Archive for the 'Lifestyle Measures' Category

Sleep Well To Prevent High Blood Pressure!!!

July 4, 2009

A simple measure to reduce BP is to have a good night’s sleep!!!

Here’s a new study that shows us one tip to have a better controlled blood pressure  published in Archives of Internal Medicine:

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BACKGROUND: Epidemiological studies have reported an association between self-reported short sleep duration and high blood pressure (BP). Our objective was to examine both cross-sectional and longitudinal associations between objectively measured sleep and BP.

METHODS: This study is ancillary to the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study. Blood pressure was measured in 2000 and 2001 and in 2005 and 2006. Sleep was measured twice using wrist actigraphy for 3 consecutive days between 2003 and 2005. Sleep duration and sleep maintenance (a component of sleep quality) were calculated. Analyses included 578 African Americans and whites aged 33 to 45 years at baseline. Outcome measures were systolic BP (SBP) and diastolic BP (DBP) levels, 5-year change in BP, and incident hypertension.

RESULTS: After we excluded the patients who were taking antihypertensive medications and adjusted for age, race, and sex,

  • shorter sleep duration and lower sleep maintenance predicted significantly higher SBP and DBP levels cross-sectionally as well as more adverse changes in SBP and DBP levels over 5 years (all P < .05).
  • Short sleep duration also predicted significantly increased odds of incident hypertension (odds ratio, 1.37; 95% confidence interval, 1.05-1.78).
  •  Adjustment for 16 additional covariates, including snoring and daytime sleepiness, slightly attenuated the associations between sleep and BP.

 CONCLUSION: Reduced sleep duration and consolidation predicted higher BP levels and adverse changes in BP, suggesting the need for studies to investigate whether interventions to optimize sleep may reduce BP.
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There you go guys… nake sure you sleep better..and rest well. 

Dont let worries or pressure bother you too much. 

Associate the bed with a good night’s sleep…  not only will you feel refreshed the next day BUT healthier too!

For a Healthier Heart… Sleep Well!!!

How To Exercise To Reduce Heart Disease…

June 30, 2009

We heard the news of Michael Jackson’s death.  It is known that Heart disease continues to be a leading killer worldwide.  Blame it to lifestyle and the world’s reliance to fast food and technology.  In parallel to the rise of heart disease is the rising prevalence of Diabetes and Obesity which I believe will no longer spare anyone because of the environment we are in and the kind of acitvities and lifestyle the next generation is in and will have!

It is therefore imperative that we deal with this rising prevalence of heart disease upfront and not relying heavily on medications to get us through!  Simple steps can be done but steps that need diligence, perseverance and discipline!  It is therefore best to start these steps NOW than later!

I myself am doing these steps NOW and not later when I will get the disease of Diabetes due to age and strong family history. 

The recent guideline of the American Heart Association is timing to the events around the world. 

There’s no better time than now to emphasize lifestyle change and exercise but now!  So what do we recommend?

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To improve cardiovascular risk, it is recommended that patients with T2DM accumulate a minimum of 150 minutes per week of at least moderate-intensity and/or 90 minutes per week of at least vigorous-intensity cardiorespiratory exercise.

In addition, resistance training should be encouraged. These guidelines can be achieved with varying contributions of moderate- to vigorous-intensity cardiorespiratory exercise.

Patients should train on at least 3 nonconsecutive days each week to maximize benefits. Individual sessions should last for no less than 10 minutes.

 Sedentary behaviors should be minimized. Exercise training should be implemented long-term.

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Additional recommendations highlighted in the guidelines include:

  • Resistance training should use all muscle groups and progress to  2–4 sets of 8–10 repetitions at a weight that cannot be lifted >8–10 times, with 1–2 minute rest periods between sets.
  • The duration of each individual session can vary, although the aim should be a minimum of 10 minutes per session, at least 3 sessions per day.
  • Patients who elect to walk should perform the task at a brisk pace to be effective.
  • Go guys… jump on to the bandwagon.  Just look around you.  Lance Gokongwei has joined the fitness world!  So can we!

    It’s in the decision When to start that somehow manages to make us Weak and defenseless. Be determined and do it now. 

    Be Fit…Be Slim…

    Be Smart and Be Healthy!

    How To Lower Cholesterol Levels Naturally

    June 3, 2009

    Here’s one interesting article from the Harvard Health Publications HealthBeat on ways we can do to lower cholesterol naturally without meds:

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    15 tips for lowering your cholesterol naturally

    Many factors contribute to the development of heart disease or stroke. Genes and gender play a role, but for most of us, what we eat is an important factor as well. The good news is that a few small changes to your diet can help lower your cholesterol, which in turn will lower your risk for heart disease and stroke. Here are 15 heart-healthy eating tips to help you in the fight against high cholesterol.

    1. Eat meat sparingly. Relegate meat to a minor part of your diet instead of making it the centerpiece of most meals. Trim off fat and skin from meats and poultry. Avoid fatty cuts of beef, pork, and lamb; instead choose lean meats, or substitute fish or skinless white-meat poultry. When dining out, choose a smaller portion of meat, or meatless pasta or fish dishes.

    2. Opt for low-fat dairy products. Avoid dairy foods that contain whole milk or cream; instead, use low-fat or nonfat versions.

    3. Watch the snacks. Choose low-fat snacks (homemade popcorn, carrots, dried fruits, or fresh fruits) instead of high-fat ones (potato chips and candy bars). Avoid store-bought bakery products unless they are explicitly low in saturated fats and free of trans fats.

    4. Cut down on saturated fat in cooking. Use liquid cooking oils rather than butter or margarine. Use nonstick pans. Instead of frying your food, bake, broil, roast, steam, or stew. Discard drippings, and baste with wine or broth.

    5. Avoid palm and coconut oils. Most vegetable oils are unsaturated, but these two contain mostly saturated fat. Choose canola, sunflower, safflower, corn, soybean, olive, and peanut oils.

    6. Reduce dietary cholesterol. Strive to eat less than 200 mg of dietary cholesterol a day. Limit eggs to no more than four egg yolks per week; two egg whites can replace a whole egg in most recipes. Limit lean meat, fish, and poultry to no more than 6 ounces per day (a 3-ounce portion is about the size of a deck of playing cards). Stay away from cholesterol-rich organ meats, such as liver, brains, and kidneys.

    7.  Increase complex carbohydrates and fiber. Emphasize foods with complex carbohydrates—such as fruits and vegetables, whole-grain products, and legumes (dried beans and peas)—that are low in calories and high in fiber. Eat more water-soluble fiber, such as that found in oat bran and fruits. This type of fiber can significantly lower your blood cholesterol level when eaten in conjunction with a low-fat diet.

    8. Eat fruits and vegetables. To protect your heart, eat plenty of fruits and vegetables.

    9. Go for nuts. Nuts are associated with a lower risk of heart disease. They’re a healthful and filling source of protein, but go easy on them; they have lots of calories, so too much could cause weight gain.

    10. Add fish to your diet. Countries with high fish consumption have a lower risk of death from all causes as well as from cardiovascular disease. Like nuts, oily fish contain the essential fatty acids known as omega-3s and omega-6s. Since our bodies can’t make these, we have to eat foods that contain them to gain their benefits, which include improved cholesterol levels.

    11. Reduce salt intake. High blood pressure is a major risk factor for cardiovascular disease. Diets high in salt increase risk of hypertension.

    12. Avoid trans fats. According to the Institute of Medicine’s Food and Nutrition Board, there are no redeeming qualities to trans fats, and no safe levels. They raise LDL cholesterol and lower HDL cholesterol. The National Cholesterol Education Program urges people to eat as little as possible. Avoid or eat only very small quantities of foods that list hydrogenated oil or partially hydrogenated oil among their first ingredients. These products contain a lot of trans fat.

    13. Drink alcohol only in moderation. Regular, moderate drinking can reduce the risk of cardiovascular disease, but heavy drinking negates the benefits. Moreover, the advantages aren’t strong enough to recommend alcohol for anyone who doesn’t already drink. For those who do, the Dietary Guidelines for Americans recommend no more than one drink a day for women, and one or two drinks a day for men.

    14. Read labels carefully. Avoid prepared foods that list any of the following among the first few ingredients: meat fat, coconut or palm oil, cream, butter, egg or yolk solids, whole milk solids, lard, cocoa butter, chocolate or imitation chocolate, or hydrogenated or partially hydrogenated fat or oil. Watch out for fast foods and other unlabeled products; when you don’t know what you’re getting, eat sparingly.

    15. Change strategies. If three months of healthy eating doesn’t bring your total and LDL cholesterol levels into the desired range, consult your physician and a dietitian. If the numbers still don’t budge after six months, it may be time to consider medication.

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    Simple measures we can at home to avoid getting th compications associated with a high cholestrol level in the blood.  High cholesterol levels have been shown to increase ones risk to suffer from stroke and heart attack. 

    The good news is , we now have ways to control and lower the cholestrol levels by taking care of what we eat and through medications.

    Be Health Smart and Check the Labels!

    Intelligence Equates Fitness!

    May 29, 2009

    I found this very interesting article and I find it rather amusing… linking inteligence to physical fitness.   This is the first time I have read such a study published in the journal Intelligence and I want to share the information to all….

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    We suggest that an over-arching ‘fitness factor’ (an index of general genetic quality that predicts survival and reproductive success) partially explains the observed associations between health outcomes and intelligence. As a proof of concept, we tested this idea in a sample of 3654 US Vietnam veterans aged 31–49 who completed five cognitive tests (from which we extracted a g factor), a detailed medical examination, and self-reports concerning lifestyle health risks (such as smoking and drinking).

    As indices of physical health, we aggregated ‘abnormality counts’ of physician-assessed neurological, morphological, and physiological abnormalities in eight categories: cranial nerves, motor nerves, peripheral sensory nerves, reflexes, head, body, skin condition, and urine tests. Since each abnormality was rare, the abnormality counts showed highly skewed, Poisson-like distributions. The correlation matrix amongst these eight abnormality counts formed only a weak positive manifold and thus yielded only a weak common factor.

    However, Poisson regressions showed that intelligence was a significant positive predictor of six of the eight abnormality counts, even controlling for diverse lifestyle covariates (age, obesity, combat and toxin exposure owing to service in Vietnam, and use of tobacco, alcohol, marijuana, and hard drugs).

    These results give preliminary support for the notion of a superordinate fitness factor above intelligence and physical health, which could be further investigated with direct genetic assessments of mutation load across individuals.

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    This study showed that being healthy is linked to being more intelligent.  And this relationship is linked to a certain genetic “fitness factor” that regulates both the health fitness  to that of brain intelligence.  

    In other studies, the relationship was believed to be more of a “cause and effect” relationship where by being more intelligent means more likely to live a healthy lifestyle by eating the right kind of food and knowing the benefits of exercise.  Unfortunately, this cause and effect relationship may not be that simple after all because I know of intelligent people who may not be at their best of fitness level.

    On the other hand, the researchers further noted that the lower intelligence predicted health problems more than deviant lifestyle factors like smoking or alcohol intake.

    All these date suggest that there indeed is the existence of a genetic ‘fitness factor’ that influences both health fitness and the way our brains work!

    Look Smart By Being Fit!!!!

    The Alcohol Paradox

    May 16, 2009

     I came across a short review on the paradox of alcohol from the Harvard Newletter which I want to share.  Its concise and full of facts worth reading.

    We may not know it but alcohol can have good benefits too… to Health.

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    Drinking increases “good” HDL cholesterol, reduces factors in blood that make it more likely to clot, and may directly affect blood vessels, keeping the linings smooth and pliable and thus less vulnerable to atherosclerosis. European researchers reported interesting findings in 2008 that show a connection between alcohol intake and higher blood levels of omega-3 fats. Indeed, temperate tippling has been associated with everything from greater bone density to less risk for Alzheimer’s disease and vascular dementia, as well as protection against heart disease and stroke.

    Moderation is paramount when it comes to alcohol, because drinking too much is patently ruinous. Triglycerides and blood pressure go up. Binge drinking can lead to stroke. Moderation is flexibly defined, but the American Heart Association guidelines are often cited: for men, one to two drinks a day; for women, just one. A drink is defined as a 12-ounce beer, 4 ounces of wine, or 1.5 ounces of 80-proof liquor.

    Women do need to worry about alcohol increasing breast cancer risk. Alcohol may drive up estrogen levels, and estrogen seems to play an integral part in the development of many breast cancers. However, at moderate amounts (the drink-a-day level), the risk is small. Folic acid may help offset the breast cancer risk posed by alcohol, so women who drink are encouraged to get an extra 400 micrograms per day.

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    Just like anything we do and eat:  Do and Eat the amount that is not more than what can harm you! 

    The line between the good and the  bad effects can be so thin that you may not know it…you are already crossing the line!

    So They Say:  DRINK MODERATELY!   Now you know what it means!

    WHY Breastfeed?

    May 8, 2009

    Go to fullsize imagehat breastfeeding is best for babies…now we know its also good for mothers as well.  Good news for those who believe in the benefits of breastfeeding based on a new study publsihed in the recent journal of Obsetrics and Gynecology, May 2009: 

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    OBJECTIVE: To examine dose-response relationships between the cumulative number of months women lactated and postmenopausal risk factors for cardiovascular disease.

    METHODS: We examined data from 139,681 postmenopausal women (median age 63 years) who reported at least one live birth on enrolling in the Women’s Health Initiative observational study or controlled trials.

    RESULTS: Dose-response relationships were seen; in fully adjusted models,

    • women who reported a lifetime history of more than 12 months of lactation were less likely to have hypertension , diabetes, hyperlipidemia, or cardiovascular disease than women who never breast-fed, but
    • they were not less likely to be obese.

    In models adjusted for all above variables and BMI, similar relationships were seen. Using multivariate adjusted prevalence ratios from generalized linear models,

    • we estimate that among parous women who did not breast-feed compared with those who breast-fed for more than 12 months, 42.1% versus 38.6% would have hypertension, 5.3% versus 4.3% would have diabetes, 14.8% versus 12.3% would have hyperlipidemia, and 9.9% versus 9.1% would have developed cardiovascular disease when postmenopausal.
    • Over an average of 7.9 years of postmenopausal participation in the Women’s Health Initiative, women with a single live birth who breast-fed for 7-12 months were significantly less likely to develop cardiovascular disease  than women who never breast-fed.

    CONCLUSION: Among postmenopausal women, increased duration of lactation was associated with a lower prevalence of hypertension, diabetes, hyperlipidemia, and cardiovascular disease.

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    What this study showed is that women who breastfed for more than one year throughout their lifetime were 10% less likely to have a heart attack or stroke.  But what’s important is that these breastfeeding women were also less likely to develop the dreaded metabolic syndrome: 20% less likely to develop of diabetes, 12% less likely to have hypertension and 19% less leklely to develop high cholesterol. 

    How long should one breastfeed top get the effect?  Well, even women who had breastfed for only one month had lower rates of diabetes, high blood pressure and high cholesterol.

    Why do benefits result with breastfeeding? 

    Well most likely women who breastfeed their babies are more careful with their health in terms of food habits and lifestyle.  Likewise the hormone oxytocin produced during breastfeeding have the capacity to relax the vessels that may play a role in delaying plaque buildup in the vessel walls.

    There you go guys…

    Breastfeeding is Good for Our Health!

    Take a Nap…Its Good for your Memory!!!

    April 2, 2009

    It is now known that being sleep deprived means…risking yourself to suffer from chronic illnesses including diabetes and heart disease.  Now comes an interesting observation published in Sleep Journal that links sleep to memory….

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    Study Objectives:

    In this study we examined the benefit of a daytime nap containing only NREM sleep on the performance of three declarative memory tasks: unrelated paired associates, maze learning, and the Rey-Osterrieth complex figure. Additionally, we explored the impact of factors related to task acquisition on sleep-related memory processing. To this end, we examined whether testing of paired associates during training leads to sleep-related enhancement of memory compared to simply learning the word pairs without test. We also examined whether strength of task acquisition modulates sleep-related processing for each of the three tasks.

    Subjects and Procedure:

    Subjects (11 male, 22 female) arrived at 11:30, were trained on each of the declarative memory tasks at 12:15, and at 13:00 either took a nap or remained awake in the sleep lab. After the nap period, all subjects remained in the lab until retest at 16:00.

    Results:

    Compared to subjects who stayed awake during the training retest interval, subjects who took a NREM nap demonstrated enhanced performance for word pairs that were tested during training, but not for untested word pairs. For each of the three declarative memory tasks, we observed a sleep-dependent performance benefit only for subjects that most strongly acquired the tasks during the training session.

    Conclusions:

    NREM sleep obtained during a daytime nap benefits declarative memory performance, with these benefits being intimately tied to how well subjects acquire the tasks and the way in which the information is acquired.

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    In short…. 

    For a sharper memory… taking a nap can definitely help!

    “Not only do we need to remember to sleep, but most certainly we sleep to remember,” . The main message of the investigator and researcher Dr. William Fishbein, a cognitive neuroscientist at the recent meeting of the Society for Neuroscience.

    So my friends… take a rest in between work…enjoy life… take it easy…

    AND remember to take care of your brain because just like anything else in life…it needs to rest to function better!

    Can I Eat Eggs Everyday? Yes You Can!!!!

    March 28, 2009

    New studies have been made to refute the previous claims that eggs can increase ones cholesterol. 

    A recent article published in the International Journal of Obesity showed that the previous notion of limiting eggs because they can increase cholesterol is no longer an acceptable fear.  In fact eggs can help one lose weight!

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    Objective:

     To test the hypotheses that an egg breakfast, in contrast to a bagel breakfast matched for energy density and total energy, would enhance weight loss in overweight and obese participants while on a reduced-calorie weight loss diet.

    Design:

    Otherwise healthy overweight or obese participants were assigned to Egg (E), Egg Diet (ED), Bagel (B) or Bagel Diet (BD) groups, based on the prescription of either an egg breakfast containing two eggs (340 kcal) or a breakfast containing bagels matched for energy density and total energy, for at least 5 days per week, respectively. The ED and BD groups were suggested a 1000 kcal energy-deficit low-fat diet, whereas the B and E groups were asked not to change their energy intake.

    Results:

    After 8 weeks, in comparison to the BD group,

    • the ED group showed a 61% greater reduction in BMI,
    • a 65% greater weight loss ,
    • a 34% greater reduction in waist circumference (P<0.06) and
    • a 16% greater reduction in percent body fat (P=not significant).
    • No significant differences between the E and B groups on the aforementioned variables were obtained.
    • Further, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, did not differ between the groups.

    Conclusions:

      The egg breakfast enhances weight loss, when combined with an energy-deficit diet, but does not induce weight loss in a free-living condition. The inclusion of eggs in a weight management program may offer a nutritious supplement to enhance weight loss.
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    It is however to be emphasized that in this study, the egg diet was part of a calorie restircted diet suggesting that eating eggs as part of a low calorie diet can help one lose weight.  
    • But the added bonus of the study is the fact that eggs did not have any effect on the blood cholesterol level suggesting that it is really the intake of Saturated fat in the diet found in pastries, cakes and cookies that is harmful to the body!
    • The results of the study  were further confirmed in a similar finding from the University of Surrey research group which showed a similar no effect on cholesterol level with intake of 2 eggs per day for 6 to 8 weeks.
    Hopefully…these two studies can now end the debate as to whether eggs are safe to eat or not.  Enjoy!!!!!

    The Nutritional Benefits of Pulses

    March 22, 2009

    Just gave a lecture to a group of food technologist, media personnel and nutritionist on the Nutritional Benefits of Pulses upon the invitation of the United States Department of Agriculture at the USDA Culinary Theater. Fortunately the Philippines now has access to the USDA products of pulses which have been neglected sources of healthy nutrients especially fiber.

    I have been a proponent of healthy foods in my website. I am an advocate of healthy lifestyle for a healthy mind. And I am not hesitant to help promote products that are healthy and nutritious.

    Pulses are actually edible seeds of legumes. Legumes include the peas, chickenpeas, beans and lentils. The good thing about them is that they are rich in fiber and have low glycemic index. As such, they therefore can be great partners to what we know as healthy diet.

    A cup of cooked peas for example can be packed with fiber and yet very low in glycemic index meaning, the capacity to increase the blood sugar upon ingestion is very low. The combination of these properties provide one an ideal food that can be both filling and nutritious. As a result therefore, one gets to enjoy a food that can less likely contribute to weight gain which we know can lead to more serious chronic illnesses like diabetes, high blood pressure and stroke.

    Several studies have now shown that obesity can lead to serious problems, and pulse based diet has been shown to help curb obesity in certain populations. Anything that can help us decrease the prevalence of obesity in this country and the world is really a welcome addition to our need to find more ways to combat this epidemic. Likewise, intake of pulses in certain regions of the world have been shown in epidemiological studies to result in long life span like the Japanese or the Swiss and reduce the risk of colon Cancer due to their pre-biotic properties. However long term studies need to be done to confirm this finding.

    We don’t go to groceries and easily grab peas or beans in the aisle. We still need to be educated more about these foods and the USDA has led the way in this regard and I am pleased to be part of it. I myself am a fan of peas and beans.

    I have started to educate my kids about the nutritious benefits of eating veggies and slowly and slowly, they’re learning to enjoy the greens more each day. So the next time you go grocery shopping… take a second look at Pulses. They are HEALTHY AND NUTRITIOUS!!!

    Take Action on Your Weight!!! The Risks Associated with Being Overweight…

    February 28, 2009

    Go to fullsize imageBeing overweight needs immediate action!  Thats why when I registered a BMI of 25.6 with a fasting blood sugar of 96, I decided to take action and become healthier with my diet and physical activity.  Being overweight carries with it chronic diseases like diabetes, high blood pressure and cholesterol problem.  Not mentioning stroke and heart attack as endpoints!

    For year 2009: Its NOW a Global Call to action as more and more children and adolescence are gaining weight.  There’s no time to sit back and relax on this matter as inaction means DISASTER in the long run for these children!

    A recent study published in www.bmj.com showed that obese adolescents have the same risk of premature death in adulthood as people who smoke more than 10 cigarettes a day!!!!   This is indeed a scary thought.

    Those who are overweight have the same risk as less heavy smokers.

    BMI is a measure of your weight according to your height.  For Caucasians, a BMI of >25 if already overweight but for Asians, a lower BMI of 23 is considered abnormal already.

    What if one is underweight?

    Being underweight carries with it a better prognosis  as it carries with it no increased risk, irrespective of smoking status.  However, if you are also too thin with a a body mass index of less than 17; then it carried with it the same risk of premature death as being overweight.

    The study suggests therefore that being OBESE and Overweight at the age of  18 carries the same risk of premature death as being too thin!  Both conditions stem from poor nutrition either too much or too little.

    Its not late to start and do something for yourself or for our kids…. NOW!

    Life is short..Take time to Take Care of your HEALTH!

    Can Daily Intake of Eggs Be Healthy?

    February 23, 2009

    Go to fullsize imageControversies continue to surround whether eggs can cause harm if taken daily or not. Debate among the experts continue with assumptions that cholesterol in the diet actually has little effect on blood cholesterol.  No doubt that intake of saturated fat can increase the level of blood cholesterol and risk a patient to develop heart attack and stroke.  The relationship of Egg intake to disease continues to be debatable.

    Now comes a new study publsished in the Diabetes Care , this February 2009  that for sure will add fuel to the ongoing controversy:

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    OBJECTIVE—Whereas limited and inconsistent findings have been reported on the relation between dietary cholesterol or egg consumption and fasting glucose, no previous study has examined the association between egg consumption and type 2 diabetes. This project sought to examine the relation between egg intake and the risk of type 2 diabetes in two large prospective cohorts.

    RESEARCH DESIGN AND METHODS—In this prospective study, we used data from two completed randomized trials: 20,703 men from the Physicians’ Health Study I (1982–2007) and 36,295 women from the Women’s Health Study (1992–2007). Egg consumption was ascertained using questionnaires, and we used the Cox proportional hazard model to estimate relative risks of type 2 diabetes.

    RESULTS—During mean follow-up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes. Compared with no egg consumption, multivariable adjusted hazard ratios for type 2 diabetes were 1.09 (95% CI 0.87–1.37), 1.09 (0.88–1.34), 1.18 (0.95–1.45), 1.46 (1.14–1.86), and 1.58 (1.25–2.01) for consumption of <1, 1, 2–4, 5–6, and 7 eggs/week, respectively, in men (P for trend <0.0001). Corresponding multivariable hazard ratios for women were 1.06 (0.92–1.22), 0.97 (0.83–1.12), 1.19 (1.03–1.38), 1.18 (0.88–1.58), and 1.77 (1.28–2.43), respectively (P for trend <0.0001).

    CONCLUSIONS—These data suggest that high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women. Confirmation of these findings in other populations is warranted.

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    The question arises: whether it is the intake of egg that increased the risk to develop diabetes.  Or is it the relationship of the high fat diet associated with the egg intake that increased the risk.  It is known that high cholesterol and saturated fat intake can increase a patients risk to develop diabetes.

    So when the study participants’ daily cholesterol intake was assessed, it showed a relationship related to diabetes risk!!!  When the researchers factored this relationship in, the association between egg intake and diabetes weakened suggesting that a cholesterol-rich diet might promote diabetes.  This also suggest that a person who may like eggs may also eat other fatty foods that will result in increasing the risk to deveolp the disease.

    So a not so good news for egg lovers who have family history of diabetes.  This is one food that one may have to limit for now until more studies will show the relationship to be otherwise.

    But for the others who have no risk of developing diabetes…I suggest that eggs should remain to be enjoyed as long as one should not exceed 3-5 eggs per week.  This recommnedation will stay for now. 

    But do … Watch out in this site if new developments come in about eggs because for sure I will be the first to know and you will be the first to be informed !!!!

    The New Way To Exercise and Get Results….

    February 9, 2009

    Go to fullsize imageGood news to those who just dont have the time to exercise.

    A new study published online by the BMC, 2009 showed a new way to exercise that will have the same or better impact on our body’s metabolism than previously thought.

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    Background

    Classic, long duration aerobic exercise reduces cardiovascular and metabolic disease risk but this involves a substantial time commitment. Extremely low volume high-intensity interval training (HIT) has recently been shown to cause similar improvements to aerobic performance, but it has not been established whether HIT has the capacity to improve glycemic control.

    Methods

    Sixteen young men  performed 2 weeks of supervised HIT comprising of a total of 15 min of exercise (6 sessions; 4-6 x 30-s cycle sprints per session). Aerobic performance (250-kJ self-paced cycling time trial), and glucose, insulin and NEFA responses to a 75-g oral glucose load (oral glucose tolerance test; OGTT) were determined before and after training.

    Results

    Following 2 weeks of HIT, the area under the plasma glucose, insulin and NEFA concentration-time curves were all reduced (12%, 37%, 26% respectively, all P<0.001). Fasting plasma insulin and glucose concentrations remained unchanged, but there was a trend towards reduced fasting plasma NEFA concentrations post-training (pre: 350 +/- 36 v post: 290 +/- 39 mumol * l-1, P=0.058). Insulin sensitivity as measured by the Cederholm index was improved by 22.5% (P<0.01). Aerobic cycling performance was improved by ~6% (P<0.01).

    Conclusions

    The efficacy of a high intensity exercise protocol, involving only ~250 kcal work each week, to substantially improve insulin action in young sedentary subjects is remarkable. We feel this novel time-efficient training paradigm can be used as a strategy to reduce metabolic risk factors in young and middle aged sedentary populations who otherwise would not adhere to a classic high volume, time consuming exercise regimens

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    In this study short burst of intense exercise activity lasting for like 30 seconds resulted in improvement of parameters that can have an impact in preventing chronic illnesses. 

    The subjects used exercise bikes which we can easily buy in sports stores… performed a quick sprint insturcted to do it at their highest possible intensity for around 30 seconds.  The results showing significant improvements in exercise parameters biochemically suggest that any highly vigorous activity carried out in few minutes in a few days per week should achieve the same protective metabolic improvements. 

    This is definitely good news to those who just cant find the right time and place to do their exercise workout.  This is one of the first studies to document that short bouts of exercise can be as effective in improving metabolic parameters as the usual recommendations of moderate exercise for 30 minutes most days of the week. 

    Now my friends… no more excuses!!!

    The Many Lessons I Learned in London

    January 29, 2009

    The experience I had travelling to London is a memorable one. I attended a postgraduate course in Endocrinology sponsored by the Royal College of Physicians and the trip was both culturally and educationally enriching.

    After this trip, London is now among my top 5 must visits places in the world.  Not only is the place rich in culture ( watched Les Miserables in Queens Theatre in West End: marvelous experience), history (from Darwin to the Queen) and beautiful landmarks ( The Big Ben, The Palaces and the Eye) but also the warm hospitality that one can feel dealing with the British citizens.  One is warmly welcomed by the time one reaches the airport to the hotel staff to the cab drivers, waiters and store keepers.  You dont see homeless loitering around your path and was it safe to walk  around the Central London without fear of being mugged or robbed.

    I was able to reunite with old  friends now staying in London and unfortunately some may have made it well but a lot of our OFWs are actually languishing in debt.  It makes one feel so vulnerable in a foreign land especially in times of economic crisis where London is the hardest hit among Europe’s developed countries.

    The good news also is that our Filipino nurses occupy around 60% of the workforce in London’s major government hospital.  Interesting to note is that nurses are now handling endoscopy procedures as well as laparoscopic cholecystectomy procedures which is probably not going to happen in our country.  This is one thing unique in the British Health Care system.

    Overall… this trip has been one welcome respite from the busy days in Cebu and what a great experience it has been.  I will definitely go back to London and this is one place that I will probably learn more things the more times I go back!

    Another Reason to Follow the Low Carb Diet… Your Blood Sugar!

    January 19, 2009

    Go to fullsize imageFinally a study that looked at the practice of using low carbohydarte diet for our diabetics in helping control their blood glucoses was recently published in Nutrition and Metabolism journal.  Everytime I give a lecture on Nutritional therapy the question of my practice in lowering the total carbohydrate content of the calorie intake is the central issue.  This study is one proof that the concept of limiting the carbs can do wonders to ones blood sugar!

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    Objective

    Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods: Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c.

    Results

    Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p=0.03), body weight (-11.1 kg vs. -6.9 kg, p=0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p<0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p<0.01).

    Conclusions

    Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

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    What is amazing of the results is that by following a low carb diet, diabetes medications were reduced or eliminated in 95 percent and likewise resulted in a greater weight loss.  We also know that by losing weight, patient becomes more insulin sensitive and therefore contributes further to improvements in metabolic profile. These are the two effects that we like whether we employ diet or medication to any patient we assessed to have a disease of the lifestyle. 

    Is this nutritional therapy easy to do? 

    Definitely not BUT its the determination to succeed and be treated without medication that can drive our patients to follow the regimen.  Just like any regimen involving FOOD… our vigilance to do what is healthy is more important than following our DESIRE to love food and EAT more!

    Tips For The Holidays…..

    December 23, 2008

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

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

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

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

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

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

    Here are some Tips in Choosing Your Protein Sources wisely:

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

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

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

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

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

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

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

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

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

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

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

    Alarming Rise in Adult Diseases Amongst Children….

    December 4, 2008

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

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

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

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

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

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

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

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

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

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

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

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

    The Conflict of Taking Care of A Loved One….

    December 2, 2008

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

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

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

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

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

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

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

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

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

    November 29, 2008

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

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

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

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

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

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

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

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

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

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

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

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

    The Healing Powers of a Doctor…

    November 25, 2008

    Patients see some of us as healers. 

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

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

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

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

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

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

    The article concluded that :

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

    What Your Waistline Means To Your Health…

    November 14, 2008

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

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

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

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

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

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

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

     

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

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

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