Archive for July, 2007

Orange Juice Can Prevent Kidney Stones

July 31, 2007

imageserty.jpgGood news for orange juice drinkers.  More benefits come your way than just taking the extra Vitamin C with this new study looking at extra help of orange juices in prevnting kidney stones.

It is known in the medical community that potassium citrate found in most citrus juice can slow down formation of kidney stones BUT are all citrus fruits the same?.

In a recent study by a team from the University of Texas Southwestern Medical Center at Dallas, published in Oct. 26 issue of the Clinical Journal of the American Society of Nephrology found that components found in orange juice can affect a juice’s ability to prevent stones.  In the study the volunteers drank 13 ounces of orange juice, lemonade or distilled water three times a day with meals. They were also put on a low-calcium, low-oxalate diet, which also helps cut stone formation.

The Results:

One possible explanation as to why OJ is better than Lemonade is that the citrate in orange is accompanied by a potassium ion ( the same goes with Grapefruit) while the citrate in lemonade and cranberry juice is accompanied by a hydrogen ion.  The problem with hydrogen ions is that they counteract the beneficial effects of high citrate content while potassium ions do not!!!

So…. for those with risks to develop Kidney stones, here’s one that we can incorporate in our diets!  One that we can enjoy every morning with our breakfast!

An OJ Each Day May Prevent Stones Today!

Dark Chocolate for Hypertension? Anyone?

July 30, 2007

22173473171.jpgWe have long heard about the good news of enjoying dark chocolates.  The mere thought of eating one makes your tummy growl for food! Just recently while browsing my JAMA journal noted another study on dark chocolate which is really good news to chocolate lovers.

The July 4, 2007 issue of the Journal of the American Medical Association reported a new study to show the benefits of cocoa in dark chocolate long-term — the study lasted 18 weeks.  

This study is a well conducted study being a randomized, controlled, investigator-blinded, parallel-group trial with 44 adults, aged 56 to 73, with untreated mildhypertension without concomitant risk factors.  This study is well matched and the two groups compared were given either a one square (6.3 g) of a commercial brand of dark chocolate per day, constituting just 30 kcal, or white chocolate which is  polyphenol-free to enjoy for 18 weeks.

Results Are Amazingly GOOD NEWS:

From baseline to 18 weeks, dark-chocolate intake reduced mean systolic BP by 2.9 mm Hg (p<0.001) and diastolic BP by 1.9 mm Hg (p<0.001) without changes in body weight, lipids, glucose, or 8-isoprostane. Hypertension prevalence decreased from 86% to 68%.  There was  a sustained increase of S-nitrosoglutathione by 0.23 nmol/L (p<0.001) and the appearance of cocoa phenols in the plasma among the dark chocolate eaters.

Te reseacrchers explain the phenomonon: “The apparent mechanisms by which dark chocolate lowered BP suggests a chronic increase in the production of nitric oxide in the vascular endothelium… and it is likely that cocoa flavanols in dark chocolate were responsible for the observed effects on S-nitrosoglutathione and BP.”

BUT before everyone indulges on dark chocolates… it is important to remember that it should be DARK and not Milk or White chocolates…likewise keep in mind the AMOUNT because remember the CALORIES! The one square of dark choco can give you around 30 kcal per day.

A Chocolate A Day Keeps Your Doctor Away!

How Much Salt Can We Take?

July 28, 2007

imagessd.jpgThe new recommendations from the American Medical Association should be a wake up call to all of us.   We know that salt is important for the taste of our foods but taking too much can be harmful.  As physicians weve been harping on lowering salt intake to our patients when they prepare their foods not recognizing that the culprit may actually be food in the restaurant and the processed foods we buy in the groceries!

We know from studies that populations with an average sodium ingestion of less than 1400 mg/day have virtually no hypertension BUT the average intake of salt in the world is around 4000 mg per day while Filipinos usually take in more.  This is way above the recommended daily allowance of 2000 to 2300 mg per day.   

The recently published advisory in the Archives of Internal Medicine, July issue urged the Food and Drug Administration to take a look at the standards set for salt and to limit sodium in processed and restaurant foods. It is recommneded that a minimum 50% reduction in sodium in processed foods, fast-food products, and restaurant meals should be sought in the next decade it we have to decrease the risks associated with high blood pressure. More so to address the labelling of products known to contain High Salt levels.

The AMA paper has this to say: 

“Across populations, the level of blood pressure, the incremental rise in blood pressure with age, and the prevalence of hypertension are directly related to sodium intake. Observational studies and randomized controlled trials document a consistent effect of sodium consumption on blood pressure. The majority of sodium consumption in the United States is derived from amounts added during food processing and preparation. Leading scientific organizations and governmental agencies advise limiting sodium intake to 2400 mg or less daily (approximately 6000 mg of salt). Substantial public health benefits accrue from small reductions in the population blood pressure distribution. A 1.3-g/d lower lifetime sodium intake translates into an approximately 5-mm Hg smaller rise in systolic blood pressure as individuals advance from 25 to 55 years of age, a reduction estimated to save 150 000 lives annually.

With an appropriate food industry response, combined with consumer education and knowledgeable use of food labels, the average consumer should be able to choose a lower-sodium diet without inconvenience or loss of food enjoyment. In the continued absence of voluntary measures adopted by the food industry, new regulations will be required to achieve lower sodium concentrations in processed and prepared foods.”

A Pinch Of Salt For A Healthy You!


The Low Cholesterol and Cancer Link…

July 27, 2007

Lowering the cholesterol level of any patient with risk for heart disease is very important.  It is a MUST for any patient with Diabetes or Hypertension. It is sometimes difficult to convince patients to take anticholesterol meds because many are so afraid of the link to liver disease rather than be afraid of the heart disease if cholesterol is not regulated.  Likewise, patient remains asymptomatic even with elevated cholestrol so the urgency to seek treatment is not there.

Now comes another story linking low cholesterol to cancer!!!!

The increase in cancer incidence among statin users was small — about one extra case per 1,000 people, according to the study in the July 31 issue of the Journal of the American College of Cardiology. Apparently the slight increase in cancer incidence was found in 13 trials among statin users who achieved the lowest LDL cholesterol levels.

Is This A Cause For Alarm?

Most likely NOT! Again this is only an observation among the 23 trials studied and NOT a Cause and Effect Situation.  This calls for more attention and further study but again just like any drug or intervention we do…If there’s an effect…there almost always a Side Effect!  If you take a drug based on a premise that it is so safe without side effects then you are in for the worst!  Most likely you were sold by the marketing strategy of the sales agent!

Remember… the economic burden of suffering from heart disease is more than the risk of getting cancer in this case.  Likewise the effect of lowering cholesterol and lowering ones risk for heart disease is PROVEN .  It is also possible that by postponing disability and death due to heart disease, we make people live longer and in population studies, the longer we live the more likely we will get other diseases and cancer is one of them!.

My Recommendation is for my patients NOT TO WORRY!

The benefits of lowering cholesterol continue to outweigh the risks! Continue taking the drugs and I will continue to implement the same strategy of aggressiive lowering of cholesterol to prevent the target organ of high cholesterol levels…The HEART!

Low Cholesterol Unlinks The Burden Of Heart Attack!

AACE Philippine Chapter Annual Convention

July 26, 2007

scan0001.jpgThe American Association of Clinical Endocrinologist – Philippine Chapter will hold its Annual Convention on August 10 to 12, 2007 at Shangrila Mactan.

All doctors of all specialties are invited to join the affair as the organization has prepared a well balanced sessions for great learning!  As the one in charge of inviting foreign speakers it was pretty tough but finally there will be 6 foreign speakers– all world renowned in their own field of interest who will join us in the event.

  • Dr Hossein Gharib of the Mayo Clinic , my friend and my great boss… a respected expert in the field of Thyroid Diseases ,who is also presently the President Elect of the American College of Endocrinology will talk of  FAQ on Thyroid Diseases and another symposium on Controversies of Thyroid Cancer.
  • DR Steven Petak who is the Past President of the American Association of Clinical Endocrinologist will talk on Updates on Osteoporosis as well as Vitamin D: Bone and Beyond.
  • Dr James Gavin of Emory University will talk about The new Drug for Diabetes called Byetta and a plenary on Diabetes in Pregnancy
  • Dr Cecil Lansang of California who will talk and teach participants on the Thyroid Ultrasonography;
  • Dr Melvin Tan from the National University of Singapore will talk on Diabetes and Hypertension
  • Dr JJ Mukherjee also from the National University of Singapore will talk on Updates in Endocrine Hypertension and Male Hypogonadism

Prominent Local Speakers will also be present:

  • Dr Augusto Litonjua of Makati Medical Center who will talk on the New Incretins and GLP1 drugs for Diabetes,
  • Dr Ricardo Fernando of ISDF on Advances in Diabetes Care,
  • DR Estrelle Lopez of UST on Nutrition and Diabetes and
  • Dr Gerry H Tan of Cebu Doctors’ University will talk on The Proper Use of Insulin in Diabetes.

Registration will be FREE for the Residents in Training from all hospitals.  For Consultants, it will be a nominal fee of only P500 for the 3 day affair.  Registration will start at 8:00 to 11:00AM on Friday Aug 10 with the First Luncheon Symposium on Insulin Therapy at 11:30AM to 1:30 PM. There will also be exhibits from our pharmaceutical partners.

This is an opportunity for fellow Cebuano Doctors and neighboring cities and provinces to take part in this grand affair where you will have the chance to ask your personal questions regarding your patients with the experts in the field of Endocrinology.

For questions…please call Dr Gerry H Tan at 032-412-4803 and Dr Marsha Tolentino at 032-412-2767.

Or you can write to me in this website for any inquiries….

Can Diet Coke Cause Heart Disease?

July 25, 2007

212693807.jpgI usually allow my patients to drink soda as long as it is a “diet” or “light” soda…meaning, no sugar added but the sweetness is plainly due to an approved sweetener.  I usually caution them to drink only 1 can a day and not more.  The only concern I have is the amount of sodium in the soda rather than it causing harm to my diabetic patients.  It is therefore rather surprising to me that a study published in Circulation July 24 issue came up with a warning that “drinking more than one soda a day — even if it’s the sugar-free diet kind — is associated with an increased incidence of metabolic syndrome, a cluster of risk factors linked to the development of diabetes and cardiovascular disease.”

The study is not the ideal study population or method that can come up with a firm conclusion or assoiciation since this is a population based study where more than 6,000 participants in the Framingham Heart Study were followed up since 1948.  The study found that after four years of the study, “people who consumed more than one soft drink of any kind a day were 44 percent more likely to develop metabolic syndrome than those who didn’t drink a soda a day.”

Theories as to why this happen are intriguing steming from the fondness of sugary foods among people drinking soda to the caramel content of the soda promoting metabolic changes in the body.  Unfortunately, this study only proves a possible association and cannot in itself infer causality.  In other words…There is no proof that soda in itself is the culprit until further studies on causality can be done.

So if you love soft drinks then I would recommend allowing yourself to enjoy a”diet” or a “light” soda and only 1 can per day.  Overconsumption of a certain food does not allow one to prevent a disease by consuming more of a certain beverage even if it deemed safe by the medical community.

So…Can Diet Coke Cause Heart Disease? 

I doubt it.  This is only an observational study.  The same kind of method that initially suggested that Estrogen hormone therapy can lower ones risk for heart disease but eventually when a randomized prospective study was done… hormone replacement therapy actually increased ones risk for heart disease. BUT the study for me tells us only one thing: that even if it is “diet and has zero calories does not mean it is safe to over indulge!

The American Heart Association continues to recommend low calorie beverage as a good option for a healthy meal and likewise issued a statement :

“Since this is an observational study, it is important to note that the study does not show that soft drinks cause risk factors for heart disease. It does show that the people studied who drank soft drinks were more likely to develop risk factors for heart disease.

“However, it is possible that other factors could explain this relationship. Often people who drink soft drinks also eat and drink more calories, saturated fat and trans fat and less fiber and dairy products. Also, these people tend to be less physically active. This was true among the subjects in this study.”

So for me … the verdict is in:

It’s the LIFESTYLE Not The Drink! 

Read My Other Related Posts:

Coffee Cuts The Risk To Develop Diabetes

July 24, 2007

3517174637.jpgAnything that we do as long as these activities dont harm us is worth enjoying.  If you love to drink coffee and enjoying your cup while reading your morning daily then this report is good news to you!!!

A recent study published in the Archives of Internal Medicine involving 28,812 postmenopausal women who were followed up for 11  years where 1,418 women developed diabetes… showed that postmenopausal women who drink coffee regularly decreased their risk  of developing type 2 diabetes by 22% compared to women who never drink coffee.  The risk continued to drop as ones coffee consumption increased!!!!

The researchers stressed “in light of the popularity of coffee consumption and the high rates of type 2 diabetes mellitus in older people, these new finding may be of significance from a public health point of view.”  But it is very important for us to remember that: the right diet and exercise continues to be the first line in preventing the onset of this chronic disease called Diabetes.

Is it the Caffeine? Or is it the Coffee itself that gave the protection?

The study found that the women in their study who consumed caffeine from other sources – not coffee – did not experience the same benefit as those who drank coffee.  Meaning it should be what is in the coffee that offered protection.  Likewise, women who regularly drink decaf experience an even lower diabetes 2 risk meaning it may not be the caffeine after all.

I am not depending on my coffee each morning to help me cut my risk to develop diabetes.  I do my own homework of eating right and doing my regular exercise BUT this report helps me enjoy my coffee even more!!!! And Lastly…I dont own a Coffee Shop…..

Double The Fun With Your Daily Coffee!

Read My Other Related Posts:

How Much Exercise To Prevent Diabetes?

July 23, 2007

imageswer.jpgExercise and exercise…we know its benefits.  But one thing that really makes me exercise is my risk to develop Diabetes.  We know we can prevent this disease by behavioral therapy like taking care of ones diet and physical activity but doing the exercise for an hour can be TOO MUCH! A lot of friends buy the exercise gadget including the famous treadmill machine…but bet you, if I survey on this site how many of you out there has this machine but has no longer been used it for more than a year?  Any takers?

According to the U.S. Centers for Disease Control and Prevention (CDC) “one in three American children born in 2000 will develop type II diabetes!!!!” So parents take note: 1 in 3. As much as we want to pamper our kids for the lack of time we sometimes spend with them…be the parents or the grandparents who usually spoil these kids ( smile)  with candies, burgers and ice cream… Be AWARE!

But there’s hope:  new study at the University of Missouri-Columbia says that acute exercise — as little as 15 minutes a day — can have a profound influence on preventing and fighting the disease.  That’s easy!!!! 15 minutes is definitely manageable to anybody and am one of those that finds this study rewarding to all of us who feel disappointed about the need to really do the workout for an HOUR! But for guys who just dont have the time…read my other article below this…

This exercise activity is not the exercise of daily living BUT an acute form of exercise which is a bout of activity in which people Actively Participate!!!.  Activities like running, walking or biking for straight 15 minutes!

Remember there is no limit as to the impact of exercise on this disease… it has been proven to be effective at all levels.  Whether you are still trying to ward off this disease because of obesity or you are already a diabetic on medications or even if you are already on insulin for several yearts, exercise can make a difference in improving your body’s response to insulin.

A bit of good news for this week folks!

Only 15 Minutes Of Exercise Can Make A Difference!

Read My Other Related Posts:

How To Live Longer Without Exercising!

July 20, 2007

3904728485.jpgBeing busy or too busy to exercise may not be bad after all….

A recent report from the Mayo Clinic may prove to be worth considering if we talk about the need to be more active to live long.  We all know the fact that increasing exercise not only prevents one from developing chronic illnesses associated with inactivity and obesity but also can make us feel better and live longer.

According to the March issue of Mayo Clinic Women’s HealthSource: marathon training or going to a gym is not required but by staying busy and active all day can do the trick.  Such activities that can help people live longer by expending more energy include household chores such as vacuuming, mopping the floor, washing windows, lawn work, caring for children or adults, walking or volunteering.

The study, published in the Journal of the American Medical Association, tracked 302 adults between the ages of 70 and 84 for six years.  The study showed that:

” Participants who had shown the highest energy expenditures due to more physical activities had about half the chances of dying of those with the lowest energy expenditures. Participants most likely to be in the high-energy group reported climbing stairs or working for pay as a daily part of their lives.”

There you go… being busy can mean healthier lives as long as people who are “too busy” for exercise,  can stay “too busy” around the house and at work, or in the community doing what they have to do and in return live healthier lives.

Great news to those busy bees…. just dont be geeks and be sedentary and “too busy” sitting in your chair facing your computers with only your fingers and mouths exercising.  Those activities dont count!

No More Excuses..Start Moving!

The Art Of A Relationship….

July 19, 2007

imagesaaa.jpgOver the years that Ive pratice medicine, what I find interesting when seeing patients is the feeling of their trust in us that we are doing the right thing for their health.  For me this is one precious gift we have that should be guarded, protected and should never be abused.  So anytime I give advises to my patients… be it medication or surgery… they know it’s for the good of their health and nothing else!

Giving time to tell them what they want to know and giving them the chance to ask questions are keys to a successful relationship.  This is A True Relationship.  I may not be as smart as the one next door but if patients feel comfortable when they see me then I am a better doctor to the eyes of that patient.

I guess my training at Mayo taught me to deal with patients more than their illness…treat them as your family…. and they will see you again…refer more patients to you and their kids to you.

I guess this is true to everything in this world.  Be it in business, government or as an employer.  It’s the relationship that you have with your customers or your employees that will put you up in the pedestal for your clients and friends to look up to and emulate.

Everytime, my patients leave my office… they often say “thank you”. This has made me think over the years.  I guess they’re thanking me for taking time to explain and to help them understand about their disease and thanking me for making them feel better by the mere fact that now they know what they have and how to handle their illness.  I guess by making them feel that I care and I am here to help was all worth their time to see me.

Build a relationship and one that should last… and that’s what I call SUCCESS!….

Love What You Do and Its Will Show! 

Foods To Avoid If You Have High Uric Acid or GOUT!

July 18, 2007

2325435892.jpgThe scenario is common: the patient goes to sleep then around early dawn, he is awakened by severe pain in the big toe followed by fever and chills. This is almost always the symptom of a gouty attack!!!!  This condition affects the age group 30 to 50 years old and is the most common cause of joint pain among men.

Hyperuricemia or an excess of uric acid in the blood is the culprit for gout and is very common among diabetic patients. Likewise, in general population, gouty arthritis due to high uric acid commonly manifests as pain in the joints especially the big toe.  Unfortunately people always mistake any form of joint pains in the body as due to uric acid and therefore wants to avoid food associated with gout.  To be sure therefore if your joint pains are due to this disease, a simple blood test called uric acid can easily be determined in any lab.

NO NO if You Have GOUT or High Uric Acid:

  • The NUMBER ONE on my list is ALCOHOL!!!!
  • Anchovies
  • Gravies
  • Herring, Sardines
  • Mussels or Tahong
  • Internal Organs like liver, kidney
  • Dinuguan, Chicharon Bulaklak
  • Mackerel
  • Patis and Soya Products
  • Bacon and scallops

Use in Moderation:

  • Crabs, Oysters, Shrimps, and eel
  • Poultry and Meat incluidng soup and broth
  • Oatmeal
  • Certain Veggies like asparagus, spinach, mushroom and cauliflower
  • Legumes like beans or lentils

Once given a diagnosis, it is prudent that one takes care of it since the condition can recur and if not treated well may lead to other complications like kidney stones! Yikes!

Taking simple steps starting with our diet can go a  long way in improving our health….

Eat To Live and Not Live To Eat!

Do You Have A Family History of Diabetes?

July 17, 2007

1997049824.jpgI always counsel my patients to inform their siblings, relatives and kids regarding the potential risk to develop diabetes in their lifetime.  I often require my patients to bring their kids during their next visit so my counseling and education can be heard and have an impact several fold!

Recently, a study from the International Diabetes Institute, Melbourne, published in the June 19 issue of the journal Circulation has shown that even the very earliest signs of Diabetes can increase the risk of dying from heart disease.  The findings confirm our previous observations that by the time ones fasting blood sugar is increased: 50% of the patients have already signs and symptoms of complications including that of the heart.   Now comes this finding that tells us more: that many more people are at risk of suffering from the complications of diabetes — even BEFORE they are diagnosed with the elevated blood sugar.

One message therefore that this study gives us is:

Dont take any abnormality of blood sugar for granted.  Consider it serious form the very start because any amount of early intervention can mean a lot to ones risk of developing heart attacks and strokes.  Not anly are they disabling but more so a tremendous economic load especially treating the complications!

So whats a normal blood sugar? Anytime your fasting blood sugar exceeds 99 mg/dl is already abnormal! Anytime of the day if your blood sugar reaches 200 even immediately after a meal is already abnormal.  Anytime if your blood sugar 2 hours after a meal is > 140mg/dl is already a red flag!  Now once your fasting blood sugar exceeds 126 mg/dl…that’s Diabetes!

So Take action…if you’re at risk! The earlier you change your lifestyle …the better!

The Earlier We Intervene in Disease… 

The Better Outcome For Health!

Dont Reuse Takeaway Plastic Containers

July 16, 2007

imageser.jpgJust came from Malaysia to attend an emergency meeting for 2 days and while going through the Malaysian Daily read an interesting headline: Plastic Peril.

The main message of the headline was that since takeaway plastic containers are made to be used only once…make sure you dont reuse them nor use them to store your food!  These plastic containers apparently dont have the sturdiness and thermal stability that are present in reusable plastic containers. 

Similar recommnedations were given for plastic mineral water containers…not only is it difficult to clean, the stability of the plastic is also questionable considering the heat and humidity of Malaysia similar to our country.

The recommendations were based on the study done by the Faculty of Medicine, University of Malaysia where in 45 containers examined …at least one chemical was detected in all.  Although the chemical content was low…repeated exposure can result in accumulation of these chemicals esepcially one particle called BBP or Benzyl Butyle Phthalate which in the long run can cause endocrine function abnormalities involving the thyroid and the pancreas!

I am sure a lot of us have the practice of reusing these containers we get from the restaurants and reusing them in reheating foods in the microwave stored in the fridge.  Now we know this is not advisable nor safe!  So always remember…..

Reusing Takeaway Containers Is  Harmful To Your Health!

The Will Power To Stop The Urge To Eat…

July 11, 2007

3582617281.jpgI follow this simple principle to following a strict dietary habit that I feel is the most rewarding in terms of curbing one’s desire to eat… and eat MORE!

When I see a patient in the clinic who is apparently Gaining Weight or with fluctuating blood sugars especially 2 hours after a meal, I know there is a problem of Discipline and Will Power. The Urge to Eat defeated his Desire to stop eating and as a result, the patient gains weight and has high blood sugar levels. 

Because of my family history of Diabetes with my two siblings having Prediabetes, my risk is high to have the same problem…so I follow what I preach to my patient.  Experience wise…I know the Will Power should defeat the Urge To eat!

It may not be easy but it’s a doable thing.  I eat my oat meal for breakfast at around 6 AM. I then have a half of a sandwich by 9 AM plus a cup of Kafe Latte which I place in my coffee heater and have small sips in between patients and finish it by 12N.  Dont wait before you feel hungry beofre having lunch- eat at 12N whether you’re hungry or not! Sometimes the Desire to eat more can be rather strong but if you have the Will Power then after finishing a plate of half a cup of rice, 1 slice of meat/fish and veggies you should STAND UP and leave the dining table and start working on something else.  If you continue to nurture that desire to eat then definitely you will eat more! Then the guilt feeling starts to sink in once you feel bloated and FULL! You therefore FAILED!

Then slowly, you will notice that you feel good because you were disciplined enough to know when to stop and fight that bad desire to make you sick!

Remember my simple meassage of Will Power… and if you carry this habit for life… then I guarantee you good health.  Remember also that everything that comes out in our body comes from what and how much we put inside our mouths! Out due to IN!

Have the Will Power To Fight The Urge To Eat For Health! 

Too Little Sleep Because Of Work?

July 10, 2007

imagesslp.jpgIt’s not uncommon to party all night… study for our exams (especially when I was in Medical school) or staying awake late at night because of hospital duties OR as parents being awake all night with a sick child!  Whew… those were the times! 

 During these “Awake” periods our body tends to compensate by making us sleep more the next day…our bodies way of        ” catching up”.  These acute sleep debt or loses are not known to be harmful because our body is able to adapt to acute changes in life from sleep to emotions to hormonal changes.  What is not known until now is the chronic lack of sleep where we lose a little bit of sleep over a period of days, months or even years due to work and work and work!!!!!

Understanding the effects of chronic lack of sleep was recently published online by the Proceedings of the National Academy of Sciences (PNAS) from the group of Northwestern University.  In that study, the researchers discovered that “when animals are partially sleep deprived over consecutive days they no longer attempt to catch up on sleep, despite an accumulating sleep deficit.”  

The impact of these finding in humans is immense as experimental studies in humans showed that chronic partial sleep loss of even two to three hours per night was found to have detrimental effects on the body.  The effects include: impairments in cognitive performance, as well as cardiovascular, immune and endocrine functions.

The problem with these sleep-debt people is that they dont look sleepy nor report feeling sleepy BUT their performance on tasks was shown to decline.  Likewise, repeated partial sleep restriction in humans has been linked to metabolic dysfunction and cardiovascular disease.  In fact in our recent Endocrine Society Meeting, Sleep debt is now considered one major risk factor for Obesity and Diabetes!!!!

So how do we counter the effects of chronic sleep loss?

 Harvard Women’s Health Watch suggests: if you’ve missed 10 hours of sleep over one week, make up for it over the weekend and the following week. If you’ve missed sleep for decades, it could take a few weeks to repay the debt. Plan a vacation with a light schedule, and sleep every night until you wake naturally. Once you’ve determined how much sleep you need, factor it into your daily schedule.

So guys… it’s not bad to work and finish our tasks on time BUT if we overdo things to satify somebody even ourselves at the expense of our health…is something else!

Enjoy Your Work But Stay Within The LIMITS!

Obesity Surgery Can Help Diabetics Live Better Lives….

July 9, 2007

imagesobesir.jpgThe prevalence of Obesity and Diabetes is fast rising with an apparent increase of 60 to 70% within a 10 year period.  The relationship between the two is closely linked which brought a new disease state called: Diabesity or Diabetes plus Obesity!  Two major epidemics in one… result into TROUBLE!  They have the same major problem of lifestyle: improper food intake and plain inactivity and the same kinds of complications long term.

One magic bullet to hit two birds with one stone is the procedure called: Laparoscopic Gastric Banding.  This is a procedure that we now routinely perform in our institution with remarkable success.  It is a less invasive procedure than gastric bypass and has written about its procedure in one post in this website.  In a study done recently, not only did the procedure resulted in weight loss but likewise resulted in changes that reduced the culprit of developing diabetes , hypertension and high cholesterol: the Insulin Resistance State.

Below is the summary of the results of the study from the American Physiological Society Homepage


   *      prior to surgery, there were expected gender differences in body composition measures. Men were heavier, had greater waist circumferences, and HbA1c( a measure of overall blood sugar control). Women had higher a percentage of body fat.

*      6months after surgery the overall group had a l5 percent reduction in body weight (275 vs. 233 pounds), a 14 percent reduction in BMI (43.4 vs. 37.3), a 13 percent reduction in body fat percentage (49 vs. 43 percent), a 13 percent reduction in waist circumference (53 vs. 46 inches) and a 10 percent reduction in hip circumference (57 vs. 51 inches).

*      six-months after surgery the insulin resistance was reduced 60 percent, according to a HOMA score. This was due primarily to a 50 percent reduction in fasting insulin concentrations with no change in fasting glucose concentrations.

*      there were a few gender differences in surgery-related changes. In women only, the waist-to-hip ratio tended to decrease (0.92 vs. 0.86), and the HbA1c tended to decrease (5.8 vs. 5.6 percent).  Diastolic blood pressured tended to decrease (81 vs. 75 mmHg) and CRP tended to decrease (8.3 vs. 4.7 mg/L).


The findings are really promising.  If we reduce the state of Insulin Resistance by making a patient lose weight then we unburden our pancreas from over producing insulin in response to our meals. Likewise we therefore reduce a patients risk from developing chronic complications that can cause disability.

The authors concluded that:” These improvements occurred despite the fact that patients were still clinically obese. Rapid improvements in insulin resistance after surgery will have a positive impact on long-term patient health and may delay or prevent progression to diabetes.”

Behavioral Therapy remains the cornerstone of losing weight as well as managing diabetes.  If one can lose weight without invasive procedures through discipline with proper food intake and physical activity…the BETTER! 

But for weight loss remedy beyond the weight loss achieved by behavioral modification that may have lasting long term outcomes especially with regard to risks for chronic complications like heart disease and stroke…then

LAP Banding Is The Way To Go!

For further readings on Lap Banding: The Magic Way To Lose Weight

One Hour of Exercise Weekly Can Lower Your Blood Pressure…

July 6, 2007

Just One Hour of Exercise A Week Controls Hypertension!!

4150893541.jpg….says one headline that caught my attention.  Apparently this amount of aerobic exercise can be spread out over a week and has been shown to reduce systolic blood pressure ( the upper number) by an average of 12 points and the diastolic reading ( the lower number) by 8 points.

The study which was published in the American Journal of Hypertension, proves that one does not need to really spend a lot of time working out to get a benefit!  But the study also showed that the more you exercise the more the benefit in terms of lowering ones BP suggesting that we should do more than just an hour a week.

It is very important to remember that several medical guidelines recommend 30 to 60 minutes of moderate exercise on most days of the week because physical activity has been shown to reduce ones risk of heart disease, cancer, diabetes and obesity.

My Advise?

  1. Make sure you make exercise FUN… in so doing… you can sustain the idea of doing it daily!  
  2. Make it part of your daily routine just like driving a car of eating your meals! Once exercise has made its way into your daily schedule, then it becomes part of your daily routine!

We should have only ONE goal in mind when we think about Exercise…simply….

Keep Fit  To Be Healthy!

Are You Eating What’s Right For Your Bones? … Nutrition and Osteoporosis

July 3, 2007

Bone health is an important part of one’3681618293.jpgs yearly checkup.  The loss of bone mass contributes to early disability and death if the consequences of bone disease take its toll.  Fractures involving the spine and the hip contribute to significant morbidity and mortality that prevention of bone loss is the KEY!

Heres an important Fact Sheet from the University of Nebraska that I want to share because this involves common concepts in bone health involving common foods that we eat:


While dietary calcium and vitamin D are important in helping prevent or treat osteoporosis, the following dietary concerns also come into play.

1.Fiber. Excessive fiber can interfere with calcium absorption. Dr. Miriam Nelson (author, Strong Women, Strong Bones) advises that the fiber occurring in food is probably not a problem. But, if you’re sprinkling extra fiber on food, such as bran on cereal, that might affect calcium absorption.

2.Caffeine. Excessive caffeine can increase urinary excretion of calcium. A 6 oz. cup of coffee has about 100 milligrams caffeine — the actual amount would depend on brewing time, etc. Tea, soft drinks and various medications also can contain caffeine. There are about 40 milligrams of caffeine in 6 oz. of regular brewed tea; green tea may contain less caffeine. Some soft drinks are comparable to tea in caffeine content.

3.Excessive sodium. Excessive sodium can increase urinary calcium excretion. Go easy on the salt shaker; taste before you salt. Limit the number of high salt foods. The Food and Nutrition Board recommends sodium be limited to 2,400 mg daily.

4.Alcohol. Consuming more than seven alcoholic drinks per week is associated with an increased risk of low bone density and of falls and fractures. Obviously, you shouldn’t drink seven drinks all in the same day.

5.Oxalic acid. This acid, present in certain foods, such as spinach, chard and beet greens, binds up the calcium in these foods. However, it doesn’t seem to affect the calcium in foods served with them. These greens are still good for you and may actually help improve calcium status in other ways. Also, though chocolate is a source of oxalic acid, it doesn’t seem to tie up the calcium in milk if you drink chocolate milk.

6.Soft drinks. When soft drinks replace milk as a beverage, individuals are drastically reducing the calcium content of their diets.


Nutrition will always remain a part of once daily life whether for health and to prevent disease… be it for diabetes, obesity,hypertension or osteoporosis.

Eat Right, Be Light and Live Longer!

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