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Michele: The keto diet is definitely popular now. Is this diet recommended from a medical point of view?
Dr. Riley: The ketogenic diet has a number of variations. Their common point is a strict restriction of carbohydrate intake and a strong dependence on fats and certain proteins as sources of energy. It is medically indicated only in a few situations. Some children with epilepsy can benefit and are used in the treatment of some rare genetic disorders. Like other very restrictive diets, some use it to lose weight, although most people find it very difficult to stick to the long term, which makes it less effective for weight loss long-term. It also eliminates many fruits and vegetables containing vitamins, anti-oxidants and nutrients considered good for health. Thus, with some exceptions in children, the ketogenic diet is not generally recommended.
Jeans: When I shake my lower back while walking on the ice, what's better – ice or heat?
Dr. Riley: Evidence suggests that heat is preferable. This can help increase blood flow to the area that promotes healing, and may help those contracted muscles to relax. I prefer moist heat to dry heat. You can spread moist heat by soaking in a bathtub, letting the shower beat on your lower back or getting a container of warm water and going with a warm, damp washcloth. Moist heat seems to penetrate below the level of the skin better than dry heat and you do not risk the burns caused to people by the heating pads. So, wet heat, continuous activity within the pain limits, anti-inflammatory medications like ibuprofen and time are usually enough to address this common problem. If the injury is more severe, muscle relaxers, professional massages and chiropractic treatment may also be helpful.
Anonymous: My friend takes TUMS every day. She says it's her source of calcium. Is it safe to take every day?
Dr. Riley: First, it is recommended to consume every day between 1000 and 1200 milligrams of calcium. You can do this with a diet only if you include calcium-rich foods such as dairy products, eggs, fish and green leafy vegetables. But some people need supplements to get enough. TUMS tablets contain about 200 milligrams of calcium carbonate, making it an option. The main benefit is that it is less expensive than most other calcium supplements. The disadvantage is that the calcium contained in the TUMS may not be absorbed as well, especially in the elderly. To answer our viewer's question, we do not have sufficient evidence to suggest that the daily consumption of small amounts of TUMS is harmful and that it may be reasonable to ensure that you consume enough calcium.