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Chewing Tobacco Riskier than Smoking

Baseball players still chew tobacco even though it causes cancer of the mouth, tongue, lip and throat. A study from the Office of Smoking and Health at the Centers for Disease Control and Prevention, Atlanta, Georgia, shows that compared to stopping smoking completely, smokers who switch from smoking to chewing or snuffing tobacco are at much higher risk for dying from lung cancer, heart attacks and strokes (Tobacco Control, February 2007). The authors feel that the high content of nitrosamine in tobacco is the cause. However the high content of nicotine in all tobacco products is the most likely cause.

The nicotine in tobacco is a potent stimulant, but most athletes produce so much adrenalin before a competition that they don't need any more stimulation. When you smoke tobacco, the nicotine is absorbed from the lungs and travels undiluted directly to the brain so that eight seconds after you puff on a cigarette, almost all the inhaled nicotine is inside your brain cells to cause a sudden jolt that calms you down, makes you more alert, and even helps you concentrate better. If you take another puff before some of the nicotine has cleared from your brain, the dose is too great and can cause headaches, nausea, dizziness, flushing and shakiness.

When you chew tobacco, nicotine is absorbed through your cheeks and mouth and is diluted by blood from the rest of the body before it reaches your brain, so that small amounts of nicotine reach the brain continuously over long periods of time, and you can tolerate much larger doses. Baseball players don't seem to care, but most people realize that this habit looks disgusting and has terrible health hazards. Solid cancers need an ever-increasing blood supply to grow in your body, and nicotine stimulates formation of new blood vessels which increases risk for many different types of cancers. Nicotine also constricts coronary arteries to increase risk for heart attacks and strokes.


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Dear Dr. Mirkin: Is there an easy way to increase the intensity of my workouts?

A study from the University of Plymouth in England show that loud music helps you to exercise more intensely (Ergonomics, December 2006). Thirty volunteers performed five 10-minute exercise sessions on a treadmill with music at four settings: fast and loud, fast and quiet, slow and loud, or slow and quiet. One session was performed with no music. The participants exercised harder with music than without, and they pushed much harder when they heard fast, loud music.

Before you use fast music or any other technique to increase the pace of your workouts, check with your doctor. Hard exercise can cause irregular heartbeats in people with blocked arteries. If your doctor is concerned, he will order a nucleotide stress test. If that is normal, it is probably safe for you to exercise to loud, fast music and benefit from you increased intensity.


Dear Dr. Mirkin: Should I avoid nuts because of their high fat content?

A review of the world's literature from the University of South Australia shows that both tree nuts and ground-nuts (such as peanuts) are healthful (Current Opinion in Lipidology, February 2007). Nuts are very rich in fat that can be classified into good and bad types. The "bad fats" include saturated fats and partially hydrogenated fats, and nuts are very low in both of these types.

Good fats include the monounsaturated fats that are healthful because they form a type of LDL cholesterol that is resistant to oxidation (LDL cholesterol must first be oxidized before it can damage arteries). Nuts are a rich source of monounsaturated fat. Another good fat is omega-3 that helps to reduce inflammation, a major cause of heart attacks, and nuts contain some omega-3s.

Even though they are a rich source of calories, nuts have not been shown to increase risk for obesity in multiple epidemiological studies. They do not cause a high rise in blood sugar and have never been associated with increased risk for diabetes. They contain arginine and polyphenols that have been shown to help protect arteries from damage. More on nuts at


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Green Pea Soup

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June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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