Posted in food, Health, news

Gummy Vitamins and Multivitamins Found to Have Wrong Amounts of Essential Nutrients

An analysis by a consumer watchdog group found 80% of gummy vitamins to either give too much or lack essential nutrients needed to be consumed daily. compared multiple multivitamin brands, including tablet form, and found 46% of them to have inconsistencies in their vitamin and mineral content.  According to their website:

  • 12 multivitamins contained much less (as low as 24%) or much more (as high as 157%) vitamin A, vitamin D, folate from folic acid, and/or calcium than listed on labels.
  • Many supplements exceeded upper tolerable intake levels — possibly doing more harm than good.
  • Gummy vitamins were especially problematic: 80% failed testing
  • Four multivitamins in tablet form failed to break apart within the required time. One needed 3 hours to fully disintegrate, 5 times the time allowed — jeopardizing the absorption of its ingredients.

Gummy vitamins are especially popular due to their taste, ability to chew rather than swallow, and their optics as they look like gum drops.

According to, gummy vitamins are more difficult to manufacture with precision, hence discrepancies could potentially occur with vitamin content.  Moreover, in order to make a vitamin taste like candy, artificial fillers need to be utilized.  These could potentially alter nutrient content or give the consumer too much sugar.

This isn’t the first time vitamins, in their various forms, have been found to lack the accurate description of their nutritional content.

As cited above, consuming more vitamins and minerals than needed could cause potential health complications. And if vitamin tablets don’t dissolve properly once ingested, distribution of the vitamins and minerals can’t be accomplished correctly.

According to, the following is the Recommended Daily Allowance (RDA) for adults age 19 and up.

vitamin woman.jpg

19-50 Yrs
>50 Yrs
19-50 Yrs
>50 Yrs
RDA Vitamins (Per Day)
vitamin A – retinol 900 µg 900 µg 700 µg 700 µg
vitamin C – ascorbic acid 90 mg 90 mg 75 mg 75 mg
vitamin D  #1 #5 5* µg 10* µg 5* µg 10* µg
vitamin E 15 mg 15 mg 15 mg 15 mg
vitamin K 120* µg 120* µg 90* µg 90* µg
vitamin B1 – thiamin 1.2 mg 1.2 mg 1.1mg 1.1 mg
vitamin B2 – riboflavin 1.3 mg 1.3 mg 1.1 mg 1.1 mg
vitamin B3 – niacin 16 mg 16 mg 14 mg 14 mg
vitamin B5 – pantothenic acid 5* mg 5* mg 5* mg 5* mg
vitamin B6 – pyridoxine 1.3 mg 1.7 mg 1.3 mg 1.5 mg
vitamin B12  #2 2.4 µg 2.4 µg 2.4 µg 2.4 µg
biotin 30* µg 30* µg 30* µg 30* µg
choline 550* mg 550* mg 425* mg 425* mg
folate – folic acid  #3 400 µg 400 µg 400 µg 400 µg
Recommended Daily Allowances for Minerals
calcium 1000* mg 1200* mg 1000* mg 1200* mg
chromium 35* µg 30* µg 25* µg 20* µg
copper 900 µg 900 µg 900 µg 900 µg
fluoride 4* mg 4* mg 3* mg 3* mg
iodine 150 µg 150 µg 150 µg 150 µg
iron 8 mg 8 mg 18 mg 8 mg
magnesium  #4 400/420 mg 420 mg 310/320 mg 320 mg
manganese 2.3* mg 2.3* mg 1.8* mg 1.8* mg
molybdenum 45 µg 45 µg 45 µg 45 µg
phosphorus 700 mg 700 mg 700 mg 700 mg
selenium 55 µg 55 µg 55 µg 55 µg
zinc 11 mg 11 mg 8 mg 8 mg
potassium 4.7* g 4.7* g 4.7* g 4.7* g
sodium  #5 1.5* g 1.3* g 1.5* g 1.3* g
chloride  #5 2.3* g 2.0* g 2.3* g 2.0* g


Food and Nutrition Board (FNB) Recommendations (#)
Food and Nutrition Board Recommended RDA Chart
#2 : As 10 to 30 percent of older people may malabsorb food-bound B12, FNB advises those older than 50 years to meet their Recommended Daily Allowances for it by consuming foods fortified with B12 or a supplement containing B12.

#3 : In view of evidence linking folate deficiency with neural tube defects in the fetus, FNB recommends that women capable of becoming pregnant consume 400 µg of folate from supplements or fortified foods, in addition to intake of food folate from a varied diet.

#4 : Men from 31 to 50 need slightly more magnesium (420 mg) than those from 19 to 30 years old (400 mg). Women from 31 to 50 also need slightly more magnesium (320 mg) than those from 19 to 30 years old (310 mg).

#5 : Adults over 70 years need slightly different levels of vitamin D (15µg), sodium (1.2g), and chloride (1.8g).


Recommended Daily Allowances for Pregnancy / Lactating Mothers
NUTRIENT Pregnancy
14-18 Yrs
19-50 Yrs
14-18 Yrs
19-50 Yrs
Recommended Daily Allowances for Vitamins
vitamin A – retinol 750 µg 770 µg 1200 µg 1300 µg
vitamin C – ascorbic acid 80 mg 85 mg 115 mg 120 mg
vitamin D  #1 5* µg 5* µg 5* µg 5* µg
vitamin E 15 mg 15 mg 19 mg 19 mg
vitamin K 75* µg 90* µg 75* µg 90* µg
vitamin B1 – thiamin 1.4 mg 1.4 mg 1.4 mg 1.4 mg
vitamin B2 – riboflavin 1.4 mg 1.4 mg 1.6 mg 1.6 mg
vitamin B3 – niacin 18 mg 18 mg 17 mg 17 mg
vitamin B5 – pantothenic acid 6* mg 6* mg 7* mg 7* mg
vitamin B6 – pyridoxine 1.9 mg 1.9 mg 2.0 mg 2.0 mg
vitamin B12 2.6 µg 2.6 µg 2.8 µg 2.8 µg
biotin 30* µg 30* µg 35* µg 35* µg
choline 450* mg 450* mg 550* mg 550* mg
folate – folic acid  #3 600 µg 600 µg 500 µg 500 µg
Recommended Daily Allowances for Minerals
calcium 1300* mg 1000* mg 1300* mg 1000* mg
chromium 29* µg 30* µg 44* µg 45* µg
copper 1000 µg 1000 µg 1300 µg 1300 µg
fluoride 3* mg 3* mg 3* mg 3* mg
iodine 220 µg 220 µg 290 µg 290 µg
iron 27 mg 27 mg 10 mg 9 mg
magnesium  #6 400 mg 350/360 mg 360 mg 310/320 mg
manganese 2.0* mg 2.0* mg 2.6* mg 2.6* mg
molybdenum 50 µg 50 µg 50 µg 50 µg
phosphorus 1250 mg 700 mg 1250 mg 700 mg
selenium 60 µg 60 µg 70 µg 70 µg
zinc 12 mg 11 mg 13 mg 12 mg
potassium 4.7* g 4.7* g 5.1* g 5.1* g
sodium 1.5* g 1.5* g 1.5* g 1.5* g
chloride 2.3* g 2.3* g 2.3* g 2.3* g


According to, the following is the Recommended Daily Allowance (RDA) for infants and children.

NUTRIENT 0-6 mths 7-12mths 1-3 yrs 4-8 yrs
RDA Vitamins (Per Day)
vitamin A – retinol 400* µg 500* µg 300 µg 400 µg
vitamin C – ascorbic acid 40* mg 50* mg 15 mg 25 mg
vitamin D  #1 5* µg 5* µg 5* µg 5* µg
vitamin E 4* mg 5* mg 6 mg 7 mg
vitamin K 2.0* µg 2.5* µg 30* µg 55* µg
vitamin B1 – thiamin 0.2* mg 0.3* mg 0.5 mg 0.6 mg
vitamin B2 – riboflavin 0.3* mg 0.4* mg 0.5 mg 0.6 mg
vitamin B3 – niacin 2* mg 4* mg 6 mg 8 mg
vitamin B5 – pantothenic acid 1.7* mg 1.8* mg 2* mg 3* mg
vitamin B6 – pyridoxine 0.1* mg 0.3* mg 0.5 mg 0.6 mg
vitamin B12 – cyanocobalamin 0.4* µg 0.5* µg 0.9 µg 1.2 µg
biotin 5* µg 6* µg 8* µg 12* µg
choline 125* mg 150* mg 200* mg 250* mg
folate – folic acid 65* µg 80* µg 150 µg 200 µg
Recommended Daily Allowances for Minerals
calcium 210* mg 270* mg 500* mg 800* mg
chromium 0.2* µg 5.5* µg 11* µg 15* µg
copper 200* µg 220* µg 340 µg 440 µg
fluoride >0.01* mg 0.5* mg 0.7* mg 1* mg
iodine 110* µg 130* µg 90 µg 90 µg
iron 0.27* mg 11 mg 7 mg 10 mg
magnesium 30* mg 75* mg 80 mg 130 mg
manganese 0.003* mg 0.6* mg 1.2* mg 1.5* mg
molybdenum 2* µg 3* µg 17 µg 22 µg
phosphorus 100* mg 275* mg 460 mg 500 mg
selenium 15* µg 20* µg 20 µg 30 µg
zinc 2* mg 3 mg 3 mg 5 mg
potassium 0.4* g 0.7* g 3.0* g 3.8* g
sodium 0.12* g 0.37* g 1.0* g 1.2* g
chloride 0.18* g 0.57* g 1.5* g 1.9* g


Recommended Daily Allowances for Older Children (9 to 18 Years)
9-13 Yrs
14-18 Yrs
9-13 Yrs
14-18 Yrs
RDA Vitamins (Per Day)
vitamin A – retinol 600 µg 900 µg 600 µg 700 µg
vitamin C – ascorbic acid 45 mg 75 mg 45 mg 65 mg
vitamin D #1 5* µg 5* µg 5* µg 5* µg
vitamin E 11 mg 15 mg 11 mg 15 mg
vitamin K 60* µg 75* µg 60* µg 75* µg
vitamin B1 – thiamin 0.9 mg 1.2 mg 0.9 mg 1.0 mg
vitamin B2 – riboflavin 0.9 mg 1.3 mg 0.9 mg 1.0 mg
vitamin B3 – niacin 12 mg 16 mg 12 mg 14 mg
vitamin B5 – pantothenic acid 4* mg 5* mg 4* mg 5* mg
vitamin B6 – pyridoxine 1.0 mg 1.3 mg 1.0 mg 1.2 mg
vitamin B12 – cyanocobalamin 1.8 µg 2.4 µg 1.8 µg 2.4 µg
biotin 20* µg 25* µg 20* µg 25* µg
choline 375* mg 550* mg 375* mg 400* mg
folate – folic acid  #3 300 µg 400 µg 300 µg 400 µg
Recommended Daily Allowances for Minerals
calcium 1300* mg 1300* mg 1300* mg 1300* mg
chromium 25* µg 35* µg 21* µg 24* µg
copper 700 µg 890 µg 700 µg 890 µg
fluoride 2* mg 3* mg 2* mg 3* mg
iodine 120 µg 150 µg 120 µg 150 µg
iron 8 mg 11 mg 8 mg 15 mg
magnesium 240 mg 410 mg 240 mg 360 mg
manganese 1.9* mg 2.2* mg 1.6* mg 1.6* mg
molybdenum 34 µg 43 µg 34 µg 43 µg
phosphorus 1250 mg 1250 mg 1250 mg 1250 mg
selenium 40 µg 55 µg 40 µg 55 µg
zinc 8 mg 11 mg 8 mg 9 mg
potassium 4.5* g 4.7* g 4.5* g 4.7* g
sodium 1.5* g 1.5* g 1.5* g 1.5* g
chloride 2.3* g 2.3* g 2.3* g 2.3* g

For more on this story see here.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in Entertainment, food, Health, news

The Office Holiday Party: Do’s and Don’ts

Above John Shaffer and Daliah Wachs at a KDWN Holiday Party.


The work holiday party is one of the most anticipated events of the year.  Free food, free drink and for 4-6 hours you can be in the same room as your boss without any risk of being told “you’re fired”.  But…..many of us make mistakes, HUGE mistakes, while tipsy and letting our guard down could be the biggest career buster ever.  Plus, there are some missed opportunities the office Holiday party offers to make your overall work life better. So let’s get right down to it.


1. Flirt with the boss

Your superior in any office setting should be the last one you try to cuddle up to.  Good management knows there is ALWAYS someone watching and, these days, recording on their phone, so they do not want to be seen in an uncomfortable situation, appearing to be flirting with you.  You can complement them, sure, but hands off!

2. Drink too much

This gets us all into trouble.  Yes the alcohol is usually free and a flow’n but this will lead to your downfall.  Your guard is down, you become flirty, you blurt out secrets, those that the whole team knows but would be never caught dead saying……and sometimes the clothes come off on the dance floor.  Please drink in moderation.

3. Drive drunk

Never, never, never plan on driving that night if you plan to drink.  Car Service, Uber, Taxi, designated drivers are a must.

4.  Let anyone tag you on Facebook

The next morning will be full of regret as it is, no need to cement it in infamy.

5. Skip on the whole soiree

Holiday season is swarming with good parties. And chances are there are two other parties calling your name that same night.  Make sure you hit the office party FIRST.  You can get too distracted or drunk at the other parties such that you never make it across town, safely.  Again, don’t drive if you plan to drink.




6.  Take the mic

This is where I take a fall (as you can see above).  A microphone is sitting up on the stage, waiting, just waiting for someone to grab it and spout out some one liners.  I fear getting close to it until the head boss makes opening remarks. Then I feel the need to interrupt him and “take over from here”.  Let your boss have the mic.  He/She’s the head honcho, let them have their glory.  They’re paying for the party……

7.  Gossip

Never, never use this opportunity to gossip. That’s what the staff lounge is for.  It’s a positive night. Don’t bring negativity.

8.  Tell off the office bully


You may feel protected with all your work peeps surrounding you but one day he/she will get you alone and ….payback.  Instead wish them some holiday cheer…..may bring out the good in the jerk.

9.  Sleep with your coworker

Everyone is watching you so your hopes of secretly hooking up is already circulating social media.  If you want to begin a relationship that’s fine, but hoping its on the down low will never happen.  People at parties pretend to be distracted, but someone is always watching.

10.  Discuss work

Never, never, never discuss work at the office Holiday party.  And please don’t ask for a raise!!! Will never happen. Even if your boss is drunk, he will forget about it by the New Year.

11.  Don’t be quiet

Being anti-social is not the way to go either. Mix, mingle and look like you’re having a good time. Even if you’re not.  If you have to leave early due to boredom, blame it on diarrhea.  This may be the only party you EVER get invited to.


1. Thank the boss and the planning committee

Even though they may roll their eyes at you as you complement them (since anyone volunteering for a planning committee in the first place probably isn’t your best bud at work), they secretly enjoy the complement.

2.  Get up and sing (if you can sing)

This is the only time your boss and team will see your other talents.  Sans beer bonging, show off your talents….dance moves, pipes, even fashion sense…. if you’re good.

3.  Let the boss know you’re happy at work

Don’t kiss up, but as you thank him, let him know you love your job.  This will be a take home message that can go a long way.

4. Tip the bartender

This is a no brainer.

5. Have fun!!

It’s the holidays!  Let’s celebrate!! Truly the most wonderful time of the year!!!
xmas party 2017.jpg
John Shaffer, Daliah Wachs, and Tom Humm

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician

Posted in Health, news, food

Mouthwash Use May Increase Risk of Diabetes

A new study finds twice daily mouthwash use increased risk of pre-diabetes and diabetes by 55%.

Researchers reviewed the data of 948 individuals who were either obese or overweight, apart of the San Juan Overweight Adults Longitudinal Study in Puerto Rico, and found over the three-year follow-up:

  • Participants who used mouthwash at least twice daily had 55 percent significantly increased risk of developing pre-diabetes or diabetes over a 3-year follow-up compared to less frequent users, and 49 percent higher risk compared to non-users of mouthwash
  • 30% of those studied developed either pre-diabetes or diabetes by the end of the period.

Now according to the study, 65% of those enrolled had poor dental health, so they might have been more inclined to using the mouthwash.  And since diabetes is a risk factor for periodontal disease, it’s no surprise that those with poor gums and teeth, due to diet and/or poor circulation, would be more at risk for diabetes.

Many use mouthwash to fight germs and plaque, freshen breath, and with fluoride to prevent cavities.  However, it does not replace bushing and flossing and its use should only complement good dental hygiene.

So why would mouthwash use increase diabetes risk?

Even though this study only found an association with those who mouthwash frequently and diabetes risk, the following could contribute to this finding:

  • Many sugary foods cause gum and tooth disease, hence those needing mouthwash more frequently may have poor diet choices.
  • High fat foods and eating large quantities, habits that contribute to diabetes, may leave one with frequent GERD, gastroesophageal reflux disease, which causes bad breath.
  • Mouthwash may kill some of the good bacteria that help protect against obesity and diabetes.


A review of diabetes

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Type I vs. Type II vs. Type IIIc Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

Type IIIc diabetes may occur in individuals who suffered damage to their pancreas.  Inflammation/infection of the pancreas (pancreatitis), a pancreatic tumor, or surgery affecting the pancreas may destroy the beta cells that produce insulin.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.


What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.




Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician


Posted in food, Health, news

Vietnam Vets May be Unknowingly Battling Deadly Parasites

Image above from Veronidae/Medical News Today

A study finds many Vietnam veterans may have contracted liver flukes decades ago that could now cause pancreatitis, liver disease and/or bile duct cancer.

The Department of Veterans Affairs commissioned a study that looked at bile duct cancer and liver flukes that may have been ingested by veterans while on tour in Southeast Asia during the Vietnam War.

This was in response to a story reported by the Associated Press in which 700 cases,of cholioangiocarcinoma, bile duct cancer, were seen in VA facilities over the last 15 years.

The current small study looked at 50 blood samples, finding 20% of which to be positive for liver flukes.  Most participants were not aware they were infected.  If infection did later lead to cancer, symptoms would come late in the diagnosis.

Tropical medicine specialist, Sung-Tae Hong, from Seoul National University in South Korea, stated he was “surprised” by the results and admits to more research needing to be done.

Cholioangiocarcinoma is still rare, however if Vietnam veterans are at increased risk due to their fish consumption while on duty, they need to be followed closely by their medical provider. Stool tests could be done to look for parasite eggs, and blood tests may look for antibodies fighting the infection.

What is a liver fluke?

Liver flukes are parasites that infect the liver and bile duct.  There are multiple species.  The disease Fasciola hepatica and Fasciola gigantica cause is called fascioliasis. Symptoms may range from none to severe liver disease.  But the liver flukes associated with bile duct cancer include Opisthorchis viverriniO. felineus, and Clonorchis sinensis.  According to the US Department of Veterans Affairs:

 The irritation and scarring caused by liver fluke infection can lead to bile duct cancer.

Two parasites are commonly involved. One is Opisthorchis verrini, which is found in Southeast Asian countries, including Thailand, Lao People’s Democratic Republic, Vietnam, and Cambodia. The other is Clonorchis sinensis, which is common in rural areas of Korea and China.

Eating raw or undercooked fish infected with these parasites introduces the pathogen into the GI system where it can hide out in the liver and bile ducts for decades.

In 2007, Sripa et al discussed how close to 600 million people were at risk of being infected with liver flukes.

In 2011, Lim et al wrote, “More than 35 million people worldwide are infected. The exceptionally high incidence of cholangiocarcinoma in Thailand and Korea is attributed to the high prevalence of liver fluke infection in these areas.”

How does one get contract liver flukes?

In addition to ingesting undercooked contaminated fish, liver flukes can infect multiple mammals, such that eating infected cattle or sheep liver (if undercooked) could transmit the parasite.  Ingesting vegetables washed with contaminated water could introduce the fluke into a person as well.

Medical News Today recommends boiling all untreated water and to avoid water from a stream near where cattle and sheep live.

What are the symptoms of infection with liver flukes?

Although some people with liver flukes may exhibit no symptoms at all, some may incur:

  • Fatigue
  • Abdominal Pain
  • Fever
  • Nausea
  • Vomiting
  • Diarrhea
  • Jaundice – yellowing of the skin and whites of eyes
  • Itchy skin
  • Weight loss

What is the prognosis of cholangiocarcinoma (bile duct cancer)?

According to, the 5 year survival, meaning living 5 years past diagnosis, is 30%, assuming the cancer stays locally.  If the cancer spreads to regional lymph nodes prognosis  for 5 year survival drops to 24%. Distant spread of the cancer reduces the 5 year survival rate to 2%.

gallbladder image.jpg

What is the treatment for liver flukes?

Antiparasite medications, such as triclabendazole, have proven effective against Fasciola. Praziquantel has been effective in fighting Opisthorchis infections.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician



Posted in food, Health, news

The Holidays and the In-laws: Your Step by Step Guide


Thanksgiving is here!! Good food, no school, no work, and most of all….. family!!

For many this is one of the best holidays ever!!

For some…..the most dreaded all year.

This is your very rare and valuable time off, and you have to spend all of it with people who don’t like you and you’re not particularly fond of. Four days of staying with family, (especially if they don’t let you stay a hotel and insist you stay with them), can be more than many can bear.

So here are some steps you can take to make the holidays easier.

1. Huddle up


Usually your spouse wants to avoid controversy just as much as you do.  Before the encounter, huddle up and create a strategy for:

a.  How to deal with insults

b.  How to take a break – take the car to go grab some last-minute Thanksgiving necessities

c.  Where you get to sit at the table

d.  Potential arguments regarding the children and their upbringing

2.  Try to get a hotel room


This gives you the much-needed reprieve at the end of the day.  However, if the family insists you stay with them and 4 nights at Hotel Hell are just too much to bear, plan a “sneak away” for an evening with your wife and tell the Grandparents they will host the kid’s slumber party.  Remember to thank them for the huge favor they are doing allowing you and the wife a much needed night away “from the kids” …wink…wink…..

3.  Football


Thank Heavens the Cowboys are playing this Thanksgiving.  Usually there is someone else in the family just as sane as you are when it comes to football, so you can immediately partner with him to get the television on and the game playing.  Although this may only give you a 15 minute “out” of the family festivities, its 15 minutes of pure euphoria.

4.  Remember you have sciatica


The most difficult part of Thanksgiving/Christmas is sitting at a table for hours and usually trapped, physically, because the chairs are pushed together so tight that you can’t push out the chair. If you ever, ever, ever had an issue with your back, knee, leg, muscle, or even pinky toe, use this as an excuse to heave the table forward so you can get up and stretch your legs.  Slowly limp over to the living room where hopefully you left the football game on……

5.  Get called to work


No in-law can or wants to take on your boss.  So during the 7 day stent, politely excuse yourself if you need to go onto a computer, make a phone call, or drive 60 miles away for “work”.  Make sure your spouse is on board with this one……

6.  Have “diarrhea”


You get to leave the room and no one wants to be near you.  You just gained escaping 3-5 times/hour since you need to “run” to the bathroom.

7.  Inform the family you feel a cold coming on


Don’t jinx yourself but this gets you out of hugs, and sloppy lipstick kisses…..



Ok this gives you a well-coordinated exit plan but what happens if they are on to you?  How do you deal with the remaining, 3 days, 23 hours and 45 minutes?

1.  Don’t take it personally

When the insults and digs come, don’t feel like these personal attacks need to stick.  You have enough people in your life telling you your shortcomings.  The in-laws are either being redundant or telling you something that doesn’t hold true.

2.  You’re not alone

Millions of adults are in the exact same position as you at the same moment in time.  You’re not alone.  Just sneak a peek on facebook and you’ll scroll through hundreds of “Ugh!!!!”s………..

3.  Make a game of it

Bet your wife or coworker that you will get the most insults over the holiday than they will and write down or note every time it happens. The more it occurs, you win.  Compare notes or use it as a “get out jail free card” with your spouse.

4.  Have a happy place

Negotiate with your spouse prior to the holiday a “free day” or “free weekend” that you will earn upon completion of a 7 day holiday with the in-laws.  Plan and fantasize about this reward throughout your tour of duty to make the path easier

5.  Bring the pets


Since you are usually outnumbered during these family events, why not have non humans come to your aid.  Dogs need to be walked, cats need to be chased, so this gives you an out and gives you a much-needed buddy during the hard times.


Look, it’s not easy, but remember why you’re there.  For YOUR family.  Your spouse and kids need to spend the holidays with you so grin and bear it.  And remember you may be luckier than the average guy.  He could be spending the WHOLE WEEK!  Ahhh, you DO have something to be thankful for.  Happy Thanksgiving!!!!


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician


Posted in food, Health, news

Fast Eaters are More Likely to Gain Weight

Another study has found eating too fast may lead to weight gain and metabolic syndrome.

Researchers from Hiroshima University in Japan found that those who ate their meals quicker were more likely to suffer from metabolic syndrome.

What is metabolic syndrome?

Metabolic syndrome is comprised of a group of risk factors that puts one at risk for heart disease, diabetes and stroke.  Any three of the following classify as one having metabolic syndrome:

  • Large waistline or apple shaped habitus
  • High blood pressure (over 130/80)
  • High fasting blood sugar (over 100)
  • High triglyceride level
  • Low HDL (good cholesterol)

Researchers looked at 1000 people in 2008 who didn’t have metabolic syndrome and rated them as slow eaters, normal eaters and fast eaters. Those who scarfed down their food were more likely to develop metabolic syndrome within 5 years.

Previously I discussed how our eating speed has helped fuel our obesity crisis.


Fast food has become the staple of many American and European diets and we’ve seen obesity rise.  True more people take public or private transportation to work over walking, and many have given up smoking every time they had a hunger itch, but the most popular reason for our waistline increase is fast food.  But is it the caloric content of the fast food that’s fueling the obesity epidemic, or the speed at which its ingested?

What is Fast Food?

According to the Merriam-Webster dictionary, Fast Food is “food that can be prepared and served quickly”.  A burger, shake and fries is considered fast food but so is a take away salad or sandwich.  It’s implied that fast food is a meal that is not made fresh but made previously and preserved such that it can taste fresh when needed to be served.

How Caloric is Fast Food?

According to CalorieKing, a McDonald’s Big Mac is 540 calories.  A large order of fries is 510 calories.  So a meal over 1000 calories is obviously not the healthiest choice.

But let’s return back to the sandwich alone.  While a Big Mac is 540 calories, CalorieKing finds Chick-Fil-A’s Cobb Salad (without dressing) 500 calories.  Bob Evans Restaurant’s Cobb Salad is 516 calories.

fast food.jpg

Now on the same site a Tuna Salad Sandwich (5 oz) w. mayo, 3 oz Bread is 679calories.

So are we becoming obese eating cobb salads and tuna salad for lunch just as one would eat a Big Mac?  We don’t know since people don’t study cobb and tuna salad eating consumers.  My guess is No.

Are we eating too fast?

Yes, and so fast that I believe it could be messing with our metabolism.

Think back to caveman days.  We had to chew.  And not on a soft sesame seed bun, but chew our meat.  Nuts and vegetables took a chewing as well.  Food was more scarce so it was savored and meals weren’t on the run while on a subway or at a stop light in one’s car.

Previous studies have shown that eating slowly and chewing it multiple times allow the body’s signals to trigger the satiety sensation sooner, hence one would eat less.

So gulping down a burger in 5 bites could be accomplished prior to the brain receiving the signal that it should be satisfied.

Now the metabolism issue.  Fast food could contain sugars, fats and preservatives that alter metabolism.  But eating on the run could cause metabolism issues in and of itself.

When a body senses that the food source is short-lived, unpredictable, and coming at a speed preventing proper absorption of nutrients, it may slow down metabolism to allow the body to make the most of what it has.  Eating a meal slow and methodical may be the most successful way to not only feel full but to eat less and lose weight.

I suggest a study be done looking at two groups of people eating the same food with the same caloric content but differing on the speed at which they eat it.

I suggest to you all to take an extra 15 minutes to complete your meal than what you’re accustomed to and determine if you see results after a few weeks.

Of course avoiding fast food would be the most beneficial for our weight but if you must eat fast food, eat it slowly.



                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in food, Health, news

Heartburn Medication Found to Double Risk of Stomach Cancer

New research suggests proton pump inhibitors (PPIs) may double the risk of stomach cancer.

In a study published in Gut, study authors further discuss how those who took PPI’s for more than a year were at 5 times increased risk for stomach cancer. Those who took them chronically for 2 years were at 6 times increased risk, and those on PPI’s consistently for 3-4 years were at 8 times increased risk for stomach cancer.

As opposed to being forms of calcium carbonate, such as acid neutralizers such as Tums, or H2 (Histamine H2 Antagonist) blockers such as Pepcid and Zantac, the PPI’s reduce stomach acid production from the start.  They’re sold under the brand names of Prilosec, Prevacid, Protonix and Nexium.  They’re popularity has been skyrocketing over the last two decades and have become a mainstay treatment for multiple gastrointestinal issues including ulcers.

According to the study authors from the University of Hong Kong and University College of London, the PPI’s help kill Helicobacter pylori, a bacteria responsible for stomach ulcers and cancer.  But use beyond the healing up’d the risk significantly. Those who took H2 blockers did not appear to be at increased risk.

They recommend against “unnecessary long term use.”

According to, 28,000 people (17,750 men and 10,250 women) in the US this year alone will be diagnosed with stomach cancer.  10,960 deaths from the disease will occur this year.

This is a developing story.

Foods that cause reflux

Gastroesophageal reflux disease can be caused by foods difficult to digest like processed foods, sugars, and those with refined carbohydrates.



Foods that help relieve acid reflux

They following may help relieve acid reflux symptoms:




Aloe vera





Lean turkey and chicken


Here’s another chart that shows foods that may help or trigger reflux:

reflux foods

Elevating the bed 45 degrees at night helps reduce reflux symptoms.

Avoiding drinking lots of water before sleep helps as well.

Eating smaller meals and avoiding a large dinner at bedtime will decrease acid reflux.

So why take medication at all?

Those suffering from GERD can be prone to esophageal cancer if the stomach acid bombarding the lower esophagus fails to be subdued.  Acid reflux can also cause chronic sore throat and chronic cough.  For these reasons, PPIs will still be recommended for severe reflux cases, but maybe lower doses and combinations with other drugs and lifestyle changes should be started first.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician