Coughing is a reflex action where the air is rapidly expelled from the lungs to clear excessive secretions, fluids, or foreign material from the airway. Therefore, cough is an important respiratory defense mechanism. However, coughing may also be a symptom of an underlying disease. Apart from the discomfort of coughing itself, excessive coughing can cause multisystem problems. For […]
12 Steps to Diagnose High Blood Pressure – Understanding Hypertension
High blood pressure (BP), also called hypertension, increases the risk of heart disease, stroke, and kidney disease. It is one of the most important causes of premature death worldwide. In 2025, an estimated 1.56 billion adults will be living with hypertension (1). According to the World Health Organization (WHO), hypertension kills nearly 8 million people every […]
Exploring the “Lore of Nutrition”
For the last few days, my Kindle has been my closest companion. “What are you reading”? my wife asked. “I’m reading Lore of Nutrition.” “Ooh, I was sure it was a thriller or one of your crime stories.” In fact, she was right. Although Lore of Nutrition is a book about nutrition, it reads like […]
19 Important Causes of Fatigue – Tiredness and Chronic Fatigue Explained
“Fatigue is here, in my body, in my legs and eyes. That is what gets you in the end. Faith is only a word, embroidered.” ― Margaret Atwood, The Handmaid’s Tale. Fatigue or tiredness is a common medical complaint that may seriously affect people’s quality of life. However, despite many possible underlying causes, a specific medical disorder is […]
In-Flight Medical Emergencies – The Role of the Flight Crew and the Medical Professional
In-flight medical emergencies on commercial flights occur every day. In 2013, it was estimated that 44.000 such events occurred worldwide every year (1). So if you are a doctor, a nurse, a medical student, an emergency medical technician or a person with first aid training, it is quite likely that one day your service will be […]
The Fate of the PURE Study – Fat and Carbohydrate Intake Revisited
Most experts agree that diet is an important modifiable risk factor for cardiovascular disease and many other chronic noncommunicable disorders. Hence, defining and implementing a healthy diet is a matter of great public health interest. However, although there is substantial agreement on many issues, such as the importance of fruits and vegetables, several matters are still […]
Muscular Strength and Longevity – The Role of Strength Training
In 1953, British researchers discovered that drivers of London’s double-decker buses were more likely to suffer a deadly heart attack than the more physically active conductors (1). Another study published five years later found that the risk of heart attack was higher among government clerks than postmen (2). These studies laid the foundation for the hypothesis […]
The CANTOS Trial – Is Targeting Inflammation the Solution to Heart Disease?
The recently published results of the long awaited CANTOS trial may forever change our approach to the prevention and treatment of coronary artery disease (1). Inescapably, there is now proof that targeting inflammation, in this case by a drug, significantly improves outcome for certain very high-risk patients. But, as so often in clinical research, things […]
Can Low-Fat Be Salvaged? – Updated WHI Dietary Modification Trial Results
A recent paper published in the American Journal of Clinical Nutrition provides updated results from the Women’s Health Initiative (WHI) Dietary Modification Trial (1). One of the questions raised is whether there is still hope for a low-fat dietary approach for the prevention of heart disease. The primary aim of the WHI Dietary Modification Trial was to […]
From Low-Fat, High-Carb to Insulin Resistance, Fatty Liver, and Heart Disease
I recently gave a talk at a meeting with colleagues, most of them cardiologists and endocrinologists, where I, among other things, discussed the current status of diet-heart hypothesis and the possible relationship between our fear of dietary fats and the obesity epidemic. After the meeting, a senior colleague of mine, an old friend, and a […]
Who Wants To Live Forever
The famous song, Who Wants to Live Forever, performed by the British rock band, Queen was used for the scenes in the film Highlander, where Connor MacLeod must endure his beloved wife Heather growing old and dying while he, as an immortal, remains forever young. The scenes are both tragic and beautiful at the same […]
18 Important Causes of Shortness of Breath – Dyspnea Explained
Shortness of breath, also known as dyspnea is a symptom that describes a sense of breathing discomfort or difficulty in breathing. It is often expressed as feeling out of breath or suffering from breathlessness. It is estimated that up to 7-8 percent of patients presenting to emergency rooms complain of dyspnea (1). In half of […]
Artificially Sweetened Beverages and the Risk of Stroke and Dementia
I’m often asked which is worse for health, sugar- or artificially sweetened beverages. My most common response is to recommend skipping both and choose water. However, in the era of fructose phobia and the apparent association between high fructose consumption and the risk of metabolic syndrome and diabetes, many tend to prefer artificially sweetened beverages […]
19 Important Causes of Chest Pain
Chest pain is a common symptom associated with a variety of underlying causes. It is estimated that more than six million people visit hospital energy departments in the United States annually because of chest pain. It is the second most frequently reported principal reason for visiting the emergency unit, only abdominal pain is more common (1). […]
Polycystic Ovary Syndrome (PCOS) – From Diagnosis to Symptoms and Treatment
Polycystic ovary syndrome (PCOS) is a common disorder among women. It is characterized by menstrual irregularities, infertility, signs of androgen excess, and polycystic ovaries. It is often associated with obesity, insulin resistance, and lipid abnormalities. PCOS is the most common cause of infertility in women (1). PCOS was first described in 1934 by Irving F. Stein […]