Archive for the 'Healthy Practice Tips' Category

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Tips To Improve Your Memory!!!!

October 12, 2007

438348334.jpgForgot about something? Missed an appointment? Where are my KEYS????

Persistence to take something to boost ones memory has always been in  the back of the minds of patients hoping to improve their memory.  They be 40 or 80 years old … does not make a difference.  Blame it on anesthesia or old age…memory enhancers as supplements are a big hit because people are so afraid to lose their memory!!!

Instead of trying your luck on these supplements which…forget it…DONT Work ( dont be fooled by their marketing strategies)… I have come accross a wonderfully written article giving us helpful tips to improve our memory : The Harvard Medical School Healthbeat issue:

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 Normal age-related changes in the brain can slow some cognitive processes, making it a bit harder to learn new things quickly or to ward off distractions. The good news is that, thanks to decades of research, most of us can sharpen our minds with proven, do-it-yourself strategies. Here are some ways to boost your ability to remember as you age.

1. Believe in yourself.
Myths about aging can contribute to a failing memory. Middle-aged and older learners do worse on memory tasks when exposed to negative stereotypes about aging and memory, and better if exposed to messages about memory preservation into old age.

2. Economize your brain use.
Take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. Designate a place at home for your glasses, keys, and other items you use frequently.

3. Organize your thoughts.
New information that’s broken into smaller chunks, such as the hyphenated sections of a phone number or social security number, is easier to remember than a single long list, such as financial account numbers or the name of everyone in a classroom.

4. Use all your senses.
The more senses you use when you learn something, the more of your brain will be involved in retaining the memory. For example, odors are famous for conjuring memories from the distant past, especially those with strong emotional content, such as the scent of your grandmother’s freshly baked cookies.

5. Expand your brain.
Widen the brain regions involved in learning by reading aloud, drawing a picture, or writing down the information you want to learn (even if you never look back at your notes). Just forming a visual image of something makes it easier to remember and understand; it forces you to make the information more precise.

6. Repeat after me.
When you want to remember something you have just heard or thought about, repeat it out loud. For example, if you’ve just been told someone’s name, use it when you speak with him or her: “So, John, where did you meet Camille?”

7. Space it out.
Instead of repeating something many times in a short period, as if you were cramming for an exam, re-study the essentials after increasingly longer periods of time — once an hour, then every few hours, then every day. Spacing out periods of study is particularly valuable when you are trying to master complicated information.

8. Make a mnemonic.
Mnemonic devices are creative ways to remember lists. They can take the form of acronyms — such as the classic “Every good boy does fine,” to remember the musical notes E, G, B, D, and F on the lines of the treble clef. For older learners, a particularly helpful system is a story mnemonic — that is, a brief narrative in which each item cues you to remember the next one.

9. Challenge yourself.
Engaging in activities that require you to concentrate and tax your memory will help you maintain skills as you age. Discuss books, do crossword puzzles, try new recipes, travel, and undertake projects or hobbies that require skills you aren’t familiar or comfortable with. 10. Take a course. Memory-improvement courses are becoming more popular. If you decide to try one, choose a program run by health professionals or experts in psychology or cognitive rehabilitation. Stay away from courses that center on computer or concentration games, which generally won’t help you with real-life memory problems. Select a course that focuses on practical ways to manage everyday challenges.

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I do recommend that we all try these exercises: they’re free, safe and effective!

Lets Keep Our Brains Healthy!

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

Why People Dont Exercise….

October 10, 2007

2533140067.jpgAs physicians, we always encourage people to be active. Patients know they need to exercise to feel better, to reduce their chances of developing diseases and of course to help “cure” and treat their ailments like arthritis or obesity.

It is therefore not surprising that in one survey done in UK that even the threat of premature death to NON exercising adults did not bother them to change their lifestyle.  In short… health may not be a primary reason for people to exercise! 

In that new survey by The British Heart Foundation,

  •  When the participants were asked if they would do more exercise if their lives depended on it… only 38% of the subject said YES!
  •  TAKE NOTE: Less than one-twentieth of UK adults say they find exercise enjoyable.

One important information we gathered from that survey is this alarming notion that HEALTH is not the Main reason for them to exercise:

  • The greatest motivation to exercise seems to be the desire to change one’s body shape especially among younger adults and women.  And this maybe true worldwide!
  • About one-in-three young adults said that if they saw an unflattering photo of themselves they would do more exercise. And again this is common sense reason but not sufficient enough to be the prime motivator!
  • Only 7% of women and 13% of men has their main motivation for doing exercise is to maintain a healthy heart.  Whew… just SAD!!!!!

According to the British Heart Foundation, the rate of death in UK is one every fifteen minutes because people did not do enough exercise.  But in spite of all these information, doing exercise is not a priority!

This survey is so important to all of us because indeed THIS IS REALITY!  Look around you or even ask yourself…what are you doing NOW to help keep yourself healthy?  Are you exercising enough or following your doctor’s recommendation to exercise?  OR still the same…reasons after reasons for NOT exercising!

Please do visit my other posts on exercise and physical activity tips because doing the right exercise does not mean going to a gym but just staying home!

Do Your Body Some Help…Exercise For Health!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts | 2 Comments »

The Good and The Bad Cholesterol…

October 9, 2007

2840505959.jpgWe know the bad effects of cholesterol in our body.  Marketing strategies have incorporated cholesterol as part of the game plan: low fat,  low cholesterol, no cholestrol in their products.  As physicians, we also take note of patients lipid profile which gives us the whole picture on patients cholesterol profile.  It is therefore not sufficient to jut check a total cholesterol because ones total cholesterol may be high because of a high Good cholesterol or HDL.  Targeting the BAD cholesterol or LDL has been the mainstay in our practice especially among our patients with high blood pressure and diabetes.  Our goal is to reduce a patient’s risk to suffer from a stroke or heart attack! 

But is lowering LDL or the bad cholesterol enough to decrease a patients risk?  And how important is the Good cholesterol in the equation?

Recently a study published in the NEJM September issue  looked at this specific question and showed that Both should be addressed.  

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Background High-density lipoprotein (HDL) cholesterol levels are a strong inverse predictor of cardiovascular events. However, it is not clear whether this association is maintained at very low levels of low-density lipoprotein (LDL) cholesterol.

Methods : A post hoc analysis of the recently completed Treating to New Targets (TNT) study assessed the predictive value of HDL cholesterol levels in 9770 patients.

Results : The HDL cholesterol level in patients receiving statins was predictive of major cardiovascular events across the TNT study cohort, both when HDL cholesterol was considered as a continuous variable and when subjects were stratified according to quintiles of HDL cholesterol level.

Even among study subjects with LDL cholesterol levels below 70 mg per deciliter, those in the highest quintile of HDL cholesterol level were at less risk for major cardiovascular events than those in the lowest quintile (P=0.03).

Conclusions: 

  •  In this post hoc analysis, HDL cholesterol levels were predictive of major cardiovascular events in patients treated with statins.
  • This relationship was also observed among patients with LDL cholesterol levels below 70 mg per deciliter.

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Lowering the LDL or bad cholesterol will remain the primary goal of therapy while not neglecting to make sure that the HDL should be made higher than 45 mg/dl.  Dietery intervention can only do so much in lowering LDL but we have ways to increase the HDL by dietary and behavioral means including exercise.Do check my post on How to Increase Your HDL for further tips in what to eat and do to improve your HDL!

In Health: Its The Balance Between the Good and The Bad!

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

Eating Together As A Family… Is Healthy!

October 5, 2007

2746116766.jpgSpending quality time with your kids have a lasting impact not only in the way children will remember us as caring parents but have been shown to have lasting impact in the way these kids eat as adults.  The way kids eat help the way they shape their health because lifestyle habits have been shown to have the most impact if started early in life!

A new study that looked at the impact of eating together as a family involved more than 1,500 students surveyed once during high school and again when they were 20 years old specifically ” to determine the long-term effects of family meals on diet quality, social eating, meal structure and meal frequency.” This study published in  September Journal of the American Dietetic Association gives us a glimpse that the truth of all the problems we have now in terms of poor eating habits among our children may stem from the fact that we may not be spending enough time with our kids….

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The Objective: To describe meal patterns of young adults and determine if family meal frequency during adolescence is associated with diet quality, meal frequency, social eating, and meal structure during young adulthood.

Surveys and food frequency questionnaires were completed by 946 female students and 764 male students in high school classrooms at Time 1 (1998-1999; mean age 15.9 years) and by mail at Time 2 (2003-2004; mean age 20.4 years).

Results:

  • Family meal frequency during adolescence predicted higher intakes of fruit, vegetables , dark-green and orange vegetables, and key nutrients and

  • Family meal frequency was associated with lower intakes of soft drinks during young adulthood.

  • Frequency of family meals also predicted more breakfast meals in females and for both sexes predicted more frequent dinner meals.

  • Family Frequency also was associated with higher priority for meal structure , and higher priority for social eating.

Conclusions : Family meals during adolescence may have a lasting positive influence on dietary quality and meal patterns in young adulthood.

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There you go my friends.  Children need our help, our support and our guidance.  They should be taught well the younger they are the better! They need our company not only for fun but to know whats right and proper…including choices of the right healthy food!  Meaning as parents we should also set the right example of what to eat and what NOT to eat!

Make sure we take time to earn a living but not to forget that we have other obligations to our children and family!  Its should be a good balance in life that one should aim for… that can make one a better person both as a family man and as a good individual in the society.

Ensure the health of our children… one way is to….

Spend More Time With Your KIDS!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity | 2 Comments »

On Why America Is Becoming Overweight!

October 4, 2007

231112061.jpgAmerica as a nation is really becoming “overweight”.  Inspite of what we know about obesity and its dreaded complications, the urge to eat or the habit to enjoy food continues to be a challenge especially among Americans.

During this recent trip to San Antonio, Texas… everything seems to be status quo.  Nobody seems to care about the kind of food that is being ordered or served in the restaurants to the amount or serving sizes that everyone is given as choices.  Or are there choices?  It seems that if one orders the regular portions of food, you just cant seem to finish them all… but I guess to them… these portions are but the routine servings that they know of since they were kids! I guess this comes to what they been exposed to since childhood…they see what their parents eat and therefore its the norm!

Steaks abound in every resto we go to.  With the food comes mashed potastoes…and you are given the choices of butter, mayonnaise or garlic.  Not a simple boiled potato but a potato laced with other stuff! Next comes the salad…but its laced with fat because of its dressing! Whew…. you really can gain weight in America!  So am just happy to be back home and settle with the usual small servings that we get and the way we cook our food.

Likewise… am not sure but I think BUFFET was discovered in America.  This has made matters worst!  The problem is… we are also starting to be enjoying buffets and you can see it being offered by our local restaurants as well.  No wonder, our country is one place that is expected to have a dramatic rise in obesity in the Asia Pacific region.

Am not sure how the US will be able to combat her battle of Obesity. Its the attitude that should change… and should start from the young!

Otherwise…San Antonio as a city was pretty quiet, rich in history and remarkably safe as we only rented a car and drove the place on our own to explore!  Of course, my friends and I did this only after we have studied and learned the newest things in Endocrinology during this past year.

It’s What We Eat That Counts!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, The Truths on Obesity | Leave a Comment »

The Danger of Eating French Fries…or Why Trans Fat Is Bad!

September 15, 2007

I have been an advocate of avoiding fried foods.  However firm we are in avoiding frying foods, you sometimes cant help and avoid enjoying eating foods that are fried…not only are they crunchy but they also taste so good.  So resisting the temptation to enjoy great food is difficult. But at the expense of health and heart attacks!

I came across a recent article in the Harvard Medical School Health Publication: HealthBeat which I want to share especially to parents who allow their kids to enjoy french fries almost at every meal.

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 If you needed another reason to avoid trans fats, here it is. Researchers with the ongoing Nurses’ Health Study measured the amount of trans fat stored in red blood cells. Among the 32,000 middle-aged women participating in the study, 166 had heart attacks or died of heart disease during a six-year period. Their red blood cells had slightly higher loads of trans fat than did red blood cells of 327 women of the same ages and characteristics who remained free of heart disease.

Artificial trans fats are found in hard margarines, many commercially baked goods, and the fried foods in many restaurants, and research has consistently shown they aren’t good for the heart and blood vessels. Across the board, the more trans fat in red blood cells, the greater the chances of having a heart attack. Women with the highest trans fat load had triple the risk of women with the lowest. This study, published in the April 10, 2007, Circulation, strongly supports recommendations by the Institute of Medicine and the USDA’s Dietary Guidelines for Americans to cut back — or better yet, cut out — trans fats in the diet. Eliminating them from the food supply could avert as many as 264,000 heart attacks and heart-related deaths each year in the United States alone.

Trans Fats at Home and Abroad

A prime source of trans fat is partially hydrogenated oil, which many fast-food restaurants continue to use for deep frying. To see if this differed by country, three Danish doctors determined the trans fat content of French fries and chicken nuggets bought in 24 McDonald’s and KFC restaurants on four continents. As shown above, a large fries-and-nuggets combination delivered 10 grams of trans fat in New York City but less than a gram in Denmark, which limits the use of trans fats. A similar serving of fries and chicken nuggets in a KFC in Hungary delivered a whopping 25 grams of trans fat.

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Anothr reason to be alarmed over what we preceived a s a way of showing affection and reward to our kids… Crunchy fried chicken and french fries.  If we indulge in these kinds of foods once in a while or only during children’s parties .. its acceptable BUT if our kids eat only fried foods because that’s the only food they will eat then it will do no good to their future!

Start training them young.  My friend Maxim is one nice guy to dine with because he’s health conscious and therefore you tend to follow what he eats or be conscious of what you order.  And I guess there is so much truth to the study that showed…if your friends are obese, the more likely you will too….

A Feast with French Fries is A Feast with Trans Fat!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, The Truths on Obesity, Tips To Protect Your Heart | 6 Comments »

What Does SPF mean?

September 8, 2007

While in Vienna, my wife always remind me to put on a sunscreen for my face.  It is always a struggle because I hate putting stuff on my face.  But being exposed to the sun with the travels and the dry weather, I obliged.  But what SPF is important to protect our skin?

We all know that sunscreens have long been promoted extensively against skin cancer.  However, it is reported that skin cancer rates continue to creep up, at about 3 percent a year according to the U.S. Centers for Disease Control and Prevention. Most likely because people ignore warnings and still bask themselves in the sun!  But most likely too, these people are protecting themselves with sunscreen…so what is wrong?

The U.S. Food and Drug Administration at the present time only allows manufacturers to only market products with a Sun Pretection Factor or SPF 30-plus on their labels, since they believe that any higher value is misleading to consumers. The belief that sunscreen is all you need to ward off the bad effects of the sun is apparently wrong.  Likewise the belief that the higher the SPF the better protection because it can last longer is also questioned.

It is advised that if you know you will burn under UV exposure in 10 minutes and you use the product with an SPF of 15 then the protection using this sunscreen will last for 150 minutes or 2 1/2 hours.  The problem is… in reality this is not so because, the sunscreen wears off with sweat or can be rub off easily after a dip in the water.  Be aware therefore that the protection you get is less than what you think. 

So, per guidelines… the recommendation is :

  • aim for a product with an SPF of 15 or higher.  But remember that the higher the SPF, the higher the protection agianst UV BUT not necessarily LONGER in protection!
  • Re apply the lotion after 30 min to 1 hour under the sun unless you dont sweat at all!  And more frequently if you swim.

There you go…. now after this post… I will follow my wife’s advise and try to use sunsscreen everyday.  But more so I guess to protect my face from early wrinkles.  So guys… protect your face will a daily sunscreen before it’s too late!

Daily Sunscreen For Baby Face!

Posted in Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts | 1 Comment »

Just A Plate A Meal…To Make You Lose Weight

August 27, 2007

I’ve been counseling my patients with regard to a meal that they should only eat the foods that can fit in a plate and that’s it! I have written about it here in my website: The Will Power To Stop the Urge To Eat suggesting that the food should consist of rice, 2 slices of meat, 2 cups of vegetables and a fruit.  I was actually happy to know that a August 2007  article in the Harvard Health Letter recommends the same concept:

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Balance your plate

Balance Your Plate

A balanced plate helps you reduce your total calories, reduce the saturated fat and carbohydrates in your diet, and increase heart-healthy nutrients like antioxidants, B vitamins, and fiber.

It’s also important to make sure you’re getting all the important nutrients your body needs. Here’s an easy way to see if you’re eating a well-balanced meal. As you prepare or serve your food, think of a three-section plate.

In the big section (half of the plate), serve yourself two different vegetables or a vegetable and a fruit. In one of the two smaller sections (a quarter of the plate), put a serving of fish, poultry, beans (like black, pinto, or kidney beans), or another healthy protein. Fill the remaining section with a whole grain, such as brown rice or a whole-wheat roll, or another healthy carbohydrate.

As you divide your plate, keep in mind that vegetables are not all the same. Starchy vegetables-sweet potatoes, peas, corn, and winter squash-have about triple the amount of calories and carbohydrates as nonstarchy vegetables. So reserve the vegetable section for the likes of broccoli, leafy greens, tomatoes, carrots, and green beans. And put starchy (but nutrient-filled) vegetables in the carbohydrate quarter.

A balanced plate helps you reduce your total calories, reduce the saturated fat and carbohydrates in your diet, and increase heart-healthy nutrients like antioxidants, B vitamins, and fiber.

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Simple and Balanced… Easy to remember.  It is the concept and remembering it that counts.  I have been sticking to this simple formula for a long time and I myself is doing this to limit and balance my meals.  Likewise this is one way to limit intake and therefore lose weight.

BUT on very important maneuver to do to make this diet a success is to avoid further visual stimulation by leaving the table after consuming the food in the plate!  Otherwise the temptation to eat more will overcome the discipline to eat the balanced meal prepared on the plate!  Guilty? 

A Balanced Diet In A Plate For Health!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips, Weight Loss Tips | 1 Comment »

The Importance of An Annual Check Up

August 25, 2007

2713261149.jpgDo we need annual physical exam? Why and How soon?

Actually there is still an ongoing debate as to whether annual exam is necessary or helpful.  Several institutions have abandoned the requirement of subjecting healthy subjects to this annual routine.  But in a recent survey published in the Archives of Internal Medicine … majority of the doctors and patients alike i.e. 9 out 10 surveyed out of the 800 still believe that annual physical exam do more benefits than harm.

In a recent publication from the Annals of Internal Medicine, Feb 2007 issue, a study was done to determine if indeed it is beneficial to have one:

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Data Synthesis: The best available evidence assessing benefits or harms of the Physical Health Exam or PHE consisted of 21 studies published from 1973 to 2004. The PHE had a consistently beneficial association with patient receipt of gynecologic examinations and Papanicolaou smears, cholesterol screening, and fecal occult blood testing. The PHE also had a beneficial effect on patient “worry” in 1 randomized, controlled trial but had mixed effects on other clinical outcomes and costs.

Conclusions: Evidence suggests that the PHE improves delivery of some recommended preventive services and may lessen patient worry. Although additional research is needed to clarify the long-term benefits, harms, and costs of receiving the PHE, evidence of benefits in this study justifies implementation of the PHE in clinical practice.

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This study has showned that one or more well visits per year may actually be beneficial to patients and doctors alike by improving patient- doctor relationship as well as alleviate patient’ worries.

By having an annual exam, one is able to check the onset of certain conditions where the abnormality will not show symptoms but may manifest initially with a biochemical or laboratory abnormality.  Healthy subjects specifically with a family history of known inherited conditions like diabetes, hypertension or high cholesterol will definitely benefit by having one.  More so with patients whose parents have a history of tumors or cancers of whatever organ should have routine annual exam.

Routine tests that have been shown to be beneficial in screening includes a fasting blood sugar, liver function tests, lipid profile to check cholesterol, occult blood and urinalysis.  Certain procedures like pap smear and breast exam for women are also beneficial since early detection and diagnosis of cancer have a big impact in terms of disability and survival.  What’s more, there did not appear to be any harm associated with period health exams, including undergoing inappropriate tests or excessive costs.

So when should one have an annual health exam? 

  • If you have a family history of chronic diseases like diabetes or heart disease … I would recommend to do the exam ealrier after the age of 30.  Majority of heart attacks is due to diabetes and the early a diagnosis of diabetes is done the better is the outcome in terms of control and prevention of complications. 
  • Between the age of 40 to 50 if you have a family history of certain tumors where occult blood testing or flexible sigmoidoscopy would be helpful
  • Otherwise after the age of 50 should be a reasonable age to do the annual exam for an otherwise healthy individual.

As the saying goes: 

It Is Better To Be Early Than Sorry…

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts | 5 Comments »

Grapefruit and Your Medications…

August 24, 2007

2592766622.jpgIt is very important that one should be careful with food to drug or drug to drug interactions.  It is for this reason that as physicians, we are so careful in allowing our patients to take any medications without our knowledge.  Chinese medications for example can be a headache because patients can just buy them anywhere.  They work BUT what do they contain and what are the side effects?

Similar problems can be encountered with foods like fruits.  Take grapefuit as an example. I was asked this question several times so I thought of sharing this information to all.

There’s no question that grapefruit juice provides many nutrients, such as vitamin C and lycopene or fiber that can help lower cholesterol and triglyserides.  But  the pulp and the peel can also contain chemicals that can affect the actions of certain medications by interfering with the enzymes that break down the drugs in your digestive system. This interaction can be deleterious as the patient can have an excessively high levels of the active drug compound resulting in an increased risk of serious side effects.

This caution includes dietary supplements that contain grapefruit bioflavonoids – because in itself…it can also interact with certain medications. So be sure to read labels of your viatmins that may contain this compound.

Below is the list of drugs that one should avoid if you are a fan of grapefruit or better still take caution with these drugs if you eat grapefruit.  The list came from the Mayo Clinic Health Site.

Grapefruit and drug interactions
The following drugs are known to have potentially serious interactions with grapefruit products, tangelos and Seville oranges.
Drug name Type of drug
Carbamazepine (Carbatrol, Tegretol) An anti-seizure medication
Buspirone (BuSpar), clomipramine (Anafranil) and sertraline (Zoloft) Antidepressants
Diazepam (Valium), triazolam (Halcion) Tranquilizers
Felodipine (Plendil), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular) and possibly verapamil (Isoptin, Verelan) Calcium channel blockers used to treat high blood pressure
Saquinavir (Invirase) and indinavir (Crixivan) HIV medications
Simvastatin (Zocor), lovastatin (Mevacor, Altoprev) and atorvastatin (Lipitor), simvastatin-ezetimibe (Vytorin) HMG-CoA reductase inhibitors used to treat high cholesterol
Cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf) and sirolimus (Rapamune) Immunosuppressant drugs
Amiodarone (Cordarone) A drug used to treat and prevent abnormal heart rhythms (arrhythmias)
Methadone Pain relief medication
Sildenafil (Viagra) Erectile dysfunction medication

Other sources of Vitamin C like oranges, and lemons are okay to eat and have not been shown to affect drug levels.

Remember, the effect of this food to drug interaction can last from 1 to 3 days so please advise your doctors especially if you are taking certain drugs whose level if they go up can have serious effects like the blood thinning medication warfarin or coumadin.

The bottom like is: … dont take anything without checking!  Please be very cautious in taking supplements or chinese medications. Check with your doctors first.  Dont believe your friends or the advertisers that they’re safe!

I guess it’s the same thing in business and personal relationships … dont get into something that you are not sure of because trouble will hit you and hit you HARD!!!!

Better To Be Sure Than SORRY!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips, Personal Thoughts | 2 Comments »

The Many Benefits of Walking…

August 17, 2007

imagesedg.jpgIs walking good? Is it enough as an exercise? Or Do we need to do more intense exercise to achieve benefit?  I love to walk…it’s my form of physical activity every afternoon after work.  I have fun doing it walking around the house or around our subdivision.  You can enjoy the view while walking… you can do it anytime and anywhere and the most important of all is that…It is FREE!

Dr James Levine who is a colleague of mine at the Mayo Clinic wrote a nice editorial at the

Mayo Clinic Proceedings based on this news report from the Mayo Clinic newsroom:

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“Getting out there and taking a walk is what it’s all about,” says James Levine, M.D., Ph.D., and a Mayo Clinic expert on obesity. “You don’t have to join a gym, you don’t have to check your pulse. You just have to switch off the TV, get off the sofa and go for a walk.”

The health benefit associated with walking is the subject of Dr. Levine’s editorial in the July issue of Mayo Clinic Proceedings. Dr. Levine’s piece is entitled, “Exercise: A Walk in the Park?” and accompanies a Proceedings article that showcases the merits of walking as beneficial exercise.

The study, undertaken by physicians from the Shinshu University Graduate School of Medicine in Matsumoto, Japan, determined that high-intensity interval walking may protect against high blood pressure and decreased muscle strength among older people.

Over five months, the Japanese researchers studied 246 adults who engaged in either no walking or moderate to high-intensity walking. The group who engaged in high-intensity walking experienced the most significant improvement in their health, the researchers found. In his editorial, Dr. Levine says the study lends credence to the notion that walking is a legitimate, worthy mode of exercise for all people. Dr. Levine says it’s a welcome message for his patients, who fight obesity and appreciate that a walk is one way to improve their health.

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It is therefore a package deal…you walk…you exercise as well as keep your health in control. There is no way I will accept any patient of mine telling me he has no time to exercise because walking can be done anywhere and anytime!

Do it now and this very minute… after reading this article…turn off your computer or TV for a while and take a stroll.  In simple terms…Just move.  It is much better than staying put and be sedentary.

Life is too short…enjoy your surroundings and walk because once you get the dreaded complication of obesity and diabetes which is a stroke or heart failure…you will end up in bed for the rest of life anyway…by then…you will miss walking!

Take A Step Forward Now For Health!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, Tips To Protect Your Heart, Weight Loss Tips | 6 Comments »

How To Keep Family Safe From HARM…

August 7, 2007

Safety is of paramount importance to us especially our kids.  With the news surrounding us regarding safety concerns of products made in China from too much formalin in certain package foods to lead content in kids toys…it is but prudent to also be vigilant with regard to food safety in our own homes.

Here are some tips that I got from the Harvard Health Letter that I want to share and hopefully help us make our home safer. Here is a summary of some of the problematic bacteria you want to protect your family from include:

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E. coli. This bacterium, found mainly in ground beef, causes an estimated 25,000 cases of food poisoning in the United States each year and kills about 100 people. Some people infected with E. coli suffer permanent kidney damage. Contamination occurs during meat processing, when E. coli from the animals’ intestines becomes mixed in with the meat.

Salmonella. This bacterium is found mostly in meat and eggs. But it spreads to other foods, such as ice cream and fruit, when they are shipped with contaminated meat or eggs.

Campylobacter. This bacterium is especially common in poultry. Antibiotic-resistant strains are becoming more prevalent because of the widespread use of antibiotics in chicken feed. In a 2001 report in the New England Journal of Medicine, 17% of chickens sampled in supermarkets in four states had campylobacter strains that were resistant to antibiotics.

You can prevent most cases of food poisoning in your household by preparing and storing your foods safely.

  • Rinse foods. Rinsing can wash off some germs from meat, poultry, and fish and pesticide residues from produce. Rinse all meat, poultry, and fish under running water before cooking. Rinse all fruits and vegetables under running water before cooking or serving them.
  • Wash your hands. Frequent handwashing helps prevent you from passing germs from one food to another. Use soap and water to wash your hands each time you handle a raw food. Don’t wipe your hands on a dishtowel without washing them first.
  • Use separate utensils. Don’t prepare meat and fish on the same surface that you use for other foods — otherwise, you risk contaminating those foods with bacteria from the meat and fish. Use one cutting board for meats and fish and a second one for produce. Be sure to wash the cutting boards with soap and water after each use. Use different knives to cut different foods to prevent cross-contamination.
  • Cooking. Cook all meat, poultry, eggs, and freshwater fish. Don’t rely on color alone to indicate whether meat is fully cooked. The USDA recommends that everyone use a meat thermometer. Different temperatures are required to kill off germs in different kinds of meat. It’s also important to cook hot dogs and other precooked meats and fish, to destroy bacteria that may have contaminated them in the processing plants.
  • Storing. Don’t leave any foods, before or after cooking, at room temperature for more than two hours (one hour if the air temperature is above 90° F). Put them in the refrigerator or freezer. The temperature inside your refrigerator should be 40° F or below; your freezer should be at 0° F or below.
  • Divide The Leftovers. If you have large amounts of leftovers, divide them into small batches when you put them away in the refrigerator or freezer. That way, the temperature of each batch will reach a safe level faster. Keep in mind that freezing does not necessarily kill bacteria; wash meats and poultry thoroughly after thawing, and handle them the same as you would fresh meats. 

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Watch the things we buy…Plan ahead the meals we’ll serve and be sure to follow simple rules of home safety. 

Remember as mentioned in my previous post to avoid storing your leftover foods in take- away plastic containers because they have been shown to be harmful if reused! 

Just a simple reminder to keep us all from harm….

Plan and Ban The Harm! 

Posted in General Health Tips, Healthy Practice Tips, Personal Thoughts | Leave a Comment »

Are You FAT But FiT?

August 4, 2007

3283079462.jpgYou maybe Fat but Fit and as a result your risk to develop heart disease is actually lower than your counterpart who Fat and Unfit!  This according to a new study published in the Archives of Internal Mediciane, July issue. 

Below is the summary of the study as published in heart.org:

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“Arsenault et al studied 169 asymptomatic men with diabetes mellitus who were participating in the Quebec Family Study, a population-based study of French Canadian families living in and around Quebec. They measured abdominal adipose tissue accumulation, cardiorespiratory fitness (CRF), and indexes of plasma glucose-insulin homeostasis and lipoprotein-lipid profiles.  

After matching individuals with similar BMIs, men with low CRF were characterized by more visceral adipose tissue accumulation than men with high CRF (mean 114.4 cm2 vs 87.8 cm2; p<0.007) and by a poorer metabolic profile. When matched for visceral ( Abdominal) adipose tissue accumulation, however, such differences were no longer significant.

“This study underlines the importance of visceral (abdominal) adipose tissue or fat accumulation in the previously reported association between CRF and metabolic complications predictive of coronary heart disease and type 2 diabetes mellitus” .

“Our results suggest that visceral abdominal tissue accumulation could be a key confounding factor when the relationship of CRF, coronary heart disease risk, and metabolic syndrome is examined.”

Physical activity should be promoted, irrespective of age, sex, or degree of obesity as a measure to reduce adiposity, to increase energy expenditure, and to potentially decrease atherogenic visceral adipose tissue mass, they conclude. “

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There you go… being fat may not actually mean poor health risk RATHER it’s the cardiovascular fitness level or the Physical Activity that counts.

The more active we become…the less evil is our fat and the less likely we develop the outcomes of the disease of obesity!

Being FIT Matters….

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, The Truths on Obesity | Leave a Comment »

The Protective Effect of Mediterranian Diet

August 3, 2007

imagesafg.jpgA diet that’s high-fat… because of the large amounts of monounsaturated fatty-acid-rich olive oil used in Mediterranean cultures—may be a useful tool against blocking of the arteries, particularly in individuals at high risk of developing heart disease.

A new study looking at High Mononunsaturated Fat( MUFA) diet has finally proven the proponents of this diet to be protective was recently published in the June 11, 2007 issue of the Annals of Internal Medicine.

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Interventions: Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months.

Results:  Compared with the low-fat diet, the 2 Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were –0.39 mmol/L (95% CI, –0.70 to – 0.07 mmol/L) and – 0.30 mmol/L (CI, –0.58 to – 0.01 mmol/L), respectively, for plasma glucose levels; –5.9 mm Hg (CI, –8.7 to –3.1 mm Hg) and – 7.1 mm Hg (CI, –10.0 to –4.1 mm Hg), respectively, for systolic blood pressure; and –0.38 (CI, –0.55 to – 0.22) and – 0.26 (CI, –0.42 to –0.10), respectively, for the cholesterol–high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet.

 Conclusion: Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.

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In short… participants in the two Mediterranean-diet groups had significantly lower mean plasma glucose levels, lower systolic blood pressure, and lower total-cholesterol/HDL-cholesterol ratios than those in the low-fat-diet group… which may explain the protective effects of this diet to develop heart disease.  

So what diet Do I recommend to my Patients? 

Ive been proponent of a 40% of total calorie diet to be from fat with 20% of total calories from MUFA.  Ive been pretty successful with this diet in terms of regulating my patients Blood sugar and lipids while maintaining their weight!  This study really proves me right. 

You will not go wrong having a diet rich in fruits and vegetables and supplemented with virgin olive oil and nuts…it’s a diet proven to  improve cholesterol ratios and the effects on blood pressure and inflammation.   One option to Olive oil that we can use daily in our cooking is Canola Oil which is also rich in MUFA and PUFA.  Likewise taking walnuts or cashew nuts for snacks as healthy alternatives to burgers and fries!

As The Saying Goes…GO NUTS!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Tips To Protect Your Heart | 1 Comment »

How To Exercise The Right Way

August 2, 2007

4143585627.jpgWe know we need to exercise.  We are often told to be active most days in a week if we want to lose weight or just 20 to 30 mintues 3 x a week for cardiovascular workout.

BUT what’s the BEST way to do it?… do we exercise 1 hour straight? or is it better to have a rest period in between activities to burn fat effectively?

Excerpts from the Study of Dr Goto published in the Journal Of Applied Physiology…. 

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This study compared the fat metabolism between “a single bout of prolonged exercise” and “repeated bouts of exercise” of equivalent exercise intensity and total exercise duration. Seven men performed three trials: 1) a single bout of 60-min exercise (Single); 2) two bouts of 30-min exercise, separated by a 20-min rest between exercise bouts (Repeated); and 3) rest.  In the Repeated trial, serum free fatty acids (FFA), acetoacetate, and 3-hydroxybutyrate concentrations showed rapid increases (P < 0.05) during a subsequent 20-min rest period. During the second 30-min exercise bout, FFA and epinephrine responses were significantly greater in the Repeated trial than in the Single trial. 

The relative contribution of fat oxidation to the energy expenditure showed significantly higher values (P < 0.05) in the Repeated trial than in the Single trial during the recovery period.

These results indicate that repeated bouts of exercise cause enhanced fat metabolism compared with a single bout of prolonged exercise of equivalent total exercise duration.

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In simple terms… it’s better to rest in between exercise activity than a single prolonged activity.  The rest period most likely made the tissues and body more efficient in burning more fat especially during the repeat exercise after the rest!

Meaning Rest in between activities is a good way to burn more calories and have time to take a breathier in between workouts!

My advise?  Exercise for 30 minutes then take a rest for 10 to 15 minutes then take a plunge to more activites again before heading back home….

What A way To Rest and Burn More Calories!

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

How Much Salt Can We Take?

July 28, 2007

imagessd.jpgThe new recommendations from the American Medical Association should be a wake up call to all of us.   We know that salt is important for the taste of our foods but taking too much can be harmful.  As physicians weve been harping on lowering salt intake to our patients when they prepare their foods not recognizing that the culprit may actually be food in the restaurant and the processed foods we buy in the groceries!

We know from studies that populations with an average sodium ingestion of less than 1400 mg/day have virtually no hypertension BUT the average intake of salt in the world is around 4000 mg per day while Filipinos usually take in more.  This is way above the recommended daily allowance of 2000 to 2300 mg per day.   

The recently published advisory in the Archives of Internal Medicine, July issue urged the Food and Drug Administration to take a look at the standards set for salt and to limit sodium in processed and restaurant foods. It is recommneded that a minimum 50% reduction in sodium in processed foods, fast-food products, and restaurant meals should be sought in the next decade it we have to decrease the risks associated with high blood pressure. More so to address the labelling of products known to contain High Salt levels.

The AMA paper has this to say: 

“Across populations, the level of blood pressure, the incremental rise in blood pressure with age, and the prevalence of hypertension are directly related to sodium intake. Observational studies and randomized controlled trials document a consistent effect of sodium consumption on blood pressure. The majority of sodium consumption in the United States is derived from amounts added during food processing and preparation. Leading scientific organizations and governmental agencies advise limiting sodium intake to 2400 mg or less daily (approximately 6000 mg of salt). Substantial public health benefits accrue from small reductions in the population blood pressure distribution. A 1.3-g/d lower lifetime sodium intake translates into an approximately 5-mm Hg smaller rise in systolic blood pressure as individuals advance from 25 to 55 years of age, a reduction estimated to save 150 000 lives annually.

With an appropriate food industry response, combined with consumer education and knowledgeable use of food labels, the average consumer should be able to choose a lower-sodium diet without inconvenience or loss of food enjoyment. In the continued absence of voluntary measures adopted by the food industry, new regulations will be required to achieve lower sodium concentrations in processed and prepared foods.”

A Pinch Of Salt For A Healthy You!

 

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Tips on Hypertension, Tips To Protect Your Heart | 2 Comments »

Can Diet Coke Cause Heart Disease?

July 25, 2007

212693807.jpgI usually allow my patients to drink soda as long as it is a “diet” or “light” soda…meaning, no sugar added but the sweetness is plainly due to an approved sweetener.  I usually caution them to drink only 1 can a day and not more.  The only concern I have is the amount of sodium in the soda rather than it causing harm to my diabetic patients.  It is therefore rather surprising to me that a study published in Circulation July 24 issue came up with a warning that “drinking more than one soda a day — even if it’s the sugar-free diet kind — is associated with an increased incidence of metabolic syndrome, a cluster of risk factors linked to the development of diabetes and cardiovascular disease.”

The study is not the ideal study population or method that can come up with a firm conclusion or assoiciation since this is a population based study where more than 6,000 participants in the Framingham Heart Study were followed up since 1948.  The study found that after four years of the study, “people who consumed more than one soft drink of any kind a day were 44 percent more likely to develop metabolic syndrome than those who didn’t drink a soda a day.”

Theories as to why this happen are intriguing steming from the fondness of sugary foods among people drinking soda to the caramel content of the soda promoting metabolic changes in the body.  Unfortunately, this study only proves a possible association and cannot in itself infer causality.  In other words…There is no proof that soda in itself is the culprit until further studies on causality can be done.

So if you love soft drinks then I would recommend allowing yourself to enjoy a”diet” or a “light” soda and only 1 can per day.  Overconsumption of a certain food does not allow one to prevent a disease by consuming more of a certain beverage even if it deemed safe by the medical community.

So…Can Diet Coke Cause Heart Disease? 

I doubt it.  This is only an observational study.  The same kind of method that initially suggested that Estrogen hormone therapy can lower ones risk for heart disease but eventually when a randomized prospective study was done… hormone replacement therapy actually increased ones risk for heart disease. BUT the study for me tells us only one thing: that even if it is “diet and has zero calories does not mean it is safe to over indulge!

The American Heart Association continues to recommend low calorie beverage as a good option for a healthy meal and likewise issued a statement :

“Since this is an observational study, it is important to note that the study does not show that soft drinks cause risk factors for heart disease. It does show that the people studied who drank soft drinks were more likely to develop risk factors for heart disease.

“However, it is possible that other factors could explain this relationship. Often people who drink soft drinks also eat and drink more calories, saturated fat and trans fat and less fiber and dairy products. Also, these people tend to be less physically active. This was true among the subjects in this study.”

So for me … the verdict is in:

It’s the LIFESTYLE Not The Drink! 

Read My Other Related Posts:

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, The Diabetes Facts | 6 Comments »

How Much Exercise To Prevent Diabetes?

July 23, 2007

imageswer.jpgExercise and exercise…we know its benefits.  But one thing that really makes me exercise is my risk to develop Diabetes.  We know we can prevent this disease by behavioral therapy like taking care of ones diet and physical activity but doing the exercise for an hour can be TOO MUCH! A lot of friends buy the exercise gadget including the famous treadmill machine…but bet you, if I survey on this site how many of you out there has this machine but has no longer been used it for more than a year?  Any takers?

According to the U.S. Centers for Disease Control and Prevention (CDC) “one in three American children born in 2000 will develop type II diabetes!!!!” So parents take note: 1 in 3. As much as we want to pamper our kids for the lack of time we sometimes spend with them…be the parents or the grandparents who usually spoil these kids ( smile)  with candies, burgers and ice cream… Be AWARE!

But there’s hope:  new study at the University of Missouri-Columbia says that acute exercise — as little as 15 minutes a day — can have a profound influence on preventing and fighting the disease.  That’s easy!!!! 15 minutes is definitely manageable to anybody and am one of those that finds this study rewarding to all of us who feel disappointed about the need to really do the workout for an HOUR! But for guys who just dont have the time…read my other article below this…

This exercise activity is not the exercise of daily living BUT an acute form of exercise which is a bout of activity in which people Actively Participate!!!.  Activities like running, walking or biking for straight 15 minutes!

Remember there is no limit as to the impact of exercise on this disease… it has been proven to be effective at all levels.  Whether you are still trying to ward off this disease because of obesity or you are already a diabetic on medications or even if you are already on insulin for several yearts, exercise can make a difference in improving your body’s response to insulin.

A bit of good news for this week folks!

Only 15 Minutes Of Exercise Can Make A Difference!

Read My Other Related Posts:

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts | 3 Comments »

How To Live Longer Without Exercising!

July 20, 2007

3904728485.jpgBeing busy or too busy to exercise may not be bad after all….

A recent report from the Mayo Clinic may prove to be worth considering if we talk about the need to be more active to live long.  We all know the fact that increasing exercise not only prevents one from developing chronic illnesses associated with inactivity and obesity but also can make us feel better and live longer.

According to the March issue of Mayo Clinic Women’s HealthSource: marathon training or going to a gym is not required but by staying busy and active all day can do the trick.  Such activities that can help people live longer by expending more energy include household chores such as vacuuming, mopping the floor, washing windows, lawn work, caring for children or adults, walking or volunteering.

The study, published in the Journal of the American Medical Association, tracked 302 adults between the ages of 70 and 84 for six years.  The study showed that:

” Participants who had shown the highest energy expenditures due to more physical activities had about half the chances of dying of those with the lowest energy expenditures. Participants most likely to be in the high-energy group reported climbing stairs or working for pay as a daily part of their lives.”

There you go… being busy can mean healthier lives as long as people who are “too busy” for exercise,  can stay “too busy” around the house and at work, or in the community doing what they have to do and in return live healthier lives.

Great news to those busy bees…. just dont be geeks and be sedentary and “too busy” sitting in your chair facing your computers with only your fingers and mouths exercising.  Those activities dont count!

No More Excuses..Start Moving!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, The Truths on Obesity, Tips To Protect Your Heart | 3 Comments »

Dont Reuse Takeaway Plastic Containers

July 16, 2007

imageser.jpgJust came from Malaysia to attend an emergency meeting for 2 days and while going through the Malaysian Daily read an interesting headline: Plastic Peril.

The main message of the headline was that since takeaway plastic containers are made to be used only once…make sure you dont reuse them nor use them to store your food!  These plastic containers apparently dont have the sturdiness and thermal stability that are present in reusable plastic containers. 

Similar recommnedations were given for plastic mineral water containers…not only is it difficult to clean, the stability of the plastic is also questionable considering the heat and humidity of Malaysia similar to our country.

The recommendations were based on the study done by the Faculty of Medicine, University of Malaysia where in 45 containers examined …at least one chemical was detected in all.  Although the chemical content was low…repeated exposure can result in accumulation of these chemicals esepcially one particle called BBP or Benzyl Butyle Phthalate which in the long run can cause endocrine function abnormalities involving the thyroid and the pancreas!

I am sure a lot of us have the practice of reusing these containers we get from the restaurants and reusing them in reheating foods in the microwave stored in the fridge.  Now we know this is not advisable nor safe!  So always remember…..

Reusing Takeaway Containers Is  Harmful To Your Health!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits | 4 Comments »

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