Archive for September, 2007

Some News About The Website

September 25, 2007

A rewarding experience to anyone writing about something… is if that something turns into an important thing that caught the media attention!  As my advocacy to educate through this medium has benefitted a lot of my patients who get to me through this website and learning from what I believe is right… not because I say so but based on studies published in reputable journals by reputable institutions.

It is just a rewarding experince also if your work has caught the attention of respectable online media.  My article on          ” Can Coffee Prevent Diabetes?” was published just today in Philippine Star and my article on The role of Vitamins and Antioxidants In Preventing Heart Disease” was cited by CNN Health Online! As a result my website got plenty of hits accessed from these sites online!

So now were reaching more people…not only my patients but readers that linked to our site as well. 

Welcome and Thanks for Visiting My Health Website!

Advertisements

The Latest on The Safety Of Aspartame….

September 24, 2007

Aspartame has been at the forefront in terms if its use among diabetic patients as a low calorie sugar substitute.  It is the primary component of the low calorie sodas that allow us to enjoy these drinks once in a while without feeling too much guilt of the calories they have.  But controversies surround the popularity of this sweetener due to reports of associated illnesses related to its intake. 

Just recently an international expert panel from 10 universities and medical schools gathered together and evaluated the safety of aspartame for people of all ages and with a variety of health conditions.  The results of the study was recently published in the September issue of Critical Reviews in Toxicology.

____________________________________________

The Expert Panel’s evaluation concluded the following:

Aspartame is safe at current levels of consumption, which remain well below established ADI levels, even among high user sub-populations. No credible evidence was found that aspartame is carcinogenic, neurotoxic or has or any other adverse effects when consumed even at levels many times the established ADI levels.

Specifically:

* Based on results of several long term studies, aspartame does not have carcinogenic or cancer-promoting activity.

* Results of extensive investigation in studies that mimic human exposure do not show any evidence of neurological effects, such as memory and learning problems, of aspartame consumption.

* Overall the weight of the evidence indicates that aspartame has no effect on behavior, cognitive function, neural function or seizures in any of the groups studied.

* Aspartame has not been shown to have adverse effects on reproductive activity or lactation.

* Studies conclude that aspartame is safe for use by diabetics and may aid diabetics in adhering to a sugar-free diet.

* There is no evidence to support an association between aspartame consumption and obesity. On the contrary, when used in multidisciplinary weight control programs, aspartame may actually aid in long-term weight control.

* The studies provide no evidence to support an association between aspartame and brain or hematopoietic tumor development.

___________________________________________

In the past several insitutions have already provided proofs and guidelines regarding the safety of aspartame… which up to this point in 2007 remains a safe alternative to all of us who wants a good tasting beverage but low in calorie and no fear of raising our blood sugar!  Reports of this compund to cause complications ranging from cancer to neurological deficits continue to be written in the internet causing a lot of our patients concerns but these claims remian unfounded.

The expert panel reports, I would say,  should close this issue on aspartame.  The panel clearly summarized their findings with one simple conclusion:

 The weight of existing evidence is that aspartame is safe at current levels of consumption as a nonnutritive sweetener.

The Best Way To Exercise….

September 21, 2007

imagese.jpgExercise as we all know has all the benefits to promote and maintain health.  Several guidelines have come up based solely on experience rather than observed studies.  Recently, a new study looked at and concluded thast there indeed is  a significant impact and benefit of both aerobics and resistance training among diabetic subjects as published in the Annals of Internal Mediicne , Sept issue.

However, when the general issue of exercise is discussed… the main question has been… what’s the best way to exercise? How long and how much activites are needed to protect oneself from illness.

Recently the American Heart Association published their guidleines  in association with the American Society of Sports Medicine. Through these guidelines, we can have a better understanding with regard to the question of how to exercise and how to do it best.

___________________________________________

  • all healthy adults aged 18 to 65 years need moderate-intensity aerobic physical activity for a minimum of 30 minutes on five days each week or
  • vigorous-intensity aerobic activity for a minimum of 20 minutes on three days each week.
  • Combining these exercises is also acceptable

What To Exercise:

  • walking briskly or
  • performing an activity that noticeably accelerates the heart rate for 30 minutes twice during the week
  • jogging for 20 minutes, or
  • performing any activity that causes rapid breathing and a substantial increase in heart rate on two other days.
  • moderate- and vigorous-intensity exercises are complementary to daily living
  • Muscle-strengthening activities are advised 
  • Shorts bouts of activity — 10 minutes or more — can be combined to meet the 30-minute daily goal. 

____________________________________________

We know exercise works.  We know its almost always a doctor’s advise with regard to controlling weight, blood pressure, or cholesterol and blood sugar.  It is an important lifestyle change that each individual should pursue.  It is really easier said than done BUT the new guidelines have set up a compormise.  Short bouts of exercise is better than none and combining the total bouts of exercise as long as they accumulate to 30 minutes should do the trick in helping us build a healthy lifestyle.

There you go….  New Rules on an Old Issue.

Exericise Is Still The Best Prevention….

The Role of Vitamins and Antioxidants In Preventing Heart Disease

September 20, 2007

2334916729.jpgJust recently, I came across a patient who brought all his supplements mainly vitamins apparently given by his nephew residing in the US.  He is one of the many patients who complains of taking too many medications for his diabetes… but unmindful of the other extra drugs in a form of vitamins.

  It is always true that Diabetics will require multiple drug therapy due to concomitant illneses associated with it like Hypertension and High Cholesterol.  These supplements always include Vitamin C, E or B because apparently it is their belief that these supplements boost their immune system… and can protect them from getting heart disease or cancer.  But what is the truth to this claim or is it worth taking these vitamins?

We know from multiple studies that these vitamins as antioxidants just dont work as claimed.  However marketing strategies of suplement makers have made convincing claims that they do have an impact but proven otherwise.

Recently, a study looking at the role of these vitamins in preventing heart disease was published in the Archives of Internal Medicine and reexamined this issue:

___________________________________________

Methods  The Women’s Antioxidant Cardiovascular Study tested the effects of ascorbic acid (500 mg/d), vitamin E (600 IU every other day), and beta carotene (50 mg every other day) on the combined outcome of myocardial infarction, stroke, coronary revascularization, or CVD death among 8171 female health professionals at increased risk in a 2 x 2 x 2 factorial design.

Participants were 40 years or older with a history of CVD or 3 or more CVD risk factors and were followed up for a mean duration of 9.4 years, from 1995-1996 to 2005.

Results and Conclusion:  There were no overall effects of ascorbic acid, vitamin E, or beta carotene on cardiovascular events among women at high risk for CVD.

______________________________________________________

The above findings are consistent with other trials looking at this matter against a cardioprotective effect from any of the these vitamins.  What is important however is the absence of any harm form taking these pills in this study in contrast to earlier studies that showed the intake of these antioxidants actually increase ones mortality.

Lastly… it is also important to emphasize that the vitamins were talking about here are the pills or the vitamin supplements and NOT the dietary sources of these vitamins which have been shown to be protective aginst heart disease in several observational studies.

Be Healthy…Through Proper Lifestyle NOT PILLS!

The Risk of Autism and Advancing Age

September 18, 2007

imagesjkl.jpgWhy am I talking about a Pediatric disease here?  Well… forgive me but Autism is one condition that I see more frequently than before and I consider pretty common among the kids of my friends.  So am wondering what could trigger such a behavioral abnormality. Are there reasons for it?

One study that I read looked at one possible scenario i.e., to look at  the risk of autism with advancing age of parents.  Sounds interesting and intriguing! I find it interesting because remember, as our goals in life get bigger, we tend to postpone our dreams of having a family.  And by the time, we decide to have a family of our own, we have reach an age that may in itself be a risk factor to develop some problems with regard to the baby.

Let me share with you the results of the study published in Archives of Pediatric and Adolescent Medicine in 2007: 

___________________________________________

Design:  Historical birth cohort study.

Setting:  Kaiser Permanente (KP) in Northern California.

Participants:  All singleton children born at KP from January 1, 1995, to December 31, 1999, were included in the study. We identified 593 children who had Autism Spectrum Disorder diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification, code 299.0 or 299.8) recorded 2 or more times in KP outpatient databases before May 2005. These children were compared with all 132 251 remaining singleton KP births.

Main Exposures:  Maternal and paternal age at birth of offspring.

Results: 

  • Risk of ASDs increased significantly with each 10-year increase in maternal age (adjusted RR, 1.31; 95% confidence interval [CI], 1.07-1.62) and paternal age (RR, 1.28; 95% CI, 1.09-1.51).
  • Adjusted RRs for both maternal and paternal age were elevated for children with autistic disorder (maternal age: RR, 1.18; 95% CI, 0.87-1.60; paternal age: RR, 1.34; 95% CI, 1.06-1.69)
  • Associations with parental age were somewhat stronger for girls than for boys, although sex differences were not statistically significant.

Conclusion  Advanced maternal and paternal ages are independently associated with ASD risk.

______________________________________________________

Lucky for me…all my babies are healthy.  But this study is just a reminder to all… that we cant have it all! 

If it’s your desire to succeed is in your business or in your work or in your family … and if that desire drives you to be better then there are always compromises.  And as long as you are willing to accept these compormises in life, then you are on to a fruitful and happy ending!

It is you who will decide what you desire to have that will make you what you will be… in life! And accept it! So guys… if you have the chance… dont postpone having  a family! It’s all worth it! and worth taking the risk!

In Life..There Are Always Risks!

A Simple Blood Test To Determine Your Risk for Diabetes…

September 17, 2007

imagesx.jpgIf you think you are at risk of developing diabetes, our recommendation for now is to check your fasting blood sugar.  This is a test always included in executive panels.  However a more important measure of diabetes control is called A1c.  It is being done every three months among our diabetic patients to check their control or compliance to their medications.  Now a new study has supported the possible role of this blood test in predicting a patient’s risk of developing diabetes.

This study published in the American Journal of Medicine looked at a cohort of subjects in the Nurses Health Study and established the possible linked of A1c and the future risk of developing diabetes:

 ___________________________________________

(HbA1c) is a marker of cumulative glycemic exposure over the preceding 2- to 3-month period.   The authors examined baseline HbA1c levels as a predictor of incident clinical diabetes in a prospective cohort study beginning in 1992 of 26,563 US female health professionals aged 45 years or more without diagnosed diabetes or vascular disease (median follow-up 10.1 years).

Results: During follow-up, 1238 cases of diabetes events occurred.  After multivariable adjustment, HbA1c remained a strong predictor of diabetes.

 In analyses of threshold effects, adjusted relative risks for incident diabetes in HbA1c categories of less than 5.0%, 5.0% to 5.4%, 5.5% to 5.9%, 6.0% to 6.4%, 6.5% to 6.9%, and 7.0% or more were 1.0, 2.9, 12.1, 29.3, 28.2, and 81.2, respectively.

Conclusions:  HbA1c levels are elevated well in advance of the clinical development of type 2 diabetes, supporting recent recommendations for lowering of diagnostic thresholds for glucose metabolic disorders.

___________________________________________

It has been a continuing debate whether to use A1c as a diagnostic tool for diabetes.  We are using it to assess control rather than diagnosis.  We know that the higher the A1c… the higher the risk of complications of diabetes espcially death and heart attacks.  Therefore, we should impart the information to our diabetics that lowering A1c is lowering your risk to suffer from disability!

Now, our focus is for those at risks and those with apparently no risks to embark on a healthy lifestyle to avoid getting this chronic disease strongly associated with obesity and poor lifestyle!  If in doubt, we may be able to use this simple blood test to determine our risk… and if indeed that risk is high… it can be a better motivational tool to change lifestyle and be better in terms of choices of food and more physical activity!

The study has shown that in those with no risk… checking A1c can predict the outcome. That if ones A1c is >5% ; the risk to develop diabetes in the future starts to double!

Be Proactive… Better to Check Early Than Have The Disease!

The Danger of Eating French Fries…or Why Trans Fat Is Bad!

September 15, 2007

I have been an advocate of avoiding fried foods.  However firm we are in avoiding frying foods, you sometimes cant help and avoid enjoying eating foods that are fried…not only are they crunchy but they also taste so good.  So resisting the temptation to enjoy great food is difficult. But at the expense of health and heart attacks!

I came across a recent article in the Harvard Medical School Health Publication: HealthBeat which I want to share especially to parents who allow their kids to enjoy french fries almost at every meal.

________________________________________

 If you needed another reason to avoid trans fats, here it is. Researchers with the ongoing Nurses’ Health Study measured the amount of trans fat stored in red blood cells. Among the 32,000 middle-aged women participating in the study, 166 had heart attacks or died of heart disease during a six-year period. Their red blood cells had slightly higher loads of trans fat than did red blood cells of 327 women of the same ages and characteristics who remained free of heart disease.

Artificial trans fats are found in hard margarines, many commercially baked goods, and the fried foods in many restaurants, and research has consistently shown they aren’t good for the heart and blood vessels. Across the board, the more trans fat in red blood cells, the greater the chances of having a heart attack. Women with the highest trans fat load had triple the risk of women with the lowest. This study, published in the April 10, 2007, Circulation, strongly supports recommendations by the Institute of Medicine and the USDA’s Dietary Guidelines for Americans to cut back — or better yet, cut out — trans fats in the diet. Eliminating them from the food supply could avert as many as 264,000 heart attacks and heart-related deaths each year in the United States alone.

Trans Fats at Home and Abroad

A prime source of trans fat is partially hydrogenated oil, which many fast-food restaurants continue to use for deep frying. To see if this differed by country, three Danish doctors determined the trans fat content of French fries and chicken nuggets bought in 24 McDonald’s and KFC restaurants on four continents. As shown above, a large fries-and-nuggets combination delivered 10 grams of trans fat in New York City but less than a gram in Denmark, which limits the use of trans fats. A similar serving of fries and chicken nuggets in a KFC in Hungary delivered a whopping 25 grams of trans fat.

_________________________________________

Anothr reason to be alarmed over what we preceived a s a way of showing affection and reward to our kids… Crunchy fried chicken and french fries.  If we indulge in these kinds of foods once in a while or only during children’s parties .. its acceptable BUT if our kids eat only fried foods because that’s the only food they will eat then it will do no good to their future!

Start training them young.  My friend Maxim is one nice guy to dine with because he’s health conscious and therefore you tend to follow what he eats or be conscious of what you order.  And I guess there is so much truth to the study that showed…if your friends are obese, the more likely you will too….

A Feast with French Fries is A Feast with Trans Fat!

Jogging and The Risk of Heart Disease…

September 14, 2007

imagesqwa.jpgPrevious studies have linked city pollution to ishcemic heart disease.  The mechanism of which was not really studied well until recently.  It has been shown that ambient air pollution is associated with increased cardiovascular morbidity and mortality.

Jogging as an exercise is perfect.  It promotes well being and health.  But the place where one jogs should be considered especially with the findings below published in New England Journal of Medicine in 2007, regarding the risk of cardiovascular disease and air pollution:

________________________________________

Brief exposure to dilute diesel exhaust promotes myocardial ischemia and inhibits endogenous fibrinolytic capacity in men with stable coronary heart disease. Our findings point to ischemic and thrombotic mechanisms that may explain in part the observation that exposure to combustion-derived air pollution is associated with adverse cardiovascular events.”  

____________________________________

The most likely mechanism of the above maybe genetics as explained in one study published also almost at the same time in Genome Biology, 2007.

________________________________________ 

Diesel exhaust particles and oxidized phospholipids synergistically affect the expression profile of several gene modules that correspond to pathways relevant to vascular inflammatory processes such as atherosclerosis.

________________________________________

I promote wellness through proper choices of food and physical activity.  These studies point out that patients with pre existing risk factors for heart disease should avoid being in areas where exposure to air pollution is present.  Exercising therefore in an area within the city where combustion particles are part of what you’ll inhale should be avoided.

I guess running a marathon in Boston area or any city for that matter can therefore have an impact on one’s risk and therefore should be reconsidered.

So running is good for the heart but for now avoid the city!

 

Smoking and The Heart…

September 13, 2007

2752053521.jpgWe know that smoking is bad.  But we still see lots of people in the streets enjoying their time smoking as if they’re oblivious to the ongoing damage that smoking has on their bodies.  It is said that the acute effects of smoking can occur within 30 seconds of inhaling that smoke… THAT FAST!  The part of the blood that is responsible for clotting… the platelets will then get stickier, and the lining of the blood vessels will no longer function well.

 One study that was presented during the European Society of Cardiology Scientific Sessions in Austria, was looking at the impact of banning smoking in workplaces in Ireland.  You see in Europe, you can still see places where smokers mingle with non smokers.  And Ireland was the first to do this in 2004.  At one time in Vienna, we have to move places or even change to another venue because my brother and I just can tolerate the smell of smoke.  It is just unfair that we be exposed to the danger of smoking when we dont smoke… the same is true to wives of husbands who smoke.. more so the children!

In the study, the investigators noted that since the introduction of a smoking ban in Ireland in 2004 , they were able to note a decline in the rate of admission of heart disease by 11% within 1 year of implementing the ban… a reduction that occurred mainly in males.

This observational study is significant because it impacts on reducing a patients risk to suffer from heart disease by avoiding the risk of second hand smoke.  Likewise, it is expected that with the smoking ban, individuals in the restaurant or public places who want to enjoy a cup of coffee who are non smokers are removed from that threat and the impact of this should be noticed right away.

The impact howevre will be higher on the smokers who will give up smoking because they are at the highest risk of developing heart disease and by giving up smoking, that risk declines very rapidly, as early as within a year!

Avoid The Smoke- It Can KILL!

Is There A Link Between Junk Food and A Hyperactive Child?

September 11, 2007

imagesaqw.jpgHave you noticed your child to be hyperactive after eating chocolates? or candies or after drinking artificially colored drinks?  I see them often when parents bring their kids to my office while having their regular check ups.  These kids almost always are munching on junk foods!  And I guess we may be right that certain foods can indeed trigger the hyperactivity of a child which in itself maybe linked to Attention Deficit Hyperactivity Disorder or ADHD as a disease.

A new study published in Lancet has provided us a new proof regarding this link between food additives like food coloring and hyperactive state. 

________________________________________________________

The study involved 300 children between 3-year-olds and 8- and 9-year-olds. Over three one-week periods, the children were then assigned to consume fruit drinks daily:

  • one contained additivies typically found in childrens diet
  • a second drink had a lower concentration of the additives
  • a third was additive-free.
  • All the drinks looked and tasted alike.
  • Qualities such as restlessness, lack of concentration, fidgeting, and talking or interrupting too much were then evaluated on each child.

________________________________________________________

The study showed that kids were more hyperactive in the first group with the highest additives in the drinks that usually occur within 1 hour after consumption.  These are additives we usually get from eating candies and other junk foods.

The above findings have the clinical implications to those whose children get the most attention from teachers in school because of restlessness and hyperactivity.  This study is also the first to note a link between food additives typically seen in drinks,  candies or chocolates and junk foods that our children love to eat!

What more with the yummy candy and junk food ads our children see on TV? No wonder we are diagnosing more and more children with hyperactive behavioral problems.  Just look around any pediatrician specializing in hyperactive child, and you’ll have problems getting an appointment.

Go For The Healthier Alternative!

Advocacy to Educate Through the Media

September 10, 2007

imagesabcds.jpgMy article on this website on coffee and diabetes has caught the attention of media people and requested me to write about it in detail for publication in major newspapers.  The first publication in People’s Tonight   came out last Saturday, subsequently it will also be published this week in major national dailies like the Philippine Daily Inqurier, Philippine Star and The Manila Bulletin.

My hope to reach more people thorugh this website has taken its hold. Now I get comments from other parts of the country through my website and I find it Great! A reader through the article in People’s Tonight inquired if I have clinic in Manila which unfortunately I dont have.  But readers can always ask me or get in contact with me anytime through this website.

It is just amazing how powerful the media can be.  And I am glad I have found a great outlet of propagating what I love to do and what I plan to do ever since I decided to take up Medicine…. to educate the inquiring minds and to share what is healthy and right to those who seek for them.

What Does SPF mean?

September 8, 2007

While in Vienna, my wife always remind me to put on a sunscreen for my face.  It is always a struggle because I hate putting stuff on my face.  But being exposed to the sun with the travels and the dry weather, I obliged.  But what SPF is important to protect our skin?

We all know that sunscreens have long been promoted extensively against skin cancer.  However, it is reported that skin cancer rates continue to creep up, at about 3 percent a year according to the U.S. Centers for Disease Control and Prevention. Most likely because people ignore warnings and still bask themselves in the sun!  But most likely too, these people are protecting themselves with sunscreen…so what is wrong?

The U.S. Food and Drug Administration at the present time only allows manufacturers to only market products with a Sun Pretection Factor or SPF 30-plus on their labels, since they believe that any higher value is misleading to consumers. The belief that sunscreen is all you need to ward off the bad effects of the sun is apparently wrong.  Likewise the belief that the higher the SPF the better protection because it can last longer is also questioned.

It is advised that if you know you will burn under UV exposure in 10 minutes and you use the product with an SPF of 15 then the protection using this sunscreen will last for 150 minutes or 2 1/2 hours.  The problem is… in reality this is not so because, the sunscreen wears off with sweat or can be rub off easily after a dip in the water.  Be aware therefore that the protection you get is less than what you think. 

So, per guidelines… the recommendation is :

  • aim for a product with an SPF of 15 or higher.  But remember that the higher the SPF, the higher the protection agianst UV BUT not necessarily LONGER in protection!
  • Re apply the lotion after 30 min to 1 hour under the sun unless you dont sweat at all!  And more frequently if you swim.

There you go…. now after this post… I will follow my wife’s advise and try to use sunsscreen everyday.  But more so I guess to protect my face from early wrinkles.  So guys… protect your face will a daily sunscreen before it’s too late!

Daily Sunscreen For Baby Face!

The Benefits of Classical Music: Lessons Learned In Vienna

September 7, 2007

Just came from a week off in Vienna , Austria.  Definitely…one of the best places to visit and one of my Top 5 places that I enjoyed very much.

Aside from the beautiful landscapes and beautiful architecture… the history and the culture are so rich that you just cant digest too much information in one setting.  But one thing that made this trip enjoyable was the people…from the receptionists in our hotel, to the taxi drivers… everyone seemd so mild mannered and helpful.  And one cant help but wonder whether the people’s exposure to classical music so well known in this part of Europe because of the influence of Mozart may have made a difference.

Does Classical Music make a place safe to live?  Does exposure to this kind of music make people well mannered?

I found this one report entitled: How Classical Music Help Fight Crime… made me realized that my conclusion may be right!

________________________________________________

In 2004 in London, England, the British Transport Police piped classical music into London Underground stations in some of the area’s most dangerous neighborhoods. After playing the music for six months:

  • Robberies were cut by 33 percent
  • Staff assaults decreased by 25 percent
  • Vandalism went down 37 percent

This is not the first time that classical music has been used to deter crime. In 2001, police in West Palm Beach, Florida installed a CD player and speakers on an abandoned building in a crime-ridden neighborhood. After playing classical music — mostly Mozart, Bach and Beethoven — 24 hours a day for about three months, shootings, thefts, loiterers and drug deals decreased.

____________________________________________

During the convention, one of the doctors suffered a minor ailment and we have to rush him to a County Hospital.  It was really a surprise because it was clean and huge but very well equipped and you dont see a lot of crime related cases loitering in the emergency rooms.  We later found out that Vienna has one of the lowest crime rates in the region…. Because of Classical Music?

While roaming District One area which is the commercial center of Vienna, one can see a lot of Mozart like costumed guides marketing different concerts featuring different orchestras playing in different parts of Vienna.  If we have lots of singers and dancers in our country, Vienna has lots of violinist or cellist in the ranks…. 

Exposing our babies to Classical Music has long been advised by our pediatricians and I guess Vienna as a place to visit confirms that teaching…. that this kind of music can soothe ones nerves, calms us down and uplifts our moods.

So….  

If You’re Not in The Mood? Listen to Mozart!