Archive for the 'Medical News Bits' Category

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How to Prevent Erectile Dysfunction….

July 7, 2008

One of the many aspects in life that we desire is to be happy in all areas of our daily activities…and that includes nighttime responsibilities of a husband to the partner! And what comes worst is the problem of impotence or erectile dysfunction due to medical diseases like diabetes or non medical like psychological in nature…being the most common cause.

Now comes a very interesting piece of information for all of us! This study on how we can prevent the problem of poor sex life due to erection problems was recently published in the American Journal of Medicine, July 2008.

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Background

Erectile dysfunction is common among men aged more than 60 years. Its cause involves both physiologic and psychosocial factors.

Methods

Data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires. The study sample consisted of 989 men aged 55 to 75 years (mean 59.2 years).

The most common comorbidities were hypertension (32%), heart disease (12%), depression (7%), diabetes (4%,) and cerebrovascular disorder (4%).

Results

The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years (95% confidence interval [CI], 27-38). After adjustment for comorbidity and other major risk factors:

  1. men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week (79 vs 33/1000, incidence rate ratio 2.2, 95% CI, 1.3-3.8).
  2. The risk of erectile dysfunction was inversely related to the frequency of intercourse.
  3. No relationship between morning erections and incidence of moderate or severe erectile dysfunction was found.

Conclusion

Regular intercourse protects against the development of erectile dysfunction among men aged 55 to 75 years.

This may have an impact on general health and quality of life; therefore, doctors should support patients’ sexual activity.

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Yes…I fully support my patients sexual activity because I know it is a very important cause of depression among my diabetic patients. In fact this is one of the reasons why I am very aggressive in treating my diabetic patients especially if they are also hypertensives because I want them to preserve the fun of sex and avoid the problem of impotence later in life.

So doing it more frequently is the way to go!!!!  What a fun way to prevent a disease… the more the better…

Enjoy Life…Have More …The Better!

Posted in Lifestyle Measures, Medical News Bits, Personal Thoughts | 4 Comments »

Hearing Loss and Diabetes…

July 2, 2008

Go to fullsize imageI have long suspected a relationship. 

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

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

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

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

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

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

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

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

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

Hearing Loss: Another Reason To Aim For Good Control!

Posted in General Health Tips, Medical News Bits, The Diabetes Facts | 1 Comment »

An Aspirin A Day Can Keep BP At Bay…

June 24, 2008

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

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

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

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

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

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

Another Wonderful News on Aspirin and Health!

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

Is Working Overtime Harmful?

June 21, 2008

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

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

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

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

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

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

Overtime Can Hinder Productivity! Learn To Manage Your Time!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits | 1 Comment »

Dark Chocolate Can Lower Blood Pressure and Cholesterol…

June 17, 2008

Another interesting research and great news for chocolate lovers. 

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

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

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

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

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

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

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

So Dark Chocolate…Anyone? 

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips | 2 Comments »
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Metformin for Pregnant Diabetics?

June 9, 2008

Go to fullsize imageYes we can!!!!

A recent published study: The MiG trail or the Metformin for Gestational Diabetes in the New England Journal of Medicine, May 2008 provide us more proofs that the use of metformin is not only preferred by pregnant dabetics BUT likewise is not associated with perinatal complications.

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Results

Of the 363 women assigned to metformin, 92.6% continued to receive metformin until delivery and 46.3% received supplemental insulin.

The rate of the primary composite outcome was 32.0% in the group assigned to metformin and 32.2% in the insulin group (relative risk, 1.00; 95% confidence interval, 0.90 to 1.10).

More women in the metformin group than in the insulin group stated that they would choose to receive their assigned treatment again (76.6% vs. 27.2%, P<0.001). The rates of other secondary outcomes did not differ significantly between the groups.

There were no serious adverse events associated with the use of metformin.

Conclusions

In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased perinatal complications as compared with insulin. The women preferred metformin to insulin treatment.

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This is one randomized trial that we have been waiting for.  Now as an endocrinologist, I have more arms to support the use of this medication for my pregnant women diagnosed with gestational diabetes.  The more options a patient have , the better!  Controlling their blood glucoses while pregnant is important!  It is our aim to hopefully prevent them from becoming diabetics after the delivery by lessening the burden of the pancreas brought about by the hormonal changes of pregnancy.

It is therefore very important that for all women to know that if they have risk factors for diabetes including obesity and a strong family history of diabetes…that they make sure to ask their obstetricians that they be screened for gestational diabetes.  This is one case where the early diagnosis is paramount to early treatment… the better for the health of the pancreas.

This is indeed good news to our women who have fear for needles because now we have a safe and effective alternative to insulin.

Another Welcome Option To The Medical World!

 

Posted in Medical News Bits, The Diabetes Facts | 3 Comments »

Quick Steps To Achieve Healthy Weight…

June 6, 2008

Go to fullsize imageI came across a well written short article on how to achieve a healthy weight.  The advises sound so simple yet precise and direct to the point of concern.  We tend to disregard simple measures in life and then look for rigorous steps to achieve our goal.  That’s where failure can set in.  Make things simple and Let them work for you….

Here’s the quick 5 steps to a healthy weight from the Harvard Medical Group: The Harvard School of Public Health

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1. Ban the strange diets. They may work in the short term, but almost any strange, extreme diet is doomed to fail. Your best friends when it comes to losing weight—and keeping it off? Choosing healthy foods and eating smaller portions, slowly.

2. Be more active. If there’s one best weight loss mantra it’s “exercise, exercise, exercise.” Choose activities you enjoy and do them every day. Exercising with a friend can help keep you on track. 

3. Turn off the television. Watching less TV can give you more time to be active—and less time to be enticed by junk food ads. Two easy ways to cut back on TV-watching: take the TV out of your bedroom, and make sure it’s off during meals.

4. Skip the sugary drinks. Drinking sugared soda, fruit drinks, or juice can give you several hundred calories a day without realizing it. Research suggests children and adults who drink soda or other sugary drinks are more likely to gain weight than those who don’t, and that switching from these to water or unsweetened drinks can reduce weight.

5. Think before you eat. Before you mindlessly reach for a snack, pause and ask yourself, Am I really hungry? Is there a healthier choice? It’s easy to lose sight of good food choices in today’s ad-crazy world. Simple questions like these can help keep us on track.

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Simple common sense tips for healthy living as well…

Live Life To The Fullest…By Living Healhty!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Weight Loss Tips | Leave a Comment »

The Many Benefits of Mediterranean Diet

June 4, 2008

What is Mediterranean Diet?

The common Mediterranean dietary pattern has these characteristics according to the American Heart Association :

  • high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
  • olive oil is an important monounsaturated fat source
  • dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
  • eggs are consumed zero to four times a week
  • wine is consumed in low to moderate amounts

The diet simply put focuses more on our consumption of olive oil, vegetables, fruits, nuts ( my post on Going nuts on Nuts) , cereals, legumes and fish ( my post on the Benefits of Eating fish)  and avoiding the well liked and “unhealthy meat and “saturated fat loaded” dairy products.

The many touted benefits of this diet has long been known in the medical field.  In fact major organizations have patterned their recommended healthy diets on the contents of the mediterranean diet.  Why?  Because… Many epidimeological studies have shown that the incidence of heart disease in Mediterranean countries is lower than in the United States where meat and saturated fat is a plenty!!!!.  In fact in those studies, where people practice the Mediterranean diet, mortality rates or the risk of death were also significantly lower!!!!

In a recent article published in the May 30 online of BMJ, Mediterranean diet has been shown to lower the risk of developing diabetes.  Another PLUS to this otherwise healthy alternative way of eating….

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

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

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

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In this study, during an average of 4 years of follow-up, the researches found that found that people who adhered to a Mediterranean diet very closely had a lower risk of developing type 2 diabetes. and their risk were reduced by 83 percent.

It is however very important to emphasize that major health benefits may not be entirely due to the diet alone.  A healthy diet should always partner with healthy lifestyle including more physical activity.  All these require no shortcut but plain discipline!

A Healthy Diet For More Wealth!

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

The Wonders of Vitamin D…

May 28, 2008

Vitamin D has been a negelcted Vitamin for several centuries.  People are so mystified by Vitamin E and Vitamin C that almost always every patient that I encounter is either on E or C as vitamin supplements.  But recent data have shown that one Vitamin that stand out among the rest in terms of preventing illnesses is Vitamin D.

A new study that looked at how important Viatmin D in terms of it causing muscle pain was recently published. It looked at how deficiency of Vitamin D may play a big role in causing this chronic complaints among the elderly population. This study published in the American Journal of Geriatrics in May 2008 involved Nine hundred fifty-eight persons (aged ≥65) selected from city registries of Greve and Bagno a Ripoli.

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Lower concentrations of 25(OH)D are associated with significant back pain in older women but not men. Because vitamin D deficiency and chronic pain are fairly prevalent in older adults, these findings suggest it may be worthwhile to query older adults about their pain and screen older women with significant back pain for vitamin D deficiency.

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The main function of Vitamin D is in helping maintain a normal calcium level in the blood which is important for bone strength.  It aids in the absorption of calcium from the gut and can provide protection from osteoporosis as well as other chronic illnesses like hypertension (high blood pressure), cancer, and others.

Some health benefits of Vitamin D although will need more studies to fully prove its worth include for:

  •  Diabetes where Vitamin D has been shown to improve insulin sensitivity; 
  •  Colon cancer where a Metaanalysis showed VitaminD supplementation decreased the risk
  •  Multiple Sclerosis
  •  Prostate cancer where a reduction in risk was noted with higher Vitamin D Intake among others….

So how can we get enough Vitamin D?

Exposure to the morning sun for 10 to 15 minutes should provide you enough Vtamin D.  Other food sources include fish like salmon and tuna , egg yolk, cheese, fortified milk including yogurt, and cod liver oil.  It is best to check your Vitamin D level to determine if you are deficient or not.  There are many supplements of Vitamin D available in the market and it is best to discuss which is best for you with your doctor.

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

Soy Protein and The Heart….

May 26, 2008

Go to fullsize imageThere are many conflicting data on soy protein and the heart especially the claim that they lower cholesterol.  In fact in 1999 based on studies during that time, the US FDA allowed a health claim on food labels stating that a daily diet containing 25 grams of soy protein, also low in saturated fat and cholesterol, may reduce the risk of heart disease. 

However, the American Heart association in January of 2006 made a review of available data and made a conclusion that soy protein in itself did not significantly lower the bad cholestrol nor did it have any significant effect in increasing the good cholesterol.

But as an endocrinologist looking for alternative source of meat protein, the use of soy protein in place of meat which has high staurated fat will continue to play a major role in our attempt to reduce the risk of our patients from cardiovascular disease.

Recently a new article on the benefit of soy protein came out in Annals of Internal Medicine.  This study is so relevant to my practice especially among diabetic patients with kidney disease.  These are the patients we try to avoid taking meat protein because of the possibility of causing kidney function deterioration.  The study did not only show a good effect in sugar control but also markers of inflammation suggesting a potential effect in reducing cardiovascular disease plus improving markers of kidney function.

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Soy protein consumption significantly affected cardiovascular risks such as fasting plasma glucose , total cholesterol , LDL cholesterol, and serum triglyceride concentrations.

Serum CRP levels were significantly decreased by soy protein intake compared with those in the control group .

Significant improvements were also seen in proteinuria  and urinary creatinine ( both measures od kidney function) by consumption of soy protein.

CONCLUSIONS—Longitudinal soy protein consumption significantly affected cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy.

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Here is a list of the common sources of soy protein that we can enjoy includes: Tofu, soymilk, soyflour. Tempeh and Miso.  The soymilk and textured soy protein can be used as subsitute for meat or cows milk while the soyflour can be used in baking needs.

I believe in the benefits of soy protein.  I hope for more studies to come that will provide us with more data on its beneifts and potential to reduce disease risk especially the Heart!

Soy Protein: A Better Partner for the Heart!

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

Having High Sugar and High Blood Pressure Can be Deadly…

May 23, 2008

Go to fullsize imageAlmost always a patient that suffers from diabetes is obese, have high triglycerides and low HDL and develops high blood pressure and high cholesterol… the combination of which is called the Metabolic syndrome.  If any of these conditions are not addressed then ones risk to suffer from chronic complication like heart disease is increased.  Whether the sum of the components or the combination of two parts or only one component is present makes a patient more at risk to die is not well documented.

The new study published in Annals of Internal Medicine May 2008 now shows that having two parts increases the risk to die more than having the combination for the components of the syndrome itself….

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  1. After multivariable adjustment, compared with persons without MetS, those with MetS had a 22% higher mortality .
  2. Higher risk with MetS was confined to persons having elevated fasting glucose level  or treated diabetes mellitus or hypertension as one of the criteria;
  3. Persons having MetS without High Fasting Glucose or MetS without hypertension did not have higher risk.
  4. Evaluating MetS criteria individually, we found that only hypertension and EFG predicted higher mortality;
  5. Persons having both hypertension and Elevated Fasting Glucose had 82% higher mortality .
  6. Substantially higher proportions of deaths were attributable to EFG and hypertension (population attributable risk fraction [PAR%], 22.2%) than to MetS (PAR%, 6.3%).

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There you go my friends…just having diabetes or hypertension makes one at higher risk to die from heart disease.  More so if high blood sugar is joined by high blood pressure then the risk to die is 82%!!!!

The above study therefore tells us that making a diagnosis of metabolic syndrome does not entail more risk to die than having just diabetes of hypertension alone.  Such that… it’s utility as a diagnosis and as a risk factor for cardiovascular mortality is put in question. 

So friends…please dont take these two conditions lightly!!! As an endocrinologist, I take these conditions seriously and that all patients with Diabetes are screened for blood pressure and cholesterol abnormalities and vice versa! 

To summarize the study:

Having High Sugar especially if with High Blood Pressure Can Be DEADLY! 

Posted in General Health Tips, Medical News Bits, Personal Thoughts, The Diabetes Facts, Tips To Protect Your Heart | 1 Comment »

Are Eggs Healthy To Eat?

May 1, 2008

One of the top posts in my website is my article on how much eggs can one eat.  The emphasis on eggs as being healthy but laden with cholesterol has made the public very confused.  Now comes a new study published in the American Journal of Nutrition done in Harvard University linking consumption of egg to increased mortality. 

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Background: A reduction in dietary cholesterol is recommended to prevent cardiovascular disease (CVD). Although eggs are important sources of cholesterol and other nutrients, limited and inconsistent data are available on the effects of egg consumption on the risk of CVD and mortality.

Objective: We aimed to examine the association between egg consumption and the risk of CVD and mortality.

Design: In a prospective cohort study of 21 327 participants from Physicians’ Health Study I, egg consumption was assessed with an abbreviated food questionnaire. Cox regression was used to estimate relative risks.

Results: In an average follow-up of 20 y, 1550 new myocardial infarctions (MIs), 1342 incident strokes, and 5169 deaths occurred.

  • Egg consumption was not associated with incident MI or stroke in a multivariate Cox regression.
  • Adjusted hazard ratios (95% CI) for mortality were 1.0 (reference), 0.94 (0.87, 1.02), 1.03 (0.95, 1.11), 1.05 (0.93, 1.19), and 1.23 (1.11, 1.36) for the consumption of <1, 1, 2–4, 5–6, and 7 eggs/wk, respectively (P for trend < 0.0001).
  • This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold (hazard ratio: 2.01; 95% CI: 1.26, 3.20; P for interaction = 0.09).

Conclusions: Infrequent egg consumption does not seem to influence the risk of CVD in male physicians. In addition, egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population.

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The data suggests that the higher the number of eggs consumed, the higher the mortality risk especially among diabetic patients.  This seems interesting because the risk to develop heart disease was not seen among those who are frequent egg eaters suggesting that the risk to die was not associated with heart disease but something else! Nevertheless, looking at prevoius relationships of cholesterol and death, the most likely explanation as assessed in the editorial by Dr Eckel of University of Colorado is still atherosclerotic disease.

The relationship between egg consumption and heart disease continues to be confusing.  This is understandable because now we know that the effect of cholesterol intake in the diet has less effect on the LDL or bad cholesterol in the blood than an intake of saturated fat or trans fat in the diet.  And as we all know, the egg yolk mainly contains cholesterol.

The editorial sums it all up:

So, if you are a male physician and are going to eat 1 egg/d, why not eat the whites only? Just think—with all of the trimmings, that 3-white egg omelet is almost indistinguishable by taste from an omelet enriched with 600 mg cholesterol, and the whites-only omelet also remains a very good source of protein, riboflavin, and selenium. If you cannot do without the yolks, go ahead and enjoy them, but why eat them >3–4 d/wk? If you are a man with diabetes, a more limited egg intake pattern seems prudent. But, remember: eggs are like all other foods—they are neither “good” nor “bad,” and they can be part of an overall heart-healthy diet.

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts | 7 Comments »

Level of Activity In the Young Predicts What You Become…

April 26, 2008

Go to fullsize imageChronic diseases will abound in the next century.  The ones who will be most affected are the children of today.  And this prediction wil come true based on this new study published in Dynamic Medicine. which looked at the level of activity of the young and the risk of developing Metabolic Sydrome in adulthood: Diabetes, Hypertension and High cholesterol.

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Purpose: Metabolic syndrome (MS) is a clustering of cardiovascular disease risk factors that identifies individuals with the highest risk for heart disease. Two factors that may influence the MS are physical activity and aerobic fitness. This study determined if adolescent with the MS had low levels of aerobic fitness and physical activity as children.

Methods

This longitudinal, exploratory study had 389 participants: 51% girls, 84% Caucasian, 12% African American, 1% Hispanic, and 3% other races, from the State of North Carolina. Habitual physical activity (PA survey), aerobic fitness (VO2max), body mass index (BMI), blood pressure, and lipids obtained at 7-10 y of age were compared to their results obtained 7 y later at ages 14 -17 y.

Results

Eighteen adolescents (4.6%) developed 3 or more characteristics of the MS. Logistic regression, adjusting for BMI percentile, blood pressure, and cholesterol levels, found that adolescents with the MS were 6.08 (95%CI = 1.18-60.08) times more likely to have low aerobic fitness as children and 5.16 (95%CI = 1.06-49.66) times more likely to have low PA levels.

Conclusions

Low levels of childhood physical activity and aerobic fitness are associated with the presence of the metabolic syndrome in adolescents. Thus, efforts need to begin early in childhood to increase exercise.

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The study tells us that the level of activity is as important as keeping fit!  One does not need to be overweight to be at risk. One may not be obese but if the level of activity is low then he is still not fit and therefore at risk of future diseases. This study tells us to allow our kids to be more active rather than live a sedentary lifestyle of gameboys, PSPs and computers.

This study clearly shows the relationship of what we train our kids to do and become to what happens to them in the future.  Lets train them early to be fit and healthy so as they can carry their lives in a healthier way! 

For me… Teaching our Kids How to keep FIT is the best future we can give them!

Posted in Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts | Leave a Comment »

The Dangers of Too Much TEA….

April 24, 2008

One of the highlights of the Mayo Endocrine Course in Mallorca Spain was the Clinical Pearls that we get after a case presentation.  And one of those cases that I found very interesting was a case of  lady who had a bone xray suggestive of a “strong” bone and a bone mass that was suggestive of a “thick ” bone.  She was therefore confident that she won’t fracture because she did not have any osteoporosis based on Xray and Bone mass measurement.

However upon review at the Mayo Clinic her bones were actually not normal.  So further evaluation was done and showed her to be drinking at least 10 tea bags of a commercial brand per day as a way of quenching her thirst.  Without her knowledge, she was taking in too much flouride into her sytsem coming from drinking too much tea!!!  She was developing a state of Flourosis which can cause a bone disease called Osteosclerosis.  From being told that she has strong bones to now being counseled to be careful not to fracture… was too extreme for her to understand!

Osteosclerosis can be due to taking in too much flouride in the body.  The problem with this disease is you have Brittle bones and therefore on Xray, you may have thick bones but the quality of the bone is poor!!!

Just how much flouride in is one tea bag?  In one study published in Amercan Journal of Medicine in 2005:

“Two independent testing laboratories determined that mean fluoride concentrations in 10 brand-name tea solutions ranged from 1.0 to 6.5 ppm. One tea exceeded the EPA safety limit of 4.0 ppm for drinking water, and several surpassed the U.S. Food and Drug Administration limit of 1.4 to 2.4 ppm for bottled beverages. “

So my frineds…please be careful with too much tea in a day.  I know of some chinese patients who use tea as their drinking water.  Just as the saying goes…

 Too much of a Good Thing can also be BAD!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts | 16 Comments »

Check The Music Your Kids Listen…and Be Warned!

April 7, 2008

Parents are sometime caught unaware that our kids Ipod is loaded with music that may not be healthy to their social and emotional well being.  We know classical music soothes our body and improves health and mood but other kinds of music like rap or rock have been shown to have disturbing impact.

An article recently published in Addiction Research and Theory, April 2008 issue showed how the rise in drug wars could be contributed by the kinds of music these kids are exposed to.

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This article explores the role of changing images of drug use in rap music from the 1970s to the 1990s. A sample of 341 rap music lyrics were coded for drug mentions, behaviours and contexts; drug attitudes and consequences; and music genres.
  • The results show that from 1979-1997, songs with references to drugs increased over 6-fold;
  • those exhibiting positive attitudes and consequences rose substantially
  • references to particular drug types changed significantly.
  • increased references to using drugs to signify glamour, wealth and sociability.

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There you go guys… be careful with what music our kids listen to.  If rap music before warns about the dangers of drug use, apparently recent rap music tend to glorify drug use… and this message may not be the kinds of inspiration our kids need.  The increase in drug reference was pretty alarming increasing form a mere 10% in the early 70’s to >60% in early 90’s!!!!

Check the music videos your kids watch and the contents of their iPods… It is better to intervene early than be sorry for the effects of these music on our kids in their social skills and adult behavior!

To Intervene Or Not To Intervene….

 

 

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

Acupuncture and Diabetes

April 5, 2008

Go to fullsize imageAlternative therapies continue to be in the mainstream of Diabetes Armamentarium.  You see patients bringing bottles of herb supplements apparently marketed as a treatment for Diabetes and related illnesses like high blood pressure and high cholesterol.  But one form of treatment that has gained wide acceptance both in the East where it originated and in the West where it is now widely practiced is Acupuncture.  And almost always in my practice do I come across a patient asking me about acupuncture and diabetes.

 

It is said that the effect of acupuncture is its ability to improve blood flow.  By balancing the energy levels, one’s circulation can be improved and therefore has the potential to prevent debilitating complications of diabetes related to poor circulation like foot amputation and the crippling nerve damage or diabetic neuropathy.  Anecdotal reports and few small scale studies have proven acupuncture to help ease pain and prevent diabetic foot ulcers but only if applied early in the disease process.   The problem is the absence of acceptable and properly done wide scale studies where proven results are duplicated. A research funding by the National Institutes of Health in the United States is being done in quest for an answer…

 

As medical practitioners, it is best to advise to patients that no studies at present can prove acupuncture to work beyond placebo effect. It is being tolerated by the US FDA considering its relative safety.  But it is always prudent for patients not to discontinue their medications or the proven therapies we provide them and to use acupuncture only conjunction with their medications.  Likewise it is best that patients should inform their physicians about their desire to have an acupuncture done and likewise should not accept any diagnosis of a disease from those performing the acupuncture..

 

Acupuncture…It’s a wait and see for now but so far results seem promising….

Posted in Medical News Bits, The Diabetes Facts | 3 Comments »

Your Weight and Your Risk To Develop Breast Cancer….

March 26, 2008

Go to fullsize imageObesity is one big epidemic that is becoming a huge economic burden due to the medical complications arising form the disease. 

In the recent issue of the the journal Clinical Cancer Research, the relationship between increased weight and the risk of developing breast cancer has been shown to be closely linked:

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Purpose: The purpose of this retrospective study was to determine the association and prognostic value of body mass index (BMI) at the time of initial diagnosis in patients with locally advanced breast cancer (LABC). 

Results: 

  • Obese patients tended to have a higher incidence of IBC compared with overweight and normal/underweight groups (P = 0.01). Median follow up was 6 years for all patients.
  • Patients with Locally Advanced Breast Cancer who were obese or overweight had a significantly worse Survival and Recurrence Free Survival (P = 0.001) and a higher incidence of visceral recurrence compared with normal/underweight patients.
  • In a multivariable model, BMI remained significantly associated with both Overall Survival and Recurrence Free Survival for the entire cohort. 

Conclusion: Patients with Locally Advanced Breast Cancer and high BMI have a worse prognosis.

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This study shows us that being obese is more than what we think it is… as mere cosmetics…rather it is a risk factor in itself that can result in a more aggressive type of a disease like breast cancer and can even lead to long term disability like stroke and early death as shown in several studies.

The excess adipose tissue or fat cell results in more circulating estrogen and more inflammatory substances that may be responsible for a more aggressive breast cancer and lesser cancer survival.  We now know that any excess fat cell results in a bigger machinery that produces a lot of substances we never knew about before… that can be harmful to our body!  In short… these fat cells are pretty active and definitely not the passive bystanders that we used to think they are… and therefore need to be dealt with more aggressively!

Another good reason for us to take care and get rid of the FAT….

Be Health and Weight Conscious!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, The Truths on Obesity | 4 Comments »

The Use of Aspirin and The Risk of Death and Cancer…

March 19, 2008

Diabetics are at risk for cardiovascular disease.  As such, an anticlotting agent like aspirin is always part of the drug regimen that we prescribe to our patients.  Studies have proven the use of aspirin to be beneficial in preventing heart disease and prolongoing survival to those at risk of cardiovascular disease in both men and women.

Now comes a new study that looked at the effect of taking aspirin on women without cardiovascular disease and to see if benefits are still present in terms of preventing heart disease or cancer.  This study involved 79,439 women who were enrolled in the Nurses’ Health Study since 1980 published in the Archives of Internal Medicine.

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  • In women who reported current aspirin use, there was a 25% reduction in death from all causes compared with women who never used aspirin regularly.
  • The risk reduction was more apparent for death from cardiovascular disease at 38%.
  • The risk reduction for death from cancer was only 12%.
  •  Use of aspirin for 1 to 5 years was associated with significant reductions in cardiovascular mortality 
  • In contrast, a significant reduction in risk of cancer deaths was not observed until after 10 years of aspirin use.
  • The benefit associated with aspirin was confined to low and moderate doses and was significantly greater in older participants and those with more cardiac risk factors.

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The above study points out that women who take low to moderate doses of aspirin meaning less than 6 tablets per week have lower risk for death from all causes as well as a lower risk for death from cardiovascular disease within 5 years of taking the drug.  However the lower risk for death from cancer was only noted after a longer exposure of 10 years. 

This study continues to propagate the magic of aspirin as a “health” drug.  It helps by preventing a complication that can result in long lasting disability like heart disease and softens the long term economic burden to an already “burdened” risk patient due to polypharmacy arising from diabetes or hypertension.

More studies of similar or better study design should give us more bullets to use to support the long term use of aspirin especially to women or men without risk of cardiovascular disease.

An Aspirin A Day Keeps Your Heart Beat Everyday!

Posted in Medical News Bits, Personal Thoughts | 2 Comments »

Nutrition in Health and Disease….

March 17, 2008

This is called the Paradox of Food:  you need food to live and survive but the very reason for disease and illnesses stem from the abundance of food and poor nutrition!

I practice a field dealing with the metabolic diseases where poor nutrition plays a key role in its onset and progression to develop complications.  Control of blood glucose requires the right balance of nutrition, exercise and medications. The same formula apllies when treating obesity, hypertension and high cholesterol.

The problem with handling these diseases stem from the medical field lack of understanding of nutrition and the lack of importance given to medical nutrition therapy!   If you make rounds in the hospital … you see the diet prepared for a diabetic hypertensive is almost similar if not similar to the other patient in the other room who is not a  diabetic…  It may not be the dietician’s fault but the doctor prescribing the diet!  This is where I am very particular with my patients because I believe the long term success of successfully controlling their blood sugar or blood pressure or cholesterol stem from not what I give them as medications but what they take in as food!

The recent 2008 ADA recommendation for Nutrition  reasons out why Nutrition is important:

Clinical trials/outcome studies of Medical Nutrition Therapy have reported decreases in HbA1c (A1C) of 1% in type 1 diabetes and 1–2% in type 2 diabetes, depending on the duration of diabetes . Meta-analysis of studies in nondiabetic, free-living subjects and expert committees report that MNT reduces LDL cholesterol by 15–25 mg/dl . After initiation of MNT, improvements were apparent in 3–6 months. Meta-analysis and expert committees also support a role for lifestyle modification in treating hypertension .

The proportion of calories in the specific nutrition Rx will now be individualized and should be prescribed by your doctor.  I have my own personal dietician in my clinic now that I offer free couseling to my patients where personal preferences of food is taken into consideration.  I believe in individualized counseling so as to offer a  more successful diet regimen.  No prepared diets printed on a piece of paper!

I have been a proponent of using a 40% of total calories from carbohydrates for my diabetic patients as more and more data are coming out regarding the benefits of limited carbohydrate not only for losing weight but for better glycemic control.  It is but proper that for the first time the American Diabetes Association came up with their position paper recommending the same.

For me…it is plain and simple challenging one’s self discipline in not giving in to the “want” but following to the details of what is nutritious and healthy!!!

Live Life To The Fullest…By Eating Right!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts, The Truths on Obesity, Tips on Hypertension, What's New in Diabetes | 4 Comments »

Wanna Lift Weights? Why Not?

March 15, 2008

When people talk about exercise… it is almost always synonymous to aerobic exercises like jogging, walking and dancing. Never does weight training come into the picture. Combining both should be better!

But why lift weights? Is it advantageous than just sweating it out by running?

A recent article from the Harvard HealthBeat beautifully illustrates the reasons  why:

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Muscle tissue, bone density, and strength all dwindle over the years. So, too, does muscle power. These changes open the door to accidents and injuries that can compromise your ability to lead an independent, active life. Strength training is the most effective way to slow and possibly reverse much of this decline.

Having smaller, weaker muscles doesn’t just change the way people look or move. Muscle loss affects the body in many ways. Strong muscles pluck oxygen and nutrients from the blood much more efficiently than weak ones. That means any activity requires less cardiac work and puts less strain on your heart.

Strong muscles are better at sopping up sugar in the blood and helping the body stay sensitive to insulin (which helps cells remove sugar from the blood). In these ways, strong muscles can help keep blood sugar levels in check, which in turn helps prevent or control type 2 diabetes and is good for the heart. Strong muscles also enhance weight control.

On the other hand, weak muscles hasten the loss of independence as everyday activities — such as walking, cleaning, shopping, and even dressing — become more difficult. They also make it harder to balance your body properly when moving or even standing still, or to catch yourself if you trip. The loss of power compounds this.

Perhaps it’s not so surprising that, by age 65, one in three people reports falls. Because bones also weaken over time, one out of every 20 of these falls ends in fracture, usually of the hip, wrist, or leg. The good news is that the risk of these problems can be reduced by an exercise and fitness routine that includes strength training.

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As we prevent complications from illnesses to happen…we also should have this obligation to live longer but healthier! And one sure thing to accomplish this goal is to exercise regularly and exercise the right way!

Incorporating weight training to your regimen not only strengthens muscles but likewise prevents obesity since the more muscle you have, the less fat you get and the more metabolically active the muscle mass is compared to fat! As a result you likewise help prevent the onset of chronic illnesses like diabetes and hypertension!

I do incorporate weights into my exercise regimen. I don’t go to the gym but after my sit-ups in the morning, I then do my routine abdominal twisting disc then do the weights using the arm band that you can buy in sports shops, or my barbell weights. You can likewise do the tiptoe setup by putting you two hands on the wall then tiptoe to raise yourself as high as you can then hold it for few seconds then repeat it 8 to 10 x daily!

Simple Rules and Simple Measures For a Healthier You!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Weight Loss Tips | 3 Comments »

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