Friday, September 7, 2018

Hidden Sugars and the Impact on Your Health


sugary cereal














Hi, I am Eric Sodicoff, M.D. Primary Care Internal Medicine doctor and Obesity Medicine Specialist at PMA Medical Specialists. I frequently query my patients about how much sugar they consume throughout the day. Happily, I have discovered many people are making some efforts to cut out sweets. But let’s back up a second and discuss why too much sugar is a problem. 


First, what is sugar anyway? 

Common table sugar, scientifically known as sucrose is a disaccharide. That means it is composed of two basic sugar units. In the case of sucrose, those are glucose and fructose. Blood sugar is only glucose; it’s what diabetics are checking when they prick their fingers. It isn’t very sweet. White rice for example is almost pure glucose, and most people don’t consider it sweet at all. Glucose circulates throughout the body 24/7. Cells throughout the body can use it as fuel. Red cells use it as their only source of energy and it powers most people’s brains most of the time. Glucose molecules get strung together and stored in the liver to be used between meals. The liver also can convert protein into glucose in a pinch.

Fructose, on the other hand, is the sweet stuff. It makes sugary soda, candy, cakes and ice cream so irresistible. Fructose comes from plants such as sugar cane, sugar beets, fruit, and since the 1970s, artificially and cheaply synthesized from corn. This is known as High-Fructose Corn Syrup. Fructose, either naturally sourced or synthetic, presents something of a challenge to our bodies. It must be converted to glucose in order to be used and there is only one location in the body that does that: the liver. The liver’s capacity to manage fructose can be overwhelmed by eating or drinking too much of it. When fructose is over consumed it becomes liver fat and then belly fat too. Fatty liver is presently an epidemic and is overtaking viral hepatitis and alcoholism as the main cause of liver failure. Fructose is very fattening.

How much sugar is too much? 

There are different answers. The American Heart Association sets the limit at 24 grams per day for women and 36 for men. The World Health organization say 50 grams. How much is that you might be asking? Just one serving of strawberry yogurt has 26 grams of sugar. Yup, just one so called healthy yogurt for breakfast is enough to break through a woman’s daily sugar budget. It’s not even considered a dessert!  Processed foods that aren’t even particularly sweet contain huge amounts of added sugars too. The processed food manufacturers have discovered people really, really love sugar and buy more when it is added to products. It pops up in unlikely places even foods that usually aren’t sweet at all.

-Check the labels and you’ll find it in jarred spaghetti sauce, whole wheat bread, ketchup and peanut butter.
- A breakfast bar made with "real fruit" and "whole grains" lists 15 grams
of sugar.
 - A single cup of bran cereal with raisins, in a box advertising "no high-fructose corn syrup," contains 20 grams of sugar per serving.
 - A cranberry/pomegranate juice product, also advertising "no high-fructose corn syrup" and "100% Vitamin C," contains 30 grams of added sugar per 8 oz. serving. Some of the sugar is naturally occurring, but some of it has been added.

 74% of all supermarket groceries have added sugar!  How does one avoid the epidemic of sugary foods? This is how I do it. Just eat real food. Avoid ultra-processed refined foods. They have long complicated ingredient lists that invariably contain something bad. There are at least 61 different synonyms that food manufacturers use that all mean sugar (see sugar names list below). As a general rule, avoid the center aisles of the supermarket.

Eat Real Foods

Choose real food that comes from a field, forest or sea. It doesn’t pass through a factory first. Real food is single ingredient. Real food doesn’t require reading an ingredient list because it’s whole and unprocessed. That being said, some fruit such as bananas and grapes do have high natural sugar content. If you are diabetic or are struggling with weight it is best to curb consumption of those as well. Above all else cut out all sugary drinks: Soda, all juice, sport drinks, sweetened teas and sweetened coffees. Many of my patients have made a big dent in their weight problems by only nixing sugary drinks.


61 Names for Sugar


       Agave nectar--- Sorry Dr. Oz.
       Barbados sugar
       Barley malt
       Barley malt syrup
       Beet sugar
       Brown sugar
       Buttered syrup
       Cane juice
       Cane juice crystals
       Cane sugar
       Caramel
       Carob syrup
       Castor sugar
       Coconut palm sugar
       Coconut sugar
       Confectioner's sugar
       Corn sweetener
       Corn syrup
       Corn syrup solids
       Date sugar
       Dehydrated cane juice
       Demerara sugar
       Dextrin
       Dextrose
       Evaporated cane juice
       Free-flowing brown sugars
       Fructose
       Fruit juice
       Fruit juice concentrate
       Glucose
       Glucose solids
       Golden sugar
       Golden syrup
       Grape sugar
       HFCS (High-Fructose Corn Syrup)
       Honey--Yup, honey is basically bee sugar, not better than any other type.
       Icing sugar
       Invert sugar
       Malt syrup
       Maltodextrin
       Maltol
       Maltose
       Mannose
       Maple syrup
       Molasses
       Muscovado
       Palm sugar
       Panocha
       Powdered sugar
       Raw sugar
       Refiner's syrup
       Rice syrup
       Saccharose
       Sorghum Syrup
       Sucrose
       Sugar (granulated)
       Sweet Sorghum
       Syrup
       Treacle
       Turbinado sugar
       Yellow sugar
    Eric J. Sodicoff, MD


Further reading about sugar:
Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease
by Robert H. Lustig

Fun documentary:

That Sugar Film
Amazon Video ~ Damon Gameau


Friday, August 10, 2018

A Visit to the ER May NOT Be the Best Option



Call Us before going to the ER

Chest pain, loss of consciousness, heat stroke, severe bleeding and other serious and life-threatening illnesses always need the fastest and most advanced medical care available.  Without question, that means immediate treatment in an Emergency Room or Urgent Care facility.  But, what about cuts, scrapes, minor bleeding, a fever, ear infection, vomiting or nosebleed?  When these and other    non-extreme emergencies happen, we suggest that you “Call Us First.”

Why Call Us First?

As one of the area’s most-respected primary and specialty physician groups, we offer a number of services to help patients get the care they need, without an unnecessary visit to the ER or Urgent Care.  In doing so, we hope to help patients avoid high ER visit cost, longer wait times, and exposure to more serious illnesses that an ER visit can entail.

The Call Us First effort invites current patients to Call Us First for non-life-threatening emergencies.  Calls will be answered 24 hours a day, 7 days a week and a staff member will help the caller determine if an ER or Urgent Care visit is necessary.  If not, we can schedule a same-day appointment at the nearest PMA office.  The Call Us First program is just one of the ways we fulfill our commitment to exceptional patient care.  To learn more about PMA Medical Specialists and the Call Us First program, visit pmadoctor.com.


Monday, July 16, 2018

Back to School and Sports Physicals Help to Keep our Children Healthy




Annual Physical Exams

Annual physical exams are vitally important for children of all ages, whether it's an annual back-to-school physical or sports exam. A lot can change in a child's health over the course of one year, and an annual physical exam allows a provider to monitor the health and development of your child. 

Annual physicals also ensure that your child is up-to-date with their vaccines which help to protect against various diseases. Completing the various recommended immunization series protects not only your child, but the community as well. 


Sports Physicals

Sports physicals help to prevent many injuries and identify current conditions that might make it unsafe to participate in the planned sports activity.  


Both back-to-school and sports physicals begin with reviewing the family’s health history, followed by the patient’s personal health and immunization history. 

What's included in a Physical?

The actual physical examination typically includes: 

  • Examining the Ear, Nose and Throat
  • Vision testing
  • Height and Weight measurements
  • Listening to heart and lungs
  • Pulse and Blood Pressure checks
  • Checking for abnormalities by examining parts of the body
  • Observing range of motion, joint flexibility, spinal alignment and posture
  • Testing motor skills, reflexes, coordination and strength
  • Hernia check

Be sure to schedule an annual back-to-school physical or sports exam today, so that your child is ready when back-to-school rolls around!     



Monday, May 14, 2018

Healthy Habits Affect Your Blood Pressure


Risk and Blood Pressure


Do you know the signs of high blood pressure?

It’s a trick question — because HBP, also known as the “silent killer,” typically has no symptoms. That’s why it’s so important to check your blood pressure and take steps to control your numbers.

May is National High Blood Pressure Education Month. Check your blood pressure and find out where your numbers fall on the new American Heart Association blood pressure chart — and make changes that matter. 
American Heart Association blood pressure chart


Adjusting your habits now — like moving more and reducing sodium — can help you avoid a high blood pressure diagnosis and stay strong for the future. And by tracking your BP at home, you’ll be the first to see how your healthy new habits are affecting your numbers.

These health tips are not a substitute for speaking to a qualified health-care provider, talk to your primary care physician or Cardiologist today. Patients Matter Always!

Thursday, May 10, 2018

New Blood Pressure Guidelines - 130 Is Too High




130 is bad for blood pressure














Under new American Heart Association guidelines announced in 2017, the definition of high blood pressure is lower, and the number of U.S. adults considered to have high blood pressure has increased. Younger people are impacted the most, as high blood pressure has tripled among men under 45 and doubled among women in the same age group.


Know Your Numbers


High blood pressure is often symptomless and can be a “silent killer” at any age — and the only way to know your risk is to have your blood pressure checked. 

This May, during National High Blood Pressure Education Month, do yourself and your family a favor: 


  1. Have your blood pressure checked and review the categories at heart.org/bplevels to  understand what your numbers mean. 
  2. Be counted as someone who knows their numbers at heart.org/bplevels. Click on the “I’ve Checked My Blood Pressure” button! 
  3. Encourage the people you care about to know their numbers, too.
These health tips are not a substitute for speaking to a qualified health-care provider, talk to your primary care physician or Cardiologist today. Patients Matter Always!

Tuesday, May 8, 2018

Healthy Habits will help to Keep Your Blood Pressure Low


Moderation for Low Blood Pressure














Even if your numbers are within the normal range on the new American Heart Association blood pressure chart, May is the perfect month to check your blood pressure and give your lifestyle a checkup. Blood pressure naturally rises as you age, so consistency is key in keeping it low. 

We’d like to encourage you to kick-start some healthy habits during National High Blood Pressure Education Month to help keep your BP low.


5 Tips to Help Lower Blood Pressure

  • Eat a heart-healthy diet 
  • Cut out excess sodium 
  • Limit alcohol intake 
  • Avoid cigarettes - QUIT NOW 
  • Make exercise a regular part of your routine  
These 5 health tips are not a substitute for speaking to a qualified health-care provider, talk to your primary care physician or Cardiologist today. Patients Matter Always!




Tuesday, April 10, 2018

Home Health Care and Care Management


Home Health Care for Elderly

The Chronic Care Management team assists in building a team-based approach with the Physician, Home Health Agency, Patient and Family. We strongly encourage self-management skills and assist in goal setting to help the patient manage their condition.  

Our Home Health Care goals are to: 

  • increase the patient’s quality of life.
  • decrease Hospital and Emergency Department visits
  • decrease medical expenses

Care Management Services

Care Management team members work very closely with local Home Health Agencies when patients are found to be in need of services. Services include, but are not limited to: Nursing Services, Physical & Occupational Therapy Services, Wound Care Services, Social Work Services, and overall monitoring of health status.

We look at the following criteria when providing patients information on Home Health Agencies to select from:
  1. Are they able to keep patients at home versus sending them to a hospital
  2. What is the patient spend (cost to the patient)?
  3. Are they known for excellent patient quality based on Medicare Star ratings?
  4. How are they at communicating with the Chronic Care Management team members and physician’s office?

When do we recommend Home Health Care?

  1. After a recent hospitalization, rehab stay
  2. Recent medication changes or misunderstanding of medications
  3. Overall decline in function
  4. Patient assessment finds the need for Home Health Care (some examples are: recurrent falls, dementia/confusion, limited mobility, weakness that limits the ability to safely ambulate long distances beyond the home)

    Home Health Agencies work with our Care Managers on a regular basis and communicate their findings directly to the Care Manager who will then address the need/issue in a timely fashion.

    If you feel that you or your loved one meet any of the above recommendations or would like more information, feel free to reach out a member of the Care Management Team or speak with your Physician today!