UPDATED: July 5, 2025
Welcome to the Healthy Living Is Good Medicine Newsletter, a totally free, health education publication covering a wide array of topics, with original articles presented as a public service to help people lead healthier lives.
Instead of taking a deep dive into a single subject, this Post will present three unrelated articles, and omit references to research studies and explanatory links. I aim to please, and based on reader feedback suggesting that I make my articles shorter and less scholarly, I am tryng out a format known as “infotainment,” a style that is less educational and more enchanting.
Milestones in Public Health and Preventive Medicine
Vaccines are perhaps the most significant public health intervention ever achieved by medical science. They have led to the eradication of smallpox, the near eradication of polio, and a drastic reduction in the incidence of diseases such as measles, diphtheria, tetanus, and pertussis. While Edward Jenner is acclaimed for his discovery of smallpox immunizations in 1798, it was Louis Pasteur in the 1880s who created the first vaccines for fowl cholera, anthrax, and rabies, using weakened or attenuated live microbes.
Sequestration of raw sewage and preventing the fecal contamination of drinking water has been essential in preventing the spread of numerous waterborne infectious diseases. A sewer system and safe public drinking water date back to 1842 London. Sanitation practices such as these have dramatically reduced the number of deaths from cholera, typhoid fever, and dysentery.
The development of antimicrobial pharmaceuticals, beginning with Alexander Fleming's discovery of benzylpenicillin in 1928, and the widespread commercial availability of penicillin since 1945, revolutionized the treatment of bacterial infections. In the years that followed, antibiotics have saved innumerable lives and radically transformed the treatment of infectious diseases.
Long before the marvels of modern medicine, the invention of soap was the earliest innovation to profoundly improve human health and extend people’s lifespans. Soap's origins date back to ancient civilizations, including the Babylonians, Egyptians, and Sumerians. The earliest indication of soap-making comes from Babylonian clay tablets dating to about 2800 BCE. They detailed how to make soap from water, alkali, and cassia oil.
Soap has literally altered the course of human history. Before the widespread adoption of hand-washing with soap after using the toilet and before eating, infectious diseases could spread rapidly throughout dense populations. Today, even in the midst of highly advanced medical technologies, soap remains one of our most powerful tools for disease prevention.
Washing with soap prevents disease transmission by physically removing pathogens from the skin's surface, while also killing some harmful microorganisms. In under-developed parts of the world, hand hygiene has reduced respiratory infections by 16 to 21 percent, and diarrheal diseases by up to 50 percent.
The United States continues to experience frequent outbreaks of norovirus infections. The norovirus is unaffected by hand sanitizers containing alcohol, but it can easily be killed by washing with soap. Take it from me, you don't want to get this nasty disease, unless you enjoy projectile vomiting and explosive diarrhea. Pass the soap, please.
How to Choose Healthier Carbs
By now, we should all know that many carbohydrates have a pretty significant downside. Simple carbohydrates such as table sugar, refined carbohydrates such as white rice, and ultra-processed carbohydrates such as white bread, can contain too much fructose, be lacking in dietary fiber, and produce a high glycemic load. I refer to these unhealthy carbs “diabetogenic” because they can increase the risk of developing type 2 diabetes.
Unfortunately, the typical Western diet contains an abundance of these diabetogens. With ultra-processed foods dominating grocery store shelves, it should come as no surprise that about a third of the U.S. adult population is estimated to have the metabolic syndrome, a harbinger of chronic diseases and shortened life expectancy.
In my recent article about bread, I suggested that people eat only those breads that are made entirely from whole grains. Ideally, your daily bread will have a high density of dietary fiber and very little sugar. As a general rule, it is best to avoid any baked goods that have lots of added sugars, regardless of their source and how delicious they might make the taste. The high amounts of fructose found in table sugar, honey, and syrups are so bad for people’s health that this metabolic toxin has been called “Sweet Death.”
Soluble fiber nourishes our gut microbiome, and a healthy microbiome pays big dividends. When planning a meal, I start by ensuring that it will contain lots of fiber. Then, I add protein as much as necessary to meet about a third of my daily requirements. Finally, I want it to contain essential micronutrients.
Just how much or how little fiber and sugar should there be in the foods you consume for them to be considered healthy? To answer that question, I came up with some simple formulas, and put AI to work writing the computer code for an interactive web page that would perform the calculations and present an assessment.
AI was able to do in 15 seconds what would take a human programmer many hours, and did it for free. You can be the judge and decide if my use of digital technology was appropriate in this case. This is what the web page looks like (just an image, not a functioning calculator):
If you really want to know how healthy grain-based food products such as bread, cereal, pasta, and pastries actually are, read the “Nutrition Facts” label on the package, and then plug the relevant numbers into the calculator to find out. Why remain an uninformed consumer when you can easily obtain information to help you make better choices? Here’s the link:
Please take into account that the ratios used are not etched into stone tablets by an unseen hand. They only serve as a realistic starting point for making comparisons. If your favorite grains don’t measure up based on my criteria, don’t give up on them just yet.
For example, brown rice is actually low in fiber and has hardly any soluble fiber. Consequently, it needs to be combined with high-fiber food sources, such as legumes (beans, peas, lentils, peanuts, tofu) and/or brassica vegetables such as cauliflower, kale, and Brussels sprouts. I typically add lentils to my oatmeal and black beans to cooked barley, which helps boost the fiber, protein, and micronutrient content of the meal. When putting health first, we need to think outside the conventional recipe box.
Adults who eat as little as a half-cup of cooked beans, peas or lentils daily show marked improvements in their cardiovascular, digestive, and metabolic health. An accompanying weight loss includes a decrease in abdominal adiposity. Legumes lower cholesterol, blood pressure, and blood sugar levels, decrease inflammatory biomarkers, and improve the composition of the gut microbiome. Being a little more gassy until your microbiome adjusts is a small price to pay for all those health benefits.
Zepbound’s Effects on the Brain
Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) such as "Oh-Oh-Oh-Ozempic" are a class of drugs first developed for the treatment of type 2 diabetes. They work by stimulating the pancreas to increase its glucose-dependent release of insulin. They also cross the blood-brain barrier and act upon the brain’s reward centers, curbing people’s appetite.
Tirzepatide, marketed as Zepbound by Eli Lilly, is prescribed for the treatment of obesity. It currently appears to be the most effective GLP-1 RA for weight loss. I was curious about the drug's impact on the brain, and asked one of my subscribers, a self-described “foodie” who is taking the drug and losing weight, to describe how their relationship with food has changed as a result. This is their story:
As long as I can remember, the food noise in my head has been deafening. I never understood the “food is fuel” concept or how anyone could “forget to eat.” For those lucky enough not to experience food noise, I’ll try to describe how I experience it.
Whenever the “eat food” switch in my brain gets flipped on, it’s time for a meal. I feel hunger, and if I see something in an ad or TV show, the food slot machine in my head starts running. I'm thinking of what I might want to eat, with every potential item like a coin that I can feed into the food's dopamine-hit slot machine. Is this pizza going to give me perfect food satisfaction? Is that burger going to provide the exact right jackpot combination? Is it going to be worth it? Should I have a salad instead? But doesn’t that fish and chips sound good?
When the potential for hitting a food jackpot appears, this kind of running internal commentary will be there in my head until I satisfy the craving, be it hours or days later. Often, by the time I eat whatever thing I’ve been quietly obsessing over, I don’t even really want it as much anymore, I just want the food noise to stop. The expected dopamine hit doesn’t come, because it has already been spent in by anticipation.
Tirzepatide has been a complete game-changer for me. The food noise is mostly gone. The hunger that could never be fully satiated is no longer there. I feel full sooner, and stay full longer. I get occasional twinges of food cravings, but it’s much easier to ignore them until they fade, which they now do. It actually takes effort and intention to eat enough food, especially protein, to nourish my body, and I’ve become one of those “food is fuel” people!
I have lost weight, yes, but infinitely more important to me than a number on a scale or a size on my jeans, is that my relationship with food has changed. I’m still a foodie. I still take great joy from a good meal, I just eat less of it. For the first time in my life, I can ask my body what it wants, and clearly hear the answer.
I hope that the above tale will help people to stop blaming themselves for having a disease (obesity), and will discourage others from shaming those who have it. Losing weight is not simply a matter of willpower and dieting. It also requires the cooperation of your brain and gut microbiome.
Regardless of how weight loss is achieved, people tend to regain that weight after ceasing treatment because they’ve underestimated the effort required to keep the weight off. Our metabolism adapts, and our brain keeps trying to push us back to our heaviest fat mass, unless we continue taking medication. Only bariatric surgery can produce results that are permanent.
Consequently, diet-induced weight loss is only temporary, unless dieting becomes a way of life. Ongoing professional coaching and/or a peer support group hase been shown to help some people maintain their weight loss over extended periods of time.
On the horizon are more pharmaceutical candidates such as amycretin, an oral medication taken once or twice a day. Amycretin targets both GLP-1 and amylin receptors, and has shown promise in a phase 1 clinical trial. It remains to be seen how it will stack up against the current crop of GLP-1 RAs.
Regardless of whether or not you want to lose weight, I suggest reading my eBook, Rx for Healthy Eating. It provides an in-depth look at the nutritional principles underlying a healthy diet, offers guidance for cooking healthy meals and making their preparation easier, and presents lots of recipes that should inspire culinary creativity. The book is available from Barnes & Noble, Google Play Books, and the Amazon Kindle Store. It costs less than a burger and fries, but unlike fast food, it could actually save you from a heart attack.
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