Friday, December 16, 2011
If you prefer Facebook...
I have a page by the name Dan Caruso MD to keep people updated on office hours, holiday and vacation closure, insurance plan coverage, etc. It's easier for me and my staff to update on Facebook than the blog. For your privacy I recommend NOT adding yourself to the page unless you want everybody on Facebook to know that you are my patient. Please do not request medical information, prescription refills or scheduling on the Facebook page. It is best to text or email me for these needs.
Wednesday, December 14, 2011
Fewer carbs=less breast cancer?
It sounds very exciting, but the study doesn't actually show a reduction in breast cancer. It shows an improvement in risk factors associated with breast cancer. The main risk factors analysed were weight loss and body fat reduction, the same factors associated with type 2 diabetes mellitus. This sounds like a simple diet that may easily be followed long term.
Medpage Today
Kristina Fiore, Staff Writer, MedPage TodayPublished: December 11, 2011Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco andDorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
SAN ANTONIO -- Limiting carbohydrate intake just two days a week can mitigate some risk factors for breast cancer by burning body fat and improving insulin sensitivity, researchers said here.
Over three months, eating fewer carbohydrates alone or combining that reduction with severe caloric restriction two days per week was associated with significant changes in body fat and insulin resistance, Michelle Harvie, PhD, of Genesis Prevention Center at University Hospital in South Manchester, U.K., reported during a poster session at the San Antonio Breast Cancer Symposium.
"Both diets showed improvement in insulin sensitivity, compared with a regular calorie-restriction diet alone," Harvie told MedPage Today. "It's an interesting finding, but we need more research. This isn't ready to be recommended to patients yet."
In an earlier study, Harvie and colleagues demonstrated that two days per week of calorie restriction was comparable to daily calorie restriction in terms of weight loss, but it wasn't any easier for patients to follow because the choice of food was limited to fruit and vegetables on restricted days.
The present study allowed for more food choices during calorie restriction, Harvie explained.
They randomized 115 overweight or obese patients who, based on their weight were at risk of breast cancer, to one of three diets over a three-month period:
1. A calorie-restricted (600 kcal), low-carbohydrate (less than 40 g) diet for two days a week
2. A low-carbohydrate diet for two days per week, plus an ad-lib Mediterranean (healthy fats, fruits, and vegetables) diet the other five days
3. A daily calorie-restriction Mediterranean diet (1,500 kcal) all week
Harvie told MedPage Today that enforcing the diet two days per week, rather than three days, or one week on and one week off, was "just pragmatic; two days is achievable."
The women met monthly with a dietitian and had bi-weekly motivational phone calls. Eighty-eight of them completed the three-month trial, plus an additional month of follow up to assess whether restricting carbohydrates one day a week could help maintain weight and metabolic changes.
Harvie and colleagues found that after three months, patients on either of the low-carbohydrate diets had significantly greater declines in insulin resistance as measured by HOMA-IR (P=0.023) and in body fat (P=0.004) compared with those who just restricted their calories every day.
Those declines were maintained over an additional month of limiting carbohydrate intake to just one day per week, Harvie said.
Three months of the low-carbohydrate diets also led to better weight loss and lower levels of insulin, both risk factors for breast cancer, compared with standard caloric restriction. Those changes were maintained after an additional month, Harvie added.
"Weight loss and reduced insulin levels are required for breast cancer prevention, but are difficult to achieve and maintain with conventional dietary approaches," Harvie said.
None of the diets, however, had any effects on several other metabolic parameters, including adiponectin, insulin-like growth factor-1, interleukin-6, or TNF-alpha.
Harvie said the diets did reduce the levels of leptin, which is the hormone that tells the brain that the body is satiated, but not significantly so.
Overall, she called the intermittent low-carbohydrate diets a possible alternative to full-blown calorie restriction "for potentially reducing the risk of breast cancer and other diseases."
The researchers reported no conflicts of interest.
Primary source: San Antonio Breast Cancer SymposiumSource reference:Harvie M, et al "Intermittent dietary carbohydrate restriction enables weight loss and reduces breast cancer biomarkers" SABCS 2011; Abstract P3-09-02.
Medpage Today
Kristina Fiore, Staff Writer, MedPage TodayPublished: December 11, 2011Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco andDorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
SAN ANTONIO -- Limiting carbohydrate intake just two days a week can mitigate some risk factors for breast cancer by burning body fat and improving insulin sensitivity, researchers said here.
Over three months, eating fewer carbohydrates alone or combining that reduction with severe caloric restriction two days per week was associated with significant changes in body fat and insulin resistance, Michelle Harvie, PhD, of Genesis Prevention Center at University Hospital in South Manchester, U.K., reported during a poster session at the San Antonio Breast Cancer Symposium.
"Both diets showed improvement in insulin sensitivity, compared with a regular calorie-restriction diet alone," Harvie told MedPage Today. "It's an interesting finding, but we need more research. This isn't ready to be recommended to patients yet."
In an earlier study, Harvie and colleagues demonstrated that two days per week of calorie restriction was comparable to daily calorie restriction in terms of weight loss, but it wasn't any easier for patients to follow because the choice of food was limited to fruit and vegetables on restricted days.
The present study allowed for more food choices during calorie restriction, Harvie explained.
They randomized 115 overweight or obese patients who, based on their weight were at risk of breast cancer, to one of three diets over a three-month period:
1. A calorie-restricted (600 kcal), low-carbohydrate (less than 40 g) diet for two days a week
2. A low-carbohydrate diet for two days per week, plus an ad-lib Mediterranean (healthy fats, fruits, and vegetables) diet the other five days
3. A daily calorie-restriction Mediterranean diet (1,500 kcal) all week
Harvie told MedPage Today that enforcing the diet two days per week, rather than three days, or one week on and one week off, was "just pragmatic; two days is achievable."
The women met monthly with a dietitian and had bi-weekly motivational phone calls. Eighty-eight of them completed the three-month trial, plus an additional month of follow up to assess whether restricting carbohydrates one day a week could help maintain weight and metabolic changes.
Harvie and colleagues found that after three months, patients on either of the low-carbohydrate diets had significantly greater declines in insulin resistance as measured by HOMA-IR (P=0.023) and in body fat (P=0.004) compared with those who just restricted their calories every day.
Those declines were maintained over an additional month of limiting carbohydrate intake to just one day per week, Harvie said.
Three months of the low-carbohydrate diets also led to better weight loss and lower levels of insulin, both risk factors for breast cancer, compared with standard caloric restriction. Those changes were maintained after an additional month, Harvie added.
"Weight loss and reduced insulin levels are required for breast cancer prevention, but are difficult to achieve and maintain with conventional dietary approaches," Harvie said.
None of the diets, however, had any effects on several other metabolic parameters, including adiponectin, insulin-like growth factor-1, interleukin-6, or TNF-alpha.
Harvie said the diets did reduce the levels of leptin, which is the hormone that tells the brain that the body is satiated, but not significantly so.
Overall, she called the intermittent low-carbohydrate diets a possible alternative to full-blown calorie restriction "for potentially reducing the risk of breast cancer and other diseases."
The researchers reported no conflicts of interest.
Primary source: San Antonio Breast Cancer SymposiumSource reference:Harvie M, et al "Intermittent dietary carbohydrate restriction enables weight loss and reduces breast cancer biomarkers" SABCS 2011; Abstract P3-09-02.
Monday, September 26, 2011
Protein for athletes: how much is enough?
I'm cautious when I receive e-mails touting specific products for exercise performance. I was impressed that this one isn't pushing anything in excess. The recommendations do have research to back up the claims. Here it is:
When winning is on the line, make sure nutrition is on your side. Athletes faced with the pressure of regular workouts and performance have increased nutritional needs, especially when it comes to protein. With Isagenix products, athletes can gain an edge. These step-by-step guidelines are full-proof for helping strength and endurance athletes meet performance goals.
Step 1: Get enough protein daily with help from high-protein IsaLean® Shakes, Bars and Soups
Protein is major in sports performance.
Without enough protein intake, athletic potential can be seriously hampered. This is because the body doesn’t store protein well. Continual replenishment is needed for repairing muscle breakdown and building new muscle tissue.
The average adult needs about 0.6-0.8 grams protein per kilogram (about 2.2 pounds) daily. Active adults should keep protein up to about 0.8 grams per kilogram daily. How much do athletes need? It can depend on exercise intensity and type of training. Studies on endurance athletes and strength training athletes suggest they can gain most from intake of 1.4 grams to 1.8 grams per kilogram daily, respectively.
Athletes can make sure they’re getting enough protein daily with IsaLean Shakes, Bars and Soups. These meal-replacements are high in protein and are balanced with healthy amounts of carbs and fats as well as a full spectrum of vitamins and minerals.
Step 2: Maximize muscle gains by drinking IsaLean® Shake in the morning and spacing protein intake throughout the day
Protein intake daily is less important than time of intake. Studies show the biggest muscle gains come from regular protein intake throughout the day. Consistent increases in plasma levels of amino acids support muscle recovery and growth.
Athletes on a typical Western-style diet may find their protein intake varies too much throughout the day. An athlete needing 90 grams of protein intake daily, for example, may eat breakfast of just an egg, toast and coffee (approximately 10 grams of protein), then a chicken sandwich for lunch (approximately 20 grams of protein), and, to make up the difference, steak for dinner (approximately 60 grams of protein).
Best advice for these athletes to make the biggest impact on muscle gains is to switch to a diet that provides quality sources of protein throughout the day. Athletes needing 90 grams of protein per day should have the same level of protein at breakfast, lunch and dinner at approximately 30 grams (see graph below). To help cover protein requirements in the morning, athletes should drink an IsaLean Shake for breakfast or with breakfast.
Plus, the combination of proteins in the shake can make a profound difference. Dairy whey is quickly absorbed protein giving athletes a large increase in amino acids. Milk protein is more slowly absorbed providing a sustained increase in plasma amino acids.
Step 3: Never end workouts without IsaPro® whey protein mixed into an IsaLean Shake
The one- to two-hour period right after a workout is prime time for muscle anabolism. It’s this time when you need protein most. The body is craving nutrients for muscle recovery and protein is highest on the list, especially if the protein is high in branched-chain amino acids (BCAAs).
Whey protein is rich in all the BCAAs: leucine, isoleucine, valine. Research studies show that extra fast-absorbing whey protein after workouts boosts muscle growth in active adults and athletes.
Enter IsaPro® Vanilla flavored whey protein: one scoop of IsaPro to one and a half scoops of IsaLean Shake provides a whopping 35 grams of protein per serving. The extra protein along with the extra nutrients from the shake makes for best muscle recovery
And don’t think it wrong to add in some fruit to your ultra-high protein shake after exercise. Studies show that some sugar during and after workouts induces an insulin response that helps drive protein synthesis along with helping to replenish muscle glycogen (carbs stored in your muscle for quick energy).
If you are interested in ordering any of theses products please click on the link to www.dancarusomd.isagenix.com
When winning is on the line, make sure nutrition is on your side. Athletes faced with the pressure of regular workouts and performance have increased nutritional needs, especially when it comes to protein. With Isagenix products, athletes can gain an edge. These step-by-step guidelines are full-proof for helping strength and endurance athletes meet performance goals.
Step 1: Get enough protein daily with help from high-protein IsaLean® Shakes, Bars and Soups
Protein is major in sports performance.
Without enough protein intake, athletic potential can be seriously hampered. This is because the body doesn’t store protein well. Continual replenishment is needed for repairing muscle breakdown and building new muscle tissue.
The average adult needs about 0.6-0.8 grams protein per kilogram (about 2.2 pounds) daily. Active adults should keep protein up to about 0.8 grams per kilogram daily. How much do athletes need? It can depend on exercise intensity and type of training. Studies on endurance athletes and strength training athletes suggest they can gain most from intake of 1.4 grams to 1.8 grams per kilogram daily, respectively.
Athletes can make sure they’re getting enough protein daily with IsaLean Shakes, Bars and Soups. These meal-replacements are high in protein and are balanced with healthy amounts of carbs and fats as well as a full spectrum of vitamins and minerals.
Step 2: Maximize muscle gains by drinking IsaLean® Shake in the morning and spacing protein intake throughout the day
Protein intake daily is less important than time of intake. Studies show the biggest muscle gains come from regular protein intake throughout the day. Consistent increases in plasma levels of amino acids support muscle recovery and growth.
Athletes on a typical Western-style diet may find their protein intake varies too much throughout the day. An athlete needing 90 grams of protein intake daily, for example, may eat breakfast of just an egg, toast and coffee (approximately 10 grams of protein), then a chicken sandwich for lunch (approximately 20 grams of protein), and, to make up the difference, steak for dinner (approximately 60 grams of protein).
Best advice for these athletes to make the biggest impact on muscle gains is to switch to a diet that provides quality sources of protein throughout the day. Athletes needing 90 grams of protein per day should have the same level of protein at breakfast, lunch and dinner at approximately 30 grams (see graph below). To help cover protein requirements in the morning, athletes should drink an IsaLean Shake for breakfast or with breakfast.
Plus, the combination of proteins in the shake can make a profound difference. Dairy whey is quickly absorbed protein giving athletes a large increase in amino acids. Milk protein is more slowly absorbed providing a sustained increase in plasma amino acids.
Step 3: Never end workouts without IsaPro® whey protein mixed into an IsaLean Shake
The one- to two-hour period right after a workout is prime time for muscle anabolism. It’s this time when you need protein most. The body is craving nutrients for muscle recovery and protein is highest on the list, especially if the protein is high in branched-chain amino acids (BCAAs).
Whey protein is rich in all the BCAAs: leucine, isoleucine, valine. Research studies show that extra fast-absorbing whey protein after workouts boosts muscle growth in active adults and athletes.
Enter IsaPro® Vanilla flavored whey protein: one scoop of IsaPro to one and a half scoops of IsaLean Shake provides a whopping 35 grams of protein per serving. The extra protein along with the extra nutrients from the shake makes for best muscle recovery
And don’t think it wrong to add in some fruit to your ultra-high protein shake after exercise. Studies show that some sugar during and after workouts induces an insulin response that helps drive protein synthesis along with helping to replenish muscle glycogen (carbs stored in your muscle for quick energy).
If you are interested in ordering any of theses products please click on the link to www.dancarusomd.isagenix.com
Monday, September 19, 2011
What's different at my new office
There are number of practice changes evident at my new office.
I do not practice primary care.
I do not draw or run lab tests at Riggins Ct. I do not have any vaccines at this office. No infusions at this office. No bone density test. No nurse, no nurse practitioner, no certified diabetes educator, no medical assistant.
Because of limited staff any procedures, tests, referrals or medications requiring prior authorization may take longer to get approved.
The office is only staffed on Tuesdays and Thursdays. If you need a full time endocrinology practice to help you with your condition you need to be seen elsewhere. If you call on a Tue or Thu and get voice mail it means all the lines are busy. When you get voice mail on Mon, Wed and Fri it means I am seeing patients at the Renown Diabetes Center and I have no one to answer the phone number you called.
I am not accepting new diabetes patients insured by Medicare. It doesn't matter what your secondary insurance is.
I will see patients transferring from Renown Diabetes Center only if your insurance has changed and no longer pays for visits there.
If you wish to see an endocrinologist with full-time staff I suggest the following:
I have full time staff at the Renown Diabetes Center.
Dr Claude Lardinois sees people with diabetes at the Renown Diabetes Center 775-982-5073. He see non-diabetes endocrinology patients down the hallway at 775-982-6130.
I'm not sure if Dr James Atcheson is seeing new patient consults at this time. You can call his office at 775-982-6130 and find out.
Dr Lisa Abbott is accepting referrals for endocrine consults. 775-786-6770.
Dr Robert Fredericks has relocated his practice to the Wittemore-Peterson Institute at the University of Nevada Medical School campus. His nurse practitioner Pat McDonald is there as well. 775-682-8250.
Dr Evan Klass and Dr Stan Shane see patients at the University of Nevada Department of Internal Medicine clinic. Phone 775-784-7500.
There are also endocrinologists in practice in Carson City:
John Sutton, DO: 775-841-6333
Quang Nguyen, DO 775-883-9003
Carol Cheney, MD 775-883-9003
I do not practice primary care.
I do not draw or run lab tests at Riggins Ct. I do not have any vaccines at this office. No infusions at this office. No bone density test. No nurse, no nurse practitioner, no certified diabetes educator, no medical assistant.
Because of limited staff any procedures, tests, referrals or medications requiring prior authorization may take longer to get approved.
The office is only staffed on Tuesdays and Thursdays. If you need a full time endocrinology practice to help you with your condition you need to be seen elsewhere. If you call on a Tue or Thu and get voice mail it means all the lines are busy. When you get voice mail on Mon, Wed and Fri it means I am seeing patients at the Renown Diabetes Center and I have no one to answer the phone number you called.
I am not accepting new diabetes patients insured by Medicare. It doesn't matter what your secondary insurance is.
I will see patients transferring from Renown Diabetes Center only if your insurance has changed and no longer pays for visits there.
If you wish to see an endocrinologist with full-time staff I suggest the following:
I have full time staff at the Renown Diabetes Center.
Dr Claude Lardinois sees people with diabetes at the Renown Diabetes Center 775-982-5073. He see non-diabetes endocrinology patients down the hallway at 775-982-6130.
I'm not sure if Dr James Atcheson is seeing new patient consults at this time. You can call his office at 775-982-6130 and find out.
Dr Lisa Abbott is accepting referrals for endocrine consults. 775-786-6770.
Dr Robert Fredericks has relocated his practice to the Wittemore-Peterson Institute at the University of Nevada Medical School campus. His nurse practitioner Pat McDonald is there as well. 775-682-8250.
Dr Evan Klass and Dr Stan Shane see patients at the University of Nevada Department of Internal Medicine clinic. Phone 775-784-7500.
There are also endocrinologists in practice in Carson City:
John Sutton, DO: 775-841-6333
Quang Nguyen, DO 775-883-9003
Carol Cheney, MD 775-883-9003
Monday, September 12, 2011
new feature at my office
Massage Therapy
Kelsey Taelour and Gennea Lane
Call Kelsey For:
Sports Massage
Deep Tissue Massage
Medical Massage
Call Gennea for:
Swedish/ Relaxation Massage
Aromatherapy/ Prenatal
5605 E. Riggins Ct.
Reno, NV 89502
Kelsey- (775)240*5252
Gennea- (775)842*0179
9 A.M. to 6 P.M. By appointment only
Friday, August 26, 2011
More information about my new office
The office is small and quiet. There is no paperwork. Your information is reviewed with you and entered electronically or scanned.
When your phone call is answered it is by one of three people: me, my wife Toni or my daughter Ariana. We will introduce ourself when answering.
Appointments are for 60 minutes for a new patient, 30 minutes for follow up. Please be on time so you can receive the full benefit of your scheduled time. If you are going to be late or can't make an appointment please call and leave a message.
I do not have your records from Endocrine Associates. You need to sign a written request releasing your medical records to me and fax it to Dr Robert Fredericks at (775) 682-8502. I can e-mail or fax you a form, or you can wait until your appointment to sign the release at my office.
I do not draw or run lab tests at Riggins Ct. I do not have any vaccines at this office. No infusions at this office. No bone density test. No nurse, no nurse practitioner, no certified diabetes educator, no medical assistant.
Because of limited staff any procedures, tests, referrals or medications requiring prior authorization may take longer to get approved.
The office is only staffed on Tuesdays and Thursdays. If you need a full time endocrinology practice to help you with your condition you need to be seen elsewhere. If you call on a Tue or Thu and get voice mail it means all the lines are busy. When you get voice mail on Mon, Wed and Fri it means I am seeing patients at the Renown Diabetes Center and I have no one to answer the phone number you called.
I am not accepting new diabetes patients insured by Medicare. It doesn't matter what secondary insurance you have. I see new Medicare diabetes patients only at Renown Diabetes Center (775) 982-5073. No referral is necessary to be seen at Renown.
I will see patients transferring from Renown Diabetes Center only if your insurance has changed and no longer pays for visits at Renown.
I do not practice primary care.
If you wish to see an endocrinologist with full-time staff I suggest the following:
I have full time staff at the Renown Diabetes Center.
Dr Caude Lardinois sees people with diabetes at the Renown Diabetes Center 775-982-5073. He see non-diabetes endocrinology patients down the hallway at 775-982-6130.
I'm not sure if Dr James Atcheson is seeing new patient consults at this time. You can call his office at 775-982-6130 and find out.
Dr Lisa Abbott is accepting referrals for endocrine consults. 775-786-6770.
Dr Robert Fredericks has relocated his practice to the Whittemore-Peterson Institute at the University of Nevada Medical School campus. His nurse practitioner Pat McDonald is there as well. 775-682-8250.
Dr Evan Klass and Dr Stan Shane see patients at the University of Nevada Department of Internal Medicine clinic. Phone 775-784-7500.
There are also endocrinologists in practice in Carson City:
Quang Nguyen MD 775-883-9003 (formerly at University of Nevada)
Carol Cheney MD 775-883-9003
John Sutton, DO: 775-841-6333
When your phone call is answered it is by one of three people: me, my wife Toni or my daughter Ariana. We will introduce ourself when answering.
Appointments are for 60 minutes for a new patient, 30 minutes for follow up. Please be on time so you can receive the full benefit of your scheduled time. If you are going to be late or can't make an appointment please call and leave a message.
I do not have your records from Endocrine Associates. You need to sign a written request releasing your medical records to me and fax it to Dr Robert Fredericks at (775) 682-8502. I can e-mail or fax you a form, or you can wait until your appointment to sign the release at my office.
I do not draw or run lab tests at Riggins Ct. I do not have any vaccines at this office. No infusions at this office. No bone density test. No nurse, no nurse practitioner, no certified diabetes educator, no medical assistant.
Because of limited staff any procedures, tests, referrals or medications requiring prior authorization may take longer to get approved.
The office is only staffed on Tuesdays and Thursdays. If you need a full time endocrinology practice to help you with your condition you need to be seen elsewhere. If you call on a Tue or Thu and get voice mail it means all the lines are busy. When you get voice mail on Mon, Wed and Fri it means I am seeing patients at the Renown Diabetes Center and I have no one to answer the phone number you called.
I am not accepting new diabetes patients insured by Medicare. It doesn't matter what secondary insurance you have. I see new Medicare diabetes patients only at Renown Diabetes Center (775) 982-5073. No referral is necessary to be seen at Renown.
I will see patients transferring from Renown Diabetes Center only if your insurance has changed and no longer pays for visits at Renown.
I do not practice primary care.
If you wish to see an endocrinologist with full-time staff I suggest the following:
I have full time staff at the Renown Diabetes Center.
Dr Caude Lardinois sees people with diabetes at the Renown Diabetes Center 775-982-5073. He see non-diabetes endocrinology patients down the hallway at 775-982-6130.
I'm not sure if Dr James Atcheson is seeing new patient consults at this time. You can call his office at 775-982-6130 and find out.
Dr Lisa Abbott is accepting referrals for endocrine consults. 775-786-6770.
Dr Robert Fredericks has relocated his practice to the Whittemore-Peterson Institute at the University of Nevada Medical School campus. His nurse practitioner Pat McDonald is there as well. 775-682-8250.
Dr Evan Klass and Dr Stan Shane see patients at the University of Nevada Department of Internal Medicine clinic. Phone 775-784-7500.
There are also endocrinologists in practice in Carson City:
Quang Nguyen MD 775-883-9003 (formerly at University of Nevada)
Carol Cheney MD 775-883-9003
John Sutton, DO: 775-841-6333
Tuesday, May 3, 2011
New Office
I have an office address for my private practice. The location is:
5605 E. Riggins Ct. #206
Reno, NV 89502
The mailing address is
PO box 18537
Reno, NV 89511
Please e-mail me if you are interested in an appointment at my new office.
I expect to be seeing patients at this address by June 7 and possibly earlier.
If you are an established patient at another office please know that I do not have any of your records. Please contact that office to have your records released to me.
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