Dr. Topher Fox

What is the Best Diet?

I know, we keep coming back to this question. I get asked this question frequently. I think that's cause lots of people are frustrated with the glut of conflicting information available, and want to know how to get results.

I wish there were a quick answer. I will say, when it comes to healthy lifestyle, I've be come obsessed with helping people understand what will produce the results they want in their own bodies. We all grow tired of the same advice of "just eat less and exercise more." While there is a certain truth to this statement, for most people such advice does not lead to changes that actually produce benefit. Something is missing.

Low-fat vs. Low-carb

Low-carb is an approach that works well for many people. Low-fat diets have fallen out of favor, although traditional low-fat diets are not the same as healthy low-fat diets that don't rely on processed foods (think vegetarian approaches that emphasize plants and whole grains).

So,...

Ahhh, the aroma

I come home from a day in clinic, and as I open the door from the garage I can tell there are cookies waiting in the kitchen. My wife and my daughter both love to bake, and during the pandemic they've both spent more time in the kitchen honing their craft. So on this day, I'm greeted by oatmeal raisin cookies, my personal favorite.

From the onset of social distancing in March, it didn't take long to figure out that having cookies on the counter all the time was not going to be a brilliant strategy for my health. Even when I might not be thinking I'm hungry, the sight of these treats is very hard for me to resist.

Not wanting to be a downer for my family, experimenting let me discover that as long as the cookies moved out of direct view (into the freezer is great), I greatly increase the odds that I won't succumb to temptation.

We are creatures of our environment

One of the lessons from the Blue Zones is that in healthy cultures, the environment "nudges" people toward...

When I was in medical school and learning how to perform basic tasks, like reading an ECG or a chest x-ray, I was taught very specific protocols for each process. For example, reading an ECG was RRABEIIM - rate, rhythm, axis, bundles, enlargements, intervals, ischemia, morphology. The goal was to make sure nothing was missed, nothing was inadvertently overlooked.

In other words, taking shortcuts - such as jumping to the evidence of a heart attack occurring - might mean missing a long QT interval, which could lead to serious problems if medication choice did not take this into account.

Pilots, auto mechanics, chefs, and in fact almost every profession uses checklists or SOP's in some form to make sure a vital process does not get short-circuited.

Supplements - Do They Work?

I have to admit, it seems logical to assume that if a substance is found to have health benefit in nature, it should have similar benefit if taken in the form of a supplement. But is this true?

It turns out...

Yesterday I swept out my garage in the morning. It's amazing how quickly the dust and dirt accumulates in that space. Then I swept the kitchen. We have a new dog (our pandemic addition), doubling our canine count and apparently our dog hair production. In the evening, I sat on the front porch for my final Zoom meeting of the day and couldn't help but notice the cobwebs and old blossoms accumulating around the bench and front door. Sigh. I saved that cleaning for another day.

Debris accumulates

It struck me that just like debris seems to accumulate around my house, debris accumulates in my lifestyle. It's a slow creep, but little things start to show up. A bit more liberal with snacks in the evening after dinner. A bit less attention to getting enough vegetables. Even a bit less focus on staying connected with my wife.

Does this happen to you too? I suspect it does. And just like our homes need a periodic sweeping and dusting, our lifestyle choices would likely benefit from periodic...

"Eat breakfast like a king, lunch like a prince, and dinner like a pauper."

It's likely you've heard this statement before. Results from a new study add additional support for the idea that this might be the way the human body was designed to eat.

Bigger dinners may increase risk of metabolic disease

Researchers analyzed data from the NHANES nutrition survey, specifically from almost 4700 people with diabetes. Based on food recall questionnaires performed on 2 separate occasions, they broke people into 5 groups based on the amount of food eaten at dinner compared with breakfast.

What they found was that compared with the group the ate the least at dinner, the group that ate the most had an increased risk of diabetes-related mortality (1.9 times greater risk) and heart disease-related mortality (1.7 times). 

The authors of the study also created risk models based on their data, and concluded that:

• Moving 5% of energy intake from dinner to breakfast could reduce the risk of...

Is this food healthy?

Before the pandemic, I ordered a latte from a local barista. In our exchange, the barista mentioned I might like to try it with coconut milk, because it's "healthier than cow's milk." Whether it's a blessing or a curse I haven't decided, but statements like these catch my attention. Where does this claim come from? Is it true? What is the evidence that supports this claim?

With all of us basically trapped at home these days because of COVID-19 and social distancing, many of us have much more time to spend online. Of course we want to stay healthy, even though the world seems like it got turned upside down, so seeking nutrition advice is common. And in the online world, there is no shortage of nutrition claims! But alas, online there is a great shortage of evidence.

Let's discuss what comprises good nutrition, emphasizing a few concepts that you will hopefully find useful.

The hero's body

Last week I wrote about how The World Needs You to Be a Hero. I believe...

Where does your mind go when you eat?

I heard this question recently when listening to the Ten Percent Happier podcast interview with Evelyn Tribole, one of the developers of the intuitive eating. I have to admit, when I heard the question my first thought was, "huh, I'm not sure."

How about you? Where does your mind go when you eat?

Let's start with a story...

My low point in my relationship with food occurred just before my 15th birthday. I so badly wanted to fit in, to be popular. Somehow in my mind I began to believe that if I were only a bit skinnier I would get what I wanted.

From 125 pounds, I dropped roughly 20% of my body weight while trying to keep my food-restricting and purging behaviors hidden from my parents. Although I was never diagnosed, I clearly had an eating disorder. I bottomed out just under 100 pounds.

Fortunately I somehow "snapped out" of this phase after about 6 months. While my weight returned to normal, I've maintained a complex relationship with...

James' system was breaking

It was too much for James*. His father was ill, and he was travelling back east frequently to help with his father's healthcare. Combined with his business travel, lots of stress, and the difficulty he faced finding the right foods on the road, it was just way to hard for James to eat well and keep his blood sugar down. He was feeling tired, frustrated, and ashamed.

About 3 years ago James found great success controlling both his blood sugar and his weight by following a ketogenic diet. He'd lost over 50 pounds, and when everything was ticking just right, all of his blood sugar numbers were excellent. He'd even been able to stop one of his diabetes medicines. And he felt really good.

The problem was that he needed to devote a fair amount of effort to keeping on track. Shopping for groceries ahead of time, packing lunches, and keeping his stress down helped him stay on track. When life was "normal," this was all very manageable.

However, with all the...

Ready, Set...Fizzle

Karl* wants to get back into the habit of running regularly. He's gained about 10 pounds over the last 2 years, and where he used to regularly hit the trails about 5 times weekly, lately he's "just not motivated" to get out the front door. 

Do you have anything like this in your life? Do you have a habit or routine you'd like to start, but either you just can't seem to get traction, or you start but find the habit impossible to maintain?

I certainly do. Let me give you a personal example. I've always wanted to become a "journaler," routinely writing about my days, what I'm learning, what challenges I'm facing, memorable events, interesting conversations, and the like. I've heard it's helpful for learning and progressing past challenges, and can be good for dealing with stress. I've tried several times to make journaling a habit, but I've never been successful. I've never been able to make it stick.

Contrast that with my morning "wake up" exercise routine. I...

Confession Time

My 15-year-old son has a metabolism like a hummingbird. It seems that if he doesn't eat every 2 hours he's likely to waste away. And because of this incredibly fast metabolism, he can get away with less than optimal food choices without showing any adverse effects.

It was therefore no surprise when I found a half eaten box of hot tamales, those little spicy cinnamon candies, in our pantry over the weekend.

You may recall that it's been about 2 months since I did my own Added Sugar Audit and took the majority of added sugar out of my own diet. However, I'm not militant about following this 100% and I do allow the occasional treat. And I really used to love hot tamales. So it seemed no big deal when I decided to have a couple while reading on Saturday.

Release the Beast

Apparently I still have a sugar fiend inside me, cause after those first two little candies, I couldn't stop thinking about hot tamales. I knew there were more. And two by two by two I kept going back...