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November 20, 2018

Top Healthcare Trends and Myths — Fact or Fiction?

By Meghan Presnell, FNP-C


1. Cracking Your Joint Can Lead to Arthritis

What happens when you crack your knuckles?

The joints pull apart slightly, which causes a decrease in pressure in synovial fluid, the fluid that lubricates the joints.  Bubbles of CO2 then form in the expanded fluid, which, with the pressure change, can cause a “cracking” sound as the fluid rushes back in. The CO2 is then reabsorbed.

So what do the studies say?

People who crack their joints are at about the same risk of developing arthritis as those who do not.  So crack away.

2. Gluten is Bad for You

What is Gluten?

A protein found in wheat, rye, spelt, and barley.

Celiac’s Disease

About 1% of the population has Celiac’s disease, which is an autoimmune disease where the gluten protein actually causes a reaction in your small intestine that can damage it, resulting in diarrhea, bloating, fatigue, and weight loss.

Gluten Sensitivity

  • About 1% of the population has a gluten sensitivity, which is very different from Celiac’s disease.  People with a gluten intolerance may experience some gastrointestinal upset or feel foggy.
  • There is NO test for this.  Best way is by elimination to see how you respond to gluten elimination.

The Verdict?

  • Going gluten free does not = healthy.  It is all about labels! Sometimes, gluten free foods are packed with sugar and preservatives while being lower in protein and fiber.  
  • Celiac’s is a very serious disease and should be treated by a licensed healthcare provider.  If you are have symptoms consistent with this disease, seek medical attention.

3. “Green Mucus? Give Me an Antibiotic!”

Why does it change colors?

The color of mucus can vary.  Usually with allergies, your mucus is clear and thin.  With viral illnesses, your body mounts an immune response.  As part of this response, your white blood cells (think your attack cells), rally and respond to the invader.  In the areas of your body with mucous membranes (nasal passages, throat, lungs), they produce an enzyme that can color the mucus a yellow or green color.  This can also occur with bacterial infections, but about 90% of the time, your green mucus simply means that your body is responding the way it is supposed to.

So when might I need an antibiotic?

      • An infection lasting longer than 10 days
      • An infection that is getting better, then suddenly worsens (double sickening)
      • A high fever that is not improving
      • Severe symptoms that are not responding to over-the-counter medications

4. “I Don’t Want the Flu Shot. It Will Give Me the Flu.”

What is the flu shot?

There are two kinds of flu shots: the traditional injection and the nasal spray.  The injection is either made from an inactivated (or dead) flu virus or recombinant virus, which includes one gene from the flu virus.

“But wait- I ALWAYS get sick from the flu vaccine.”  

The most common reactions to the flu shot are some local tenderness and redness.  There was a study that took a group of people and gave half a placebo shot (just saline) and the other an actual flu vaccine, and the same amount of people in each group stated they developed fever, headache, and muscle aches.

“It doesn’t work.  I always get the flu, even if I’ve received the vaccine.”

There are many possible explanations for this:

        1. Rhinovirus, adenovirus, and other viruses are also circulating during the flu season.  You may become sick from one of these.
        2. You may have been exposed to the flu before getting the shot, or in the 2 week window it takes to fully develop immunity.
        3. You may get another strand that isn’t covered by the flu vaccine.  The flu vaccine is a “best guess” at what strains will be the most prevalent, and therefore does not include all strains (there are over 150!)  The flu vaccine protects against either 3 or 4, depending on if you get the trivalent or the quadrivalent.

5. Vaccinations Cause Autism

The Wakefield Study

      • Dr. Andrew Wakefield wrote an article in the 1990s that stated that there was proof that vaccines, specifically the MMR vaccine, causes autism.  His original research consisted of looking at 8 children with autism and taking biopsies of their colon, blood, and cerebral spinal fluid. He stated that he found evidence of the measles virus in all of these fluids.  
      • Dr. Wakefield was later accused of severe research misconduct, conflict of interest, and falsehood.  The original publication, The Lancet, retracted his article.
      • Since the original article, there have been dozens of other studies investigating possible links connecting childhood vaccinations and autism.  As the rate of vaccination in some areas declined, the rates of autism continued to increase. Also, additional studies did find presence of the mumps virus in tissues of children, but not at any increased amount in children without autism when compared to children with autism.

The Conclusion:  

There is no evidence that vaccinations cause autism, and plenty of evidence to support that they do not.  Additionally, vaccinations save lives. It is estimated that over 20.4 million lives were saved from 2000 to 2016 as a direct result of the MMR vaccination.

6. Coconut Oil. Why is Everyone Going So CocoNUTS Over It?

Coconut oil has become one of the “it” foods recently popping up in everything from smoothies, to popcorn, and even as an add-in for coffee.  

The good:

Coconut oil, when used topically, has been proven to help with certain skin conditions, such as dermatitis and eczema, when used twice daily.  Additionally, some studies show it can increase HDL or your body’s “good” cholesterol, as well as offer some antioxidative effects.

The bad:  

In addition to increasing HDL, it also increases LDL, or the “bad” cholesterol that is linked with increased cardiovascular events, namely heart attacks and strokes.  In fact, some studies actually use more processed coconut oil that has been treated and heated as a control in studies running experiments on fats.

The conclusion:

 When ingested, it appears that coconut oil does more harm than good.  Topically, though, it can offer some benefit, so slather away!

7. “I Don’t Need Fruits and Vegetables. I Take a Multivitamin.”

First and foremost, vitamins are NOT a replacement for a well-rounded diet.  There are many non-essential, but beneficial, nutrients and micronutrients that are found in foods and not found in supplements.  Examples of these are flavonoids, carotenoids, and antioxidants. If you are concerned you aren’t getting enough nutrients in your diet, consider consulting a registered dietitian to help you incorporate these.  

The FDA does not regulate supplements as closely as they do pharmaceuticals.  A company does not have to submit any evidence of their supplements’ health claims before placing it on the market.  Any advertising for supplements actually doesn’t even fall under the FDA’s jurisdiction. This is regulated by the FTC, or Federal Trade Commission.  

So who does need supplements?

  • Those who can’t get enough through their diet and can’t make the necessary lifestyle changes
  • Vegetarians and vegans, who are notoriously deficient in vitamin B12, which is only found in animal products.  They may also be deficient in iron, calcium, and zinc.
  • All pregnant women need to be taking a prenatal vitamin daily to ensure that they have the appropriate amount of folic acid to support the development of their baby.  
  • Other medical conditions that decrease absorption in your GI tract.  Please speak to your medical provider if you have concerns about this.  

8. Wearables – Do They Really Work?


a technological device, worn on the body, that helps track information related to health and fitness.  


  1. Fitbit
  2. Apple watch
  3. Garmin
  4. Jawbone
  5. Up band

So what are the benefits?

They can give you insight into your daily activities.  You get actual data on how many steps you have taken, how many hours you slept, how long you are sedentary, and how many calories you may be burning at rest and with exercise.  These can serve as tools to help motivate individuals to eat less, move more, and obtain a longer night’s sleep. You can also take this information to your healthcare provider so they can help you determine opportunities for improvement.  

And the drawbacks?

  • They are not cheap.  They can cost anywhere from $50 to $500.  
  • They are NOT 100% accurate.  Wrist wearables, specifically, operate by shining a light through the skin to help measure heart rate by reflecting in the blood stream.  If the band is loose, more light can shine in, interfering with readings. Individuals with darker skin may also have an inaccurate reading because the light has a more difficult time penetrating the skin.  

The bottom line:

 Use them, as they can be beneficial, but do not rely 100% on their data.  I have had patients that are overeating based on the calories that their wearable states they are burning.  

9. Keto Diet – A Sustainable Solution for Weight Loss


At its simplest form, a keto diet is very low in carbohydrates and high in proteins and fats.  Think Atkins diet, but more restrictive. The keto diet, on average, consists of only 5% carbohydrates, 20% protein, and a whopping 75% fat.  

What does it do?

The theory behind the keto diet is that your body enters ketosis, which is when it breaks down fats instead of carbohydrates, thus resulting in loss of fat.  

So what are the drawbacks?

Ketosis can come with some negative side effects, including nausea, headaches, mental fatigue, and bad breath.  You can also become deficient in vitamins and minerals found in fruits and vegetables. Additionally, you are more prone to kidney stones and, depending on what fats you use, you may be more at risk for a heart attack or stroke.  

The bottom line:

The keto diet is currently only recommended for individuals suffering from seizures, as it has been medically proven to help decrease the frequency of seizures.  The most well-studied diets for weight loss are the Mediterranean diet or the DASH diet. They are rich in fruits and vegetables as well as lean proteins and healthy fats.  

10. Alcohol – NO Amount is Safe

Where does this come from?   

So there is a lot of buzz (pun intended) about this as of late.  An article published in August 2018 (also in The Lancet), reviewed data from almost 700 sources and came to the conclusion that alcohol is associated with increased risk of cancer and car accidents.  The small benefit that alcohol (1 glass a day for women and 2 glasses a day for men) offers with regards to reduction in the rates of stroke, heart attack, and diabetes, was outweighed by this increased risk of cancer and car accidents.

So is this true?

You have to look at this study along with the entire body of evidence consisting of hundreds of other studies that have previously been performed as well.  For example, a 2017 study showed that those who did not drink alcohol were more at risk for heart disease, stroke, heart failure, and peripheral artery disease as compared to moderate drinkers.  Another study in Diabetes Care in 2015 showed an 18% decreased risk in type 2 diabetes in those who consumed alcohol as compared to those who didn’t.  

The conclusion:

Whether or not you should consume alcohol should be a decision that you make with your medical provider.  Always keep in mind the daily CDC recommendations of one alcoholic beverage per day for women and two per day for men.  If you feel that you have a problem with drinking, please consult your medical provider.

Meghan Presnell is a Board-Certified Family Nurse Practitioner by the American Academy of Nurse Practitioners and a provider at Avance Care’s Central Raleigh location. Practitioner Presnell approaches healthcare through a holistic lens, striving to establish a trusting and collaborative relationship with her patients in order to help them achieve their optimal state of health. She also has a special interest in complementary and alternative therapies. Practitioner Presnell is happily married to her husband, Stuart, and in her free time enjoys singing, exercise, traveling, and cooking.

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