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

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.

New Office Location

I will be relocating my practice to the Bearden area of Knoxville effective September 6, 2017.

The Seymour office and the Fort Sanders office will be closing at the end of August.

The new office address is:

407 North Forest Park Boulevard

Knoxville, TN 37919

Tel 865 577.1914   Fax 865 577.1714

There will be several exciting changes to announce in the near future, so keep posted.

If you have questions, concerns or recommendation please do not hesitate to contact our office.

Donald Lakatosh, M.D.

Whole Body Vibration Training (WBVT): It may be good to shake things up.

Whole Body Vibration Therapy is a passive exercise using vertical directional force against gravity. This creates what some refer to as “hyper gravity”.  Our body responds subconsciously to vibration frequencies of 23 Hz or higher by contracting muscles fibers. This is because the stretch receptors in our muscles and tendons are activated; they respond by rapidly contracting and relaxing every 2-3 seconds resulting in a near 100% activation of muscle fibers, a response that otherwise can only be achieved by extended weight training.  This in turn activates a cascade of physiological responses that can improve bone mass, circulation, and balance. There is also a release of hormones such as human growth hormone (HGH) and serotonin. The benefits include increased muscle tone, prevention of osteoporosis and improved balance to name a few.

Below is a list of potential benefits which are linked to a scientific article. I also linked to Dr. Mercola’s “Peak Fitness” which discusses Whole Body Vibration Therapy. Below are 2 videos demonstrating WBV; one on “The Doctors” and another on Advanced Whole Body Vibration Workout.

The Many Health Benefits of Whole Body Vibrational Training (Dr. Mercola)


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


Sitting All Day? Well it’s time to move.

Most of us are busy and technology which can make work more efficient. It can also lead us do MORE work. This technology whether it be a phone, tablet, computer or smart watch takes our attention and we usually are sitting still using them. With these advances, most of use have become less “mobile” throughout the day. We may go to the gym and exercise, but for most of our day we are either sitting or standing in place, but not moving.

Below are several articles that explain what happens it we don’t move and innovative ways to change that. So if you have the chance just move, take the stairs, walk or even dance. You body needs to move and you will feel better for it.

10 Things That Happen When You Sit Down All Day

·       Weak Legs and Glutes
·       Weight Gain
·       Tight Hips and a Bad Back
·       Anxiety and Depression
·       Cancer Risk
·       Heart Disease
·       Diabetes Risk
·       Varicose Veins
·       Deep Vein Thrombosis (DVT)
·       Stiff Shoulders and Neck

Sitting Is Killing You, But Standing Isn’t the Answer (And Neither is Exercise) by Fitness in Post

How to Survive Sitting All Day by Nerd Fitness

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”

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.