Fearless cardiologist author, Dr Aseem Malhotra, busts myths and shares Pioppi health secrets

One of the most influential cardiologists in Britain and a world leading expert in the prevention, diagnosis and treatment of heart disease, Dr Aseem Malhotra is a brave advocate for public health initiatives. An award-winning NHS cardiologist, Dr Malhotra has successfully motivated leading academics, the media and politicians to make sugar reduction a health priority in the UK. His academic publications can be found in the BMJ and BJSM (see links below) and he is prominent in mainstream media. He recently published what is already a best-seller, “the Pioppi Diet: A 21 day lifestyle plan”.

For more BJSM (British Journal of Sports Medicine) podcasts click here: BJSM Podcasts

Mediator Release Test (MRT) in combination with the LEAP Protocol

“Let food be thy medicine and medicine be thy food.”― Hippocrates

This quote is often cited to emphasize food’s importance. A food’s quality is usually thought to be what agencies such as the USDA and the FDA have to say. There have certainly been great strides in food quality with improved storage techniques and cleanliness. But is it good for me?  The accepted food pyramid may not be the best way to know. The increasing ++incidence of illnesses like diabetes and obesity brings our current understanding of food into question.

In an attempt to solve this riddle, there has been an increase in special tests for food allergies and specialty diets. Are these just fads, or are they based on science? Is there a test of diet that is right for you? This has become a hot topic. There are many “experts”, and it can be difficult to make sense of it all.

I want to share with you my practice’s experience with food sensitivity testing and diet modifications, which uses a practical approach and sets realistic goals. This has been very positive. The process begins with dietary counseling and interventions to decrease inflammation. This usually has secondary benefits such as weight loss and improved blood sugar control. I then proceed to test for food sensitivity with Mediator Release Test (MRT) followed by dietary counseling and coaching with the LEAP (Lifestyle, Eating, And Performance) protocol. Success is measured by the increase in function, decreased pain, and improvement in chronic conditions such as high blood pressure and diabetes.

Below is a video by Susan Linke, a registered and licensed dietitian, Certified LEAP Therapist (CLT), and Certified Gluten Practitioner (CGP). She explains this concept. To learn more, contact my office at (865) 577-1914 for more information.

To your health – Dr. Lakatosh


Water: How much should you drink every day? This is what the Mayo Clinic has to say.

Water is essential to good health, yet needs vary by individual. These guidelines can help ensure you drink enough fluids.

By Mayo Clinic Staff

How much water should you drink each day? It’s a simple question with no easy answer.

Studies have produced varying recommendations over the years. But your individual water needs depend on many factors, including your health, how active you are and where you live.

No single formula fits everyone. But knowing more about your body’s need for fluids will help you estimate how much water to drink each day.

Health benefits of water

Water is your body’s principal chemical component and makes up about 60 percent of your body weight. Your body depends on water to survive.

Every cell, tissue and organ in your body needs water to work properly. For example, water:

·        Gets rid of wastes through urination, perspiration and bowel movements

·        Keeps your temperature normal

·        Lubricates and cushions joints

·        Protects sensitive tissues

Lack of water can lead to dehydration — a condition that occurs when you don’t have enough water in your body to carry out normal functions. Even mild dehydration can drain your energy and make you tired.

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

So how much fluid does the average, healthy adult living in a temperate climate need? The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is:

·        About 15.5 cups (3.7 liters) of fluids for men

·        About 11.5 cups (2.7 liters) of fluids a day for women

These recommendations cover fluids from water, other beverages and food. About 20 percent of daily fluid intake usually comes from food and the rest from drinks.

What about the advice to drink 8 glasses a day?

You’ve probably heard the advice, “Drink eight 8-ounce glasses of water a day.” That’s easy to remember, and it’s a reasonable goal.

Most healthy people can stay hydrated by drinking water and other fluids whenever they feel thirsty. For some people, fewer than eight glasses a day might be enough. But other people might need more.

Factors that influence water needs

You might need to modify your total fluid intake based on several factors:

·        Exercise. If you do any activity that makes you sweat, you need to drink extra water to cover the fluid loss. It’s important to drink water before, during and after a workout. If exercise is intense and lasts more than an hour, a sports drink can replace minerals in your blood (electrolytes) lost through sweat.

·        Environment. Hot or humid weather can make you sweat and requires additional fluid intake. Dehydration also can occur at high altitudes.

·        Overall health. Your body loses fluids when you have a fever, vomiting or diarrhea. Drink more water or follow a doctor’s recommendation to drink oral re-hydration solutions. Other conditions that might require increased fluid intake include bladder infections and urinary tract stones.

·        Pregnancy or breast-feeding. Women who are pregnant or breast-feeding need additional fluids to stay hydrated. The Office on Women’s Health recommends that pregnant women drink about 10 cups (2.4 liters) of fluids daily and women who breast-feed consume about 13 cups (3.1 liters) of fluids a day.

Beyond the tap: Other sources of water

You don’t need to rely only on what you drink to meet your fluid needs. What you eat also provides a significant portion. For example, many fruits and vegetables, such as watermelon and spinach, are almost 100 percent water by weight.

In addition, beverages such as milk, juice and herbal teas are composed mostly of water. Even caffeinated drinks — such as coffee and soda — can contribute to your daily water intake. But water is your best bet because it’s calorie-free, inexpensive and readily available.

Sports drinks should be used only when you’re exercising intensely for more than an hour. These drinks help replace electrolytes lost through perspiration and sugar needed for energy during longer bouts of exercise.

Energy drinks are different from sports drinks. Energy drinks generally aren’t formulated to replace electrolytes. Energy drinks also usually contain large amounts of caffeine or other stimulants, sugar, and other additives.

Staying safely hydrated

Your fluid intake is probably adequate if:

·        You rarely feel thirsty

·        Your urine is colorless or light yellow

A doctor or registered dietitian can help you determine the amount of water that’s right for you every day.

To prevent dehydration and make sure your body has the fluids it needs, make water your beverage of choice. It’s also a good idea to:

·        Drink a glass of water or other calorie-free or low-calorie beverage with each meal and between each meal.

·        Drink water before, during and after exercise.

·        Drink water if you’re feeling hungry. Thirst is often confused with hunger.

Although uncommon, it’s possible to drink too much water. When your kidneys can’t excrete the excess water, the sodium content of your blood is diluted (hyponatremia) — which can be life-threatening.

Athletes — especially if they participate in long or intense workouts or endurance events — are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who eat an average American diet.

Ten (plus one) nutrients to look for in your diet

Nutrition along with exercise, hydration and sleep are essential elements for optimal health. Nutrition may be the most important in that without the proper “fuel”, our “engine” will not work. The elements of nutrition are critical to counteract the daily wear and tear our bodies experience. This prepares us for aging. Yes, we are getting older. It was once said that you cannot run away from a poor diet. The health choices you make now will catch up with you later; it all starts with nutrition.

What we eat, regarding both amount and content are important. Our diet is something we can control, so it is important to know what it contains and what we need. In addition to protein, healthy fats and limited sugars, we need vitamins and minerals. But how much do we need, and where do we get them?  The links below will help. Not all foods are created equal; some contain more and some less.

Our body best recognizes and then absorbs nutrients when they are in foods rather then supplements. My advice is to be mindful of the foods you eat to ensure your body’s nutritional needs are met. Supplements, that is pills, may not be as well absorbed and most likely will cost more in the long term. You may feel that you did your part by taking you vitamin or mineral pill, but it may not be absorbed and does not substitute for a well balance diet.

Below is a list of ten (+1) nutrients to look for in your diet. Each is linked to the University of Maryland Complimentary and Alternative Medicine website and explains what they do and foods that they are contained in.

You can find more information about diet and nutrition on previous blogs. Dr. Andrew Weil’s discussion about the Anti-inflammatory diet is where I recommend starting.

Bon Appetit and Good Health


Are you in the Zone?

Several years ago, I had the pleasure of hearing Dr. Barry’s Sears, a world-renowned biochemist, speak about omega 3 fatty acids, inflammation and being  in “the Zone”.  His lecture has influenced the way I view diet, the treatment of inflammation, and illnesses such as arthritis and muscle pain.

Dr. Sears identifies specific chemicals in our body that increase and decrease inflammation and developed to an ingenuous way of using these to measure our body’s inflammatory state.

The key chemicals Dr. Sears chose to monitor are fats known as lipids and measure the ratio of Triglycerides (TG) to High Density Lipoprotein (HDL), the ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) and the blood level of hemoglobin with glucose attached known as HgbA1c. Together these markers can tell how much inflammation is present in our body as well as monitor our body’s response to diet.

Below is information from Dr. Sears’ website  www.zonediet.com/the-zone-diet/


Clinical Marker Ideal Value What It Indicates
TG/HDL ratio
From your diet.
< 1 Level of insulin resistance in the liver.
AA/EPA ratio
From your diet & fish oil.
1.5-3 Level of diet-induced Inflammation in the body.
From your diet & polyphenols.
5% Level of Advanced Glycoslated Endproducts (AGE) tied to your blood glucose


AA/EPA Ratio Cellular Inflammation Future Wellness
1.5 to 3.0 Low Excellent
3.1 to 6.0 Moderate Good
6.1 to 15 Elevated Moderate
Greater than 15 High Poor


Benefits of being in the Zone include:

·        Losing excess body fat at the fastest possible rate

·        Maintaining wellness for a longer period of time

·        Performing better

·        Thinking faster

·        Slowing down the rate of aging


I welcome you to visit Dr. Sears website www.thezonediet.com to learn more and see if you are in the Zone.

Medical Nutrition Therapy (MNT)

What Is Medical Nutrition Therapy (MNT)?

Medical Nutrition Therapy is a treatment based on nutrition that examines an individual’s nutritional status and nutritional needs. It may add or eliminate foods and/or nutrients to improve medical conditions such as diabetes, heart disease or gastrointestinal disorders. This may be accomplished by simply modifying a person’s diet or involving testing for nutritional deficiencies or sensitivities. The goal of Medical Nutrition Therapy (MNT) is to insure your body is getting the right “fuel” to maximize function.

Here are several articles that review Medical Nutrition Therapy:

The Evidence for the Effectiveness of MNT in Diabetes Mgn

Probiotics and Medical Nutrition Therapy

Example of the conditions treated with Medical Nutrition Therapy:

  • Celiac disease
  • Diabetes Mellitus, Type II
  • Overweight/Obesity
  • Crohn’s disease
  • Food allergies
  • Food intolerances
  • Gastroparesis (Slow Stomach Emptying)
  • Gastroesophageal reflux disease (GERD)
  • Inflammatory bowel disease
  • Ulcerative colitis

What to Expect from Medical Nutrition Therapy:

A medical nutrition therapy program will teach you what you eat is just as important as how you eat and how it makes you feel. Your therapy starts with a comprehensive nutrition assessment.

How it works:

A registered dietitian works with each client individually to create a realistic meal plan and determines appropriate lifestyle changes needed for a healthy lifestyle. Medical Nutrition Therapy is tailored to each client’s needs under the direction of the physician. Testing such as a Mediator Release Test (MRT®) or measuring of blood levels of vitamins and minerals may be considered.

Medical Nutrition Therapy is a tool to help you learn how to achieve a healthy lifestyle and feel better doing it.

“Let food be thy medicine and medicine be thy food”

Knee replacement? There are more options.

Knee osteoarthritis can be painful and disabling. Above age 50 years, 25% of Americans will experience symptomatic knee osteoarthritis. There are approximately 700,000 total knee replacement surgeries each year. It has become almost a right of passage as we age to have a joint replacement with the average cost being almost $50,000. There is also rehabilitation after surgery requiring weeks to months. This surgery is very successful, but there are alternatives.

Several factors predispose many of us to osteoarthritis.  Some risk factors we can control like weight and smoking. However, there are others we cannot control like genetics. Some of these are listed below. Knee osteoarthritis prevalence, risk factors 2011

Risk Factors:

  • Demographic characteristics and family history – Female, Increasing Age, Genetic, Family History.
  • Obesity and metabolic syndrome – Just one pound of weight gain causes 6 pounds of increased stress on the knee.
  • Nutritional and vitamin factors- Deficiency in Vitamins D, K2 and C may accelerate osteoarthritis.
  • Bone density and bone mass – Loss bone mass results in increased risk.
  • Smoking – Increased risk of painful osteoarthritis.
  • Other individual risk factors – Low birth weight, Pre-term birth

Things you can do:

There is no assurance that a knee replacement can be avoided, especially in advanced osteoarthritis, but hopefully, my list of alternative treatments will help reverse the progression of the disease before a knee replacement is necessary.

Anti-Inflammatory Diet

Benefits of the Anti-Inflammatory Diet:

Help reduce certain markers if inflammation (such as a substance called C-reactive protein).

Help manage chronic inflammation-related conditions like diabetes, metabolic syndrome and obesity.

Below is Dr. Andrew Weil discussing the anti-inflammatory diet and his food pyramid. Enjoy good food and good health.



Metagenics Science Based Supplements: Now Available to Our Patients

Metagenics, a triple GMP-Certified medical nutrition company, has partnered with SPORTBLUE to make their products available directly to our patients.

  • Certified Gluten-Free
  • Over 100 vegetarian supplements
  • Science Base Products
  • Non-GMO ingredients

Ask Dr. Lakatosh or his staff what is the right supplement for you. There are supplements we recommend for effective healing of muscle, tendon, and ligament injuries. These supplements also help maximize the benefit of Regenerative Injection Therapy (RIT), such as Prolotherapy and Platelet Rich Plasma (PRP) injections.

Remember, though the supplements recommended are of the highest quality, they may interact with prescription medications or other herbs and supplements. Before beginning supplements make sure you discuss with Dr. Lakatosh or your provider.

Nutrition counseling will be a part of SPORTBLUE in the near future to help guide your choice of foods and supplements to maximize recovery and maintain health.