted on 09/26/2011 9:31 AM by Paul J. Leavitt, M.D.
Friday, 23 September 2011
Ask Dr. Leavitt--Does smoking really cause wrinkles?

Is it true that smoking causes wrinkles?

Yes. Premature wrinkles are great reasons to quit smoking, and the sooner the better. Smoking can speed up the normal aging process of your skin, contributing to wrinkles. These skin changes may occur after only 10 years of smoking.

The more you smoke and the longer you smoke, the more skin wrinkles you are likely to have — even though the early skin damage from smoking can be difficult to see at first.

Smoking does not cause wrinkles just on your face. Smoking is also associated with increased wrinkling and skin damage on other parts of your body, including your inner arms. You can prevent worsening of wrinkling by quitting smoking now.

How does smoking lead to wrinkles? The nicotine in cigarettes causes narrowing of the blood vessels in the outermost layers of your skin. This reduces blood flow to your skin. With less blood flow, your skin does not get as much oxygen and important nutrients, such as vitamin A.

Many of the over 4,000 chemicals in tobacco smoke also damage collagen and elastin, which are fibers that give your skin its strength and elasticity. As a result, skin begins to sag and wrinkle prematurely because of smoking.

Also, prolonged and repeated exposure to heat from burning cigarettes and the facial expressions you make when smoking — such as pursing your lips when inhaling and squinting your eyes to keep out smoke — may contribute to wrinkles.

If you are interested in quitting smoking, talk to your family doctor and work together to form a plan that will best help you quit for good. The benefits to your body begin within the first 24 hours of stopping smoking.


 ]At Leavitt Family Medicine, we are here for all of your medical needs. We welcome your questions and comments; please let us know how we can help you today!

Posted on 09/23/2011 10:33 AM by Dr. Paul Leavitt
Thursday, 22 September 2011
Ask Dr. Leavitt--I have abdominal pain that hasn't gone away. What could it be?


For a while now, I have had abdominal pain. I thought it would go away, but it hasn’t. What could it be?

Sometimes new patients to my practice say they have lived with abdominal pain for years. They have been told it is in their head or that it is part of getting older. Nothing could be further from the truth. Abdominal pain can be somewhat tricky to deal with, but with a good history and physical examination, the cause of the pain can be found.

Think of your abdomen as a tic-tac-toe board. Right upper pain can be gallstones or a liver mass. Middle pain can be a stomach ulcer, inflammation of the pancreas or gastritis. Left sided pain can be diverticulitis or sometimes constipation. Pain along the sides can be either a kidney infection or renal stones. Lower abdominal pain can signify appendicitis on the right side and sigmoid spasms on the left. Generalized pain can sometimes be celiac sprue, irritable bowel syndrome, or Crohn’s disease. Ulcerative colitis usually starts from the rectum and works backward.

The key to getting rid of the pain is getting medical attention right away. Sit down and have a discussion with your family doctor about your specific abdominal pain.

At Leavitt Family Medicine, we are here for you, for all of your medical needs. We welcome your questions and comments; Please let us know how we can help you today!

Posted on 09/22/2011 11:36 AM by Dr. Paul Leavitt
Thursday, 22 September 2011
Ask Dr. Leavitt--I was recently diagnosed with metabolic syndrome. What can I do to change my health for the better?

My resolution this year was to take better care of my health. I was diagnosed last year with metabolic syndrome. What can I do to fix this?

Metabolic syndrome is simply insulin resistance and inflammation within the body. It is also known as pre-diabetes or syndrome X. The American Heart Association defines metabolic syndrome as having an elevated waist circumference, high triglycerides, reduced good cholesterol (HDL), hypertension (>130/85), and elevated blood sugar.

Common risk factors are stress, obesity and sedentary lifestyle. . You are not alone as many people deal with this syndrome and the good news is it is reversible. Positive changes include daily physical activity, reduced caloric intake, finding new outlets to handle stress, losing excess weight and limiting sugar, salt, and fat in the diet.

A great way to track your progress is to sit down and talk with your family doctor as you begin your lifestyle changes. Get your complete blood work done and discuss your plan to achieve your health goals. Redrawing labs every six months will show what progress you’ve made in improving your health. Your doctor can be a great partner and coach in helping you achieve your health goals. This is the year to begin living the life you want to live!

At Leavitt Family Medicine, we are here for you. We welcome your questions and comments; Please let us know how we can help you today!

Posted on 09/22/2011 5:02 PM by Dr. Paul Leavitt
Wednesday, 21 September 2011
Ask Dr. Leavitt--I have high blood pressure. What is normal blood pressure and how can I get there?

I’ve been told I have high blood pressure. What is normal blood pressure and what can I do to get there?

High blood pressure, or hypertension, is elevated arterial blood pressure in your system.

Normal blood pressure is <120/80mmHg.

Prehypertension is 120-139/80-89mmHg.

Stage 1 hypertension is 140-159/90-99mmHg.

Stage 2 hypertension is >=160/100mmHg.

Persistent hypertension is one of the risk factors for stroke, myocardial infarction, heart failure, and arterial aneurysm, and is a leading cause of chronic kidney failure. Moderate elevation of arterial blood pressure leads to shortened life expectancy.

Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment may prove necessary in patients for whom lifestyle changes prove ineffective or insufficient. Here are some excellent ways to lower your blood pressure:

  • Eliminate or effectively handle stress
  • Reduce salt intake
  • Eat a heart-healthy balanced diet
  • Get 30 minutes of exercise every day
  • Get quality sleep
  • Take an aspirin (81mg) each day
  • Drink plenty of water

Medicine can serve as a temporary way to keep your blood pressure normalized until your lifestyle changes serve to lower blood pressure on their own. Be sure to sit down and talk with your family doctor about getting your blood pressure to normal. It can add years to your life and life to your years!

At Leavitt Family Medicine, we are here for you. We welcome your questions and comments; Let us know how we can help you today!

Posted on 09/21/2011 12:03 PM by Dr. Paul Leavitt
Wednesday, 21 September 2011
Ask Dr. Leavitt--How do I find out if I have Alzheimer's?

It seems the older I get, the more I keep forgetting. What can I do to find out if I have Alzheimer’s?

Alzheimer’s dementia and memory loss in general are very common areas of concern for patients in my clinic. Many have family members or friends who have Alzheimer’s dementia and want to do everything they can to avoid memory loss. Several types of blood tests are available to check for memory loss.

Genetic risk factors, including the apoE gene, E4, can be tested for Alzheimer’s dementia. Other risk factors for memory loss include sleep apnea, depression, alcohol or drug abuse, certain types of cancer and cancer fighting treatments, smoking and cerebral vascular disease.

High homocysteine levels can indirectly lead to memory loss, as well as low estrogen levels in women and low testosterone levels in men. It is important to sit down and talk with your family doctor to discuss and assess your memory loss, to make sure you are utilizing preventative measures, such as controlling high blood pressure and diabetes, and to help prevent any further memory loss.

At Leavitt Family Medicine, we are here for you, for all your medical needs. We welcome your questions and comments; please let us know how we can help you today!

Posted on 09/21/2011 12:09 PM by Paul J. Leavitt, M.D.
Wednesday, 21 September 2011
Ask Dr. Leavitt-- I have high cholesterol. What can I do to lower my cholesterol number?

I have been told I have high cholesterol. What is normal and how can I get there?

Reaching your cholesterol goal is one of the most important things you can do for your health. Hyperlipidemia, or high cholesterol, is directly associated with increased risk of heart disease, coronary artery disease, stroke, and heart attack.

Your cholesterol level, found through a simple blood test, includes Total Cholesterol, HDL (known as good cholesterol), Triglycerides (a type of fat found in your blood), and LDL (known as bad cholesterol).

Normal range for most adults is Total Cholesterol (125-200mg/dL), HDL (>40mg/dL), Triglycerides (<150mg/dL) and LDL (<130mg/dL).

However, patients with coronary heart disease or diabetes should aim for an LDL of <100mg/dL; patients with diabetes and known heart disease should aim for an LDL of <70mg/dL.

Ways to lower your cholesterol include lifestyle modifications such as eating a heart-healthy diet—reduce saturated fat (especially trans fat) and salt intake, doing at least 30 minutes of physical activity every day—walk, bike, swim, jog, dance—whatever you love to do, do it, reducing stress, not smoking, and getting enough sleep.

Natural supplements, such as Omega 3 fatty acids from fish oil, vitamin E, and antioxidants will help. Also, various medications can lower blood cholesterol levels. The types of medications include statins, selective cholesterol absorption inhibitors, resins (also known as bile acid-binding drugs), fibrates, and niacin.

For the best possible results, you should sit down and talk with your family doctor. Discuss your specific cholesterol goals and how to reach them.

At Leavitt Family Medicine, we are here for you, for all your medical needs. We welcome your questions and comments; Please let us know how we can help you today!

Posted on 09/21/2011 12:12 PM by Paul J. Leavitt, M.D.
Wednesday, 21 September 2011
Ask Dr. Leavitt--I have Diabetes and check my blood sugar 4 times a day. Is there a better way?

I have diabetes and check my blood sugar four times a day. Is there a better way of monitoring my blood sugar?

Yes, there could be. If you have non-insulin dependent diabetes mellitus, known as type 2 diabetes, daily blood glucose monitoring may not be necessary. 

Two different blood tests are available to help monitor your blood glucose levels. 

The first test is the hemoglobin A1C test, which measures what your blood sugar has been running on average for the last three months.  You do not need to be fasting for this test to get an accurate reading. 

The second test is new, and is called the Glycomark test.  This test has been approved by the FDA to measure intermediate term glycemic control with diabetes. It allows your doctor to determine how well your blood sugar is controlled after eating meals, which can be problematic for patients with diabetes.

Both tests are usually done every three to six months. Be sure to sit down and have a good discussion with your family doctor about achieving and maintaining your blood sugar goals.

At Leavitt Family Medicine, we are here for you, for all of your medical needs. We welcome your questions and comments; Please let us know how we can help you today!

Posted on 09/21/2011 3:46 PM by Dr. Paul Leavitt
Tuesday, 20 September 2011
Ask Dr. Leavitt--I have high cholesterol and was just put on a statin. Is there anything else I can try?

My doctor started me on a statin drug for high cholesterol, but I've heard about bad side effects with this type of medicine. Is there anything else I can try?

In treating high cholesterol, there are many factors to consider.  Treatment depends on which part of the cholesterol is high (LDL, HDL, Triglycerides, Total Cholesterol), how high it is, and what your cholesterol goals are. Statins are the most commonly prescribed drugs for treating high cholesterol.  In my practice I prescribe them for patients with very high total cholesterol and very high LDL, commonly known as ‘bad cholesterol’. 

One possible side effect of statins is rhabdomyolysis, which is the breakdown of muscle tissue.  Patients who experience a severe muscle cramp, should discontinue the medication immediately.  Statins can also lead to liver damage, therefore, blood tests are needed every three months when statin therapy is initially started to monitor liver function.

Additional effective treatments include other classes of cholesterol drugs and omega-3 fatty acid supplements, which not only help lower total and LDL cholesterol but can also raise the HDL or good cholesterol.  Statins are very good drugs for lowering cholesterol, but there are other types of medicine to help regulate cholesterol when statins cause serious side effects.

Talk to your family doctor and work together as a team to create the best plan to reach your cholesterol goals. It’s important to tailor your treatment to what works best for you and your specific cholesterol needs.

At Leavitt Family Medicine we are here for you. We welcome your questions and comments; Let us know how we can help you.


Posted on 09/20/2011 6:23 PM by Paul J. Leavitt, M.D.
Monday, 19 September 2011
Ask Dr. Leavitt--why is it important to check my Vitamin D3 level?

I am hearing a lot of talk about Vitamin D3; why is it important to check my level?

In recent years, there has been an increase in Vitamin D deficiency.  Studies report that nearly half of the U.S. population suffers from lack of Vitamin D.  So why is having enough Vitamin D important? Without enough Vitamin D, calcium in our diet cannot be absorbed, thus leading to osteomalacia in adults, and rickets in children, both of which are bone thinning and deforming disorders. 

Lack of Vitamin D has been linked with depression and immune system dysfunction. So if you’re the person who is always catching the latest cold/sinus infection/24 hour bug going around, Vitamin D deficiency may be to blame.

The prefrontal cortex of the brain is also affected by Vitamin D deficiency, leading to poor planning of complex cognitive behaviors and decision making.  Vitamin D can help slow the progression of Alzheimer’s dementia by helping the immune system fight dangerous amyloid proteins. 

Making sure you have enough Vitamin D can improve muscle function and help prevent diabetes and cancer (most notably pancreatic cancer).  Vitamin D levels can be checked with a simple blood test.  Make sure that your active Vitamin D level is checked (25-hydroxy-cholecalciferol).  If your levels are low, a Vitamin D3 supplement is now recommended at 2000 IU per day according to the National Institute of Health.  Blood levels are then usually checked every 3 to 6 months to track your progress, making sure you reach the optimal level for your health. Be sure to sit down and talk with your family doctor about how to reach your Vitamin D3 goal.

At Leavitt Family Medicine, we are here for you. We welcome your questions and comments. Please let us know how we can help.

Posted on 09/19/2011 5:15 PM by Dr. Paul Leavitt
Monday, 19 September 2011
Ask Dr. Leavitt--What is early-onset dementia?

I have been reading about early-onset dementia. What exactly is it?

Early onset dementia is a disorder that is usually hereditary in nature.  It is typically seen in patients before age 55. Alzheimer’s dementia usually occurs after the age of 65. Geneticists have mapped out several different types of gene sets for Alzheimer’s dementia. Genetic testing is now available to test for this disease.

Symptoms of Alzheimer’s dementia include subtle memory failure, confusion, poor judgment, language difficulties, and agitation. There are several effective medications, along with lifestyle modifications and natural therapies, that can slow the progression of the disease and newer therapies are currently under investigation.

According to both the Mayo Clinic and Harvard Medical School there is no evidence to date that early-onset dementia has any more rapid progression than regular onset Alzheimer’s. Patients with either early-onset or Alzheimer’s dementia can live a long, productive, and active life.

Your family doctor can check for both types of dementia with a simple mini-mental status exam. Be sure to sit down and have a good discussion with your family doctor about any symptoms you have.

At Leavitt Family Medicine, we are here for you. We welcome your questions and comments; please let us know how we can help you.

Posted on 09/19/2011 6:14 PM by Paul J. Leavitt, M.D.
Sunday, 18 September 2011
Ask Dr. Leavitt--I am bruising easily; should I be concerned?

Q.  As I have gotten older I notice I bruise easier than I use to. Sometimes I'll have a bruise on my arm and not even remember bumping it on anything. Is this something to be concerned about?

A. Many times people will wonder, "Now when did I do that?" as they look at a dark blue mark on their arm. If you bruise easily, you are not alone. As we age, bruising can become more common. One reason for this is because skin tends to thin with age. Sun damaged skin bruises easily and genetics can take some of the blame--some families just tend to bruise easier than others. Also, some medications, such as blood thinners, gout medicine, arthritis medications, and steroids, can result in bruising easily.

Usually bruising easily isn't a sign of anything serious, but sometimes it indicates another problem that may require a professional medical care.

Bruises are caused by the breakage of blood vessels under the skin. When a blow to the area causes these vessels to break, blood leaks out and causes the "black and blue" appearance we call a bruise. The harder you're hit, the darker and larger the bruise will be, but sometimes even little bumps can cause significant bruises.

Sometimes bruising easily is a symptom of a lack of vitamins or problems with clotting. If you have never bruised easily before but suddenly find yourself dealing with a myriad of bruises, you may want to call your family doctor. The same is true if your bruises are especially painful or tend to be large and you can't remember bumping yourself. Bleeding elsewhere (nose or gums) in addition to bruising also points to the need for medical attention.

At Leavitt Family Medicine, we are here for you. We welcome your questions and comments. Feel free to contact our office for an appointment with any medical problems you may have. .

Posted on 09/18/2011 3:01 PM by Dr. Paul Leavitt
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