Archive for the 'General Health Tips' Category

Heart Rate Predicts Heart Disease…..

September 20, 2008

I came accross this health tidbit which I want to share.  A simple test we can do anytime anywhere:

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DID YOU KNOW:?
Heart Rate of More Than 70 Beats Per Minute Increases Risk of Heart Failure: The finding that heart rate, specifically a heart rate more than 70 beats per minute, increased the risk of cardiac events in heart failure patients was the top take-home message for the Dutch cardiologist who chaired the European Society of Cardiology program committee.

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This is where exercise and being in “conditioned” is a plus factor.  It helps lower ones heart rate and being fit and active as protective against chronic heart ailments.

Lower Your Heart Rate By Being FIT!

We All Deserve A BREAK!!!!

September 18, 2008

I just came back from a very relaxing Mediterranean Cruise with my wife. It was a well deserved break for both of us and boy do I recommend everyone who has a chance to get a cruise for vacation.

Taking a break gives you a better outlook in life… a better understanding of the need to enjoy while we are still alive! We all deserve to relax and enjoy and have a break in between the hard work.  I hate those trips where you need to take a break after your vacation because you were so exhausted with the vacation you had!!!  Cant see the logic there.

The cruise took us to Barcelona then to Malta then to Naples where we had a chance to visit Pompei, Capri and Sorrento.  Then we proceeded to Rome then to Florence then finally to Nice where we had a visit to Monacco.  What made the trip so fun is the fact that one does not need to pack and unpack everytime you visit a place.  You can relax and enjoy the facilities especially the gym of the ship at your own convenient time.

The downside however for me is the FOOD!  It was just everywhere and anytime plus it was always a Buffet from breakfast to lunch to dinner!  It was not a happpy site for me to see people gorging for food even if they dont need to.  A sad fact of life!

We need a Break BUT be sure you do it to maintain your health both “emotional” and physical Health!  If you neglect the right way to proper nutrition then you are doing harm even for the duration of the trip and for me it is no excuse!

This is our third cruise together and I will continue to endorse a Cruise as the right way to enjoy a vacation where you can have both fun and relsxation at their peak! But enjoy it the right way!

Take a Break for Health But Dont Break It By Indulging the Unhealthy Way!

How To Reduce Your Risk To Develop DIABETES….

September 1, 2008

If you have a family history of diabetes, if you are overweight and sedentary  and wants to reduce your risk to develop diabetes, then this article is for you!

This new study was recently published in the Archives of Internal Medicine and as far as I know is the first one that conclusively looked at how fruits and vegtables can alter the risk of a patient to develop this chronic disease called diabetes.

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Methods  We administered a semiquantitative food frequency questionnaire to men and women from a population-based prospective cohort (European Prospective Investigation of Cancer–Norfolk) study who were aged 40 to 75 years at baseline (1993-1997) when plasma vitamin C level was determined and habitual intake of fruit and vegetables was assessed. During 12 years of follow-up between February 1993 and the end of December 2005, 735 clinically incident cases of diabetes were identified among 21 831 healthy individuals. We report the odds ratios of diabetes associated with sex-specific quintiles of fruit and vegetable intake and of plasma vitamin C levels.

Results 

  • A strong inverse association was found between plasma vitamin C level and diabetes risk.
  • The odds ratio of diabetes in the top quintile of plasma vitamin C was 0.38 (95% confidence interval, 0.28-0.52) in a model adjusted for demographic, lifestyle, and anthropometric variables.
  • In a similarly adjusted model, the odds ratio of diabetes in the top quintile of fruit and vegetable consumption was 0.78 (95% confidence interval, 0.60-1.00).

Conclusions  Higher plasma vitamin C level and, to a lesser degree, fruit and vegetable intake were associated with a substantially decreased risk of diabetes. Our findings highlight a potentially important public health message on the benefits of a diet rich in fruit and vegetables for the prevention of diabetes.

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A word of caution from this study is that the plasma Vitamin C level correlated with the intake of fruits and vegetables and NOT Vitamin C Supplements.  Therefore do not grab all the Vitamin C supplements in the shelves to boost up your levels.  It is believed that beyond Vitamin C, there are properties in fruits and vegetables that help patients reduce their risk to develop diabetes.

As fas a I know, this is the first conclusive evidence that looked objectively at the effect of fruit and vegetable intake and the risk of diabetes.  And a reduction of diabetes risk by 62% is a great bonus to those who love fruits and vegetables on top of the other benefits associated with their intake.

So Eat Vegetables everyday and every meal… take fruits after each meal and you can even enjoy an apple or pear for snacks. Chances are… the more you eat the better the risk reduction.  Again…go for the low glycemic index fruits like apple and pear instead of a mango, banana or pineapple!

Love Yourself By Eating Right!

Sleep and High Blood Pressure… Check Your Kids!

August 27, 2008

Go to fullsize imageI just came across a new study that showed poor sleep is affecting a lot of our teens these days.  Its either they have problems falling asleep or problems waking up early or just plain LACK of Sleep for whatever reason.  This study involved around 200 adolescents between ages 13-16 was recently published in the Journal Circulation August issue and is really an eye opener for parents with kids… by making sure that their kids follow a sleep habit that is healthy.

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Odds of prehypertension associated with sleep disturbances

Sleep problem Unadjusted OR (95% CI) p Adjusted OR p
Low sleep efficiency (<85%) 4.52 (2.11-9.70) 0.0001 3.50 0.0028
Short sleep (<6 h) 2.79 (1.07-7.34) 0.0366 2.54 0.0679

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The kids with sleep inefficiency meaning they have trouble falling asleep or wake early and those with poor sleep (6.5 hours or less) had systolic blood-pressure levels that were higher than their peers on average 4 mm Hg.  This problem of hypertension may result in long lasting complications and development of end organ damage involving the heart, kidneys and eyes among our kids at an early age.  Fortunately this is one risk of hypertension that is MODIFIABLE.

What then can be modified to afford better sleep habit among our teens? 

I have three Simple recommendations:

  • Limit Home Internet Use.  Only for school work and no to games during school days!  Overexcitement results in being hyperactive due to adrenaline rush and this limits sleep quality.
  • A Good Study Habit to avoid cramming.  This should have been trained as early as preschool!
  • Limit soda or other drinks rich in caffeine especially during dinner time

A Better Adjusted Kid Is A Healthy Kid!

Vitamin D and The Risk of Death….

August 22, 2008

While reviewing my journals…I again came across another study on Vitamin D but this time relating this vitamin to mortality or the risk of death in the general population.  This study was published in the Archives of Internal Medicine, August 15, 2008 issue.

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Background  In patients undergoing dialysis, therapy with calcitriol or paricalcitol or other vitamin D agents is associated with reduced mortality. Observational data suggests that low 25-hydroxyvitamin D levels (25[OH]D) are associated with diabetes mellitus, hypertension, and cancers. However, whether low serum 25(OH)D levels are associated with mortality in the general population is unknown.

Methods  We tested the association of low 25(OH)D levels with all-cause, cancer, and cardiovascular disease (CVD) mortality in 13 331 nationally representative adults 20 years or older from the Third National Health and Nutrition Examination Survey (NHANES III) linked mortality files. Participant vitamin D levels were collected from 1988 through 1994, and individuals were passively followed for mortality through 2000.

Results 

  •  In cross-sectional multivariate analyses, increasing age, female sex, nonwhite race/ethnicity, diabetes, current smoking, and higher body mass index were all independently associated with higher odds of 25(OH)D deficiency (lowest quartile of 25(OH)D level, <17.8 ng/mL
  • while greater physical activity, vitamin D supplementation, and nonwinter season were inversely associated.
  • During a median 8.7 years of follow-up, there were 1806 deaths, including 777 from CVD.  compared with the highest quartile, being in the lowest quartile (25[OH]D levels <17.8 ng/mL) was associated with a 26% increased rate of all-cause mortality (mortality rate ratio, 1.26; 95% CI, 1.08-1.46) and a population attributable risk of 3.1%.
  • The adjusted models of CVD and cancer mortality revealed a higher risk, which was not statistically significant.

Conclusion  The lowest quartile of 25(OH)D level (<17.8 ng/mL) is independently associated with all-cause mortality in the general population.

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Another reason for us to check our Vitamin D level.  All along I am right.  I have been a proponent of the wonders of Vitamin D and the perils of what Vitamin D Deficiency can do.

The best way again for us to avoid getting the lowest Vitamin D level is to eat foods rich in Vitamin D and to enjoy the sun as much as we can! The flesh of fish such as salmon, tuna, and mackerel aa well as fish liver oils are among the best sources of Vitamin D that we can get naturally.  I would not recommend supplements if we can avoid them.

Live Long… Enjoy the SUN!

Vitamin D and Your Risk To Fracture….

August 20, 2008

Go to fullsize imageVitamin D is a neglected vitamin.  I always consider it as one of those vitamins that have powerful effects on the body but has never got the attention fo the media. 

Through this website, I have been harping on the benefits of Vitamin D and the problems associated with subtle vitamin D Deficiency.

I recently had one patient who suffered from severe muskuloskeletal weakness that the neurologist was already doing a battery of tests but no diagnosis was given. When her vitamin D was checked..it was extremely low and with supplementation of Vitamin D, she eventually recovered in 1-2 months. The neurologist discounted the effect saying she is living in a hot tropical country with plenty of sun and therefore he doubts that she is vitamin D deficient.  Unknowingly to everyone… people in our country hide from the sun… they bring umbrellas during sunny days… they avoid the sun because it can cause wrinkles and freckles.  My patient was no exception!!!

Now comes a new study linking Vitamin D Deficiency to fractures….publsihed in the Annals of Internal Medicine August issue…

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Participants: 400 case-patients with incident hip fracture and 400 control participants matched on the basis of age, race or ethnicity, and date of blood draw. Both groups were selected from 39 795 postmenopausal women who were not using estrogens or other bone-active therapies and who had not had a previous hip fracture.

Measurements: Serum 25(OH) vitamin D was measured and patients were followed for a median of 7.1 years (range, 0.7 to 9.3 years) to assess fractures.

Results: Mean serum 25(OH) vitamin D concentrations were lower in case-patients than in control participants (55.95 nmol/L [SD, 20.28] vs. 59.60 nmol/L [SD, 18.05]; P = 0.007), and

  • lower serum 25(OH) vitamin D concentrations increased hip fracture risk (adjusted odds ratio for each 25-nmol/L decrease, 1.33 [95% CI, 1.06 to 1.68]).
  • Women with the lowest 25(OH) vitamin D concentrations (47.5 nmol/L) had a higher fracture risk than did those with the highest concentrations (70.7 nmol/L) (adjusted odds ratio, 1.71 [CI, 1.05 to 2.79]), and
  • the risk increased statistically significantly across quartiles of serum 25(OH) vitamin D concentration (P for trend = 0.016).
  • This association was independent of number of falls, physical function, frailty, renal function, and sex-steroid hormone levels and seemed to be partially mediated by bone resorption.

Limitations: Few case-patients were nonwhite women. Bone mineral density and parathyroid hormone levels were not accounted for in the analysis.

Conclusion: Low serum 25(OH) vitamin D concentrations are associated with a higher risk for hip fracture.

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This study for me is very important.  For one, we know that Vitamin D supplementation has always been part of the cocktail of meds a patient with osteoporosis have to take.  But this is one study that looked at Vitamin D deficiency and the risk to fracture.  The results clearly show a relationship!

My take home message for this is that…dont assume a patient to be Vitamin D replete just because she is living in the tropics. Again one reason why this vitamin is a neglected vitamin not only in terms of preventing a disease but also in its relationship to causing a disease. 

Getting Vitamin D level is an easy blood test and if found deficient, Vitamin D replacement can have a tremendous impact in terms of how the patient feels in terms of improving his/her quality of life and how it can prevent diseases like a fracture!

The best way to prevent Vitamin D Deficiency is to enjoy the SUN …the morning sun at least 10-15 min daily while goign to work or doing your daily exercise.  Or just leisurely sun bathing with a book to read!

It’s About Time We Take Respect and Enjoy The SUN!

Watermelon Can Boost Your Sexual Function… How True?

August 11, 2008

Go to fullsize imageI saw the news: Watermelon as the Natural Viagra..how true? 

The study where this headline was taken from was published recently in the Journal NUTRITION and really is an eye opener for those who have problems with sexual function.  The question is…will the results translate to actual outcome?

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Methods

Subjects (n = 12–23/treatment) consumed a controlled diet and 0 (control), 780, or 1560 g of watermelon juice per day for 3 wk in a crossover design. The treatments provided 1 and 2 g of citrulline per day. Treatment periods were preceded by washout periods of 2 to 4 wk.

Results

Compared with the baseline, fasting plasma arginine concentrations increased 12% after 3 wk of the lower-dose watermelon treatment; arginine and ornithine concentrations increased 22% and 18%, respectively, after 3 wk of the higher-dose watermelon treatment. Fasting citrulline concentrations did not increase relative to the control but remained stable throughout the study.

Conclusion

The increased fasting plasma concentrations of arginine and ornithine and stable concentrations of plasma citrulline in response to watermelon juice consumption indicated that the citrulline from this plant origin was effectively converted into arginine. These results demonstrate that plasma concentration of arginine can be increased through intake of citrulline from watermelon.

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The only association with viagra is the fact that watermelon is rich in a substance called citrulline know to have dilating effects on the vessel as the study implies.  This amino acid citrulline is actually converted into arginine which is a precursor for nitric oxide that helps blood vessel dilate!  In theory…it looks good but how about in actual practice?

SO…before we grab all the watermelons in the market, it is very important for us to understand that no study as of now has been done to confirm if indeed intake of watermelon can improve erection!!!!  And likewise nobody knows how much watermelon we need to take to achieve the effect!!!! Probabaly tons of watermelon before enough arginine can be made to cause an effect!

So to say that watermelon is a natural viagra is a doubtful claim. And definitely needs more studies if ever any study will be done.  Remember, arginine deficiency is not the sole cause of erectile dysfunction but rather it is more complicated than that! 

I love watermelon…if indeed it can help me in my other needs…the better!!!! It’s a PLUS!

 

Happy Anniversary!!!!

August 7, 2008

Go to fullsize imageIts our 2nd year in providing you with medical information and updates not only in diabetes but updates on anything  affecting our general health.

To the readers and patients… thanks for all your comments.  Your visits to the site are the ones that drive me to continue doing what I love to do best…  And I cant do my work as a physician better than keeping my patients well informed through this website! 

Thanks also to this site, I met new friends along the way….

To more years of medical knowledge….

Cheers to more fun and learning!!!!

LICKING…A Way To Speed Up Wound Healing

August 6, 2008

Out of reflex…the moment we feel pain in any part of the body especially our fingers…our immediate reflex is to bring that finger into our mouth and start licking it.   I do the same all the time…believing that it eases the pain, and stops the bleeding!  And in reality, we were actually all right!

Now comes a study showing that indeed licking the wound with our saliva can accelerate wound healing.  This study will be published in the November issue of Federation of American Societies for Experimental Biology.

A specific compound found in human saliva that has the potential to heal wounds is the product called HISTATIN which in experimental studies have been shown to have antibacterial properties. Meaning this substance can indeed KILL the bacteria!  We were actually doing right in curing our small wound through licking through these years! 

This indeed is also great news especially the potential of this  product to be the answer to our diabetics with recurring and chronic ulcers since these non healing wounds can result in major morbidity and disabilty due to amputation.

Let’s wait therefore for commercial quantities of this product soon to be in the market.  In the same line as alcohol gels or handwashing lotions….

And for the meantine…stick with our tongues and continue licking … it’s easy and FREE!

Can Coffee Increase Your Lifespan?

August 4, 2008

I am a coffee drinker.  I usually have a cup of coffee everyday and nothing more.  Except on occasions where I take another cup in the afternoon but usually I average only 5-7 cups per week.  I’ve written about the many benefits of coffee in this website and in the newpapers…and seems like more benefits are being known the more we know about coffee.

Now comes a recently published article on coffee and mortality published in the Annals of Internal Medicine, June of 2008: the official journal of the American College of Physicians.

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Design: to investigate the association between coffee consumption and incidence of all-cause and disease-specific mortality in a prospective cohort study.

Setting: Health Professionals Follow-up Study and Nurses’ Health Study: 41 736 men and 86 214 women with no history of CVD or cancer at baseline.

Results: After adjustment for age, smoking, and other CVD and cancer risk factors, the relative risks for all-cause mortality in men across categories of coffee consumption (<1 cup per month, 1 cup per month to 4 cups per week, 5 to 7 cups per week, 2 to 3 cups per day, 4 to 5 cups per day, and 6 cups per day) were 1.0, 1.07 (95% CI, 0.99 to 1.16), 1.02 (CI, 0.95 to 1.11), 0.97 (CI, 0.89 to 1.05), 0.93 (CI, 0.81 to 1.07), and 0.80 (CI, 0.62 to 1.04), respectively (P for trend = 0.008). For women, the relative risks were 1.0, 0.98 (CI, 0.91 to 1.05), 0.93 (CI, 0.87 to 0.98), 0.82 (CI, 0.77 to 0.87), 0.74 (CI, 0.68 to 0.81), and 0.83 (CI, 0.73 to 0.95), respectively (P for trend < 0.001). This inverse association was mainly due to a moderately reduced risk for CVD mortality and was independent of caffeine intake.

By contrast, coffee consumption was not statistically significantly associated with risk for cancer death after adjustment for potential confounders.

Decaffeinated coffee consumption was associated with a small reduction in all-cause and CVD mortality.

Conclusion: Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of coffee consumption on all-cause and CVD mortality needs to be further investigated.

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To further summarize the data in layman’s terms:

  • This study shows that increasing consumption of coffee was associated with decreasing mortality or death.  
  • People who drank at least 5 -7 cups of coffee per week had a significantly LOWER overall risk of dying from any cause. 
  • People who drank 4-5 cups per day or more had the strongest protection.

What was interesting also in the study was that among women who were coffee drinkers, most reduction in death was due to a reduction in cardiovascular disease. What I like most in coffee are the studies showing its frequent consumption to result in a reduction albeit small, in the risk of diabetes.

Is Regular better than Decaf?  Well, In the study, whether people drank regular or decaffeinated coffee, benefits were noted, suggesting that the one product present in coffee that results in health benefits maybe its high levels of polyphenols  known to reduce inflammation and also known to provide other positive effects on the heart, blood vessels, and blood sugar.

What more can you ask?

I will continue to enjoy my coffee everyday whatever benefits they give me is already a PLUS!!!!

Why Japanese Men Have Low Heart Disease….

August 1, 2008

Japanese are known to be workaholic.  They ahve been known to work long hours. Many are also smokers BUT why do they have a lower risk of heart disease?

A recent study published in the Journal of American College of Cardiology, August 2008 may have the reasons why….

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Methods: A population-based cross-sectional study in 281 Japanese (defined as born and living in Japan), 306 white (defined as white men born and living in the U.S.), and 281 Japanese-American men (defined as Japanese men born and living in the U.S.) ages 40 to 49 years was conducted to assess intima-media thickness (IMT) of the carotid artery, coronary artery calcification (CAC), and serum fatty acids.

Results:

  • Japanese men had the lowest levels of atherosclerosis, whereas whites and Japanese Americans had similar levels.
  • Japanese had 2-fold higher levels of marine-derived n-3 fatty acids than whites and
  • Japanese Americans in the U.S. Japanese had significant and nonsignificant inverse associations of marine-derived n-3 fatty acids with IMT and CAC prevalence, respectively.

Conclusions: Very high levels of marine-derived n-3 fatty acids have antiatherogenic properties that are independent of traditional cardiovascular risk factors and may contribute to lower the burden of atherosclerosis in Japanese, a lower burden that is unlikely the result of genetic factors.

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This study further proves why Fish is the healthiest meat to eat. This trully explains why Japanese have a low risk of heart disease because of their lifetime increased intake of fish esepcially salmona dn mackerel which are both rich in omega 3 fatty acids.

I caution those who are buying Omega 3 supplements though because the effects are not proven in terms of the omega 3’s protective effect on the heart with regard to supplements. 

Instead to reap the benefits of Omega 3:

Eat FISH 2-3 x a week!

Are You Sure Your Sugar Is Normal?

July 29, 2008

Go to fullsize imageHere’s an interesting article: published in the American Journal of Medicine this July.  I bet after reading this article…you will have to review your old blood tests and determine if you are at risk to develop diabetes in the near future.

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This study included:

46,578 members of Kaiser Permanente Northwest who had fasting plasma glucose levels less than 100 mg/dL between January 1, 1997, and December 31, 2000, and who did not previously have diabetes or impaired fasting glucose.

  • Subjects developed diabetes at a rate of less than 1% per year during a mean follow-up of 81.0 months.
  • Each milligram per deciliter of fasting plasma glucose increased diabetes risk by 6% (hazard ratio [HR] 1.06, 95% confidence interval [CI], 1.05-1.07, P < .0001) after controlling for other risk factors.
  • Compared with those with fasting plasma glucose levels less than 85 mg/dL, subjects with glucose levels of 95 to 99 mg/dL were 2.33 times more likely to develop diabetes (HR 2.33; 95% CI, 1.95-2.79; P < .0001).
  • Subjects in the 90 to 94 mg/dL group were 49% more likely to progress to diabetes (HR 1.49; 95% CI, 1.23-1.79; P <.0001).
  • All other risk factors except sex were significantly associated with a diabetes diagnosis.
Conclusions

The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range.

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This study although with limitations sends a strong signal that everytime one gets an executive panel test.. a thorough evaluation has to be made from the numbers that will give us SIGNALS of future disease risk.  There is no room for saying that the results are borderline or of no significance because waiting fo the sugar to be abnormal before one recommends action is tantamount to negligience!

Targeting out patients early means preventing onset of the the disease resulting in lesser chances of developing chronic complications which can be disabling and costly!

Lifestyle changes will continue to be the mainstay for these patients with sugars within the normal range but are at the highest risk to develop diabetes in the next few years!  A little sacrifice can do a long way in preventing illness and promoting health!

Get hold of your last years blood tests…look at the numbers…is your blood suagr 97 mg/dl?  Then be aware that you are at risk to develop diabetes in the near future… and therefore DO SOMETHING!!!! Lose weight, take care of what you eat and MOVE!

The Benefits of Eating Apple

July 17, 2008

As I was preparing for the things to bring on my trip to Hawaii thia afternoon, I felt the urge to eat something.  And what I found inside my fridge were 6 apples.  Being the favorite fruit of my second child, I always make sure there are apples for her to eat after each meal.  So there I was, eating on apple with the SKIN and slowly feeling satisfied and full!  Boy, was it nice, and healthy….

So I though of leaving you something nice about apple.

Definitely the saying: “An apple a day keeps doctors away” was true all along as more studies have found out that apples have plenty of vitamins and minerals, as well as phytonutrients especailly the flavonoids called quercetin, which has high antioxidant activity. Likewise apples are high in fiber and potassium, and contain no fat or salt.

The UC Davis Department of Internal Medicine study showed that “not only do apples and apple juice contain a variety of phytonutrients, but that making apples a regular part of the diet may translate into real health benefits”.  Eating apples in that study showed reduced oxidation indicators and a 22-percent increase in dietary fiber.

Other studies have also shown that individuals who regularly incorporated apples into their diet cut their lung cancer risk in half. lower the risk for stroke, reduce the growth of colon cancer and liver cancer cells with just two-thirds of a medium apple!!!!!

Lastly… dont peel the skin when eating apple. It is said that most of the fiber and antioxidants are in the peel.   Contrary to popular belief…laboratories have consistently shown that the skin of apples contain very low levels of pesticides….So they’re SAFE to eat!!!!

There You Go…

An Apple A Day…Saves You More Than A Day!

A Hearty Breakfast Equals Weight Loss?

July 10, 2008

This new study again refutes what has been said about the low carb hype.

We all know the breakfast is an important meal. In this website, I have emphasized that skipping breakfast equals weight gain equals metabolic syndrome. Therefore it is a must that we all have to break the fast to maintain our weight and be healthy.

In the recent convention of the Endocrine Society, one abstract that caught the attention of many was the study comparing the low carb high fat high protein diet versus high carb, high protein low fat diet.

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The low-carb diet allowed 1,085 calories a day with 17 grams of carbohydrates, 51 grams of protein, and 78 grams of fat. Breakfast for members of this group was to be 290 calories with 7 grams of carbohydrates and 12 grams of protein.
The modified form of this diet allowed 1,240 calories a day with less total fat (46 grams) but more carbs (97 grams) and protein (93 grams). The main feature was a 610-calorie “big breakfast” accounting for about half of the daily carbohydrates (58 grams), protein (47 grams), and fat (22 grams).

During the first 16-week weight-loss phase, the big-breakfast group lost about the same amount of weight as the low-carb group (10.6 kg versus 12.6) with no significant difference between groups.

During the following 16-week maintenance phase, though, the groups’ experience diverged. The big-breakfast group continued losing weight and reached an average 21.3% weight loss by the end of the trial (18.1 kg below baseline).

The low-carb group, on the other hand, regained much of the weight lost to end at just 4.5% below baseline (4.3 kg). The protein- and carbohydrate-heavy breakfast appeared to regulate hunger cues, the researchers said.

Visual analog scale scores after breakfast for the two groups were improved with the big-breakfast diet compared with the low carb diet for the following:

  • Hunger (P=0.018)
  • Feeling of still being able to eat a lot more food (P=0.001)
  • Fullness (P=0.001)
  • Satiety (P=0.07)

The difference in fullness extended beyond lunch and through 11 p.m. (P=0.001).

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This study suggests that having a heart high carb and high protein breakfast translates to lesser craving for sweets and lesser hunger.  Again as we emphasized in any weight loss counseling, it is not recommended that patients trying to lose weight are on a dietary regimen that makes them feel hungry.

This is one study that I will wait for the final posting in a peer reviewed journal.  It would be nice to see how the study was conducted and see where the flaws could be and whether this can be translated into clinical practice.

For now…

Eat Your Breakfast To Help You Lose Weight!

Hearing Loss and Diabetes…

July 2, 2008

Go to fullsize imageI have long suspected a relationship. 

It seems more prevalent the older the patient gets but seems to be more common among my diabetic nowadays.  And my suspicion is right based on a new article published in the Annals of Internal Medicine, July issue:

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Background: Diabetes might affect the vasculature and neural system of the inner ear, leading to hearing impairment.

Design: Cross-sectional analysis of nationally representative data. National Health and Nutrition Examination Survey, 1999 to 2004.

Results: 5140 noninstitutionalized adults age 20 to 69 years who had audiometric testing.

  • Hearing impairment was more prevalent among adults with diabetes. Age-adjusted prevalence of low- or mid-frequency hearing impairment of mild or greater severity in the worse ear was 21.3% (95% CI, 15.0% to 27.5%) among 399 adults with diabetes compared with 9.4% (CI, 8.2% to 10.5%) among 4741 adults without diabetes.
  • Similarly, age-adjusted prevalence of high-frequency hearing impairment of mild or greater severity in the worse ear was 54.1% (CI, 45.9% to 62.3%) among those with diabetes compared with 32.0% (CI, 30.5% to 33.5%) among those without diabetes.

Conclusion: Hearing impairment is common in adults with diabetes, and diabetes seems to be an independent risk factor for the condition.

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The more likely explanation to this complication is still diabetes related microcirculation abnormality which is seen in other organs affected by this condition. Whether tight control of blood glucose can help prevent the onset and progression of this condition remains to be seen. 

Still the same, good control has been shown to help prevent circulatory problems of the affected organs in the body such as the eyes and the kidneys….and therefore there should be no reason why the same wont hold true to the cochlea.

This study therefore helps us realize that patients with diabetes should probably start screening for hearing impariment so as to avoid exposure to unnecessary factors that can help aggravate the condition like noise pollution, loud music and some drugs that have been shown to cause hearing loss.

Hearing Loss: Another Reason To Aim For Good Control!

Mediterranean Diet and Diabetes

June 30, 2008

Reducing the risk of developing a disease requires discipline. Taking measures may be difficult but in the long run preventing the disease from causing harm will be worth all the sacrifice.

We know from the most usual of all: proper diet and exercise have been advised by all to prevent an illness!!! It may be true that… it’s so easy to say…so difficult to do. BUT again if there’s no discipline …there’s no success! And success in Health means… Being Healthy!

One study that I found very important in our quest to reduce the prevalence of diabetes worldwide was recently published in the British Medical Journal, 2008 issue.

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Objective To assess the relation between adherence to a Mediterranean dietand the incidence of diabetes among initially healthy participants.

Design Prospective cohort study . Participants 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years.

Results:

Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3).

In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis.

Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

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This study further proves the health benefits of adhering to Meditteranean diet. It is known to have protective effect in preventing cardiovascular disease and NOW… this study proves it to be protective in preventing diabetes.

For those who dont known the components of this diet: Here’s a summary:

  1. High intake of Fiber; High Intake of vegetable fat
  2. Low intake of trans fatty acids with abundant us of olive oil!!!!
  3. High intake of fruits, nuts, vegetables, cereals and legumes
  4. Minimal meat or dairy products!
  5. Moderate consumption of alcohol

Again…the study emphasizes…

What We Take In is What We Get!

Vitamin D and The Risk For Heart Attack!

June 27, 2008

Go to fullsize imageAnother reason for us to check our Vitamin D levels… the study published in the June issue of the Archives of Internal Medicine: showing that low levels of Vitamin D can be a contributing factor to increase heart attack risk.

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Background  Vitamin D deficiency may be involved in the development of atherosclerosis and coronary heart disease in humans.

Methods  A nested case-control study was conducted in 18 225 men in the Health Professionals Follow-up Study; the men were aged 40 to 75 years and were free of diagnosed cardiovascular disease at blood collection.  During 10 years of follow-up, 454 men developed nonfatal myocardial infarction or fatal coronary heart disease. Using risk set sampling, controls (n = 900) were selected in a 2:1 ratio and matched for age, date of blood collection, and smoking status.

Results  After adjustment for matched variables, men deficient in 25(OH)D (≤15 ng/mL) were at increased risk for MI compared with those considered to be sufficient in 25(OH)D (≥30 ng/mL) with a relative risk of 2.42.

Even men with intermediate 25(OH)D levels were at elevated risk relative to those with sufficient 25(OH)D levels (22.6-29.9 ng/mL: RR, 1.60 ; 15.0-22.5 ng/mL: RR, 1.43 respectively).

Conclusion  Low levels of 25(OH)D are associated with higher risk of myocardial infarction in a graded manner, even after controlling for factors known to be associated with coronary artery disease.

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The study involved patients free of any heart risk.  This finding therefore will have a significant impact in reducing further the risk of those patients already with other concomitant risk factors like diabetes and high blood pressure.  Knwoing your Vitamin D level will do more benefit than harm!

Checking Vitamin D level is a simple blood test.  This can be done easily and the results if low can have significant impact on the patient’s sense of well being since low levels can cause musculoskeletal symptoms and back pains. Vitamin D replacement is also simple since all one needs to do is take a pill!

Check Your Levels in Your Next Doctor’s Visit!

 

An Aspirin A Day Can Keep BP At Bay…

June 24, 2008

Aspirin has been touted a miracle drug because of its health benefits in protecting high risk patients like our diabetics from heart attack and stroke. The combination of illnesses including diabetes , hypertension and cholesterol increases a patients risk for stroke and heart attack.

In the recent American Society of Hypertension Annual Convention, a particular study was presented regarding the effect of aspirin on hypertension. The study is discussed in detail at the Diabetes in Control website...

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The subjects were randomized into three groups: lifestyle modification only, lifestyle modification plus aspirin 100 mg every morning, or lifestyle modification and aspirin 100 mg taken at bedtime. They underwent continuous blood pressure monitoring for 48 hours at baseline and after 3 months of intervention.

Ambulatory blood pressure was unchanged in the nonpharmacologic group and in the morning aspirin group, but the nighttime aspirin administration resulted in a mean decrease of 5.4 mm Hg in systolic blood pressure and 3.4 mm Hg in diastolic blood pressure compared to baseline values, without any change in heart rate or physical activity. Reductions in blood pressure were similar for both day and night.

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This study will somehow affect the way we give aspirin. In clinical practice, it really doesnt matter when aspirin is taken as long as patients are taking it eveyday. But with this recent outcome…might as well give them at night until this study will be proven otherwise….

And as always…we continue to emphasize a low salt diet and more physical activity on top of medications to help curb the rising prevalence of complications arising from hypertension.

Another Wonderful News on Aspirin and Health!

Is Working Overtime Harmful?

June 21, 2008

Here’s a study for all workaholics and overtime workers. It may be the time to reflect… and ask… if we can only manage our time better and try to avoid long night hours at work…so much the better. One has to realize and believe that having the time to take care of ones health is an obligation and a GIVEN!

This study looked at whether working overtime can have harmful effects on the body especially the psychological well being. This study was recently published in the Journal of Occupational and Environmental Medicine.

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Objective: To examine whether long work hours are associated with increased levels and prevalences of anxiety and depression.


Results: Overtime workers of both genders had significantly higher anxiety and depression levels and higher prevalences of anxiety and depressive disorders compared with those working normal hours. Findings suggest a dose-response relationship between work hours and anxiety or depression.

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So to the boses and managers out there…your employees well being is tantamount to more productivity and better work outcome. Take time to analyze each workload and better still instill the discipline of not working long hours because in the long run, health takes its toll and work output suffers in the end…physically and psychologically,

Again… I practice this principle at work. I make sure I dont work long hours as I instill on my patients the discipline of setting an appointment. Have time to relax and exercise. Burning out is the layman’s term to being depressed and losing steam at work. Avoid this from happening otherwise Work becomes a Burden!

Overtime Can Hinder Productivity! Learn To Manage Your Time!

Dark Chocolate Can Lower Blood Pressure and Cholesterol…

June 17, 2008

Another interesting research and great news for chocolate lovers. 

A new study published in the Journal of Nutrition has shown a beneficial effects of dark chocolate in reducing cholesterol and blood pressure.

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This double-blind, placebo-controlled, cross-over study evaluated the efficacy of daily consumption of a cocoa flavanol-containing dark chocolate bar with added PS on serum lipids, blood pressure, and other circulating cardiovascular health markers in a population with elevated serum cholesterol.

Regular consumption of the PS-containing chocolate bar resulted in reductions of 2.0 and 5.3% in serum total and LDL cholesterol (P < 0.05), respectively. Consumption of CF also reduced systolic blood pressure at 8 wk (-5.8 mm Hg; P < 0.05).

Results indicate that regular consumption of chocolate bars containing PS and CF as part of a low-fat diet may support cardiovascular health by lowering cholesterol and improving blood pressure.

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In this study the participants utilized the AHA style diet, and were instructed to consume 2 cocoa flavanol-containing dark chocolate bars per day with (1.1 g sterol esters per bar) or without PS.  The participants really had fun because they were asked to consume 1 bar 2 times per day for 4 wk then switched to the other bar for an additional 4 wk. How I wished I can be part of a study like this!!!!

The research is again one of the many studies done so far on dark chocolate that provides intriguing information regarding the role of plant sterols (PS) and cocoa flavanols (CF) in maintaining cardiovascular health.

Remember though, these are dark chocolates supplemented with plant sterols in addition to cocoa flavanols. These are available in both CVS and Walgreens Pharmacy Stores in the US.  Meaning these dark chocolates are not the usual regular dark chocolates available anywhere. 

So Dark Chocolate…Anyone?