MDchat November 30 2010

8/8/2019 MDchat November 30 2010

http://slidepdf.com/reader/full/mdchat-november-30-2010 1/19

Transcript of #MDchat for November 30, 2010

Follow @MD_chat for Regular Updates

Twitter.com/MD_chat

MDchat.org

Topics:

Topic 1 (T1)

T2 IOM report on Vit D & Ca: How does this impact pt education? How do youdeal with conflicting/shifting recommendations?

Topic 2 (T2)

T2 Sugar: How ramifying is the sugar in our food chain on health? Strange as itsounds: might we need a policy on sugar?

Chat:

philbaumann

For tonight's #MDchat at 9pm, article on Vit D Calcium for one of the topics:

http://ow.ly/3hSnb

MD_Chat Welcome to #MDchat! If you're new, feel free to join or just watch. We'll startsoon, but first introduce yourselves!

RichmondDocGood evening, all. Family doc in #RVA; multi-tasking as usual, but here toparticipate in #mdchat

MD_ChatOK, first topic coming up in a minute! When responding to a topic, pleaseprepend tweet with T1, T2, etc. Good luck! #MDchat

MD_Chat @RichmondDoc Good evening! #MDchat (Might be a slow start - we'll see ;)

MD_ChatT1 IOM report on Vit D Ca: How does this impact pt education? How do youdeal with conflicting/shifting recommendations? #MDchat

RichmondDoc @MD_Chat We shall see. I can monologue for a while if needed. #mdchat

mkmackey RT @MD_Chat: T1 IOM report on Vit D Ca: How does this impact pteducation? How do you deal w conflicting/shifting recommendations? #mdchat

healthgist

http://j.mp/d5Z8gi @RichmondDoc Good evening, all. Family doc in #RVA;

multi-tasking as usual, but here to participate in #mdchat



RichmondDocT1 As a health care provider, I think we need to be honest w/ pts when we'reuncertain, when recs change, etc. #mdchat

rsm2800T1 Complicated for oncologists since AI's (eg Arimidex) cause osteop. Datalacking. We see many pts on megadose Vit D from PCP's #mdchat

RichmondDocT1 I think the IOM Vit D and calcium announcement simply highlights the needto keep on top of recs, admit uncertainty when present. #mdchat

chukwumaonyeije @GailZahtz Welcome to #mdchat

GailZahtz@MD_Chat Hi. Is the chat closed to MD's only? I'm involved w/ other medchats from health communications w/a startup #hcsm project #mdchat

chukwumaonyeijeT1: Recommendations of any form are just that. Recommendations. Notcommandments. They can change and vary dep on situation #mdchat

peds_id_doc@GailZahtz #MDchat - I don't think you can 'close' anything on twitter to anyone:o) Welcome! We have students, nurses, other folks here

RichmondDocT1 I'm not that sure that the IOM report is all that definitive. Levels below 32result in increased markers of bone disease... #mdchat

GailZahtz @chukwumaonyeije Thank you! #mdchat

peds_id_doc

#mdchat Heyup. Not sure I know much about Vit D but I can chip in :) Peds ID

Fellow from Upstate NY

RichmondDocT1 There is *correlation* between low vit D and other illnesses, but notcausation. But the bone health seems reliable. #mdchat

murzee Hello, everyone. T1? #mdchat

GailZahtz@peds_id_doc While you can't close things on twitter, I also want to berespectful and not barge in :) #mdchat

RichmondDoc

T1 ... but the IOM used a cut-off of 20. I think aiming to get above 32 is good for

bones, can't promise other benefits. #mdchatPAFPStudents So my med school nutrition notes are outdated again! #mdchat #MDchat

chukwumaonyeijeForgot my intro.... Chuck Onyeije Maternal-Fetal Medicine specialist. Part time

Android developer. Nerd. #mdchatpeds_id_doc @GailZahtz #mdchat [tip of the hat] but of course ;)

RichmondDoc@PAFPStudents Sadly, that's going to be true for the rest of your medical career.#mdchat

MaverickNY T1 #mdchat Have not read the IOM report, will add it to my long Kindle list of reading materials



yayayarndivaHello Dr. Pierrette Mimi Poinsett unemployed pediatrician since 5/08, federal UI

benefits cut off today #99er #mdchat

peds_id_doc@PAFPStudents #mdchat T1 my immunology med school notes were outdated

by the first lecture (no joke!)

chukwumaonyeije@RichmondDoc Ah yes. Correlation vs. Causation. The bane of my existence...#mdchat

murzee Oh, The IOM report! The pendulum swings. #mdchat

RichmondDoc@murzee T1 IOM report on Vit D Ca: How does this impact pt education? How do you deal with conflicting/shifting recommendations? #mdchat

peds_id_doc#mdchat T1 I find if I don't understand it, how can I be expected to explain it topts (and offer my own thoughts/opinions)...

chukwumaonyeijeIndeed! @murzee: In a multi-causality model there can be no panacea, tho' we

want one #mdchat

chukwumaonyeije@murzee IOM report, pendulum swings and interpretation/utilization of data/info sounds right up your alley... #mdchat

murzee In a multi-causality model there can be no panacea, tho' we want one #mdchat

peds_id_doc

#mdchat T1 I'm personally a little confused - I probably need to read the primary

literature better, rather than derivative guidelines.

RichmondDocT1 I aim for Vit D levels above 32 b/c of the biochem markers and b/c it makessome sense; I wouldn't push any higher. #mdchat

murzee we have to think about the evolution -- nature is no fool #mdchat

ability4lifeRT @RichmondDoc: T1 As a health care provider, I think we need to be honest

w/ pts when we're uncertain, when recs change, etc. #mdchat

peds_id_doc

#mdchat T1 ...and therefore apply the guidelines in the proper context? medicine

is an art after all, not (just) a science.

RichmondDocT1 I also realize this could be analogous to Vit B12 and homocysteine/MMA re: to

vascular disease; might not bear out over time. #mdchat

ability4lifeLate to #MDchat Kathy Kastner, prepping for FamMed conference. Listeningmostly 2nite.But glad 4 discussion of VitD

RichmondDocT1 I'm intrigued by the research showing correlation of low Vit D and increasedfall risk in elderly--but don't Rx for that reason. #mdchat

GailZahtzRT @RichmondDoc @murzee T1 How does this impact pt education? <=Isn'tthis an issue with any info pts get outside of treating MD? #mdchat



chukwumaonyeije#mdchat: I would also add that the search for a panacea has lead medicineastray many times before #mdchat @murzee @RichmondDoc

murzee When we get into small incremental differences at the margins, uncertainty grows. Things we know for sure: Smoking, asbestos --> CA #mdchat

peds_id_doc@yayayarndiva welcome to #mdchat :o) The issue of the #99ers is close tohome...I feel for you.

ability4lifeRT @RichmondDoc: T1 I'm intrigued by the research showing correlation of low

Vit D and increased fall risk in elderly--but don't Rx for that reason. #mdchat

PAFPStudentsT1: The IOM should study Vit D Levels in med students/residents - we need toget out more. Which recs will we get pimped on? #mdchat #MDchat

murzee

Does vit D prevent CA? Maybe at the margins, but the big diff is to eliminate

smoking, other carcinogens, no? #mdchatchukwumaonyeije @murzee Absolutely. #mdchat. Many elephants in the room before Vit. D defic.

yayayarndiva@peds_id_doc sad but feelins are not going to pay for my food, shelter, gas, jobsearch- I am so over this #mdchat #99ers

GailZahtz@ability4life Hi Kathy. Sidebar hi- don't want to disrupt conversation. Hopethings are going well for you in CA :) #mdchat

ability4life RT @RichmondDoc: research showing correlation of low Vit D and increased fallrisk in elderly--but don't Rx 4that reason. #mdchat #seniors

sarasteinmdEvening all, glad to be here. The IOM should be ashamed, they had NO Vit Dexperts on the panel didnt use the draft critiques #mdchat

chukwumaonyeijeI'm concerned about jumping on a therapeutic bandwagon (eg. estrogenreplacement) even with seemingly strong studies. #mdchat

MD_Chat

@gailzahtz It's totally open! We want physicians' voices to breath of course - but

it's a fully public commons. #MDchat - Cheers! - Phil

RichmondDoc@GailZahtz @murzee True--we need to cognizant of how we discuss/review info

w/ pts for any condition/illness, etc. Be open/honest. #mdchat

murzee Also, these pendulum swing are inefficient way of assimilating info. Need moremiddle ground and better rules. #mdchat

chukwumaonyeijeT1: So how do we address sexy study results in the media with patients..@RichmondDoc: @GailZahtz @murzee #mdchat

murzee We need to do a better job educating public ab uncertainty in clinical research.#mdchat



peds_id_doc@PAFPStudents #mdchat T1 pimping is never the real issue - the real issue is

what do the folks end up prescribing/testing for!

RichmondDoc@chukwumaonyeije @GailZahtz @murzee I do a lot of shoulder-shrugging andthen try to highlight the uncertainty inherent in all this. #mdchat

murzeeEducation re uncertainty! RT @chukwumaonyeije: T1: So how do we addresssexy study results in the media with patients.. #mdchat

drpoppyBHRT@sarasteinmd I agree. The fact is Vit D deficient pts can be replenished easily

w/minimal side effects potential benefit #mdchat

murzee We also need better risk data to balance with benefits -- need better education onrisk analysis/perception #mdchat

ability4life

RT @GailZahtz: @RichmondDoc My question was more- isn't the conflicting

report pt comm indicative of a larger problem of pt comm in online age?T1#mdchat

GailZahtz@RichmondDoc My question was more- isn't the conflicting report pt commindicative of a larger problem of pt comm in online age?T1 #mdchat

chukwumaonyeije@murzee In many cases when I discuss risk I use charts/graphs/slides. Worksfor some learning styles. Sadly not all... #mdchat

murzee @GailZahtz @RichmondDoc Not just pt comm, all science comm -- need betterliteracy #mdchat

napernurse

RT @EinsteinMed: Study shows #obese women more likely to develop #ER positive breast cancer recurrence and die from it. High insulin levels suspected.#MDchat

sarasteinmdsocmed is the perfect way to address silly media reporting or silly research. Icomment on newsblogs, tweet, run FB info site #HCSM #mdchat

ability4life Whose perception?RT @murzee: We also need better risk data to balance with benefits need better education on risk analysis/perceptin #mdchat

PAFPStudents@peds_id_doc T1 It is an issue b/c when attending docs don't agree w/ theevidence/lack of, there's not much we can do about it #MDchat

drpoppyBHRT@murzee One study does not overshadow thousands of other studies withcountering information. #mdchat

ability4life

Amen 2 that RT @murzee: @GailZahtz @RichmondDoc Not just pt comm, all

science comm -- need better literacy #mdchat #hcsm #hcsmcamurzee @ability4life Public risk perception -- many studies show it is distorted #mdchat



GailZahtz@chukwumaonyeije Perhaps opportunities for MD's themselves to discuss new research online would benefit all md's pt communication? #mdchat

sarasteinmd@drpoppyBHRT @murzee here's the first of many responses to the IOM study section. http://bit.ly/hjkOpA sad to doubt their integrity #mdchat

peds_id_doc@PAFPStudents T1 #mdchat that's when you pull out the literature and educatethe attendings --> bonus marks (at least where I work)

murzee@chukwumaonyeije We need large scale education in addition to individualencounter #mdchat

ability4lifeThnx. 4 clarifctn AbsolutelyRT @murzee: @ability4life Public risk perception --many studies show it is distorted #mdchat #hcsmca#hcsm

GailZahtz

RT: @murzee @GailZahtz @RichmondDoc Not just pt comm, all science comm

-- need better literacy <=AGREE think its possible #mdchat

AureliaCotta@ability4life @RichmondDoc But wouldn't that correlation make it worth doinga blood test? Just in case? #mdchat

GailZahtzRT @RichmondDoc: @GailZahtz I think the issues of conflicting information andpatient comm can be addressed via SocMed. #mdchat <=AGREE

chukwumaonyeije

@murzee Not to mention professional education. There are new genetic risk

tests which confuse seasoned MDs #mdchat

peds_id_doc@PAFPStudents #mdchat T1 the real pain with guideline changes in the EXAMS- you have to ask yourself do they want the old or the new..?

ability4lifeRT @RichmondDoc: @GailZahtz I think the issues of conflicting information andpatient comm can be addressed via SocMed. #mdchat

ability4lifeRT @GailZahtz: RT: @murzee @GailZahtz @RichmondDoc Not just pt comm,all science comm -- need better literacy <=AGREE think its possible #mdchat

RichmondDoc@GailZahtz I think the issues of conflicting information and patient comm can

be addressed via SocMed. #mdchat

chukwumaonyeijeRT @RichmondDoc: @GailZahtz I think the issues of conflicting information andpatient comm can be addressed via SocMed. #mdchat

murzeeThere is perception that benefits come w/o risk -- just look at the NLST trial, andthe holy grail mentality ab that #mdchat

RichmondDoc

@AureliaCotta @ability4life I think following Vit D levels and aiming for

appropriate levels re: bone health is fair game. #mdchat



GailZahtz@chukwumaonyeije Do you think there is a lack of CME online? It appears thatthere are many to help w/ issues like genetic risk.. #mdchat

sarasteinmd@RichmondDoc I treat obesity and depression and chronic pain with vitamin Dand have great success with all three #mdchat

RichmondDoc@AureliaCotta @ability4life But I don't go higher than that as yet, and I don'tpromise any further benefits beyond bones. #mdchat

PAFPStudents@peds_id_doc T1 Totally agreed Re: exams. Especially where they can make or

break grades/board scores -puts a dent on residency app #MDchat

ability4lifeRT @sarasteinmd: @RichmondDoc I treat obesity and depression and chronicpain with vitamin D and have great success with all three #mdchat

rsm2800

T1: IMHO many pts have an innate belief that vitamins can't possibly hurt them

blood tests accurately diagnose most diseases #mdchat

CrescendoCGRT @RichmondDoc: @GailZahtz I think the issues of conflicting information andpatient comm can be addressed via SocMed. #mdchat

ability4lifegood 2 know :) RT @RichmondDoc: @AureliaCotta But I don't go higher thanthat as yet, and dn't promise further benefits beyond bones.#mdchat

chukwumaonyeije@murzee Preg patients with diabetes fear insulin because it is a medicine whenthey should fear hyperglycemia... #mdchat

chukwumaonyeije@murzee Risk tolerance and risk appraisal are skewed by society, media andculture. #mdchat

RichmondDoc@sarasteinmd I have anecdotal benefits in my practice (and I think they may well

bear out), but need to consider they may not. #mdchat

AureliaCotta@RichmondDoc @ability4life uhh, perhaps lab levels are diff here, but 20-80 islow normal at my osteoporosis clinic. 80+ is normal #mdchat

ability4life Agree but 2 what endRT @chukwumaonyeije: @murzee Risk tolerance and risk appraisal are skewed by society, media and culture. #mdchat #hcsmca

murzeeRT @chukwumaonyeije: @murzee Preg patients with diabetes fear insulin

because it is a medicine when they should fear hyperglycemia #mdchat

RichmondDoc@AureliaCotta @ability4life The research in the US I've seen says that markers of

bone turnover normalize over 30-32. #mdchat

ability4life

Agree wi yho RT @rsm2800: T1: IMHO many pts hav innate blief tht vit can't

possibly hurt blood tests accurately diagnse mst diseas #mdchat



RichmondDoc@rsm2800 T1 You're right--that's the misconception. But hyper-Vit A exists andis dangerous; beta-carotene and Vit E not benign. #mdchat

hjluks Late to show... as usual. What is the question at hand?? #mdchat

PAFPStudents

RT @chukwumaonyeije Risk tolerance and risk appraisal are skewed by society,

media and culture. #MDchat

RichmondDoc@hjluks T1 IOM report on Vit D Ca: How does this impact pt education? How do you deal with conflicting/shifting recommendations? #mdchat

sarasteinmd@RichmondDoc My entire clinic is a testimony to walkers and canes. I'm happy to have something relatively benign to offer them! #mdchat

hjluks@RichmondDoc @sarasteinmd cartilage has vit D receptors too. Currentthinking that low level--> OA #mdchat

CrescendoCG@rsm2800 Consumer research would suggest that this is the case, unfortunately.#mdchat

MD_Chat Shoulder tap: Next topic coming up in a few minutes. #MDchat

AureliaCotta@RichmondDoc @ability4life I have osteoporosis, and at 32, I feel sick, and amin pain. #mdchat

RichmondDoc@AureliaCotta @ability4life 30-32 ng/mL is the target dose for the labs we work

with. #mdchat

murzeeIt really boils down to science literacy and honesty by the providers about what

we really know #mdchat

hjluks Vitamins and Neutraceuticals, herbals etc a BIG problem in a surgical practice... bleeding, hepatic rxn with anesthesia, etc. #mdchat

ability4lifeI sure hope u have hcp that helpRT @AureliaCotta: @RichmondDoc@ability4life I have osteoporosis, at 32, feel sick, and am in pain. #mdchat

chukwumaonyeije @GailZahtz Lots of CME online. IMHO very little of if sticks . I see lots of memorable SM presentations online. Few memorable CME #MDCHAT

drpoppyBHRTRT @sarasteinmd: @RichmondDoc I treat obesity and depression and chronicpain with vitamin D and have great success with all three #mdchat

hjluks@AureliaCotta @RichmondDoc @ability4life osteoporosis should not hurt...osteomalacia does hurt !?!? #mdchat

sarasteinmd

@hjluks I see alot of improvement in pain including joint pain, but I dont know if

anyone actually has structural improvement Wow #mdchat



AureliaCotta@RichmondDoc @ability4life Again, perhaps lab levels are measured differently there, but Reinhold Veith at UofT would disagree...... #mdchat

chukwumaonyeijeRT @rsm2800: T1: IMHO many pts have an innate belief that vitamins can't ..hurt them blood tests accurately diagnose most diseases #mdchat

hjluksRT @MD_Chat: Shoulder tap: Next topic coming up in a few minutes. Big fan of shoulders :-) #mdchat

GailZahtz@chukwumaonyeije Do you think it's because the CME isn't done well? Would it

be better more like offline Education w/ peer-review? #mdchat

AlisynGayleRT @murzee: RT @chukwumaonyeije: @murzee Preg patients with diabetes fearinsulin because it is a medicine when they should fear hyperglycemia #mdchat

mkmackey @hjluks.. what dosing for Vit D is common in your ortho clinic? #mdchat

RichmondDoc@AureliaCotta @ability4life I think that this speaks to the current uncertainty--the very topic we're discussing! Timely... :) #mdchat

hjluks @RichmondDoc thx #mdchat

sarasteinmdRT @chukwumaonyeije: @murzee Risk tolerance and risk appraisal are skewed

by society, media and culture << great observation! #mdchat

AlisynGayle

RT @RichmondDoc: @rsm2800 T1 You're right--that's the misconception. Buthyper-Vit A exists and is dangerous; beta-carotene and Vit E not benign.#mdchat

ability4lifeCan sm help changeRT @sarasteinmd: RT @chukwumaonyeije: @murzee Risk tolerance and ppraisal skewed by socity, media culture #mdchat

hjluks Who determined what proper vit D level is... 30... 50.... 80? We have nolongitudinal studies to compare! #mdchat

chukwumaonyeije

@GailZahtz My vision for good CME would (actually) be something like

#mdchat. Interactive/relevant/Evidence based/peer focused

GailZahtzRT @chukwumaonyeije: @GailZahtz My vision for good CME would (actually) besomething like #mdchat. Interactive/relevant/Evidence based/peer focused

ability4lifeLove it RT @MD_chat: T2 Sugar: How ramifying is sugar in r food chain onhealth? Strange as it sounds: might we need policy on sugar?#MDchat

chukwumaonyeije Yes. SM can help in terms of a true conversation / interaction @ability4life: Cansm help changeRT @sarasteinmd: @murzee #mdchat

sarasteinmd@AlisynGayle they should fear weight gain - insulin is the biggest weight gainerof all the diabetes meds! #mdchat



skewedupRT @chukwumaonyeije Risk tolerance and risk appraisal are skewed by society,media and culture. #MDchat http://bit.ly/gjJcoc

RichmondDoc@AureliaCotta @ability4life My main caveat is Vit B12 levels vasculardz/dementia: labs make sense, but no clinical benefits. #mdchat

drpoppyBHRT@sarasteinmd I treat low serum Vitamin D levels with Vit D therapy, low cost,great clinical results #IsmellaBigPharmarat #mdchat

MD_ChatT2 Sugar: How ramifying is the sugar in our food chain on health? Strange as itsounds: might we need a policy on sugar? #MDchat

ability4life

RT @chukwumaonyeije: Yes. SM can help in terms of a true conversation /interaction @ability4life: Can sm help changeRT @sarasteinmd: @murzee#mdchat

RichmondDoc@hjluks The closest I've seen so far (re Vit D levels) involves biochem markersand such; no real pt-focused evidence/info. #mdchat

AureliaCotta@hjluks @RichmondDoc @ability4life I had osteomalacia when my D was 16.

And fractures when D was 30-40 + osteoporosis #mdchat

sarasteinmd@drpoppyBHRT I'm totally with you Poppy, especially here in Cleveland the landof eternal cloud cover! #mdchat

hjluks@mkmackey I dose between 2000-4000 Units/day if all other systems normal..and serum levels rarely rise... #mdchat

DrJonathan@sarasteinmd also a prime cause for weight gain in NON-diabetics: insulinsecretion from carbohydrate ingestion #mdchat

hjluks @AureliaCotta been there... that's why I'm an orthopedist. #mdchat

RichmondDocT2 Not sure that we can easily have a policy limiting sugar, but I think it would befair to require disclosure of sugar content. #mdchat

hjluks @RichmondDoc agreed... #mdchatmkmackey @hjluks thanks #mdchatmurzee T2: Legislate sugar? Wow! Say more #mdchat

AureliaCotta @hjluks @RichmondDoc @ability4life Fractures suck FYI #mdchat

murzeeSM may openly show how we think, and this can help start the discussion@ability4life @chukwumaonyeije @sarasteinmd @murzee #mdchat

sarasteinmd

@AlisynGayle it takes some work to get hypervitaminosis A - more likely to go

blind from Vit A deficiency - 5th leading cause #mdchat



peds_id_doc#mdchat T2 absolutely, in pediatrics. Childhood obesity is growing, leads to adultobesity, leads to chronic health problems...start early

hjluks @mkmackey welcome #mdchat

ability4life

RT @RichmondDoc: T2 We lament when patients don't take charge of their

health, but we don't empower/inform patients to take charge of their health.#mdchat

hjluks @MD_Chat what are you trying to say :-)?? #mdchat

RichmondDoc@sarasteinmd @AlisynGayle It ain't easy to get hypervitaminosis A, but it canhappen. Just noting that it ain't entirely benign. #mdchat

ability4life@hjluks: you continue 2 amaze @hjluks RT @AureliaCotta been there... that's

why I'm an orthopedist. #mdchat

GailZahtzRT @murzee: SM may openly show how we think, and this can help start thediscussion @ability4life @chukwumaonyeije @sarasteinmd @murzee #mdchat

peds_id_doc#mdchat T2 but how/where to implement it? at the consumer level? The foodprocessor? The farms...? #omnivoresdilemma

RichmondDocT2 We lament when patients don't take charge of their health, but we don'tempower/inform patients to take charge of their health. #mdchat

chukwumaonyeije@MD_chat T2: DGMS!!! (don't get me started). Issue is not just sugar butindustrialized food production. #mdchat (#ThereISaidIt)

MD_Chat @hjluks http://ow.ly/3hTMO #MDchat ;)

AureliaCotta@hjluks @RichmondDoc @ability4life But too often real symptoms/broken

bones are dismissed as depression, old age aches/pains. #mdchat

CrescendoCGRT @RichmondDoc: We lament when pts dont take charge of their health, butdont empower/inform patients to take charge. #mdchat

peds_id_doc @chukwumaonyeije #mdchat Is it useful to use abbreviations if you then spellthem out ;-) SWIM (see what I mean?)

ability4lifeRT @murzee: SM may openly show how we think, and this can help start thediscussion @ability4life @chukwumaonyeije @sarasteinmd @murzee #mdchat

ability4lifeRT @chukwumaonyeije: @MD_chat T2: DGMS!!! (don't get me started). Issueis not just sugar but industrialized food production. #mdchat (#ThereISaidIt)

RichmondDoc

RT @chukwumaonyeije: @MD_chat T2: DGMS!!! (don't get me started). Issue

is not just sugar but industrialized food production. #mdchat (#ThereISaidIt)



sarasteinmd@murzee TAX IT! LABEL IT! OUT the sugar contents in food!!! YESSSS! (in theinformation is power vein) #mdchat

murzeeRather than legislate sugar (again may be erroneous panacea approach) need toaddress the whole lifestyle-nutrition axis #mdchat

murzeeRT @chukwumaonyeije: @MD_chat T2: DGMS!!! Issue is not just sugar butindustrialized food production. #mdchat #mdchat

PAFPStudentsT2: Tobacco/Alcohol legislation and patient education - working well? Will it

work for sugar? #MDchat

GailZahtz

RT @RichmondDoc: T2 We lament when patients don't take charge of theirhealth, but we don't empower/inform patients to take charge of their health.#mdchat

ability4life

RT @AureliaCotta: @hjluks @RichmondDoc @ability4life But too often realsymptoms/broken bones are dismissed as depression, old age aches/pains.#mdchat

hjluksRT @chukwumaonyeije: @MD_chat T2: DGMS!(dont get me started).Issue isnot just sugar but industrialized food production. #mdchat #mdchat

sarasteinmdRT @RichmondDoc: RT @chukwumaonyeije: @MD_chat Issue is not just sugar

but industrialized food production. #mdchat (#ThereISaidIt) #mdchat

ability4lifeNeeds sugar tax RT @PAFPStudents: T2: Tobacco/Alcohol legislation and pteducation working well? Will it work 4 sugar? #MDchat

sarasteinmd@GailZahtz we give out far too difficult change instructions - eg tobacco. We say quit (Hard to do) I say pick out 3 you can skip. #mdchat

AlisynGayle

RT @RichmondDoc: @sarasteinmd @AlisynGayle It ain't easy to gethypervitaminosis A, but it can happen. Just noting that it ain't entirely benign.

#mdchat

murzee Agree! RT @sarasteinmd: TAX IT! LABEL IT! OUT the sugar contents in food!!! YESSSS! (in the information is power vein) #mdchat

chukwumaonyeije @peds_id_doc LOL (laughing out loud). #mdchat

RichmondDocT2 Will be tough to get meaningful nutrition info into patient's hands, but itshould be a public policy priority. This matters. #mdchat

ability4life

RT @murzee: We need more than just nutrition info -- we need to present public

with accessible alternatives, @RichmondDoc #mdchat



drpoppyBHRT@murzee Just what we need, food police...pretty soon people will be refused carefor being obese when reasons are multifactorial. #mdchat

murzee We need more than just nutrition info -- we need to present public withaccessible alternatives, @RichmondDoc #mdchat

hjluksEven when we do empower patients with information, etc... many still choose todisregard advice compliance vs. participation #mdchat

ability4lifeRT @RichmondDoc: T2 Will be tough to get meaningful nutrition info intopatient's hands, but it should be a public policy priority. This matters. #mdchat

chukwumaonyeijeRT @murzee: Agree! RT @sarasteinmd: TAX IT! LABEL IT! OUT the sugarcontents in food!!! YESSSS! (in the information is power vein) #mdchat

ability4life

RT @sarasteinmd: @GailZahtz we give out far too difficult change instructions -

eg tobacco. We say quit (Hard to do) I say pick out 3 you can skip. #mdchat

hjluksCompliance vs Participation.... http://goo.gl/WefpT BTW... never shoot video

when lying down on couch #doublechin :-( #mdchat

mkmackey RT @murzee: We need more than just nutrition info -- we need to present public

with accessible alternatives, @RichmondDoc #mdchathjluks @drpoppyBHRT yup :-( But we take the hit for it #mdchat

murzee Agree! RT @sarasteinmd: @drpoppyBHRT @murzee its the food industry thatneeds policing not the consumers #obesity #mdchat

chukwumaonyeijeRT @sarasteinmd: @drpoppyBHRT @murzee it's the food industry that needspolicing not the consumers #obesity #mdchat

RichmondDocRT @murzee: We need more than just nutrition info -- we need to present public

with accessible alternativesoc, [agree!] #mdchatdrpoppyBHRT @hjluks Yes that is called freedom and autonomy. #mdchat

ability4life RT @sarasteinmd: @drpoppyBHRT @murzee it's the food industry that needspolicing not the consumers #obesity #mdchat

sarasteinmd@drpoppyBHRT @murzee it's the food industry that needs policing not theconsumers #obesity #mdchat

peds_id_doc#mdchat T2 the difficulty in 'policing' the industry is that the regs are currently set up to support processed food --> high sugar

chukwumaonyeije

@drpoppyBHRT In many places in this country a person simply *cannot*

autonomously choose a healthy diet #foodDeserts #mdchathjluks You are on a roll Chuck !!!! #mdchat



GailZahtz@sarasteinmd Perhaps w/ more technology, more comm through MD socialmedia and time, more lifestyle change could occur for pts? #mdchat

hjluksRT @chukwumaonyeije: RT @sarasteinmd: @drpoppyBHRT @murzee its thefood industry that needs policing not the consumers #obesity #mdchat

sarasteinmd@GailZahtz wouldnt that be wonderful - we're trying to get docs to tweet/blogetc, ppl want health info from reliable sources #HCSM #mdchat

RichmondDocRT @chukwumaonyeije: In many places in this country a person simply *cannot*autonomously choose a healthy diet #foodDeserts #mdchat

ability4life

RT @DrJonathan: We too often approach this problem from consumerperspective- any way to go after American's food producers instead to reducesugar? #mdchat

murzeeSome neighborhds do not have easy access to nutritious foods or safe exercisespaces @GailZahtz @sarasteinmd #mdchat

chukwumaonyeije@hjluks LOL, I'm trying to control myself. This is one of my hot buttons.#mdchat

PAFPStudentsThere are many low/non-sugar alternatives sitting right next to the problem -consumers still not choosing the right label #MDchat

RichmondDoc@drpoppyBHRT @hjluks Adults have a right to make decisions I don't like, butthe nation has a right to ensure accurate risk info. #mdchat

mkmackey Looks like a start for good nutrition with the McDonalds issue in Calif for Happy Meals #mdchat

DrJonathan We too often approach this problem from consumer perspective- any way to goafter American's food producers instead to reduce sugar? #mdchat

sarasteinmd

@murzee @GailZahtz @sarasteinmd I saw a lady today trying to support family

of 5 on minimum wage-lot of ramen noodles/peanut butter #mdchat

drpoppyBHRT@chukwumaonyeije Education and self-awareness/reliance is necessary to makegood decisions in every area of life. #mdchat

ability4lifeXclnt Reality Check RT @murzee: Some neighborhds do nt hve easy access 2nutritious foods safe xercise spces @GailZahtz @sarasteinmd #mdchat

rsm2800 Yep RT @murzee: Some neighborhds do not have easy access to nutritious foodsor safe exercise spaces @GailZahtz @sarasteinmd #mdchat

RichmondDoc@chukwumaonyeije We live in a nation where the cheapest foods are caloriedense and the healthy alternatives are expensive/unavail. #mdchat



murzee RT @hjluks: You are on a roll Chuck !!!! #mdchathjluks @chukwumaonyeije so I've noticed.... keep goin' #mdchatmkmackey Excellent In the trenches wellness discussion going on here at #mdchat

ability4life

RT @hjluks: RT @chukwumaonyeije We live in a nation where the cheapest

foods are calorie dense and the healthy alternatives are expensive #mdchat

peds_id_doc#mdchat T2 ...cheetos. Right at the door. Cheaper than fruit too. Highercalories. Easier to stay alive on a tight budget.

GailZahtz@sarasteinmd I believe that if there were #hcsm that had privacy options forHCP's peer-reviewed info, many more would participate #mdchat

ability4lifeRT @peds_id_doc: @PAFPStudents #mdchat T2 ever walked into a posh foodstore? First up - fruit and veg....tried the same in a 'less affluent neighborhood? ..

hjluksRT @chukwumaonyeije We live in a nation where the cheapest foods are caloriedense and the healthy alternatives are expensive #mdchat

ability4life

RT @sarasteinmd: @murzee @GailZahtz @sarasteinmd I saw a lady today trying to support family of 5 on minimum wage-lot of ramen noodles/peanut

butter #mdchat

ability4lifeRT @murzee: Nutrition is a social issue, as is lifestyle. For us privileged SMers itmay be a choice. But for many not so. #mdchat

peds_id_doc@PAFPStudents #mdchat T2 ever walked into a posh food store? First up - fruitand veg....tried the same in a 'less affluent neighborhood? ..

murzeeNutrition is a social issue, as is lifestyle. For us privileged SMers it may be achoice. But for many not so. #mdchat

murzeeOur food policy subsidizes garbage loaded w HFCS, animals raised in deplorableconditions -- don't even know human health effects! #mdchat

sarasteinmd RT @hjluks: RT @chukwumaonyeije We live in a nation where cheapest foodsare calorie dense and healthy alternatives are expensive #mdchat

MD_Chat We're coming up on our hour. Before we wrap up, let's hear your parting wisdom.#MDchat

RichmondDoc@peds_id_doc This is why fast food value meals are a devil's bargain: cheap,calorie-filled but no true nutritional value. #mdchat

MattMerg

T2 People want to make the right decisions about their diet; they want info. But it

needs to be reliable, trustworthy, and available #mdchat



ability4lifeRT @mkmackey: Excellent In the trenches wellness discussion going on here at#mdchat

GailZahtz@sarasteinmd @murzee @ability4life Agree w/ you all- nutrition is a socialeconomic issue and can only change w/social change. #mdchat

ability4life Can't wait to share at med health conf 4 topic: to twitter or not Before we wrapup, let's hear your parting wisdom. #MDchat

murzeeParting thoughts: Need integrated solutions, not one-offs. Societal ANDindividual responsibilities at play. #mdchat

ability4life

RT @sarasteinmd: @MD_Chat Final thoughts, I wish health care providers would return to see one, do one, teach one, using Soc med as the teaching tool#mdchat

peds_id_doc#mdchat - T2 so we all agree on the problem, but how on earth do we (or anyone)fix it...?

RichmondDocRT @murzee: Our food policy subsidizes garbage loaded w HFCS, animals raisedin deplorable conditions -- don't even know human health effects! #mdchat

mkmackey Thanks.. it never fails, I always gain insight from listening to discussion from#mdchat

sarasteinmd@MD_Chat Final thoughts, I wish health care providers would return to see one,do one, teach one, using Soc med as the teaching tool #mdchat

ability4life

RT @GailZahtz: @sarasteinmd @murzee @ability4life Agree w/ you all-nutrition is a social economic issue and can only change w/social change.#mdchat

AureliaCotta.@ability4life @hjluks see here http://bit.ly/hekPi8 for inaccurate historicalreason excess D was thought unsafe. #mdchat

GailZahtz #MDchat wrapup: TY everyone. It was a great group!!! Thanks for having me-hope to come often and get to know all of you. Great chat!

peds_id_doc#mdchat T2 going to promote The Omnivores Dilemma - Wifey is reading it,

very interesting stuff. Should be mandatory for all!philbaumann @peds_id_doc That's the 7.5 Trillion Dollar question. ;) #mdchat

ability4life Agree!RT @mkmackey: Thanks.. it never fails, I always gain insight fromlistening to discussion from #mdchat

hjluks @GailZahtz Impressed!!! just read your 'about' section #mdchat



ability4lifeTnx :)RT @AureliaCotta: @ability4life @hjluks c here http://bit.ly/hekPi8 forinaccurate historical reason xcss D ws thought unsafe.#mdchat

MattMergT2 Re:NYC calorie posting laws, I was originally skeptical about this, but I findmyself, quite often, making decisions w/ this info #mdchat

AureliaCotta .@ability4life @hjluks They confused D toxicity with a rare genetic disorder.Except they were wrong. #mdchat

AlisynGayleRT @murzee: Agree! RT @sarasteinmd: @drpoppyBHRT @murzee its the foodindustry that needs policing not the consumers #obesity #mdchat

GailZahtzRT @hjluks: @GailZahtz Impressed!!! just read your 'about' section #mdchat<=TY so much! So I'll count you in as a friend and ally :)))

ability4life RT @hjluks: @GailZahtz Impressed!!! just read your 'about' section #mdchat

RichmondDocParting wisdom: As docs as a society we should prioritize helping pts getaccurate info make health choices--for all of society. #mdchat

ability4life #MDchat Thanks Phil, and everyone. I'm jazzed and juiced as always.:) Kathy

MD_ChatThat's a wrap! Good time, everyone! THANK you for participating. Next#MDchat is next Tuesday 9pm Eastern. Transcript will be up later! :)

>>>Official End of Chat<<<

Post-Chat:

sarasteinmdRT @MattMerg: Re:NYC calorie posting laws, originally skeptical,find myself making decisions w/ this info < nice study showed same! #mdchat

murzee Thanks, everyone! great chat, as usual. #mdchat

ability4life {head smack)RT @AureliaCotta: .@ability4life @hjluks They confused D toxicity with a rare genetic disorder. Except they were wrong. #mdchat

hjluksRT @RichmondDoc: Parting wisdom: As docs as a society we should prioritizehelping pts get accurate info make health choices--for all of society. #mdchat

rawarriorRT @hjluks Compliance v Participation... http://goo.gl/WefpT BTW..nevershoot video lying on couch #doublechin #mdchat /lol! still good vid

AlisynGayle

RT @hjluks: RT @chukwumaonyeije: @MD_chat T2: DGMS!(dont get me

started).Issue is not just sugar but industrialized food production. #mdchat#mdchat



chukwumaonyeijeDitto. Good Night. RT @murzee: Thanks, everyone! great chat, as usual.#mdchat

mkmackey Thanks @murzee its nice having an epidemiologist on hand to keep theconversation in line... #mdchat

MD_Chat @chukwumaonyeije Good night! You were rollin' tonight! Thanks!! #MDchat

ePatientDave

RT @chukwumaonyeije: RT @murzee: Agree! RT @sarasteinmd: TAX IT!LABEL IT! OUT the sugar contents in food!!! YESSSS! (in the information ispower vein) #mdchat

RichmondDoc@ability4life @AureliaCotta @hjluks Though, in fairness, the genetic condition

was apparently not found till genetic testing avail. #mdchat

ability4life

RT @chukwumaonyeije: Ditto. Good Night. RT @murzee: Thanks, everyone!

great chat, as usual. #mdchat

ability4life

RT @RichmondDoc: @ability4life @AureliaCotta @hjluks But it also highlightsthe importance of re-assessing what we *think* we know as time moves on.#mdchat

MD_Chat We'll get one of you physicians to host #MDchat! You can do it. It's very cool to watch the stream from this side. :)

ability4lifeRT @drpoppyBHRT: @chukwumaonyeije Education and self-awareness/relianceis necessary to make good decisions in every area of life. #mdchat

RichmondDoc@ability4life @AureliaCotta @hjluks But it also highlights the importance of re-assessing what we *think* we know as time moves on. #mdchat

sarasteinmd night all good one! #mdchat

RichmondDoc@MD_Chat It's funny--the more I do this, the more likely I am to land right onthe 140 more often than I'd imagine. #mdchat

rawarrior I hate this argument. It takes more work to cook, but healthy dried beans are thecheapest food. Just 1 example. #MDchatMD_Chat @richmonddoc Very good use of less than 140. Great parting thought! #MDchat

AureliaCotta@RichmondDoc @ability4life @hjluks Of course, and it also shows the faults of RCT, the supposed gold standard. Sigh. #mdchat

RVAFamilyMagRT @RichmondDoc: Parting wisdom: As docs as a society we should prioritizehelping pts get accurate info make health choices--for all of society. #mdchat

academicobgyn Academic OB/GYN Podcast Episode 27: Journals for November 2010. Blog:http://bit.ly/dUJcRl iTunes: http://bit.ly/dxklAS RT Pls #mdchat



chukwumaonyeijeRT @academicobgyn: Academic OB/GYN Podcast Episode 27: Journals forNovember 2010. Blog: http://bit.ly/dUJcRl #mdchat

RichmondDoc@AureliaCotta @ability4life @hjluks The RCT and well-designed meta-analysisare the best tools we have, albeit limited. #MDChat

kathycorey RT @MD_Chat: The Social Physician by @BunnyEllerin http://bit.ly/gvrW9O#MDchat

EinsteinMedMore on TailorX #breast cancer trial. http://bit.ly/fd9P1K Einstein-Montefioredoc says results could spare 20k women/yr fr chemo. #MDchat

AlisynGayleRT @sarasteinmd: @AlisynGayle it takes some work to get hypervitaminosis A -more likely to go blind from Vit A deficiency - 5th leading cause #mdchat

AlisynGayle

RT @sarasteinmd: @AlisynGayle they should fear weight gain - insulin is the

biggest weight gainer of all the diabetes meds! #mdchat

GailZahtzTY new Docs for following and welcoming me into your #MDchat !@CrescendoCG @sarasteinmd @drpoppyBHRT @mkmackey @hjluks @murzee

Twitter.com/MD_chatMDchat.org

Moderated by @PhilBaumann

PhilBaumann.comHealthIsSocial.com

Date post:	09-Apr-2018
Category:	Documents
Upload:	md-chat
View:	218 times
Download:	0 times

MDchat November 30 2010

Documents