When I make a diagnosis and start treatment, many patients want to know “are there any vitamins I can take to support my getting better?” I love this question because it tells me that the patient wants to be an active participant in their recovery. They don’t just believe that medication will make it all right. Multivitamins and other supplements are multimillion-rand industries. Just walk into any major pharmacy and view the confusing array of vitamins. Time magazine in 1992: I have fallen for the hype too. My son can be a bit of a picky eater, I feel like a…
Facts on Fasting
Somewhere along the line, we got the message that three meals a day plus snacks is the healthiest. That if we let ourselves get hungry we risk binging to catch up on – and then overshoot – our daily calorie requirements. We know that breakfast is the most important meal of the day and we must not skip it under any circumstance. The idea behind breakfast is that we are hypoglycemic in the mornings, so need breakfast to get our metabolisms going. It seems that we have to once again change how we think about food. Current evidence supports the…
Going straight for the gut
I am taking a break over the holidays. For the next four weeks, I will be republishing a few of my favourite blogs. We have always known that our mood affects our guts. My anxious patients complain of diarrhoea and my depressed patients of constipation. I could never have imagined how much of a role the gut microbiota plays in communicating with the brain and modulating behavior. I never took “gut feeling” literally! Our gut, the small intestine and the large intestine, is filled with over a kilogram of bacteria, the gut microbiota. That’s almost the weight of an average…
Let’s talk about food
I am taking a break over the holidays. For the next four weeks I will be republishing a few of my favourite blogs. In continuing with thoughts about selfcare, I would like to talk about food. I hosted a dinner party the other night and there was a vegetarian, someone who was Banting-it and a gluten intolerant guest. We generally agreed that Trump was a disaster, wailed about corruption in SA politics and lamented the drought. But when we got to food, the opinions clashed and arguments got heated. I bet that Mrs Cavewoman host did not have these problems.…
The weight issue- if diets don’t work, what does?
Diets don’t work. (www.drmarcellestastny.co.za/diets do not work) An obese woman has a one in 677 chance of achieving a normal weight in a year. An obese man has a one in 1 290 chance of being a normal weight in a year. A major risk factor for being 5kg heavier in a year from now is to be on a diet now. All recommendations seem to be that whatever you do it must be “simple, flexible and sustainable.” Kilojoule restriction for weight loss does not work. Permanent modifications to diet and lifestyle do work. If you have been gaining 2kg every…
Diets do not work
You have had a look at yourself in the mirror and realised that you don’t like what you see. Your doctor has told you that you must lose weight. You have researched Atkins, Detox diet, Banting, Intermittent Fasting and a few others. You are ready to start your diet. Again. You probably feel that you don’t need to have your resolve weakened by reading a blog espousing that diets don’t work. Worse, a major risk factor for being 5kg heavier in a years time, is to be on a calorie restricting diet now. Dieting results in weight gain. Diets don’t work. A…
Let’s talk about weight- why are we so fat?
Worldwide there is an obesity problem; they call it the “globesity epidemic”. In South Africa 70% of women are overweight and 40% obese (BMI over 30). A third of South African men are overweight. Despite what the “Fat and Proud” counter-revolution and our defence mechanisms tell us, it’s not okay to be fat. Obesity results in numerous health problems. In the States, it’s the number 1 cause of preventable deaths. For generations, each generation has died older than the last. This trend is now being reversed because of obesity-related illnesses including diabetes, heart disease, metabolic syndrome, certain cancers and stroke. When…
Let’s talk about the value of ideal weight
Ideal weight is such a sensitive issue. In my practice, almost every woman and many of the men are unhappy with their weight. I often wonder what it would be like if every person in the world woke up one day, happy with how they looked. I think a lot of diet and beauty industries would go bankrupt! What is “ideal weight”? Surprisingly, this concept is not that easy to define. First off, there seems to be a paradox in patients’ awareness. Next, doctors can not seem to agree as to what it is and how best to measure it.…
Going straight for the gut
We have always known that our mood affects our guts. My anxious patients complain of diarrhoea and my depressed patients of constipation. I could never have imagined how much of a role the gut microbiota plays in communicating with the brain and modulating behavior. I never took “gut feeling” literally! Our gut, the small intestine and the large intestine, is filled with over a kilogram of bacteria, the gut microbiota. That’s almost the weight of an average brain. These bacteria carry more than a hundred times the genes of the human genome. It is comprised of 150 common bacteria and…
Let’s talk about food
I am taking a break over the holidays. For the next four weeks I will be republishing a few of my favourite blogs. In continuing with thoughts about selfcare, I would like to talk about food. I hosted a dinner party the other night and there was a vegetarian, someone who was Banting-it and a gluten intolerant guest. We generally agreed that Trump was a disaster, wailed about corruption in SA politics and lamented the drought. But when we got to food, the opinions clashed and arguments got heated. I bet that Mrs Cavewoman host did not have these problems.…