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Health Controversies

Medical Advice can be Contradictory

Trying to keep up with the latest developments in medicine can be confusing. Physicians in practice for several decades inevitably discover that what was dogma when they started out is often not only discarded but replaced by practices that are the reverse of what they were taught.

During my Residency training, heart attack patients were routinely placed in an oxygen tent on complete bed for a week followed by a week of modified bed rest and sitting in a chair with another week or so of progressive ambulation. Hospitalization for a month was not unusual. Patients with uncomplicated infarcts are now urged to sit up the next day and are home in a week or ten days.

Diverticulitis patients used to be warned to stick to a strict low residue diet and avoid any roughage to prevent particles from getting trapped and causing inflammation. For the past twenty years the advice has been to adhere to a high fiber diet, which is the exact opposite. Most recently, this changed again and patients with acute diverticulitis were again told to go on a low residue diet and avoid any fiber for a week or until symptoms subsided before resuming eating lots of roughage.

The current constant barrage of medical research reports can be equally contradictory. The National Research Council recently recommended that daily calcium requirements be increased 50 percent in children, teens and postmenopausal females to prevent osteoporosis and fractures. There is evidence that calcium can reduce the risk of hypertension, high cholesterol and colon cancer. An article in the September 15 issue of The Lancet was entitled: Cure of lifelong fatigue by calcium supplementation.

However, a study in last September's the American Journal Of Clinical Nutrition reporting on over 20,000 physicians followed for 11 years found that those with increased calcium intake, especially from dairy products, were 34 percent more likely to develop prostate cancer! People who form calcium stones are routinely told to avoid dairy products and high calcium foods but studies now suggest that dairy products actually help to prevent calcium stones. (The treatment of choice was just reported to be a diet low in salt and meat). At the same time, taking calcium supplements can increase the likelihood of stone formation. So, is calcium good for some but bad for others?

Coffee is just as controversial as calcium. A September 4 news release stated that drinking one cup of coffee could increase arterial stiffness for at least two hours and increase risk for stroke. The next day, another report claimed that coffee had a higher content of the antioxidants that prevent strokes and heart attacks than tea. Which one should you believe?

Paul J. Rosch, M.D., F.A.C.P.
President, The American Institute of Stress
Clinical Professor of Medicine and Psychiatry
New York Medical College

The American Institute of Stress publishes many more quality articles in their monthly newsletter Health and Stress. Click here for a table of contents of their magazine from 1994-2001. Click here for information on subscribing and ordering back issues (available from 1988) or email stress125@earthlink.net or call 914-963-1200.


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