What is Conjugated Linoleic Acid?
CLA, an essential fatty acid, is an isomer of linoleic acid, which is an
essential polyunsaturated fatty acid found in many vegetable oils. An
isomer is a compound with the same molecular formula but different
structural formula.

Where is CLA  found?
CLAs are found naturally in eggs, milk fat, beef, and the meat of cud
chewing animals, called ruminant animals. Kangaroo meat has the highest
concentration of CLAs. CLAs are much higher in grass-fed ruminants than
grain-fed ones. It can also be produced synthetically by exposing plant
oils that are rich in linoleic acid (like safflower and soybean oil) to a base
and heat.

What are the benefits of CLA?
CLAs have been found to be effective in reducing the risk of colorectal
cancer and improving body composition in people who are obese or
overweight. Studies have shown that it helps decrease body fat and
increase lean body mass. Other possible uses are for bodybuilding, breast
cancer, cachexia (weight loss due to disease), decreasing food allergies,
and atherosclerosis.

Are there interactions between CLA and food, herbs or other supplements?
There is some evidence that CLAs may increase the storage of Vitamin A in
the liver and breast tissues.

Are there side effects from CLAS?
Some people report GI issues while taking CLAs, such as diarrhea, nausea,
fatigue, and dyspepsia. There is also concern that CLA supplements may
create or worsen insulin resistance in extremely overweight individuals,
which may worsen diabetes and or put them at an increased risk for
developing diabetes.

To purchase CLAs:

Practitioner code: DGroothuisRD



What is inositol and where is it found?
Inositol is a vitamin-like substance that is found in many foods, especially fruit
such as cantaloupe and oranges. It is also found in grains and beans, but in a
form that is not bio-available to the human body. Unofficially, it is referred to as
vitamin B8. It works by balancing certain chemicals in the body, like
neurotransmitters, and may participate in the action of serotonin. Inositol is sold
as a supplement.

What are the benefits of inositol?
Inositol has been shown to be effective in treating obsessive-compulsive
disorder, panic disorder, and polycystic ovary syndrome. Some people take
inositol to treat Alzheimer’s disease, ADHA, depression, and diabetic neuropathy
and autism. Others take it to treat high blood pressure, psoriasis, and high

Are there interactions with food or medications and inositol?
None known.

Are there side effects from inositol?
It is well tolerated but can possible cause nausea, tiredness, headache, and

Green Tea

Green Tea

What is Green Tea?
Green tea is a type of tea made from the leaves of Camellia sinensis. It is not
fermented like black and oolong teas. Instead, it is steamed at high
temperatures, which prevents oxidation by inactivating certain oxidizing
enzymes. As a result, green tea is high in polyphenols, such as flavanols (which
include catechins), flavandiols, flavonoids and phenolic acids. Catechins seem to
be responsible for many of the benefits of green tea.

Where is it found?
Green tea can be found in any grocery store tea section. Both caffeinated and
decaffeinated varieties are available. It is also sold as an oral supplement and
topical extract ointment.

What are the benefits of green tea?
Intake of green tea is used to improve cognitive performance and mental
alertness. It is also used to treat prevent/treat certain cancers, hyperlipidemia,
Parkinson’s disease, and hypotension. It may be effective as an aid in weight
loss, osteoporosis, cardiovascular disease, and hypertension. When used
topically, green tea is used to treat genital warts. Additionally, the bags can be
used to wash and soothe sunburn and as a compress for a headache or tired

Are there interactions with medications and green tea?
Because of the caffeine in green tea, one should be cautious and consult a
doctor when taking amphetamines, cocaine, ephedrine, mexiletine, terbinafine
(lamisil), adenosine, anticoagulant drugs, beta-andrenergic agonists, boronic
acid-based proteaseome inhibititors, bortezomib (velcade), cimetidine (tagamet),
clozapine (clozaril), dipyridamole (persantine), lithium, hepatotoxic drugs,
fluvoxamine (luvox), fluconazole (diflucan), and estrogens.
Green tea appears to reduce the absorption of iron from foods. Also, milk added
to green tea has been shown to enhance some of the cardiovascular benefits of
green tea.

Are there side effects from green tea?
Some possible (but rare) side effects may be nausea, vomiting, abdominal
bloating and pain, flatulence, diarrhea, dizziness, insomnia, fatigue, and

Green Coffee Extract

Green Coffee Extract

What is Green Coffee Extract?
Green coffee extract come from green coffee beans, which are coffee beans that
have not been roasted. Therefore, they have a higher level of chlorogenic acid,
which is an antioxidant that boosts metabolism by changing the way glucose is
absorbed in the body.
Most of the research on green coffee has used Svetol by Naturex, which is a type
of green coffee bean extract. Svetol comes from the Robusta variety of beans
instead of the Arabica variety used by many other companies. Svetol is
decaffeinated and is only sold to nutraceutical companies to manufacture their
own weight loss supplements.

Where is green coffee extract found?
It is a supplement. It is recommended to take 400mg 30 minutes before each

What are the benefits of green coffee extract?
Green coffee extract has been shown to be effective in decreasing blood
pressure and aiding in weight loss. It is also used to improve cardiovascular
health and lower blood sugar levels.

Are there interactions with green coffee extract and medications?
Too much caffeine interferes with the absorption of calcium. Also, be careful
when taking hypotensive medications since it has as blood pressure lowering

Are there side effects from green coffee extract?
Green coffee contains caffeine and therefore may have caffeine-related side
effects, such as insomnia, upset stomach, headaches, anxiety, and nervousness.
The caffeine may also worsen diarrhea, osteoporosis and Irritable Bowel



What is ginseng and where is it found?
Ginseng is an herbal supplement that comes from a plant root. There are two
main types: Asian/Korean (Panax) ginseng and American ginseng, which have
different benefits. Ginseng does not come naturally from foods. In additional to
being an oral supplement, ginseng is also used to make soaps and cosmetics,
and it is a flavoring in many beverages.

What are the benefits of ginseng?
Panax ginseng is used to improve thinking, concentration, and memory. It is
also used to enhance well-being and to help people cope with stress; hence, it is
known as an “adaptogen.” Panax ginseng has also been shown to be effective
for diabetes, male impotence, COPD, and premature ejaculation.
American Ginseng has been shown to lower blood sugar levels and to decrease
the risk of developing symptoms from upper respiratory tract infections. It also
may boost the immune system, improve mood, and increase endurance.
People take both types of ginsengs to increase athletic performance and physical
stamina. They also take ginseng to treat depression, anxiety, cancer, anemia,
heart disease, hepatitis C, menopausal symptoms, blood pressure and insomnia.

Are there interactions between ginseng and food or medications?
Ginseng shouldn’t be taken with other diabetes medications because of its affect
on blood sugar levels. It also may also interfere with warfarin or other
medications for depression. One should also avoid stimulant drugs and caffeine
while taking ginseng.

Are there side effects from ginseng?
The side effects are generally mild. Some people experience insomnia, dizziness,
stomach upset, or nervousness.

Vitamin D

Guidelines for Vitamin D may change

Vitamin D is essential for  bone growth and maintenance, and may be linked to cancer and cardiovascular disease. Over the last 10 years, blood panels commonly include Vitamin D, since approximately 40% of people in the US do not have sufficient levels of Vitamin D in the body. Vitamin D is synthesized in the body after exposure to the sun. However, most people do not get all the vitamin D they require from sun exposure alone, and therefore they must rely on foods. There are two types of vitamin D in foods, D-2 from plant sources and D-3 from animal sources. Recent research has shown that vitamin D-3 was twice as effective as D-2 in increasing blood Vitamin D levels. Many food and supplement companies currently use Vitamin D-2 in their products, and this finding may affect the retail sector. This is just another reason to read food labels and to make sure you are purchasing the most active nutrients to benefit your health.


Seniors Should Keep Moving

New Research posted in the journal Obesity found that exercise can help improve the daily activities of obese older adults. As people age, especially if they are obese, sometimes they lose the ability to perform day to day tasks or even walk short distances, which can negatively affect their independence. The study focused on balance, flexibility, walking and strength and found that obese seniors improved their mobility and decreased their risk for a mobility disorder when engaged in the exercise program compared to those that just received education. The take home message is that exercise is important at any age and at any weight. Exercise is vital to remain functional and independent, and its benefits must be taken seriously!


The Fame and Fortune of Being a TV Doc

My patients often ask me, “What is like to be ringside for the biggest fights in the world,” or “What is Mike Tyson like?”  Having worked professional fights for over 20 years from Madison Square Garden and Barclay’s to Mohegan Sun and Foxwoods, I have really had a lot of fun being a boxing doctor. It is fun for my patients to see me on tv and I enjoy when they tell me they saw me on HBO or Showtime over the weekend. I have presented on Ringside Medicine at conferences in Beijing, China and Berlin, Germany and of course numerous times in Las Vegas and Atlantic City. Traveling is part of the fun of being a ringside doc but meeting and teaching my fellow doctors around the world has been extremely rewarding and I know I am giving back to this great sport.

Working ringside is really about one thing – protecting the fighter. When do I stop a fight? The golden rule of ringside medicine is to stop the fight when the combatant can no longer adequately defend himself. For example, this happened at a fight I worked at in Yankee Stadium when one of the fighters tore his ACL. Also, at a fight on Long Island when one of the boxers dislocated his shoulder.  I have stopped numerous matches when a fighter’s eye was so swollen he could not see out of it or when a fighter just stopped throwing punches. Rarely will a boxer want to stop a fight and hardly ever will his cornermen (even if it is the fighter’s father) be willing to quit. It is my job to step up, evaluate and stop those fights.
Although I sit in the corner for the fights, I am working and not there to just enjoy the fight. While people are cheering for their fighter to destroy his or her opponent, I am hoping no one gets too badly hurt. I really enjoy the fights and the energy of the crowds is electrifying. However, when one of the fighters is taking a beating, it can be difficult to watch. The crowd does not want the fight to stop and it is only through years of experience and working hundreds of fights that I have developed the sense when it is time to end the fight. I have had great teachers and I thank them for how they have educated me. I am still learning and it is a great responsibility and honor to help protect these courageous athletes.
The glory of being a TV doc is great, but people don’t realize how much we do behind the scenes. The day before the bouts, we examine every fighter from head to toe. We review their blood tests, EKGs, and brain MRIs. The night of the fight we arrive around 3PM and often don’t leave until 1AM. We re-examine every fighter before the fight and again after the fight and of course sit in the corner during the fights. Typically, there are 6-10 fights in a night.  Assuming everything goes well, it is a fun night but exhausting.
Oh, and the question of how is Mike Tyson? He is very nice, but I would have to say the most intimidating person I have ever met in my entire life.
Cutting calories on white background

Not All Calories Are Equal

From a young age we are taught that the key to maintaining weight is to burn off as many calories as we ingest. We also have learned that weight loss occurs when we consume less calories than we expend, and that we gain weight when we eat more than we burn off. However, research over the past decade has shown us that this formula may not be quite as simple as it seems.

A calorie is actually a measurement of heat energy. Specifically, it is the amount of energy  that is needed to raise the temperature of one kilogram of water by one degree Celsius.  This heat energy is what gives our body fuel.  Our calories come from the protein, fat and carbohydrates that we eat. Protein and carbohydrates have 4 kcal/g, fat has 9 kcal/g, and alcohol has 7 kcal/g.

Current research shows us that the source of our calories is extremely important, and that different food groups affect our weight status differently. It is a myth that a calorie is just a calorie. While all calories do have the same amount of energy – 4184 Joules of energy – our body reacts to the sources of calories differently. This is because we digest and absorb various types of food differently. Those foods go through diverse biochemical pathways and affect hormones in the body, which may also affect satiety and hunger.

As stated above, different foods are digested and go through different metabolic pathways, some of which are more efficient than others.  Protein requires a lot more energy to metabolize than fats or carbohydrates. When protein is ingested, it requires more energy to digest and absorb, which uses more energy.  Therefore, the calories ingested from protein are less fattening than carbohydrate or fat calories.

Another benefit to protein is that it increases satiety more than the other macronutrients. Appetite is reduced and less food and calories are consumed, which may lead to weight loss. This just demonstrates that the type of food that you eat is extremely important, and that all calories are NOT the same.

Further, people who eat whole foods rather than processed foods tend to eat less and have less issues with obesity. Whole foods require more energy to break down and digest than processed foods. This is because many processed foods contain refined carbohydrates, which are low in fiber, low in nutrients, and usually have a high glycemic index. Foods with a high glycemic index are digested quickly and rapidly spike blood sugar levels. This causes food cravings and increased hunger and food intake.

Additionally, foods high in fiber are less likely to cause weight gain. This is because more energy is needed to breakdown the food, and much of the fiber is not absorbed into the body but rather is excreted as waste. Therefore, the body is not necessarily getting the amount of calories listed on the label.

The take home message is not to worry about counting your calories to lose weight. The food choices that you make are much more important for both your health and for your weight. Different food sources affect energy expenditure, hormones, and hunger, which all affect satiety and weight gain. Think about what you are eating rather than how many calories you are eating and look at your food a little differently. If you change your perspective, you will ultimately reach your goals and get healthy!


By Denise Groothuis


How to Reach Your Peak Performance

Do you remember a time when you had to sink a 3-foot putt to win a championship, meet a deadline to present a project to your boss, or study for next day final exam? The simple perception or expectation we placed in ourselves to execute a task entails an arousal in our nervous system. The challenge we all face is how much of an arousal is optimum to achieve top performance? The Yerkes-Dodson Law, also known as the Inverted “U” Model, has attempted to help us identify our ideal level of arousal to achieve peak performance.

The Model indicates that feeling high level of tension or feeling too relaxed will not be ideal to achieve our best. Some level of tension is needed to stay focused and attain our peak performance. Identifying what level of arousal is ideal for you, it will depend on three factors: Trait Anxiety; Expectations vs. Acceptance; Focus Ability.

Trait Anxiety

Trait anxiety refers to the general level of anxiety that is experienced throughout all aspect of the individual’s life. State anxiety refers to the specific situation that is tension provoking. A person who has high levels of trait anxiety will be more likely to negatively respond to a particular stressful situation than a person with low trait anxiety. These individuals will more likely see the negative aspects of the upcoming performance and focus on the obstacles. Their mindset will be aligned toward pessimism or putting blame on others. They will be more easily distracted by outside factors, such as: referee’s calls, opponent’s good shots, weather, and opponent’s ranking.

Also, individuals who practice group sports or teamwork are less likely to feel state anxiety. One of the challenges for these individuals is not elevating enough their level of arousal while in practice only to feel not mentally prepared when the competitive arousal increases during competition or project is due. One useful technique is to simulate the real performance to elevate your arousal enough. The more you practice, the better your ability to manage stress.

Expectation vs. Acceptance

When an individual has doubts about his or her abilities to achieve the desired outcome, and such an outcome is important, the level of state anxiety increases. The perceived lack of control increases the level of state anxiety, particularly for those individuals who experience high levels of trait anxiety. For individuals who show low trait anxiety, they will most likely see the positive side of the situation. They will be more optimistic and/or focus on accepting what they can manage instead of being mentally derailed by non-controllable factors, such as zeroing in on meeting self or other’s expectations.

Placing focus on expectations may lead to an elevated increase in arousal. Given that there is no such a thing as a guarantee result, individuals who pursue expectations embark into a zero-sum game whereas winning, and only winning, matters. One of the key attributes successful individuals share is that of learning from defeats. Individuals who learn from unsuccessful experiences have consistently shown to have made persistent improvement in the pursuit of their goals. They focus on process and acceptance rather than expecting that an outcome must happen.

Focus Ability

Before a performance, individuals are either goal or behavior directed. Those individuals who are goal oriented will more likely give a negative interpretation to their arousal by labeling it as anxiety. Those individuals who are behavior oriented will interpret the same arousing situation as excitement. Highly achieving individuals know that focus is a short-lived experience. They understand that increasing focus rests on enhancing the awareness of the moment when loss of focus takes place. It is precisely then when they shift their attention back to the present moment. Unless they know they lost focus, they have no way of regaining it. Meditation has been shown to enhance one’s ability to shift attention to the present moment. Those who consistently practice it have been better able to regain their focus to what it is in front of them rather than being mentally derailed by non-controllable factors.