Archive for November, 2008

My Advise for a Practical and Doable Way to Lose Weight!

November 29, 2008

I happened to be in Manila yesterday to attend the blessing of our society’s AACE office then had a meeting till 12N then another meeting at 1PM then another event at 6:30 PM.  And throughout the day from the time I got to the airport to the time I was in the Blessing…I was asked only ONE question…How did I lose weight?!

Can you imagine me retelling the reason and the way I did to more than 15 people up to the time I got back to airport early morning today ….so I thought of this topic should be retold and discussed in my website….

The best way to help yourself avoid the probelms of the new century is to mainitain a healthy weight.  And if you are overweight then the best gift you can give to yourself for the holidays is to lose weight.  I did it for health reasons since I am at risk to become a diabetic being the youngest of a family of 9 with a mother who is a diabetic.

I am not a fan of any fad diet and will never be. I believe a high protein diet can help one lose weight but I dont believe it as the magic formula for wieght loss and I know the effect will not last long term.

My prescription for a successful weight loss is plain and simple cutting down on calorie intake PERIOD!  Sounds Boring but it works and heres how I did it:

Three key points: 1) set a goal 2) work on it 3) maintain on the strategy.

Simple way of cutting calories? Heres my Practical DOABLE advise:

Get a little rice, a serving of meat and veggies then eat… after the portions are consumed…assess if you still need more BUT NOT because you like the food BUT based on whether you’re still hungry or full already.  If you FEEL full…then stop…leave the table and o something else.  SIMPLE? yes… but in reality the temptation to eat more is so strong that if you dont have the DISCIPLINE to achieve the goal you have set for you to do… then the strategy will FAIL!  THAT’s IT!

That is my strategy..meaning…I eat what I like but I stop once I feel full. Simple and yet perfect in cutting down a lot of calories.

The problem with our society nowadays is that we use food for COMFORT…to Destress our minds…and to ENJOY but at the expense of HEALTH!

Then I do my afternoon exercise of enjoying my iPod while brisk walking. Enjoy the sceneries my friends…enjoy the fresh air and get out of your web!!!!

For the Holidays…Watch OUT for the FOOD!  Yummmy!!!!

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The Healing Powers of a Doctor…

November 25, 2008

Patients see some of us as healers. 

Patients see us because they’re sick. It is therefore our role to give them comfort.  Never to make them feel useless or hopeless.

The trials of being a physician are enormous.  It is a skill to master the art of healing. Diagnosing a disease can be easy with enormous references to read but to learn the art of healing needs mastery…and this differentiates a healer from an ordinary doctor.

In a recent article published in the Annals of Internal  Medicine, some interesting facts came out as eight skills necessary to be considered a healer:

  • do the little things;
  • take time;
  • be open and listen;
  • find something to like, to love;
  • remove barriers;
  • let the patient explain;
  • share authority; and
  • be committed.

It is however sad that a lot of the above are forgotten in clinical practice. Oblivious of the fact that following the art of healing to every patient that we see allows us to be better persons and better doctors. 

It is just fulfilling to see patients welcome your passion to treat them with dignity, not to be in a hurry but willing to take time for them to share what they feel… in return will be their admiration and deep gratitude because they can feel your healing powers. And more than enough… for them- seeing you is worth the wait!

The article concluded that :

“Mastery of these skills would provide enduring improvements in patient care and reaffirm medicine’s calling as a healing profession.” 

The Dangers of Having a Poor Sleep….

November 18, 2008

How many hours of sleep do you have daily?  Does the duration matter?

Yes it does based on a new study published in Archives of Internal Medicine:

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Background  It is not known whether short duration of sleep is a predictor of future cardiovascular events in patients with hypertension.

Methods  To test the hypothesis that short duration of sleep is independently associated with incident cardiovascular diseases (CVD), we performed ambulatory blood pressure (BP) monitoring in 1255 subjects with hypertension (mean [SD] age, 70.4 [9.9] years) and followed them for a mean period of 50 (23) months. Short sleep duration was defined as less than 7.5 hours (20th percentile). Multivariable Cox hazard models predicting CVD events were used to estimate the adjusted hazard ratio and 95% confidence interval (CI) for short sleep duration. A riser pattern was defined when mean nighttime systolic BP exceeded daytime systolic BP. The end point was a cardiovascular event: stroke, fatal or nonfatal myocardial infarction (MI), and sudden cardiac death.

Results 

  • In multivariable analyses, short duration of sleep (<7.5 hours) was associated with incident CVD (hazard ratio [HR], 1.68; 95% CI, 1.06-2.66; P = .03).
  • A synergistic interaction was observed between short sleep duration and the riser pattern (P = .09).
  • When subjects were classified according to their sleep time and a riser vs nonriser pattern, the group with shorter sleep duration plus the riser pattern had a substantially and significantly higher incidence of CVD than the group with predominant normal sleep duration plus the nonriser pattern (HR, 4.43; 95% CI, 2.09-9.39; P < .001), independent of covariates.

Conclusions  Short duration of sleep is associated with incident CVD risk and the combination of the riser pattern and short duration of sleep that is most strongly predictive of future CVD, independent of ambulatory BP levels. Physicians should inquire about sleep duration in the risk assessment of patients with hypertension.

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It has long been known that sleep debt is one factor that affects a patient’s risk to develop diseases like diabetes.  This new study relates sleep deprivation to a more devastating illness of the cardiovascular system.

The study showed that if one sleeps less than 7.5 hours per night, he or she has a 68-percent higher risk to develop heart attack, stroke or cardiac arrest than the counterparts that sleep better.  Furthermore, if one does not show a drop in overnight blood pressure, the risk is even higher — a more than four-fold greater chance of heart attack, stroke or cardiac death.

Again,.. this boils down to STRESS! Stress factors deprive one of a good sleep… if one goes to bed with deep mental anguish and thoughts, this can result in a hyperactive nervous system that can manifest as anxiety.  Overwokred individuals with too many worries to think for the next day can suffer the fate of sleep debt.  You should seek help if suddenly in the middle of the night you are awake and unable to go back to sleep.  This can lead to non dipping of blood pressure overnight that can increase your risk of heart disease even more.

Dont go to sleep Angry or worried.  Associate your bed with good rest and leave worries for the next day!

Indeed…Sleep is GOOD!

What Your Waistline Means To Your Health…

November 14, 2008

Go to fullsize imageI just came from a trip to Rio, Brazil to attend the International Congress of Endocrinology which is held every 2-4 years.  Our hotel was stationed right across the Copacobana Beach.  This is a place that epitomizes physical activity where unlike the Waikiki Beach front, I dont see a lot of people swimming but rather engaged in activities like walking, jogging or playing volleyball using their hands or feet.  On the sides are people eateries serving fresh coconut juice but also burgers and fries!  But an interesting observation was that… not a lot of Brazilians can be considered obese and not a lot have their bellies haging out of their waist….

We know about the risk of death and weight and BMI.  For Asians, anything above 23 is considered overweight already and increases ones risk to develop chornic diseases like Diabetes and cancer.  A waistline of more than 36 is considered high risk for men and 34 inches for women for chronic diseases.  It is for this reason that I have been committed to a healthier lifestyle and now from a waistline of 34 , I was able to maintain a waistline of  31inches and my BMI dropped from a high of 25.6 to 23.  It is all about a balance of what you eat and what you do and the DISCIPLINE you put into your goal! 

Now comes a timely study published in the New England Journal of Medicine, November issue regarding the risk of dying based on ones waistline and weight:

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Background Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. Methods We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Results During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women.

  • After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death.
  • Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and
  • in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively.
  • BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001).

Conclusions These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.

 

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IN SHORT…The risk of dying was higher among participants with a larger waistline of more than 47.2 inches for men and more than 39.4 inches for women compared to subjects with a smaller waistline of less than 31.5 inches for men and less than 25.6 inches for women. This study showed us that for each 2-inch increase in waist circumference, there was an associated 17% higher risk for death in men and a 13% higher risk for death in women .

There you go guys… thess bulging bellies are no longer as silent as we thought these”fats” can be but rather we know them now as machines producing substances that can harm the heart and vessels.  Aside from trying to aim for a BMI of 23 and below, one therefore has to be more aware of the risk of premasture death with higher waistline! 

Every little loss of the waist circumference can go a along way in helping us maintain HEALTH!  Do somtehting now and reap the rewards along the way!  It requires a lot of discipline but health benefits are enormous…and this equates to what I call Wealth!

Are Your Supplements “FDA Approved?”

November 5, 2008

You see supplements marketed as FDA Approved! Am not sure how the policy of the local FDA works but almost always, the same agencies operating elsewhere look at policies of the US FDA as their basis for regulating drugs.

Let us be clear what”FDA Approved” means.  The US FDA website has this to say:

FDA approves new drugs and biologics.

New drugs and biologics must be proven safe and effective to FDA’s satisfaction before companies can market them. FDA does not develop or test products; FDA experts review the results of laboratory, animal, and human clinical testing done by manufacturers.

If FDA grants an approval, it means the agency has determined that the benefits of the product outweigh the risks for the intended use.

Meaning research should be done and presented to the body and then these studies should prove the products benefit outweigh the risks.  If however the risks outweigh the benefits then the marketing of the drug is not approved!

Now…How about the Dietary Supplements?  What about their claims for FDA Approval?

FDA does not approve dietary supplements.

Unlike new drugs, dietary supplements are not reviewed and approved by FDA based on their safety and effectiveness. The notification must include the information that was the manufacturer or distributor’s basis for concluding that the dietary supplement will reasonably be expected to be safe.

After dietary supplements are on the market, FDA evaluates their safety through research and adverse event monitoring.

If you will note…the supplement will be in the market first and then if  adverse events occur then action will be taken by the FDA.  Meaning..no review of side effects or untoward effects are made before releasing a supplement to the market. BUT how many patients will complain of side effects especially that supplements are marketed as having Zero side effects?  and where do they go to report when only the salesmen or networking friends advised or convinced  them of the safety of the supplements?

FDA does not approve structure-function claims on dietary supplements and other foods.

Structure-function claims describe the role of a food or food component (such as a nutrient) that is intended to affect the structure or function of the human body. 

Structure-function claims on dietary supplements carry a disclaimer stating that the claim has not been reviewed by FDA, and that the product is not intended to diagnose, treat, cure, or prevent any disease. Conventional foods are not required to carry such a disclaimer.

So Beware of the claims that these supplements are good for Diabetes, to boost ones Immunity or other medical benefits because NONE are based on studies and no proofs exist that they work!

In short DONT be FOOLED by claims that the product is FDA or BFAD APPROVED!!!

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