Archive for October, 2008

How to EAT and Lose Weight….

October 27, 2008

Go to fullsize imageMy previous posts have always been toward trying to help people lose weight.  I am one person following my own theories and they worked and are working up to now.  Here are the no-nonsense tips that I follow DAILY: 

If you want to lose weight…

  • EAT,  But stop when you feel you’re already FULL and Leave the table at once. 
  • CHEW your food properly so it will take time for you to finish a meal and by the time you’re halfway through…you’re FULL! 
  • Avoid the visual stimulation of food… the longer you stay in the table, the more likely you’ll eat more!

Then of course… you MOVE!

A recent article publsihed in the British Medical Journal confirms these basic prinicples:

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Participants 3287 adults (1122 men, 2165 women) aged 30-69 who participated in surveys on cardiovascular risk from 2003 to 2006.

Main outcome measures Body mass index (overweight 25.0) and the dietary habits of eating until full (lifestyle questionnaire) and speed of eating (validated brief self administered questionnaire).

Results 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women.

Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

___________________________________________________________________________________________________________________ There you go…Simple tips and simple measures that will surely WORK for ALL!

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How To Be Active Without Trying….

October 22, 2008

Physical activity is part of the equation of fitness and weight maitenance. 

“Easier said than done”, everyone knows it best that exercise is key to a healthy lifestyle.  Excuses to avoid feeling guilty continue to be part of what makes us believe that we just dont have enough time to exercise!  But new studies have been published that physical activity need not be a structured time frame that we should follow … rather any activity should be the norm to our day to day life.  In short…as long as one does not follow a sedentary lifestyle… one should be better off following an active lifestyle.

Heres a new study Published in the journal Current Opinions in Endocrinology that proves nothing is better than just being active:

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Purpose of review: To discuss the potential importance of spontaneous physical activity in regulating body weight and outline possible reasons for the large interindividual variance in spontaneous physical activity.

Recent findings: Spontaneous physical activity is highly variable among people, with some having high levels and some low, and can contribute significantly to interindividual differences in total daily energy expenditure. Cross-sectionally, spontaneous physical activity is inversely related to body weight; however, more importantly, spontaneous physical activity is inversely associated with weight gain in prospective studies, and experimental weight perturbations do not appear to change spontaneous physical activity behavior. Spontaneous physical activity is a familial trait and is biologically influenced, although the environment exerts a significant impact.

Summary: Although spontaneous physical activity is a biologically driven behavior, interventions to increase nonexercise activity within the workplace and school hold promise in increasing daily energy expenditure for the average sedentary American. However, many large-scale efforts will need to take place within our sedentary-promoting environment to encourage more daily spontaneous physical activity-related activity.

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This new study tells us one thing: No more EXCUSES!!!!

Any spontaneous movement or activity is better.  Even fidgety movements while sitting down working on your computer and other daily tasks that require activity is more than enough for the body to be healthy.  Any household chores and any walking to the workplace or the act of getting something are activities of daily living that can help with energy expenditure. These nonexercise activities should not be a problem for anyone to follow.  Meaning NO MORE EXCUSES!

There you go… The best way to be active without really trying ( going to a gym) is to be more active in our day to day activities. Do it everyday and make it part of a habit and you’re on your way to healthier you!

The Many Benefits of Broccoli…

October 16, 2008

Go to fullsize imageI am a fan of Brocolli.  I thought of making broccoli the star of today’s post and thought of what ways can this veggie benefit us all.

A recent study done in University of Warwick published in the Journal Diabetes showed some interesting findings that made me realize how lucky am I to enjoy Broccoli.  The study looked at a compound present in broccoli that has the potential to help prevent complications of diabetes.

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RESEARCH DESIGN AND METHODS–: Human microvascular HMEC-1 endothelial cells were incubated in low and high glucose concentrations (5 and 30 mM) and activation of nrf2 assessed by nuclear translocation. The effect of SFN on multiple pathways of biochemical dysfunction, increased reactive oxygen species (ROS) formation, hexosamine pathway, protein kinase C pathway and increased formation of methylglyoxal, was assessed.

RESULTS–: Activation of nrf2 by SFN induced nuclear translocation of nrf2 and increased ARE-linked gene expression. For example, 3 – 5 fold increased expression of transketolase and glutathione reductase. Hyperglycemia increased the formation of ROS – an effect linked to mitochondrial dysfunction and prevented by SFN. ROS formation was increased further by knockdown of nrf2 and transketolase expression. This also abolished the counteracting effect of SFN, suggesting mediation by nrf2 and related increase of transketolase expression. SFN also prevented hyperglycemia-induced activation of the hexosamine and protein kinase C pathways, and prevented increased cellular accumulation and excretion of the glycating agent, methylglyoxal.

CONCLUSION–: We conclude that activation of nrf2 may prevent biochemical dysfunction and related functional responses of endothelial cells induced by hyperglycemia in which increased expression of transketolase has a pivotal role.

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This study is particularly interesting because it is known that patients with diabetes are at higher risk to develop complications especially heart disease.  And from previous studies, it has also been shown that eating vegetables like broccoli was significantly linked to reduced heart disease.  The relationship stems from the finding that damage to blood vessels is due to an increased levels of reactive oxygen species (ROS) in the presence of high sugar.  The recent study has confirmed that the substance Sulforaphane present in Broccoli can indeed prevent damage brought about by these ROS with high sugar level. 

Sulforaphane substance present in abundance in broccoli was able to reduce ROS level by 73% and likewise results in activation of an gene regulator in the cells that resulted in the increase of antioxidant compounds. Great news!!! Great findings!!!

But does this mean lets all eat broccoli? We have to wait for studies that will look at end result.  But whatever it is…we know veggies are healthy food, broccoli for one has the potential to be a “star” vegetable due to its touted many benefits including prevention of cancer, cataracts Plus this new finding which am sure will make my diabetic patients crave for more broccoli.

Eat Veggies…Eat Broccoli… for Health!

The Benefit of Smoking…. or Is There?

October 14, 2008
Actually none except ill health. But no, I found the intriguing editorial from the Archives of Internal Medicine that made me believe that probably there is a hidden reason why smokers just refuse to quit…
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 Cigarette smoking remains a persistent and difficult public health problem. Approximately 1 in 5 adults continues to smoke, and annual long-term successful abstinence rates run around 2% to 3%. Most smokers are aware that smoking poses risks to their health, and approximately 60% to 70% of smokers report having been counseled by their physicians to quit smoking.

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Clearly… education regarding smoking cessation has failed to fully take effect as abstinence form addiction to smoking remains nil.  Every smoker knows it is not healthy to smoke nor is it healthy for members of the family to inhale their smoke but still the practice of smoking continues to be very prevalent.

And I agree fully with the editor when he titled his editorial to fully state what we as medical practitioners believe is the true essence why smokers refuse to quit…. is that they want to:

Live Fast, Die Young, Leave a Good-looking Corpse!

Obesity and Forgetfullness: Is There A Link?

October 10, 2008

Go to fullsize imageOtherwise categorized as cosmetic in nature, we now know that being overweight or obese is already a considered a culprit for developing chronic diseases like diabetes, high blood pressure, cancer and now dementia.  Increased adiposity or fat cells in the belly results in production of substance known to cause harm meaning, having fat around your belly is a serious matter!

A recent finding on the link between obesity and dementia was recently  published in October issue of Neurology which I want to share with you:

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Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.

Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.

Results: A total of 1,049 participants (15.9%) were diagnosed with dementia.

  • Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35).
  • Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m2), whereas
  • those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).

Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.

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What this study shows is that: Being overweight and obese combined with increased abdominal fat or BIG bellies , increased risk of dementia by 2.3-fold and 3.6-fold, respectively.  While if one is overweight or obesity but has low or small abdominal fat, the risk is lower: a 1.8-fold increased risk of dementia.

Remember my friends, the risk of dementia increased the heavier you are and the bigger your belly is BUT is worst if you have both!  And mind you, in the study the relationship between dementia and obesity was related to the individual’s weight at midlife!

Am at an almost midlife years so am I so glad that I started my own lifestyle change of being more careful with the food I eat and steady increase in physical activity that my BMI has gone down from 25 to 23 and boy…with good calorie counting, my waistline hs dropped 2 inches!!!! I follow what I preach!

It’s not too late to do changes in our lives…. for the better  !!!

Be Productive At Work But More So With Health!

High Protein Diets and Health…..

October 6, 2008

I am always asked regarding the best diet to have to lose weight. People tend to adhere to diet fads for easy way out.  But studies after studies have shown that a fad will always fade and therefore will not have long term success.

High protein diets initially were received with overwhelming rejection by the medical community.  However, although it is hard to accept, the usual recommendation of healthy diets recommended by authorities never were popular because these diets never resulted in significant weight loss. Until the high protein diet came into full force.

A new study published in Current Opinions in Endocrinology, 2008 that looked at evidence regarding the benefits of high protein diet show that this diet really works albeit so far only on short term basis.  But coupled with other lifestyle changes and discipline, I bet this is the diet that will work well with diabetic and obese people trying to shed some pounds with a long term aim of beng able to maintain their weights.

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Abstract:
Purpose of review: High-protein diets, often with carbohydrate restriction, are quite popular among overweight Americans pursuing strategies for weight control. Recently, well designed clinical trials have evaluated the anthropometric and metabolic effects of these diets. This review focuses on the impact of high-protein diets on energy expenditure and satiety; the diets’ effects on weight loss, body composition, cardiovascular risk, and glycemic control; and potential detrimental consequences of high-protein intake.

Recent findings:

  • Current evidence indicates that protein-induced energy expenditure and satiety contribute to weight control.
  • Randomized, controlled trials continue to show comparable, if not superior, effects of high-protein diets compared with lower protein diets on weight loss, preservation of lean body mass, and improvement in several cardiovascular risk factors for up to 12 months.
  • Evidence that chronic high-protein intake affects glucose metabolism is inconclusive at present.
  • Further study of the long-term safety of diets with varying amounts of protein is warranted.

Summary:

On the basis of patients’ metabolic profiles and preferences, practitioners can recommend individualized, nutrient-rich diets within current nutritional guidelines for weight control.

Diets moderately increased in protein and modestly restricted in carbohydrate and fat, particularly saturated fat, may have beneficial effects on body weight, body composition, and associated metabolic parameters.

Key issues must be resolved regarding the long-term compliance and safety of chronic high-protein intake.

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This diet resulted in sigificant wieght loss which in turn resulted in significant improvements in cholesterol, blood sugar and reductions in markers of cardiovascular risk like CRP.  Cosmetic PLUS health: a bonus!

So, do I recommend this diet to my patients.  Acutally YES.  I have my own dietician and I specifically formulate the plan for my patients with specifics in terms of percent calories per food group. The choice of protein source however is important because one may have a high protein source but also high in saturated fat and therefore harmful to the body example is s Steak!!!!  I dont advocate a No carbohydrate meal with the high proetein diet because long term this will never work.

Then of course, any meal plan as long as there is discipline, determination to do lifestyle change and maintain the good habit of healthy choices and good clean living should result in more success than you think!

We’ll await more long term studies on high protein diets.  So far however as long as one is careful not to harm the kidneys further with a high protein load, one should be cautious in recommneding this diet to patients with renal or kidney disease.

A Better Weight BY Eating Right!

How To Check Your Blood Pressure At Home….

October 1, 2008

High blood pressure is now a common ailment that we hear among our friends.  The way we live our lives, the genes and our lifestyle contribute sugnoificantly to increasing this risk.  Almost always, doctors require patienhts to monitor their blood pressure at home however, majority do it wrongly or make use of wrong machines to record their BP.

The Harvard News Letter has come up with some tips that I want to share with you:

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Your blood pressure changes from hour to hour, sometimes even minute to minute. Standing up, watching an exciting sports event, eating a meal, even the time of day influence your blood pressure. It jumps around so much that you are more likely to get a “normal” reading if you check it at home rather than in the doctor’s office.

When it comes to measuring blood pressure, technique matters. Doing it wrong can give you a reading that’s too high or too low. (To see a brief video on using a home blood pressure monitor, visit health.harvard.edu/128.)
There are two things to do before you start. First, check your machine against the one in your doctor’s office. Second, make sure you have the right size cuff — the inflatable part should encircle at least 80% of your upper arm.

When you first start to check your blood pressure at home, measure it early in the morning, before you have taken your blood pressure pills, and again in the evening, every day for a week. After that, follow the plan your doctor recommends, or check it one or two days a month. Each time you take a reading:

  • Avoid caffeinated or alcoholic beverages, and don’t smoke, during the 30 minutes before the test.
  • Sit quietly for five minutes with your back supported and feet on the floor.
  • When making the measurement, support your arm so your elbow is at the level of your heart.
  • Push your sleeves out of the way and wrap the cuff over bare skin. Measure your blood pressure according to the machine’s instructions. Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, repeat again and average the three readings.
  • Don’t panic if a reading is high. Relax for a few minutes and try again.
  • Keep a record of your blood pressure readings and the time of day they are made.

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Simple tips that can go a long way in ensuring good control of BP.  Remember, the doctor can only help in advising what type of drug is best for you.  Then the remaining half of the job is done by you… making sure you eat the right food, the right amount of salt and getting the right amount of “stress”.

By making it a habit to check your blood pressure may not help “cure the disease” as 99% of hypertension has no identifiable cause,  BUT it will help ensure a smooth control of BP during the day to day activity that you do.  As a result, you can be assure that the simple measures that you do are being done to help prevent complications including heart attack and stroke.

Keep Your BP in Control!