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.


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.

 


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….


Are All Sugars The Same?

January 11, 2013

Read the rest of this entry »


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.

 

 


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….


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.


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.


Is Frying Foods Bad for the Health?

February 16, 2012

Almost a resounding YES! Until recently the British Medical Journal 2012 published an article that looked at frying and the risk of heart disease. The data will otherwise give us a smile for most who love frying as a way to cook and enjoy food!

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Abstract

Objective To assess the association between consumption of fried foods and risk of coronary heart disease.
Design Prospective cohort study.
Setting Spanish cohort of the European Prospective Investigation into Cancer and Nutrition.
Participants 40,757 adults aged 29-69 and free of coronary heart disease at baseline (1992-6), followed up until 2004.
Main outcome measures Coronary heart disease events and vital status identified by record linkage with hospital discharge registers, population based registers of myocardial infarction, and mortality registers.
Results During a median follow-up of 11 years, 606 coronary heart disease events and 1,135 deaths from all causes occurred. Compared with being in the first (lowest) quarter of fried food consumption, the multivariate hazard ratio of coronary heart disease in the second quarter was 1.15 (95% confidence interval 0.91 to 1.45), in the third quarter was 1.07 (0.83 to 1.38), and in the fourth quarter was 1.08 (0.82 to 1.43; P for trend 0.74). The results did not vary between those who used olive oil for frying and those who used sunflower oil. Likewise, no association was observed between fried food consumption and all cause mortality: multivariate hazard ratio for the highest versus the lowest quarter of fried food consumption was 0.93 (95% confidence interval 0.77 to 1.14; P for trend 0.98).
Conclusion In Spain, a Mediterranean country where olive or sunflower oil is used for frying, the consumption of fried foods was not associated with coronary heart disease or with all cause mortality.

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It is always our notion that frying is really bad. Foods that are fried lose water and instead take up fat and increase the caloric density of the food that is fried.  Worst is when the oil is reused as one loses the healthier unsaturated fat and instead increases the amount of the unhealthiest fat which is the trans fat!  What is known is that the risk of obesity and overweight strongly correlated with eating fried foods but this is the only study so far that has evaluated prospectively the relationship between fried foods and cardiovascular disease.

In this study Olive oil or Sunflower oil were used.  Of the total amount of fried food consumed, 24% (34 g/day) was fish, 22% (31 g/day) meat, 21% (30 g/day) potatoes, and 11% (15 g/day) eggs.

In this study population, the detailed analysis of the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition significantly found no association between consumption of fried food and risk of coronary heart disease or all cause mortality.

Some explanations can be made:

1. The oil used in the study was mainly olive and sunflower rather than solid fat.  Olive oils is less prone to oxidation than other edible oils or fat.

2. We are not talking here of fried food in Fast food Burger joints where oils used in deep frying are reused several times and therefore unhealthy!

3. The analysis should not be made to say that fried chips or snacks therefore are safe because the study population here has low consumption of fried snacks that are usually loaded with salt.

This is indeed an exciting development in the field of FRYING!

Just the same..choose foods wisely ….

Choose Healthy!


What Makes Us OVEREAT….

January 4, 2012

Let me share with you one nice article from theHarvard Medical School publication: HealthBeat on what makes people overeat…

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How stress can make us overeat

It’s been another hectic day. On impulse, you grab an extra-large candy bar during your afternoon break. You plan to take just a few bites. But before you know it, you’ve polished off the whole thing — and, at least temporarily, you may feel better.

Rest assured you’re not alone. Stress, the hormones it unleashes, and the effects of high-fat, sugary “comfort foods” push people toward overeating.

Effects on appetite

In the short term, stress can shut down appetite. A structure in the brain called the hypothalamus releases corticotropin-releasing hormone, which suppresses appetite. The brain also sends messages to the adrenal glands atop the kidneys to pump out the hormone epinephrine (also known as adrenaline). Epinephrine helps trigger the body’s fight-or-flight response, a revved-up physiological state that temporarily puts eating on hold.

But if stress persists — or is perceived as persisting — it’s a different story. The adrenal glands release another hormone called cortisol, and cortisol increases appetite and may also ramp up motivation in general, including the motivation to eat. Once a stressful episode is over, cortisol levels should fall, but if the stress doesn’t go away — or if a person’s stress response gets stuck in the “on” position — cortisol may stay elevated.

Fat and sugar cravings

Stress also seems to affect food preferences. Numerous studies — granted, many of them in animals — have shown that physical or emotional distress increases the intake of food high in fat, sugar, or both. High cortisol levels, in combination with high insulin levels, may be responsible. Other research suggests that ghrelin, a “hunger hormone,” may have a role.

Once ingested, fat- and sugar-filled foods seem to have a feedback effect that inhibits activity in the parts of the brain that produce and process stress and related emotions. So part of our stress-induced craving for those foods may be that they counteract stress.

Of course, overeating isn’t the only stress-related behavior that can add pounds. Stressed people lose sleep, exercise less, and drink more alcohol, all of which can contribute to becoming overweight.

Different responses

Some research suggests a gender difference in stress-coping behavior, with women being more likely to turn to food and men to alcohol or smoking. A Finnish study that included over 5,000 men and women showed that obesity was associated with stress-related eating in women but not in men. Other research has shown that high stress levels lead to weight gain in both women and men, but the effect is typically greater in men.

Harvard researchers have reported that stress from work and other sorts of problems correlates with weight gain, but only in those who were overweight at the beginning of the study period. One explanation: overweight people have elevated insulin levels, and stress-related weight gain is more likely to occur in the presence of high insulin.

How much cortisol people produce in response to stress may also factor into the stress–weight gain equation. Several years ago, British researchers designed an ingenious study that showed that people who responded to stress with high cortisol levels in an experimental setting were more likely to snack in response to daily hassles in their regular lives than low-cortisol responders.

Steps you can take

Stress reduction is a growth industry these days.

There are dozens of things to try. Here are three suggestions:

    1. Meditate. Countless studies show that meditation reduces stress, although much of the research has focused on high blood pressure and heart disease. Meditation may also help you be more mindful of food choices. With practice, a person may be able to pay better attention to the impulse to grab a fat- and sugar-loaded comfort food and inhibit the impulse.
   2.  Exercise more. Intense exercise increases cortisol levels temporarily, but low-intensity exercise seems to reduce them. University of California researchers reported results in 2010 that exercise — and this was vigorous exercise — may blunt some of the negative effects of stress. Some activities, such as yoga and tai chi, have elements of both exercise and meditation.
    3. Visit with friends. Social support seems to have a buffering effect on the stress people experience. For example, researchers have found that the mental health of people working in stressful situations, like hospital emergency departments, is better if they receive it. But even those of us who live and work in situations where the stakes aren’t as high will, as Lennon and McCartney suggested, be better off if we get a little help from our friends.

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Steps you can do to reduce stress anytime of the the day…

Bad Habits to avoid when stressed!

Sound Simple and Pure…

 


2011 in Review for That Health Rules

January 1, 2012

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

London Olympic Stadium holds 80,000 people. This blog was viewed about 300,000 times in 2011. If it were competing at London Olympic Stadium, it would take about 4 sold-out events for that many people to see it.

Click here to see the complete report.


What a way to END the YEAR

January 1, 2012

2011 has been very busy for me as i was inducted as the President of the American Association of Clinical Endocrinologists Philippines (AACE Philippines). My term will end by August 2012. This is the only year where I did not have a post every month.

One of the legacies I want to give and share during my presidency is the giving back our precious time to help and treat those in far flung barangays who cant afford the fee of a specialist. Thus was born the Goiter Obesity Osteoporosis and Diabetes (GOOD) doctors outreach and medical mission held end of November 2012. The group was able to treat and helped 2800 residents of Argao, Cebu. a total of 40 specialists from all over the country helped in the effort.

Overall…the feeling of having helped and served your fellowmen is what makes the true essence of what a doctor is all about.

Thanks 2011…. And more challenges ahead for 2012…


How To Lose Weight: A Novel Way To Teach Kids About Proper Nutrition

December 24, 2011

Recent article published in AMERICAN JOURNAL OF PUBLIC HEALTH brings us back to how fast our world is becoming obese and how slow we have been in addressing this issue.  The temptation to eat and the lack of discipline to follow what is right and adequate make each one of us vulnerable to this dreaded condition we call Obesity.

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Objectives. We examined the effect of an intervention to provide caloric information about sugar-sweetened beverages (SSBs) on the number of SSB purchases.

Methods. We used a case-crossover design with 4 corner stores located in low-income, predominately Black neighborhoods in Baltimore, Maryland. The intervention randomly posted 1 of 3 signs with the following caloric information: (1) absolute caloric count, (2) percentage of total recommended daily intake, and (3) physical activity equivalent. We collected data for 1600 beverage sales by Black adolescents, aged 12–18 years, including 400 during a baseline period and 400 for each of the 3 caloric condition interventions.

Results. Providing Black adolescents with any caloric information significantly reduced the odds of SSB purchases relative to the baseline (odds ratio [OR] = 0.56; 95% confidence interval [CI] = 0.36, 0.89). When examining the 3 caloric conditions separately, the significant effect was observed when caloric information was provided as a physical activity equivalent (OR = 0.51; 95% CI = 0.31, 0.85).

Conclusions. Providing easily understandable caloric information—particularly a physical activity equivalent—may reduce calorie intake from SSBs among low-income, Black adolescents.

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The study tells us one thing:

Letting out kids understand the nutrition information of the food they eat versus telling them how long they have to workout or exercise to burn the calories can make a difference.

The impact was noticeable more if kids understand how long they have to run to burn the amount of calories they ingested from the sugary drinks.  The easier it is for everyone to understand the equivalent amount of physical activity of what we take in makes sense.  You get a clearer picture of what you need to do to burn those calories.

A great article and a great wake up call for everyone.

AACE Philippines as part of our advocacy is providing modules to Grade school students on the Power of Prevention Through Fitness and Nutrition or POPFTN. For this year, we already have started the program and involved the Grade 5 students of St Bennedicts and for January, we will go to PAREF Springadale both in Cebu.  AACE Philippines as an organization composed of Endocrine Specialists dealing with Diabetes, Obesity and endocrine diseases hope to make a difference in the early lives of these kids.


Do We Need MULTIVITAMINs?

November 2, 2011

The concept of taking mutivitamins as a way to improve health has never been proven.  It has not been shown to cause harm BUT has not been shown to help reduce disease… so when a study on multivitamin around 2009 came out saying that taking these supplements has not been shown to have any effect on health or disease prevention…I literally stopped taking one.

Now comes a new study that gtives us more doubt on this practice. A study published in Archives of Internal Medicine, Oct issue showed that these supplements are not helpful healthwise, they can actually be HARMFUL

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Methods We assessed the use of vitamin and mineral supplements in relation to total mortality in 38 772 older women in the Iowa Women’s Health Study; mean age was 61.6 years at baseline in 1986. Supplement use was self-reported in 1986, 1997, and 2004. Through December 31, 2008, a total of 15 594 deaths (40.2%) were identified through the State Health Registry of Iowa and the National Death Index.

Results  In multivariable adjusted proportional hazards regression models, the use of multivitamins (hazard ratio, 1.06; 95% CI, 1.02-1.10; absolute risk increase, 2.4%), vitamin B6(1.10; 1.01-1.21; 4.1%), folic acid (1.15; 1.00-1.32; 5.9%), iron (1.10; 1.03-1.17; 3.9%), magnesium (1.08; 1.01-1.15; 3.6%), zinc (1.08; 1.01-1.15; 3.0%), and copper (1.45; 1.20-1.75; 18.0%) were associated with increased risk of total mortality when compared with corresponding nonuse. Use of calcium was inversely related (hazard ratio, 0.91; 95% confidence interval, 0.88-0.94; absolute risk reduction, 3.8%). Findings for iron and calcium were replicated in separate, shorter-term analyses (10-year, 6-year, and 4-year follow-up), each with approximately 15% of the original participants having died, starting in 1986, 1997, and 2004.

Conclusions  In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron. In contrast to the findings of many studies, calcium is associated with decreased risk.

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This study confimrs what I have been suspecting in a long time.  As a supplement, these drugs are not being screened for what they contain.  The drugs dont need to prove they work… for them to be sold in the market nor are these drugs required to show their long term safety. Now I hope the public knows better!!!!

In this paper, the patients who were studied took supplements in the form of calcium, multivitamins, vitamin C, and vitamin E.  The data showed that the use of multivitamins especially those containing vitamin B6, folic acid, iron, magnesium, zinc, and copper supplements were associated with greater all-cause mortality through 19 years of follow-up.  This is BIG news!!!!

What then is our recommendation?

Better invest in healthy lifestyle.  As always, it has been our advocate to promote what is proven right and safe.  Eat right and Move!!!

Avoid taking a palm full of supplements thinking this can make one live longer and healthier because on the contrary…the fewer supplements or ZERO supplements – the better!!!!  We cannot and will NEVER recommend the use of vitamin and mineral supplements as a preventive measure!!!!, As they dont add anything beneficial from what we can get by eating the healthy fruits and vegetables!


Regular Exercise Keeps Your Arteries Healthy….

June 19, 2011

Go to fullsize imageIt is known that high sugar and high cholesterol in the blood spell trouble.  Any diabetics almost always has high blood pressure or high cholesterol problem.  Therefore, we aggressively treat their sugars, blood pressure and cholesterol hoping to lower their risk to suffer from a stroke and heart attack.

Most often, doctors tend to forget to remind patients to be more physically active.  Some patients also feel so comfortable that they are already on medications that they dont need to watch out what they eat or do. 

Now comes a new study presented at the Annual Meeting of the American College of Sports Medicine that looked at the value of regular physical activity among patients already on aggressive lowering of sugar and cholesterol and see if regular exercise contributes further to preventing heart disease.

This is so far the first study to document that if one exercise reglarly at least 30 minutes like walking, further reduction in ones risk to heart disease progression can be seen.  When pulse wave activity was measured after 2-5 years, those that exercise less or not at all, had a 14% increase in pulse wave activity suggesting more arterial stiffness.  The study confirms that progression of atherosclerosis or blockage of blood vessels can be sloweddown or halted by adding physical activity to the usual medications we give to lower sugar and cholesterol.

This study further emphasizes to all of us that whatever we do and have in life…

 if we are healthy.. go out and exercise;

if we have heart disease…go out and exercise

if you’re pregnant…go out and exercise….

Exercise will continue to add benefit to whatever medications youre taking for whatever disease you have! PLUS

Exercise difinitely PREVENTS you from falling ill…

Take care of your body…its the only one you have!


Sleep and Diabetes: Quality Matters NOT Quantity!!!!

May 30, 2011

Go to fullsize imageLack of sleep causes stress. Stress increases stress hormones that can increase glucose. Understandably,lack of sleep equals risk for diabetes.  I used to believe from previous studies that a duration of sleep less than 7 hours increases ones risk to develop diabetes. 

 Now comes a new study published in Diabetes Care March 2011, that tell us Quality is important than Quantity…

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OBJECTIVE To examine whether sleep duration and quality are associated with fasting glucose, fasting insulin, or estimated insulin resistance in a community-based sample of early middle-aged adults.

RESEARCH DESIGN AND METHODS This was an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Habitual sleep duration and fragmentation were estimated from 6 days of wrist actigraphy collected in 2003–2005. Insomnia was defined as self-reported difficulty falling asleep or waking up in the night three or more times per week plus average sleep efficiency of <80% based on actigraphy. Fasting blood samples to measure glucose and insulin were collected after the sleep measures during the CARDIA clinical examination in 2005–2006. Insulin resistance was estimated using the homeostatic model assessment (HOMA) method. Analyses were cross-sectional and stratified by the presence of diabetes.

RESULTS There was no association between sleep measures and fasting glucose, insulin, or HOMA in the 115 subjects without diabetes. Among the 40 subjects with diabetes, after adjustment for covariates, 10% higher sleep fragmentation was associated with a 9% higher fasting glucose level, a 30% higher fasting insulin level, and a 43% higher HOMA level. Insomnia was associated with a 23% higher fasting glucose level, a 48% higher fasting insulin level, and an 82% higher HOMA level.

CONCLUSIONS The observed association between poor sleep quality and higher glucose, insulin, and estimated insulin resistance among subjects with diabetes warrants further examination of the effect of sleep disturbances on glucose control in type 2 diabetes.

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In the study, sleep duration was assessed as the amount of sleep obtained per night while sleep fragmentation was based on the periods of restlessness and movements that the pateints had during the night.

What is interesting in the study was that there was no association between sleep duration and glucose metabolism in groups with or without diabetes.  This is in contrast to earlier studies which showed otherwise. 

However sleep fragmentation was signicantly associated with increasing blood sugar so that for every 10% higher sleep fragmentation,  there was an associated 9% higher fasting glucose and higher insulin level suggesting insulin resistance.  What is important is that sleep fragmentation WAS not associated with higher glucose if one is NOT a diabetic.  Meaning, sleep disturbance is a risk factor  for poor blood sugar control among diabetics!

In conclusion, the authors assessed that POOR sleep and NOT Short Duration is associated with poor glucose control!!!  That intervention to warrant investigations of causes for poor sleep can help make diabetics have better control.

So do you snore? and probably stop breathing often?

Ask your partner… and better have your sleeping pattern assessed as this may lead to better control of your blood sugar if corrected!


Calcium Supplements May Not Be That Safe After All….

April 25, 2011

It has always been my practice to make sure women take their daily calcium supplements to prevent osteoporosis.  It is my contention that by building bone the right way and preventing a fracture is very important health issue.  It is recommended by diffirent medical societies that calcium supplements be given between 1000- 1200 mg per day. 

Now comes a new study showing proofs that calcium supplements may not be that safe after all.  A study published in BMJ in JUly 2010 with a reanalysis done in 2011 showed that calcium supplementation should be reviewed due to inherent harm.

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Abstract

OBJECTIVE:

To investigate whether calcium supplements increase the risk of cardiovascular events.

DESIGN:

Patient level and trial level meta-analyses.

DATA SOURCES:

Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic database searches repeated in March 2010.

STUDY SELECTION:

Eligible studies were randomised, placebo controlled trials of calcium supplements (>or=500 mg/day), with 100 or more participants of mean age more than 40 years and study duration more than one year. The lead authors of eligible trials supplied data. Cardiovascular outcomes were obtained from self reports, hospital admissions, and death certificates.

RESULTS:

15 trials were eligible for inclusion, five with patient level data (8151 participants, median follow-up 3.6 years, interquartile range 2.7-4.3 years) and 11 with trial level data (11 921 participants, mean duration 4.0 years). In the five studies contributing patient level data, 143 people allocated to calcium had a myocardial infarction compared with 111 allocated to placebo (hazard ratio 1.31, 95% confidence interval 1.02 to 1.67, P=0.035). Non-significant increases occurred in the incidence of stroke (1.20, 0.96 to 1.50, P=0.11), the composite end point of myocardial infarction, stroke, or sudden death (1.18, 1.00 to 1.39, P=0.057), and death (1.09, 0.96 to 1.23, P=0.18). The meta-analysis of trial level data showed similar results: 296 people had a myocardial infarction (166 allocated to calcium, 130 to placebo), with an increased incidence of myocardial infarction in those allocated to calcium (pooled relative risk 1.27, 95% confidence interval 1.01 to 1.59, P=0.038).

CONCLUSIONS:

Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.

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The reanalysis of this study done recently and published in the same journal showed that the risk of MI is actualy MODEST at best around 20% for MI and 30% for stroke BUT… considering the huge number of women doctors have been recommending to take calcium supplements… justify a further close look at this practice as this will have enormous impact on health care risk.

For the past year…I have not been recommending calcium supplements to my patients especially my diabetic hypertensive patients.  I make sure that my dietitian supplements their diet with enough calcium sources from food and milk.  If need be, those patients who cant take enough from food are the ones given the supplements but this number is becoming less each day.

If you are taking calcium supplements on your own , my recommendation is to stop.  If you are taking the supplements as part of your osteoporosis program then talk to your doctor first before stopping.


The Health Issue of Cell Phone Use

April 13, 2011

Ive long been cautious of letting my kids use cell phones even for a short period of time.  Their brains are still developing and need the best nurturing they can get and if we can limit inflicting harm to avoid long term defects would be ideal.

A novel study recently published in JAMA tells us that cell phone use was shown to affect brain activity:

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Context The dramatic increase in use of cellular telephones has generated concern about possible negative effects of radiofrequency signals delivered to the brain. However, whether acute cell phone exposure affects the human brain is unclear.

Objective To evaluate if acute cell phone exposure affects brain glucose metabolism, a marker of brain activity.

Design, Setting, and Participants Randomized crossover study conducted between January 1 and December 31, 2009, at a single US laboratory among 47 healthy participants recruited from the community. Cell phones were placed on the left and right ears and positron emission tomography with (18F)fluorodeoxyglucose injection was used to measure brain glucose metabolism twice, once with the right cell phone activated (sound muted) for 50 minutes (“on” condition) and once with both cell phones deactivated (“off” condition). Statistical parametric mapping was used to compare metabolism between on and off conditions using paired t tests, and Pearson linear correlations were used to verify the association of metabolism and estimated amplitude of radiofrequency-modulated electromagnetic waves emitted by the cell phone. Clusters with at least 1000 voxels (volume >8 cm3) and P < .05 (corrected for multiple comparisons) were considered significant.

Main Outcome Measure Brain glucose metabolism computed as absolute metabolism (μmol/100 g per minute) and as normalized metabolism (region/whole brain).

Results Whole-brain metabolism did not differ between on and off conditions. In contrast, metabolism in the region closest to the antenna (orbitofrontal cortex and temporal pole) was significantly higher for on than off conditions (35.7 vs 33.3 μmol/100 g per minute; mean difference, 2.4 [95% confidence interval, 0.67-4.2]; P = .004). The increases were significantly correlated with the estimated electromagnetic field amplitudes both for absolute metabolism (R = 0.95, P < .001) and normalized metabolism (R = 0.89; P < .001).

Conclusions In healthy participants and compared with no exposure, 50-minute cell phone exposure was associated with increased brain glucose metabolism in the region closest to the antenna. This finding is of unknown clinical significance.

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Analysis of the data showed that the human brain is indeed sensitive to the effects of radiofrequency from acute cell phone use.  And that the area closest to the antennae revealed the highest brain activity.  Whether this disruption in brain activity has long term consequences is still unknown.

Take Home message?

Use the phone for texting…and use it sparingly for calling.

Restricting use of cell phones in kids will continue to be my recommendation until better studies will show that indeed its use is safe for kids until age 18.  Too late? well better be safe than sorry….

But hopefully soon before my son reaches tha age where cell phones are a must..we have better studies showing its safety…Cross my fingers!!!


Tylenol and Hypertension: Is There A Link?

April 13, 2011

It has always been my notion that tylenol is the safest of all pain relievers.  Most patinets of mine are advised to take acetaminophen instead of NSAIDS especially if they have arthritis  and have concomitant heart disease or kidney problem.  We all know about the Viox controversy when it was pulled out due to cardiovascular safety.

Now comes a recent report from the Harvard Health Beat regarding a Swiss study that showed taking acetaminophen better known for the brand Tylenol, can actually cause an elevation of Blood pressure.

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The researchers asked 33 men and women with one or more of these problems to take either 1,000 milligrams (mg) of acetaminophen or an identical placebo three times a day for two weeks. Then, after a two-week break, each volunteer took the other treatment. The amount of acetaminophen used in the study is a standard daily dose for pain.

When the participants took acetaminophen, average systolic blood pressure (the top number of a blood pressure reading) increased from 122.4 to 125.3, while the average diastolic pressure (the bottom number) increased from 73.2 to 75.4. Blood pressure stayed steady when participants took the placebo. These increases aren’t large. But they indicate that acetaminophen, like NSAIDs, somehow affects the cardiovascular system.

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Acetaminophen indeed is a safe alternative to the pain killers known as NSAIDs becuase it is safe to the stomach and avoid gastric irritation. 

It is also a better alternative especially to patients taking anticoagulants or drugs to prevent blood clots because it does not interfere with their actions nor further increase bleeding tendencies.

However… people should be extra careful with this new information and therefore should not take acetaminophen lightly.  Meaning, one should also be cautious in taking acetaminophen with a slight onset of headache especially among patients with concomitant cardiovascular disease. 

No matter how safe a drug is perceived to be… along the way comes an alternative that will always be safer… or the other way around.  It is best that we be kept informed because we may be taking drugs that may instead cause harm than good. It is therefore always worth having a periodic visits to your family doctor.


Precautions To Be Taken During a Nuclear Mealtdown

March 18, 2011

I am reposting this article from the American  Thyroid Association for all of us to be aware of certain precautions we can take in the event of a nuclear meltdown to avoid radiation induced injuries….

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American Thyroid Association
Dedicated to Scientific Inquiry, Clinical Excellence, Public Service, Education, and Collaboration


American Thyroid Association
ATA underscores importance of KI distribution prior to nuclear emergencies 

 

ATA underscores importance of KI distribution prior to nuclear emergencies The tragic events in Japan over the last several days underscore the importance of distribution of potassium iodide (KI) in regions surrounding nuclear power plants. Radioactive iodine can be released in nuclear accidents. Infants and children are particularly at risk for thyroid cancer following exposures to high levels of radioactive iodine. If taken soon after exposure to the radioactive iodine released during a nuclear emergency, potassium iodide can help to provide protection against thyroid cancer. Distribution of potassium iodide in the area around a nuclear reactor prior to an accident can ensure that it is available in a timely fashion, even in the setting of major disruptions to transportation and other infrastructure, as have occurred in Japan.

Since 1984, the American Thyroid Association has advocated that:

  • Potassium iodide should be part of an emergency plan that includes evacuation, sheltering, and avoiding contaminated food, milk, and water.
  • Potassium iodide should be made available to populations living within 200 miles of a nuclear power plant.
  • Potassium iodide should be “predistributed” to households within 50 miles of a plant.
  • Potassium iodide should be used only under regulatory guidance.

Additional information about potassium iodide distribution can be found at: http://www.thyroid.org/professionals/publications/statements/ki/02_04_09_ki_qa.html

ATA Brochures and FAQS:

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For now it is safe to keep a close eye on the events unfolding in Japan.  Whats important is that precautionary measures are available for all of us to avoid harm.