Category Archives: Health

Health Mongering – Widening the Diagnostic Boundaries of Health and Normality

To make better sense of what Health Mongering is, you have to know about “disease mongering.”

Disease mongering is what some people refer to as “selling sickness.” It’s the term used to describe the current phenomenon of the spread of more and more diseases to diagnose at increasing rates. This, in turn, in my opinion, makes people feel they are not healthy or normal; that they have a disorder that needs treatment.

I am actually a medical doctor who began practicing as a general practitioner or “family doctor,” as it is known in America. However, my experiences led me to question the attitude surrounding traditional medicine, particularly with disease mongering. I then started to look deeper into our concept of health and well-being, which in turn, cultivated my interest in the psychological aspects of health.

Since my particular interest is in psychiatry, let’s look at anxiety and depression as an example of disease mongering.

The statistics of the number of people who report anxiety or are depressed has just been growing further and further each year — turning people into diseases. Years ago, maybe 1% of people were depressed but now, maybe 10% will now claim being depressed. Where did the 9% come from?

So, then, what is health mongering? Health mongering is the reverse of that!

Health mongering is talking about people’s illnesses as some normal occurrence rather than something abnormal. It’s taking all those things back and saying,

“No, those people are healthy.”

Health mongering is sending a message that what these people have is not something that’s an illness. It’s saying they actually have something healthy, which is called “feeling depressed,” and that feeling depressed is actually a very useful response to the fact that things aren’t going well. It’s part of being healthy and normal. Not abnormal and “diseased.”

In fact, the natural therapists who talk about “dis-ease” are probably closer to what i think of as normal and appropriate than a lot of what is called “disease” that is put out there.

And so, I built this site, Health Mongering, to write down my thoughts, insights and reviews about health and promote further awareness of “Health Mongering.” I look forward to what comes of this, most importantly hoping for your feedback and developing a discussion around the concept of health mongering and making it more widely known.

How can you help? Well first of all you can Facebook Like this page, Google+, Stumble, Tweet etc etc. Let others know there is a place for their ideas.

And you can also post your own comments below. Disagree, agree, is this all new and still confusing to you? Let me know below.

-Dr. Martin Russell

A New Diabetes Exercise Regimen – Is It For You?

diabetes exercise

I’ve just finished watching this BBC TV program below which was done back in February 2012.

At the start, it says that with a total of 3 minutes of intense exercise per week, you can get health benefits and one of those health benefits is to improve your sensitivity to insulin.

What that means is, for diabetics, you may have less need for insulin and low sugar levels and for normal people you may just have the chance to prevent getting diabetes.

These seem like worthwhile things so i’d certainly suggest you watch this video below.

There are two extra things as you do so.

The first is that, as it points out, exercise is not a good method for losing weight.

So if you want to exercise, go into it with realistic expectations.

The second thing however is and i’ll include a link here to a better article about the Timmons regimen for this process, the actual whole exercise itself takes 21 minutes a week not just the 3 minutes of intense exercise that it mentioned in the start.

But still, 21 minutes for an entire week is pretty good and I think you might be interested in finding out what the results exactly are. Give it a go.

The Truth About Exercise from Chef Central on Vimeo.

WARNING: As it says in the program itself, do not begin any any new exercise program without consulting your health practitioner first.

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How to Reduce Surgical Deaths By 47%

When I left standard general practice back in 2000 I recognized that the family doctor was going to be making way for the Nurses.

The growing reality is that government can’t afford to pay for doctors – nurses are much cheaper.

BUT … I also recognized that nurses – as heretical as it sounds – are probably better for the patient’s health too.

Doctor’s, as well meaning as they generally are, can be dangerous cowboys.

Nurses don’t have the mindset of doctors. They have been trained much more in the way Dr Atul Gawande recommends in this video below.

Hopefully we are seeing the rise of a ‘new medicine’ in the seeds of this talk.

[Note: the surgical part starts at 13:00, but the whole video is well worth watching.]

How Much To Pay For Running Shoes?

If you are truly trying to do the best by your feet, surely you would choose the best shoes when you are pounding the ground, or the court, or the treadmill. Wouldn’t you?

But what is ‘the best’?

And then, how much does it cost?

Well most of the opinion suggests you want a shoe that supports, and is specifically fitted for, your foot.

I believed this, until I read the books by Pete Egoscue which explained it quite simply.

If a shoe that supports your foot does its job then it replaces support that your muscles are meant to be providing.

Sure it may be more comfortable at the start, but in the long run it allows your own foot support to wilt away, leaving you MORE prone to problems than when you began.

Pete’s recommendation: wear at little shoe as possible, and get your foot aligned properly from head to toe. (For the first steps on how to do this see “Where is Your Pain?” at Pete’s website www.Egoscue.com or order his book Pain-Free.)

But that’s all nice theory.

Where is the research proof?

Well with all the money spent on shoes by consumers, health experts and shoe manufacturers, there should be a few good studies to turn to, right?

Sorry. Wrong.

In their recently published study in the British Journal of Sports Medicine, “Is your prescription of distance running shoes evidence-based?” Dr Chris Richards, and his 2 co-authors reported that…

“Since the 1980s, distance running shoes with thick, heavily cushioned heels and features to control how much the heel rolls in, have been consistently recommended to runners who want to avoid injury,” Dr Richards said.

“We did not identify a single study that has attempted to measure the effect of this shoe type on either injury rates or performance.”

In fact Dr Richards is being kind in his paper. This is objective science after all.

The media loved this story.

“Sports shoes a sham: research”

“Running down myths on jogging shoes”

“Don’t do it: pricey running shoes not worth it, study finds”

But on a blog of his called “Barefoot versus the shoe” Dr Richards is more frank when he went directly to shoe companies to ask them for the evidence. His subsequent post is titled, “Is there a running shoe mafia?”

I have been busily contacting all the major shoe companies asking them to direct me to the evidence that their distance running shoes either prevent injuries or improve performance.

The most entertaining responses so far have been from Mizuno and Puma who both claimed that whether or not their running shoes prevent injuries or improve performance was a trade secret.

Refusing to tell consumers whether or not your product works is certainly a unique marketing ploy!

Unfortunately I would have to say hiding information it is NOT a unique marketing ploy.

I would say it is an extremely consistent and pervasive marketing ploy thoughout all health products and services in particular.

The end results of Dr Richard’s enquiries?

Number of major running shoe manufacturers contacted= 18
Number who have responded= 11
Number who have provided evidence that their running shoes decrease injury rates= 0
(Number of legal threats= 0)

Here is how Dr Richard sums up the published research on the lack of any studies on the health impacts of running shoes.

He says there are only two possible conclusions…

…1) the studies have not been done or 2) their results have been suppressed because they show that modern running shoes are either of no benefit or are in fact harmful. Only the shoe manufacturers know which of these is true.

We can only hope that an entire generation of runners have not been the unwitting victims of unethical corporate behaviour.

We have consistently seen how large corporations behave when their profits are threatened by the truth. Big Tobacco, the pharmaceutical industry and asbestos manufacturers come to mind as poignant examples.

Will the multinationals who perpetuate and feed on the myth of the modern running shoe be next?

Couldn’t have put it better myself.

My self help suggestion is to walk in bare feet as often as you can, and buy shoes that you are prepared to throw away when they start to get old. Continuing to use a worn shoe simply aggravates any misalignments you already have.

Or, if you want something more sophisticated check out this post here. Just the pictures of feet that have never had shoes on are amazing.

-Dr Martin Russell

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The LAP-BAND Solution

No, this is not my line.

The LAP-BAND Solution: A Partnership in Weight Loss” is the title of a book by Australian surgeon Dr Paul O’Brien which I read with interest when one of my patients found it in a library and showed it to me.

Since the start of 2007 I have been doing public talks on the myths and facts about weight loss.

The key question I ask people at those talks is this…

What would you advise someone who wanted to lose a SIGNIFICANT amount of weight LONG-TERM?

By which I mean, what actually works to lose >10% of bodyweight for >5 years.

People will come back with all sorts of answers.

I’d love to be able to say it was some sort of psychological intervention, but I can’t (more on this later.)

The fact is that the only research-PROVEN answer is an operation.

There are a few types of stomach operations for weight loss, also known as bariatric surgery, but to my mind they fall into two camps; ones that irreversibly rearrange the gut in some way, and ones that leave your insides intact and put in some sort of stomach banding instead.

The commonest operation of the first type is called gastric bypass surgery, and it is popular in the US.

The most well-known of the gastric banding type is LAP-BANDing (TM), and it is the most popular in Australia.

In “The LAP-BAND SolutionDr Paul O’Brien is described as one of the originators of this device, and has extensive experience in academic, research, and professional areas of obesity and bariatric surgery.

The book therefore promised to be an authoratitive text, and also very pro-LAP BAND(TM). It was both of these.

It is also fairly readable which is a nice bonus too.

The best bit about finding people who have one solution to a problem, is to listen to what they say about other suggested solutions. They will tend to be scathing.

Here’s what Paul O’Brien says about drugs…

The long-term efficacy is poor and the long-term safety is unknown … the average weight loss after 1 year of orilistat [Xenical] is about 7 lb (3 kg) and for sibutramine [Meridia or Reductil] is 10 lb (4.5 kg) … these results are just not good enough.

Here’s what he has to say about weight loss by dieting and lifestyle modification…

The commercial weight-loss centers have made fortunes by promising excellent weight loss through various twists on the “lifestyle” methods, and their constant advertisements always show the classic “before and after” pictures. Invariably, the “äfter” picture is only a few months after. They do not show the “after” pictures at 5 years.

A recent comprehensive review of all the high-quality scientific studies of the options for weight control has found that there is no evidence of a durable effect from any current lifestyle intervention methods for obesity.

The only problem with this statement is that the review he refers to is in fact from 1997. Not exactly ‘recent’ in my opinion.

Still, the last 11 years haven’t proven any better studies that I am aware of either.

[The approach I recommend has not been proven in the research, and since there is no pill or expensive program, ie no money in it, I very much doubt the required multi-year studies will ever be done.]

However, my patient was already losing weight without surgery.

She gave the book to me for an entirely different reason.

She pointed out that the book talks about patients with a LAP-BAND(TM) learning to eat in an entirely different way – a way that mimics many (but not all) of the things I recommend in my non-surgical, non-dieting approach.

This is really interesting.

What if surgery is merely an extreme way to change someone’s eating behaviors?

I don’t think that is all of the effect, but I certainly think it is some of it, and maybe all of the long-term lasting results.

Why would I say this?

Because I have worked with people who lost weight with surgery, but then gained much of it back again. Their results didn’t last, and I then teach them the additional changes.

Every method of weight loss reports some successes.

Some of people even keep the weight off long-term.

A few become celebrities (eg Biggest Loser winners) and their new life then depends upon keeping the weight off. That might help as motivation.

But I think there are another group of people who discover a few other tips and habits that give them the success they need – effortlessly.

I think they discover, albeit accidentally, the non-dieting method that naturally thin people live unconsciously and automatically.

If you are over-weight enough to qualify for surgery, then it certainly is worth pursuing. In the US you might need to push to get access to LAP-BAND(TM) because apparently insurance companies are still trying to avoid paying for this, but I agree with Dr O’Brien that it is a better option than gastric surgery, if for no other reason than it is entirely reversible.

But also know that you can make many of the same changes without surgery, and all for free!

Here’s how.

Enter your name and email address for the blog notification list at the top of the page here, and you will be sent a complete audio of all the steps I suggest.

[If you are in my home town of Adelaide, then you can get the Adelaidean-only emails with the same audio here instead.]

-Dr Martin Russell

Exercise And Weight Loss… The Final Nail?

The problem with studying exercise for weight loss is that you can’t really disguise the exercise.

If exercise came in a pill you could do it.

You could get a big group of people and randomly give half the pill with exercise in it, and the other half a dummy, sugar pill that looks, smells, tastes etc just the same (aka a ‘placebo’.)

This is the scientific way to test whether pills works for weight loss.

But what about exercise?

It’s a bit hard to have a ‘dummy, sugar pill’ for physical activity. The sweating and heart-pumping bit sort of gives it away.

What this means is that for exercise for weight loss there is no way to do the gold-standard of a “double-blind, placebo-controlled” study.

Is this a problem?

Oh my wordy, YES!

Time after time it has been shown that the psychological power of medicines is a huge part of their overall effectiveness.

But is this specifically a problem for exercise and weight loss?

Well I only know of one good study that covers that question.

The researchers didn’t invent a dummy, sugar pill, but they did the next best thing as Ben Goldacre at Bad Science reports

Alia Crum and Ellen Langer from Harvard psychology department took 84 female hotel attendants in 7 hotels. They were cleaning an average of 15 rooms a day, each requiring half an hour of walking, bending, pushing, lifting, and carrying.

These women were clearly getting a lot of good exercise, but they didn’t believe it: 66.6% of them reported not exercising regularly, and 36.8% said they didn’t get any exercise at all.

The study abstract reports that one group of the hotel attendants was…

…told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General’s recommendations for an active lifestyle. Examples of how their work was exercise were provided.

Subjects in the control group were not given this information.

Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before.

As a result, compared with the control group, they [the hotel attendants who were told that their cleaning job was in fact ‘exercise’] showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index.

These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.

Now here is the really interesting bit.

HOW MUCH weight did people lose in 4 weeks merely by being thinking they were exercising?

These details are from PsyBlog

The average weight of those in the intervention group reduced from 145.5 lbs to 143.72 lbs. Over the same period the control group showed no significant change. For those of you working metric-style that’s 66.14 kg down to 65.33 kg.

That’s weight loss of almost 2 pounds, just under 1 kilogram, in just 4 weeks.

Not bad huh, for doing nothing extra?

So here’s the kicker.

Doesn’t that sound scarily similar to the 1 kilogram or 2.5 pounds in 12+ weeks that is the ENTIRE benefit of exercise anyway?!!!

[If you didn’t know this was all exercise does, see my previous post with the scientific evidence.]

Exercise, if done for weight loss alone, has suddenly become not just a minor factor, but instead an utter waste of time!

Could this really be the final nail in the exercise / weight loss coffin?

Massive industries of gyms, fitness equipment manufacturers, personal trainers etc etc hope it’s not true.

But what is there left that could resurrect exercise as a real weight loss tool?

If any one knows, I’m all ears.

-Dr Martin Russell

Exercise For Weight Loss

There is so much misinformation around about the benefits of exercise, particularly in regard to weight loss.

But let’s use a bit of common sense, shall we?

When we get active ie exercise, we use up energy.

If you don’t eat more calories, then this energy has to come from your body stores ie from fat.

So exercising more will burn off fat, and you will lose weight.

Simple, isn’t it?

NO!!!

Common sense has failed you and everyone else who pushes this line of thinking.

Don’t kill the messenger. I’m just passing on the researched reality.

Exercise has a pitifully small weight loss advantage.

Mild to moderate exercise removes an average of less than 3 pounds / 1 kilogram.

Vigorous exercise produces barely any more weight loss at 4 pounds or 1.5 kilograms.

That’s all!

Now that isn’t to say exercise doesn’t have other important. It does.

Exercise tones up your muscles, improves your heart, is a more effective mood enhancer than anti-depressants, helps you live longer, among other benefits. Pretty important if you ask me.

It’s just that exercise isn’t all it’s cracked up to be for losing weight.

This totally non-commonsense finding is systematically proven by a review of all the best literature on exercise put together by the most authoritative research collation body in the world, the Cochrane Collaboration. They are not sponsored by medical companies so they are uniquely independent reviewers.

The header of their “Exercise for overweight or obesity” review does indeed say…

We found that exercise has a positive effect on body weight

But buried lower down in the sleep-inducing technical details they admit how miserably small the weight loss is…

When compared with no treatment, exercise resulted in small weight losses across studies. Exercise combined with diet resulted in a greater weight reduction than diet alone (WMD – 1.0 kg; 95% confidence interval (CI) -1.3 to -0.7). Increasing exercise intensity increased the magnitude of weight loss (WMD – 1.5 kg; 95% CI -2.3 to -0.7).

The small weight loss is the same whether you exercise for 6 weeks, 12 weeks, 6 months or 12 months!

Not only that but no matter what type of exercise it is, the results are still unerringly the same.

You can check out the full study here.

In summary.

When someone, a gym instructor, a personal trainer, a friend, a health adviser, or even a medical authority, tells you that exercise will help you lose weight, I invite you to challenge them.

Ask them how much weight they think exercise will help you lose and watch them ignore your question, squirm, or outright invent stuff.

If they disagree with the study above then have them send their research proof to me. No one has yet.

Bust the myth-making.

Truth is that yes, on average, exercise will lose you weight. Just not much.

-Dr Martin Russell

The Diet Spring Clean

Welcome Readers, old and new … it’s Spring in the Southern Hemisphere!

Time for that famous phrase “spring clean” – making sure things are not just tidied away or half-done, but thoroughly cleaned out ready for summer.

Do you want to lose weight, a little or lots?

Do you want to stop feeling guilty, or ‘out of control’ around food?

Have you tried eating differently, and either it was great for a while but then fell back, or it simply didn’t get the results you wanted at all?

Then this is could well be for you.

But What Is A ‘Diet Spring Clean’ ???

Thanks to Radio 5AA’s Amanda Blair, who herself ended up using just such a non-dieting approach through her own trial and error, for letting me announce this on her show on Sept 24 and recommending people come here to find out more.

I’m anti-diet, because for 95+% of people they don’t work in the long term.

People who go on diets are likely to regain all the weight they lost if not more, AND end up feeling bad and guilty about their eating as well.

Not a good result!

So instead, I’m proposing a whole clean-out of your approach to your weight, what you eat (the original meaning of the word diet before “the industry” took it over), the way you eat, your mindset, and food in general – a total “diet spring clean”.

What could possibly sweep clean aside all those rules, restrictions, “healthy” hints, nutrition tips, calorie counting, and “helpful advice” that infests the media, our friends and families, and often ourselves?

Four simple steps…

  • Step 1.  When you are hungry, eat.
  • Step 2.  Eat what you want (NOT what you think you should.)
  • Step 3.  Savour every mouthful.
  • Step 4.  When you are full, stop.

That’s it. Really.

No pills. No surgery. No meal replacements, shakes, supplements, counting, points, calories, carbs etc etc etc aaaAARFGH! Stop!

Everything else is unnecessary clutter and garbage, until and unless you have these 4 steps in place.

Skeptical?

Good. I would be too.

In fact I was very skeptical when I first came across this, and I needed to know much more.

I’ve set up a way for you to learn more too. There is an interview with complete detail of the 4 steps packed into a short 27 minutes, and it’s all yours completely for FREE.

Simply put in the details so we can send you local Adelaide details including the interview. Type in your name, email address, and click Send.

Full Name:

Email Address:

-Dr Martin Russell

8 Glasses Of Water Daily. Really?

One of the most recurring health wisdoms is that you need to drink 8 glasses of water daily.

Also known as the 8×8 (8 glasses of 8 ounces each) or 2 Litres of water daily.

I seems to make sense to so many people, including bottled water sellers, that for many people it is pure common sense.

From my medical training I already liked to tell people who tried to convince me to have my 8 daily glasses, the stories of people who died from “water intoxication” including a spate of deaths in my own state from people trying to avoid the dehydration when they took the party drug, Ecstasy.

On a more personal level, this idea of 8 daily glasses of water ended for me when I watched the “Lawrence of Arabia” movie and watched an Englishman train himself to drink water like a desert-living Arab.

Of course this was a movie, not science.

But often movies are better than science for personal change anyway.

Still the idea of 8 glasses of water on a daily basis has been put to the test by researchers, and in summary – the idea doesn’t hold water.

The most complete study was this year in the Journal of the American Society of Nephrology.

The best thing about this study was that they specifically addressed the 4 key health benefits proposed for 8 glasses of water daily: that it leads to more toxin excretion, improves skin tone, makes one less hungry and reduces headache frequency.

All these had no scientific evidence of benefit, and the closest was the question of affecting appetite where two studies disagreed with each other, and the researchers considered it was worth looking into further.

Of course this all begs one question.

Where did this daily water myth come from?

An excellent review paper in 2002 in the American Journal of Physiology suggested a possible source. Professor Valtin proposed that…

…the notion may have started when the [US] Food and Nutrition Board of the National Research Council recommended approximately “1 milliliter of water for each calorie of food,” which would amount to roughly two to two-and-a-half quarts per day (64 to 80 ounces). Although in its next sentence, the Board stated “most of this quantity is contained in prepared foods,” that last sentence may have been missed, so that the recommendation was erroneously interpreted as how much water one should drink each day.

Myth busted. There is no scientific basis for a recommendation of 8 glasses of water a day.

So what’s my advice?

I say decide for yourself.

[What do you expect on a self help blog, really.]

More specifically, figure out how to know when you are thirsty. The signals for wanting water in are as clear-cut as the ones for wanting water out. We just seem to get better trained on the full bladder than we do on the parched lips.

Then have what ever you feel like; water, other fluids (even caffeinated ones), or foods that have water in them.

If adding a bit more water than that helps you with headaches, skin tone, appetite etc go for it.If it doesn’t then don’t.

-Dr Martin Russell