 I get questions from patients all the time about how to eat at a restaurant without derailing their diet. Of course cooking your own food is best because you can control everything that goes into it (not to mention you save a lot of money!) but when you want to be social and go to dinner that’s ok too!
Here is what you should order when eating at a Mexican restaurant: Appetizer:
SK  There are thousands of different supplements in the market today, and the efficacy is questionable for at least half of them. Let me start this first by saying that I believe diet and lifestyle are always best, but in cases where this is not enough, taking a supplement can certainly be beneficial.
Here is a list of supplements that I get the most questions about - and which I actually recommend you take on a daily basis. I recommend after reading this post you check out Labdoor which is a company that ranks brands based on efficacy, safety, and label accuracy. 1. Omega-3 DHA/EPA Just about everyone could benefit from taking an omega-3 DHA/EPA supplement because most are not getting enough from the diet. There are many benefits with taking DHA/EPA, the most notable being that it decreases your overall risk of cardiovascular disease (think decreased risk of stroke, heart attack, etc) because it decreases systemic inflammation, lowers triglyceride cholesterol, and decreases blood pressure . Make sure your supplement contains at least 1,000mg combined DHA/EPA. Dietary sources: Fatty fish (salmon, sardines, mackerel) are best. Other sources include fortified foods, most notably eggs - just note that this is highly dependent on what the chickens eat. So if chickens are fed flax, this means you are not getting DHA/EPA omega-3, but instead ALA omega-3. More on this below. Note: The most common and easily absorbable forms of omega 3 are DHA/EPA. Plant based sources of Omega-3 contain ALA and not DHA or EPA. ALA must be converted to DHA/EPA which your body has a hard time doing. So yes, flax and chia are a "good source of omega-3," but this is highly deceiving because your body has a hard time absorbing any of it. 2. Magnesium One of the most important minerals, magnesium is essential for bone formation and adequate vitamin D absorption. Magnesium can help with many ailments, but the most common everyday uses include prevention of headaches and migraines, constipation, pre-menstrual syndrome, and muscle aches. If you suffer from any of the above, a 400mg daily magnesium supplement may help, I recommend magnesium citrate. Dietary sources: Almonds, sesame seeds, black beans, leafy greens, and cashews. Note: There are many different types of magnesium and most are readily absorbable, but a few that you should avoid include magnesium oxide – this formulation is not easily absorbable by the body and unlikely to give you any benefit. Also avoid magnesium glutamate and aspartate which are linked to the artificial sweetener aspartame. 3. Vitamin D Vitamin D also promotes calcium absorption and is therefore a necessary factor for keeping bones strong. Very few foods contain much Vitamin D, so the best way to get is from UV light – which most of us will not get especially with the winter and with the use of sunscreen. Low levels of vitamin D are linked to headaches, depression, dizziness, and fatigue. Make sure you take Vitamin D3 and not Vitamin D2 because Vitamin D3 is much more absorbable by your body. Take at least 1,000mg per day and make sure to take with a fatty meal because Vitamin D is a fat soluble vitamin and needs fat to be absorbed. Dietary sources: Fatty fish contain the highest amount. Other foods that contain minimal amounts include eggs, cheese, and beef liver. 4. Biotin For those of you who want strong, healthy hair and nails (who doesn't?) this is a supplement worth trying. Studies have shown that getting adequate biotin helps brittle nails become stronger and firmer and makes hair stronger thereby preventing hair loss. Dietary sources: Eggs, fatty fish, meat, almonds, and beans. 5. Folate If you are a woman of child bearing age and there is a chance you could become pregnant make sure you are taking at least 600mg of folate daily. Folate protects against major birth defects (i.e. neural tube defects) because it is essential for proper brain and spine development of a growing fetus - additionally it helps protect you from developing a folate induced anemia. Folate (aka L-methlyfolate, L-5-Methyltetrahydrofolate) is the natural form found in foods and is preferred over folic acid. Folic acid is a synthetic version of folate and it must be broken down via several different steps into a compound that can be absorbed (aka its active form). This means when you take folic acid rather than folate there is a higher risk of buildup of folic acid derivatives and less vitamin being absorbed. Read more about this here. Dietary sources: Eggs, green leafy vegetables, beef liver, and fortified foods. Note: If you have the MTHFR mutation you should definitely be taking folate rather than folic acid, because this mutation means that you cannot fully break folic acid down to its absorbable form and this can lead to dangerous buildup of folic acid derivatives. 6. Probiotics There are many benefits of taking a probiotic, but the most common everyday benefits include decreasing chronic gas, bloating, diarrhea, constipation, as well as improving immune function, absorbing nutrients, and for a healthy weight. Fun fact: Microbes in your gut will eat up some that food you put into your system meaning this prevents you from absorbing calories – another reason to skip antibiotics if you can. Your gut has trillions of bacteria so aim to get a probiotic that has at least 5 billion CFU (ideally 30-50 billion), because anything less is not going to do much for you . I recommend Ultimate Flora by Renew Life. Dietary sources: Kimchi, kombucha, sauerkraut, pickles, and miso. Note: I always recommend taking a probiotic when taking antibiotics, just keep in mind there is a chance of the antibiotic deactivating the probiotic when taken together. To prevent this from happening, take your probiotic on an empty stomach and make sure it has been a couple hours since you took your antibiotic or are going to take it. 7. Lysine If you are someone who gets cold sores regularly, this may be a good option for you. Studies have shown that taking 500-1000mg of lysine daily can decrease cold sore outbreaks as well as decrease severity and duration of the outbreak. I've heard great success from many patients who take lysine, and I recommend trying if you get cold sores regularly. Dietary sources: Eggs, beans, meat, cheese, fish, and nuts. Note: At the first sign of a cold sore, contact your provider immediately to get a prescription of anti-viral medication. Prescription anti-virals, such as Valtrex, work best when taken within the first 24-48 hours of an outbreak. SK  There are over 200 different types of viruses that can cause the common cold, and you are much more likely to be infected with a virus than bacteria. Unfortunately, antibiotics do not work on viruses and your cold will just have to run its course. That being said, there are certainly many things you can take to make yourself feel better.
Here is a list of the most common cold symptoms I hear in practice and what to look for at the pharmacy to make you feel better. 1. “My nose won’t stop running” This is one of the most common symptoms associated with a cold, and can be incredibly annoying to be constantly grabbing for a tissue. Start taking a first generation histamine blocker, the most common is diphenhydramine (aka Benadryl) – yes these are marketed as allergy medication, but a side effect of these drugs is that they dry you out and will dry up that snot coming out of your nose and down your throat. Unfortunately, first generation anti-histamines can make you drowsy so best to take only at night time. Note that second generation anti-histamines ( i.e. Claritin, Allegra) do not have as much of a drying effect, but can take these during the day for possible relief. 2.“I am so stuffed up and congested” Hands-down, most effective medication for this is pseudoephedrine (aka Sudafed) . Pseudoephedrine restricts blood vessels in your nassal passages, in effect reducing the pressure of your sinuses. Unfortunately, this constriction happens to all vessels in your body and can make your blood pressure go up a couple of points and may make you feel jittery because of this - so do not take if you already have high blood pressure and also do not take right before you want to go to bed. Another effective medication for sinus pressure is a nasal steroid such as Flonase. Note that nasal steroids take about a week to see full effect, so you are unlikely to get as much of a response compared to Sudafed. Important note: Do not buy a product with phenylephrine (aka Sudafed PE), you will see this ingredient listed in any product that markets itself as a decongestant. This is the “Sudafed” that you see on the shelf that you can just walk out with without showing your ID. Phenylephrine has shown to be no more effective then placebo – and yes it will also raise your blood pressure, so not a good alternative for anyone 3. “My ears feel full” This is an extension of your inflamed sinuses - your ears feel full because your sinuses are blocked, so how do you clear your ears? Clear your sinuses. As stated above, take pseudoephedrine and/or Flonase to help clear this congestion. 4. “I have a cold and the worst part is the cough” There are a couple of different remedies for this.The American Academy of Chest Physicians recommends a combination of a first generation anti-histamine (i.e. diphenhydramine or Benadryl) PLUS a decongestant (pseudoephedrine or nasal decongestants such as Flonase). Another popular ingredient for cough is dextromethorphan which you will as the main component in Robitussin DM or Delsym. Dextromethorphan theoretically works to make you stop coughing by blocking the cough reflex in the brain. Studies have shown this to be marginally effective, and I’ve had mixed results in practice as well. Read more about this here. 5. “My cold is gone, but I still have a cough” AKA “post-infectious cough” can last up to 8 weeks after your cold goes away – 8 weeks! You can try one of the above remedies for cough, but if the cough is very irritating probably best to see your provider for an inhaler or prednisone which should make it go away quicker. Note that if it has been over 8 weeks your cough is likely due to some other cause and you should make an appointment to see your practitioner for evaluation. 6. “I'm coughing up thick phlegm” For thick gunky mucus, Guaifenesin (aka Mucinex) is the ingredient you should look for to help with this. Note that this medication needs fluids to be able to work, so you must be hydrating yourself properly. Another potential benefit of taking this medication is that is has been shown to work as an anti-cough agent. Studies have shown this medication to be possibly effective for the above, this is another medication I've had mixed results with in practice. 7. “I have body aches” Take nothing. Try light exercise, stretching, and avoid taking pain relievers. Body aches are a side effect of interferons, which are released in the presence of an infection, and whose job is to fight off the invader making you sick. In other words, body aches are a good sign because this means your body is trying to fight off the infection, let it be. Avoid taking ibuprofen because ibuprofen will block production of these virus killing cells - meaning longer duration and severity of cold symptoms for you. 8. “I had a fever of 102 this morning” Take nothing. Plenty of fluids. A fever is a normal physiologic defense mechanism by your body to kill the pathogen making you sick - the American Academy of Pediatrics stresses that fever has beneficial effects and no evidence that a fever prolongs illness or causes any neurologic effect in the future. How does a fever work to help you? The increased body temperature stimulates production of your white blood cells (ie your immune system which functions to get rid of the bug making you sick), it lowers viral replication rate, (meaning less virus in your system), and high temperatures are toxic for some of the most virulent bacteria - such as those that cause pneumonia. Bottom line, let your body do its job and avoid taking fever reducers like acetaminophen or ibuprofen. 9. “I need to get better ASAP” If you want to cut back on the length of your cold, start taking zinc gluconate now. Many studies have shown that zinc can decrease the length of your cold by 4-7 days – that’s like a 50% reduction in the length of your symptoms! If you are going to take anything for your cold, take zinc and take zinc gluconate specifically as it has shown to be the most absorbable formulation - the zinc needs to coat the throat where the virus normally lies. Also make sure to take in lozenge form as pills or drinks with zinc are less effective. Read more about this here. Honorable mention: Vitamin C has also shown to be able to shorten the length of your cold, but there are limited studies on this, and the studies that do show a positive effect show only a ½ day reduction in the length of your cold when you take Vitamin C. SK |
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