What Your Waistline Means To Your Health…

November 14, 2008

Go to fullsize imageI just came from a trip to Rio, Brazil to attend the International Congress of Endocrinology which is held every 2-4 years.  Our hotel was stationed right across the Copacobana Beach.  This is a place that epitomizes physical activity where unlike the Waikiki Beach front, I dont see a lot of people swimming but rather engaged in activities like walking, jogging or playing volleyball using their hands or feet.  On the sides are people eateries serving fresh coconut juice but also burgers and fries!  But an interesting observation was that… not a lot of Brazilians can be considered obese and not a lot have their bellies haging out of their waist….

We know about the risk of death and weight and BMI.  For Asians, anything above 23 is considered overweight already and increases ones risk to develop chornic diseases like Diabetes and cancer.  A waistline of more than 36 is considered high risk for men and 34 inches for women for chronic diseases.  It is for this reason that I have been committed to a healthier lifestyle and now from a waistline of 34 , I was able to maintain a waistline of  31inches and my BMI dropped from a high of 25.6 to 23.  It is all about a balance of what you eat and what you do and the DISCIPLINE you put into your goal! 

Now comes a timely study published in the New England Journal of Medicine, November issue regarding the risk of dying based on ones waistline and weight:

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Background Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. Methods We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Results During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women.

  • After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death.
  • Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and
  • in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively.
  • BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001).

Conclusions These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.

 

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IN SHORT…The risk of dying was higher among participants with a larger waistline of more than 47.2 inches for men and more than 39.4 inches for women compared to subjects with a smaller waistline of less than 31.5 inches for men and less than 25.6 inches for women. This study showed us that for each 2-inch increase in waist circumference, there was an associated 17% higher risk for death in men and a 13% higher risk for death in women .

There you go guys… thess bulging bellies are no longer as silent as we thought these”fats” can be but rather we know them now as machines producing substances that can harm the heart and vessels.  Aside from trying to aim for a BMI of 23 and below, one therefore has to be more aware of the risk of premasture death with higher waistline! 

Every little loss of the waist circumference can go a along way in helping us maintain HEALTH!  Do somtehting now and reap the rewards along the way!  It requires a lot of discipline but health benefits are enormous…and this equates to what I call Wealth!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity | 3 Comments »

Are Your Supplements “FDA Approved?”

November 5, 2008

You see supplements marketed as FDA Approved! Am not sure how the policy of the local FDA works but almost always, the same agencies operating elsewhere look at policies of the US FDA as their basis for regulating drugs.

Let us be clear what”FDA Approved” means.  The US FDA website has this to say:

FDA approves new drugs and biologics.

New drugs and biologics must be proven safe and effective to FDA’s satisfaction before companies can market them. FDA does not develop or test products; FDA experts review the results of laboratory, animal, and human clinical testing done by manufacturers.

If FDA grants an approval, it means the agency has determined that the benefits of the product outweigh the risks for the intended use.

Meaning research should be done and presented to the body and then these studies should prove the products benefit outweigh the risks.  If however the risks outweigh the benefits then the marketing of the drug is not approved!

Now…How about the Dietary Supplements?  What about their claims for FDA Approval?

FDA does not approve dietary supplements.

Unlike new drugs, dietary supplements are not reviewed and approved by FDA based on their safety and effectiveness. The notification must include the information that was the manufacturer or distributor’s basis for concluding that the dietary supplement will reasonably be expected to be safe.

After dietary supplements are on the market, FDA evaluates their safety through research and adverse event monitoring.

If you will note…the supplement will be in the market first and then if  adverse events occur then action will be taken by the FDA.  Meaning..no review of side effects or untoward effects are made before releasing a supplement to the market. BUT how many patients will complain of side effects especially that supplements are marketed as having Zero side effects?  and where do they go to report when only the salesmen or networking friends advised or convinced  them of the safety of the supplements?

FDA does not approve structure-function claims on dietary supplements and other foods.

Structure-function claims describe the role of a food or food component (such as a nutrient) that is intended to affect the structure or function of the human body. 

Structure-function claims on dietary supplements carry a disclaimer stating that the claim has not been reviewed by FDA, and that the product is not intended to diagnose, treat, cure, or prevent any disease. Conventional foods are not required to carry such a disclaimer.

So Beware of the claims that these supplements are good for Diabetes, to boost ones Immunity or other medical benefits because NONE are based on studies and no proofs exist that they work!

In short DONT be FOOLED by claims that the product is FDA or BFAD APPROVED!!!

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Posted in General Health Tips, Medical News Bits, Personal Thoughts | 14 Comments »

How to EAT and Lose Weight….

October 27, 2008

Go to fullsize imageMy previous posts have always been toward trying to help people lose weight.  I am one person following my own theories and they worked and are working up to now.  Here are the no-nonsense tips that I follow DAILY: 

If you want to lose weight…

  • EAT,  But stop when you feel you’re already FULL and Leave the table at once. 
  • CHEW your food properly so it will take time for you to finish a meal and by the time you’re halfway through…you’re FULL! 
  • Avoid the visual stimulation of food… the longer you stay in the table, the more likely you’ll eat more!

Then of course… you MOVE!

A recent article publsihed in the British Medical Journal confirms these basic prinicples:

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Participants 3287 adults (1122 men, 2165 women) aged 30-69 who participated in surveys on cardiovascular risk from 2003 to 2006.

Main outcome measures Body mass index (overweight 25.0) and the dietary habits of eating until full (lifestyle questionnaire) and speed of eating (validated brief self administered questionnaire).

Results 571 (50.9%) men and 1265 (58.4%) women self reported eating until full, and 523 (45.6%) men and 785 (36.3%) women self reported eating quickly. For both sexes the highest age adjusted mean values for height, weight, body mass index, and total energy intake were in the eating until full and eating quickly group compared with the not eating until full and not eating quickly group. The multivariable adjusted odds ratio of being overweight for eating until full was 2.00 (95% confidence interval 1.53 to 2.62) for men and 1.92 (1.53 to 2.40) for women and for eating quickly was 1.84 (1.42 to 2.38) for men and 2.09 (1.69 to 2.59) for women. The multivariable odds ratio of being overweight with both eating behaviours compared with neither was 3.13 (2.20 to 4.45) for men and 3.21 (2.41 to 4.29) for women.

Conclusion Eating until full and eating quickly are associated with being overweight in Japanese men and women, and these eating behaviours combined may have a substantial impact on being overweight.

___________________________________________________________________________________________________________________ There you go…Simple tips and simple measures that will surely WORK for ALL!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity, Weight Loss Tips | 4 Comments »

How To Be Active Without Trying….

October 22, 2008

Physical activity is part of the equation of fitness and weight maitenance. 

“Easier said than done”, everyone knows it best that exercise is key to a healthy lifestyle.  Excuses to avoid feeling guilty continue to be part of what makes us believe that we just dont have enough time to exercise!  But new studies have been published that physical activity need not be a structured time frame that we should follow … rather any activity should be the norm to our day to day life.  In short…as long as one does not follow a sedentary lifestyle… one should be better off following an active lifestyle.

Heres a new study Published in the journal Current Opinions in Endocrinology that proves nothing is better than just being active:

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Purpose of review: To discuss the potential importance of spontaneous physical activity in regulating body weight and outline possible reasons for the large interindividual variance in spontaneous physical activity.

Recent findings: Spontaneous physical activity is highly variable among people, with some having high levels and some low, and can contribute significantly to interindividual differences in total daily energy expenditure. Cross-sectionally, spontaneous physical activity is inversely related to body weight; however, more importantly, spontaneous physical activity is inversely associated with weight gain in prospective studies, and experimental weight perturbations do not appear to change spontaneous physical activity behavior. Spontaneous physical activity is a familial trait and is biologically influenced, although the environment exerts a significant impact.

Summary: Although spontaneous physical activity is a biologically driven behavior, interventions to increase nonexercise activity within the workplace and school hold promise in increasing daily energy expenditure for the average sedentary American. However, many large-scale efforts will need to take place within our sedentary-promoting environment to encourage more daily spontaneous physical activity-related activity.

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This new study tells us one thing: No more EXCUSES!!!!

Any spontaneous movement or activity is better.  Even fidgety movements while sitting down working on your computer and other daily tasks that require activity is more than enough for the body to be healthy.  Any household chores and any walking to the workplace or the act of getting something are activities of daily living that can help with energy expenditure. These nonexercise activities should not be a problem for anyone to follow.  Meaning NO MORE EXCUSES!

There you go… The best way to be active without really trying ( going to a gym) is to be more active in our day to day activities. Do it everyday and make it part of a habit and you’re on your way to healthier you!

Posted in Exercise and Activity Tips, General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, Weight Loss Tips | 1 Comment »

The Many Benefits of Broccoli…

October 16, 2008

Go to fullsize imageI am a fan of Brocolli.  I thought of making broccoli the star of today’s post and thought of what ways can this veggie benefit us all.

A recent study done in University of Warwick published in the Journal Diabetes showed some interesting findings that made me realize how lucky am I to enjoy Broccoli.  The study looked at a compound present in broccoli that has the potential to help prevent complications of diabetes.

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RESEARCH DESIGN AND METHODS–: Human microvascular HMEC-1 endothelial cells were incubated in low and high glucose concentrations (5 and 30 mM) and activation of nrf2 assessed by nuclear translocation. The effect of SFN on multiple pathways of biochemical dysfunction, increased reactive oxygen species (ROS) formation, hexosamine pathway, protein kinase C pathway and increased formation of methylglyoxal, was assessed.

RESULTS–: Activation of nrf2 by SFN induced nuclear translocation of nrf2 and increased ARE-linked gene expression. For example, 3 – 5 fold increased expression of transketolase and glutathione reductase. Hyperglycemia increased the formation of ROS – an effect linked to mitochondrial dysfunction and prevented by SFN. ROS formation was increased further by knockdown of nrf2 and transketolase expression. This also abolished the counteracting effect of SFN, suggesting mediation by nrf2 and related increase of transketolase expression. SFN also prevented hyperglycemia-induced activation of the hexosamine and protein kinase C pathways, and prevented increased cellular accumulation and excretion of the glycating agent, methylglyoxal.

CONCLUSION–: We conclude that activation of nrf2 may prevent biochemical dysfunction and related functional responses of endothelial cells induced by hyperglycemia in which increased expression of transketolase has a pivotal role.

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This study is particularly interesting because it is known that patients with diabetes are at higher risk to develop complications especially heart disease.  And from previous studies, it has also been shown that eating vegetables like broccoli was significantly linked to reduced heart disease.  The relationship stems from the finding that damage to blood vessels is due to an increased levels of reactive oxygen species (ROS) in the presence of high sugar.  The recent study has confirmed that the substance Sulforaphane present in Broccoli can indeed prevent damage brought about by these ROS with high sugar level. 

Sulforaphane substance present in abundance in broccoli was able to reduce ROS level by 73% and likewise results in activation of an gene regulator in the cells that resulted in the increase of antioxidant compounds. Great news!!! Great findings!!!

But does this mean lets all eat broccoli? We have to wait for studies that will look at end result.  But whatever it is…we know veggies are healthy food, broccoli for one has the potential to be a “star” vegetable due to its touted many benefits including prevention of cancer, cataracts Plus this new finding which am sure will make my diabetic patients crave for more broccoli.

Eat Veggies…Eat Broccoli… for Health!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips | 6 Comments »

The Benefit of Smoking…. or Is There?

October 14, 2008
Actually none except ill health. But no, I found the intriguing editorial from the Archives of Internal Medicine that made me believe that probably there is a hidden reason why smokers just refuse to quit…
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 Cigarette smoking remains a persistent and difficult public health problem. Approximately 1 in 5 adults continues to smoke, and annual long-term successful abstinence rates run around 2% to 3%. Most smokers are aware that smoking poses risks to their health, and approximately 60% to 70% of smokers report having been counseled by their physicians to quit smoking.

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Clearly… education regarding smoking cessation has failed to fully take effect as abstinence form addiction to smoking remains nil.  Every smoker knows it is not healthy to smoke nor is it healthy for members of the family to inhale their smoke but still the practice of smoking continues to be very prevalent.

And I agree fully with the editor when he titled his editorial to fully state what we as medical practitioners believe is the true essence why smokers refuse to quit…. is that they want to:

Live Fast, Die Young, Leave a Good-looking Corpse!

Posted in General Health Tips, Healthy Practice Tips, Personal Thoughts | 3 Comments »

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!

Posted in General Health Tips, Medical News Bits, Personal Thoughts, Weight Loss Tips | Leave a Comment »

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!

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

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!

Posted in General Health Tips, Medical News Bits | 1 Comment »

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!

Posted in General Health Tips, Lifestyle Measures, Personal Thoughts | 1 Comment »

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!

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

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!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Personal Thoughts | 1 Comment »

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 »

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