Being Overweight Predicts Poor Health Outcome with Age

March 14, 2017

A recent study has come out from the recent Epidimeology and Preventive/Lifestyle and Cardiometabolic Health 2017 Scientific sessions showing that indeed Obesity in the youger age predicts future poor health outcomes.  At most what is affected is poor physical performance including poor walking speed and grip strength.

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“To examine this, Vu and colleagues analyzed findings from participants the Chicago Healthy Aging study, a subset of the Chicago Heart Association Detection Project, which enrolled 39,565 participants from Chicago workplaces who were 18 to 74 during 1967–1973.

The researchers had complete data from 1325 men and women who were examined at baseline and again from 2007 to 2010.

The three measures of physical performance at follow-up were: hand-grip strength, 4-m walking speed, and the SPPB score—a composite score of 4-m walking speed, time to rise from a seated position, and standing balance, for a total score of 0 (worst) to 12 (best).

The participants were classed into six groups depending on their baseline BMI and change in weight after 39 years:

BMI >25 kg/m2; >10-pound weight loss (n=50).

BMI <25 kg/m2; 10-pound weight loss up to a 20-pound weight gain (n=319; reference group; minimal weight change).

BMI <25 kg/m2; >20-pound weight gain (n=312).

BMI >25 kg/m2; >10-pound weight loss (n=130).

BMI >25 kg/m2; 10-pound weight loss up to a 20-pound weight gain (n=300).

BMI >25 kg/m2; >20-pound weight gain (n=214).

About a quarter of the sample (29%) were women and 9% were black.

At follow-up, 10.3% of the participants had a low SPPB score (≤8); 8.4% had slow walking speed (<0.8 m/s on a 4-m course); and 23.8% had low sex-specific handgrip strength (<18 kg for women and <30 kg for men).

Compared with participants with a normal initial BMI and minimal weight change at the follow-up examination, those who were initially overweight and had gained the most weight (>20 pounds) were significantly more likely to have a low SPPB score, a slow walking speed, or low sex-specific handgrip strength (odds ratios 4.55, 4.58, and 1.86, respectively, after adjustment for sex, race, initial cardiovascular disease risk factors, and current age, education, ankle-brachial index, systolic blood pressure, total cholesterol, smoking status, diabetes, cholesterol, and blood-pressure medication use).

Similarly, compared with the reference group, those who were initially overweight or obese and lost less than 10 pounds or gained up to 20 pounds were significantly more likely to have a low SPPB score or a low sex-specific handgrip strength (ORs 2.11 and 1.59, respectively)”

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Bottom line is:

We better shape up and invest in our health for a better physical well being when old age comes!!!!

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Diabetes Care in the Philippines

April 22, 2016

Screen Shot 2016-04-22 at 1.14.02 PMMy article on Diabetes Care in the Philippines is now published in the Annals of Global Health Volume 81, issue 6 November-December 2015. This is a thorough review of the kind of Diabetes Care the Philippines available to our countrymen.

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Diabetes Care in the Philippines

Gerry H. Tan, MD

Abstract
Background

Diabetes is increasing at an alarming rate in Asian countries including the Philippines. Both the prevalence and incidence of type 2 diabetes (T2D) continue to increase with a commensurate upward trend in the prevalence of prediabetes.

Objectives

The aim of this study was to review the prevalence of diabetes in the Philippines and to describe extensively the characteristics of diabetes care in the Philippines from availability of diagnostics tests to the procurement of medications.

Methods

A literature search was performed using the search words diabetes care and Philippines. Articles that were retrieved were reviewed for relevance and then synthesized to highlight key features.

Findings

The prevalence of diabetes in the Philippines is increasing. Rapid urbanization with increasing dependence on electronic gadgets and sedentary lifestyle contribute significantly to this epidemic. Diabetes care in the Philippines is disadvantaged and challenged with respect to resources, government support, and economics. The national insurance system does not cover comprehensive diabetes care in a preventive model and private insurance companies only offer limited diabetes coverage. Thus, most patients rely on “out-of-pocket” expenses, namely, laboratory procedures and daily medications. Consequently, poor pharmacotherapy adherence impairs prevention of complications. Moreover, behavioral modifications are difficult due to cultural preferences for a traditional diet of refined sugar, including white rice and bread.

Conclusions

Translating clinical data into practice in the Philippines will require fundamental and transformative changes that increase diabetes awareness, emphasize lifestyle change while respecting cultural preferences, and promote public policy especially regarding the health insurance system to improve overall diabetes care and outcomes.

Key Words
diabetes; diabetes care; Philippines; Southeast Asia; type 2 diabetes

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International Clinician Award, 2015 by AACE in Nashville Tenessee…

May 22, 2015

From the AACE Press Release for the Annual Meeting, 2015 in Nashville Tenessee..

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Gerry H. Tan, MD, FACP, FACE, FPCP, FPSEDM, received the International Clinician Award during the American Association of Clinical Endocrinologists (AACE) 24th Annual Scientific & Clinical Congress in Nashville this week.

The International Clinician Award is given to an AACE member who is a clinical endocrinologist practicing outside of the United States in recognition of dedicated and compassionate care provided to patients with endocrine diseases. Recipients possess an exceptional knowledge and expertise in the field of clinical endocrinology and active advocacy AACE’s mission in both professional and public environments.

“Success is not measured by how many accolades one receives, but how complete one feels as a recognized endocrinologist being selected as this year’s recipient of the most prestigious International Clinician Award by the AACE,” said Dr. Tan. “I owe this recognition not only to my colleagues – especially my AACE-Philippines family, but most importantly to my patients who have taught me not only to become an astute compassionate clinician, but by being instrumental in molding me to be a better person, too.”

Dr. Tan practices in Cebu City, Philippines. In addition to his busy clinical practice, he finds time to teach medical students, endocrinology fellows and internal medicine residents at two major tertiary teaching institutions. He speaks at various public venues about wellness, diabetes and endocrine disorders and writes a monthly column for the Philippines’ FOOD Magazine.

After his internal medicine residency at New York Medical College, he performed his fellowship training in endocrinology, diabetes and metabolism at the Mayo Clinic Medical School in Rochester, Minnesota.

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About the American Association of Clinical Endocrinologists (AACE)
The American Association of Clinical Endocrinologists (AACE) represents more than 7,000 endocrinologists in the United States and abroad. AACE is the largest association of clinical endocrinologists in the world. A majority of AACE members are certified in endocrinology, diabetes and metabolism and concentrate on the treatment of patients with endocrine and metabolic disorders including diabetes, thyroid disorders, osteoporosis, growth hormone deficiency, cholesterol disorders, hypertension and obesity. Visit our site at http://www.aace.com.

About the American College of Endocrinology (ACE)
The American College of Endocrinology (ACE) is the educational and scientific arm of the American Association of Clinical Endocrinologists (AACE). ACE is the leader in advancing the care and prevention of endocrine and metabolic disorders by: providing professional education and reliable public health information; recognizing excellence in education, research and service; promoting clinical research and defining the future of Clinical Endocrinology. For more information, please visit http://www.aace.com/college.

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The Health Benefits of Sauna Bathing

February 28, 2015

Suana has been touted as a habit that can prolong life by supposedly improving your bodys blood flow and aiding hemodynamic function. A recent study published in JAMA Feb 2015 seems to prove the theory right…..

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Abstract

Importance: Sauna bathing is a health habit associated with better hemodynamic function; however, the association of sauna bathing with cardiovascular and all-cause mortality is not known.

Objective: To investigate the association of frequency and duration of sauna bathing with the risk of sudden cardiac death (SCD), fatal coronary heart disease (CHD), fatal cardiovascular disease (CVD), and all-cause mortality.

Design, Setting, and Participants: We performed a prospective cohort study (Finnish Kuopio Ischemic Heart Disease Risk Factor Study) of a population-based sample of 2315 middle-aged (age range, 42-60 years) men from Eastern Finland. Baseline examinations were conducted from March 1, 1984, through December 31, 1989.

Exposures: Frequency and duration of sauna bathing assessed at baseline.

Results: During a median follow-up of 20.7 years (interquartile range, 18.1-22.6 years), 190 SCDs, 281 fatal CHDs, 407 fatal CVDs, and 929 all-cause mortality events occurred. A total of 601, 1513, and 201 participants reported having a sauna bathing session 1 time per week, 2 to 3 times per week, and 4 to 7 times per week, respectively. The numbers (percentages) of SCDs were 61 (10.1%), 119 (7.8%), and 10 (5.0%) in the 3 groups of the frequency of sauna bathing. The respective numbers were 89 (14.9%), 175 (11.5%), and 17 (8.5%) for fatal CHDs; 134 (22.3%), 249 (16.4%), and 24 (12.0%) for fatal CVDs; and 295 (49.1%), 572 (37.8%), and 62 (30.8%) for all-cause mortality events. After adjustment for CVD risk factors, compared with men with 1 sauna bathing session per week, the hazard ratio of SCD was 0.78 (95% CI, 0.57-1.07) for 2 to 3 sauna bathing sessions per week and 0.37 (95% CI, 0.18-0.75) for 4 to 7 sauna bathing sessions per week (P for trend = .005). Similar associations were found with CHD, CVD, and all-cause mortality (P for trend ≤.005). Compared with men having a sauna bathing session of less than 11 minutes, the adjusted hazard ratio for SCD was 0.93 (95% CI, 0.67-1.28) for sauna bathing sessions of 11 to 19 minutes and 0.48 (95% CI, 0.31-0.75) for sessions lasting more than 19 minutes (P for trend = .002); significant inverse associations were also observed for fatal CHDs and fatal CVDs (P for trend ≤.03) but not for all-cause mortality events.

Conclusions and Relevance: Increased frequency of sauna bathing is associated with a reduced risk of SCD, CHD, CVD, and all-cause mortality. Further studies are warranted to establish the potential mechanism that links sauna bathing and cardiovascular health.

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Or those who frequent the sauna were also health buffs and have regular physical activity????

Whatever the final take of the study is….

Sauna is fun and healthy so enjoy!

Posted in General Health Tips | 4 Comments »

Sedentary Behavior and Disease Risk

February 16, 2015

Trending lately are articles on how sitting for almost the entire day can be harmful to health.  The latest issue of the Annals of Internal Medicine, reports how the bad effects of sitting can affect health and how these effects are not be “reversed” by physical activity….

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Background: The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear.

Purpose: To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity.

Data Sources: English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations.

Study Selection: Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome.

Data Extraction: Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies.

Data Synthesis: Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels.

Limitation: There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity.

Conclusion: Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity.

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Take note however, that the deleterious effects of prolonged sitting time on health from watching TV, working in our office overtime,  are more pronounced among those who do little or no exercise than among those who exercise regularly.

It is therefore advised to take breaks by standing and walking few minutes for every hour of sitting.

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Television Viewing and Diabetes: The LINK

November 17, 2014

We just celebrated the World Diabetes Day this November 14 and what a better way to celebrate this day than to help share awareness of this disease to the general public. I was invited to share about Diabetes on radio last sunday and was happy to share to the public general information and knowledge about what diabetes is, how it is diagnosed and what the treatment options are.

I recently read an article which I believe will be worth contemplating about.

in the clinics I now advised my patients that for every hour of sitting in office, make sure to take time to stand and walk for at least 10 minutes. This practice not only can curb obesity but also can increase your metabolic rate and help curb chronic diseases like diabetes and heart disease.

It is therefore not surprising that in a recent article published in JAMA , a study showed further a strong link between TV viewing and the risk for Diabetes and Heart disease risk:

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Abstract

CONTEXT:

Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available.

OBJECTIVE:

To perform a meta-analysis of all prospective cohort studies to determine the association between TV viewing and risk of type 2 diabetes, fatal or nonfatal cardiovascular disease, and all-cause mortality.

DATA SOURCES AND STUDY SELECTION:

Relevant studies were identified by searches of the MEDLINE database from 1970 to March 2011 and the EMBASE database from 1974 to March 2011 without restrictions and by reviewing reference lists from retrieved articles. Cohort studies that reported relative risk estimates with 95% confidence intervals (CIs) for the associations of interest were included.

DATA EXTRACTION:

Data were extracted independently by each author and summary estimates of association were obtained using a random-effects model.

DATA SYNTHESIS:

Of the 8 studies included, 4 reported results on type 2 diabetes (175,938 individuals; 6428 incident cases during 1.1 million person-years of follow-up), 4 reported on fatal or nonfatal cardiovascular disease (34,253 individuals; 1052 incident cases), and 3 reported on all-cause mortality (26,509 individuals; 1879 deaths during 202,353 person-years of follow-up). The pooled relative risks per 2 hours of TV viewing per day were 1.20 (95% CI, 1.14-1.27) for type 2 diabetes, 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and 1.13 (95% CI, 1.07-1.18) for all-cause mortality. While the associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day. The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year.

CONCLUSION:

Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.

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The study clearly shows that for every two hours of television watched daily,

Diabetes development is increased by 20%,
Cardiovascular disease is increased by 15%, and
All-cause mortality and death is increased by 13%.
Obviously the habit of watching TV correlates with the amount of popcorn, chips, sugary drinks that accompany the activity. Meaning this practice of prolonged TV viewing is worst that any passive sedentary activities like driving or tinkering on a computer.

So guys, it is therefore not yet late to adopt on a different lifestyle. Learn to change and remember to include your children on this health change. Let them see you as parents embarking on a healthy lifestyle so they also can adopt to it.

No TV on weekdays for my kids but this rule is solely to let them focus on studying BUT I let them join me everyday of our bonding of fun run , biking and swimming.

Take time to Care about your Health… be active and Proactive!

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Sitting All Day and Your Health

August 21, 2014

AACE_EmPower5K_LasVegas_2014_542A new study published at the Mayo Clinic Proceedings showed that being an office worker and sitting all day may not be good for your health at all.

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Objective
To determine the association between cardiorespiratory fitness and sedentary behavior, independent of exercise activity.

Patients and Methods
We included 2223 participants (aged 12-49 years; 1053 females [47%]) without known heart disease who had both cardiovascular fitness testing and at least 1 day of accelerometer data from the National Health and Nutrition Examination Survey 2003-2004. From accelerometer data, we quantified bouts of exercise as mean minutes per day for each participant. Sedentary time was defined as less than 100 counts per minute in mean minutes per day. Cardiorespiratory fitness was derived from a submaximal exercise treadmill test. Multivariable-adjusted linear regression analyses were performed with fitness as the dependent variable. Models were stratified by sex, adjusted for age, body mass index, and wear time, and included sedentary and exercise time.

Results
An additional hour of daily exercise activity time was associated with a 0.88 (0.37-1.39; P<.001) metabolic equivalent of task (MET) higher fitness for men and a 1.37 (0.43-2.31; P=.004) MET higher fitness for women. An additional hour of sedentary time was associated with a −0.12 (−0.02 to −0.22; P=.03) and a −0.24 (−0.10 to −0.38; P<.001) MET difference in fitness for men and women, respectively.

Conclusion
After adjustment for exercise activity, sedentary behavior appears to have an inverse association with fitness. These findings suggest that the risk related to sedentary behavior might be mediated, in part, through lower fitness levels.

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The study actually tells us interesting facts about prolonged sitting.  That for every hour we  spend sitting in our offices, it will reduce the gains of a daily workout by eight percent.  So it is suggested that we stand and walk in between our daily routine work sitting in our office tables.  One can use the break times to take short brisk walks around the building or to a vending machine and back as simple means to achieve the goal.

What is interesting in the study also is the fact that a daily dose of an hour of exercise can work wonders.  It can offset the bad effects of the six to seven hours of sitting. Perfect data for me!!!!

This is what I practice in my daily routine…..

As a physician, sitting all day listening to my patients is a routine.  I therefore interspersed my sitting times listening to their problems by simply standing up to do the physical examination. This is on top of my daily afternoon run and my daily morning weights and sit ups that totally make my day complete!

Perfect Combination of Sitting , Standing or just Simply MOVING!

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Stress and the Risk of Weight Gain

July 19, 2014

Stress and weight gain? Yes they are closely associated.  Recently published data from the Biological Psychiatry has closely examined the relationship.

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Background
Depression and stress promote obesity. This study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on obesity-related metabolic responses to high-fat meals.

Methods
This double-blind, randomized, crossover study included serial assessments of resting energy expenditure (REE), fat and carbohydrate oxidation, triglycerides, cortisol, insulin, and glucose before and after two high-fat meals. During two separate 9.5-hour admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar control subjects), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. Prior day stressors were assessed by the Daily Inventory of Stressful Events.

Results
Greater numbers of stressors were associated with lower postmeal REE (p = .008), lower fat oxidation (p = .04), and higher insulin (p = .01), with nonsignificant effects for cortisol and glucose. Women with prior MDD had higher cortisol (p = .008) and higher fat oxidation (p = .004), without significant effects for REE, insulin, and glucose. Women with a depression history who also had more stressors had a higher peak triglyceride response than other participants (p = .01). The only difference between meals was higher postprandial glucose following sunflower oil compared with saturated fat (p = .03).

Conclusions
The cumulative 6-hour difference between one prior day stressor and no stressors translates into 435 kJ, a difference that could add almost 11 pounds per year. These findings illustrate how stress and depression alter metabolic responses to high-fat meals in ways that promote obesity.

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Stress indeed can bring about eating the wrong choice of food.  Almost always we can’t avoid stress BUT we can do something about it to avoid stress induced weight gain.

It has always been my recommendation to my patients that one way to avert the temptation of eating wrong foods is to stock our pantry and refrigerator with foods that are healthy like fruits or nuts so one can prepare healthy food choices instead.

 

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More Vegetables and Fruits Make More Years of Your Life….

April 3, 2014

True enough, and more studies proving that eating veggies really make a more healthier life.  A recent study offered more information detailing that more fruits and veggies really help deter the onset of diseases especially cancer and heart disease.

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Background Governments worldwide recommend daily consumption of fruit and vegetables. We examine whether this benefits health in the general population of England.

Methods Cox regression was used to estimate HRs and 95% CI for an association between fruit and vegetable consumption and all-cause, cancer and cardiovascular mortality, adjusting for age, sex, social class, education, BMI, alcohol consumption and physical activity, in 65 226 participants aged 35+ years in the 2001–2008 Health Surveys for England, annual surveys of nationally representative random samples of the non-institutionalised population of England linked to mortality data (median follow-up: 7.7 years).

Results Fruit and vegetable consumption was associated with decreased all-cause mortality (adjusted HR for 7+ portions 0.67 (95% CI 0.58 to 0.78), reference category <1 portion). This association was more pronounced when excluding deaths within a year of baseline (0.58 (0.46 to 0.71)). Fruit and vegetable consumption was associated with reduced cancer (0.75 (0.59–0.96)) and cardiovascular mortality (0.69 (0.53 to 0.88)). Vegetables may have a stronger association with mortality than fruit (HR for 2 to 3 portions 0.81 (0.73 to 0.89) and 0.90 (0.82 to 0.98), respectively). Consumption of vegetables (0.85 (0.81 to 0.89) per portion) or salad (0.87 (0.82 to 0.92) per portion) were most protective, while frozen/canned fruit consumption was apparently associated with increased mortality (1.17 (1.07 to 1.28) per portion).

Conclusions A robust inverse association exists between fruit and vegetable consumption and mortality, with benefits seen in up to 7+ portions daily. Further investigations into the effects of different types of fruit and vegetables are warranted.

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The study clearly shows the inverse relationship between the amount of consumed fruits and veggies and risk of death and diseases.  The consumption of seven or more servings of fruits and vegetables was associated with reduced cancer mortality  and  mortality associated with heart disease more than what has been recommended by policy makers of 5 servings daily.

So here’s one food where consumption of more leads to better health.

 

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Nuts and Health

December 5, 2013

I ama  regular nut eater… mostly pistachios. Nuts are my favorite snacks.

Health benefits derived from eating nuts are numerous and this new study published in NEJM, 2013 affirms that association.

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BACKGROUND

Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. However, the association between nut consumption and mortality remains unclear.

METHODS

We examined the association between nut consumption and subsequent total and cause-specific mortality among 76,464 women in the Nurses’ Health Study (1980–2010) and 42,498 men in the Health Professionals Follow-up Study (1986–2010). Participants with a history of cancer, heart disease, or stroke were excluded. Nut consumption was assessed at baseline and updated every 2 to 4 years.

RESULTS

During 3,038,853 person-years of follow-up, 16,200 women and 11,229 men died. Nut consumption was inversely associated with total mortality among both women and men, after adjustment for other known or suspected risk factors. The pooled multivariate hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.93 (95% confidence interval [CI], 0.90 to 0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86 to 0.93) for once per week, 0.87 (95% CI, 0.83 to 0.90) for two to four times per week, 0.85 (95% CI, 0.79 to 0.91) for five or six times per week, and 0.80 (95% CI, 0.73 to 0.86) for seven or more times per week (P<0.001 for trend). Significant inverse associations were also observed between nut consumption and deaths due to cancer, heart disease, and respiratory disease.

CONCLUSIONS

In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (Funded by the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation.)

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Rosiglitazone (Avandia) Does not cause Heart Attack

November 26, 2013

Rosiglitazone (Avandia) Does not cause Heart Attack

Been a user of this drug prior to its removal.  I strongly believe in its usefulness as a drug.  Now I can safely tell my patients that I was indeed right all along.  Sometimes its how the news is perceived by the public that forces others to listen and then strongly believes.  It is best to instead let the Facts do the talking.

 

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Sleep and Diabetes…. The Close Link

October 14, 2013

 

Sleep debt has been considered one major risk factor for developing Diabetes. Stress hormones apparently are increased during times when one is awake instead of being asleep.  Other studies have shown that not only is quantity important but also the quality of sleep.

A study done by the Centers for Disease Control (CDC) involving more than 54,000 participants in 14 states, published in the SLEEP journal, October 2013....showed that sleep duration is critical to the development of disease.

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Study Objective:

To examine the effects of obesity and frequent mental distress (FMD) on the relationship of sleep duration with coronary heart disease (CHD), stroke, and diabetes.

Design: Cross-sectional study.

Setting:Population-based surveillance.

Participants: There were 54,269 adults age 45 y or older who completed the 2010 Behavioral Risk Factor Surveillance System survey in 14 states.

Results:

Nearly one third (31.1% or an estimated 11.1 million) of respondents age 45 y and older reported being short sleepers (≤ 6 h), 64.8% being optimal sleepers (7-9 h), and 4.1% being long sleepers (≥ 10 h) in a 24-h period. Compared with the optimal sleep duration, both short and long sleep durations were significantly associated with obesity, FMD (mental health was not good ≥ 14 days during the past 30 days), CHD, stroke, and diabetes after controlling for sex, age, race/ethnicity, and education. The U-shaped relationships of sleep duration with CHD, stroke, and diabetes were moderately attenuated by FMD. The relationship between sleep duration and diabetes was slightly attenuated by obesity.

Conclusions:

Sleep duration had U-shaped relationships with leading chronic diseases. Further prospective studies are needed to determine how mental health and maintenance of a normal weight may interact with sleep duration to prevent chronic diseases.

Citation:

Liu Y; Wheaton AG; Chapman DP; Croft JB. Sleep duration and chronic diseases among US adults age 45 years and older: evidence from the 2010 Behavioral Risk Factor Surveillance System. SLEEP2013;36(10):1421-1427.

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The study showed that the optimal number of hours of sleep should be 7-9 hours. Short sleepers averaged six hours or less, while long sleepers and averaged 10 hours or more of sleep.  There was an increased prevalence of being overweight and obese and higher rates of chronic diseases like diabetes, heart disease and stroke among the short and long sleepers. 

The study further proves that sleep indeed is a time for the body to regenerate and that rest is key to wellness.

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Skipping Breakfast? Read This!

July 30, 2013

Breakfast is considered the most important meal of the day.  It breaks the fasting period and therefore allows ones metabolism to be back up and running for the day.  Likewise, skipping breakfast has been shown in studies to put a patient at risk for multiple conditions including increasing risk of diabetes since fat breakdown during the period of prolonged fast can cause insulin resistance.  Now comes a new study published in Circulation 2013, showing that skipping breakfast is not healthy and friendly to the heart.

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Abstract

Background—Among adults, skipping meals is associated with excess body weight, hypertension, insulin resistance, and elevated fasting lipid concentrations. However, it remains unknown whether specific eating habits regardless of dietary composition influence coronary heart disease (CHD) risk. The objective of this study was to prospectively examine eating habits and risk of CHD.

Methods and Results—Eating habits, including breakfast eating, were assessed in 1992 in 26 902 American men 45 to 82 years of age from the Health Professionals Follow-up Study who were free of cardiovascular disease and cancer. During 16 years of follow-up, 1527 incident CHD cases were diagnosed. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals for CHD, adjusted for demographic, diet, lifestyle, and other CHD risk factors. Men who skipped breakfast had a 27% higher risk of CHD compared with men who did not (relative risk, 1.27; 95% confidence interval, 1.06–1.53). Compared with men who did not eat late at night, those who ate late at night had a 55% higher CHD risk (relative risk, 1.55; 95% confidence interval, 1.05–2.29). These associations were mediated by body mass index, hypertension, hypercholesterolemia, and diabetes mellitus. No association was observed between eating frequency (times per day) and risk of CHD.

Conclusions—Eating breakfast was associated with significantly lower CHD risk in this cohort of male health professionals.

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This study may not be conclusive due to study limitations BUT the results are not surprising to me at all.

Further studies need to be done especially on the relationship of late snacking and death.

A common theme arises however in all these studies that BREAKFAST is important for health and preservation of life.

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Tips To Protect Your Heart | 24 Comments »

The Amount of Exercise You need to Burn off Calories from eating a Burger…

April 26, 2013

Let me share you this link from Yahoo. Very interesting fact that one can use this strategy to lose weight.  Think how much exercise you need to do to burn off the calories from the food you re eating…

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Is a Burger Worth 7,500 Sit-Ups?

Most people have stared down a pint of ice cream or a bag of chips and tried to figure out how much more they’d need to work out in order to burn off the extra calories. Unfortunately, you can’t really eat whatever you want and just work out a little more later. “No, it is not an even exchange,” Franci Cohen, a personal trainer, certified nutritionist, and exercise physiologist in New York City, told Yahoo! Shine. “In fact, over-exercising will actually cause the muscles to break down instead of build up, and the metabolism slows down as a result of excess exercise as well.” Still, a Texas Christian University study of 300 adults presented at the Experimental Biology 2013 conference in Boston this week found that learning how much more you’d need to exercise to work off a burger was enough to make people pick a lower-calorie meal. Wondering if that candy bar is worth it? Here’s what it would take to work off some of our favorite indulgences. 

A single Whopper from Burger King is 630 calories, or the equivalent of spending an hour going full-tilt on the elliptical machine. Rather do sit-ups or crunches? You’ll have to bust out 7,500 of them. (All workout results calculated for a 140 pound woman, using exercise data from HealthStatus.com.)

Ben & Jerry’s Phish Food premium ice cream packs 280 calories into each 1/2-cup serving. That’s a little more than an hour’s worth of pumping iron. But who stops at a single serving? Eat the whole pint and do about five hours of weight lifting (or almost two hours of bare-handed rock climbing).

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I enjoyed reading the link that it makes us realize… fat is really from all the food we eat..and therefore…controlling ones desire to indulge is key to curbing  your appetite.

Indulge but only on occasions.

 

Posted in Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips, Weight Loss Tips | 2 Comments »

Walk the Talk… The Risk fo Sedentary Lifestyle….

February 3, 2013

It is now advised that for every hour of sitting in office, make sure to take time to stand and walk for at least 10 minutes.  This practice not only can curb obesity but also can increase your metabolic rate and help curb chronic diseases like diabetes and heart disease.

It is therefore not surprising that in an article published in JAMA , a study showed further a strong link between TV viewing and the risk for Diabetes and Heart disease risk:

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Abstract

CONTEXT:

Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available.

OBJECTIVE:

To perform a meta-analysis of all prospective cohort studies to determine the association between TV viewing and risk of type 2 diabetes, fatal or nonfatal cardiovascular disease, and all-cause mortality.

DATA SOURCES AND STUDY SELECTION:

Relevant studies were identified by searches of the MEDLINE database from 1970 to March 2011 and the EMBASE database from 1974 to March 2011 without restrictions and by reviewing reference lists from retrieved articles. Cohort studies that reported relative risk estimates with 95% confidence intervals (CIs) for the associations of interest were included.

DATA EXTRACTION:

Data were extracted independently by each author and summary estimates of association were obtained using a random-effects model.

DATA SYNTHESIS:

Of the 8 studies included, 4 reported results on type 2 diabetes (175,938 individuals; 6428 incident cases during 1.1 million person-years of follow-up), 4 reported on fatal or nonfatal cardiovascular disease (34,253 individuals; 1052 incident cases), and 3 reported on all-cause mortality (26,509 individuals; 1879 deaths during 202,353 person-years of follow-up). The pooled relative risks per 2 hours of TV viewing per day were 1.20 (95% CI, 1.14-1.27) for type 2 diabetes, 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and 1.13 (95% CI, 1.07-1.18) for all-cause mortality. While the associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day. The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year.

CONCLUSION:

Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.

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The study clearly shows that for every two hours of television watched daily,

  • Diabetes development is increased by 20%,
  • Cardiovascular disease is increased by 15%, and
  • All-cause mortality and death is increased by 13%.

Obviously the habit of watching TV correlates with the amount of popcorn, chips, sugary drinks that accompany the activity.  Meaning this practice of prolonged TV viewing is worst that any passive sedentary activities like driving or tinkering on a computer. So guys, it is therefore not yet late to adopt on a different lifestyle. Learn to change and remember to include your children on this health change. Let them see you as parents embarking on a healthy lifestyle so they also can adopt to it. No TV on weekdays for my kids  but this rule is solely to let them focus on studying BUT I let them join me everyday of our bonding of fun run , biking and swimming. Its Sunday… so its TV time later after our round of running….

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits | 20 Comments »

Are All Sugars The Same?

January 11, 2013

Read the rest of this entry »

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Your Neighborhood Can Put You At Risk of Diabetes….

September 30, 2012

It is a known fact that diabetes develops because of the changing environment.  From processed food to urbanization resulting in the lack of time to do exercise. But one study done recently and published in Diabetes Care, Sept 2012, tells us that this maybe in reality just right in the corner of our backyard.

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Abstract

OBJECTIVE This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects.

METHODS We conducted a population-based, retrospective cohort study to assess the impact of neighborhood walkability on diabetes incidence among recent immigrants (n = 214,882) relative to long-term residents (n = 1,024,380). Adults aged 30–64 years who were free of diabetes and living in Toronto, Canada, on 31 March 2005 were identified from administrative health databases and followed until 31 March 2010 for the development of diabetes, using a validated algorithm. Neighborhood characteristics, including walkability and income, were derived from the Canadian Census and other sources.

RESULTS Neighborhood walkability was a strong predictor of diabetes incidence independent of age and area income, particularly among recent immigrants (lowest [quintile 1 {Q1}] vs. highest [quintile 5 {Q5}] walkability quintile: relative risk [RR] 1.58 [95% CI 1.42–1.75] for men; 1.67 [1.48–1.88] for women) compared with long-term residents (Q1 to Q5) 1.32 [1.26–1.38] for men; 1.24 [1.18–1.31] for women). Coexisting poverty accentuated these effects; diabetes incidence varied threefold between recent immigrants living in low-income/low walkability areas (16.2 per 1,000) and those living in high-income/high walkability areas (5.1 per 1,000).

CONCLUSIONS Neighborhood walkability was inversely associated with the development of diabetes in our setting, particularly among recent immigrants living in low-income areas.

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This study has general implications for primary prevention of diabetes. Choosing the right place to live is probably the most preventable risk to developing diabetes which is not well controlled can have significant long term health implication.

It is the belief that if your neighborhood is conducive to walking or running or biking… then most of the dwellers will have no reason not to exercise.  But if the environment where you live is not conducive to walking, then this becomes an excuse to be a couch potato.

 

 

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, The Diabetes Facts | 3 Comments »

Red Meat and Disease

September 12, 2012

The benefits of eating vegetables are certain. The Risk of developing a disease with red meat intake is also certain.  Now comes a study showing that by merely cutting your intake of red meat by half, will also result in fewer cases of heart disease, diabetes, and cancer.

In this study done in Cambridge, by cutting your intake of a burger by 1/2 in terms of amount, you cut your risk of developing bowel cancer and diabetes by 12%…

In an earlier study also in BMJ… by consuming red meat less than 42 gm/day…equivalent to a size of a small burger…one is able to cut the risk of death by 9%!!!

The study merely emphasizes… be particular with amount… lean meat will continue to be an important source of protein.

Portion sizes of veggies, meat and carbohydrates with fruit in a plate should continue to be the mainstay of what is nutritious, healthy and fun in eating….

Posted in General Health Tips | 4 Comments »
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Statins and Diabetes: What’s New?

August 22, 2012

The fear of developing Diabetes due to the use of cholesterol lowering drug Statins made headlines in the past few years.

We use Statins to lower cholesterol known to cause heart attack and stroke. Studies have shown that statins indeed can lower ones risk to suffer a heart attack or stroke. So when the issue of this drug increasing the blood sugar…which then is the lesser evil?

Or are we treating on one disease and in return give rise to another disease?

The recent analysis of the big statin study called JUPITER  published in Lancet August 11, 2012 raised some very important issues that can clear the controversy:

  1. The risk of developing diabetes mellitus with statin therapy is limited to patients already at a high risk for developing diabetes. These individuals include those with impaired fasting glucose, metabolic syndrome, severe obesity, or increased hemoglobin A1c (HbA1c) levels.
     
  2. In these high-risk patients however, the benefits of statin therapy outweighed the risk of diabetes

This is therefore a very welcome development in this area of Medicine.

Posted in Medical News Bits, Tips To Protect Your Heart | 3 Comments »
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Jogging Can Prolong Your Life

May 23, 2012

Let me share with you this interesting article from The Coopenhagen Heart Study soon to be published presented at EuroPRevent2012 in Dublin on the effect of jogging on one’s health and one’s life .

The study has one simple but strong conclusion:

Men who regularly jog can add at least 6.2 years to their life.

Women who regularly jog can add 5.6 years to their life.

How Much Jogging is necessary to reap the benefits?

Not that long but a mere 1 hour up to 2 hours and 30 min per week that can be broken down in 2 to 3 sessions, done at slow to average pace that can leave you a little breathless. Don’t OVERDO it though because the figures from the study indicate that people who do a lot of jogging actually had the tendency to die early similar to those who don’t engage in jogging at all.

There you go guys. My daily “me time” of running around the block in my own home backyard every afternoon at least 2 x is therefore not only ideal but a perfect pace for long life.

Remember in another study done few years ago, maintaining an aerobic fitness through middle age has been shown to delay biologic aging by 12 years.

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits | 1 Comment »

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