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My Favorite Five Medical Journal Articles for the Past Month

by Dr. John McDougall

My favorite 5 articles found from my medical journals from this past month are:

1) Current Concepts – Chronic Constipation in the October 2, 2003 issue of the New England Journal of Medicine places no emphasis on a low-fiber diet nor says anything about dairy products as the cause of constipation. As far as dietary treatment is concerned, the article contains a single sentence suggesting an increase in fruits and vegetables.  This nine page article dedicates two pages to drug therapy and the rest to verbiage irrelevant to your practicing doctor’s care for his patients.  When something as obvious as the connection between the food that enters your body and the “digested food” that leaves your body is neglected by one of the world’s most respected medical journals, you can understand why your doctors rarely mention diet in connection with your problems, but prescribe bags full of drugs, and as a result, almost never solve your health problems.  For more information on curing constipation see my September 2002 Newsletter article – In Search of the Perfect Bowel Movement.

Lembo A. Chronic constipation. N Engl J Med. 2003 Oct 2;349(14):1360-8.

2) Lifetime Risk for Diabetes Mellitus in the United States in the October 8, 2003 issue of the Journal of the American Medical Association reports that for individuals born in the year 2000, 33% of males and 39% of females will develop diabetes.  The risk for minorities is even higher with an estimate of half of Hispanic females developing diabetes.  Most of these diabetics will go on to have kidney and/or heart disease.  Who is going to pay for all of this?  Disease from unhealthy eating is the greatest threat facing the future of developed countries.  The solution is simple:  type 2 diabetes is due to rich food, lack of exercise, and the resulting obesity – change the obvious.

Narayan K. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003 Oct 8;290(14):1884-90.

3) Azithromycin (an antibiotic) for secondary prevention of coronary heart disease events in the September 17, 2003 issue of the Journal of the American Medical Association reports that a 3 month course of antibiotics given to people with a history of a previous heart attack and bacterial infection produced no reduction in their risk of future heart trouble after 14 months of follow-up.  There is a theory that artery disease is due to an infection of the arteries with a bacteria (like C. pneumoniae) – if this theory is right then there is no need to give up cheeseburgers and go for a walk – instead, a course of antibiotics will kill the bacteria and stop the progression of artery disease.  Unfortunately, there is no easy way out – but that fact is important to know so that proper attention can be given to what really matters.

O'Connor CM.  Azithromycin for the secondary prevention of coronary heart disease events: the WIZARD study: a randomized controlled trial. JAMA. 2003 Sep 17;290(11):1459-66.

4) Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? In the October 2003 issue of the American Journal of Clinical Nutrition this study tries to answer the question, “How much exercise do I have to do to lose weight?” Comparing a goal of burning 1000 calories a week with 2500 calories a week, the higher exercise goal resulted in about the same weight loss at 6 months (18 vs. 20 pounds), but better loss at 18 months (9 vs. 15 pounds) – they obviously gained some of their lost weight back.  To burn 1000 calories a week people have to walk briskly 30 minutes a day; and to burn 2500 calories a week they have to walk 75 minutes a day.  These figures tell me it takes a lot of physical activity to burn off calories and that I would save a lot of time and effort if I thought before eating all that high-calorie food.  Consider: one McDonald’s cheeseburger is 330 calories and a Double Quarterpounder with cheese is 770 calories – you would have to briskly walk more than one hour to burn off the calories in one simple cheeseburger (and two hours for the double cheeseburger).  Not that exercise isn’t important for fitness – I just want to  emphasize how much easier it is to regain lost health and appearance by focusing on the food first.

Jeffery RW.  Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr. 2003 Oct;78(4):684-9.

5)  Comparison of screening mammography in the United States and the United Kingdom in the October 2003 issue of the Journal of the American Medical Association reports that twice as many women were subjected to further evaluations and open surgical biopsies (leaving physical and mental scars) in the United States (US), as in the United Kingdom, yet cancer detection rates were similar – in other words, healthy women are unnecessarily frightened and mutilated twice as often in the US.  Fear of malpractice suits and inexperience of the US radiologists reading the mammograms were among the reasons given for this discrepancy.  My advice for women on both sides of the Atlantic is to avoid all the controversy, stay away from the breast cancer screening business, and refuse mammography, because it fails to detect cancer early enough to make any difference in a woman’s chance of survival and results in serious harm to the woman.  Also, eat a healthy diet in order to avoid (and possibly treat) breast cancer.  Read more in my February 2002 newsletter article “Mammography is Unjustified” and in the McDougall Program for Women book.

Smith-Bindman R.  Comparison of screening mammography in the United States and the United Kingdom. JAMA 2003; 290:2129-2137.

You can look up these articles and others at the National Library of Medicine (free) at www.nlm.nih.gov.  Most often you will only be provided an abstract.  You will need to pay a fee or to go to a medical or university library to obtain the full article. 


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