Archive for April, 2008

Level of Activity In the Young Predicts What You Become…

April 26, 2008

Go to fullsize imageChronic diseases will abound in the next century.  The ones who will be most affected are the children of today.  And this prediction wil come true based on this new study published in Dynamic Medicine. which looked at the level of activity of the young and the risk of developing Metabolic Sydrome in adulthood: Diabetes, Hypertension and High cholesterol.

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Purpose: Metabolic syndrome (MS) is a clustering of cardiovascular disease risk factors that identifies individuals with the highest risk for heart disease. Two factors that may influence the MS are physical activity and aerobic fitness. This study determined if adolescent with the MS had low levels of aerobic fitness and physical activity as children.

Methods

This longitudinal, exploratory study had 389 participants: 51% girls, 84% Caucasian, 12% African American, 1% Hispanic, and 3% other races, from the State of North Carolina. Habitual physical activity (PA survey), aerobic fitness (VO2max), body mass index (BMI), blood pressure, and lipids obtained at 7-10 y of age were compared to their results obtained 7 y later at ages 14 -17 y.

Results

Eighteen adolescents (4.6%) developed 3 or more characteristics of the MS. Logistic regression, adjusting for BMI percentile, blood pressure, and cholesterol levels, found that adolescents with the MS were 6.08 (95%CI = 1.18-60.08) times more likely to have low aerobic fitness as children and 5.16 (95%CI = 1.06-49.66) times more likely to have low PA levels.

Conclusions

Low levels of childhood physical activity and aerobic fitness are associated with the presence of the metabolic syndrome in adolescents. Thus, efforts need to begin early in childhood to increase exercise.

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The study tells us that the level of activity is as important as keeping fit!  One does not need to be overweight to be at risk. One may not be obese but if the level of activity is low then he is still not fit and therefore at risk of future diseases. This study tells us to allow our kids to be more active rather than live a sedentary lifestyle of gameboys, PSPs and computers.

This study clearly shows the relationship of what we train our kids to do and become to what happens to them in the future.  Lets train them early to be fit and healthy so as they can carry their lives in a healthier way! 

For me… Teaching our Kids How to keep FIT is the best future we can give them!

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The Dangers of Too Much TEA….

April 24, 2008

One of the highlights of the Mayo Endocrine Course in Mallorca Spain was the Clinical Pearls that we get after a case presentation.  And one of those cases that I found very interesting was a case of  lady who had a bone xray suggestive of a “strong” bone and a bone mass that was suggestive of a “thick ” bone.  She was therefore confident that she won’t fracture because she did not have any osteoporosis based on Xray and Bone mass measurement.

However upon review at the Mayo Clinic her bones were actually not normal.  So further evaluation was done and showed her to be drinking at least 10 tea bags of a commercial brand per day as a way of quenching her thirst.  Without her knowledge, she was taking in too much flouride into her sytsem coming from drinking too much tea!!!  She was developing a state of Flourosis which can cause a bone disease called Osteosclerosis.  From being told that she has strong bones to now being counseled to be careful not to fracture… was too extreme for her to understand!

Osteosclerosis can be due to taking in too much flouride in the body.  The problem with this disease is you have Brittle bones and therefore on Xray, you may have thick bones but the quality of the bone is poor!!!

Just how much flouride in is one tea bag?  In one study published in Amercan Journal of Medicine in 2005:

“Two independent testing laboratories determined that mean fluoride concentrations in 10 brand-name tea solutions ranged from 1.0 to 6.5 ppm. One tea exceeded the EPA safety limit of 4.0 ppm for drinking water, and several surpassed the U.S. Food and Drug Administration limit of 1.4 to 2.4 ppm for bottled beverages. “

So my frineds…please be careful with too much tea in a day.  I know of some chinese patients who use tea as their drinking water.  Just as the saying goes…

 Too much of a Good Thing can also be BAD!

In Quest For More Learning…

April 15, 2008

I will not be able to update my blog for this week because I will be attending the Mayo Endocrine Course in Mallorca, Spain which will officially start tomorrow April 16.

This will be an opportunity to review the latest in Endocrinology with my former mentors who fortunately after having graduated there for my fellowship 10 years ago… 14 of the professors who will be giving lectures were my former mentors. Two of the speakers were my former co-fellows…so it will be worth the learning and the fun of meeting them again in Spain.

As doctors , we continue to study and learn the new trends in diagnosing and treating diseases from the world experts. Will continue to do so in the near future so as i can provide the best care to my patients assuring them of what is right and what is best!

In quest for more learning…I may be out of my clinic but rest assured…it is for the best of everyone so I can provide the best care possible.

Learning should be Continuous…it should have no END!

A High Fiber Diet: Does It Really Matter?

April 11, 2008

Go to fullsize imageWe have been exposed to ads regarding the benefits of a high fiber diet.  We know it is good for our health but what does it do and where do we get these fiber rich products?

It has been shown in several studies that a high fiber diet can indeed lower ones risk to develop heart diseaese by as much as 30% as well as lower ones risk to develop diabetes and improve cholesterol.   We know it works well for roughage and therefore can prevent constipation and improve bowel habits.  In fact it was recommended as a way of preventing colon polyps and cancer BUT so far no long term studies have proven that fiber can indeed lower the risk for colon cancer.  Nonetheless, the multiple benefits we can get from eating a high fiber meals are more than enough to recommend intake of these products to our patients and the public in general.

But what are the best sources of fiber? Here is a list of the different kinds of fiber compiled by the Harvard School of Nutrition:

Sources of Fiber

Soluble Fiber

Insoluble Fiber

oatmeal
oatbran
nuts and seedslegumes

  • dried peas
  • beans
  • lentils

apples
pears
strawberries
blueberries

whole grains

  • whole wheat breads
  • barley
  • couscous
  • brown rice
  • bulgur

whole-grain breakfast cereals
wheat bran
seeds
carrots
cucumbers
zucchini
celery
tomatoes

The best fiber source in several studies that proved a high fiber diet to be beneficial is the cereal based fiber or fiber from grains and those coming from fruits.  It is recommended that a diet with at least 21 to 38 gms of fiber should be taken per day.  On an average Filipino diet, we are only consuming at most less than 15 gms of fiber per day so we better bulk it up more with the sources mentioned in the table for health reasons.  Increase the fiber intake gradually rather that abruptly and to make sure we also increase the intake of water ans fiber absorbs water.

What Do I recommend: here’s a sample advise that I give to my patients:

  • Avoid fruit juices as they are devoid of fiber, instead eat whole fruits.
  • Eat brown rice instead of white rice
  • Buy whole grain products instead of white bread and pasta.
  • Try snacking with raw veggies..they may not be as yummy as a pastry BUT they are triple times  as healthy.
  • Choose whole-grain cereals for breakfast instead of rice and sausage! 
  • Eat Right By Eating Healthy..Try FIBER!

     

    The Magic of Fish Oil… Is It Hype or a Fact?

    April 8, 2008

    Go to fullsize imageWe have heard about the benefits of fish oil. Touted as a magic pill to protect the heart.  They are found on the shelves of supermarkets and health stores.  The problem with fish oil supplements is that as supplements the content of the drug is not regulated by the FDA and therefore the quality cant be tested.

    Recently the Mayo Clinic Proceedings, March 2008 published a timely article that tackles the issue of fish oil…are the benefits really real? and are they worth becoming part of the drug therapy against heart disease?

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    The most compelling evidence for the cardiovascular benefit provided by omega-3 fatty acids comes from 3 large controlled trials of 32,000 participants randomized to receive omega-3 fatty acid supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or to act as controls.

    These trials showed reductions in cardiovascular events of 19% to 45%.

    These findings suggest that intake of omega-3 fatty acids, whether from dietary sources or fish oil supplements, should be increased, especially in those with or at risk for coronary artery disease.

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    So furthermore, the data based on the review article suggest and recommend:

    • Patients should consume both DHA and EPA.
    • The target DHA and EPA consumption levels are about 1 g/d for those with known coronary artery disease and at least 500 mg/d for those without disease.
    • Patients with hypertriglyceridemia benefit from treatment with 3 to 4 g/d of DHA and EPA, a dosage that lowers triglyceride levels by 20% to 50%.
    • Although 2 meals of oily fish per week can provide 400 to 500 mg/d of DHA and EPA,
    • Secondary prevention patients and those with hypertriglyceridemia must use fish oil supplements if they are to reach 1 g/d and 3 to 4 g/d of DHA and EPA, respectively.
    • Combination therapy with omega-3 fatty acids and a statin is a safe and effective way to improve lipid levels and cardiovascular prognosis beyond the benefits provided by statin therapy alone.
    • Blood DHA and EPA levels could one day be used to identify patients with deficient levels and to individualize therapeutic recommendations.

    But dont just grab any fish oil in the market because what is sold in the health food stores have not been validated to contain the amount stated on the label. Ask your physician if you will start taking fish oil and if it will not interfere with the other drugs you are currently taking.

    What is important is that evidence for now has shown it to be beneficial….

    Fish Oil To The Rescue!!!! 

    Check The Music Your Kids Listen…and Be Warned!

    April 7, 2008

    Parents are sometime caught unaware that our kids Ipod is loaded with music that may not be healthy to their social and emotional well being.  We know classical music soothes our body and improves health and mood but other kinds of music like rap or rock have been shown to have disturbing impact.

    An article recently published in Addiction Research and Theory, April 2008 issue showed how the rise in drug wars could be contributed by the kinds of music these kids are exposed to.

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    This article explores the role of changing images of drug use in rap music from the 1970s to the 1990s. A sample of 341 rap music lyrics were coded for drug mentions, behaviours and contexts; drug attitudes and consequences; and music genres.
    • The results show that from 1979-1997, songs with references to drugs increased over 6-fold;
    • those exhibiting positive attitudes and consequences rose substantially
    • references to particular drug types changed significantly.
    • increased references to using drugs to signify glamour, wealth and sociability.

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    There you go guys… be careful with what music our kids listen to.  If rap music before warns about the dangers of drug use, apparently recent rap music tend to glorify drug use… and this message may not be the kinds of inspiration our kids need.  The increase in drug reference was pretty alarming increasing form a mere 10% in the early 70’s to >60% in early 90’s!!!!

    Check the music videos your kids watch and the contents of their iPods… It is better to intervene early than be sorry for the effects of these music on our kids in their social skills and adult behavior!

    To Intervene Or Not To Intervene….

     

     

    Acupuncture and Diabetes

    April 5, 2008

    Go to fullsize imageAlternative therapies continue to be in the mainstream of Diabetes Armamentarium.  You see patients bringing bottles of herb supplements apparently marketed as a treatment for Diabetes and related illnesses like high blood pressure and high cholesterol.  But one form of treatment that has gained wide acceptance both in the East where it originated and in the West where it is now widely practiced is Acupuncture.  And almost always in my practice do I come across a patient asking me about acupuncture and diabetes.

     

    It is said that the effect of acupuncture is its ability to improve blood flow.  By balancing the energy levels, one’s circulation can be improved and therefore has the potential to prevent debilitating complications of diabetes related to poor circulation like foot amputation and the crippling nerve damage or diabetic neuropathy.  Anecdotal reports and few small scale studies have proven acupuncture to help ease pain and prevent diabetic foot ulcers but only if applied early in the disease process.   The problem is the absence of acceptable and properly done wide scale studies where proven results are duplicated. A research funding by the National Institutes of Health in the United States is being done in quest for an answer…

     

    As medical practitioners, it is best to advise to patients that no studies at present can prove acupuncture to work beyond placebo effect. It is being tolerated by the US FDA considering its relative safety.  But it is always prudent for patients not to discontinue their medications or the proven therapies we provide them and to use acupuncture only conjunction with their medications.  Likewise it is best that patients should inform their physicians about their desire to have an acupuncture done and likewise should not accept any diagnosis of a disease from those performing the acupuncture..

     

    Acupuncture…It’s a wait and see for now but so far results seem promising….