Dr. Robert J. Tozzi: Bio

Dr. Robert J. Tozzi, M.D., F.A.A.P., F.A.A.C, is Chief of Pediatric Cardiology and the Founding Medical Director of The Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at the Hackensack University Medical Center (HUMC), Hackensack, N.J. He is the past-Director of the Sports Readiness Program at The Pediatric Center for Heart Disease and past-Co-Director of the Pediatric Intensive Care Unit at HUMC. Tozzi also served as a Clinical Instructor of Pediatric Cardiology at the New York University Medical Center. In addition to holding a medical license from the State of New Jersey, Tozzi holds certifications from the American Board of Pediatrics and the American Board of Pediatric Cardiology. He is responsible for obtaining more than $1.75 million in grants for the perfection of biomedical technology applications, as well as the development of hospital infrastructure and facilities.

He is a current Fellow of the American Academy of Pediatrics; a Fellow of the American College of Cardiology; a current member of the American Medical Association; the Bergen County Medical Society; the Academy of the Pediatrics, Section Member of Cardiology, Neonatology, and Sports; the Society of Critical Care Medicine; the Northeast Pediatric Cardiology Society; and the Pediatric Oncology Group. Tozzi is the Medical Director of the Ukrainian Gift of Life, Glen Rock, N.J., and was the Founder, Medical Director, and Member of the Board of Trustees of Hope with Heart, the first summer camp for children with heart disease in the State of New Jersey.

He is the co-author of several papers published in refereed research journals, and he has lectured extensively in his field at numerous professional conferences. Tozzi graduated Board Certified in Pediatric Cardiology from New York University Medical Center. He performed his Pediatric Residency and was Board Certified in Pediatrics at the University of Medicine and Dentistry of New Jersey (UMDNJ), where he also received an Award for Excellence in Continuity of Health Care. Tozzi obtained his M.D. from UMDNJ (Alpha Omega Alpha Medical Honor Society), and graduated as Valedictorian with a Bachelor of Science degree in Biochemistry (Phi Beta Kappa-NJ) from Upsala College, East Orange, N.J.


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‘Sweet’ New Way to Prevent Heart Disease

Preventing heart disease never sounded so sweet.

According to a study published in the British Medical Journal in late August 2011, people who ate more chocolate reduced their risk of heart disease by 37 percent, their risk for stroke by 29 percent.

Eating chocolate clearly reduces the risk of cardiovascular disease, but this should come as no surprise. Chocolate is made from cocoa beans, and the less it is processed, the greater the health benefits to the human body. When selecting chocolate to eat, the less fat content and the more cocoa, the better. Dark chocolate is a palatable way to get your daily fix. Eating about 150 calories worth of chocolate each day, at 60-percent or higher cocoa content, should be part of a heart-healthy dietary plan for many at-risk patients.

Consumption of dark chocolate lowers your bad cholesterol and blood pressure, and also protects your blood vessels. It raises good cholesterol and may even increase cognitive function by increasing blood flow to the brain. This commonly available candy also reduces the risk of stroke and heart disease.

Chocolate, like meditation and walking, increases the feel-good compound nitric oxide in the bloodstream. The production of nitric oxide can help with sexual dysfunction in males. Cocoa consumption can even help guard against the damaging effects of sun exposure.

In a challenging financial climate where medical and pharmaceutical costs are skyrocketing, we finally have a sweet answer to several cardiovascular threats: Daily chocolate consumption.

Look out Lipitor – we have a better over-the-counter product that is cheaper, safer and widely available to adults and children alike.

New Guidelines for Fighting Obesity and Heart Disease in Children

There are new recommendations on cholesterol screening, and much more, just issued by the National Heart, Lung and Blood Institute (NHLBI). TheirBob Tozzi at the November 2011 AHA Conference mission is clear from the document’s title: “Cardiovascular Risk Reduction in Children and Adolescents: The New NHLBI Guideline.”

The document is in direct response to the alarming proportion of children who have markedly abnormal cholesterol levels and evidence of atherosclerosis – a disease normally thought of as an adult medical problem. These recommendations are designed to help reverse the epidemic of obesity and the related diseases that are growing at an alarming rate in our children.

At the November 2011 American Heart Association Convention in Orlando, as I observed the NHLBI presentation about these new and much-anticipated recommendations for preventing heart disease in children, I looked around at the sparsely-filled room. It was set up with seats to accommodate 600 professionals. There were fewer than 200 in attendance. Perhaps this was because it was an evening presentation, or maybe it reflects physician frustration at the enormity of the public-health issue of obesity, with its secondary problems of hypertension, hypercholesterolemia and resultant heart disease.

In any case, the guideline document needs to be widely disseminated within the medical community.

The comprehensive NHLBI review began with a computer-generated initial list of 1 million articles. The final document incorporated the best-of-the-best research on the topic, representing a derived-consensus document.

These are the significant take-away points:

  • High cholesterol in children is related to the development of heart disease in the adult.
  • With the obesity epidemic, cholesterol levels are rising even higher. Reduction in obesity will lower cholesterol levels.
  • Early intervention is needed for hypercholesterolemia and poor health habits in children (the behaviors as well as the diseases continue into adulthood).
    Initial management for abnormal serum cholesterol is education about healthy diet and exercise.
  • Healthy diet-education is best handled with the entire family involved and a dietitian.
  • Examples of healthy diet include the DASH diet and the Mediterranean diet.
  • There should be universal screening for elevated cholesterol for ages 9-11 years.
  • There should be earlier screening for high-risk individuals.
  • Medications may be needed in about 1percent of children (upwards of 200,000 children).
  • Parents must increase the activity level of children and reduce TV and computer time. The recommended activity level for 5 years and older is one hour of moderate to vigorous exercise per day.

Quite simply, this list should be posted in every pediatric physician’s office across the United States.

Video: The Watanabe Rabbits

The Top 10 Reasons Why School Sports are Unhealthy

I believe that high school sports, and behaviors related to school athletics, are fostering obesity, eating disorders and illness in America. Here is my Top 10 List of reasons why school sports are – counter-intuitively – leading to bad habits and worse health for America’s young people.

1)    Rapid weight-gain in childhood is associated with life-long obesity and heart disease. Bad behaviors that are associated with school athletics include bulking up for football, dropping and gaining weight for wrestling, and ultra-thin eating habits, leading to anorexia in young gymnasts.

2)    The concept that, “You’re an athlete – you’re working out, so you can eat whatever you want to eat,” promotes consumption of junk foods, which also extends to the spectators who consume junk foods sold at sporting events.

3)    Teaching the concept that endurance and intense aggressive training is a healthy lifestyle – “no pain, no gain” – reduces the likelihood that voluntary athletic behavior will continue into adulthood.

4)    If “winning isn’t everything, it’s the only thing” as the goal in sports participation, then inevitably there will be many losers. Ultimately this concept becomes a psychological negative when one thinks of health and its relationship to exercise.

5)    Lengthy afterschool practice sessions, combined with late-evening competition in Junior Varsity team sports, leads to missed hours of sleep, a drop in metabolism and a propensity toward obesity.

6)    Head injuries in soccer and hockey, as well as football concussions, are becoming a common cause of extended illness in young people.

7)    Repetitive damage to joints results in long-term disability, including back, knee and hip disease.

8)    This results not only in limiting one’s ability to ambulate as an adult, but subsequently results in weakened cardio-pulmonary function due to a lack of mobility, thereby increasing the likelihood of obesity, hypertension, diabetes, heart disease and stroke.

9)    Sadly, school athletics encourage the culture of drugs:  Taking stimulants for added stamina, including energy drinks such as Red Bull, often leads to the accepted use of steroids and other harmful and/or prohibited substances.

10) The overriding concept that winning is the most important part of the game is perhaps the umbrella theme promoting all the other unhealthy behaviors that affect today’s young athletes.

A Vicious Cycle of Subsidized Diet and Disability

Where do your tax dollars go?

It is a medical fact that soda and sugary drinks contribute to our nation’s rampant obesity problem. According to a 2010 report in The American Journal of Public Health, the federal government’s Food Stamps program allows an estimated $4 billion per year to be used to help fuel the obesity epidemic by paying for these high-calorie, obesogenic drinks. So every year, our tax payments are used to fund this unhealthy dietary practice, fostering a national health crisis.

Not only are we paying for consumption of these drinks, but we must also subsidize the health care costs that are related to obesity, hypertension, diabetes, and joint-replacements, as well as for scooters that allow these overweight and disabled individuals to have some freedom of movement.

Our tax dollars that are used to pay for these unhealthy products make their way back to the companies that produce these products. Those tax dollars can then be recycled to pay for the advertising that helps fuel our children’s’ consumption of products that promote obesity, sickness and dependence on the subsidized healthcare.

It is a vicious cycle that requires vigorous action at the medical, educational and regulatory levels.

As a wise commentator said, when you subsidize a certain kind of behavior, you get more of it.

As with too many generic crises, unfortunately, we can thank the logic of subsidies and entitlements for the perpetuation of an entirely avoidable and worsening behavior-related health disaster.



Where Have All the Parents Gone?

It was a typical office day…

“Dr. TOZZI, she will not LISTEN to me!” shrieked the irate mom, pointing to her daughter. “Tell her that she CANNOT have Chicken McNuggets and supersized fries for dinner. That’s all she wants to eat!”

Rebellious teenager gone wild? Not this time: This was about an overweight four-year-old girl.

Truth be told, I could substitute a boy or girl of any age for this four-year-old, and the story would be the same.

I remember listening to this particular mom because it was not one of my shining moments as a giver of good counsel. Perhaps like any parent with a history of disciplining unruly youngsters, I had heard enough by the time the woman uttered the word “McNuggets,” and this time I responded poorly.

I turned to the mother and said, “Why should I tell her? Is she old enough to drive? No – she’s a child – you have a responsibility here.”

It was, as I say, an unfortunate reaction.

We as parents, teachers and health professionals must slow down and take the time to teach by structured example.

We must support each other as parents, and share experiences and knowledge. Most of all, we must be willing to set limits and make the tough choices. It may be fast food now, but it will be drugs, alcohol, and risky behavior next.

Confronting our responsibilities as parents in the early years earns us the moral authority (and respect) that we will need in those later years to steer our growing children away from harmful temptation and the pitfalls of peer pressure.

Are Your Supplements Killing You?

Certain benefits that have been widely publicized for many years regarding dietary supplements may be ill-advised at best, according to a recent study in the Archives of Internal Medicine.

Indeed, one might almost say that confusion abounds. This new study on women’s health reports that dietary supplements are resulting in a higher mortality rate for women. But before we start to panic, let’s look at a few facts.

1) This study was conducted on older women with a mean age of 61 years.

2) Those taking iron supplements showed the greatest risk of earlier mortality.

Excess iron in the bloodstream is associated with increased atherosclerosis and subsequent heart attacks and strokes. It acts as a catalyst that increases the risk of free radical damage to the vascular system and associated tissue, thereby accelerating the aging process.

But back to the study.

When attempting to analyze this study, the most important piece of information is that these women are in a post-menopausal group that would no longer need to take extra iron to maintain health. After loss of menses, the risk of iron-deficiency anemia is low, and the risk of over accumulation increases.

Of course, most women who are trying to stay healthy are probably getting enough iron from fortified foods and dark green vegetables, as well as the occasional intake of red meat.

So here’s the bottom line: Iron supplementation is needed for the iron-deficient person. This is much more common in younger women, especially those who experience a heavy menstrual flow each month.

So, my recommendation for older men and women is to be smart, have blood work to check your iron status. Unless you receive a doctor’s indication that you are iron deficient, it’s best to skip that vitamin that contains iron.

Making Health Connections: Family-Centered Care

The new wave in medicine is family-centered care. The journal “Dimensions of Critical-Care Nursing” just published an article titled, “Goal of the Day: Initiating Goal of the Day to Improve Patient- and Family-Centered Care.” But just what is family-centered care, and who are the family members? Is it the classic family unit, or is it much more?

It has been well documented that, with ailing patients, human or animal connections improve health.

In women diagnosed with terminal breast cancer, simply meeting regularly with other women in a similar disease-state improved outcomes.

Talking and connecting with other women resulted in a doubling of life expectancy – a result that could not be achieved by any known medical intervention.

Walkers of dogs have less incidence of heart disease and are more adept at surviving heart attacks. Even observation of animal behavior can achieve dramatic results in treating and potentially curing some forms of autism and Asperger syndrome. This phenomenon was illustrated by anthropologist Dawn Prince-Hughes, M.A., Ph.D., in her book “Songs of the Gorilla Nation: My Journey through Autism.” The book chronicles her journey from social isolation and homelessness as an Asperger sufferer to her emergence as a world-renowned researcher. Prince-Hughes attributes her dramatic personal transformation to her early experiences observing and interacting with gorillas at the Woodland Park Zoo in Seattle, Wash., where she was employed as a young adult.

While some of her subsequent conclusions concerning primate behavior are inevitably controversial, the researcher’s life story is itself an important demonstration of one kind of transformative health connection.