Archive for the 'Personal Thoughts' Category

AACE Philippines 2nd CME Update: A Success!

February 2, 2008

Go to fullsize imageThe American Association of Clinical Endocrinologists or AACE Philippines recently held our 2nd CME update in Hongkong where members were invited sponsored by the organization for a 2 day meeting of lectures, comaraderie and family fun!

Dr Augusto Litonjua gave us an update on the Pathophysiology of Daibetes while I gave an update on Pathophysiology of Hypertension.  There was a lively interaction among the members and it was a fun intellectually stimulating CME overall!

The fellowship night was full of fun and excitement as members around 50 attended. Part of the itinerary of course was a full day fun at Disneyland and we all gathered to watch the fire works display. 

AACE Philippines strives to be family oriented. So we try to include the family members in all activities that we do.

We hope to invite more members to our team as our membership has been growing yearly.  Likewise the officers strive to make this organization an asset and a support arm to the members in clinical practice. 

Next in line is the Endocrine Day in March and we are now extra busy finalizing a more exciting program for our Annual Convention to be held again in Mactan Shangrila on August 15 to 17 where more debates, workshops and exciting plenary lectures from distinguished foreign and local faculty members will be on hand.

Check out some photos of the members in action under the catagory: AACE Philippine Chapter News (soon…..)

Health Tips To A Successful Retirement

January 24, 2008

I recently read a nice article on tips to a successful retirement in the Wall Street Journal which made a lot of sense to me.  We know of retirement as one event in our lives where for once…we can now have all the time for ourselves…BUT are we prepared enough both emotionally, physically and health wise before we plunge into it?

The bottom line in retiring is to plan this stage in life ahead of time.  It is suggessted that start planning about retirement at least 5 years before you quit the work force.

The research is clear: “People who dont have a purpose in life, dont live long.” So if you retire and then do nothing except golfing, going to the beach…these will not last long before BOREDOM sets in because of not being productive….then Depression!  So plan on doing voluntering work and anything that is intellectually stimulating can make you stay sharp!

Staying Healthy is the most important factor to a successful retirement.  Statistics have shown that in US alone: half of the 60 year old will live up to age 85.  It is for this reason that saving money prior to retirement is also key to enjoy the benefits of all the hard work.  BUT always Remember… being healthy is also KEY! Why? because….a healthy lifestyle and good health can keep your medical costs down.

So if you plan to retire early and enjoy the benefits of retirement … then make sure you keep wellness ahead of everything else in life.   If you are saving enough to spend…make sure you spend them on luxuries you want to enjoy and not the frequent visits to doctors and pharmacies for your medications due to neglect of health!  Again It is thru Health where you enjoy your wealth!

 In summary, quoting Hartford’s Ms Mohyde in the article:

“Wellness in retirement maybe one fo the Best Financial Strategies”

Can Ginkgo Biloba Improve Memory?

January 18, 2008

I am always asked this question whether there is a vitamin or supplement to improve memory.  There are alreay several claims of ginkgo biloba being a “great” memory enhancer but so far I havent come across a study that says it does.

Ginkgo herbs and supplements are actually derived from the tree leaves and is being marketed in supermarkets everywhere.  Again just like any herbal preparations, it should be taken at your own risk because I dont see any clinical indication in medicine to provide herbal supplements or medications that do not have studies to support any claims.

Medscape Endocrinology Online recently published an article on Gingko which I want to share:

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Studies in the United States have found that ginkgo stabilized — and in some cases improved — cognitive function and socialization in patients with Alzheimer’s disease, although the clinical significance of the improvement was not known. LeBars and colleagues reviewed 2020 patients in an intention-to-treat analysis that resulted in a 1.4-point advantage over placebo in the Alzheimer’s Disease Assessment Scale-Cognitive subscale.

In addition, studies have also demonstrated that the standardized extract of ginkgo biloba (EgB) 761, is effective in reducing symptoms of claudication, giving patients a 50% increase in pain-free walking distance.

In contrast, a recent clinical trial failed to demonstrate any improvement in cognitive function or in the quality of life in cognitively intact, older individuals.

Ginkgo leaves have been associated with mild gastrointestinal side effects and headache. Ingestion of ginkgo seeds may result in serious neurologic and allergic reactions; therefore, they are not used for medical purposes. Ingestion of leaf-based extracts has been associated with a spontaneous hyphema (blood in the anterior chamber of the eye) in an elderly man, and with spontaneous subdural hematomas.

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Whether this supplement will have a place in the therapeutic armamentarium of Alzheimer’s disease or conditions that lead to poor memory remains to be seen.  For now… it is best to ask for advice from your doctors before you take any herbal preparations because they may interact with some drugs that you are taking for your medical condition.

So my recommendtion to those who wish to take ginkgo to enhance their memory for purposes of taking a supplement…I would say NO!  To those who wish to take ginkgo to improve their memory for test taking skills… my advise is: better study more than depend on pills!

In short… no study yet has been done to support an indication of ginkgo as a treatment option. More studies need to be done to prove it works and that its benefits outweigh the risks.

Anxiety and The Risk For Heart Attack!

January 11, 2008

Are you always Anxious? Jittery? Worried on something? Have you been suffering from anxiety that you just cant help it be worried that something may happen?

Anxiety is defined as a feeling of fearfullness and uncertainty. Transient anxiety due to family problems or death can be normal BUT once anxiety continues overtime and is affecting your daily activities and is getting worse then intervention should be made.

I have long suspected Stress secondary to anxiety can definitely be harmful.  Stress hormones that our body produces can be harmful and in fact Stress is now considered a risk factor for developing diabetes.  Now a new study published in the Journal of Cardiology, January issue considers anxiety as a risk factor for one to develop heart attack.

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Anxiety characteristics independently and prospectively predicted MI incidence after controlling for age, education, marital status, fasting glucose, body mass index, high-density lipoprotein cholesterol, and systolic blood pressure in proportional hazards models.

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The above study is the first to show this relationship….and am sure more studies will come that will show Stress from whatever cause can lead to what we know now the Diseases of the New Century….

Remember…LIFE is Too Short….

  • Each day is a new day and once it passes…it’s one less day for you!
  • Live each day to the fullest…
  • Do things the best way you can and
  • Enjoy what you do best and Improve on Things you want to learn
  • Thank God for what you have.. and Stop being Bitter!
  • Learn how to appreciate things… understand why some things just dont work the way you desire. 

In short….

To Be Stress Free….ENJOY Being Alive!

Honey for Cough and Colds ?

January 10, 2008

If cough and colds medicnes are not that effective such that the US FDA recently made an announcement not to use these medications among children less than 6 years old… then what is our altrernative as parents with children arriving from school with cough and colds?

I have long heard about honey and its supposed “healthy” properties so I was not surprised when in a recent article published in Archives of Pediatric and Adolescent Medicine, Dec 2007 , honey was assessed to be a safe alternative to cough and colds medicine which for me is just timely!!!! 

In this study the, the children with cough and colds were given either honey, honey-flavored DextroMethorphan ( a cold remedy), or no treatment 30 minutes before bedtime.  ______________________________________________

Results:  Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst.

In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences.

Conclusions :  Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection.

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The study used buckwheat honey which contains more phenolic compounds than other varieties.  Apparently these substances have been shown to have antioxidant properties whihc may have contributed to the improvement of the symptoms of cough and colds.   The question therefore whether the effect is limited to this kind of honey only remains unanswered.

For me honey is easy to get and safe to drink.  Based on the study… it worked. I would definietly try it on my kids and then let’s all share experiences once we have tried it.

Bring Home The Honey! 

Foods To Eat To Help Reduce Wrinkles….

January 7, 2008

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Using data from the first National Health and Nutrition Examination Survey, we examined associations between nutrient intakes and skin aging in 4025 women (40–74 y).  Clinical examinations of the skin were conducted by dermatologists. Skin-aging appearance was defined as having a wrinkled appearance, senile dryness, and skin atrophy.

Conclusions: Higher intakes of vitamin C and linoleic acid and lower intakes of fats and carbohydrates are associated with better skin-aging appearance.

Promoting healthy dietary behaviors may have additional benefit for skin appearance in addition to other health outcomes in the population.

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Vitamin C as anti-aging has some meat to it.  It is known that vitamin C as an antioxidant play a role in the synthesis of collagen, which is a protein that helps keep skin elastic.  It can therefore be presumed that higher intakes of Vitamin C can bring luster to ones skin.

Great sources of Vitamin C that we can buy anywhere include brussel sprouts, red cabbage, snow peas and broccoli as well as canned and fresh tomatoes and of course our fruits especially the freshly squeezed orange juice.

What is interesting about the study is that those that had a high fat or a high carbohydrate meal developed more wrinkles and senile atrophy of the skin suggesting the long notion that fat is really bad even for the skin!

I do recommend foods rich in vitamin C but not to take any Vitamin C supplements in the form of a tablet especially on top of food.  Not only will these excess supplements adidify the urine but likewise increases the likelihood of stone formation.

Lastly…. 

The Best Way to Prevent Wrinkles?… Sunscreen!

Smoking and Impotence: A Deadly Combination

January 2, 2008

IGo to fullsize imaget is very difficult to stop an addiction.  Smoking is one problem that we almost always encounter among our male patients who come in with Diabetes.  Seldom do many realize that smoking in itself doubles or triples the harm that high blood sugar entails among our diabetic patients.

But one complication that many dont realize is that smoking contributes to the increasing risk of impotence. 

A survey published in the American Journal of Epidimeology showed that the risk to develop impotence among smokers is 42% higher compared to non smokers!!!!   If this vice is coupled with alcohol consumption and obesity then the risk of erectile dysfunction substantially increases further!

So to all smokers out there… you may just ward off the effects of smoking on the heart, and the lungs but to be impotent is a DISASTER!!!!!

This New Year’s: Resolve To Stop Smoking For Health and Wellness!

Merry Christmas and a Happy New Year To ALL!!!!

December 27, 2007

As much as I want to read more and share some new things in my website…time for the holidays is mainly for the family and the kids.  We just came back from a family gathering with my father and my 8 bros and sisters in the province and it was not only relaxing but worth the effort and time of the travel to see my folks again and make sure they keep themselves in good health!  It is actually a time also for them to ” consult” with me and make sure they are doing right with their health!

Tomorrow will be my time for my own family where for the first time I’ll bring my three kids to Hongkong Disneyland… I have already brought my 2 older kids to Hongkong last summer, to Korea last year and Singapore and China 2 years ago but this trip will be the first for the youngest one.  The disneyland affair in December is also worth the fun! I am sure I will need a massage and spa after this trip but my kids deserve this trip!

So to all my friends in the web… Merry Christmas and A Happy New Year To ALL!!!!

CHEERS to a Better Health in the Coming Year!!!

Yogurt And Its Health Benefits….

December 22, 2007

My family loves Yogurt so I thought of sharing with you how this great tasting beverage can be healthy as well.

1. Yogurt contains active, living cultures and the most abundant are lactobacillus bulgaricus and streptococcus thermophilus. These cultures help keep the colon healthy with studies showing it to lower the risk of colon cancer.

2. Yogurt contains lots of protein, vitamins, and minerals — and now you have choices of which to choose depending on the amount of calories each preparation has.  But overall for the weight conscious…it contains less calories than you think.

3. Yogurt uses nonfat milk in its preparation, and therefore a rich source of calcium and water as well. Meaning good for the bones!!!!

4. For those who have lactose intolerance and therefore unable to tolerate milk can easily enjoy yogurt.  The culturing process of yogurt makes it easily digestible.  The cultures present in yogurt help create the substance lacking in patients with lactose intolerance which is lactase.

5. Yogurt helps increase the absorption of certain nutrients and vitamins including Vitamin B and calcium.

6. Lastly, some studies have shown it to boost ones immunity and is considered a grow food… good for our children because it is rich in protein but also it helps in the absorption of other food protein needed for growth!!!

Need I say more my friends.  I let my kids bring yogurt to school daily as snack instead of the usual fruit juices which are rich in sugar and therefore calories.  I also prefer yogurt mixed with my fruits and they just blend very well….Use it in place of ice cream and one can even use yogurt in place of milk for baking goodies….

So next time you go grocery shopping in time for the Christmas celebration dinner… grab a yogurt on your way out or two!

Yogurt Does Your Body GOOD!

Intensive Blood Sugar Control Can Reduce Risk of DEATH

December 20, 2007

Go to fullsize imageFor my diabetic patients, it is very important that they understand that the reason for controlling their blood sugar is… to reduce the risk for complications like heart disease and stroke.

Now comes a new study that proves…tight control of blood sugar can indeed lower the risk of a patient to die from the disease…. published in Diabetes Research and Clinical Practice 2007

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The study concluded:

Normal mortality was attained in the elderly under intensive mutifactorial diabetes control ( Including control for BP and cholesterol)

Renal dysfunction, prior stroke, high LDL-cholesterol, and prior obesity were prominent risks for mortality, macroangiopathy and/or ESRD.

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For me the bottom line in addressing any disease is based on two key  things:

  1. Discipline to live a healthy lifestyle! Remember…to live longer does not mean controlling blood sugar alone because if you continue to gain weight with high blood pressure and high BAD cholesterol due to poor choices of food then the end result is still early mortality due to complications!
  2. Follow Your doctor’s advise!.But choose the right doctor for your specific disease to get the best solution to your problem because just like any job we want done… you find for the best person to do the job RIGHT! and not just to finish the job!…

In the end of the day… everything boils down to one conlcusion….

To Live LOnger Requires Discipline!

Red Meat and Your Risk for Cancer…

December 18, 2007

I eat meat…. who doesn’t?  I know of few friends that are purely vegetarians but I can only count them with my one hand.  I try to introduce veggies to my kids as often as I can but food is finished faster if there is meat especially red meat from fried chicken!!!!

Now comes a new study linking red meat consumption to increased cancer risk.  This study was recently published online in PLOS Medicine, December of 2007 with a conclusion from the editorial below:

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…Red and processed meat intake appears to be positively associated with risk of cancer of the colon and rectum, esophagus, liver, lung, and pancreas in a new, large US cohort study of 500,000 men and women.

….However, this study provided little support for an association with other cancer sites. Current dietary guidelines recommend selecting meats that are lean, low-fat, or fat-free, thus promoting limited consumption of red and processed meats.

…..Overall, the strongest risk factors for cancer in the US are smoking and obesity. However, understanding the complex interaction of diet with smoking and obesity, and how specific foods and nutrients are metabolized, may provide further clues into the etiology and, most importantly, the prevention of cancer.

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It is also important to note that while red meat is indeed a risk factor for cancer…majority of patients on red meat are also taking processed foods which are high in fat and therefore associated with obesity which in itself increases ones risk to develop cancer.  And therefore the interaction of the different risk factors is in itself a matter of importance.

For this holiday season…let us therefore examine the way we lead our lives … the way we eat and the way we take care of our health. It is really up to us to interpret and practice the things we know that are healthy and avoid or shy away from the things we know that are harmful. 

….Which way to go and adopt the practice in our lifestyle is up to us!….

Be Informed! and Live Well!

Experience in Taipei, Taiwan….

December 15, 2007

Go to fullsize imageJust on my way home from a trip to Taipei …was here in the 90’s and so much has changed since then. The progress is evident but it seems that the progress has not changed the culture at all.  The cleanliness is evident as well as the character…of the place and the people.

This is touted as one of the safest places to go around in Asia. It may not boast of a lot of touristic destinations but the history in itself is worth the visit.  You dont see a lot of tourists from the US or Europe and majority or 90% of the people visiting places like the museums and nearby cities are from the domestic travelers.  It is unfortunate though that one place which is worth the visit which is the Chiang Kai Skek Memorial Museum will be closed down in the near future and will be renamed the Democracy Museum…for whatever reason for now mainly political.

From the way people live to the way they manufacture things are totally not the same as in mainland China.  For one… the motorcycle scooters are parked without locks including the helmets…just incredible trust with their fellow Taiwanese that nothing is going to be stolen.  The taxi drivers are honest and the services are great that you dont fear going around by yourself.  The plus factor is that many Taiwanese including the waiters and waitresses speak good english…a plus for foreigners who dont speak Mandarin.  The market also is not flooded by imitations but true Taiwanese made that are cheap and looks sturdy especially the elctronics icluding clothes.  There is no intimidation of haggling which I like and they dont get angry of you dont buy the things you are asking for unlike in other Asian countries.

I seldom see people smoke and I dont see a lot of obese Taiwanese. This translates to a healthy standard of living.

Overall…this trip has been rewarding in terms of learning more about the history and the culture of Taiwan and how this renegade province of China has become one the safest and disciplined countries in the world… and probably healthier that the mainland China.

I will be posting some picture soon in my flicker website and travel website for the sites in Taipei including the now tallest buildng in the world: the Taipei 101 with 101 floors and having the fastest elevator that can bring you to the top in less than 40 seconds. 

And lastly…of course…the experience of Excellent Chinese food…nothing beats Taiwan!

Diabetes and Obesity: The Cancer Link…

December 11, 2007

New studies recently surfaced regarding the increased risk of diabetics or obese individuals to different kinds of cancer.  The hyperinsulinemic state associated with these two metabolic conditions may be responsible to predisposing these individuals to a higher cancer risk.

The American Cancer Research Society website published recent researches linking the two conditions to cancer:

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1.Women with diabetes are 1.5 times more likely to develop colorectal cancer than those who do not have the metabolic disorder, according to researchers at the University of Minnesota.

2.Women with invasive breast cancer and high blood levels of C-peptide (a marker of insulin secretion) face a risk of death nearly three times higher than women with lower blood levels of C-peptide, according to findings from the Health, Eating, Activity and Lifestyle (HEAL) Study, a long-term observational study of breast cancer patients. The effect was most notable, researchers say, among women in their 40s.

3.Gaining weight following a diagnosis of invasive breast cancer could increase a woman’s risk of death from the disease by more than half, according to researchers leading the Collaborative Women’s Longevity Study. In fact, the researchers associated weight gain with a measurable increase in risk of death due to all causes, not just breast cancer.

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But this risk is not uniform to all types of cancer. Diabetics for example have been shown to have lower risk to develop prostate cancer.  As to why remains unclear but maybe related to diabetics having a lower testosterone level.

New reasons for us to really be aware of the dangers of gaining weight to the level of being overweight and to avoid being obese.

So….. 

This Holidays…Think Healthy and Be Wise!

Another Milestone…. With 100,000 MARK!

December 10, 2007

The website just reached it’s 100,000 visits after 1 year and 2 months in existence.  I thank all of those who have helped made this possible especially my patients who endorsed this website to their relatives and to my friends who have been loyal followers of the site. 

However this would have not been possible without the support of my bro-in- laws help by way of my websites exposure through his company’s website and portal: The NgKhai Portal and his multiawarded top blog site: The Bizdriven Life….

Will continue to not only update you with what is the real truth with regard to health but also upgrade the contents of this site based on what the readers really want to know.

I likewise have been invited and hopefully be starting to write articles for the Monthly magazine FOOD by their editor who likes the articles in the website starting March of next year if plans will push through.

Another Milestone I Call A Success !

“Don’T Sit Close To TV Or Else You Go Blind” and Other Myths About The EYE!

December 8, 2007

Hearsays are what the physicians hate the most.  Patients always have some hesitancy to follow some of our advices due to what they hear from their friends or relatives.  Good if the problem is not life threatening but if so, almost always the skill of the physician is put to the test versus that of the popular beliefs based on hearsay within the community.

Since childhood, I was told not to sit too close to a TV or else Ill go blind.  Or not to go straight to bed if my hair is wet otherwise Ill also get blind.  Am sure a lot of parents continue to counsel their kids based on hearsays that have been passed from generation to generation.

I cam across a nice compilation of myths regarding the eye and its care from the Harvard Health Publications: The Harvard Health Beat which I want to share:

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5 common eye myths dispelled

  1. Myth: Doing eye exercises will delay the need for glasses.Fact: Eye exercises will not improve or preserve vision or reduce the need for glasses. Your vision depends on many factors, including the shape of your eye and the health of the eye tissues, none of which can be significantly altered with eye exercises.

  2. Myth: Reading in dim light will worsen your vision.Fact: Although dim lighting will not adversely affect your eyesight, it will tire your eyes out more quickly. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is the best possible arrangement. A light that shines over your shoulder will cause a glare, making it more difficult to see the reading material.

  3. Myth: Eating carrots is good for the eyes.Fact: There is some truth in this one. Carrots, which contain vitamin A, are one of several vegetables that are good for the eyes. But fresh fruits and dark green leafy vegetables, which contain more antioxidant vitamins such as C and E, are even better. Antioxidant vitamins may help protect the eyes against cataract and age-related macular degeneration. But eating any vegetables or supplements containing these vitamins or substances will not prevent or correct basic vision problems such as nearsightedness or farsightedness.

  4. Myth: It’s best not to wear glasses all the time. Taking a break from glasses or contact lenses allows your eyes to rest.Fact: If you need glasses for distance or reading, use them. Attempting to read without reading glasses will simply strain your eyes and tire them out. Using your glasses won’t worsen your vision or lead to any eye disease.

  5. Myth: Staring at a computer screen all day is bad for the eyes.Fact: Although using a computer will not harm your eyes, staring at a computer screen all day will contribute to eyestrain or tired eyes. Adjust lighting so that it does not create a glare or harsh reflection on the screen. Also, when you’re working on a computer or doing other close work such as reading or needlepoint, it’s a good idea to rest your eyes briefly every hour or so to lessen eye fatigue. Finally, people who stare at a computer screen for long periods tend not to blink as often as usual, which can cause the eyes to feel dry and uncomfortable. Make a conscious effort to blink regularly so that the eyes stay well lubricated and do not dry out.

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Hope this post will remind everyone that myths will continue to be with us but the access of new information technology should now help us decide to follow them or not! Gone are the days that we rely on what our grandparents say about something and believe in everything they say about the ins and outs of daily living.

In Health… Rely Only on FACTS!

Dark Chocolate and Your Heart

December 6, 2007

More and more studies have found new reasons for us to enjoy dark chocoalate this holiday season… or we are just looking for excuses to indulge in one. 

But a new study published in the Journal Circulation in November of 2007 showed the potential mechanism why Dark Chocolate especially the 70% cocoa can be healthy:

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Conclusions— Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption. These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration.

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The above conclusion points out that indeed dark chocolate can increase blood flow to the heart and more so in patients who are already on medications like ACE inhibitors and Beta blockers. Therefore beneficial to prevent blockage of blood vessel that can lead to heart attack!

But caution to those who will start indulging in Dark chocolate.  Remember the color of the chocolate does not necessarily mean its dark.  It’s the content of the cocoa and more so the content of the flavanol.  This study was done using 70% cocoa.

But before grabbing a chocolate…make sure you are careful not to over do it.  Remember …chocolate is rich in calories and fat! But at least we now have reasons to take a bite before and after a meal without feeling too much guilt!

A Bite of Dark Chocolate for the Holidays!

How Not To Gain Weight This Christmas In 3 Simple Steps!

December 4, 2007

It’s already December… the weather is getting cooler… and the Christmas music is everywhere…. and next comes PARTIES!!!!

As much as we want to say no… we always resort to the saying: ” This only comes once a year”.  How many” once a year” events have you been to this year?

Here are some tips I would like to share to help curb the urge to eat but not necessarily avoid the enjoyment of the season and the food!

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1. Take a Break in between helpings.  After an appetizer, rest for 10 minutes to allow yourself to socialize and enjoy a nice conversation with friends.  Then reassess if you’re still hungry and then just select certain foods you really like before taking another break.  Breaks help tell your brain that you have eaten already!

2. Dont go to a party HUNGRY!!!!!  I always hear friends telling me…” I missed my lunch so I can really enjoy the buffet”.  I just dont like to spoil the fun they have in their minds at that particular point but I do tell them afterwards that what they’re doing is terribly wrong! They are doomed to suffer the binging!

3. Avoid Alcohol with an empty stomach.  Alcohol has been shown to increase your appetite! Enjoy other drinks that are low calorie and still satisfying!

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Lastly… while enjoying the food and conversation in between… drink more liquids especially water to keep your mouth BUSY… they can trick your brains and your mouth at the same time!

And of course … end the night with a cup of coffee.  Remember the health benefits of coffee  plus it’s low in calories!!!!

Let’s Enjoy Christmas Without The GUILT!

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Notes From Our Marketing Friends 

One goes through many incentives for healthy weight loss over the internet. These incentives involve weight loss with the help of supplements, diets, pills and drugs. They allow you to buy these drugs online as well. You can buy adipex, xenadrine and many other diet supplements online very easily.
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The Motivation To Lose Weight….

November 30, 2007

Go to fullsize imageI just found this new finding very intriguing and really true.  We doctors need to know what motivates people to lose weight so we can focus our attention to achieve the goal with more success.

In one study done in University of Bath in UK revealed some interesting facts:

“Fear of looking unattractive can be a stronger motivation for keeping people going to the gym than the hope of looking good”

This is really something… I guess this is where marketing strategies of beauty products are engaged in. You see beautfiul actresses marketing beauty products luring women to use the same products so as to look like them!  And I guess they’re pretty successful.

But what happens is when fear can motivate people to lose weight and look good…  once that fear subsides, either because they feel they have lost weight and now look good.. the motivation from fear goes away.  And I believe this is one reason why the yo-yo phenomenon in losing weight comes in.  You lose now then you gain….

Motivating people using the positive outlook should be the way to go.  How losing weight results now in better health  for a more lasting effect!

Motivating Poeple The Right Way Is Key To Better Health and Better Life!


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 adtxtimg5.gif 2/18/08

Notes From Our Marketing Friends: 

People are becoming fitness freaks and are very conscious to lose weight. Many health centers and weight loss centers provide people with healthy weight loss program. This includes many supplementary diets like the south beach diet and many others. However such diets must not be taken without consulting the physicians.
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Vitamin E and Heart Disease Among Diabetics…

November 27, 2007

Vitamin E has received a lot of good news and bad news. Now you read it being the antioxidant of choice in one study…then the next…it shows the opposite result.  Majority of these studies however are epidimeological and observational in nature and not well controlled prospective studies.  The HOPE and NIH studies were prospective studies that did not show positive effect of Vitamin E on heart disease.

Recently a new data on the possible important role of Vitamin E came about in a new prospective study which is worth looking published in the Journal Atherocsclerosis, Thrombosis and Vascular Biology….

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Methods- 1434 DM individuals  55 years of age with the Hp 2-2 genotype were randomized to vitamin E (400 U/d) or placebo. The primary composite outcome was myocardial infarction, stroke, and cardiovascular death. At the first evaluation of events, 18 months after initiating the study, the primary outcome was significantly reduced in individuals receiving vitamin E (2.2%) compared with placebo (4.7%; P=0.01) and led to early termination of the study.

Conclusions—Vitamin E supplementation appears to reduce cardiovascular events in individuals with DM and the Hp 2-2 genotype.

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Since 40% of our diabetic population has the Hp 2-2 gene…It’s probably about time for us to rethink whether all diabetics should take Vitamin E or not…

However the bottom line is:  more studies need to be done and outcome studies to support this new finding!

Vitamin E Is Worth a Second Look!

Does Avandia Cause Heart Attack? : The Ongoing Controversy

November 16, 2007

Recently, The US FDA made a new ruling regarding the controversy on whether the popular antidiabetic agent Avandia can really cause heart attack.  Below are important excerpts of the FDA ruling released as of November 14, 2007:

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People with type 2 diabetes who have underlying heart disease or who are at high risk of heart attack should talk with their health care provider about the revised warning as they evaluate treatment options. FDA advises health care providers to closely monitor patients who take Avandia for cardiovascular risks.

Avandia is approved to be used as a single therapy or used in combination with metformin and sulfonylureas, other oral anti-diabetes treatments.

During the past year, FDA has carefully weighed several complex sources of data, some which show conflicting results, related to the risk of chest pain, heart attacks and heart-related deaths, and deaths from any cause in patients treated with Avandia.

At this time, FDA has concluded that there isn’t enough evidence to indicate that the risks of heart attacks or death are different between Avandia and some other oral type 2 diabetes treatments. Therefore, FDA has requested that GSK conduct a new long-term study to evaluate the potential cardiovascular risk of Avandia, compared to an active control agent. GSK has agreed to conduct the study and FDA will ensure it is initiated promptly.

The revision of Avandia’s existing boxed warning – FDA’s strongest form of warning – includes the following statement:

A meta-analysis of 42 clinical studies (mean duration 6 months; 14,237 total patients), most of which compared Avandia to placebo, showed Avandia to be associated with an increased risk of myocardial ischemic events such as angina or myocardial infarction. Three other studies (mean duration 41 months; 14,067 patients), comparing Avandia to some other approved oral antidiabetic agents or placebo, have not confirmed or excluded this risk. In their entirety, the available data on the risk of myocardial ischemia are INCONCLUSIVE!

The previous upgraded warning, added to certain diabetes drugs (in class of drugs related to Avandia) on Aug. 14, 2007, emphasized that these types of drugs may worsen heart failure, a condition in which the heart does not adequately pump blood, in some patients. GSK is also developing a Medication Guide for patients to provide additional information about the benefits and risks and safe use of Avandia.

To date, no oral anti-diabetes drug has been conclusively shown to reduce cardiovascular risk. Consequently, the agency also will be requesting that labeling of all approved oral anti-diabetes drugs contain language describing the lack of data showing this benefit.

Today’s action follows recommendations made at the July 2007 joint meeting of FDA’s Endocrine and Metabolic Drugs and Drug Safety and Risk Management Advisory Committees. At the meeting, members voted 22-1 to recommend that Avandia stay on the market, pending a review of additional data. The committee also advised that information warning of the potential for increased risk of heart attacks should be added to the drug labeling. _______________________________________________

Ever since the data on avandia came into light after the Niessen article, further analysis of that article showed flaws in the statistical analysis.  It is therefore not surprising to me why this drug will not be pulled out in the market solely because of that article.  The medical community looks at actual facts rather than what is reported in newspapers or the media.

Based on my experience, the benefits of this drug continue to outweigh the potential risks…and just like any other drugs… all one needs to do is use the right drug for the right patient profile!

Meaning..never use this drug if the patient has heart failure or heart disease.  And this is true to all antidiabetic agents as reported by the US FDA as the risk of heart attack has not been shown to be different among the different oral agents. 

Plus…all patient with Diabetes…by the time of diagnosis… more than 5o% or probably ALL already have ongoing heart disease because by the time ones fasting blood sugar is abnormal…the disease process has been ongoing for 7 to 10 years already!

Therefore and Again… I always emphasize to all patients at risk: Lifestyle Change.  If one has the risk to develop Diabetes … do something NOW!  

Remember… All medications have risks!  But the benefits should always outweigh the risks before any drug is started on any patient!