Archive for the 'Personal Thoughts' Category

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Foods That Can Make Us Feel FULL….

May 12, 2008

Go to fullsize imageDifferent kinds of food give us different levels of satiety and the feeling of fullness.  You may not have realized it but in one meal, you get easily hungry in less than 2 hours and are wondering why this is so.

It is important for us to remember that the main role of food is solely to satisfy our craving, our hunger and definitely to provide us the needed calories for energy.  But the kind of food we eat will determine if we feel the feeling of satisfaction or not.  This satiety factor therefore will be a factor in making us eat more and therefore provide us with unecessary calories that make us gain weight!

What determines the feeling of fullness include the quantity of food we eat, the actual contents of the food and the texture including the smell.  Signals to the brain from the stomach make us feel satisfied or make us eat more.   

What foods can give us the highest satiety level? 

If your food contains a high level of protein, enough amounts of fiber and water, this food will give you the highest satisfaction rating.  In contrast foods high in fat will make you less satisfied and makes you want to eat more…this be the reason why a high fat diet makes you gain weight!  Intake of protein like a meal that includes fish meat or egg  gives a higher satiety level than carbohydrates.  But carbohydrate rich foods like pasta, rice or bread also provides a high satiety level. 

So to provide one with the highest satiety level of food for a meal… a whole grain bread with leans cuts of meat can provide a better satiety level and longer period of preventing hunger than if one eats a croissant!

The satiety factor of a food like glycemic index is just one of the many factors that affect the way we eat, the way we manage our lifestyle and the way we prevent weight gain. Complex factors come into play including social norms, culture and even mood in deciding whether we feel satisifed and enough food is enough for the meal!

The bottom line is: the higher the satiety factor the lesser we eat!  Likewise…my advise to all: once you feel full…then stop eating especially if you are indulging in a high carbohydrate meal!!!! Sometimes, its the great taste of food even if we are already full that makes us want to eat more. 

Dont be Fooled by Food…Be “Fulled” The Right Way!

Posted in General Health Tips, Lifestyle Measures, Nutrition Health Tips, Personal Thoughts, Weight Loss Tips | 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 »

A High Fiber Diet: Does It Really Matter?

April 11, 2008

Go to fullsize imageWe have been exposed to ads regarding the benefits of a high fiber diet.  We know it is good for our health but what does it do and where do we get these fiber rich products?

It has been shown in several studies that a high fiber diet can indeed lower ones risk to develop heart diseaese by as much as 30% as well as lower ones risk to develop diabetes and improve cholesterol.   We know it works well for roughage and therefore can prevent constipation and improve bowel habits.  In fact it was recommended as a way of preventing colon polyps and cancer BUT so far no long term studies have proven that fiber can indeed lower the risk for colon cancer.  Nonetheless, the multiple benefits we can get from eating a high fiber meals are more than enough to recommend intake of these products to our patients and the public in general.

But what are the best sources of fiber? Here is a list of the different kinds of fiber compiled by the Harvard School of Nutrition:

Sources of Fiber

Soluble Fiber

Insoluble Fiber
oatmeal
oatbran
nuts and seedslegumes

  • dried peas
  • beans
  • lentils

apples
pears
strawberries
blueberries

 whole grains

  • whole wheat breads
  • barley
  • couscous
  • brown rice
  • bulgur

whole-grain breakfast cereals
wheat bran
seeds
carrots
cucumbers
zucchini
celery
tomatoes

The best fiber source in several studies that proved a high fiber diet to be beneficial is the cereal based fiber or fiber from grains and those coming from fruits.  It is recommended that a diet with at least 21 to 38 gms of fiber should be taken per day.  On an average Filipino diet, we are only consuming at most less than 15 gms of fiber per day so we better bulk it up more with the sources mentioned in the table for health reasons.  Increase the fiber intake gradually rather that abruptly and to make sure we also increase the intake of water ans fiber absorbs water.

What Do I recommend: here’s a sample advise that I give to my patients:

  • Avoid fruit juices as they are devoid of fiber, instead eat whole fruits.
  • Eat brown rice instead of white rice
  • Buy whole grain products instead of white bread and pasta.
  • Try snacking with raw veggies..they may not be as yummy as a pastry BUT they are triple times  as healthy.
  • Choose whole-grain cereals for breakfast instead of rice and sausage! 

    • Eat Right By Eating Healthy..Try FIBER!

     

    Posted in General Health Tips, Healthy Practice Tips, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts | 1 Comment »

    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 »

    Lower Your Risk To Develop Diabetes By Eating Veggies….

    March 24, 2008

    www.calpoly.edu/~lcimarel/vegetables.jpgWe all know veggies are good.  But this recent finding that veggies can prevent diabetes is a welcome news to us trying to curb the epidemic of this disease due to unhealthly lifestyle and poor dietary habits.

    I have trained my kids to eat veggies.  I found it amusing that one day my son said to me:  “Dad my classmates are teasing me that I am a Vegetarian!”  Suggesting that of all his classmates, he was the only one who had veggies on his lunch box.  Lucky me… my kids love veggies….and for a good reason!

    This good news about veggies and diabetes was published in the March 2008 issue of the Journal of Nutrition:

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    A population-based prospective study of 64,191 women with no history of T2D or other chronic diseases at study recruitment and with valid dietary information.

    The relative risk for T2D for the upper quintile relative to the lower quintile of vegetable intake was 0.72 (95%CI: 0.61–0.85; P < 0.01) in multivariate analysis. Individual vegetable groups were all inversely and significantly associated with the risk of T2D.

    Fruit intake was not associated with the incidence of diabetes in this population.

    Our data suggest that vegetable consumption may protect against the development of T2D.

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    This data is great suggesting that those who consumed the highest amount of vegiies in 4-5 years reduced the likelihood of developing diabetes by 28%.  That is… taking 428 grams of veggies per day reduced ones chances to develop this chronic disabling disease compared to if you only take 121 grams of veggies per day!

    The advantages of veggies is that it contains high fiber as well as other substances like phytates and isoflavones that may help in reducing the risk for developing diabetes.

    Although fruits did not show benefit…it likewise did not show harm.  Just the same fruits have been shown to reduce the risk of developing other diseases like cancer or heart disease.  Such that… its intake remains to be a cornerstone in promoting health!

    Train Yourself and Your Kids To Eat Veggies for Health!

    Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts, What's New in Diabetes | 1 Comment »

    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 »

    The Pedometer: “Small But Terrific” Gadget for Losing Weight

    March 12, 2008

    Go to fullsize imageObesity continues to be a problem worldwide.  Measures to make people lose weight have made a lot of entrepreneurs out of doctors from selling miracle drugs to lose weight to marketing centers promising dramatic weight loss.  The bottom line however continues to be the need to incorporate lifestyle change to every measure that we implement in increasing chances to a successful weight loss.

    The pedometer is one such gadget that is small and handy but a powerful tool to help patients lose weight.  A new meta-analysis published recently in the Annals of Family Medicine showed the effectiveness of this gadget in curbong obesity.

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    RESULTS Nine studies met the study inclusion criteria. Cohort sample size ranged from 15 to 106, for a total of 307 participants, 73% of whom were women and 27% of whom were men. The duration of the intervention ranged from 4 weeks to 1 year, with a median duration of 16 weeks. The pooled estimate of mean weight change from baseline using a fixed-effects model and combining data from all 9 cohorts was –1.27 kg (95% confidence interval, –1.85 to –0.70 kg). Longer intervention duration was associated with greater weight change. On average, participants lost 0.05 kg per week during the interventions.

    CONCLUSION Pedometer-based walking programs result in a modest amount of weight loss. Longer programs lead to more weight loss than shorter programs.

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    What This Study Found as stated by the Editors of the AFM “In Brief”:

     Walking programs that use a pedometer as a motivational tool result in a moderate amount of weight loss in overweight or obese sedentary adults. The average participant in a pedometer-based walking program without dietary change can expect to lose about 1 pound every 10 weeks, or about 5 pounds per year. Longer programs are associated with greater weight loss.

    Implications

    • The amount of weight loss from pedometer-based walking programs is small but significant from a clinical perspective.
    • Walking programs that use pedometers can have health benefits that are associated with both a modest weight loss and increased physical activity.

    Small Steps Can Lead to Big Changes in Health!!!

    Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity, Weight Loss Tips | 8 Comments »

    How To Increase Compliance To Lifestyle Change…

    March 10, 2008

    Nowadays, physicians just dont have the time to talk with their patients. Patients feel shortchanged when they have been waiting outside our clinics only to be seen for 5 minutes. 

    The lesson I’ve learned from my training at the Mayo Clinic was the importance of patient – doctor relationship that should go beyond treating a disease.  But more so to provide comfort to an anxious patient not knowing what she or he has and the need to listen and care!  The words of advise from a doctor’s mouth is more than worth their time in seeing you and these patients see us because they trust us to help them lead a better healthy life.

    Now comes a new study that confirms my practice in my clinic published in the Archives of Internal Medicine this 2/2008.

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    Background  Our objective was to test the effect of physicians providing brief health lifestyle counseling to patients with type 2 diabetes mellitus during usual care visits.

    Methods  We conducted a randomized controlled trial of a 12-month intervention at 2 large community health centers, enrolling 310 patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater. In the intervention group, self-management goals for nutrition and physical activity were set using a tailored computer program. Goals were then reviewed at each clinic visit by physicians. The control group received only printed health education materials. The main outcome measures included change in physical activity and body weight.

    Results  In the intervention group, recommended levels of physical activity increased from 26% at baseline to 53% at 12 months (P < .001) compared with controls (30% to 37%; P = .27), and 32% of patients in the intervention group lost 6 or more pounds at 12 months compared with 18.9% of controls (odds ratio, 2.2; P = .006).

    Conclusion  A brief intervention to increase the dialogue between patients and health care providers about behavioral goals can lead to increased physical activity and weight loss.

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    This study confirms my belief and practice of spending more time with the patient in trying to help them understand how one can implement the standard of care in dealing with chronic diseases like obesity, high blood pressure, high cholesterol and diabetes.  If one understands the concept of why exercise and nutrition are important then the pressure is with the patient to comply otherwise he will suffer the consequences.

    Compliance to medications and behavioral therapy is a must if one aims to reach the goal of preventing complications like stroke and heart attack!  I am always asked if I am successful with behavioral modification and in letting patient follow my dietary guidelines.  I guess I am because I spend time with them.

    This has been my standing principle and guide in my practice and thus this website to help educate my patients and the public because I believe that….

    “Understanding One’s Disease Is Key To Better Health”. 

    Posted in General Health Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts | 6 Comments »

    Is Acupuncture Safe?

    March 6, 2008

    Before I left the Mayo Clinic after my fellowship, the center was already into research regarding the efficacy of this ancient chinese remedy called the Acupuncture.  It is one of the widely practiced alternative medicine in the US and therefore the National Institute of Health is also funding research into this area.  It is one alternative therapy that does not entail any intake of drugs and therefore I bend a little and allow the use of this form of therapy among my patients.

    Here is an excerpt of what acupuncture is from the National Institutes of Health:

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    Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine. In TCM, the body is seen as a delicate balance of two opposing and inseparable forces: yin and yang

    Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. According to TCM, health is achieved by maintaining the body in a “balanced state”; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi (vital energy) along pathways known as meridians. Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Sources vary on the number of meridians, with numbers ranging from 14 to 20. One commonly cited source describes meridians as 14 main channels “connecting the body in a weblike interconnecting matrix” of at least 2,000 acupuncture points.

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    The US FDA admits that this form of therpay is pretty safe with very few complications.  However it is advised that needles be sterile, nontoxic, and labeled for single use by qualified practitioners only.  Furthermore, the NIH site cautions that: “Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs.”

    Whether the therapy really works for osteoarthritis to low back pain to diabetic foot ulcers remain to be seen.  The NIH is already funding research into these areas and their conclusions are worth waiting for!

    For now… just like any alternative medicine…it is done at the patient’s will. It is not prescribed or advised but if asked then the doctor may tend to bend a little and allow this therapy to be done if other known modalities fail.

    If Anything Else Fails..Try Acupuncture!

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

    Can Multivitamins Prevent Cancer?

    March 3, 2008

    Do you take multivitamins daily?  Why? Out of habit? or because you believe they can prevent illneses especially cancer?

    Well a new study refutes the claims that multivitamins can prevent cancer.  Recently published in the American Journal of Respiratory and Critical Care Medicine suggest that in fact the contrary maybe true and that is… it can be harmful!!!!__________________________________________________________

    Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk.

    Objectives: To explore the association of supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer.

    Methods: Prospective cohort of 77,721 men and women aged 50–76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle–Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry.

    Measurements and Main Results:

    • Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose).
    • This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase) and was greatest for non–small cell lung cancer (HR, 1.07 for every 100-mg/d increase).

    Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk.

    Patients should be counseled against using these supplements to prevent lung cancer.

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    We have been disappointed with studies looking at whether multivitamins are beneficial or not.  Almost always they turn out to be negative and sometimes even do harm.  And yet we continue to take MVI as supplements to our diet for hope that they may replenish what have been lacking in our diets.  I even have patients who continue to show me their MVI preparations bought by their loved ones in the US whether they can take them or not.

    What we know is that foods rich in vitmains have been proven to reduce the risk of cancer…BUT once these vitamins are packaged as pills…then the benefit is nowhere to be found!  And what is worst…in the above published study…Vitamin E was noted to increase the risk of lung Cancer especially among smokers!

    The best option for us is not to rely on shortcuts to health packaged as pills…its in our lifestyle..the food we eat , the physical activities we do and the way we live our lives that matter most!

    Health Shortcuts Packaged As Pills Are Of No Benefit!

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

    The Obesity and Fatness Tax

    February 27, 2008

    Go to fullsize imageJust came from a convention in Agra India where I read in the papers that UK is starting to charge more in terms of insurance premium depending on the degree of obesity. 

    Meaning the higher the BMI ( a measure of fatness) , the higher the premium!  It is the insurance way of probably getting back at the skyrocketing cost of Obesity in terms of medical costs.

    Fatness therefore is now becoming a Liability! 

    Whether this measure will translate into more people taking care of themeselves remain to be seen!  But it is one way to getting people to exercise and live a healthier lifestyle.  And in the long run benefit both the patient and of course the insurance compnay!

    Insure Yourself To Better Health!

    Posted in Medical News Bits, Personal Thoughts, The Truths on Obesity | 2 Comments »

    Can Noise Increase Blood Pressure?

    February 21, 2008

    Go to fullsize imageA sudden noise or commotion can make your heart rate go up and can be felt as sudden chest beating or palpitation.  We all know that one reason for an increased BP is an increase in heart rate.

    A new study published in the European Journal of Hypertension Februaury 12, 2008 looked at this relationship and examined the population living near the airport. The BP and heart rates were checked and evaluated during the noise caused by the airplanes and the results were interesting.

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    Non-invasive ambulatory BP measurements at 15 min intervals were performed. Noise was measured during the night sleeping period and recorded digitally for the identification of the source of a noise event.

    • An increase in BP 6.2 mmHg for systolic and 7.4 mmHg for diastolic was observed over 15 min intervals in which an aircraft event occurred.
    • A non-significant increase in HR was also observed (by 5.4 b.p.m.).
    • When the actual maximum noise level of an event was assessed there were no systematic differences in the effects according to the noise source.

    Conclusion: Effects of noise exposure on elevated subsequent BP measurements were clearly shown. The effect size of the noise level appears to be independent of the noise source.

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    This study has clinical implications on the future risk of heart disease and stroke with elevated BP. It would be nice to know the future risk of these population compared to the general population in terms of heart disease in relation to their exposure to noice.

    Environment plays an important role in how stress manifests in our body. Noise generated from any source will definitely have the same effect as the study population and in itself increases a patient’s risk for heart disease due to rises in BP.  What is important is that the study also found that any level of noise including traffic sounds and other bedtime noise like snoring can cause a BP to spike!

    For me… relaxing in between stresses in life can make a difference.  Any noise generated while at work can be stressful in itself and taking time to relax and listen to music or the waves of the sea and enjoy can spell a huge Difference!

    Take a Break From Noise…Why Not Enjoy a Spa?

    Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, Tips on Hypertension, Tips To Protect Your Heart | 3 Comments »

    Stress and Heart Disease: A Close Circuit!

    February 18, 2008

    Stress from work?  Who isnt? But the way we handle stress can make a difference in how it affects our lives.  We always associate it as part of our day to day activity otherwise, it is not living if we dont have stress.  It gives us the challenge to move on and to pursue what we have in mind to achieve. But along the way comes the roadblocks called “Stress”

    Recently an nice article examined how stress can affect out health.  I am a believer of stress as a big factor in increasing a patient’s risk to develop chronic illnesses like diabetes and high blood pressure.  Now published in the European Heart Journal is a detailed examination of how stress can affect the heart!

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    A total of 10 308 London-based male and female civil servants aged 35–55 of the Whitehall II study were studied. Exposures included work stress and outcomes included behavioural risk factors, the metabolic syndrome, heart rate variability, morning rise in cortisol, and incident CHD on the basis of CHD death, non-fatal myocardial infarction, or definite angina.

    • Chronic work stress was associated with CHD and this association was stronger among participants aged under 50 by 68%.
    • There were similar associations between work stress and low physical activity, poor diet, the metabolic syndrome, its components, and lower heart rate variability.
    • Cross-sectionally, work stress was associated with a higher morning rise in cortisol.
    • Around 32% of the effect of work stress on CHD was attributable to its effect on health behaviours and the metabolic syndrome.

    Conclusion: Work Stress may be an important determinant of CHD among workiing-age populations, which is mediated through indirect effects on health behaviours and direct effects on neuroendocrine stress pathways.

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    The above results are clear: once you’re stressed out… you produce stress hormones through the nueroendocrine system resulting in an increase of serum cortisol which can be harmful to the body including the way it signals how the heart beats! End result: Heart disease….

    Further examination revealed that work stress is associated with a poorer diet in terms of eating less fruit and vegetables, and less exercise which also then contribute to increasing one’s risk for heart disease further.  I am sure a lot of the readers are guilty of this!  Too little time…too much to do! In fact in this study around 32% of the effect of work stress on CHD could be explained by its effect on health behaviors and the metabolic syndrome.

    In short….Enjoy your work…problems come but solutions are abundant.  It is a matter of finding them!

    Mind Your Heart… Eat Healthy, Exercie Freely and Be Stress Free!

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

    The Plenary Debate… Good Luck To Me!!!!

    February 13, 2008

    plearny-board.jpgplenary-debate-inside.jpg

    This will be a fun learning debate and will be the highlight of the joint annual convention of the  Philippine Society of Hypertension and Philippine Lipid Society in Manila.

     As doctors… we continue to study and learn non stop!

    And as a lecturer and speaker… that’s where I study more and as a result I learn more!

    Again.. In Health…Learning is NonStop!

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

    Exercise As An Investment In Life…. Offers Great Returns!

    February 12, 2008

    Go to fullsize imageExercise can reduce risk of death!!!

    Exercise can make you live longer and make you enjoy your life better. We know this for centuries but lifestyle continues to be one big struggle for doctors to ask their patients to comply. 

    That’s the conclusion reached in a study recently published in Circulation Feb 2008.

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    Methods and Results— We assessed the association between exercise capacity and mortality in  male veterans with and without cardiovascular disease who successfully completed a treadmill exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. Fitness categories were based on peak metabolic equivalents (METs) achieved. Subjects were followed up for all-cause mortality for 7.5±5.3 years.

    Among clinical and exercise test variables, exercise capacity was the strongest predictor of risk for mortality. The adjusted risk was reduced by 13% for every 1-MET increase in exercise capacity

    • Compared with those who achieved <5 METs, the mortality risk was 50% lower for those with an exercise capacity of 7.1 to 10 METs
    • 70% lower for those achieving >10 METs 
    •  The findings were similar for those with and without cardiovascular disease.

    Conclusions— Exercise capacity is a strong predictor of all-cause mortality !

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    So the study suggests…the more we exercise and the more calories we burn resulting in a better shape and better exercise capacity, the longer we live!  A 70% reduction in the risk of death is GREAT news for exercise lovers! There you go guys…. it’s about time that we sit down and think…how much do we love ourselves.  Are we doing things to satisfy our ambitions in life with great disregard to our well being?

    We may be great thinkers, scholars or successful businessmen… we may be great in everything we do BUT our body also deserves to be treated right.  Success in life comes in different forms and all come from doing what you think is best!

    If you therefore want to to enjoy that success and live longer…enjoy the fruits of your labor longer…enjoy life and have more fun times with your kids and family… then take the extra steps to health.  Just like what you do in taking the extra effort to be successful in your careers and goals in life.  So take time to Exercise…It is indeed an investment worthy of its great returns…..

    Take The Extra Time To EXERCISE!!!

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

    The Truth About The Medical Myths….

    February 9, 2008

    Go to fullsize imageCame across a light article published in the reputable British Medical Journal December 2007 issue on the common myths in Medicine that have been passed from generations to generations and carried on in our practice as facts!

    Below is my edited and shortened version of the original article which I hope you’ll all find useful inofrmation.

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    People should drink at least eight glasses of water a day

    The advice to drink at least eight glasses of water a day can be found throughout the popular press. One origin may be a 1945 recommendation that stated: A suitable allowance of water for adults is 2.5 litres daily in most instances…the statement could be interpreted as instruction to drink eight glasses of water a day. The complete lack of evidence supporting the recommendation to drink six to eight glasses of water a day is exhaustively catalogued in an invited review by Heinz Valtin in the American Journal of Physiology.

    Hair and fingernails continue to grow after death

    Johnny Carson even perpetuated this myth with his joke, “For three days after death hair and fingernails continue to grow, but phone calls taper off.

    Dehydration of the body after death and drying or desiccation may lead to retraction of the skin around the hair or nails. The skin’s retraction can create an appearance of increased length or of greater prominence because of the optical illusion created by contrasting the shrunken soft tissues with the nails or hair. 

    Shaving hair causes it to grow back faster, darker, or coarser

    Strong scientific evidence disproves these claims. As early as 1928, a clinical trial showed that shaving had no effect on hair growth.  More recent studies confirm that shaving does not affect the thickness or rate of hair regrowth.  

    Reading in dim light ruins your eyesight

    Suboptimal lighting can create a sensation of having difficulty in focusing. It also decreases the rate of blinking and leads to discomfort from drying, particularly in conditions of voluntary squinting.  The important counterpoint is that these effects do not persist.

    Mobile phones create considerable electromagnetic interference in hospitals

    After publication of a journal article citing more than 100 reports of suspected electromagnetic interference with medical devices before 1993, the Wall Street Journal published a front page article highlighting this danger. Since that time, many hospitals banned the use of mobile phones, perpetuating the belief.

    At the Mayo Clinic in 2005, in 510 tests performed with 16 medical devices and six mobile telephones, the incidence of clinically important interference was 1.2%.  

    We Use only 10% of our Brain

    The belief that we use only 10% of our brains has persisted for over a century, despite dramatic advances in neuroscience.  Some sources attribute this claim to Albert Einstein, but no such reference or statement by Einstein has ever been recorded. Evidence from studies of brain damage, brain imaging, localisation of function, microstructural analysis, and metabolic studies show that people use much more than 10% of their brains.  Detailed probing of the brain has failed to identify the “non-functioning” 90%.

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    There you go guys…common myths that have been practiced by medical professionals as facts. We continue, for example to recommend patients to drink at least 8 glasses of water but so far based on the evidence…it is limited or nil.

    As the author of the article concluded: “Medical practitioners should at least recognise when their practice is based on tradition, anecdote, or art.  Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge.“

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

    Exercise for Life….

    February 4, 2008

    Go to fullsize imageHarvard News Letter: The HelathBeat just came out with an article solely devoted to the benefits of exercise.  This post is just a reminder to all that exercise is good for the health not only to prevent disease but to live long and enjoy a better life:

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    Exercise at a glance

    This is what exercise can do:

    • reduce your chances of getting heart disease. For those who already have heart disease, exercise reduces the chances of dying from it.
    • lower your risk of developing hypertension and diabetes.
    • reduce your risk for colon cancer and some other forms of cancer.
    • improve your mood and mental functioning.
    • keep your bones strong and joints healthy.
    • help you maintain a healthy weight.
    • help you maintain your independence well into your later years.

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    It’s a matter of taking time to do it and the willingness to do it! 

    Because in Health … There is NO Shortcut!

    Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Personal Thoughts | 3 Comments »

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