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Studies reveal high fat, sodium content in restaurant meals.

Studies reveal high fat, sodium content in restaurant meals.


Bloomberg News (5/14, Wayne) reports that the “average meal at a chain restaurant contains more than half the calories, 1.5 times as much sodium and almost all the fat that people are recommended to consume in an entire day,” according to a study published online May 13 in the journal JAMA Internal Medicine. The University of Toronto researchers “analyzed nutritional information for 685 meals and 156 desserts reported by 26 sit-down restaurant chains” and found that the meals contained an average of “1,128 calories, or 56 percent of the US Food and Drug Administration’s 2,000 calorie-a-day recommendation.”

Reuters (5/14, Seaman) reports that in a separate study published online in the same issue of JAMA Internal Medicine, US Department of Agriculture Energy Metabolism Lab Director Dr. Susan Roberts, who is also a professor at Tufts University, and colleagues, analyzed the calories in 157 meals at small ethnic restaurants – American, Chinese, Italian, Japanese, Mexican and Thai – in the Boston metropolitan area and found that the meals contained an average of 1,327 calories, or 66 percent of the FDA’s daily calorie-intake recommendation.

AFP (5/14) notes that the “Italian meals had the highest average calories per meal (1,755), followed by American (1,494 calories) and Chinese (1,474 calories). Vietnamese meals had the fewest calories on average (922), and Japanese meals had the second lowest (1,027).”

The New York Daily News (5/14, Miller, 543K) adds that the FDA is “working on legislation that will require chains with 20 or more locations to post calorie content for all of their menu items.” But the Dr. Roberts, the lead study author of the Boston area study, said that only “accounts for about half the nation’s restaurants. ‘Fifty percent of restaurant locations are small places that don’t post calories and aren’t going to have to when the new legislation comes in,’ she told the Daily News.”

The Boston Globe (5/14, Kotz, 250K) “Daily Dose” blog adds, “Other new research published in the same issue of JAMA Internal Medicine found that fast-food restaurants have done little to reduce their sodium content.” A study by “researchers from the Centers for Science in the Public Interest, a nonprofit nutrition activist group, found that sodium increased in restaurant meals by nearly 3 percent from 2005 to 2011.”

The CBS News (5/14, Castillo) websites add that the CSPI study also “showed that the average sodium content in 402 packaged foods only decreased 3.5 percent between 2005 and 2011.”

MyHealthNewsDaily (5/14, Rettner) reports that in an editorial accompanying the CSPI study, “Dr. Mitchell Katz of the Journal of the American Medical Association noted that government regulation of salt content may be difficult. ‘Regulating calorie size, or the maximum of a necessary nutrient, such as salt, will always raise questions of whether the government is going too far in regulating our lives,'” he noted.

Additionally, the Huffington Post (5/13) points out that the “new studies come on the heels of a report (pdf) just published in the American Journal of Preventive Medicine, showing that the nutrition quality of fast food has improved just 3 percent over a 14-year period.” Also covering the three JAMA Internal Medicine studies are HealthDay (5/14, Reinberg), MedPage Today (5/14, Petrochko) and Heartwire (5/14, O’Riordan).

Successful Dieting Requires Less Calorie Counting

The AP (4/11, Choi) reports that dieters are doing less calorie-counting and instead focusing on foods that make them feel more satisfied. The piece notes that “the new thinking is that eating foods with more protein or fat will make dieters less likely to binge later, even if they’re higher in calories.” This is what we at the Center for Plastic Surgery have been saying for years. Also, by changing the composition of foods so that the sugar content is less and it is higher in acid and fiber as well as fat and protein, blood spikes are prevented by slowing the absorption of what is eaten. This reduces Insulin production and maintains a steady blood sugar level. The steady blood sugar level keeps you from being hungry. Insulin spikes drive excess sugar into the cell storing it as fat and preventing Glucagon and Growth Hormone (the hormones secreted by exercise) from removing fat from the cell. Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, said, “People are recognizing that it’s not enough to just go on a diet and lose weight. Nutrition comes more into play.” The reason that “diets” do not work is that you never change your tastes. When you reach your goal, your old tastes take back over and you regain the weight. By gradually changing what you eat, you gradually change your taste and maintain what you have achieved.

Want a Tummy Tuck or Facelift? Quit Smoking First!

The reminder to quit smoking has always been present yet most people still find themselves not heeding such advice. Yet, here at our North Carolina plastic surgery practice, the better and quicker results following plastic surgery has been motivating for most patients.

Why Quit the Stick?

Aside from the well-publicized ill effects of smoking such as stroke, heart disease, and various types of cancer, tobacco smoke has been shown to delay healing and significantly increase your risk of developing complications following surgery.

Specifically, smoking has the following effects after plastic surgery:

  • Cigarette smoke constricts the blood vessels which in turn reduces the amount of oxygen to your vital organs. If you continue to smoke post-surgery, there’s a huge chance that the area you’re operated on will receive lesser blood supply resulting to delayed healing.

  • With delayed healing, you also put yourself at risk of wound separation, infection, and significant scarring. This also translates to increased hospital stays and increased chances of admission to intensive care units.

  • Furthermore, smoking increases your risks of developing complications post-surgery. This study, focusing on the effects of smoking to elective or non-emergency surgeries, found a strong link between smoking and the likelihood of developing blood clots, kidney failure, and pneumonia post-surgery.

Quit Smoking Before Your North Carolina Plastic Surgery

Let us help you quit smoking before your North Carolina plastic surgery! We are located at 209 Hospital Drive, Suite 202, Highlands, NC.  Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We look forward to your visit!

Because Your Hands Will Give Your Age Away!

Although the face is often the subject of anti-aging procedures, you might be surprised to know that your hands could actually betray you when it comes to revealing your true age. Here at our North Carolina plastic surgery practice, we often advise our clients to also take the time to take care of their hands. After all, no matter what you do to make your overall appearance look younger, your hands will most likely just give your age away.

Hand Care Tips and Tricks

1. Don’t skimp on the lotion, moisturizer or hand cream. While your hands won’t reveal signs of aging until you’re in your 30s or 40s, using hand moisturizers as early as your 20s will work to your advantage later in life.

2. Be generous with your sunscreen, too. If possible, choose moisturizers with sunscreen properties! UV exposure is the #1 culprit of blemishes, sun spots, and premature appearance of wrinkles on your lovely hands.

3. If your skin is extra sensitive, avoid products which are quite harsh. This will only make your hands flaky and dry.

4. If you frequently do household chores such as doing the laundry, wear rubber gloves as much as possible.

5. Consider hand rejuvenation procedures such as chemical peels and laser skin resurfacing.

If you’re noticing obvious signs of aging in your hands, let us help you out! We have a variety of anti-aging options suited to your needs and preferences.  We are located at 209 Hospital Drive, Suite 202, Highlands, NC.  Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We look forward to your visit!

Your Exercise Could Be Making You Look Older

Apart from time itself, aging is influenced by a variety of factors — from sun exposure to nutrition to one’s lifestyle. However, did you know that your workout could actually make you look older? Find out why below.

Premature Aging

High-impact exercises such as running could actually make you look older by making your skin thinner, resulting to that prematurely old and gaunt appearance. Increase intake of oxygen also makes those wrinkles appear earlier than usual. Add in prolonged exposure to the sun and fluctuating levels of temperature and your collagen easily degenerates.

Bouncing Breasts

Ill-fitting sports bra and too much exercise may cause your breasts to sag as they are constantly bouncing up and down while doing your workouts.

The Action Plan

You do not have to stop exercising in order to avoid sagging breasts and premature aging. Here at our North Carolina plastic surgery practice, we recommend the following tips and tricks to make your workout more enjoyable and less stressful on your end.

1. Consider trail running over road running. The trails offer less pollution and less impact (which also means less risk of injury).

2. Slather on sunscreen before going out and always follow label instructions as to the amount and timing of application.

3. Wear proper support.

If you’ve been exercising for a while now and you’re noticing obvious signs of aging, let us help you out! We have a variety of anti-aging options suited to your needs and preferences.  We are located at 209 Hospital Drive, Suite 202, Highlands, NC.  Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We look forward to your visit!

Daily Sunscreen Saves Your Skin

Although I have been preaching use of sunscreen to protect skin aging for years, a new study from Australia has now provided the strongest evidence yet to support my contention. Regular sunscreen use keeps your skin looking younger. The study which examined skin casts of 903 patients over 4 ½ years and was published June 3rd in the Annals of Internal Medicine showed conclusively that use of sunscreen regularly fights wrinkles. Previous studies suggesting the importance of sunscreen use were all done in animals. This is the first conclusive study in humans and it showed a 24% decrease in skin aging in those using daily broad-spectrum sunscreen over those who used it whenever they thought about it. This is a huge difference for such a short study, especially when the control group occasionally also used sunscreen. Broad-spectrum sunscreens are those that block both UVB (those rays present mid-day in the summer causing sun Burn and relatively easy to block) and UVA (deeper penetrating rays present all day, year around, and at all latitudes making up 97% of the UV rays and thought most responsible for Aging). Interestingly, the FDA instituted new labeling rules last December requiring better labeling of broad-spectrum sunscreens rather than the old SPF system that indicated only blockage of UVB. However, not all of these are equal. For practicality, we recommend use of a sunscreen containing Zinc Oxide of from 5-12%. This blocks both UVA and UVB and only has to be reapplied again if it rubs off. We carry four different brands all personally tested to reduce the risk of reaction.

Are You Going Under the Knife for the Wrong Reasons?

By and large, a cosmetic procedure is designed to improve your appearance, whether it’s achieved via surgical or nonsurgical methods. If you are considering going under the knife with Dr. Buchanan, may it be a North Carolina liposuction or lunchtime Botox, it is quite important that you are honest with yourself. Getting a bit of nip and tuck for the wrong reasons may just lead to disappointment and further dip in your self-esteem.

Now, let’s figure out if you’re getting plastic surgery for the wrong reasons.

Are you in crisis?

Circumstances such as divorce, the loss of a job, or the death of a spouse could lead men and women to opt for plastic surgery. “Revenge cosmetic surgery” often refers to bitter lovers who run for the nearest plastic surgery center to change something in their physical appearance so they could get back to their former lover. A CNN report even talked about this disturbing trend.

For patients in crisis and wanting a plastic surgery fix, Dr. Buchanan recommends that these patients try to work through the crisis first.

Do you have unrealistic expectations?

If you insist on copying Kate Middleton’s nose or Angelina Jolie’s lips with hopes that people will treat you like a celebrity afterwards, you might want to reassess your goals. Unrealistic expectations in plastic surgery also refers to individuals who had a severe accident or illness which left them disfigured and would want to restore their appearance to perfection.

Do you want plastic surgery because your lover said so?

If your partner is telling you that you should have Botox or breast augmentation to look younger and sexier, stop right there. The decision to have plastic surgery should be yours alone. While it’s important to ask your partner, friends, and other family members about their opinions, the decision should be made by you after weighing in your feelings towards a certain procedure.

The Center for Plastic Surgery in Highlands, North Carolina

We invite you to explore your cosmetic options with us! We perfectly understand that cosmetic surgery is not just about improving the physical aspect but making you feel better about yourself, too.

Dr. Buchanan has hospital privileges at both Highlands-Cashiers Hospital and at Harris Regional Hospital in Sylva.  The procedures are performed either in his office or at Highlands-Cashiers Hospital.  We are located at 209 Hospital Drive, Suite 202, Highlands, NC.  Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We look forward to your visit!

Plastic surgeon Robert Buchanan gives lecture on ‘Turning Back the Clock’

Below is the text of an article appearing in the Highlands Newspaper and the Highlander the week before Labor Day.

Everyone wants to stop aging or at least, prevent the visible signs of aging. Although there are no miracle creams or magic drugs that will stop the body’s internal aging process, living a healthy “optimal” lifestyle can limit or slow the inevitable,” said Highlands-Cashiers Hospital’s Board Certified Plastic Surgeon, Dr. Robert Buchanan.

Earlier this month, Dr. Buchanan presented “Turning Back the Clock – Anti-Aging Secrets” to nearly 50 community residents, providing education and tools to live a healthy and long life.

“Proper medical care and body modification are proven strategies that can improve and extend our life, improve our looks or both,” said Dr. Buchanan. “Most importantly, diet, regular exercise, stress control and the avoidance of negative influences can reduce and sometimes eliminate the development of chronic diseases such as diabetes, heart disease, stroke, and some cancers. Eating a moderate calorie balanced diet of no more than 40% carbohydrates and the rest lean protein with good fat and minimal salt can maintain healthy blood pressure and prevent insulin spikes, allowing the body to burn already stored fat, reducing the waistline.”

Dr. Buchanan stressed that healthy eating plays a large role in anti-aging as does the commitment to live a healthy life style. “We all have to change our “taste,” change our mindset, train our brain and body to crave natural healthy foods and avoid sugar, salts, and bad fats. Sugar substitutes can do as much damage as the real thing and also prolong the body’s dependence on sweets and sugary foods. Modifying your lifestyle should be a gradual process in which diet and negative lifestyle habits are slowly changed over the course of weeks or several months. Your body and brain will accept the new routine and the willingness to continue will grow. Dieting with sudden change in habits is the cause of “yo-yo” weight loss and regain.” Dr. Buchanan offered helpful eating tips listing “things to have in your frig” which included: 1% or 2% milk, fresh fruit, fresh herbs for flavor instead of sugar or salt, organic eggs with yolk, greens, and water. A list of “things to have in your pantry” included: nuts, dark chocolate, legumes, seeds such as flax, steel cut oatmeal/barley, dried herbs and peanut butter. And a list of “things to have in your medi- cine cabinet” included: baby aspirin (recommended 2 per day), omega 3, vitamin D, multivitamins, and calcium. He noted to avoid vitamin E, which can cause increased bleeding, and most over the counter supplements.

Dr. Buchanan also advised the audience on the importance of exercise and how daily/weekly schedules of both aerobic and anaerobic activities can promote health, disease prevention and longevity. “Exercise is crucial; studies show that walking just one mile per day can help you lose 10 lbs. per year and walking 2 miles per day can reduce your chance of death from all diseases by an incredible 50%. Three hours a week can reduce a woman’s chance of developing breast cancer by 30%, and just one additional hour can reduce her chances of breast cancer by 60%.”
“Along with a healthy diet and exercise, sun screen with UVA and UVB protection should be applied each and every day to reduce skin damage. Limiting one’s alcohol intake to one glass per day or less, avoiding smoking and others who smoke will boost one’s optimal health.”

Dr. Buchanan ended the lecture by explaining how cosmetic procedures performed these days have age defying, long lasting results. Minimally invasive treatment such as a rejuvenative skin care routine prompts new skin cell growth and reduces the appearance of wrinkles. IPL (Intense Pulsed Light), an in office procedure, can remove brown age spots as well as red discolorations/blotches on the skin’s surface. The Zerona® laser can melt fat without pain, incision or downtime.

“We are using better injectables such as Botox, which reduces muscle function and, thus, wrinkles and others that fill in soft tissue including Juvéderm®, Radiesse® that offer immediate results, reducing lines, wrinkles or contour deformities,” said Dr. Buchanan. “And these are now administered with less discomfort.”

As for surgical procedures, Dr. Buchanan explained how various “lifts” can markedly reverse the outward effects of aging. “Today’s Facelift”, the facelift technique performed by Dr. Buchanan, maintains facial fat and achieves a more natural result. The technique, unlike older facelifts, prevents the pulled or “windswept” look leaving the neck and face looking refreshed, rested, and healthy.

Maintaining A Healthy Lifestyle

There is no magic antiaging device or drug. Optimal health and longevity are the result of a healthy lifestyle. A study of identical twins showed the twin who maintained the healthier lifestyle had fewer medical problems, aged less and lived longer.

Medicine has reduced death from cancer and other chronic diseases by understanding them and identifying other things that shorten our lives. Additionally, we have discovered how to reduce the other lifestyle limiting effects from many common diseases. This has given us the information we need to maintain a healthy lifestyle and, thus, live longer healthier lives. The best examples of the latter are high blood pressure, heart disease and diabetes. Though all three are still quite prevalent, we have learned ways of modifying or controlling each by lifestyle modification.
The four components of a healthy lifestyle, in order of importance, are diet, exercise, avoidance of negative influences and stress control. Each alone is a powerful antiager, but, combined, they multiply each other.

Most important in maintaining a healthy lifestyle is a proper diet. Besides being fuel for the body, food is a drug, and we need to think about it as such. Many of the problems I see with the skin and associated with surgery and healing are directly related to diet. Diet is said to be responsible for 1/3rd of all cancer deaths in this country. Almost all of the diabetes and most of the high blood pressure and heart disease is directly related to diet. When I was in medical school, we all got called to study anyone with Type II Diabetes because it was so rare. Now, it constitutes 95% of the cases among the 26 million Americans with diabetes. Part of this is a change in what we eat. Most diets now consist of 70-90% carbohydrate. It should be 40% carbs low on the glycemic index, 30% protein and 30% non-animal fat. It should also be less processed and be more colorful than most diets today. Another part is that we are living longer from other improvements and an improper diet affects us more the older we get. Diet even overcomes genetics, as shown in a study of the Zuni Indian tribe and, later, other tribes. Over 95% of the Zuni tribe had diabetes and high blood pressure. Of those who modified their diet and began to exercise regularly, all got off medications and normalized their blood pressure and blood sugar levels.

Exercise, the second part of the Zuni success, alone will not control your weight or markedly change your health. When added to a proper diet, the effects are multiplied. It can help improve your circulation, and lower your blood pressure and your risk of heart disease. It can also elevate our energy and mood. Amazingly enough, it also reduces the risk of multiple cancers, including breast. By increasing the brain’s production of endorphins, it relaxes us, clears our minds and reduces tension.

It is also important to avoid those things that have a negative influence on us. The major things in this list are tobacco products, alcohol, the sun, caffeine, sugar and drugs. Tobacco of any type (including nicotine products to help reduce tobacco use) reduce the blood supply to all organs of the body. Plastic Surgeons actually discovered this problem in a study of facelift complications done about thirty years ago. The only one of forty variables to increase the incidence of poor scar and skin loss was tobacco use. It has now been found responsible for reducing the immune system, speeding aging and increasing the incidence of cataracts and cancers. Its vascular reduction also contributes to the effect of the smoke on the lining of the lung and the incidence of respiratory disease. Alcohol has been found to have both good and bad effects. One glass of red wine contains antioxidants that protect us. However, two glasses begin to leach folic acid and other nutrients. In women this increases the risk of breast and ovarian cancers. Although we cannot avoid the sun, which causes skin aging and cancers, we can protect ourselves with clear Zinc Oxide sun block and sun protective clothing. Although most drugs are useful, if we can reduce the number we take, we reduce the risk of a cross reaction.

Reduction of tension and stress is also important in improving our lifestyle. Stress has two parts, the event and our reaction. If we cannot avoid the event, then we need to learn to reframe it, much like changing our perception of a half empty glass to one half full. Of course, the best way to avoid stress is to avoid the precipitating event. We can do this by organizing our time, learning to say “no,” grouping similar activities and avoiding distractions. Something we all need to do is to make time for ourselves. Fortunately, since we are in Highlands, we have already discovered how to do this. If we still are stressed, perhaps we just need to allow the area to work its magic.

Although there are many things that are available to purportedly help us age better, there are only four that actually work. These are diet, exercise, avoidance of negative influences, and stress management. Food is a drug that determines our wellness. It can keep us well or cause us to be ill. Exercise protects us. It builds lean body mass and reduces fat. By eliminating those things that are detrimental, we improve our health and longevity. Reducing stress is additive to the others

We at the Center for Plastic Surgery are dedicated to not only helping you look your best, but also helping you maintain a healthy lifestyle. For more information, please contact us.

Sun Protection

Almost all of us will agree with the concept of sun protection. After all, we know that the sun causes sunburn, aging and cancers of the skin. The problem is that most of what we are told and have used will not accomplish the protection we need. A portion of the Sun’s emitted electromagnetic spectrum, namely radio waves, some infrared, visible light and some UV waves, penetrates the atmosphere to strike us. All but UVA and UVB are considered harmless.

For the last 30 or 40 years, we have worried about UVB rays because we could see their effects. They are absorbed easily by the atmosphere and anything else they hit. They are, therefore, strongest when they come straight through the atmosphere, down south, midday in the summer. If they strike us, they are absorbed quickly within the outermost part of the skin where they make our skin feel hot, and, if we get enough, cause sunburn. The first sunscreens were developed to block UVB and prevent sunburn. They did a good job at this, some better than others. To inform us how good each was, the FDA created a system that rated their performance. This is known as SPF or Sun Protection Factor.

For years, we thought that the heating and burning of the skin was what caused all the damage and eventually led to skin aging and cancer. This caused us to hypothesize that, since most sunburns occurred when we were young, all the damage was done then. We now know better. UVA penetrates the atmosphere almost as well as light. It is, therefore, present dawn to dusk, summer and winter and from North Dakota to South Florida. It also makes up 97-98% of the UV Rays that hit the earth and us. It is not absorbed well by anything, and penetrates clouds, glass and clothing to reach us. When it hits the skin it penetrates and is absorbed slowly. Though it does not cause sunburn or heat the skin, it does cause direct cell damage.
It is, thus, UVA that causes most of the damage to our skin. It is almost all of the UV radiation that actually hits our skin. It is present all the time. Though we no longer lay in the sun, we are still getting UVA radiation, even in the house, in cars and through our clothes. If we do get a sunburn from UVB, much of the damaged cells are shed. We have also shown that damage is cumulative over a lifetime. What we get now is additive to what we have already gotten to further skin aging or stimulate skin cancer production.

So, how do we protect ourselves? Since SPF only indicates our protection from UVB and sunburn, it is worthless in determining whether we are protected from UVA. The FDA has tried four times over about 14-15 years to create a standard to indicate UVA protection similar to Australia and Europe. Their latest attempt was to go into effect in July of this year. Implementation has now been pushed back to December. So, how do you know how to protect yourself? In spite of the lack of present standards, there is an easy way.

Of the sun protection products presently available, there are only two that block the full spectrum of UVA. One of these, avobenzone (including Helioplex by Neutrogena), as far as we now have data, only lasts about an hour or two and takes 30 minutes to start working. Since we need to reapply it hourly, it is impractical. The other is Zinc Oxide. It, too, was impractical, since it made you appear white. However, new formulations of Zinc Oxide now go on clear and still protect from both VUB and UVA. We, therefore, recommend you look for a product containing at least 5-11% Zinc Oxide. (This amount protects but still goes on easily. Just turn the container over and look under the ingredients. If it does not have a percentage, it does not contain enough.) This has been somewhat hard to find. With the looming new requirements, it is now much easier. Even so, we stock five different brands in our office. We recommend, since UVA is constantly present, that you apply it daily year round to any exposed areas, reapplying if you wipe it off. In the US, because Vitamin D is in so many foods and multivitamins, we, do not have to worry about Vitamin D deficiency.

What about non-exposed areas? Since UVA goes through regular clothing, there is now sun protective clothing available at the Highland Hiker and other retailers. You can also wash your present clothing in Sun-Guard by Rit, available, for your convenience, at our office as well as elsewhere. This is used in the washer and imparts sun protection to the washed garments for 20 washes (about 6 months).

For more information call the Center for Plastic Surgery at 828-526-3783, or toll free 877-526-3784, or go to “Contact Us” elsewhere in this site.