Understanding labels in a supermarket can be a daunting task, and can seem like “word salad” to even the highly educated shopper. So let me provide you with a few clarifications along with some suggestions:

Reduced Sodium” versus “Low Sodium”: Reduced means that the product contains 25% less sodium than the same food with the usual amount, both of which could be quite high. On the other hand, “low sodium” means that the food can contain no more the 140 milligrams per serving. So, in either case, check the actual amounts they contain. In general, since we all consume too much sodium, I would choose the “low sodium” option or alternatively, look for a “salt free” label.

“Excellent Source of Fiber” versus “Extra Fiber”: To be labeled an “excellent source”, a food must contain at least 20% of the recommended daily value of the nutrient, thus if the daily value is 25 grams of fiber, a given product must contain at least 5 grams. “Extra Fiber” simply means that a product contains at least 10% more than its conventional counterpart. For example, a puffed-rice breakfast cereal that naturally contains on 0.8 grams of fiber per cup could claim to have “extra fiber” if it had a puny 0.9 grams. Moreover, not all fiber has equal health benefits. For instance, whole grains are rich in insoluble fiber (bran), a beneficial nonabsobable nutrient that, for unclear reasons, is also associated with reduced diabetes and cardiovascular risk. In any case, however, it’s best to opt for the “excellent source” choice.

“Sugar free” versus “No Added Sugar”: Sugar free means that the product contains less than 0.5 grams of sugar per serving, assuring that you are receiving very little total sugar. By contrast, a label of “no added sugar”, (including also “high fructose corn syrup,”) means that, although none of these sugars are added, a given product can contain any amount of naturally occurring sugars that could still be quite high in calories. Nevertheless, if the calories are not terribly high and the food is a good source of healthy nutrients, it could still be a good choice.

“Low Fat” versus “Low in Saturated Fat”: Foods labeled “low fat” can contain as much as 3 grams of total fat preserving, while “low in saturated fat” means that a given product contains no more the 1 gram of saturated fat (but may contain any amount of healthier unsaturated fats). Recent information, however, indicates that too much emphasis has been placed on reducing total fat, but that the real focus should be on limiting saturated fat. In general, therefore, low in saturated fat is the better choice.

“Low Calorie” versus “Light”: “Low calorie” means that the product contains no more than 40 calories per serving. “Light” is a relative term meaning that it contains 25% fewer calories than its normal counterpart. Depending upon the item selected, it’s usually best to choose the “low calorie” option.


In the United States, there are laws/regulations and agencies in place to protect the consumer when purchasing food products, specifically dedicated to the packaging and labeling. The Food Safety and Inspection Service (FSIS) agency is a subsection of the United States Department of Agriculture (USDA), which is tasked with the responsibility of “ensuring that the nation’s commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged.” The USDA is partnered with the Food and Drug Administration (FDA) to develop and issue regulations in regards to appropriate usage of “natural” labels; yet, the FDA does not have specific rules for “natural” labeling.

The term “natural” has, in the past, meant that nothing artificial or synthetic (including all color additives regardless of source) has been included in or added to a food that would not normally be expected to be in that food. But this definition is, at best, nebulous, allowing for questions such as whether the presence of high fructose corn syrup or genetically engineered components can still be considered “natural.”

In response to such a vague definition, the FDA is asking for public comments about use of the term “natural” in food labeling. This action was triggered in part by three citizen petitions asking the agency to define the term for food labeling and one calling for an outright ban of this label. Although the FDA has not engaged in rule-making to establish a formal definition, its longstanding policy simply referred to lack of the above-mentioned additives. Moreover, their policy was not intended to address food production methods such as the use of pesticides, nor did it explicitly address food processing or manufacturing methods such as thermal technologies, pasteurization, or irradiation. The FDA also did not consider whether the term “natural” should describe any nutritional or other presumed health benefit.

For some reason, the FDA has decided to open this subject for public discourse. Until February 10, 2016, comments can be made via docket folder FDA-2014-N-1207 on But this procedure appears to be pure folly, allowing the term “natural” to be subjected to a popularity contest, or worse yet, political debate!

It seems quite evident to me that the use of the term “natural” has no meaning whatsoever, and should not be officially justified under any circumstances!

Hopefully, these comments will help to clarify the some of the confusion we all face when navigating the massively stocked aisles in the grocery store.



A typical TV commercial shows an actively exercising—and profusely sweating—athlete, drinking a “sports drink”, often Gatorade (or “G”) to replace the lost fluid in his or her body. But what are the advantages or disadvantages of this type of drink for the general population?  The two most popular drinks are Gatorade and Powerade, which have been developed to furnish carbohydrates and replace fluid and electrolytes (minerals), especially sodium that has been lost through perspiration.

But let’s look at some facts. When we exercise and get sweaty, we lose moisture from the body primarily in the form of water, which in the process of evaporation, helps to prevent the body from overheating. Sweat also contains a small amount of sodium, which is lost but not in major amounts. As a result, before the rise of sports drinks, athletes (and the rest of us) drank plain water when we got sweaty from exercise. To replace fluid loss, the way humans have known for eons—thirst is our main guide. Recently, however, sports drink makers spent a lot of money sponsoring less-than-rigorous research damning thirst as a guide to hydration and casting doubt on water as the beverage for staying hydrated. To make matters worse, recommendations once aimed at endurance athletes have now trickled down to anyone who exercises.

Notwithstanding these recommendations, there is no evidence that dehydration alone has ever killed a marathoner. By contrast, overhydration poses the greater threat. There is a common misconception that athletes must stay fully hydrated and drink before they become thirsty, and this can result in overhydration. That’s what killed a healthy, 28-year-old woman during the 2002 Boston Marathon. She collapsed a few miles short of the finish line and died a day later. The cause of death was hyponatremia—abnormally low sodium concentration in her blood caused by drinking too much fluid before and during the marathon. According to one report, 16 marathoners have died and more than 1,600 have become critically ill due to overhydration and hyponatremia. Unfortunately, sports drinks don’t appear to prevent hyponatremia. A study of marathoners by Harvard-based researchers found that 13% had some degree of hyponatremia, and that it was just as likely to happen among those who guzzled sports drinks during the marathon as it was among those who stuck with water.

Let thirst be your guide; drink water

With regard to most competitive athletes, thirst is a good guide for hydration. In the most extreme cases, athletes may develop muscle cramping, which requires drinking extra water and adding more electrolytes as well. Unless someone is exercising or competing in a sporting event for longer than 90 minutes, there is no reason to drink something with excess sugar and electrolytes. Moreover, excessive salt supplementation during exercise may lead to gastrointestinal problems or cause further impairment of fluid balance that may cause salt-induced cramps.  As a result, for most of us who may run a couple miles in the morning or play a few sets of tennis, thirst should be our guide, and water our beverage.

One concern with sports drinks is that they deliver lots of calories. Some contain 150 calories, the equivalent of 10 teaspoons of sugar, which can be helpful to a distance runner or equivalent. But the rest of us, and especially children, definitely don’t need sports drinks, for that runs the risk of adding to the burgeoning rate of obesity.


Unfortunately, sports drinks are available to anybody. They sit in the drink section as if they belonged in the same category. It’s bad enough that these drinks contain sugar already, but sports drinks also have salt, making things worse. Their contents include sucrose syrup (liquefied table sugar) which is high in empty calories. Powerade actually contains less sugar than Gatorade; the latter contains 14g of sugar per 100g, which is equivalent to about 3.3 teaspoons of sugar. The entire bottle (which is one serving) will give you 8 teaspoons of sugar. In addition to salt, the high fructose corn syrup content has been shown to significantly and independently increase risk of hypertension in people with no previous history of this disease. Imagine a regular person adding all this to their diet because they perceive the sports drink as being healthier than the soft drink!

In fact, even if you are an athlete and regularly exercise, I still would not recommend sports drinks at any time other than when you are actually in the middle of exercising. This is the only time where a sugar and salt hit will not necessarily be bad for you. All in all, I would still go for just water and maybe a quick, bite sized snack like fruit or nuts.

Bottom line: With rare exceptions, when exercising, let thirst be your guide, and drink plain water!




        Going back to the days of Ponce De Leon, we humans have been obsessed with trying to retard the aging process. Now, however, we are in the modern era of science, and surely, we have some better answers to this conundrum than did Ponce. But do we? Unfortunately, far too many are seduced by slick salesmen offering pseudoscientific remedies promising to add years to your life, but, instead of this, your outlook may be unchanged or worse, while at the same time they are lining their own pockets with lots of cash—at your expense, of course.

So let’s begin by defining the issues. The first is longevity. The second pertains to enhancing your looks in order to make you look more youthful in the absence of any change in outlook. The main issue here is the first, i.e., methods to live longer.

Lifestyles that Add Years

Lots of data accumulating over the past century have clearly established the importance of proper diet, maintaining a healthy weight, regular exercise, avoidance of smoking and other toxins such as excessive alcohol. These have been covered in previous posts and in my books.1, 2 

What about gimmicks?

    Can supplements such as hormones and prescription drugs keep you young? The quest to keep age-related physical and cognitive changes at bay has created a huge industry, now estimated to amount to $300 billion yearly worldwide. But, before getting caught up in the hype, let’s look at some major promotions and examine the evidence.

Drugs to improve mental function: Some of these products, often referred to as “nootropics”, include a wide variety of ingredients such as caffeine, fish oil, and various herbals. Concerning one heavily promoted product, Lipogen PS Plus, containing a compound, phosphatidylserine, we encountered sparse evidence of efficacy after a thorough search of the world’s scientific publications.

Another group of brain stimulants are the ADHD prescription medications such as RitalinR and Adderall.R.  But the evidence that they will improve cognition, at least in the long-run, is non-existent. Making matters even worse, many of the non-prescription supplements, unless verified by a group such as the U.S. Pharmacopeia, may not even contain the ingredients claimed on the labels, which actually could be a blessing in disguise! Moreover, side effects and interaction with one’s other medications pose additional risks. So the consumer that is in good health and not suffering from any disorder of brain function is well-advised to avoid any of these products. Some emerging evidence suggests that regular exercise can help to preserve brain function with advancing age.

Aids to general vitality: Testosterone replacement has been widely touted to take care of “Low T” in men, a treatment promising to boost your sex drive, energy, and youthful appearance. But these apparent shortcomings in aging men are seldom a sign of deficient testosterone production by the testicles. Testosterone, in the form of AndroGel, Aveed, Axiron, Fortesta, and Testim, should not be prescribed unless there is a confirmed deficiency by laboratory testing. Using this hormone can be attended by significant risks that include higher chances of heart attack and stroke, possible blood clots in various areas, enlarge the prostate gland, and increase growth of prostate cancer.

Human Growth Hormone (HGH) has been advocated by the unscrupulous to combat aging. But this hormone has been approved only for medical conditions such as replacement of a proven deficiency. Instead of combating the aging process, it may cause joint pain and swelling, organ enlargement, type 2 diabetes, and greater cancer risk. Also into this category we place the product, SeroVital, which is claimed to stimulate HGH production by the body, which is doubtful, and any long-term benefits from such stimulation are totally unproven.

Adrenal Supplements are now being promoted to prevent “adrenal fatigue syndrome”, which presumably occurs when the adrenal glands are overwhelmed, resulting in fatigue, sugar and salt craving, sleep problems, and a need for caffeine. But there are no biologic bases for these claims, and if you are experiencing any of the symptoms above, schedule a checkup with your physician.

Other “anti-aging” supplements: Among many such products, DHEA (didehydroepiandrosterone) is among the heaviest promoted. It is an important steroid hormone that is produced in the adrenal glands, the gonads, and the brain, where it functions predominantly in the synthesis of the male and female sex steroids. Although promoted not only to retard aging, it supposedly improves depression, sexual function, and more. Needless to say, none of these claims has been substantiated in the tribunal of medical science. Not only does it pose the same risks as testosterone, but it may interact with blood pressure drugs, blood thinners, and drugs for diabetes.

Vitamin/Mineral Infusions: These are cocktails, often used by the wealthy, that are infused by vein with the promise to send higher-than-normal levels of nutrients directly into your bloodstream. One center claims that they can “kick-start those cells which are performing below par.”  The reality, however, is far different. Some vitamins, especially in high doses, in addition to being pricey, carry some risk of toxicity. A well-balanced diet is quite capable of supplying any needs in this arena, and far safer and cheaper.

Preserving a Youthful Appearance

We won’t cover artificial means to look younger, such as plastic surgery, Botox, and others, in favor of some natural suggestions.

The general lifestyle changes noted above will usually keep you looking young, but specifically, to keep the skin from aging, the two most important means are: 1) Avoiding smoking, and 2) Liberal use of sunscreens.


Living longer can be accomplished through making the right life-style decisions. This can even promote a younger appearance. Forget drugs and supplements; they are not only a waste of money, but could be dangerous.


1 Tavel ME, Snake Oil is Alive and Well: The Clash between Myths and Reality. Reflections of a Physician. Brighton Press, Chandler, Ariz. 2012

2. Tavel, ME. Health Tips, Myths, and Tricks. A Physician’s Advice. Brighton Press, Chandler, Ariz. (In Press)