I’ve recently returned from two weeks’ vacation in Italy, arriving home just in time to celebrate America’s 250th birthday. As of this week, the office will be back open and running as usual. Thank you to all of our patients for their understanding while we took our annual vacation.
While nobody really cares (nor should they) what a small town doctor thinks about the world at large, I’m going to use this post to just make a few brief comments about the United States on this momentous date.
We will be closed starting mid-day on June 18th for vacation, and will reopen on Monday, July 6th. Please note the following during the June 16-July 5 period:
If you are not a current patient and wish to speak with me, or if you are a patient with a very non-urgent question, please call or text me after July 6.
If you are a patient with an urgent issue, go to an emergency room or urgent care. You can text me afterwards to fill me in, and after I get back I will see you for a follow up visit if needed.
Finally, if you are a patient and have a concern that cannot wait until July 6th to discuss, but that doesn’t warrant a trip to an emergency room (for example you need a refill or a bit of routine medical advice), please text the office line and I will get back to you within 48 hours.
Recently I was doing research on xanthelasmas. Xanthelasmas are soft, yellow plaques on the eyelids that are made up of cholesterol deposits. An example is shown in the photo above. They are fairly common and completely benign. Other than being cosmetically bothersome, they do not cause any harm.
Some studies have shown they are more common in people with high cholesterol and, more importantly, that they may be an INDEPENDENT marker for heart disease risk. In other words: if two people have the same high level of cholesterol but one of them has xanthelasma and the other doesn’t, the one who has the xanthelasma may be at higher risk for a heart attack than the one who doesn’t. However, the studies on this question are conflicting, with some research showing no particular link between xanthelasma and cardiovascular risk.
I thought I would discuss this study today, not because most of you are affected by xanthelasmas, but rather because it is a good example of how medical literature can take its eye off the proverbial ball of what truly matters, and how crucially important details are often buried deep inside a paper.
If you are one of the approximately 75% of Americans who regularly drink coffee, you will probably be interested to hear about a study I recently came across. In it, doctors in Japan randomly assigned overweight adults to drink one cup of black coffee per day with the only difference being that half the participants were given coffee low in chlorogenic acids, and half were given coffee high in chlorogenic acids (I will explain what this means momentarily).
After 12 weeks, the group receiving the higher chlorogenic acid coffee had lost a little bit of weight, and crucially, shrunk their visceral fat (the type of fat that most increases the risk for diseases such as diabetes and heart attacks), whereas the group drinking the regular coffee had not. Though this a relatively small study and only lasted for 12 weeks, the results are very promising, because it was a well-done randomized controlled trial, meaning that – other than the type of coffee being consumed – there really was no difference between the two groups. They were not otherwise instructed to exercise, change their diet, or do anything else that might have led to weight loss or improved health. Hence, it appears that consuming coffee high in chlorgenic acids might lead to a little bit of weight loss and to some metabolic health improvements. You can read the full study by clicking here.
Now, you are probably thinking: what the heck is chlorogenic acid? And how can I get my hands on some? Read on.
One of my favorite movies is the very underrated Avalon, from 1990. The film tells the story of an immigrant family in Baltimore, from their arrival around the time of the first world war up through several generations, until around the late 1960s. The family is fictional and from somewhere in eastern europe (I got the sense watching the film that they were probably a Jewish family from Poland, though I don’t recall that their background was ever definitively specified), but their experience could easily stand in for millions of Americans, no matter the ethnic or religious background.
At first the family are poor and work menial jobs as they struggle to acclimate to life in America. But as the years pass and successive generations take over, they climb the ladder, achieving the American Dream of middle class affluence: better jobs, a big home in the suburbs, automobiles and televisions. However, there is a price to pay for this success, as the close family cohesion that they share at the start of the film begins to dissolve. By the film’s end, the members of the family are well assimilated into American life and much more prosperous, but also lonelier and less happy.
It’s a very beautiful film and if you take nothing from this blog post other than that you should see Avalon, then I’ve done something good for the world today. But of course, I didn’t create today’s post just to share my taste in cinema with you.
