Getting to – and maintaining – a healthy weight

By D. Bernard & Co, Melbourne (photographer) Adam Cuerden (restoration) via Wikimedia Commons

It is practically an expectation in health and wellness forums to talk about weight loss after the first of the year.  New Year’s resolutions being all the rage in January.  Perhaps you plan to lose a few pounds this year?

For me, it’s always around the middle where I put on a few pounds.  You know, the little beer belly.  The muffin top.  The love handles.  Begone, all of ye!

I was doing so well last fall, eating right, exercising more and so forth.  Then winter in Minnesota hit.  Now it gets dark at 4:30 in the afternoon.  The perpetual ice slick on the sidewalks turn running or walking outside into a potentially bone-shattering experience.  I mean, literally, bone-shattering as in broken hips and wrists.  It has been so cold outside that your teeth hurt the minute you leave the house.

So I tend to hibernate a bit.  Evenings on the couch reading next to a warm fire, although evoking images of Norman Rockwell, are not the way to shed pounds.  Especially if I’m eating unhealthy foods all evening and maybe having a glass of wine with my chocolates.  Wow that is starting to sound good:  warm fire, wine chocolates, a good book . . . ah, but I digress.  I’m supposed to be talking about diet and exercise here.


Reminds me of a post I did about the challenges of staying active in northern climates. Check it out here.

To show you the depth of my dedication to the cause of fitness, I included a recent photo of me above.  Yup, that’s me all right.

Healthy life choices

So we talked weight loss and healthy livin’ on the show this week.

Natalie IkemanTo help me out, I invited a repeat guest to last Sunday’s Healthy Matters broadcast.  Joining me on the radio show was Natalie Ikeman, who is a Physician Assistant HCMC’s Golden Valley Clinic.  She runs “The Great Slim Down” weight loss program which you can check out here.



If you missed the show, you can to the podcast by clicking the “Play” arrow here: Healthy Matters logo alternate


Tips for losing weight and keeping it off

Natalie gave us some great tips from her work with patients trying to lose weight.  I’ll review some of them here.

Make goals.  

With her patients, Natalie meets monthly to set goals.  The good news is that they don’t have to be huge undertakings.  The goals can be small changes in your daily lifestyle which you continually adjust, a process which Natalie refers to as “turning up the dial” on your goals.

Just a few examples of achievable goals are:

  • Stress management tactics
  • Better food choices
  • Portion control when eating
  • Finding time for daily movement, like taking small walks on your lunch hour

Nothing big, nothing huge, just small changes to your daily routine.

People who are successful at weight loss have some common characteristics:

Natalie’s patients in the Great Slim Down have lost an average of about 16 pounds.  That is not only impressive but it is a sustainable amount of loss.  She points out a few characteristics of these patients:

  • They keep a daily record of their food intake.  The simple act of recording what you eat – whether on paper or using one of the many apps for your mobile device – makes a person aware and less likely to fool themselves into thinking they are eating healthier than they really are.  People usually eat more calories than they realize!
  • They are active often in their daily lives.  They find a way to move throughout the day.
  • They are striving to meet their own goals, not goals set by someone else.
  • They hold themselves accountable by sticking with it.

Pop (soda for those of you not from Minnesota) is not a healthy choice.

The sugar in soft drinks has virtually no nutritional value, and in fact, it probably leads to weight gain.  For more on that, see my previous blog post, “Just a spoonful of sugar . . . is really not good for you.”

After Natalie and I suggested that we ought to avoid so much sugary soft drinks, a few listeners asked if diet pop is healthier.  In a word, no.  Although diet soft drinks are probably better than sugary drinks, they also contain ingredients that lack much nutritional value.  Maybe stick to water!

So how about water?

For years, decades really, people have been taught to drink more water.  Most of us probably remember the “8 glasses a day” advice.  That is, in fact, what I told patients for years.  But the reality is that there is not a lot of scientific evidence that otherwise healthy people need to drink more water than they already do.  In other words, if you are thirsty you get a drink and if you are not, you don’t.

Photo: Jean Fortunet
Photo: Jean Fortunet

So that’s it?  Is that all there is to the water story – that it doesn’t matter?

Well, maybe not so fast. . . as we talked about on the radio program, there are some studies from this past year that suggest that there really is a benefit to drinking more water.  One study found that more water was associated with less obesity.  You can read about that one here.  Another study found that drinking more water made people consume fewer calories, – check out this article about that one from the Atlantic.

I should caution that no single study can be used to definitely prove anything.  Truth with a capital “T” is hard to come by in medical science!  So whenever I refer you to studies like these, I do so to get you thinking about your own situation and not to imply that one study is proof of anything.  Replication is the key in scientific studies (the findings of one study must be confirmed with separate studies).

But the water studies are at least thought-provoking.  It makes sense to me that if you are focusing your liquid intake on water, you will be less likely to drink soft drinks and fruit juices that are loaded with calories and sugar.  That has to be a good thing.

As Natalie said on the show, none of us should be “drinking our meals.”  Amen to that.

Move more

One half of the healthy equation is Eat Less.  The other half is Move More.  But how?  Most of us are not about to lace up our running shoes and hit the pavement for a long run.  Most of us can’t get to the gym for a run on the treadmill or an exercise class.  If you can do those things – great!

But lots of us have physical limitations that prevent vigorous work outs.  And gym memberships ain’t cheap!  So what can we do?

Let’s turn to Natalie again.  As a companion to “The Great Slim Down” program, she has produced a series of short videos to give you ideas for exercise that may be right for you.  Some are low intensity, others more vigorous.  Some require standing and moving while others can be done by people from a seated position.

Here’s an example of one of Natalie’s videos:

To see the rest of them, go to the HCMC YouTube channel.  If the link doesn’t work, simply search online for “HCMC YouTube channel” and click Playlists.  You’ll find them there.

Housework is good for you

Listen to the show podcast (the player is above in this post).  We talked about housework as a form of exercise.  And you know what?  It works.  One listener to the show moved nearly 10,000 steps in one day simply doing housework.  I complained that now I really have no excuse not to vacuum the house.  Rats.

The Great Slim Down

I’ll close with one last word about the Great Slim Down.  If you are in the Minneapolis area and struggling to lose some weight, maybe you should see Natalie.  Simply call 612-873-6963 or check out the Golden Valley Clinic site here.  No better time than now!

Thanks for reading.  Hope you are all having a good day, a good week, a good winter where ever you are!





It’s a cold . . . it’s the flu . . . its FluChat!




It’s dreaded “cold and flu” season here in the not-yet-frozen tundra of Minnesota and probably where you live as well.

This is a quick post to announce #FluChat – which I am doing along with my friends at HealthFair 11 and the Minnesota Department of Health on Tuesday, December 6 from Noon to 1:00 p.m.

We are observing National Influenza Vaccination Week with what will be my 3rd Twitter chat.  What is a Twitter chat, you say?  I’m glad you asked.  Our Twitter chat is one-hour of LIVE questions and answers about colds, flu, and vaccinations.   To join in, simply tweet our team any question or comment you have about influenza and vaccinations via your own Twitter account.  Include my handle @DrDavidHilden and include #FluChat in your Tweet.  And then look for our response!

I’m not doing this alone!  Joining me for #FluChat will be:

  • Jennifer Heath, DNP, MPH, RN from the Minnesota Department of Health.  She’s the supervisor of education and partnerships unit for the MDH immunization program.
  • Lynn Bahta, RN, PHN.  Lynn is the immunization clinical consultant for the Minnesota Department of Health immunization program.
  • Sam Ives, MD.  Sam is a friend and colleague of mine in Internal Medicine at Hennepin County Medical Center.  Regular listeners to HealthyMatters on WCCO radio may recognize him as an occasional guest host for me.

The whole shebang is moderated by our partners in health, HealthFair 11.

I hope you’ll join us.  It is easy and fun.  Yes, fun!  I have done two previous Twitter chats (one on Allergies and one on Mammograms) and it is fast-moving and energizing.

So put it on your calendar.  What better way to spend your lunch?

It’s #FluChat on  Tuesday, December 6, Noon – 1:00 pm.

You’ll find us @DrDavidHilden and use the hashtag #FluChat.

For more information, check out my partners at HealthFair 11 and the #FluChat page at the Minnesota Department of Health.





Do you need a mammogram?

breastcancerawarenessOctober is Breast Cancer Awareness Month.

I wrote this post about 4 or 5 times.  The first draft found me in the weeds of details and statistics.  In the second draft I sounded too preachy.  My third attempt covered every aspect of breast cancer from risk factors to diagnosis to treatment and was waaaaaaay too long.   I just couldn’t seem to get it right.

Then I realized that breast cancer is a multi-headed beast.  It has technical clinical aspects.  It has emotional overtones.  It has a definite gender angle that I, as a man, really cannot fathom.  It has controversy.  It is scary.

It is just too much to cover in one blog post, ergo, my troubles in writing about it.  So I’ve decided to talk about a single aspect of breast cancer – that being the role of mammography in screening.

I know people with breast cancer.  I bet you do as well.

Do you know anyone who has been diagnosed with breast cancer?  I’m guessing you do.  Perhaps someone you love died of breast cancer.  Perhaps you know someone living with breast cancer.  Perhaps you or someone in your life was recently diagnosed.  Perhaps you are a survivor yourself.

I know so many people in my life (not just my doctor life, I mean my real life) who have or have had or did have breast cancer.  It is really sobering.  Really close friends.  Several women from my church congregation.  Relatives.  My own mother-in-law.  Wonderful strong women all of them.

The point is that breast cancer is a relatively common disease that affects nearly 1 in 8 women in their lifetime.  The other point is that breast cancer takes a variety of forms and affects women (and men) with many different faces from every community.  And another point is that breast cancer is treatable.

This Sunday on Healthy Matters (my weekly health and wellness radio show) we talked about breast cancer screening with the major focus on mammography as the single most effective screening method available.  In this post I will cover:

  • Expert advice from last Sunday’s radio broadcast featuring radiologist and mammography expert Dr. Tony Severt.
  • Some solid information about breast cancer screening – the guidelines for mammography, including the newest 2016 guidelines
  • A look at the controversy around mammography guidelines.

Thanks for joining me.  Let’s learn something together . . .

Continue reading “Do you need a mammogram?”


Our 400th radio show!

DRH 400This Sunday morning, September 4, at 7:30, Denny Long and I will take to the veranda at the WCCO Radio booth at the Minnesota State Fair.  It will be our 16th time doing a show live from beneath the shadow of the Giant Slide and sandwiched between Sweet Martha’s cookies and the Ye Olde Mill.  But more significantly, it will be the 400th Healthy Matters radio broadcast.

That’s right.  Since our first broadcast in January 2009, we have done 399 one-hour shows and I tell you what – we’re going to keep doing it until we get the hang of it!  The 400th attempt will be on Sunday which just so happens to be one of our popular State Fair shows.

So consider this your invitation to join Denny and me on Sunday morning!  Last week we had a pretty good crowd at the radio booth around the corner of Underwood and Carnes, and that was only for the 399th show, small potatoes compared to the awesome-ness of the 400th show.

Love this Tweet from my awesome friends at HCMC (hint – hit the play button on the picture):


So come to the fair on Sunday, Minnesota (and Wisconsin, and Iowa, and North Dakota, and South Dakota, or where ever you are from . . . last week we had a wonderful woman from San Diego . . .).  If you ask a medical question live on the air, I just may have a special gift for you, one never knows . . . !  

As life-changing and memorable as it will be to be in the audience for the 400th show on Sunday, there is LOTS more to do at the Fair.  Here’s a recap of some cool activities related to medicine. Continue reading “Our 400th radio show!”


Got a tooth question? We have answers!

toothHey, friends, I’m back.  This time with a slew of questions from all of YOU about your teeth.  Last Sunday on the radio broadcast we talked about dental topics  – something I don’t do very often.  I don’t talk about the teeth much because basically in medical school we learn exactly NOTHING about teeth.  Happily, HCMC (the health care system that employs me) has a terrific group of dentists and oral surgeons.

On the show, we intended to talk about dental implants and other oral surgeries. Eventually, we did do this.  But I, of course, had other insightful and probing questions for my guest (oral surgeon Louis Christensen) – questions like:

  • “Why are they called ‘wisdom teeth’?”
  • And maybe more to the point, “Did I get dumber when I had my wisdom teeth yanked out?”

I think the correct answer to the first questions is “nobody knows” and the answer to the second question is “Yes.

Dental implants are really cool if you are a hockey player.  Or even if not a hockey player.

Christensen studioFortunately, listeners to the show had questions that were much more en pointe, as they say.  We learned cool stuff from Dr. Louis Christensen (that’s him in the picture) who joined me early on a Sunday morning in the WCCO studios in downtown Minneapolis.  He’s an oral surgeon who does surgeries not only on wisdom teeth, but he does dental implants, jaw reconstruction, face reconstruction (oh my!) and lots of other work to keep our teeth and faces in top shape.

As is often the case, though, we didn’t get to cover all the questions people had, so in this post we’ll try to answer some.  If you missed the show, you may want to check out the podcast here. Continue reading “Got a tooth question? We have answers!”


Concerned about allergies? Maybe you should feed your baby some peanut butter

peanuts butterOK, first off that is a delish-looking bowl of peanut butter in this picture.  And I love peanut butter.  Especially on a banana.  Anybody else put peanut butter on bananas?  Or apples?  I put it on both!

Seriously that is some quality peanut butter. But who really makes homemade peanut butter from scratch?  Ha!

But I digress before I’ve even introduced the topic of this post . . .

There is new information about peanut allergies that I think is important to know – especially for parents of young kids.  So this is a post about reducing risk of developing peanut allergies in kids.   Continue reading “Concerned about allergies? Maybe you should feed your baby some peanut butter”


My dog is a slob: staying upright and avoiding falls (and a patient story)

Before I get started on this post . . .  I have started reading How Doctors Think by Jerome Groopman, which is the selection for our online Healthy Matters book club.  Check out the recent post about it here and start reading!


Zoe clutter
Zoe needs to clean up her toys

Check out our dog, Zoe.

She is a sweet and happy beast with bad hips and definitely has some issues with staying tidy.  This is a small sampling of her extensive toy collection which is strewn throughout our house.  She’s a slob.

So why am I showing pictures of my dog?

Just imagine yourself in the middle of the night navigating that minefield of toys and dog beds and sleeping dogs and not tripping.  Ugh.  I’m going to talk about falls, mostly in the elderly, but really it could be in anybody.

In this post you will find:

  • Photo evidence of my “research” in the form of an unplanned walk through my own house.
  • A story of a patient for whom a fall was life-changing.
  • Risk factors for falls.
  • Lots of links to great resources and videos.
  • Guidance from experts in fall prevention from the Healthy Matters radio show.
  • Two cools things – a checklist for safety in your own home and video clips which demonstrate the effect of vision on falls.  Check out both of these later in this post

Continue reading “My dog is a slob: staying upright and avoiding falls (and a patient story)”


Pearls from Medical Science – High Blood Pressure

Reading this stuff . . . so you don’t have to.

One goal of mine for this blog is to connect people to medical science. But ask any doctor – staying current on the latest in medical evidence is not easy.  Look at this picture – it could be the nightstand of many a doctor.  It is actually the table in my office after I simply grabbed a few recent journals from my shelf.  Seriously.  Glamorous it may not be, but it is oh, so important.  By staying abreast of latest medical science, we can give you the best advice possible.

So every now and then I’m going to do a pJournals photoost highlighting a “Pearl from Medical Science” in which I will summarize one item from the medical literature – a pearl, if you will.  Basically reading this stuff so you don’t have to.  I’ll try to distill the medical jargon and heady science into something meaningful – something you can act on in your own life.

So here goes this first pearl, which is taken from the Annals of Internal Medicine from November 2015.

PEARL: Get your blood pressure checked

Continue reading “Pearls from Medical Science – High Blood Pressure”


No more ipecac! National Poison Prevention Week 2016

I have the great fortune to work side by side with the smart folks at the Minnesota Poison Control Center, which is housed right here in my hospital.  Each year we try to do a service to the community by higJon Cole studiohlighting National Poison Prevention week, which is going on right now.   Dr. Jon Cole is the Medical Director of the Poison Center, and Kirk Hughes is the Education Director.  You won’t find two more dedicated experts than these two guys – and I was happy to have them on the Healthy Matters broadcast this week.  That’s Dr. Cole’s smiling face on the left and Kirk below – bright and early on a Sunday morning.   Now wouldn’t you want this guy to be the one helping you?

Listen to the podcast of the show here by clicking the logo here –> .logo_healthy-matters

I encourage you to click the link to the Minnesota Poison Center.  It is a site loaded with information, including tip sheets that you can download for your own use.

My own daughter and the iron tablets

First my personal tale of woe.  I mentioned on the radio show about a brush with poisoning with our own daughter.  The story is a scary one for any parent . . . our little one was just 1 or 2 years old when we found her on the floor with an open bottle of iron tablets, some of them spilled out.  We had no idea if she had swallowed any of them.  Yikes.   Iron tablets don’t sound all that bad, right?  But these common supplements are really dangerous in overdose for the wee ones.  So we took her to a doctor and she had to have a x-ray (to look for the pills in her digestive system).  Thankfully she was all right, but today we would have called 1-800-222-1222 and talked to the poison experts.

What I learned about poison prevention

Here are just a few of the things our listeners learned from Dr. Cole and Kirk (that’s Kirk in the picture below – he’s a guy with a head-full of knowledge from his career as a nurse, a basic EMT, and a poison prevention educator).  And down below, look for a neat video of Kirk in action with a grateful parent.  It’s worth a few minutes.

  • The most important thing of all – know this number.  1-800-222-1222.  This is the number for the Poison Center, and the beauty of it is that it is valid nationwide.  The system will direct your call to the Poison Center nearest you, based on thKirk Hughes studioe area code you are calling from (or the area code of your cell phone).
  • Calling the Poison Center number is the first thing you should do if you have a question about poisoning – unless you or a child is experiencing chest pain, difficulty breathing, or seizures.  In that case, call 911.
  • It doesn’t have to be an emergency – call if you simply have a question.
  • In the vast majority of cases (>90% of the time), the experts at the Poison Center can safely get you advice and treatment recommendations while you stay at home.  It is highly likely that you can avoid a trip to the Emergency Department or clinic by calling them first.
  • Program the number into your cell phone under Poison Center!

A word about keeping kids safe

More than half the calls to Poison Centers involve children under the age of six, and the problems are usually right in their own homes.  Kirk and Dr. Cole told us that there are several reasons why kids are at risk in the home.  Could these happen at your house?

  • Poisons are not stored properly.  Keep them up high, in original containers, well out of reach of curious minds.  Grandparents, your home may have your pills out on the counter or bathroom sink where you won’t forget them.  But if little ones come to visit, it takes just a second for them to grab them and swallow them.  Keep your grandchildren safe by keeping the medications out of sight!
  • Children are naturally curious.  Pills look like candy.  Spray bottles look interesting.  Brightly colored liquids look pretty.  But all can be deadly.
  • Many poisonous liquids look and smell like something safe to drink.  Fuels, cough syrups, even shampoo are like this.  Keep them out of sight and not accessible to kids.
  • Children imitate adults.  They see you taking medications or drinking liquids, they are certain to try to do the same.

This all sounds like common sense but in reality, many if not most of our homes are not particularly safe for children.  So if you have kids coming to visit, think of how to keep them safe.  It just takes a second when you are not paying attention for a kid to get into something that is really dangerous to them.  In my little story of my daughter’s scare with iron tablets, we failed to do these simple things.  Now I know better!

What about good ‘ol syrup of ipecac?

Lots of us probably still have an old crusty bottle of syrup of ipecac in our cabinets, especially if you are a bit older.  Well get rid of it!  It is no longer recommended to use ipecac to get kids or adults to vomit.  If fact, you should not even keep it in your home.  Ipecac is yesterday’s news.  Today, call 1-800-222-1222 instead.

Final thoughts

Poison prevention is a huge topic that I could never cover in a blog post such as this.  Rather, I hope to have provoked you to think a little bit more about keeping ourselves and our kids safe.

A listener to our Poison Prevention show on Healthy Matters posed the simple but really good question – just what is considered a poison?   I learned that a poison can be darn near anything – medications, cleaning supplies, fumes in the air, plants in your garden.  I also learned that poisoning is the leading cause of injury death in the United States.

Here’s that video of Kirk Hughes in action, about a family far away from a hospital but who did the right thing and called the Poison Center:

A final word on the Poison Control system in the United States.   Poison Centers are available to you:

  • Anytime.  24/7, including holidays
  • Anywhere.  Call from home, school, business.  Anywhere in the country.
  • Anyone.  Whether you are a concerned parent, a caregiver, a senior, a teenager, a teacher, a clinician – experts are there to help you.

And it comes free of charge to you.  

1-800-222-1222.  It’s a number you should know.


When weight loss surgery makes sense

“Ohartley in studionly 1-2% of people who could benefit from weight loss surgery are actually getting it done”

So says Dr. Gil Hartley, my radio guest this week on Healthy Matters.  Dr. Hartley is an internal medicine physician, like me, who specializes in the care of people who are very overweight.  We focused our conversation on bariatric surgery – which is the medical term for weight loss surgery.

Here is the Healthy Matters podcast page to listen to this show or any of our recent shows.

BMI checkerThe first step to knowing if weight loss surgery may be right for you is to calculate your own Body Mass Index, or BMI.  You just have to know your height and weight, and it takes less than a minute to do.  Find out your BMI by clicking the button —>

What does the BMI mean

Here are the categories of BMI:

  • <18.5       = Underweight
  • 18.5 – 25 = Healthy weight
  • 25 – 30    = Overweight
  • 30 – 40    = Obese
  • >40          = Severely obese

It may be emotionally hard to find out which category you fall into – and you’d be right to note that it is just a number.  But think of it as a starting place, and if your BMI is high, perhaps now is the time to take action.  Especially if your BMI is greater than 40 in which case  I really encourage you to see a weight loss surgery expert.  For people with diabetes, the BMI at which to consider surgery drops to 35.

Is weight loss surgery right for me?

As Dr. Hartley mentioned, weight loss surgery is the best option for many people who are excessively overweight – the people who are at risk for complications due to their weight – diabetes being the most prominent example but also including high blood pressure and obstructive sleep apnea.  I won’t get into all the details, as there are lots of good resources for people who are overweight or obese (for instance, check here for good info from the National Institutes of Health – a source you can trust).   But what struck me about my conversation with Dr. Hartley was when he said the resistance of people to getting weight loss surgery is still a real problem.  And he isn’t trying to peddle unnecessary surgeries on anyone.  He simply knows firsthand that surgery is the best solution for many people.

And don’t be too hard on yourself.  Being overweight is not a character flaw.  For most people, it is also not just a problem with overeating (although that is the problem for some).  Rather, obesity is a complex chronic condition with lots of causes and contributing factors.

I’ll close with a few more things I learned from Dr. Hartley today about weight loss surgery:

  • Weight loss surgery may be the most effective treatment for diabetic patients who are obese.  Some patients actually leave the hospital after the surgery without needing their diabetes medications anymore!
  • We used to think it did not matter when you did your surgery.  We told people to just think about it and do it whenever you are ready.  Doctors are reconsidering this due to more recent evidence that suggests that getting it done earlier leads to better longer-term health in patients with diabetes.  So waiting for years and years to do the surgery may not be the best idea after all.
  • The laparoscopic banding surgery, which showed great promise 10 years ago, is used much less today.  The two more common surgeries are gastric bypass (Roux-en-Y), and vertical sleeve gastrectomy.
  • You can drink liquids without problem after weight loss surgery.  One caller to the show was worried about being thirsty after surgery.  Not to worry, you can still drink liquids normally as they just pass through your system just like they always did before surgery.
  • Loose skin can be a problem for some after weight loss surgery (to the degree that cosmetic surgery is considered), but for many people the skin does remodel back to a less bothersome condition over time.

If you are in Minnesota and want to take action on your weight . . . here is information on Dr. Hartley and his team at the Hennepin Bariatric Center.

Thanks for joining me on the air, streaming online, and on!