Archive for the 'Medical News Bits' Category

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Meat Is Not NEAT!

April 7, 2009

Go to fullsize imageIt is easier to convince a child to eat meat than to eat veggies.  This scenario is given.  We are exposed to too many ads on meat whether chicken meat or beef meat on TV and newspapers.  It is therefore a challenge to parents to introduce other varieties of food that we deem healthier to the next generation.  It may take us some time to be successful but a little step can indeed go a long way overtime!

Now comes another study to support the concept that meat is really not neat!  Published in the latest edition of  Archives of Internal Medicine:

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Background  High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.

Methods  The study population included the National Institutes of Health–AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.

Results  There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up.

  • Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality.
  • Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes.
  • Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes.
  • When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.

Conclusion  Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

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This study further confirms the relationship between red meat and cancer, heart and overall risk of death.  Likewise, the study also showed that fish or intake of white meat was associated with a reduction in the risk of death.

Translating the data to common language…it means…

Over 10 years, those that eat meat equivalent to a quarter-pound hamburger can increase ones risk to die from cancer by 22 percent and the risk to die from heart disease by 27 percent. 

Bottom Line is:

Cut The Red Meat… Enjoy Fish in time for the Lenten Season….

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Tips To Protect Your Heart | 5 Comments »

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!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits | 4 Comments »

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!!!!!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity | 213 Comments »

How Safe Are Artificial Sweeteners….

March 25, 2009

One topic that has never died down during these years is the safety of artifical sweteeners.  The problem stems from internet messages and information being propagated by unknown sources regarding the dangers of these products.  As an endocrinologist, I have been recommending these sweeteners to my patients as they actually help stave off the craving for sugar without necessarily increasing the sugar load.

But how much is enough for these sweeteners?

Recently the Mayo Clinic organization published views on this controversy and recommendations.

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The Food and Drug Administration (FDA) has approved the following low-calorie sweeteners for use in a variety of foods. The FDA has established an “acceptable daily intake” (ADI) for each sweetener. This is the maximum amount considered safe to eat each day during your lifetime. ADIs are intended to be about 100 times less than the smallest amount that might cause health concerns.

Artificial sweetener ADI* Estimated ADI equivalent** OK for cooking?
Aspartame (NutraSweet, Equal) 50 milligrams (mg) per kilogram (kg) 18 to 19 cans of diet cola No
Saccharin (Sweet’N Low, SugarTwin) 5 mg per kg 9 to 12 packets of sweetener Yes
Acesulfame K (Sunett, Sweet One) 15 mg per kg 30 to 32 cans of diet lemon-lime soda*** Yes
Sucralose (Splenda) 5 mg per kg 6 cans of diet cola*** Yes

*FDA-established acceptable daily intake (ADI) limit per kilogram (2.2 pounds) of body weight.
**Product-consumption equivalent for a person weighing 150 pounds (68 kilograms).
***These products usually contain more than one type of sweetener.

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How about the safety of these products?

Although this is one product has been bombarded with bad publicity probably because of its popularity being present in almost any low calorie foods to diet sodas… the National Cancer Institute and other major health oragnizations including the American Diabetes Association and the US FDA continue to refute these claims… as so far,  there’s no scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer and that there are now numerous studies to confirm that artificial sweeteners are safe for the general population.

I for one contnue to use aspartame or splenda for my coffee eevry morning or in the afternoon. I am a user and a believer in these low calorie sweeteners that as long as used properly and not in excess of what is recommended…then it is safe!

Enjoy The Sweetness of Health!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts | 2 Comments »

Can Vitamin C Help Prevent GOUT?

March 19, 2009

Go to fullsize imageGood news for patients at risk of developing gout because a very common remedy and very affordable at that has been shown to help prevent gout.

A new study published in the latest edition of Archives of Internal Medicine showed a relationship linking higher intake of Vitamin C to lower risk of developing gout:

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Background  Several metabolic studies and a recent double-blind, placebo-controlled, randomized trial have shown that higher vitamin C intake significantly reduces serum uric acid levels. Yet the relation with risk of gout is unknown.

Methods  We prospectively examined, from1986 through 2006, the relation between vitamin C intake and risk of incident gout in 46 994 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout. Vitamin C intake was assessed every 4 years through validated questionnaires.

Results  During the 20 years of follow-up, we documented 1317 confirmed incident cases of gout. Compared with men with vitamin C intake less than 250 mg/d, the multivariate relative risk (RR) of gout was 0.83  for total vitamin C intake of 500 to 999 mg/d, 0.66  for 1000 to 1499 mg/d, and 0.55 (0.38-0.80) for 1500 mg/d or greater. The multivariate RR per 500-mg increase in total daily vitamin C intake was 0.83 . Compared with men who did not use supplemental vitamin C, the multivariate RR of gout was 0.66  for supplemental vitamin C intake of 1000 to 1499 mg/d and 0.55 (0.36-0.86) for 1500 mg/d or greater.

Conclusions  Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout.

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 What the study patients took were supplements of 1,500 mg daily.  What is interesting to note is that for every increase in Vitamin C intake of 500 mg per day, the risk of developing gout was decreased by 17%.

Likewise, those who took the 1500 mg supplemental form of Vitamin C had a 45% lower risk of developing gout than those who took lower doses of Vitamin C.  On the other hand those that took 1000 mg ov Vitamin had a 34% lower risk of developing gout!

It is known that Vitamin C can decrease the levels of uric acid oin the blood by increasing its excretion in the urine.

Does this mean,. we now go ahead and grab more Vitamin Cs in the market? I guess we need to wait for more studies to confirm this finding. 

But to those who continue to believe in Vitamin C and its role in preventing colds, this is one good news!

For me… getting the Vitmain Cs from fruits would be a better option.  Remember one orange can give you 70 mg of Vitamin C already.  Plus the ther benefits of fruit intake!

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

Reduce Your Risk for Diabetes Through Weight Loss: The Impact of Weight Loss Surgery

March 9, 2009

Go to fullsize imageWeight gain and Obesity play very important roles in the development of chronic diseases like Diabetes, High blood pressure and complications like Stroke and Heart Attack.  One therefore has to incorporate proper lifestyle and good behavior through daily physical acitvity to help avoid developing these conditions.  However there are certain inidividuas where weight loss through these behvioral methods no longer are enough to provide the weight loss one desires and therefore for ” medical” reasons, one resorts to drastic measures like Bariatric surgery.

But do they work in decreasing the risk? or do they help patients improve disease outcomes?

Now comes s study published in the American Journal of Medicine, March 2009  to show that weight loss indeed can work wonders to diabetes and that bariatric surgery can help:

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  • 621 studies from 1990 to April of 2006 were analyzed:  78.1% of diabetic patients had complete resolution and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery.
  •  Gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3% and BPD/DS 95.1%.
  •  After more than 2 year post-operative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%.
  • The Percent excess weight loss was 46.2%, 55.5%, 59.7% and 63.6%, for the type of surgery performed suggesting that BPD yielded the best result.

Concluding that:

  • 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and
  • 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group).

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The study for me tells us one thing: that weight loss indeed can work wonders.  However lets not all resort to surgery to achieve improvement in our risk for diseases as surgery also entails risks! 

While proper diet and physical activity are completely free and easy to do…all they need are the Two D’s to succeed: DETERMINATION and DISCIPLINE!

Posted in General Health Tips, Medical News Bits, The Diabetes Facts, The Truths on Obesity, What's New in Diabetes | 3 Comments »

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!

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

High Blood Sugar Predicts Death in Heart Attack Patients

February 26, 2009

Just a note for all of the readers with family members who are diabetics.  This is just to make you aware that control of sugar is of paramount importance even at the time of hospitalization especially due to heart attack.

This new study published in Archives of Internal Medicine, Feb 2009 shows that the relationship between fasting blood sugar on admission and its ability to predict outcome of death within 6 months of the acute attack.

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Background  Elevated blood glucose level at admission is associated with worse outcome after a myocardial infarction. The impact of elevated glucose level, particularly fasting glucose, is less certain in non–ST-segment elevation acute coronary syndromes. We studied the relationship between elevated fasting blood glucose levels and outcome across the spectrum of ST-segment elevation and non–ST-segment elevation acute coronary syndromes in a large multicenter population broadly representative of clinical practice.

Methods  Fasting glucose levels were available for 13 526 patients in the Global Registry of Acute Coronary Events. A multivariate logistic regression analysis was used for assessing the association between admission or fasting glucose level and in-hospital or 6-month outcome, adjusted for the variables from the registry risk scores.

Results 

  • Higher fasting glucose levels were associated with a graded increase in the risk of in-hospital death (odds ratios [95% confidence intervals] vs <100 mg/dL: 1.51 [1.12-2.04] for 100-125 mg/dL, 2.20 [1.64-2.60] for 126-199 mg/dL, 5.11 [3.52-7.43] for 200-299 mg/dL, and 8.00 [4.76-13.5] for 300 mg/dL).
  • When taken as a continuous variable, higher fasting glucose level was related to a higher probability of in-hospital death, without detectable threshold and irrespective of whether patients had a history of diabetes mellitus.
  • Higher fasting glucose levels were found to be associated with a higher risk of postdischarge death up to 6 months.
  • The risk of postdischarge death at 6 months was significantly higher with fasting glucose levels between 126 and 199 mg/dL (1.71 [1.25-2.34]) and 300 mg/dL or greater (2.93 [1.33-6.43]), but not within the 200- to 299-mg/dL range (1.08 [0.60-1.95]).

Conclusions  Short-term and 6-month mortality was increased significantly with higher fasting glucose levels in patients across the spectrum of acute coronary syndromes, thus extending this relation to patients with non–ST-segment elevation myocardial infarction. The relation between fasting glucose level and risk of adverse short-term outcomes is graded across different glucose levels with no detectable threshold for diabetic or nondiabetic patients.

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Better still…. across the spectrum of diabetes management that good control should always be practiced.  

No ifs or buts…its the RULE!

Reduction in short term complications, the sense of well being…plus reduction of long term complications like stroke and heart attack…are more than enough for any diabetic in the family to make sure that good control should always be practiced.  

Ths study tells us that up to the time of the acute event, high sugar continues to present itself as a menace.  And that high sugar should not be relegated as a mere stress effect but for me should be aggressively treateed as metabolic effects can have lasting impact on ones health and are irreversible!

Be aggressive as high sugar may not manifest any symptoms until its late!

Posted in Medical News Bits, The Diabetes Facts, Tips To Protect Your Heart, What's New in Diabetes | 9 Comments »

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 !!!!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, What's New in Diabetes | 3 Comments »

Is There Any Benefit in Taking A Multivitamin?

February 12, 2009

Go to fullsize imageI used to take one multivitamin pill per day.  I know of others who take tons of vitamins because they make them feel “better”. Or just a habit difficult to change. Or better still, relatives in the US send us with big bottles of these Vitamins as presents.  But are they USEFUL? 

Ever since, I already doubted the usefullness of these vitamins UNLESS one is not eating properly or is very choosy with food that predisposes one to deficiency of certain vitamins that we usually get from food.  But for people that have problems of the Opposite, that is… controlling the intake, I suggest you might as well spend your money on something else that’s healthy and has important benefit on ones health.

The latest issue of the Archives onf Internal Medicine published this recent study looking at the effectiveness of taking multivitamins.

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Background  Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease (CVD). Therefore, we decided to examine associations between multivitamin use and risk of cancer, CVD, and mortality in postmenopausal women.

Methods  The study included 161 808 participants from the Women’s Health Initiative clinical trials (N = 68 132 in 3 overlapping trials of hormone therapy, dietary modification, and calcium and vitamin D supplements) or an observational study (N = 93 676). Detailed data were collected on multivitamin use at baseline and follow-up time points. Study enrollment occurred between 1993 and 1998; the women were followed up for a median of 8.0 years in the clinical trials and 7.9 years in the observational study. Disease end points were collected through 2005.

We documented cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary, and lung; CVD (myocardial infarction, stroke, and venous thromboembolism); and total mortality.

Results  A total of 41.5% of the participants used multivitamins. After a median of 8.0 years of follow-up in the clinical trial cohort and 7.9 years in the observational study cohort, 9619 cases of breast, colorectal, endometrial, renal, bladder, stomach, lung, or ovarian cancer; 8751 CVD events; and 9865 deaths were reported. Multivariate-adjusted analyses revealed no association of multivitamin use with risk of cancer (hazard ratio [HR], 0.98, and 95% confidence interval [CI], 0.91-1.05 for breast cancer; HR, 0.99, and 95% CI, 0.88-1.11 for colorectal cancer; HR, 1.05, and 95% CI, 0.90-1.21 for endometrial cancer; HR, 1.0, and 95% CI, 0.88-1.13 for lung cancer; and HR, 1.07, and 95% CI, 0.88-1.29 for ovarian cancer); CVD (HR, 0.96, and 95% CI, 0.89-1.03 for myocardial infarction; HR, 0.99, and 95% CI, 0.91-1.07 for stroke; and HR, 1.05, and 95% CI, 0.85-1.29 for venous thromboembolism); or mortality (HR, 1.02, and 95% CI, 0.97-1.07).

Conclusion  After a median follow-up of 8.0 and 7.9 years in the clinical trial and observational study cohorts, respectively, the Women’s Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women.

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In short … wanna live long?  Live a healthy lifestyle.  There are other ways to better living not simple taking of pills as a shortcut or better still … lets take a walk and think again.

Pills or exercise?  I know your answers…keep it to yourselves.  You choose … it’s your life!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips | 2 Comments »

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!!!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits | 5 Comments »

Saw Palmetto and Bleeding….

January 23, 2009

Go to fullsize imageI just came across a patient who is taking this herb without my knowledge.  He apparently was taking this supplement to treat his urinary urgency secondary to an enlarged prostate.  Thinking it as an approved herbal supplement and therefore safe, he thought of not telling anyone regarding this pill.  Not until he underwent dental extraction when he was referred because of bleeding.

I have always been against taking herbal supplements as a drug.  These meds may have “no apporved therapeutic claims”  BUT the advertisements that we see on TV and hear on radio claim otherwise and in fact a “cure for all” sort of ads.  Therefore we cant blame our laymen to be enticed to take them in hopes of feeling better, looking younger and curing their illness.

Mayo Clinic website  has this to say in the side effects of saw palmetto:

Few severe side effects of saw palmetto are noted in the published scientific literature. The most common complaints involve the stomach and intestines, and include stomach pain, nausea, vomiting, bad breath, constipation, and diarrhea. Stomach upset caused by saw palmetto may be reduced by taking it with food. Some reports suggest that there may be less abdominal discomfort with the preparation lipidosterolic extract of Serenoa repens (LSESR). A small number of reports describe ulcers or liver damage and yellowing of the skin (jaundice), but the role of saw palmetto is not clear in these cases. Similarly, reports of headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, and heart disease have been reported, but are not clearly caused by saw palmetto. People with health conditions involving the stomach, liver, heart, or lungs should use caution.

Caution is advised in people scheduled to undergo some surgeries or dental work, who have bleeding disorders, or who are taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

So BEWARE…again..Be Aware… that not all what you hear are TRUE.  Consult your doctors if you are taking any herbal supplements as they may interfere with the actions of the drugs we are giving to make you feel better!

A lesson to my patient? DEFINITELY!

Posted in General Health Tips, Medical News Bits | Leave a Comment »

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!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, The Diabetes Facts, What's New in Diabetes | 9 Comments »

The Protective Effect of Eating Fish On Your Kidneys…

January 6, 2009

Go to fullsize imageWe know the many benefits of eating fish.  I love fish and I cultivate the fun of eating fish rather than meat to my kids.  It may take several trials to be successful but for them to eat fish and enjoy it is worth the many trials.

A recent study published in the American Journal of Kidney Diseases gave us a new look at how fish can be beneficial to our kidneys.  The study measure ther urine excretion of albumin which is a measure of kidney damage.

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Background

Studies have shown a potential beneficial role for fish and fish oil consumption in the management of diabetes and its complications. The aim of this study is to examine the association between fish consumption and albuminuria in individuals with and without diabetes.

Study Design

A cross-sectional analysis conducted in the European Prospective Investigation of Cancer–Norfolk population-based cohort study.

Setting & Participants

22,384 men and women from general practices in the city of Norwich and vicinity, of whom 517 had diabetes by self-report and 21,867 did not report diabetes.

Predictors

Fish consumption was measured in a validated semiquantitative food frequency questionnaire and categorized as less than 1, 1 to 2, and more than 2 portions/wk. Interaction between fish intake and diabetes status was hypothesized a priori.

Results

Prevalences of microalbuminuria were 22.6% in participants with diabetes and 11.4% in participants without diabetes. Prevalences of macroalbuminuria were 8.3% and 0.6%, respectively. Fish consumption was associated with a lower risk of macroalbuminuria in participants with diabetes (odds ratio, 0.22, >2 versus <1 portion/wk; 95% confidence interval, 0.07 to 0.70; P for trend = 0.009) after adjustment for confounding. This association was not observed in participants with diabetes with microalbuminuria or in the nondiabetic population. There was a significant interaction between diabetes status and fish consumption of 1 to 2 portions/wk (P = 0.03) and more than 2 portions/wk (P = 0.007) for risk of macroalbuminuria.

Conclusions

Greater fish intake was associated with a lower risk of macroalbuminuria in a self-defined diabetic population. These findings merit confirmation in prospective studies and intervention trials and suggest that fish intake may be beneficial for albuminuria in people with diabetes.

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This study confirms my practice of asking patients to minimize red meat and eat more white meat to help protect their kidneys.  Diabetes continues to be a leading cuase of kidney failure worldwide and haviong dialysis two to three times a week is not only physically disabling but emotionally and financially as well.

So for the new year… even if one is not a diabetic… eating fish should be the way to go.

You Cant Go Wrong With FISH!

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Read my previous post on The Benefits of Eating FISH

Posted in General Health Tips, Medical News Bits, The Diabetes Facts | 2 Comments »

Quit Smoking and Get Back Your Health…

December 11, 2008

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

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

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

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

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

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

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

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

Alarming Rise in Adult Diseases Amongst Children….

December 4, 2008

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

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

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

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

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

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

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

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

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

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

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

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

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

What Your Waistline Means To Your Health…

November 14, 2008

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

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

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

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

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

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

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

 

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

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

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

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

Are Your Supplements “FDA Approved?”

November 5, 2008

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

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

FDA approves new drugs and biologics.

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

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

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

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

FDA does not approve dietary supplements.

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

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

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

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

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

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

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

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

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

How to EAT and Lose Weight….

October 27, 2008

Go to fullsize imageMy previous posts have always been toward trying to help people lose weight.  I am one person following my own theories and they worked and are working up to now.  Here are the no-nonsense tips that I follow DAILY: 

If you want to lose weight…

  • EAT,  But stop when you feel you’re already FULL and Leave the table at once. 
  • CHEW your food properly so it will take time for you to finish a meal and by the time you’re halfway through…you’re FULL! 
  • Avoid the visual stimulation of food… the longer you stay in the table, the more likely you’ll eat more!

Then of course… you MOVE!

A recent article publsihed in the British Medical Journal confirms these basic prinicples:

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Participants 3287 adults (1122 men, 2165 women) aged 30-69 who participated in surveys on cardiovascular risk from 2003 to 2006.

Main outcome measures Body mass index (overweight 25.0) and the dietary habits of eating until full (lifestyle questionnaire) and speed of eating (validated brief self administered questionnaire).

Results 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women.

Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

___________________________________________________________________________________________________________________ There you go…Simple tips and simple measures that will surely WORK for ALL!

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

How To Be Active Without Trying….

October 22, 2008

Physical activity is part of the equation of fitness and weight maitenance. 

“Easier said than done”, everyone knows it best that exercise is key to a healthy lifestyle.  Excuses to avoid feeling guilty continue to be part of what makes us believe that we just dont have enough time to exercise!  But new studies have been published that physical activity need not be a structured time frame that we should follow … rather any activity should be the norm to our day to day life.  In short…as long as one does not follow a sedentary lifestyle… one should be better off following an active lifestyle.

Heres a new study Published in the journal Current Opinions in Endocrinology that proves nothing is better than just being active:

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Purpose of review: To discuss the potential importance of spontaneous physical activity in regulating body weight and outline possible reasons for the large interindividual variance in spontaneous physical activity.

Recent findings: Spontaneous physical activity is highly variable among people, with some having high levels and some low, and can contribute significantly to interindividual differences in total daily energy expenditure. Cross-sectionally, spontaneous physical activity is inversely related to body weight; however, more importantly, spontaneous physical activity is inversely associated with weight gain in prospective studies, and experimental weight perturbations do not appear to change spontaneous physical activity behavior. Spontaneous physical activity is a familial trait and is biologically influenced, although the environment exerts a significant impact.

Summary: Although spontaneous physical activity is a biologically driven behavior, interventions to increase nonexercise activity within the workplace and school hold promise in increasing daily energy expenditure for the average sedentary American. However, many large-scale efforts will need to take place within our sedentary-promoting environment to encourage more daily spontaneous physical activity-related activity.

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This new study tells us one thing: No more EXCUSES!!!!

Any spontaneous movement or activity is better.  Even fidgety movements while sitting down working on your computer and other daily tasks that require activity is more than enough for the body to be healthy.  Any household chores and any walking to the workplace or the act of getting something are activities of daily living that can help with energy expenditure. These nonexercise activities should not be a problem for anyone to follow.  Meaning NO MORE EXCUSES!

There you go… The best way to be active without really trying ( going to a gym) is to be more active in our day to day activities. Do it everyday and make it part of a habit and you’re on your way to healthier you!

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

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