Archive for the 'General Health Tips' Category

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Tips For The Holidays…..

December 23, 2008

The Christmas holiday spirit is just around the corner and everyone is now busy preparing for reunions with family and friends.  And what better way to prepare the celebration is to have a feast!  What is Christmas anyway without the parties?  The bulge and the extra fat that we get after these merry making activities is what makes us feel guilty enough to make us vow to do better on our Annual New Year’s resolutions.

So how can one avoid gaining weight during the holidays? Common sense advise is to keep in mind to always keep track of the calories we take in. But most of all, in situations where food is in abundance in the buffet table…my advise is to enjoy the foods that are nutrient rich but modestly high in protein (20 to 25% of the total calories) and low in carbohydrates (40% to 45% of total calories).

The fad of low carbohydrate and high protein diet has put protein at the center stage.  Since the Atkins Diet and the South Beach diet came into our attention, a lot of controversies has been made because of the absence of long term studies to document their efficacy and safety.  Recent data however have shown that a moderate intake of protein is not only efficacious in making one lose weight but also in improving blood sugar and cholesterol.

Protein intake is important to our body. If we don’t get enough protein- it can lead to growth failure, loss of muscle mass, a reduction in heart and lung function as well as impairment in ones immunity.  However, too much protein can also cause harm.  It can take a lot of calcium from the bone and can lead to fractures. Likewise, people with kidney disease should be warned about a high protein diet since it can further exacerbate the kidney problem.

Let me give you some tips on how to enjoy the benefits of a modestly high protein diet SAFELY….

Remember…different protein sources give different effects on our health.  Proteins coming from vegetables definitely are healthier because they are devoid of fat than those coming from meat. A steak and a salmon may have the same amount of protein but the saturated fat in beef is more than half that of the fish. It is the FAT that can cause harm and can lead to chronic disabling conditions like heart attack and stroke! 

Here are some Tips in Choosing Your Protein Sources wisely:

1. If you are a meat lover then get the lean cuts of beef or pork.  However a healthier alternative would be the white meat of fish and chicken breast.

2. A better option for a healthier protein source would be from vegetable sources like nuts, lentils, beans and whole grain.

3. For your daily protein needs, get them from different sources…mix and match for variety!

4. Soy based foods are also good alternatives to red meat but limit to 2 to 3 servings a week.

Lastly… simple lifestyle measures that you can observe during parties or in preparation for the holiday parties that can matter most in avoiding weight gain:

1.     Always eat breakfast everyday of your life.  If you haven’t done so regularly…do it now!  Avoid skipping meals as this habit can cause more weight gain!

2.     Begin your meals with soup or salad to lessen your cravings for the sinful fat filled dishes on the buffet table.

3.     Try to eat slowly by chewing your food thoroughly so your body will have time to analyze that you are already full.

4.     Once full then stop and walk away from the sight of food.  This habit will make you avoid getting more food even if you are no longer hungry!

5.     Use a smaller plate so it will look full with only a small amount of food.  

A nutrient rich meal that has a modest increase in protein content and a modest restriction of carbohydrates coupled with simple practical lifestyle measures can go along way in helping us avoid the holiday bulge!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips | 5 Comments »

Cancer Is On The RISE… Blame the Lifestyle…

December 12, 2008

Cancer is on the rise year after year… why?

It is set to overtake Cardiovascular disease as the number one killer…why?

Blame it on the poor eating habits and bad lifestyle … the “western” habits of enjoying life!…so BEWARE!

Here’s the excerpt of the recent media release of the International Research on Cancer in cooperation with the American Heart Association:

the burden of cancer doubled globally between 1975 and 2000 and is set to double again by 2020 and nearly triple by 2030.

The report—which was discussed at an event in Atlanta this week called Conquering Cancer: A Global Effort—says that low- and middle-income countries will experience the impact of higher cancer incidence and death rates more sharply than industrialized countries.

WHY? Apparently the cause of this rise is similar to why cardiovascualr disease used to be number 1:

  • Poor eating habits: high fat low fiber, high calorie foods…they are just so yummy that we cant afford not to eat and enjoy them at the expense of diseases!  They say..life is too short…lets enjoy whatever we food we like.  I love that saying life is too short therefore we should enjoy…I do BUT I dont like to suffer and endure a hard suffering and ending.  That’s the main reason I am careful!  Poor eating habits have been blamed to be the culprit of OBESITY…obesity on the other hand is responsible for increasing the prevalence of breast cancer and other cancers.  The link between food intake and obesity to diseases are getting closer and closer and becoming dangerously closely linked!
  • Smoking and tobacco use: a known culprit of chronic illness but up to now continues to be a major health issue. 

Just a BAD habit to break so everyone says.  Again for me…just like losing weight..it all boils down to the plain D as in DISCIPLINE!

Life is too short…I agree.  But live it well… take care of the short life.  Be healthy and enjoy a wonderful healthy sense of well being!

Posted in General Health Tips | 1 Comment »

Quit Smoking and Get Back Your Health…

December 11, 2008

Smoking is indeed addicting.  A lot of smokers know the risks but cant help themselves to quit smoking.  It is actually easier said than done… similar to asking patients to eat less to lose weight!

The good news is…quitting smoking can do a lot of things to reverse the bad efffects of smoking done to ones body and therefore, it is never too late to QUIT.

The Harvard News Letter nicely summarized how the body responds immediately to weeks and months after quitting smoking:

Why bother? Even if you’ve smoked for years, you’ll greatly improve your health.

  • Within days, your blood vessels will regain much of the normal function that is damaged by smoking.
  • Within weeks, you’ll be able to taste food better, and your sense of smell will recover from tobacco’s assault.
  • Within months, symptoms of chronic bronchitis ease up, and lung function improves within a year.
  • Quitting reduces the risk of heart attack and stroke within two to five years.
  • And the risk of lung cancer begins to drop substantially within five to nine years of quitting.

More benefits await one that will decide to come clean this Christmas and the New Year. 

What better Christmas gift to give to oneself than a Clean bill of health… and what better resolution to have for oneself is to Aim for Discipline for Good Health for the New Year!

Posted in General Health Tips, Medical News Bits, Personal Thoughts | 1 Comment »

Alarming Rise in Adult Diseases Amongst Children….

December 4, 2008

As the world is becoming more obese… as our food industry is creating better marketing strategies to entice people to eat… as we see more children spending more time watching television… not surprisingly, we see more kids suffering from the chronic illnesses not known to kids in last century!

Now new data support our fear that indeed obesity is becoming more prevalent in our region as more international food chains are creeping up and luring our kids with better and bigger processed foods.  In the ned, our own personal health, our kids health and the health of our nation will suffer because we will be spending our fortune in treating the complications of what we have eaten during our lifetime.

A study published in Pediatrics this year is not only alarming but an eye opener…for all of us with kids!!!!

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First-quarter 2002 baseline prevalence of chronic medication use per 1000 child beneficiaries ranged from a high of 29.5 for antiasthmatics to a low of 0.27 for antihyperlipidemics. Except for asthma medication use, prevalence rates were higher for older teens aged 15 to 19 years.

During the study period, the prevalence rate for type 2 antidiabetic agents doubled, driven by 166% and 135% increases in prevalence among females aged 10 to 14 and 15 to 19 years, respectively.

Prevalence of use growth was more moderate for antihypertensives and antidepressants (1.8%). R

Rates of growth were dramatically higher among girls than boys for type 2 antidiabetics (147% vs 39%), 

CONCLUSIONS. Prevalence of chronic medication use in children increased across all therapy classes evaluated. Additional study is needed into the factors influencing these trends, including growth in chronic disease risk factors, greater awareness and screening, and greater affinity toward early use of drug therapy in children.

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Well for me this data say it all.  Where else can one get diabetes at an early age except from the rising prevalence of obesity.  Excess fat results in a state called insulin resistance where the body has to produce more insulin to counteract the resistance by fat to the effect of insulin.  We need insulin to drive sugar inside our muscles to be used for energy!!! 

Simple equation of FAT= Insulin resitance + Diabetes and others.

Others mean: high blood pressure, high cholesterol, hgh uric acid, infertility, increased risk for blood clot, cancer and more…  Meaning, our kids if we let them be with their choices of food nowadays will be taking the medications that our fathers used to take when they were in their 70’s.  A scary though indeed BUT it’s now a reality!

In short… start good nutrition among the young. And have a happy healthy kid.

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts, The Truths on Obesity | 3 Comments »

The Conflict of Taking Care of A Loved One….

December 2, 2008

Obejectivity is important as a physician taking care of patients. But the personal side of it is as important as patients seek our help to feel comfort that their illness is not all that bad after all…  The conflict comes when as physicians, we have to deal with an illness in the family.  Almost always by chance, we commit a blunder in our decision which creates the conflict… a situation we all want to avoid.

The recent article published in the Annals of Internal Medicine succinctly targetted the issue of the conflict that a physician in the family and the sick loved one have to expect with medical care:

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Conventional wisdom and professional ethics generally dictate that physicians should avoid doctoring family members because of potential conflicts of interest.
Nevertheless, cross-sectional surveys find that the practice is commonplace. Physicians have unique opportunities to influence their family member’s care because they possess knowledge and status within the health care system; however, when physicians participate in the care of family members, they must not lose objectivity and confuse their personal and professional roles.

Because health care systems are complicated, medical information is difficult to understand, and medical errors are common, it can be a great relief for families to have someone “on the inside” who is accessible and trustworthy. Yet, the benefits of becoming involved in a loved one’s care are accompanied by risks, especially when a physician takes action that a nonphysician would be incapable of performing. Except for convenience, most if not all of the benefits of getting involved can be realized by physician–family members acting as a family member or an advocate rather than as a physician.

Rules about what is or what is not appropriate for physician–family members are important but insufficient to guide physicians in every circumstance. Physician–family members can ask themselves, “What could I do in this situation if I did not have a medical degree?” and consider avoiding acts that require a medical license.

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The best role that a physician family member can do is support.  And be there in times of need.  And the thought that other family members know that there is a doctor in the family that knows better than they do….is comforting enough…. 

The conflict though begins whan the question of … where do personal reasoining ends when objectivity is required….

Life is But a Full of Challenges…and for us physicians, the situation can be one..

Posted in General Health Tips, Lifestyle Measures, Personal Thoughts | 3 Comments »

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!!!!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Personal Thoughts, Weight Loss Tips | 7 Comments »

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.” 

Posted in General Health Tips, Lifestyle Measures, Personal Thoughts | 6 Comments »

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!

Posted in General Health Tips | 4 Comments »

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!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity | 3 Comments »

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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Posted in General Health Tips, Medical News Bits, Personal Thoughts | 14 Comments »

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!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity, Weight Loss Tips | 4 Comments »

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!

Posted in Exercise and Activity Tips, General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, Weight Loss Tips | 1 Comment »

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!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips | 6 Comments »

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!

Posted in General Health Tips, Healthy Practice Tips, Personal Thoughts | 3 Comments »

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!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, The Truths on Obesity | 7 Comments »

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!

Posted in General Health Tips, Medical News Bits, Personal Thoughts, Weight Loss Tips | Leave a Comment »

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!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Tips To Protect Your Heart | 4 Comments »

Socioeconomic Class And the Risk for Cancer….

September 29, 2008

We all know that disease affecting an elderly can differ from the young.  A new study highlights the impact of one socioeconomic status and the risk of common ailments that we dread of having: CANCER.

Here’s an interesting study opublished recently in the BMC-Cancer looking at how ones socioeconomic status can have an impact on ones risk to develop cancer:

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Background

Cancer incidence varies by socioeconomic group and these variations have been linked with environmental and lifestyle factors, differences in access to health care and health seeking behaviour. Socioeconomic variations in cancer incidence by region and age are less clearly understood but they are crucial for targeting prevention measures and health care commissioning.

Results

  • Incidence was highest for the most deprived patients for lung cancer and cervical cancer
  • the opposite was observed for malignant melanoma and breast cancer.
  • The difference in incidence between the most and the least deprived groups was higher for lung cancer patients aged under 65 at diagnosis than those over 65 at diagnosis, which may indicate a cohort effect. 
  •  If the incidence of lung and cervical cancer were decreased to that of the least deprived group it would prevent 36% of lung cancer cases in men, 38% of lung cancer cases in women and 28% of cervical cancer cases.
  • Incidence of breast cancer and melanoma was highest in the least deprived group

Conclusions

National comparison of socioeconomic variations in cancer incidence by region and age can provide an unbiased basis for public health prevention and health commissioning. Decreasing inequalities in incidence requires the integration of information on risk factors, incidence and projected incidence but targeted public health interventions could help to reduce regional inequalities in incidence and reduce the future cancer burden.

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The way we live and the way we practice how we live definitely can have an impact on what diseases will affect our bodies. Breast cancer is noted to be predominant among the wealthy obviously because for me, these people tend to more vigilant in doing yearly exams but more so because they tend to behave not very well in terms of lifetstyle.  I have heard news from relatives to friends who developed breast cancer.

 Look around you and you will see obese women with their obese siblings.  Culture tells us that being a little fat is better and “culturally” better than thin because the “fatness conotes a happy marriage! WHEW! I absolutely DIASGREE! 🙂  and am sure a lot of you are!  I am happily married with three kids BUT I keep it a point to be careful with what I eat including my wife and kids MAKING sure we will not be one of th tagged “obese family” that will increase our chances of getting obesity related diseases like cancer.

Being obese will increase your chances of having a higher circulating estrogen which can increase ones chances to develop breast cancer.  So by keeping oneself fit and avoiding red meat can one improve to lower that risk.

What You Can Afford Does Not Mean It is Healthy!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity | 1 Comment »

Recommended Foods If You ARe AT Risk Of Diabetes?

September 24, 2008

Go to fullsize imageI am one of those at risk to develop Diabetes.  I am the youngest of 9 siblings and am sure my mom was already a diabetic by the time I was born.  In short I have the genetic makeup to have one and it now depends on the environment …how I can modify the risk factors… that will determine if indeed I will develop this disease or not.

So when my latest Fasting blood sugar reached 96 mg/dl… I was laready alarmed.  Remember from my previous posts that individuals with a normal fasting blood sugar between 89 to 99 mg/dl have the highest risk to become diabetic in the next few years.  So the first thing I did was to change the way I eat…modify my lifestyle in terms of preference of food and settled in to more fruits and vegetables PLUS brisk walking almost everyday. I have already lost at least 14 pounds and I have reached a normal BMI of 22 …YAHOOO:)

Now comes a new study publsihed this September 2008 in Diabetes Care:

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Subjetcs: White, black, Hispanic, and Chinese adults, aged 45–84 years and free of cardiovascular disease and diabetes, completed food frequency questionnaires at baseline (2000–2002). Incident type 2 diabetes was defined at three follow-up exams (2002–2003, 2004–2005, and 2005–2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication.
Two types of dietary patterns were studied: four empirically derived (principal components analysis) and one author-defined (low-risk food pattern) as the weighted sum of whole grains, vegetables, nuts/seeds, low-fat dairy, coffee (positively weighted), red meat, processed meat, high-fat dairy, and soda (negatively weighted).
RESULTS—

  • High intake of tomatoes, beans, refined grains, high-fat dairy, and red meat was associated with an 18% greater risk :95% CI 1.06–1.32]
  •  High intake of whole grains, fruit, nuts/seeds, green leafy vegetables, and low-fat dairy was associated with a 15% lower diabetes risk (0.85 [0.76–0.95]; P = 0.005).
  • The low-risk food pattern was also inversely associated with diabetes risk (0.87 [0.81–0.99]
  • Individual component food groups were not independently associated with diabetes risk.
  • Associations were not modified by sex or race/ethnicity.

CONCLUSIONS—Multiple food groups collectively influence type 2 diabetes risk beyond that of the individual food groups themselves.

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Beans and tomatoes are nutrient-rich foods so I thought they should be part of a healthy meal?  But the most likely reason why intake of tomatoes and beans are linked to a higher risk of diabetes is the fact that in the study group, their intake was associated with intake of less healthy meals from pizza parlors or burger junctions as well as cheese and tacos

The study specifically also points out that in terms of health benefits and effects of foods, one should focus more on the importance of the whole diet rather than on certain foods or food groups that might be beneficial to us.

So…I guess am doing well with my lifestyle change because I am eating foods now proven to help me lower my risk and am enjoying eating them.

Again By Eating Right … We Should Live Well!

 

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, The Diabetes Facts | Leave a Comment »

Massage and Mood…

September 22, 2008

Go to fullsize imageIve long believe in massage and touch therapy to help alleviate pts of anxiety, hyperactivity and mood.  I go to massage 2 x every week to relax and be pampered after a long day’s hard work.  It de- stresses me as well as improve my mood for work the next day.

Now comes a study published in the Annals of Internal Medicine that fully supports my belief in massage.  Although the study is not conclusive that massage is superior to light touch… the feeling of relaxation and pampering oneself is more than worth the time to do it.

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Objective: To evaluate the efficacy of massage for decreasing pain and symptom distress and improving quality of life among persons with advanced cancer.

Patients: 380 adults with advanced cancer who were experiencing moderate-to-severe pain; 90% were enrolled in hospice.

Intervention: Six 30-minute massage or simple-touch sessions over 2 weeks.

Measurements: Primary outcomes were immediate (Memorial Pain Assessment Card, 0- to 10-point scale) and sustained (Brief Pain Inventory [BPI], 0- to 10-point scale) change in pain. Secondary outcomes were immediate change in mood (Memorial Pain Assessment Card) and sustained change in quality of life (McGill Quality of Life Questionnaire, 0- to 10-point scale), symptom distress (Memorial Symptom Assessment Scale, 0- to 4-point scale),

Results: 298 persons were included in the immediate outcome analysis and 348 in the sustained outcome analysis. A total of 82 persons did not receive any allocated study treatments (37 massage patients, 45 control participants).

  • Both groups demonstrated immediate improvement in pain (massage, –1.87 points [95% CI, –2.07 to –1.67 points]; control, –0.97 point [CI, –1.18 to –0.76 points]) and mood (massage, 1.58 points [CI, 1.40 to 1.76 points]; control, 0.97 point [CI, 0.78 to 1.16 points]).
  • Massage was superior for both immediate pain and mood (mean difference, 0.90 and 0.61 points, respectively; P < 0.001).

Conclusion: Massage may have immediately beneficial effects on pain and mood among patients with advanced cancer. Given the lack of sustained effects and the observed improvements in both study groups, the potential benefits of attention and simple touch should also be considered in this patient population.

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This simple study is worth looking into.  Although the study only involved cancer patients but the implication of the study results can be applied to every patient that we see or be advised to those with chronic illness beyond their usual therapies.

Simple touch to patients can definitely offer hope, relief and comfort.  This is what I learned at the Mayo Clinic.  Bedside skills involving interaction with patients through touch were as important as the skill of a surgeon or the bright minds of the internists.  How much more with a soothing massage… whew!  I cant wait to get one while composing this post 🙂

In Bad Mood? or Feeling sick and getting Depressed? or Maybe from too much pressure from work?

Massage To The Rescue!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts | 1 Comment »

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