Chicken with Roasted Garlic and Balsamic Vinegar

4 boneless chicken breastsOLYMPUS DIGITAL CAMERA
1 jar whole mushrooms
2 Tbsp flour
salt and pepper, to taste
2 Tbsp olive oil
6 cloves garlic, peeled
4 Tbsp balsamic vinegar
1 cup chicken broth
1 bay leaf
1/4 tsp dried thyme
1 Tbsp butter

Season flour with salt and pepper and dredge chicken breasts in flour mix.  Heat olive oil in heavy skillet and brown chicken on one side, approx. 4 minutes.  Add whole garlic cloves.  Turn chicken pieces and scatter the mushrooms all over.  Continue cooking, shaking skillet.  Cook approx. 4 minutes and add the balsamic vinegar and broth.  Add bay leaf and thyme.  Cover closely and cook over medium low heat, about 10 minutes.  Turn pieces occasionally as they cook.  Transfer pieces to warm serving platter and cover with foil.  Let the sauce with the mushrooms cook uncovered, over medium high heat about 5-7 minutes.  Swirl in butter.  Remove and discard bay leaf.  Pour sauce over chicken and serve.

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Pan Poached Salmon Piccata

½ cup waterOLYMPUS DIGITAL CAMERA
2 teaspoons lemon juice
1/8 teaspoon chicken broth granules
2 (4-6 oz. each) Salmon fillets
1 tablespoon butter
1 tablespoon capers
Black pepper
Chopped parsley, for garnish

Bring water and lemon juice to a boil in medium-sized skillet.  Stir in chicken granules.  Reduce heat to a simmer and place salmon in pan.  Cover and simmer over low heat, 10 minutes per inch of thickness, measured at the thickest part, or until fish flakes when tested with a fork.  Remove salmon from pan; keep warm.  Boil remaining liquid in pan until it reduces to approximately ¼ cup.  Whisk in butter and stir in capers.  Spoon sauce over fish.  Season with pepper and sprinkle with fresh parsley.  Makes two servings.  Note:  Recipe may be easily doubled.

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Our Bodies are Truly Temples

woman doing yoga outdoors
Last week my son started Veterinary Medicine School. As with Medical School, the quintessential class for indoctrination in the Medical Arts is Gross Anatomy. He is dissecting a dog; I dissected a human being. Remarkably, they are quite similar. In order to help him and contemporaneously restore my own misplaced memories I took the opportunity to dust off my thirty-year-old Clemente Atlas of the human body. What I discovered was both astonishing and unanticipated. First the bad news – I had forgotten much more than I had remembered. Second and far more interesting and uplifting was my reinforcement that countless marvels abide within us all. Each of us is a universe of infinite possibilities. To say we are complex, intricate, amazing, unparalleled falls so short of the mark that it is nearly not worth saying. Our complexity is ineffable. Over the past decade my focus in cardiovascular prevention has been on our bodies’ microscopic goings-on; biochemistry, cell biology, molecular biology, and organic chemistry have been my playgrounds. Each time I’ve learned something new I’ve recognized how little I (we) know. With all we appreciate, we have merely scratched the surface of the elaborate, multifarious activities engaging each of our trillions of cells at every moment of life. And that’s the microscopic. I had neglected the macroscopic: our bones, muscles, nerves, organs, and network of vascular tributaries. Looking at the visible is no less remarkable than the invisible. Do this now. Lift your arm to scratch your head. In performing this singular simple act you have activated countless neural, muscular, vascular, and skeletal systems. And that doesn’t include all the cell-cell communications requiring the activation of genes and creation of proteins as well as the intentional movement of made-to-order bio-chemicals as well as armies of cells. All this just to scratch your head! Try to imagine how spectacularly intricate are our bodies’ activities when there’s a crisis, say a pneumonia or deep wound to your leg. The coordinated responses of layers of participants in maintaining our health and physical prosperity become fully activated. These reactions are so far beyond our wildest imagination that I predict no supercomputer will ever crack the code.

Yes we can pound our chests and pretend we are gods when we clone sheep. The truth is, to god, we are no god.

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Distortion of Scientific Findings: Here We Go Again!

“Baby’s Blocked Belly Tied to Low Cholesterol” is the headline of today’s Medscape article reporting on a just-released JAMA publication. Contrast this with the article’s actual title, “Plasma Lipids, Genetic Variants Near APOA1, and the Risk of Infantile Hypertrophic Pyloric Stenosis”. Notice a difference? Accurate headlines don’t sell papers, or blogs. Apparently our interest is peaked only by findings or events that have an immediate and preferably negative impact. One would infer from the headline that low cholesterol is bad, causing the “blocked bellies” in babies. In no way does this study actually come to such a conclusion. Instead it reveals that the genes causing pyloric stenosis reside near those controlling certain lipid levels. Both sets of genes can experience changes (polymorphisms) resulting in abnormalities. So, abnormal lipids in these children are more likely the result of being in the wrong place at the wrong time. It is likely that the two disorders occur concurrently not because of causality, but rather misfortune. Low cholesterol is not necessarily causing the pyloric stenosis even if it is associated with the disorder. Similarly, pyloric stenosis is likely not causing the abnormal cholesterol.  The bottom line again; read everything with cautious eyes.

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CoQ10 Levels – Another Example that Knowledge is Power

I have always believed it is better to know than not to know. In Medicine such a philosophy often translates into performing tests in order to acquire data. Novel blood tests represent a safe and effective way to better understand subtle perturbations in our patients. About eight months ago the Cleveland Heart Lab added CoQ10 levels to its offerings and since then I have monitored them in my patients. The results have been eye opening. Ironically, although a long-time advocate of appropriate supplementation (in 2002 I founded an ultra-conservative nutritional supplement company www.vitalremedymd.com) I have grossly under-appreciated the prevalence of low CoQ10. Yes, statins can lower these levels, but my contention had been that the absence of statin-related symptoms assured the adequacy of body stores of this nutrient. Quantifying my patients’ CoQ10 levels disproved my prior conviction as I have witnessed a surprisingly high number of asymptomatic people harboring low CoQ10 levels. And, understanding that low CoQ10 might be associated with larger heart attacks and lower levels of HDL, I now feel compelled to correct this problem through supplementation.

Although many years back I had formulated StatinGuard® to maintain normal CoQ10 levels, I had never recommended it to asymptomatic individuals, my aim being to always minimize the ingestion of anything superfluous (supplement or medicine). Since the revelation produced by utilizing the CoQ10 blood test, I’ve recommended StatinGuard far more frequently. A CoQ10 measurement is just one of many innovative windows now available for physicians to peer through in order to inspect the metabolism of individual patients. Each test holds its own distinctive place in the practice of patient-centric medicine. The lesson once again: it is always better to know than not to know.

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Knowledge Reveals Profound Ignorance: the Hallmark of Medicine

I’ve said this many times before, Medicine Is a process, one that replaces old ideas with new understanding. HDL offers a perfect example. We all know HDL to be “the good cholesterol”. Simple, correct? HDL is the cholesterol that protects us from heart attacks and strokes; that’s its job. Low HDL implies risk while high HDL, protection. Enter the science of the past decade. Everything has changed. We’ve discovered that raising HDL in patients already on statin medications does not (as we previously believed) necessarily equal risk reduction. Far more profound than this realization is the fact that HDL is NOT “the good cholesterol”. Yes, it is a carrier of cholesterol, and yes it helps reduce the risk of heart attack, but NO it is NOT cholesterol.

It turns out that HDL is an extraordinarily complex structure with many phases of life and many forms and functions. HDL can be a disc and it can be a sphere. It can be very large or very small. Its surface can carry over 200 different types of fats and about 200 various forms of proteins. And, specific combinations of these fats and proteins will imbue the HDL particle with specific functions. HDL particles can help us fight infections, carry vitamins and nutrients throughout our bodies, protect LDL particles from oxidation, and shuttle proteins around the body to be given to more needy recipients. The list goes on. HDL is amazing. And the more amazing we know it to be the more we must admit how little we understand HDL. So if HDL is so complex, imagine how intricate our entire bodies are. The bottom line, please be patient with your doctor. He or she is trying desperately to understand and work with an ever-expanding field of information. Please understand that what may seem to be mistakes in science are often simply the byproducts of growth and development. We all aspire to the same goal, the expansion of health and reduction of illness. We really are all on the same team.

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Preventive Health News

couple bike riding

This week’s roundup of important preventive health and health-related news.

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