Category Archives: GENERAL INFO

Exercise no good for weight loss

I have written in past blogs about the futility of exercise as a weight reduction method.

Here is a link to a previous blog;

Recently another article in the Washington post newspaper corroborates what I have been telling my patients for years; Exercise no good for weight loss. The article mentions several medical studies that have been performed and which show that weight loss is essentially independent of exercise and that one does not lead to the other. Even all that stuff about getting a higher metabolic rate because of exercise ends up being false; Tanzanian bushmen running around all day in hunts have no higher metabolic rates than the couch potatos in Cleveland!

Here is the link ;

I tell my patients that exercise is good for lowering blood pressure, decreasing cholesterol and decreasing chances of diabetes -that is all its been proven to do – nothing else.  Even then, as the article points out, those that exercise daily and hard, don’t live any longer that moderate exercisers… which means you need to get your heart rate up above  100 beats per minute for 20 minutes a few times a week (3-5 times)- that is all!

Also, remember this about  why exercise is no good for weight loss; one hour of hard spinning (cycling) makes you loose 360 calories.  One gin and tonic has 240 calories!

To lose weight all you need to do is…eat less!!!  Now isn’t that a novel thought!


Don’t Google it

A few months ago the Flemish Government hired a firm to dissuade the public from going to google to look for their symptoms and signs. Invariably the results are ridiculous at best and only lead to confusion and unnecessary fear.

Here is a link to the Washington Post article that discussed this situation and google,

A few years ago I wrote about getting medical information from google and sources of medical information that are trustworthy. Here is a link to that blog.

Especially after cosmetic surgery, there are many normal aspects of healing that may appear strange or alarming not only to patients but even to most other physicians! Remember that cosmetic plastic surgery is a highly specialised field of surgery and even most general surgeons have never seen many of the procedures plastic surgeons perform.

If you have symptoms after cosmetic plastic surgery your best bet is to call the plastic surgeon’s office and discuss your concerns. A minute on the phone can save you hours and days of anguish when you speak to Dr. Google.

Saturated Fat is not bad?

Saturated Fat is not bad for you in turns out

fat food

Research showing saturated fat being bad wrong

Some time in the 1980s was the first time I personally became aware of the touted “fact” that saturated fat was bad for humans and the cause of numerous evils that shortened our lives by causing plaques to build up in our arteries and having them harden. This in turn would lead to heart disease, heart attacks and strokes.

What is saturated fat

Saturated fats are made of triglycerides from fatty acids with no double bonds between the carbon atoms and hydrogen atoms saturating the carbon skeleton. All that just means that saturated fats are simple molecules that can be easily broken up into smaller molecules that are metabolized easily.

Common sources of saturated fat include, meat, dairy products, and some types of plant oils such as coconut oil, chocolate, and palm oil.

Duped by Doctor

In the 1950s, Dr. Ancel Keys, a nutritionist at the Univ. of Minnesota  decided that saturated fats lead to an increase in cholesterol and hence heart attacks.

Keys then set out to prove his theories by choosing to study diets in countries where saturated fat ( meat) consumption was low and where incidence of heart disease was also low. he chose countries such as Yugoslavia, Italy and Finland but did not look at countries such as France where the population eats a great deal of saturated fat in the form of meats and chees and …also have low rates of heart disease!!

Most of the study conclusions were actually based  on studies of just a few dozen men in Crete form an original 655 – a scientifically unrepresentative number- in a small Mediterranean island. These men were not eating much meat or cheese and had low levels of heart disease- the Mediterranean diet was born…BUT

The study was done after World war 2 , when the island was having major food shortages (the men were staving), during the month of Lent ( when the men where not eating the little meat and cheese they had anyway!) – Unreliable results.

This study and the fact that Dr. Keyes became a “big Cheese” in the American Heart Association and its push for better heart health, led to more studies being done to support Dr. Keyes. All the studies were flawed and gave unreliable results. It was not till 2002 that someone figured out that Keys’s original research was flawed and everyone had been going down the wrong path.

Finally in 2012 a huge study  of many other studies in the American Journal of Clinical nutrition showed that there was no relationship between heart disease and saturated fat.

Saturated fat is associated with

  • colorectal cancer- faintly
  • Ovarian cancer- possibly
  • Decreased Bone density in men
  • Prostate cancer- possibly

Saturated Fat is not associated with

  • Breast cancer- multiple studies have shown a relationship but the majority seem to show no relationship.


So, what to do?

I have again started to eat butter with my bread and jam in the morning having deprived myself for years.

I will continue to eat lean meats and stay away from fat laden cuts ( which I never liked anyway).

I will not take any of the research too seriously since,as usual in many aspects of medicine, no one really knows what is going on.



Latest Cosmetic surgery techniques 2014

The American Society of Aesthetic Plastic surgery meeting 2014

latest techniques

I was recently at the annual meeting of the American society for aesthetic plastic surgery (ASAPS) in San Francisco to see the latest cosmetic surgery techniques 2014.

There are about 6500 Board certified plastic surgeons in the US. Of those, only about 2000 are members of the American society for aesthetic surgery (ASAPS). This select group of plastic surgeons are those whose practice is primarily devoted to aesthetic plastic surgery- cosmetic surgery. Plastic surgeons from all over the world go to the meeting to learn the latest techniques in cosmetic surgery.

Fat injections to the face

The concept of fat injections, and by definition almost, stem cells, continues to be widely popular.

Plastic surgeons are increasingly injecting fat into the face for facial rejuvenation during a face lift. The fat seems to stay in the face for some patients and not for others. Cause unknown.

Fat injections into breasts

fat injections into the breast continues to be problematic. A recent study shows that fat injection by itself does not cause breast cancer. But… if you have a breast cancer, the fat injection will make the migration of  the cells faster and increase the chance of metastatic cancer- not good. Specially when 1 out of 9 women in the US is going to get cancer, getting metastatic cancer is a death sentence.

Fat injections into joints

The most exciting reports for fat/stem cell injections come from studies where fat is being injected into knee joints that have suffered injury. The torn cartilage actually seems to heal itself. Studies are being done now to reproduce the early study which cam from Pakistan…

Deep Vein Thrombosis

Deep vein thrombosis or DVT is a cause of pulmonary emboli which is the number one cause of death in cosmetic plastic surgery patients. Several protocols have been identified for dealing with patients at high risk for DVT. These are patients with previous history of DVT, women who are smokers, and women on birth control. Sitting in a particular position for a long time will also increase the risk.

Putting patients on blood thinners before the surgery was widely advocated as the thing to do. It now turns out the the risk of bleeding during the surgery outweighs the risk of actually getting a PE.

Bacteria around breast implants

Bacteria have long been thought of as being contributors to capsular contracture- a condition which occurs for unknown reasons around some breast implants. The bio-film, a film of bacteria that covers the implants was thought to be the main contributor to this “chronic infection”. Now it may be that the bio-film does nothing or may actually protect against the contracture! Essentially, no one knows.

Take home message

I have rarely come back from a medical conference more confused that when I went there. It seems that the science of cosmetic surgery is in a period of flux. What we thought was true, isn’t, and  what was not true is not true or is true.

What was it that former defense secretary Rumsfeld said recently,

“Reports that say there’s — that something hasn’t happened are always interesting to me, because as we know, there are known knowns; there are things that we know that we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns, the ones we don’t know we don’t know.”