Obesity and Forgetfullness: Is There A Link?

October 10, 2008

Go to fullsize imageOtherwise categorized as cosmetic in nature, we now know that being overweight or obese is already a considered a culprit for developing chronic diseases like diabetes, high blood pressure, cancer and now dementia.  Increased adiposity or fat cells in the belly results in production of substance known to cause harm meaning, having fat around your belly is a serious matter!

A recent finding on the link between obesity and dementia was recently  published in October issue of Neurology which I want to share with you:

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Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.

Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.

Results: A total of 1,049 participants (15.9%) were diagnosed with dementia.

  • Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35).
  • Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m2), whereas
  • those both obese (BMI >30 kg/m2) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).

Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.

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What this study shows is that: Being overweight and obese combined with increased abdominal fat or BIG bellies , increased risk of dementia by 2.3-fold and 3.6-fold, respectively.  While if one is overweight or obesity but has low or small abdominal fat, the risk is lower: a 1.8-fold increased risk of dementia.

Remember my friends, the risk of dementia increased the heavier you are and the bigger your belly is BUT is worst if you have both!  And mind you, in the study the relationship between dementia and obesity was related to the individual’s weight at midlife!

Am at an almost midlife years so am I so glad that I started my own lifestyle change of being more careful with the food I eat and steady increase in physical activity that my BMI has gone down from 25 to 23 and boy…with good calorie counting, my waistline hs dropped 2 inches!!!! I follow what I preach!

It’s not too late to do changes in our lives…. for the better  !!!

Be Productive At Work But More So With Health!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, The Truths on Obesity | 7 Comments »

High Protein Diets and Health…..

October 6, 2008

I am always asked regarding the best diet to have to lose weight. People tend to adhere to diet fads for easy way out.  But studies after studies have shown that a fad will always fade and therefore will not have long term success.

High protein diets initially were received with overwhelming rejection by the medical community.  However, although it is hard to accept, the usual recommendation of healthy diets recommended by authorities never were popular because these diets never resulted in significant weight loss. Until the high protein diet came into full force.

A new study published in Current Opinions in Endocrinology, 2008 that looked at evidence regarding the benefits of high protein diet show that this diet really works albeit so far only on short term basis.  But coupled with other lifestyle changes and discipline, I bet this is the diet that will work well with diabetic and obese people trying to shed some pounds with a long term aim of beng able to maintain their weights.

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Abstract:
Purpose of review: High-protein diets, often with carbohydrate restriction, are quite popular among overweight Americans pursuing strategies for weight control. Recently, well designed clinical trials have evaluated the anthropometric and metabolic effects of these diets. This review focuses on the impact of high-protein diets on energy expenditure and satiety; the diets’ effects on weight loss, body composition, cardiovascular risk, and glycemic control; and potential detrimental consequences of high-protein intake.

Recent findings:

  • Current evidence indicates that protein-induced energy expenditure and satiety contribute to weight control.
  • Randomized, controlled trials continue to show comparable, if not superior, effects of high-protein diets compared with lower protein diets on weight loss, preservation of lean body mass, and improvement in several cardiovascular risk factors for up to 12 months.
  • Evidence that chronic high-protein intake affects glucose metabolism is inconclusive at present.
  • Further study of the long-term safety of diets with varying amounts of protein is warranted.

Summary:

On the basis of patients’ metabolic profiles and preferences, practitioners can recommend individualized, nutrient-rich diets within current nutritional guidelines for weight control.

Diets moderately increased in protein and modestly restricted in carbohydrate and fat, particularly saturated fat, may have beneficial effects on body weight, body composition, and associated metabolic parameters.

Key issues must be resolved regarding the long-term compliance and safety of chronic high-protein intake.

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This diet resulted in sigificant wieght loss which in turn resulted in significant improvements in cholesterol, blood sugar and reductions in markers of cardiovascular risk like CRP.  Cosmetic PLUS health: a bonus!

So, do I recommend this diet to my patients.  Acutally YES.  I have my own dietician and I specifically formulate the plan for my patients with specifics in terms of percent calories per food group. The choice of protein source however is important because one may have a high protein source but also high in saturated fat and therefore harmful to the body example is s Steak!!!!  I dont advocate a No carbohydrate meal with the high proetein diet because long term this will never work.

Then of course, any meal plan as long as there is discipline, determination to do lifestyle change and maintain the good habit of healthy choices and good clean living should result in more success than you think!

We’ll await more long term studies on high protein diets.  So far however as long as one is careful not to harm the kidneys further with a high protein load, one should be cautious in recommneding this diet to patients with renal or kidney disease.

A Better Weight BY Eating Right!

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How To Check Your Blood Pressure At Home….

October 1, 2008

High blood pressure is now a common ailment that we hear among our friends.  The way we live our lives, the genes and our lifestyle contribute sugnoificantly to increasing this risk.  Almost always, doctors require patienhts to monitor their blood pressure at home however, majority do it wrongly or make use of wrong machines to record their BP.

The Harvard News Letter has come up with some tips that I want to share with you:

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Your blood pressure changes from hour to hour, sometimes even minute to minute. Standing up, watching an exciting sports event, eating a meal, even the time of day influence your blood pressure. It jumps around so much that you are more likely to get a “normal” reading if you check it at home rather than in the doctor’s office.

When it comes to measuring blood pressure, technique matters. Doing it wrong can give you a reading that’s too high or too low. (To see a brief video on using a home blood pressure monitor, visit health.harvard.edu/128.)
There are two things to do before you start. First, check your machine against the one in your doctor’s office. Second, make sure you have the right size cuff — the inflatable part should encircle at least 80% of your upper arm.

When you first start to check your blood pressure at home, measure it early in the morning, before you have taken your blood pressure pills, and again in the evening, every day for a week. After that, follow the plan your doctor recommends, or check it one or two days a month. Each time you take a reading:

  • Avoid caffeinated or alcoholic beverages, and don’t smoke, during the 30 minutes before the test.
  • Sit quietly for five minutes with your back supported and feet on the floor.
  • When making the measurement, support your arm so your elbow is at the level of your heart.
  • Push your sleeves out of the way and wrap the cuff over bare skin. Measure your blood pressure according to the machine’s instructions. Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, repeat again and average the three readings.
  • Don’t panic if a reading is high. Relax for a few minutes and try again.
  • Keep a record of your blood pressure readings and the time of day they are made.

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Simple tips that can go a long way in ensuring good control of BP.  Remember, the doctor can only help in advising what type of drug is best for you.  Then the remaining half of the job is done by you… making sure you eat the right food, the right amount of salt and getting the right amount of “stress”.

By making it a habit to check your blood pressure may not help “cure the disease” as 99% of hypertension has no identifiable cause,  BUT it will help ensure a smooth control of BP during the day to day activity that you do.  As a result, you can be assure that the simple measures that you do are being done to help prevent complications including heart attack and stroke.

Keep Your BP in Control!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Tips To Protect Your Heart | 4 Comments »

Socioeconomic Class And the Risk for Cancer….

September 29, 2008

We all know that disease affecting an elderly can differ from the young.  A new study highlights the impact of one socioeconomic status and the risk of common ailments that we dread of having: CANCER.

Here’s an interesting study opublished recently in the BMC-Cancer looking at how ones socioeconomic status can have an impact on ones risk to develop cancer:

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Background

Cancer incidence varies by socioeconomic group and these variations have been linked with environmental and lifestyle factors, differences in access to health care and health seeking behaviour. Socioeconomic variations in cancer incidence by region and age are less clearly understood but they are crucial for targeting prevention measures and health care commissioning.

Results

  • Incidence was highest for the most deprived patients for lung cancer and cervical cancer
  • the opposite was observed for malignant melanoma and breast cancer.
  • The difference in incidence between the most and the least deprived groups was higher for lung cancer patients aged under 65 at diagnosis than those over 65 at diagnosis, which may indicate a cohort effect. 
  •  If the incidence of lung and cervical cancer were decreased to that of the least deprived group it would prevent 36% of lung cancer cases in men, 38% of lung cancer cases in women and 28% of cervical cancer cases.
  • Incidence of breast cancer and melanoma was highest in the least deprived group

Conclusions

National comparison of socioeconomic variations in cancer incidence by region and age can provide an unbiased basis for public health prevention and health commissioning. Decreasing inequalities in incidence requires the integration of information on risk factors, incidence and projected incidence but targeted public health interventions could help to reduce regional inequalities in incidence and reduce the future cancer burden.

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The way we live and the way we practice how we live definitely can have an impact on what diseases will affect our bodies. Breast cancer is noted to be predominant among the wealthy obviously because for me, these people tend to more vigilant in doing yearly exams but more so because they tend to behave not very well in terms of lifetstyle.  I have heard news from relatives to friends who developed breast cancer.

 Look around you and you will see obese women with their obese siblings.  Culture tells us that being a little fat is better and “culturally” better than thin because the “fatness conotes a happy marriage! WHEW! I absolutely DIASGREE! 🙂  and am sure a lot of you are!  I am happily married with three kids BUT I keep it a point to be careful with what I eat including my wife and kids MAKING sure we will not be one of th tagged “obese family” that will increase our chances of getting obesity related diseases like cancer.

Being obese will increase your chances of having a higher circulating estrogen which can increase ones chances to develop breast cancer.  So by keeping oneself fit and avoiding red meat can one improve to lower that risk.

What You Can Afford Does Not Mean It is Healthy!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity | 1 Comment »

Recommended Foods If You ARe AT Risk Of Diabetes?

September 24, 2008

Go to fullsize imageI am one of those at risk to develop Diabetes.  I am the youngest of 9 siblings and am sure my mom was already a diabetic by the time I was born.  In short I have the genetic makeup to have one and it now depends on the environment …how I can modify the risk factors… that will determine if indeed I will develop this disease or not.

So when my latest Fasting blood sugar reached 96 mg/dl… I was laready alarmed.  Remember from my previous posts that individuals with a normal fasting blood sugar between 89 to 99 mg/dl have the highest risk to become diabetic in the next few years.  So the first thing I did was to change the way I eat…modify my lifestyle in terms of preference of food and settled in to more fruits and vegetables PLUS brisk walking almost everyday. I have already lost at least 14 pounds and I have reached a normal BMI of 22 …YAHOOO:)

Now comes a new study publsihed this September 2008 in Diabetes Care:

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Subjetcs: White, black, Hispanic, and Chinese adults, aged 45–84 years and free of cardiovascular disease and diabetes, completed food frequency questionnaires at baseline (2000–2002). Incident type 2 diabetes was defined at three follow-up exams (2002–2003, 2004–2005, and 2005–2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication.
Two types of dietary patterns were studied: four empirically derived (principal components analysis) and one author-defined (low-risk food pattern) as the weighted sum of whole grains, vegetables, nuts/seeds, low-fat dairy, coffee (positively weighted), red meat, processed meat, high-fat dairy, and soda (negatively weighted).
RESULTS—

  • High intake of tomatoes, beans, refined grains, high-fat dairy, and red meat was associated with an 18% greater risk :95% CI 1.06–1.32]
  •  High intake of whole grains, fruit, nuts/seeds, green leafy vegetables, and low-fat dairy was associated with a 15% lower diabetes risk (0.85 [0.76–0.95]; P = 0.005).
  • The low-risk food pattern was also inversely associated with diabetes risk (0.87 [0.81–0.99]
  • Individual component food groups were not independently associated with diabetes risk.
  • Associations were not modified by sex or race/ethnicity.

CONCLUSIONS—Multiple food groups collectively influence type 2 diabetes risk beyond that of the individual food groups themselves.

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Beans and tomatoes are nutrient-rich foods so I thought they should be part of a healthy meal?  But the most likely reason why intake of tomatoes and beans are linked to a higher risk of diabetes is the fact that in the study group, their intake was associated with intake of less healthy meals from pizza parlors or burger junctions as well as cheese and tacos

The study specifically also points out that in terms of health benefits and effects of foods, one should focus more on the importance of the whole diet rather than on certain foods or food groups that might be beneficial to us.

So…I guess am doing well with my lifestyle change because I am eating foods now proven to help me lower my risk and am enjoying eating them.

Again By Eating Right … We Should Live Well!

 

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, The Diabetes Facts | Leave a Comment »

Massage and Mood…

September 22, 2008

Go to fullsize imageIve long believe in massage and touch therapy to help alleviate pts of anxiety, hyperactivity and mood.  I go to massage 2 x every week to relax and be pampered after a long day’s hard work.  It de- stresses me as well as improve my mood for work the next day.

Now comes a study published in the Annals of Internal Medicine that fully supports my belief in massage.  Although the study is not conclusive that massage is superior to light touch… the feeling of relaxation and pampering oneself is more than worth the time to do it.

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Objective: To evaluate the efficacy of massage for decreasing pain and symptom distress and improving quality of life among persons with advanced cancer.

Patients: 380 adults with advanced cancer who were experiencing moderate-to-severe pain; 90% were enrolled in hospice.

Intervention: Six 30-minute massage or simple-touch sessions over 2 weeks.

Measurements: Primary outcomes were immediate (Memorial Pain Assessment Card, 0- to 10-point scale) and sustained (Brief Pain Inventory [BPI], 0- to 10-point scale) change in pain. Secondary outcomes were immediate change in mood (Memorial Pain Assessment Card) and sustained change in quality of life (McGill Quality of Life Questionnaire, 0- to 10-point scale), symptom distress (Memorial Symptom Assessment Scale, 0- to 4-point scale),

Results: 298 persons were included in the immediate outcome analysis and 348 in the sustained outcome analysis. A total of 82 persons did not receive any allocated study treatments (37 massage patients, 45 control participants).

  • Both groups demonstrated immediate improvement in pain (massage, –1.87 points [95% CI, –2.07 to –1.67 points]; control, –0.97 point [CI, –1.18 to –0.76 points]) and mood (massage, 1.58 points [CI, 1.40 to 1.76 points]; control, 0.97 point [CI, 0.78 to 1.16 points]).
  • Massage was superior for both immediate pain and mood (mean difference, 0.90 and 0.61 points, respectively; P < 0.001).

Conclusion: Massage may have immediately beneficial effects on pain and mood among patients with advanced cancer. Given the lack of sustained effects and the observed improvements in both study groups, the potential benefits of attention and simple touch should also be considered in this patient population.

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This simple study is worth looking into.  Although the study only involved cancer patients but the implication of the study results can be applied to every patient that we see or be advised to those with chronic illness beyond their usual therapies.

Simple touch to patients can definitely offer hope, relief and comfort.  This is what I learned at the Mayo Clinic.  Bedside skills involving interaction with patients through touch were as important as the skill of a surgeon or the bright minds of the internists.  How much more with a soothing massage… whew!  I cant wait to get one while composing this post 🙂

In Bad Mood? or Feeling sick and getting Depressed? or Maybe from too much pressure from work?

Massage To The Rescue!

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Heart Rate Predicts Heart Disease…..

September 20, 2008

I came accross this health tidbit which I want to share.  A simple test we can do anytime anywhere:

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DID YOU KNOW:?
Heart Rate of More Than 70 Beats Per Minute Increases Risk of Heart Failure: The finding that heart rate, specifically a heart rate more than 70 beats per minute, increased the risk of cardiac events in heart failure patients was the top take-home message for the Dutch cardiologist who chaired the European Society of Cardiology program committee.

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This is where exercise and being in “conditioned” is a plus factor.  It helps lower ones heart rate and being fit and active as protective against chronic heart ailments.

Lower Your Heart Rate By Being FIT!

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We All Deserve A BREAK!!!!

September 18, 2008

I just came back from a very relaxing Mediterranean Cruise with my wife. It was a well deserved break for both of us and boy do I recommend everyone who has a chance to get a cruise for vacation.

Taking a break gives you a better outlook in life… a better understanding of the need to enjoy while we are still alive! We all deserve to relax and enjoy and have a break in between the hard work.  I hate those trips where you need to take a break after your vacation because you were so exhausted with the vacation you had!!!  Cant see the logic there.

The cruise took us to Barcelona then to Malta then to Naples where we had a chance to visit Pompei, Capri and Sorrento.  Then we proceeded to Rome then to Florence then finally to Nice where we had a visit to Monacco.  What made the trip so fun is the fact that one does not need to pack and unpack everytime you visit a place.  You can relax and enjoy the facilities especially the gym of the ship at your own convenient time.

The downside however for me is the FOOD!  It was just everywhere and anytime plus it was always a Buffet from breakfast to lunch to dinner!  It was not a happpy site for me to see people gorging for food even if they dont need to.  A sad fact of life!

We need a Break BUT be sure you do it to maintain your health both “emotional” and physical Health!  If you neglect the right way to proper nutrition then you are doing harm even for the duration of the trip and for me it is no excuse!

This is our third cruise together and I will continue to endorse a Cruise as the right way to enjoy a vacation where you can have both fun and relsxation at their peak! But enjoy it the right way!

Take a Break for Health But Dont Break It By Indulging the Unhealthy Way!

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How To Reduce Your Risk To Develop DIABETES….

September 1, 2008

If you have a family history of diabetes, if you are overweight and sedentary  and wants to reduce your risk to develop diabetes, then this article is for you!

This new study was recently published in the Archives of Internal Medicine and as far as I know is the first one that conclusively looked at how fruits and vegtables can alter the risk of a patient to develop this chronic disease called diabetes.

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Methods  We administered a semiquantitative food frequency questionnaire to men and women from a population-based prospective cohort (European Prospective Investigation of Cancer–Norfolk) study who were aged 40 to 75 years at baseline (1993-1997) when plasma vitamin C level was determined and habitual intake of fruit and vegetables was assessed. During 12 years of follow-up between February 1993 and the end of December 2005, 735 clinically incident cases of diabetes were identified among 21 831 healthy individuals. We report the odds ratios of diabetes associated with sex-specific quintiles of fruit and vegetable intake and of plasma vitamin C levels.

Results 

  • A strong inverse association was found between plasma vitamin C level and diabetes risk.
  • The odds ratio of diabetes in the top quintile of plasma vitamin C was 0.38 (95% confidence interval, 0.28-0.52) in a model adjusted for demographic, lifestyle, and anthropometric variables.
  • In a similarly adjusted model, the odds ratio of diabetes in the top quintile of fruit and vegetable consumption was 0.78 (95% confidence interval, 0.60-1.00).

Conclusions  Higher plasma vitamin C level and, to a lesser degree, fruit and vegetable intake were associated with a substantially decreased risk of diabetes. Our findings highlight a potentially important public health message on the benefits of a diet rich in fruit and vegetables for the prevention of diabetes.

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A word of caution from this study is that the plasma Vitamin C level correlated with the intake of fruits and vegetables and NOT Vitamin C Supplements.  Therefore do not grab all the Vitamin C supplements in the shelves to boost up your levels.  It is believed that beyond Vitamin C, there are properties in fruits and vegetables that help patients reduce their risk to develop diabetes.

As fas a I know, this is the first conclusive evidence that looked objectively at the effect of fruit and vegetable intake and the risk of diabetes.  And a reduction of diabetes risk by 62% is a great bonus to those who love fruits and vegetables on top of the other benefits associated with their intake.

So Eat Vegetables everyday and every meal… take fruits after each meal and you can even enjoy an apple or pear for snacks. Chances are… the more you eat the better the risk reduction.  Again…go for the low glycemic index fruits like apple and pear instead of a mango, banana or pineapple!

Love Yourself By Eating Right!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts | 15 Comments »

Sleep and High Blood Pressure… Check Your Kids!

August 27, 2008

Go to fullsize imageI just came across a new study that showed poor sleep is affecting a lot of our teens these days.  Its either they have problems falling asleep or problems waking up early or just plain LACK of Sleep for whatever reason.  This study involved around 200 adolescents between ages 13-16 was recently published in the Journal Circulation August issue and is really an eye opener for parents with kids… by making sure that their kids follow a sleep habit that is healthy.

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Odds of prehypertension associated with sleep disturbances

Sleep problem Unadjusted OR (95% CI) p Adjusted OR p
Low sleep efficiency (<85%) 4.52 (2.11-9.70) 0.0001 3.50 0.0028
Short sleep (<6 h) 2.79 (1.07-7.34) 0.0366 2.54 0.0679

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The kids with sleep inefficiency meaning they have trouble falling asleep or wake early and those with poor sleep (6.5 hours or less) had systolic blood-pressure levels that were higher than their peers on average 4 mm Hg.  This problem of hypertension may result in long lasting complications and development of end organ damage involving the heart, kidneys and eyes among our kids at an early age.  Fortunately this is one risk of hypertension that is MODIFIABLE.

What then can be modified to afford better sleep habit among our teens? 

I have three Simple recommendations:

  • Limit Home Internet Use.  Only for school work and no to games during school days!  Overexcitement results in being hyperactive due to adrenaline rush and this limits sleep quality.
  • A Good Study Habit to avoid cramming.  This should have been trained as early as preschool!
  • Limit soda or other drinks rich in caffeine especially during dinner time

A Better Adjusted Kid Is A Healthy Kid!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Tips To Protect Your Heart | 2 Comments »

Vitamin D and The Risk of Death….

August 22, 2008

While reviewing my journals…I again came across another study on Vitamin D but this time relating this vitamin to mortality or the risk of death in the general population.  This study was published in the Archives of Internal Medicine, August 15, 2008 issue.

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Background  In patients undergoing dialysis, therapy with calcitriol or paricalcitol or other vitamin D agents is associated with reduced mortality. Observational data suggests that low 25-hydroxyvitamin D levels (25[OH]D) are associated with diabetes mellitus, hypertension, and cancers. However, whether low serum 25(OH)D levels are associated with mortality in the general population is unknown.

Methods  We tested the association of low 25(OH)D levels with all-cause, cancer, and cardiovascular disease (CVD) mortality in 13 331 nationally representative adults 20 years or older from the Third National Health and Nutrition Examination Survey (NHANES III) linked mortality files. Participant vitamin D levels were collected from 1988 through 1994, and individuals were passively followed for mortality through 2000.

Results 

  •  In cross-sectional multivariate analyses, increasing age, female sex, nonwhite race/ethnicity, diabetes, current smoking, and higher body mass index were all independently associated with higher odds of 25(OH)D deficiency (lowest quartile of 25(OH)D level, <17.8 ng/mL
  • while greater physical activity, vitamin D supplementation, and nonwinter season were inversely associated.
  • During a median 8.7 years of follow-up, there were 1806 deaths, including 777 from CVD.  compared with the highest quartile, being in the lowest quartile (25[OH]D levels <17.8 ng/mL) was associated with a 26% increased rate of all-cause mortality (mortality rate ratio, 1.26; 95% CI, 1.08-1.46) and a population attributable risk of 3.1%.
  • The adjusted models of CVD and cancer mortality revealed a higher risk, which was not statistically significant.

Conclusion  The lowest quartile of 25(OH)D level (<17.8 ng/mL) is independently associated with all-cause mortality in the general population.

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Another reason for us to check our Vitamin D level.  All along I am right.  I have been a proponent of the wonders of Vitamin D and the perils of what Vitamin D Deficiency can do.

The best way again for us to avoid getting the lowest Vitamin D level is to eat foods rich in Vitamin D and to enjoy the sun as much as we can! The flesh of fish such as salmon, tuna, and mackerel aa well as fish liver oils are among the best sources of Vitamin D that we can get naturally.  I would not recommend supplements if we can avoid them.

Live Long… Enjoy the SUN!

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Vitamin D and Your Risk To Fracture….

August 20, 2008

Go to fullsize imageVitamin D is a neglected vitamin.  I always consider it as one of those vitamins that have powerful effects on the body but has never got the attention fo the media. 

Through this website, I have been harping on the benefits of Vitamin D and the problems associated with subtle vitamin D Deficiency.

I recently had one patient who suffered from severe muskuloskeletal weakness that the neurologist was already doing a battery of tests but no diagnosis was given. When her vitamin D was checked..it was extremely low and with supplementation of Vitamin D, she eventually recovered in 1-2 months. The neurologist discounted the effect saying she is living in a hot tropical country with plenty of sun and therefore he doubts that she is vitamin D deficient.  Unknowingly to everyone… people in our country hide from the sun… they bring umbrellas during sunny days… they avoid the sun because it can cause wrinkles and freckles.  My patient was no exception!!!

Now comes a new study linking Vitamin D Deficiency to fractures….publsihed in the Annals of Internal Medicine August issue…

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Participants: 400 case-patients with incident hip fracture and 400 control participants matched on the basis of age, race or ethnicity, and date of blood draw. Both groups were selected from 39 795 postmenopausal women who were not using estrogens or other bone-active therapies and who had not had a previous hip fracture.

Measurements: Serum 25(OH) vitamin D was measured and patients were followed for a median of 7.1 years (range, 0.7 to 9.3 years) to assess fractures.

Results: Mean serum 25(OH) vitamin D concentrations were lower in case-patients than in control participants (55.95 nmol/L [SD, 20.28] vs. 59.60 nmol/L [SD, 18.05]; P = 0.007), and

  • lower serum 25(OH) vitamin D concentrations increased hip fracture risk (adjusted odds ratio for each 25-nmol/L decrease, 1.33 [95% CI, 1.06 to 1.68]).
  • Women with the lowest 25(OH) vitamin D concentrations (47.5 nmol/L) had a higher fracture risk than did those with the highest concentrations (70.7 nmol/L) (adjusted odds ratio, 1.71 [CI, 1.05 to 2.79]), and
  • the risk increased statistically significantly across quartiles of serum 25(OH) vitamin D concentration (P for trend = 0.016).
  • This association was independent of number of falls, physical function, frailty, renal function, and sex-steroid hormone levels and seemed to be partially mediated by bone resorption.

Limitations: Few case-patients were nonwhite women. Bone mineral density and parathyroid hormone levels were not accounted for in the analysis.

Conclusion: Low serum 25(OH) vitamin D concentrations are associated with a higher risk for hip fracture.

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This study for me is very important.  For one, we know that Vitamin D supplementation has always been part of the cocktail of meds a patient with osteoporosis have to take.  But this is one study that looked at Vitamin D deficiency and the risk to fracture.  The results clearly show a relationship!

My take home message for this is that…dont assume a patient to be Vitamin D replete just because she is living in the tropics. Again one reason why this vitamin is a neglected vitamin not only in terms of preventing a disease but also in its relationship to causing a disease. 

Getting Vitamin D level is an easy blood test and if found deficient, Vitamin D replacement can have a tremendous impact in terms of how the patient feels in terms of improving his/her quality of life and how it can prevent diseases like a fracture!

The best way to prevent Vitamin D Deficiency is to enjoy the SUN …the morning sun at least 10-15 min daily while goign to work or doing your daily exercise.  Or just leisurely sun bathing with a book to read!

It’s About Time We Take Respect and Enjoy The SUN!

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A Very Successful AACE Convention in Cebu!!!!

August 19, 2008

Go to fullsize imageAs host to the recent Annual Convention of Clinical Endocrinologist- Philippine Chapter, it was really a very rewarding and a learning experience for me as all the efforts were visibly rewarded by the number of delegates we had: a total of 575 doctors and the great feedback we received from excellent to fulfilling!!!

The doctors really enjoyed the sessions as topics were carefully selected including our speakers with a total of 9 foreign speakers.  This included my mentor from the Mayo Clinic DR Hossein Gharib who is presently the President of the American College of Endocrinology, as our keynote lecturer. 

The society headed by our energetic president Dr George Tan made sure that the venue to the session hall to the details of the exhibit were all planned out!

So guys… this is the reason why Ive been out of new posts for the past few days… Bear with me as I will be updating this site again on a regular basis. 

Only two reasons for not coming out with regular posts: am out of the country attending a convention OR am busy preparing for a talk or a covention like this one held last August 14 to 18 in Mactan Shangrila.

Will be posting photos for everyone to see soon…

Again thanks to all our friends on the pharmaceutical who were so busy transporting doctors in and out of the venue.  And to the MRC and PCOC guys who made the event very succesfull and kudos to my good friend Ike Amor whose expertise in video clips and presentations made the event at par with foreign conventions…

Cheers to AACE: It was a Team Effort At Its BEST!

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

Watermelon Can Boost Your Sexual Function… How True?

August 11, 2008

Go to fullsize imageI saw the news: Watermelon as the Natural Viagra..how true? 

The study where this headline was taken from was published recently in the Journal NUTRITION and really is an eye opener for those who have problems with sexual function.  The question is…will the results translate to actual outcome?

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Methods

Subjects (n = 12–23/treatment) consumed a controlled diet and 0 (control), 780, or 1560 g of watermelon juice per day for 3 wk in a crossover design. The treatments provided 1 and 2 g of citrulline per day. Treatment periods were preceded by washout periods of 2 to 4 wk.

Results

Compared with the baseline, fasting plasma arginine concentrations increased 12% after 3 wk of the lower-dose watermelon treatment; arginine and ornithine concentrations increased 22% and 18%, respectively, after 3 wk of the higher-dose watermelon treatment. Fasting citrulline concentrations did not increase relative to the control but remained stable throughout the study.

Conclusion

The increased fasting plasma concentrations of arginine and ornithine and stable concentrations of plasma citrulline in response to watermelon juice consumption indicated that the citrulline from this plant origin was effectively converted into arginine. These results demonstrate that plasma concentration of arginine can be increased through intake of citrulline from watermelon.

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The only association with viagra is the fact that watermelon is rich in a substance called citrulline know to have dilating effects on the vessel as the study implies.  This amino acid citrulline is actually converted into arginine which is a precursor for nitric oxide that helps blood vessel dilate!  In theory…it looks good but how about in actual practice?

SO…before we grab all the watermelons in the market, it is very important for us to understand that no study as of now has been done to confirm if indeed intake of watermelon can improve erection!!!!  And likewise nobody knows how much watermelon we need to take to achieve the effect!!!! Probabaly tons of watermelon before enough arginine can be made to cause an effect!

So to say that watermelon is a natural viagra is a doubtful claim. And definitely needs more studies if ever any study will be done.  Remember, arginine deficiency is not the sole cause of erectile dysfunction but rather it is more complicated than that! 

I love watermelon…if indeed it can help me in my other needs…the better!!!! It’s a PLUS!

 

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts | 5 Comments »

Happy Anniversary!!!!

August 7, 2008

Go to fullsize imageIts our 2nd year in providing you with medical information and updates not only in diabetes but updates on anything  affecting our general health.

To the readers and patients… thanks for all your comments.  Your visits to the site are the ones that drive me to continue doing what I love to do best…  And I cant do my work as a physician better than keeping my patients well informed through this website! 

Thanks also to this site, I met new friends along the way….

To more years of medical knowledge….

Cheers to more fun and learning!!!!

Posted in General Health Tips | 3 Comments »

LICKING…A Way To Speed Up Wound Healing

August 6, 2008

Out of reflex…the moment we feel pain in any part of the body especially our fingers…our immediate reflex is to bring that finger into our mouth and start licking it.   I do the same all the time…believing that it eases the pain, and stops the bleeding!  And in reality, we were actually all right!

Now comes a study showing that indeed licking the wound with our saliva can accelerate wound healing.  This study will be published in the November issue of Federation of American Societies for Experimental Biology.

A specific compound found in human saliva that has the potential to heal wounds is the product called HISTATIN which in experimental studies have been shown to have antibacterial properties. Meaning this substance can indeed KILL the bacteria!  We were actually doing right in curing our small wound through licking through these years! 

This indeed is also great news especially the potential of this  product to be the answer to our diabetics with recurring and chronic ulcers since these non healing wounds can result in major morbidity and disabilty due to amputation.

Let’s wait therefore for commercial quantities of this product soon to be in the market.  In the same line as alcohol gels or handwashing lotions….

And for the meantine…stick with our tongues and continue licking … it’s easy and FREE!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits | 2 Comments »

Can Coffee Increase Your Lifespan?

August 4, 2008

I am a coffee drinker.  I usually have a cup of coffee everyday and nothing more.  Except on occasions where I take another cup in the afternoon but usually I average only 5-7 cups per week.  I’ve written about the many benefits of coffee in this website and in the newpapers…and seems like more benefits are being known the more we know about coffee.

Now comes a recently published article on coffee and mortality published in the Annals of Internal Medicine, June of 2008: the official journal of the American College of Physicians.

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Design: to investigate the association between coffee consumption and incidence of all-cause and disease-specific mortality in a prospective cohort study.

Setting: Health Professionals Follow-up Study and Nurses’ Health Study: 41 736 men and 86 214 women with no history of CVD or cancer at baseline.

Results: After adjustment for age, smoking, and other CVD and cancer risk factors, the relative risks for all-cause mortality in men across categories of coffee consumption (<1 cup per month, 1 cup per month to 4 cups per week, 5 to 7 cups per week, 2 to 3 cups per day, 4 to 5 cups per day, and 6 cups per day) were 1.0, 1.07 (95% CI, 0.99 to 1.16), 1.02 (CI, 0.95 to 1.11), 0.97 (CI, 0.89 to 1.05), 0.93 (CI, 0.81 to 1.07), and 0.80 (CI, 0.62 to 1.04), respectively (P for trend = 0.008). For women, the relative risks were 1.0, 0.98 (CI, 0.91 to 1.05), 0.93 (CI, 0.87 to 0.98), 0.82 (CI, 0.77 to 0.87), 0.74 (CI, 0.68 to 0.81), and 0.83 (CI, 0.73 to 0.95), respectively (P for trend < 0.001). This inverse association was mainly due to a moderately reduced risk for CVD mortality and was independent of caffeine intake.

By contrast, coffee consumption was not statistically significantly associated with risk for cancer death after adjustment for potential confounders.

Decaffeinated coffee consumption was associated with a small reduction in all-cause and CVD mortality.

Conclusion: Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of coffee consumption on all-cause and CVD mortality needs to be further investigated.

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To further summarize the data in layman’s terms:

  • This study shows that increasing consumption of coffee was associated with decreasing mortality or death.  
  • People who drank at least 5 -7 cups of coffee per week had a significantly LOWER overall risk of dying from any cause. 
  • People who drank 4-5 cups per day or more had the strongest protection.

What was interesting also in the study was that among women who were coffee drinkers, most reduction in death was due to a reduction in cardiovascular disease. What I like most in coffee are the studies showing its frequent consumption to result in a reduction albeit small, in the risk of diabetes.

Is Regular better than Decaf?  Well, In the study, whether people drank regular or decaffeinated coffee, benefits were noted, suggesting that the one product present in coffee that results in health benefits maybe its high levels of polyphenols  known to reduce inflammation and also known to provide other positive effects on the heart, blood vessels, and blood sugar.

What more can you ask?

I will continue to enjoy my coffee everyday whatever benefits they give me is already a PLUS!!!!

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

Why Japanese Men Have Low Heart Disease….

August 1, 2008

Japanese are known to be workaholic.  They ahve been known to work long hours. Many are also smokers BUT why do they have a lower risk of heart disease?

A recent study published in the Journal of American College of Cardiology, August 2008 may have the reasons why….

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Methods: A population-based cross-sectional study in 281 Japanese (defined as born and living in Japan), 306 white (defined as white men born and living in the U.S.), and 281 Japanese-American men (defined as Japanese men born and living in the U.S.) ages 40 to 49 years was conducted to assess intima-media thickness (IMT) of the carotid artery, coronary artery calcification (CAC), and serum fatty acids.

Results:

  • Japanese men had the lowest levels of atherosclerosis, whereas whites and Japanese Americans had similar levels.
  • Japanese had 2-fold higher levels of marine-derived n-3 fatty acids than whites and
  • Japanese Americans in the U.S. Japanese had significant and nonsignificant inverse associations of marine-derived n-3 fatty acids with IMT and CAC prevalence, respectively.

Conclusions: Very high levels of marine-derived n-3 fatty acids have antiatherogenic properties that are independent of traditional cardiovascular risk factors and may contribute to lower the burden of atherosclerosis in Japanese, a lower burden that is unlikely the result of genetic factors.

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This study further proves why Fish is the healthiest meat to eat. This trully explains why Japanese have a low risk of heart disease because of their lifetime increased intake of fish esepcially salmona dn mackerel which are both rich in omega 3 fatty acids.

I caution those who are buying Omega 3 supplements though because the effects are not proven in terms of the omega 3’s protective effect on the heart with regard to supplements. 

Instead to reap the benefits of Omega 3:

Eat FISH 2-3 x a week!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips | Leave a Comment »

Are You Sure Your Sugar Is Normal?

July 29, 2008

Go to fullsize imageHere’s an interesting article: published in the American Journal of Medicine this July.  I bet after reading this article…you will have to review your old blood tests and determine if you are at risk to develop diabetes in the near future.

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This study included:

46,578 members of Kaiser Permanente Northwest who had fasting plasma glucose levels less than 100 mg/dL between January 1, 1997, and December 31, 2000, and who did not previously have diabetes or impaired fasting glucose.

  • Subjects developed diabetes at a rate of less than 1% per year during a mean follow-up of 81.0 months.
  • Each milligram per deciliter of fasting plasma glucose increased diabetes risk by 6% (hazard ratio [HR] 1.06, 95% confidence interval [CI], 1.05-1.07, P < .0001) after controlling for other risk factors.
  • Compared with those with fasting plasma glucose levels less than 85 mg/dL, subjects with glucose levels of 95 to 99 mg/dL were 2.33 times more likely to develop diabetes (HR 2.33; 95% CI, 1.95-2.79; P < .0001).
  • Subjects in the 90 to 94 mg/dL group were 49% more likely to progress to diabetes (HR 1.49; 95% CI, 1.23-1.79; P <.0001).
  • All other risk factors except sex were significantly associated with a diabetes diagnosis.
Conclusions

The strong independent association between the level of normal fasting plasma glucose and the incidence of diabetes after controlling for other risk factors suggests that diabetes risk increases as fasting plasma glucose levels increase, even within the currently accepted normal range.

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This study although with limitations sends a strong signal that everytime one gets an executive panel test.. a thorough evaluation has to be made from the numbers that will give us SIGNALS of future disease risk.  There is no room for saying that the results are borderline or of no significance because waiting fo the sugar to be abnormal before one recommends action is tantamount to negligience!

Targeting out patients early means preventing onset of the the disease resulting in lesser chances of developing chronic complications which can be disabling and costly!

Lifestyle changes will continue to be the mainstay for these patients with sugars within the normal range but are at the highest risk to develop diabetes in the next few years!  A little sacrifice can do a long way in preventing illness and promoting health!

Get hold of your last years blood tests…look at the numbers…is your blood suagr 97 mg/dl?  Then be aware that you are at risk to develop diabetes in the near future… and therefore DO SOMETHING!!!! Lose weight, take care of what you eat and MOVE!

Posted in General Health Tips, Medical News Bits, The Diabetes Facts | 2 Comments »

The Benefits of Eating Apple

July 17, 2008

As I was preparing for the things to bring on my trip to Hawaii thia afternoon, I felt the urge to eat something.  And what I found inside my fridge were 6 apples.  Being the favorite fruit of my second child, I always make sure there are apples for her to eat after each meal.  So there I was, eating on apple with the SKIN and slowly feeling satisfied and full!  Boy, was it nice, and healthy….

So I though of leaving you something nice about apple.

Definitely the saying: “An apple a day keeps doctors away” was true all along as more studies have found out that apples have plenty of vitamins and minerals, as well as phytonutrients especailly the flavonoids called quercetin, which has high antioxidant activity. Likewise apples are high in fiber and potassium, and contain no fat or salt.

The UC Davis Department of Internal Medicine study showed that “not only do apples and apple juice contain a variety of phytonutrients, but that making apples a regular part of the diet may translate into real health benefits”.  Eating apples in that study showed reduced oxidation indicators and a 22-percent increase in dietary fiber.

Other studies have also shown that individuals who regularly incorporated apples into their diet cut their lung cancer risk in half. lower the risk for stroke, reduce the growth of colon cancer and liver cancer cells with just two-thirds of a medium apple!!!!!

Lastly… dont peel the skin when eating apple. It is said that most of the fiber and antioxidants are in the peel.   Contrary to popular belief…laboratories have consistently shown that the skin of apples contain very low levels of pesticides….So they’re SAFE to eat!!!!

There You Go…

An Apple A Day…Saves You More Than A Day!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips | 2 Comments »

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