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.

________________________________________________________________________________________________

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.

_________________________________________________________________________________________________

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.

Posted in General Health Tips, Medical News Bits, Tips To Protect Your Heart | 3 Comments »

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….

__________________________________________________________________________________________________

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:

________________________________________________________________________________________________

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.

Posted in Medical News Bits | 1 Comment »

Why Daily Video and Internet Gaming Can Be Harmful….

January 20, 2011

I am planning to publish this article for my son to read in FB ( which he is allowed to do in my room only during weekends) and for the other parents to reconsider the practice of allowing kids to play video and internet games at their leisure. It is easy to use these gadgets as surrogate nannies because they make our kids stay put and have their own world.  Part of the compromise for busy parents is to buy their kids the best gadgets because kids wont complain their absence as long as they have the gadgets to enjoy.

Now comes a study published in Pediatrics regarding the long term dangers of allowing our kids to enjoy these gadgets on a daily basis:

_________________________________________________________________________________________________

 Objectives : We aimed to measure the prevalence and length of the problem of pathological video gaming or Internet use, to identify risk and protective factors, to determine whether pathological gaming is a primary or secondary problem, and to identify outcomes for individuals who become or stop being pathological gamers.

Methods : A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3 (N = 743), 4 (N = 711), 7 (N = 916), and 8 (N = 664). Several hypothesized risk and protective factors for developing or overcoming pathological gaming were measured, including weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety, and school performance.

Results:  The prevalence of pathological gaming was similar to that in other countries (9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming.

Conclusion:  This study adds important information to the discussion about whether video game “addiction” is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.

__________________________________________________________________________________________________

According to the opinion of Medpage Today… two important things that we learned from the study: 

  • That spending hours with a PlayStation or an Xbox including Internet Games every day can lead to serious psychiatric problems in children.
  • That increases in pathological gaming symptoms were predictive of depression, anxiety, social phobia, and school performance at follow-up.

That’s a WAKE-UP call…

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

Why I Dont Recommend Supplements…

January 5, 2011

I have always been against supplements.  As a physician where safety to patients is of utmost importance, giving drugs that are marketed as natural, herbal and safe without any research background and no published studies in REPUTABLE journals is not acceptable.  This also holds true to Chinese medications. Anybody can just print out a magazine touting the benefits and health effects of certain hebral prepartations and present these to clients as proofs that these natural supplements work!  Not only are they unsafe, they may also have interactions with the drugs we give that really can help our patients.

Here’s one reason why I refuse to recommend supplements to my patients…this is a recent experience published in Medpage Today, January issue  on an over the counter ” natural” supplements to help patients lose weight….

_________________________________________________________________________________________________

The marketer of two dietary weight-loss supplements sold as “100% all natural” issued a voluntary recall of the products after FDA testing confirmed they contained the banned weight-loss drug sibutramine.

The FDA has received a number of adverse event reports related to Fruta Planta and Reduce Weight Fruta Planta, including multiple cardiac events and one death.

Sibutramine, withdrawn from the U.S. market in October 2010 due to an increased risk of stroke and myocardial infarction, may also cause patients to experience elevated blood pressure or pulse rate; may increase risk to patients with a history of coronary artery disease, congestive heart failure, arrhythmias, or stroke; and may have negative and life-threatening interactions with some drugs.

The agency recommended consumers stop using the product and throw any remaining samples away in a sealed container or return the product to the marketer, PRock Marketing of Kissimmee, Fla. Patients who experience any negative side effects from the product should consult a healthcare professional immediately.

The product was sold online in 30-capsule boxes.

_________________________________________________________________________________________________

The risk is enormous because these products may contain true drugs that are already banned but are not included in the product label.  As a result these supplements will really work because they contain active drug ingredients. The risk involves doctors not knowing what to expect in terms of side effects. The patients also take them lightly without regard to the effects on their body becuase they are “Herbal”, ” Natural” and apparently without side effects!

So please take note.  The above story is just one of the many horror stories we have encountered as medical practitioners.

Posted in Medical News Bits | 2 Comments »

Healthy Cereals for Breakfast

December 14, 2010

Its always difficult to wake kids up during school days…more difficult to let them eat.  I usually alternate oatmeal, cereals and rice on my kids breakfast meal.  Oats with fruits and milk, low sugar Cherrios cereals and in between days they get rice and eggs with ham.  It is always good to start the kids young and learn the importance of a healthy breakfast.

The mistake that parents always have with regard to kids food choices is that we always allow our kids to dictate what they like to eat.  Or rely our kids meals on their yayas.  It is easier for us to fry chicken with french fries because for sure the kids will eat them BUT are they healthy?  Likewise yayas find it easier to feed fried chicken than veggies.  As the saying goes..at least they eat rather than no breakfast!  This is the reason why in the long run, parents will find it difficult to introduce healthy food choices for the kids.

Now comes a new study published in Pediatrics that these Cherrios low sugar cereals are really acceptable options for a healthy breakfast.  Likewise surprisingly kids love them!

_________________________________________________________________________________________________

Objectives To test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk.

Participants and Methods Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating. Researchers measured the amount and calories consumed of each food.

Results In both conditions, children reported “liking” or “loving” the cereal they chose. Children in the low-sugar cereal condition consumed, on average, slightly more than 1 serving of cereal (35 g), whereas children in the high-sugar condition consumed significantly more (61 g) and almost twice the amount of refined sugar in total (24.4 vs 12.5 g). Milk and total calories consumed did not differ significantly between conditions, but children in the low-sugar condition were more likely to put fruit on their cereal (54% vs 8%) and consumed a greater portion of total calories from fresh fruit (20% vs 13%).

Conclusions Compared with serving low-sugar cereals, high-sugar cereals increase children’s total sugar consumption and reduce the overall nutritional quality of their breakfast. Children will consume low-sugar cereals when offered, and they provide a superior breakfast option.

_______________________________________________________________________________________________________________

This clinical study is true based on my experience.  My kids love these Cherrios low sugar low fat whole grain cereals more than the sugary chocolate laden corn flakes.   The good news with these data is that those children in the study who were offered low-sugar cereals enjoyed their breakfast with good satisfaction but only consumed half the amount of refined sugar at breakfast compared with those who ate high-sugar cereals (12.5 g versus 24.4 g, P<0.001).  Not only are the parents happy but the kids are satisfied too!

It is really best to start our kids day with a healthy meal that can provide them with calories that matter…

Choose wisely and Be Involved!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips | 3 Comments »

The Dangers of Sugary Drinks

November 16, 2010

Consumption of sugary drinks not only make you gain weight BUT now has been proven to strongly increase your risk to develop Diabetes and other obesity related diseases. 

A new study has shown us there is a  link regarding the risk of developing diabetes to intake of sugary drinks and this link is high enough to approximate the risk that one gets from smoking!!!!

This new study is published in the recent publication of Diabetes Care in 2010:

________________________________________________________________________________________________

OBJECTIVE: Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed.

RESEARCH DESIGN AND METHODS: We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes.

RESULTS: Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1-2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12-1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02-1.42].

CONCLUSIONS: In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.

_________________________________________________________________________________________________

In practical terms, the association between intake of sugary drinks and Diabetes can be translated to something like this:

For every  12 oz sugar laden drink that you order in a restaurant today like the ever famous and popular sugary and tasty Ice Tea or canned OJ… a roughly 25% increase in risk  for you to develop Diabetes on top of your risk to gain more weight!

So if one actually drinks 2-3 bottles of Soda per day then the risk is further increased to 30% roughly similar to the risk one gets due to smoking!

Would it be better to take Diet Drinks then? It maybe safer BUT the associated increase in food intake is the culprit.  Likewise there are some concerns now that link Diet Sodas also to increased risk of Metabolic syndrome suggesting that artificial sweeteners may have a role in itself. 

So my recommendation to my patients is to limit one’s consumption to only 1 diet soda per day and if possible enjoy Water instead!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, The Diabetes Facts, What's New in Diabetes | 3 Comments »

Diet Alone without Exercise Can Reduce risk of Diabetes

October 26, 2010

The title indeed is intriguing but it’s TRUE. 

For the first time, a study has looked at controlling food and specifying the kind of food without restricting it and without any exercise resulted in health benefit.  We always recommend the combination of proper healthy diet and exercise to achieve benefit but this new study published in Diabetes Care showed us otherwise.

_________________________________________________________________________________________________

Objective – To test the effects of two Mediterranean-diet interventions versus a low-fat diet on incidence of diabetes.

Research Design and Methods – Three-arm randomized trial in 418 nondiabetic subjects aged 55-80 years recruited in one center (PREDIMED-Reus, North-Eastern Spain) of the PREDIMED study, a large nutrition-intervention trial for primary cardiovascular prevention in persons at high cardiovascular risk. Participants were randomized to education on a low-fat diet (control group) or one of two Mediterranean diets, supplemented with either free virgin olive oil (1 liter/week) or nuts (30 g/day). Diets were ad libitum and no advice on physical activity was given.

The main outcome was diabetes incidence diagnosed by the 2009 American Diabetes Association criteria. Results – After a median follow-up of 4.0 years, diabetes incidence was 10.1% (95% confidence interval [CI], 5.1-15.1), 11.0% (5.9-16.1), and 17.9% (11.4-24.4) in the Mediterranean-diet with olive oil group, the Mediterranean-diet with nuts group, and the control group, respectively. Multivariable-adjusted hazard ratios of diabetes were 0.49 (0.25-0.97) and 0.48 (0.24-0.96) in the Mediterranean-diet groups supplemented with olive oil and nuts, respectively, compared to the control group. When pooling the two Mediterranean-diet groups compared to the control group, diabetes incidence was reduced by 52% (27-86). In all study arms, increased adherence to the Mediterranean-diet was inversely associated with diabetes incidence. Diabetes risk reduction occurred in the absence of significant changes in body weight or physical activity.

Conclusion – Mediterranean diets without calorie restriction appear to be effective in the prevention of diabetes in subjects at high cardiovascular risk.

______________________________________________________________________________________

The traditional Mediterranean diet, which was recommended in the present study,included the following components:

  • Use of olive oil for cooking and dressing.
  • Increased consumption of fruit, vegetables, legumes, and fish.
  • Reduction in total meat consumption, white meat instead of red meat.
  • Use of homemade sauce with tomato, garlic, onion, and spices with olive oil to dress vegetables, pasta, rice, and other dishes.
  • No No to butter, cream, fast-food, sweets, pastries, and sugar-sweetened beverages.
  • In alcohol drinkers, moderate consumption of red wine.

This diet is not difficult to follow.  In fact, the study showed no restriction resulting in no weight loss.  Remember, this is to see if this diet can indeed help lower the diabetes risk and not specifically to reduce weight.  Calorie intake continues to be a factor in affecting ones weight. 

In short, if one aims for both risk reduction and weight loss, then simply restricting calories using this diet plus exercise should achieve optimal benefit!

This diet resulted in a 52% reduction in the risk of developing diabetes. This reduction is understandable considering that the diet is rich in monounsaturated fats as well as anitoxidants known to combat the risk factors of chronic ailments including heart disease…suggesting that long term, this diet should also help reduce risk for heart disease.

But…dont aim for less…aim for more…

Please do continue to aim to be more physically active and achieve OPTIMAL benefit for Your HEALTH!

Posted in General Health Tips | 1 Comment »

TV Time and the Kids

October 12, 2010

I have practiced limiting my kids TV times to only during the weekends.  This rule includes palying PSP or nintendo.  They only open the computer for assignments but never for games. So they resort to board games like scrabble, chess, Game of the generals and Mastermind Game.  My eldest also writes his own  ” book” about Clyde and Clod and he is now on his third series on these two characters.  This aside from finishing 3 ” do it your own” Diary of the Wimpy Kid book.  The two girls obviously followed.  Kids therefore can have other fun stuff to do and use their brains to think instead of a one sided affair with TV’s.  On occasions I allow them to play the Wii provided they sweat.  I dont bring them to my daily run this past few days because of the dengue scare especially I run aroung 5:30PM.   My wife also bought them Hullahoop where the kids except the youngest can now do the Hullahoop thing up to 400 counts…imagine the sweat!

My rule had basis after all….now comes a study published in Pediatrics  linking TV time to Psych problems and peer relationship problems.

_________________________________________________________________________________________________

Objective: We hypothesized that greater screen use would be associated with greater psychological difficulties and that children with high levels of screen entertainment use and low levels of physical activity would have the most-negative psychological profiles.

Methods: Participants were 1013 children (age, mean ± SD: 10.95 ± 0.41 years), who self-reported average daily television hours and computer use and completed the Strengths and Difficulties Questionnaire. Sedentary time (minutes per day with <100 cpm) and moderate/vigorous physical activity (MVPA) (minutes with 2000 cpm) were measured by using accelerometers. Multivariate regression models examined the association between television viewing, computer use, sedentary time, and Strengths and Difficulties Questionnaire scores, with adjustment for MVPA, age, gender, level of deprivation, and pubertal status.

Results: Greater television and computer use were related to higher psychological difficulty scores after adjustment for MVPA, sedentary time, and confounders. However, sedentary time was inversely related to psychological difficulties after adjustment. Children who spent >2 hours per day watching television or using a computer were at increased risk of high levels of psychological difficulties (television, odds ratio [OR]: 1.61 [95% confidence interval [CI]: 1.20–2.15]; computer, OR: 1.59 [95% CI: 1.32–1.91]), and this risk increased if the children also failed to meet physical activity guidelines (television, OR: 1.70 [95% CI: 1.09–2.61]; computer, OR: 1.81 [95% CI: 1.02–3.20]).

Conclusion:

 Both television viewing and computer use are important independent targets for intervention for optimal well-being for children, irrespective of levels of MVPA or overall sedentary time.

______________________________________________________________________________________________________________

In short, allowing your kids to watch TV for more than two hours a day will result in them a 61%  risk  of having an increased  hyperactivity and emotional problems… PLUS difficulty in concentration and conduct problems which can be an issue with poor grades in school and peer problems with friends and classmates.

Now I see my kids grades getting better without the TV and more attention span.  I dont have to pressure them to read or study!   Plus the bonding time with them is better and great interaction with board games and fun!

Guys.. Discpline really works.  Just adhere to what you think is best for the kids…and once the rule becomes a habit…everything flows  smoothly!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures | 4 Comments »

Heres A Simple Way To Lose Weight…

September 11, 2010

Go to fullsize imageJust being too busy or just plain lazy, we have many excuses why we cant exercise.  Too stressed out at work gives us the reason to indulge in  food that we feel comfortable and happy.  But outcomes do matter and weight gain spells disaster.

We have heard of fad diets that do work but temporarily.  It still boils down to strict discipline and watching carefully what we eat and following the right regimen to the right activity.  We all know that… we heard that advice in the news, in the magazine so what esle is new?  Something that is simple and so close within your grabs but never thought about it?

Well heres something interesting and novel study  that was presented at the 2010 National Meeting of the American Chemical Society in Boston:

________________________________________________________________________________________________

The study included 48 adults between age 55 and 75 who were divided into two groups.  The study participants drank about 1.5 cups of water per day prior to joining in the study.

One group drank two cups of water before meals and the other didn’t. All participants ate a low-calorie diet throughout the study.

After 12 weeks, water drinkers lost about 15.5 pounds, compared to non-water-drinking dieters, who lost only 11 pounds.

Not only were those who drank water before meals more successful after 12 weeks, but they also kept “the weight off for a full year after the weight loss study.”  Even better, most water drinkers, followed for an additional 12 months, not only kept weight off but “even lost another 1 to 2 pounds”.

________________________________________________________________________________________________

The study is really not novel in idea but for the first time, a scientific study has been done to substantiate what I have been recommending to my patients who are diabetics and overweight.  It is a smple formula of dirinking water before each meal to allow one to feel full and therefore less hungry.  By doing so, one tends to be more careful with what one eats and therefore has the best  chance of losing weight or maintaining it.

Water is still the best to fill you up…. its available 24 hours and free.  How much water do I recommend one to take daily?

I recommend at least 8- 10 glasses of water for women and up to 14 glasses for men!

But remember.. to be successful means the triad of discipline, low calorie healthy food and the right amount of exercise! Now ADD Plenty of WATER!!!!

Simple regimen to lose weight…TRY IT!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity | 5 Comments »

Coffee is GOOD for the HEART

August 27, 2010

Go to fullsize imageAnother good news for us coffee lovers. 

Coffee has been shown to have good effects on the vessels and has been shown to improve the vessels capacity to dilate.  This finding is another plus factor for us drinkers of coffee because it helps reduce the stress of the heart in pushing blood out of the vessels. 

And this plus effect is on top of previous studies showing coffee to be protective against developing diabetes.

The study will be presented during the European Society of Cardiology meeting as an abstract.  The abstract was discussed online in MedPage today.

________________________________________________________________________________________________

One to two cups a day correlated with greater aortic distensibility compared with rarely consuming coffee (P=0.45) in a cohort of men and women 65 and older on the Greek island of Ikaria

Likewise, Chrysohoou and colleagues found that, compared with rarely drinking coffee, moderate consumption of one or two cups a day was associated with:

  • Lower prevalence of diabetes (22% versus 34%, P=0.02)
  • Lower prevalence of high cholesterol (41% versus 55%, P=0.001)
  • Lower body mass index (28 versus 29 kg/m2, P=0.04)
  • Higher creatinine clearance levels (70.2 versus 65 mL/min, P=0.01)
  • Lower prevalence of cardiovascular disease (19% versus 26%, P=0.04)
  • Higher values of aortic distensibility (P<0.05)

________________________________________________________________________________________________

The coffee blend that was used according to the authors were of the traditional Greek blends, which apprently have higher levels of phenol compounds thought to be protective for the heart than coffee typically consumed in the U.S.

This study tells us to drink coffee in moderation and advises us to drink only 1-2 cups per day.

There you go guys…another toast to more days of fun with coffee……

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, The Diabetes Facts, Tips on Hypertension, Tips To Protect Your Heart | 7 Comments »

Napping May Not Be Healthy After All….

August 23, 2010

Go to fullsize imageSiesta is still practiced by some of us up to now.  We take a break after lunch to take a nap to recharge and be back to work in the afternoon feeling fresh. But is this practice really healthy or can it cause harm instead?

A new study published in Sleep has this to say:

_________________________________________________________________________________________________

Study Objective: Intentional napping is very common, particularly in China. However, there are limited data regarding its potential health effects. We therefore examined the possible relationship between napping and type 2 diabetes.
 

Design: Cross-sectional analysis of baseline data from the Guangzhou Biobank Cohort Study.

Setting: Community-based elderly association in Guangzhou, China.

Participants: 19,567 Chinese men and women aged 50 years or older.

Measurements and Results: Self-reported frequency of napping was obtained by questionnaire and type 2 diabetes was assessed by fasting blood glucose and/or self-reports of physician diagnosis or treatment. Participants reporting frequent naps (4-6 days/week and daily) were 42% to 52% more likely to have diabetes. The relationships remained essentially unchanged after adjustments were made for demographics, lifestyle and sleep habits, health status, adiposity, and metabolic markers (odds ratio for diabetes 1.36 [95% CI 1.17–1.57] in 4-6 days/week, 1.28 [1.15–1.44] in daily nappers). Similar associations were found between napping and impaired fasting glucose. Removal of those with potential ill health and daytime sleepiness did not alter the observed associations.

Conclusions: Napping is associated with elevated prevalence of diabetes and impaired fasting glucose in this older Chinese sample. Our finding suggests that it is less likely that diabetes leads to daytime sleepiness. This raises the possibility that napping may increase the risk of diabetes. Confirmation by longitudinal studies is needed.

__________________________________________________________________________________________________

In the study approxiametly 2/3 of the napper took a nap just like everyopne else i.e. around 1 hour after lunch and usually lasts around 60 minutes. 

So I guess the population is really well represented as this is the usual behaviour of a typical napper. 

 What is important is that the longer and more frequent one naps, the higher the risk of developing diabetes.

The study confirms previous studies from the US and Germany regarding the association of napping and diabetes as well as all cause mortality or death.  Imagine trying to take a break to feel better and instead cuts down on your life span.  Something to think about! 

In Short: Napping may not be safe or healthy after all!!!

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

Coffee or Tea To Prevent Diabetes…

July 27, 2010

I have posted studies on coffee and tea as a way to prevent diabetes based on single study results.  Now comes a metaanalysis which compiles all data from  different studies to see if there are trends toaward prevention.  This new metaanalysis was published in  Archives of Internal Medicine this year:

_______________________________________________________________________

Background  Coffee consumption has been reported to be inversely associated with risk of type 2 diabetes mellitus. Similar associations have also been reported for decaffeinated coffee and tea. We report herein the findings of meta-analyses for the association between coffee, decaffeinated coffee, and tea consumption with risk of diabetes.

Methods  Relevant studies were identified through search engines using a combined text word and MeSH (Medical Subject Headings) search strategy. Prospective studies that reported an estimate of the association between coffee, decaffeinated coffee, or tea with incident diabetes between 1966 and July 2009.

Results  Data from 18 studies with information on 457 922 participants reported on the association between coffee consumption and diabetes. Six (N = 225 516) and 7 studies (N = 286 701) also reported estimates of the association between decaffeinated coffee and tea with diabetes, respectively. We found an inverse log-linear relationship between coffee consumption and subsequent risk of diabetes such that every additional cup of coffee consumed in a day was associated with a 7% reduction in the excess risk of diabetes relative risk, 0.93 [95% confidence interval, 0.91-0.95]) after adjustment for potential confounders.

 Conclusions  Owing to the presence of small-study bias, our results may represent an overestimate of the true magnitude of the association. Similar significant and inverse associations were observed with decaffeinated coffee and tea and risk of incident diabetes. High intakes of coffee, decaffeinated coffee, and tea are associated with reduced risk of diabetes. The putative protective effects of these beverages warrant further investigation in randomized trials.

_________________________________________________________________________________

 This study hypothesizes what we believe is a true association to the protective effect of coffee and tea in developing diabetes.

What is significant is the fact that so far no untoward problems have been encountered with drinking coffee except a benefit to preventing diabetes which may have a great implication to those at risk of the disease.

But dont forget…lifestyle change should continue to be the priority in the heirarchy of prevention.  Coffee is just an add on….

I will definitely continue to enjoy my cup of coffee every morning and another cup in the afternoon daily.  Decaf at night is tempting.

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts | 1 Comment »

Another Reason To Exercise…

July 1, 2010

weight-loss.womendiary.net/pic/kids-exercise.jpgI really dont look at exercise as a way to lose weight. Definitiely it can help but the bottom line for weight loss is really restricting the amount of calories one takes in.  But the reality of exercise are the benefits one gets with it especially if done regularly.

I do exercise daily by jogging solely to maintain my weight to a normal level for my height because of my risk to develop diabetes due to a strong family history.

Recently in a report from the American Diabetes Association as reported in Medscape Endocrinology June 26, 2010 is a good study that looked at the effect of exercise in preventing diabetes:

___________________________________________________________

Obese boys who engaged in regular aerobic or resistance exercise — without dietary changes — had significant improvements over 3 months in their total body fat, visceral adipose tissue concentrations, and insulin sensitivity than their more sluggish counterparts.

The results were independent of the type of exercise assigned, and suggest that a moderate increase in activity (180 minutes per week) can help prevent type 2 diabetes mellitus in this high-risk population.

_____________________________________________________

In the study, whether aerobic or resistance training did not matter.  The insulin sensitivity analysis was the same in both groups although better with the resistance training group. 

Plus… this study only looked at the effect of exercise and risk for diabetes without restricting calorie intake.  Suggesting that exercise indeed can have tremendous benefical effects in preventing one from developing chronic medical metabolic conditions that can have long term complications.

There you go guys… another good reason to get going…grab your shoes and start running!

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

Cut Down on Sweetened Juice To Help Improve BP

June 14, 2010

Go to fullsize imageOne major aspect in controlling ones BP is to lower salt intake. Salt basically increases the reaction of the blood vessels to contrict or “close” – raise your BP then increase the pressure of the heart in pumping blood out of the circulation which in the long term cause heart failure or heart enlargement. As a precaution, we always warn patients from enjoying too much salt.

Now comes an interesting study published in Circulation in June 2010 looking at another aspect of food that we know should be avoided if one has high sugar…but now is known to affect and lower ones BP also.

___________________________________________________________

BACKGROUND: Increased consumption of sugar-sweetened beverages (SSBs) has been associated with an elevated risk of obesity, metabolic syndrome, and type II diabetes mellitus. However, the effects of SSB consumption on blood pressure (BP) are uncertain. The objective of this study was to determine the relationship between changes in SSB consumption and changes in BP among adults.

METHODS AND RESULTS: This was a prospective analysis of 810 adults who participated in the PREMIER Study (an 18-month behavioral intervention trial). BP and dietary intake (by two 24-hour recalls) were measured at baseline and at 6 and 18 months. Mixed-effects models were applied to estimate the changes in BP in responding to changes in SSB consumption. At baseline, mean SSB intake was 0.9+/-1.0 servings per day (10.5+/-11.9 fl oz/d), and mean systolic BP/diastolic BP was 134.9+/-9.6/84.8+/-4.2 mm Hg. After potential confounders were controlled for, a reduction in SSB of 1 serving per day was associated with a 1.8-mm Hg (95% confidence interval, 1.2 to 2.4) reduction in systolic BP and 1.1-mm Hg (95% confidence interval, 0.7 to 1.4) reduction in diastolic BP over 18 months. After additional adjustment for weight change over the same period, a reduction in SSB intake was still significantly associated with reductions in systolic and diastolic BPs (P<0.05). Reduced intake of sugars was also significantly associated with reduced BP. No association was found for diet beverage consumption or caffeine intake and BP. These findings suggest that sugars may be the nutrients that contribute to the observed association between SSB and BP.

CONCLUSIONS: Reduced consumption of SSB and sugars was significantly associated with reduced BP. Reducing SSB and sugar consumption may be an important dietary strategy to lower BP.

___________________________________________________________

What does this study tell us:

 That of the >800 adults in the study: that drinking one less sugar-sweetened beverage a day resulted in the lowering of both systolic and diastolic BP by about 1.2 mm Hg and 1.1 mm Hg  over 18 months period of observation.

I am actually not surprised by this relationship.  We all know, anytime a patient has high BP, I always make sure he is not at risk to become diabetic with high cholesterol since the three always come in groups and are always partners in crime. So controlling for one may result in the improvement of the other.  So any dietary intevention that I do for my patients incorporate for the control of the three conditions.

Remember: For every 3-mm-Hg reduction in systolic BP : the risk of dying from stroke is reduced by 8% and the risk of dying for heart disease is redcued by 5%.  So any small amount of decrement is worth it!

There you go guys: another reason to cut down on SUGAR!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts, Tips on Hypertension, Tips To Protect Your Heart | 2 Comments »

Coffee or Tea Keeps Diabetes Away….

May 11, 2010

Anothe rgood news for coffee lovers like me… Now comes a new study agina showing the reduction in ones risk to develop diabetes.  The study was recently published in the Archives of Internal Medicine December issue…

____________________________________________________________________________________________

Background  Coffee consumption has been reported to be inversely associated with risk of type 2 diabetes mellitus. Similar associations have also been reported for decaffeinated coffee and tea. We report herein the findings of meta-analyses for the association between coffee, decaffeinated coffee, and tea consumption with risk of diabetes. Methods  Relevant studies were identified through search engines using a combined text word and MeSH (Medical Subject Headings) search strategy. Prospective studies that reported an estimate of the association between coffee, decaffeinated coffee, or tea with incident diabetes between 1966 and July 2009.

Results  Data from 18 studies with information on 457 922 participants reported on the association between coffee consumption and diabetes. Six (N = 225 516) and 7 studies (N = 286 701) also reported estimates of the association between decaffeinated coffee and tea with diabetes, respectively. We found an inverse log-linear relationship between coffee consumption and subsequent risk of diabetes such that every additional cup of coffee consumed in a day was associated with a 7% reduction in the excess risk of diabetes relative risk, 0.93 [95% confidence interval, 0.91-0.95]) after adjustment for potential confounders.

Conclusions  Owing to the presence of small-study bias, our results may represent an overestimate of the true magnitude of the association. Similar significant and inverse associations were observed with decaffeinated coffee and tea and risk of incident diabetes. High intakes of coffee, decaffeinated coffee, and tea are associated with reduced risk of diabetes. The putative protective effects of these beverages warrant further investigation in randomized trials.

 __________________________________________________________________________________________

This study again shows same conclusion as in the past that a mere 4 cups of coffee per day whether regular or decaf has been shown to reduce ones risk to develop diabetes by 27%.  And what is interesting is that for every extra cup of coffee, an additional 7 % further reduction is risk to develop diabetes was noted.

The study therefore points out to one thing…that caffeine may not be the factor as decaf can result in similar reduction in risk.  Other chemicals present in coffee therefore need to be explored…. 

However…one should not resort to just relying on coffee to reduce our risk to develop diabetes.  We have to remember that lifestyle and proper food intake has been shown to reduce the risk of developing diabetes by a whoooping 50%….

There you go guys…enjoy our coffee!!!!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, The Diabetes Facts, What's New in Diabetes | 9 Comments »

Carbohydrate Fanatics and the Heart…

April 14, 2010

Filipinos love bread.  We are carbohydrate eaters. You see bread shoppes in every corner of the Philippines. Cheap and easy to get and filling.  But in every food that we eat comes the recommendation of moderation.  One reason why diabetes is rising  in epidemic proportion in our country is because of the loads of carbos that we eat and the lack of exercise that we usually hate. 

Now comes this article published in Archives of Internal Medicine, April 2010 that looked at carbohydrate intake and the risk of heart disease.

_____________________________________________________________________________________________

Background  Dietary glycemic load (GL) and glycemic index (GI) in relation to cardiovascular disease have been investigated in a few prospective studies with inconsistent results, particularly in men. The present EPICOR study investigated the association of GI and GL with coronary heart disease (CHD) in a large and heterogeneous cohort of Italian men and women originally recruited to the European Prospective Investigation into Cancer and Nutrition study.
 
Methods  We studied 47 749 volunteers (15 171 men and 32 578 women) who completed a dietary questionnaire. Multivariate Cox proportional hazards modeling estimated adjusted relative risks (RRs) of CHD and 95% confidence intervals (CIs).

Results  During a median of 7.9 years of follow-up, 463 CHD cases (158 women and 305 men) were identified. Women in the highest carbohydrate intake quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.00; 95% CI, 1.16-3.43), with no association found in men (P = .04 for interaction). Increasing carbohydrate intake from high-GI foods was also significantly associated with greater risk of CHD in women (RR, 1.68; 95% CI, 1.02-2.75), whereas increasing the intake of low-GI carbohydrates was not. Women in the highest GL quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.24; 95% CI, 1.26-3.98), with no significant association in men (P = .03 for interaction).

Conclusion  In this Italian cohort, high dietary GL and carbohydrate intake from high-GI foods increase the overall risk of CHD in women but not men.

____________________________________________________________________________________________

So what are the foods that have high Glycemic Index?

Foods we usually eat daily like white bread, honey, the ube or mango jam that we usually spread in our bread,the yummy cheese and bacon pizza, and our daily rice.  On the other hand the foods that are low in glycemic index include noodles or pasta and fruit.  Low GI foods are what we recommend to our diabetic pateints becuase they dont increase the blood sugar as much.

The study showed that increasing carbohydrate intake from foods with a high glycemic index was associated with increasing risk of developing heart disease. The increase in risk is as high as 68% which is really significant compared to those who took foods that are low in sugar content.  The risk maybe related to the changes in triglycerides and HDL ( the good cholesterol) seen among women known to have a significant impact in heart disease risk.  The higher the carbo intake, the higher the triglycerides will be and the lower the good cholesterol can become.

So,,,Easy on Pizza loading the next time you are in the mall!!!!

To our carbo fanatics… take it easy on your next craving. 

Posted in General Health Tips | 11 Comments »

Is Running A Marathon Healthy?

March 26, 2010

I run leisurely… the most I have run is 5K and am happy to get the target below 30 minutes. I love the feeling of rush when you reach your goal target and I guess that’s what keeps marathoners going for more.  A lot of my friends are convincing me to run a marathon…I doubt if Ill ever do that.  A 42 K marathon…running for that long will probably take me 6 hours…hehe.  Anyway, the question that has always come to my mind is this: is running too long healthy or can it do harm long term? 

In the recent American College of Cardiology meeting, the question of distance running and its effect on health was discussed.  Ill quote the article published recently in Heartwire online:

___________________________________________________________________________________________

Presenting the results of the study at the American College of Cardiology (ACC) 2010 Scientific Sessions, Schwartz, along with senior investigator Dr Robert Schwartz (Minneapolis Heart Institute, MN), his father, said that at least three runners have died this year during marathons, and three runners died during the 2009 Detroit Marathon, a race that included nearly 4000 finishers. Runners are typically considered a healthy subgroup of the general population, so these deaths are usually high profile and attract a great deal of media attention. One recent estimate suggests the rate of sudden cardiac death among marathoners is rare, roughly 0.8 per 100 000 participants.

In this study, the father-and-son team, both runners, wanted to assess coronary artery plaque in an elite group of marathon runners and compare their arteries with a control group. They identified 25 runners who completed the Minneapolis-St Paul Twin Cities Marathon every year for 25 consecutive years, thus completing a minimum of 25 marathons.

All subjects underwent coronary computed tomography angiography (CTA) using a 64-slice machine. Compared with controls, marathoners had significantly more calcified plaque volume—274 mm3 for the marathoners and 169 mm3 for the controls—and higher calcium scores and noncalcified plaque volumes, although the latter two measures did not reach statistical significance.

patient age, systolic blood pressure, total cholesterol, LDL cholesterol, and triglyceride levels were similar between the marathoners and controls, but heart rate, weight, and body-mass index were lower in the runners. Also, HDL-cholesterol levels were significantly higher in the runners than in the controls. The average total- and LDL-cholesterol levels were 190 mg/dL and 115 mg/dL, respectively, in the marathon runners, suggesting that diet is not the reason for the increased calcification.

Jonathan Schwartz said they don’t know why the runners had more plaque in the arteries than the controls and that the findings are “counterintuitive.” However, he pointed out that metabolic and mechanical stresses might be a contributing factor. For example, long-distance runners train at increased heart rates and blood pressures, as well as spend increased time in an anaerobic state, possibly leading to antioxidant damage. Also, damage to the bones might lead to calcium leaking into the bloodstream. They stressed, however, such possible explanations need to be explored further.

Another study, also presented during the ACC meeting, suggested that marathon runners had increased aortic stiffness compared with individuals who exercised recreationally. The researchers, led by Dr Despina Kardara (Athens Medical School, Greece), evaluated blood pressure and aortic elasticity in 42 males and seven females who trained for and ran marathons and 46 men who did not participate in endurance exercise training. On average, the runners trained between two to nine hours per week and had been doing so for periods of 30 months to 21 years.

The marathon runners had significantly higher systolic blood pressure compared with the control group (126 mm Hg vs 115 mm Hg) and higher diastolic blood pressures. Pulse-wave velocity, used to assess aortic stiffness, was significantly higher in the marathon group.

___________________________________________________________________________________________

The findings however need further studies.  But suffice it to say that too much mechanical stress to any part of the body can do harm than good.   

I guess the take home message on this particular study is this:

Try not to push too hard in achieving your goal especially if it entails putting too much pressure on ones body especially the heart… Running is healthy as a form of exercise but anything we do and if we push ourselves to the limit may cause more harm than good.

If you run a marathon…dont stop.  Continue to enjoy it but again dont push yourself too hard….

Take Life In A Stride…!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits | 5 Comments »

Soft Drinks and Health….

March 1, 2010

More and more studies are linking the consumption of soft drinks to health hazards… a recent article published in Cancer, Epidimeology, Biomarkers and Prevention showed that consumption of thses sugary drinks can increase ones risk to develop pancreatic cnacer.

___________________________________________________________________________________________

Background: Sugar-sweetened carbonated beverages (called soft drinks) and juices, which have a high glycemic load relative to other foods and beverages, have been hypothesized as pancreatic cancer risk factors. However, data thus far are scarce, especially from non-European descent populations. We investigated whether higher consumption of soft drinks and juice increases the risk of pancreatic cancer in Chinese men and women.

Methods: A prospective cohort analysis was done to examine the association between soft drink and juice consumption and the risk of pancreatic cancer in 60,524 participants of the Singapore Chinese Health Study with up to 14 years of follow-up. Information on consumption of soft drinks, juice, and other dietary items, as well as lifestyle and environmental exposures, was collected through in-person interviews at recruitment. Pancreatic cancer cases and deaths were ascertained by record linkage of the cohort database with records of population-based Singapore Cancer Registry and the Singapore Registry of Births and Deaths.

Results: The first 14 years for the cohort resulted in cumulative 648,387 person-years and 140 incident pancreatic cancer cases. Individuals consuming ≥2 soft drinks/wk experienced a statistically significant increased risk of pancreatic cancer (hazard ratio, 1.87; 95% confidence interval, 1.10-3.15) compared with individuals who did not consume soft drinks after adjustment for potential confounders. There was no statistically significant association between juice consumption and risk of pancreatic cancer.

Conclusion: Regular consumption of soft drinks may play an independent role in the development of pancreatic cancer. Cancer Epidemiol Biomarkers Prev; 19(2); 447–55

___________________________________________________________________________________________

The study highlights the consumption of sugar laden soft drinks as a culprit but not other sugary fruit juices.  Other findings that I need to highlight include:

  • Smokers in the study  had a 49% increased risk for pancreatic cancer.  Another reason for one to consider stopping smoking.
  • A history of diabetes was not associated with an increased risk for pancreatic cancer.  But I would say…any diabetic should be screend for pancreatic cancer and this disease manifests a high blood suagr.
  • Drinking 2 or more soft drinks per week was associated with more than 80% increase in risk for pancreatic cancer after adjustment for other risks.  Now …. I know of some who drink soft drinks daily 2-3 x. Scary thought indeed!!!!  In short LIMIT!

Heres a confusing thought from the study though: after adjustment, juice intake of 2 or more drinks per week overall was not associated with increased risk, but when smokers were excluded, there was an association between juice intake and pancreatic cancer risk increasing a persons risk by 60%.  More studies need to be done to examine this relationship. 

So friends…just like my reminder all the time… Limit and limit and not totally eliminate!

We still dont know what is really in the soft drinks that make us unwell.  For now… enjoy it but limit the consumption to sugar free Diet soft drinks. 

Better still enjoy the water!  its FREE!

Posted in Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Diabetes Facts | 5 Comments »

Avandia or Rosiglitazone is In The News Again!

February 24, 2010

I have to write this special post on avandia as many of my patients at present are on it.   Unfortunatelty people responsible for this controversy will not lay to rest the issue that has long been addressed.  In short this is plain OLD issue that has been repackaged and made again into a media hype!  The problem is the laymen – our patients who read the news and interpret the news as they are written. 

Here is the response of the American Association of Clinical Endocrinologists: the Voice of Endocrinology on this particular issue.  The same sentiments as I have.  It is just unfortunate that this drug is involved in  the midst of a controversy inside the FDA.

___________________________________________________________________________________________

AACE Patient Safety – Editorials
 
Commentary on February 19 New York Times article on Avandia
2010-02-22 15:41:32
By: Alan Garber, MD, PhD
Editor, AACE Patient Safety Exchange

 

A rash of headlines appeared this weekend as a Senate report on Avandia was leaked to the New York Times. It contained the usual accusations and concerns of certain FDA staffers such as Dr Graham who spoke 1-2 years ago at prior Avandia Advisory Boards and whose comments were largely based upon the meta-analysis of Nissen and Wolski using post hoc data derived from short term studies with Avandia. Those studies were largely conducted to obtain glycemic control data. Since that time considerable republication of similar meta-analyses, using the same or similar data have appeared. These have spread the concerns regarding Avandia further. Of course since that original meta-analysis was published in 2007, a number of subsequent studies have appeared to alleviate or to directly address the concerns raised by Drs Nissen and Wolski. In 2007, two prior large scale randomized prospective clinical trials had also contained data regarding CHD events with Avandia, namely DREAM and ADOPT. Both studies failed to show increased risk with Avandia, contrary to the conclusions attributed to them in the current New York Times article by Gardiner Harris. But these were post hoc analyses and therefore not definitive. Of course the meta-analysis was as well. Subsequent studies were also analyzed for potential adverse consequences of Avandia, including ACCORD and VADT. Neither trial showed adverse effects and VADT may have suggested benefit instead. A direct test of cardiovascular safety – the RECORD was completed and published in Lancet in June 2009 (373:2125-35) by Philip Home and colleagues. This five year study of nearly 4500 patients with diabetes randomized to treatments containing or not containing Avandia showed no increased risk of death or hospitalization for cardiovascular disease in patients taking Avandia as compared to those not taking Avandia. Since this was the prespecified primary endpoint, it seems proven that the suggestions provided by the meta-analysis have no validity. This conclusion is support by the recently published Perspective by Charles Hennekens and David DeMets in JAMA (302:2361-2, 2009). Here the authors decry overreliance upon meta-analyses of small scale short term studies in favor of data provided by large scale randomized long term trials. Dr Hennekens, a former Professor of Preventive Medicine at Harvard, and a colleague on the NCEP, concludes that the findings of RECORD lay to rest the concerns raised by the meta-analysis.
 
None of these newer studies are addressed or even considered in the article now appearing in the New York Times and the concerns it raises appear to have been adequately addressed and laid to rest by these newer studies. In short, this is old news, quite old indeed.

___________________________________________________________________________________________

So to my patients: no need to worry.  Again this is an old issue repackaged by the New York Times made big in the headlines due to Senate inquiry.

Unless the US FDA will succumb to the pressures by the media and the senate…. there is no reason for this drug not to be available to our patients who need it!

Subsequent proscpective- meaning better made studies like the RECORD, ACCORD and the BARI2D that looked at patient safety on avandia have consistently shown that those taking avandia had in fact lesser risk for cardiovascular  mortality than the comparator drugs including a recent publication in UK  that compared avandia to the commonly used sulfonylurea and metformin.

A Diabetes Care metaanalysis in 2008 likewise showed that Sulfonylurea -metfomin combination in fact also increases risk of heart attack but this study was never caught by the media.  Again since this is only a metaanalysis- exactly the same kind of study that started the Avandia contorversy…it is a hypothesis driven article and therefore cant be trusted but worth proving by making prospective randomized trials.

I hope this article will clear some issues hounding the patients on avandia.  Remember…one reason why we need to control a patient’s blood sugar together with cholesterol and blood pressure is to reduce a patient’s risk for heart attack and stroke!

In medical field…. Analysis of data is of paramount importance.  Dont believe what you read in the news!

Posted in Medical News Bits | 1 Comment »

Parents: WE Still RULE

February 13, 2010

 Go to fullsize imageWhile coming back from San Francisco after attending the postgrad course of the American Diabetes Association, I happened to read a very nice article in USA today on: Teenagers do Listen.  I will be having a teenager son soon, so I was intrigued about the article.

 The article discussed a recent media survey by Kaiser Family Foundation that showed typical kids spend as much as 7 hours and 38 minutes a day consuming entertainment media like TV, computer and game consoles.  Not surprisingly why obesity is now a main global concern with our kids high tech lifestyle.

 But what was astounding about the survey was that the kids whose parents set the rule plugged in to the media for only 3 hours suggesting parents have a big influence on our kids in terms of what they do and think.

 Other studies likewise have shown that activities and behavior of kids are mainly influence by their parents:

 1. Teens who had a bedtime at 10PM or earlier set by parents got more sleep and were less likely to be depressed published in Sleep in January.

2. Teen drivers whose parents set and enforced rules were more likely to wear seat belts and less likely to suffer road accidents including the use of cellphones while driving published in Pediatrics in September.

3.Teens whose parent also set the rules also smoke less, delay sex and do better in school.

 The reality is… Teenagers care deeply about what their parents say… the challenge is getting across the rules and boundaries that don’t seem controlling!

 There you go guys.  It’s not too late. 

Let’s GIVE MORE  time to communicate with our kids…be it while eating dinner together or while driving our kids to school or while bringing them back home. The notion that fewer rules mean lesser fights may not be right after all.  The welfare of our kids continue to be a priority because for me…

What they will become is a reflection of how good we are AS  parents!!!

Posted in Lifestyle Measures, Medical News Bits, Memories and Trips, Personal Thoughts | 1 Comment »

« Older posts
Newer posts »