A Hearty Breakfast Equals Weight Loss?

July 10, 2008

This new study again refutes what has been said about the low carb hype.

We all know the breakfast is an important meal. In this website, I have emphasized that skipping breakfast equals weight gain equals metabolic syndrome. Therefore it is a must that we all have to break the fast to maintain our weight and be healthy.

In the recent convention of the Endocrine Society, one abstract that caught the attention of many was the study comparing the low carb high fat high protein diet versus high carb, high protein low fat diet.

____________________________________________________________________________

The low-carb diet allowed 1,085 calories a day with 17 grams of carbohydrates, 51 grams of protein, and 78 grams of fat. Breakfast for members of this group was to be 290 calories with 7 grams of carbohydrates and 12 grams of protein.
The modified form of this diet allowed 1,240 calories a day with less total fat (46 grams) but more carbs (97 grams) and protein (93 grams). The main feature was a 610-calorie “big breakfast” accounting for about half of the daily carbohydrates (58 grams), protein (47 grams), and fat (22 grams).

During the first 16-week weight-loss phase, the big-breakfast group lost about the same amount of weight as the low-carb group (10.6 kg versus 12.6) with no significant difference between groups.

During the following 16-week maintenance phase, though, the groups’ experience diverged. The big-breakfast group continued losing weight and reached an average 21.3% weight loss by the end of the trial (18.1 kg below baseline).

The low-carb group, on the other hand, regained much of the weight lost to end at just 4.5% below baseline (4.3 kg). The protein- and carbohydrate-heavy breakfast appeared to regulate hunger cues, the researchers said.

Visual analog scale scores after breakfast for the two groups were improved with the big-breakfast diet compared with the low carb diet for the following:

  • Hunger (P=0.018)
  • Feeling of still being able to eat a lot more food (P=0.001)
  • Fullness (P=0.001)
  • Satiety (P=0.07)

The difference in fullness extended beyond lunch and through 11 p.m. (P=0.001).

____________________________________________________________________________

This study suggests that having a heart high carb and high protein breakfast translates to lesser craving for sweets and lesser hunger.  Again as we emphasized in any weight loss counseling, it is not recommended that patients trying to lose weight are on a dietary regimen that makes them feel hungry.

This is one study that I will wait for the final posting in a peer reviewed journal.  It would be nice to see how the study was conducted and see where the flaws could be and whether this can be translated into clinical practice.

For now…

Eat Your Breakfast To Help You Lose Weight!

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

How to Prevent Erectile Dysfunction….

July 7, 2008

One of the many aspects in life that we desire is to be happy in all areas of our daily activities…and that includes nighttime responsibilities of a husband to the partner! And what comes worst is the problem of impotence or erectile dysfunction due to medical diseases like diabetes or non medical like psychological in nature…being the most common cause.

Now comes a very interesting piece of information for all of us! This study on how we can prevent the problem of poor sex life due to erection problems was recently published in the American Journal of Medicine, July 2008.

______________________________________________________________________________

Background

Erectile dysfunction is common among men aged more than 60 years. Its cause involves both physiologic and psychosocial factors.

Methods

Data were analyzed from a population-based 5-year follow-up study that was conducted in Pirkanmaa, Finland, using postal questionnaires. The study sample consisted of 989 men aged 55 to 75 years (mean 59.2 years).

The most common comorbidities were hypertension (32%), heart disease (12%), depression (7%), diabetes (4%,) and cerebrovascular disorder (4%).

Results

The overall incidence of moderate or complete erectile dysfunction was 32 cases per 1000 person-years (95% confidence interval [CI], 27-38). After adjustment for comorbidity and other major risk factors:

  1. men reporting intercourse less than once per week at baseline had twice the incidence of erectile dysfunction compared with those reporting intercourse once per week (79 vs 33/1000, incidence rate ratio 2.2, 95% CI, 1.3-3.8).
  2. The risk of erectile dysfunction was inversely related to the frequency of intercourse.
  3. No relationship between morning erections and incidence of moderate or severe erectile dysfunction was found.

Conclusion

Regular intercourse protects against the development of erectile dysfunction among men aged 55 to 75 years.

This may have an impact on general health and quality of life; therefore, doctors should support patients’ sexual activity.

____________________________________________________________________________

Yes…I fully support my patients sexual activity because I know it is a very important cause of depression among my diabetic patients. In fact this is one of the reasons why I am very aggressive in treating my diabetic patients especially if they are also hypertensives because I want them to preserve the fun of sex and avoid the problem of impotence later in life.

So doing it more frequently is the way to go!!!!  What a fun way to prevent a disease… the more the better…

Enjoy Life…Have More …The Better!

Posted in Lifestyle Measures, Medical News Bits, Personal Thoughts | 4 Comments »

Hearing Loss and Diabetes…

July 2, 2008

Go to fullsize imageI have long suspected a relationship. 

It seems more prevalent the older the patient gets but seems to be more common among my diabetic nowadays.  And my suspicion is right based on a new article published in the Annals of Internal Medicine, July issue:

___________________________________________________________________________________________

Background: Diabetes might affect the vasculature and neural system of the inner ear, leading to hearing impairment.

Design: Cross-sectional analysis of nationally representative data. National Health and Nutrition Examination Survey, 1999 to 2004.

Results: 5140 noninstitutionalized adults age 20 to 69 years who had audiometric testing.

  • Hearing impairment was more prevalent among adults with diabetes. Age-adjusted prevalence of low- or mid-frequency hearing impairment of mild or greater severity in the worse ear was 21.3% (95% CI, 15.0% to 27.5%) among 399 adults with diabetes compared with 9.4% (CI, 8.2% to 10.5%) among 4741 adults without diabetes.
  • Similarly, age-adjusted prevalence of high-frequency hearing impairment of mild or greater severity in the worse ear was 54.1% (CI, 45.9% to 62.3%) among those with diabetes compared with 32.0% (CI, 30.5% to 33.5%) among those without diabetes.

Conclusion: Hearing impairment is common in adults with diabetes, and diabetes seems to be an independent risk factor for the condition.

________________________________________________________________________________________________________________________________________________________________________________

The more likely explanation to this complication is still diabetes related microcirculation abnormality which is seen in other organs affected by this condition. Whether tight control of blood glucose can help prevent the onset and progression of this condition remains to be seen. 

Still the same, good control has been shown to help prevent circulatory problems of the affected organs in the body such as the eyes and the kidneys….and therefore there should be no reason why the same wont hold true to the cochlea.

This study therefore helps us realize that patients with diabetes should probably start screening for hearing impariment so as to avoid exposure to unnecessary factors that can help aggravate the condition like noise pollution, loud music and some drugs that have been shown to cause hearing loss.

Hearing Loss: Another Reason To Aim For Good Control!

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

Mediterranean Diet and Diabetes

June 30, 2008

Reducing the risk of developing a disease requires discipline. Taking measures may be difficult but in the long run preventing the disease from causing harm will be worth all the sacrifice.

We know from the most usual of all: proper diet and exercise have been advised by all to prevent an illness!!! It may be true that… it’s so easy to say…so difficult to do. BUT again if there’s no discipline …there’s no success! And success in Health means… Being Healthy!

One study that I found very important in our quest to reduce the prevalence of diabetes worldwide was recently published in the British Medical Journal, 2008 issue.

______________________________________________________________________________

Objective To assess the relation between adherence to a Mediterranean dietand the incidence of diabetes among initially healthy participants.

Design Prospective cohort study . Participants 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years.

Results:

Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3).

In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis.

Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

_____________________________________________________________________________

This study further proves the health benefits of adhering to Meditteranean diet. It is known to have protective effect in preventing cardiovascular disease and NOW… this study proves it to be protective in preventing diabetes.

For those who dont known the components of this diet: Here’s a summary:

  1. High intake of Fiber; High Intake of vegetable fat
  2. Low intake of trans fatty acids with abundant us of olive oil!!!!
  3. High intake of fruits, nuts, vegetables, cereals and legumes
  4. Minimal meat or dairy products!
  5. Moderate consumption of alcohol

Again…the study emphasizes…

What We Take In is What We Get!

Posted in General Health Tips | 1 Comment »

Vitamin D and The Risk For Heart Attack!

June 27, 2008

Go to fullsize imageAnother reason for us to check our Vitamin D levels… the study published in the June issue of the Archives of Internal Medicine: showing that low levels of Vitamin D can be a contributing factor to increase heart attack risk.

____________________________________________________________________________________________

Background  Vitamin D deficiency may be involved in the development of atherosclerosis and coronary heart disease in humans.

Methods  A nested case-control study was conducted in 18 225 men in the Health Professionals Follow-up Study; the men were aged 40 to 75 years and were free of diagnosed cardiovascular disease at blood collection.  During 10 years of follow-up, 454 men developed nonfatal myocardial infarction or fatal coronary heart disease. Using risk set sampling, controls (n = 900) were selected in a 2:1 ratio and matched for age, date of blood collection, and smoking status.

Results  After adjustment for matched variables, men deficient in 25(OH)D (≤15 ng/mL) were at increased risk for MI compared with those considered to be sufficient in 25(OH)D (≥30 ng/mL) with a relative risk of 2.42.

Even men with intermediate 25(OH)D levels were at elevated risk relative to those with sufficient 25(OH)D levels (22.6-29.9 ng/mL: RR, 1.60 ; 15.0-22.5 ng/mL: RR, 1.43 respectively).

Conclusion  Low levels of 25(OH)D are associated with higher risk of myocardial infarction in a graded manner, even after controlling for factors known to be associated with coronary artery disease.

______________________________________________________________________________

The study involved patients free of any heart risk.  This finding therefore will have a significant impact in reducing further the risk of those patients already with other concomitant risk factors like diabetes and high blood pressure.  Knwoing your Vitamin D level will do more benefit than harm!

Checking Vitamin D level is a simple blood test.  This can be done easily and the results if low can have significant impact on the patient’s sense of well being since low levels can cause musculoskeletal symptoms and back pains. Vitamin D replacement is also simple since all one needs to do is take a pill!

Check Your Levels in Your Next Doctor’s Visit!

 

Posted in General Health Tips | Leave a Comment »

An Aspirin A Day Can Keep BP At Bay…

June 24, 2008

Aspirin has been touted a miracle drug because of its health benefits in protecting high risk patients like our diabetics from heart attack and stroke. The combination of illnesses including diabetes , hypertension and cholesterol increases a patients risk for stroke and heart attack.

In the recent American Society of Hypertension Annual Convention, a particular study was presented regarding the effect of aspirin on hypertension. The study is discussed in detail at the Diabetes in Control website...

____________________________________________________________________________

The subjects were randomized into three groups: lifestyle modification only, lifestyle modification plus aspirin 100 mg every morning, or lifestyle modification and aspirin 100 mg taken at bedtime. They underwent continuous blood pressure monitoring for 48 hours at baseline and after 3 months of intervention.

Ambulatory blood pressure was unchanged in the nonpharmacologic group and in the morning aspirin group, but the nighttime aspirin administration resulted in a mean decrease of 5.4 mm Hg in systolic blood pressure and 3.4 mm Hg in diastolic blood pressure compared to baseline values, without any change in heart rate or physical activity. Reductions in blood pressure were similar for both day and night.

_____________________________________________________________________________

This study will somehow affect the way we give aspirin. In clinical practice, it really doesnt matter when aspirin is taken as long as patients are taking it eveyday. But with this recent outcome…might as well give them at night until this study will be proven otherwise….

And as always…we continue to emphasize a low salt diet and more physical activity on top of medications to help curb the rising prevalence of complications arising from hypertension.

Another Wonderful News on Aspirin and Health!

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

Is Working Overtime Harmful?

June 21, 2008

Here’s a study for all workaholics and overtime workers. It may be the time to reflect… and ask… if we can only manage our time better and try to avoid long night hours at work…so much the better. One has to realize and believe that having the time to take care of ones health is an obligation and a GIVEN!

This study looked at whether working overtime can have harmful effects on the body especially the psychological well being. This study was recently published in the Journal of Occupational and Environmental Medicine.

________________________________________________________________________________

Objective: To examine whether long work hours are associated with increased levels and prevalences of anxiety and depression.

Results: Overtime workers of both genders had significantly higher anxiety and depression levels and higher prevalences of anxiety and depressive disorders compared with those working normal hours. Findings suggest a dose-response relationship between work hours and anxiety or depression.

_________________________________________________________________

So to the boses and managers out there…your employees well being is tantamount to more productivity and better work outcome. Take time to analyze each workload and better still instill the discipline of not working long hours because in the long run, health takes its toll and work output suffers in the end…physically and psychologically,

Again… I practice this principle at work. I make sure I dont work long hours as I instill on my patients the discipline of setting an appointment. Have time to relax and exercise. Burning out is the layman’s term to being depressed and losing steam at work. Avoid this from happening otherwise Work becomes a Burden!

Overtime Can Hinder Productivity! Learn To Manage Your Time!

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

Dark Chocolate Can Lower Blood Pressure and Cholesterol…

June 17, 2008

Another interesting research and great news for chocolate lovers. 

A new study published in the Journal of Nutrition has shown a beneficial effects of dark chocolate in reducing cholesterol and blood pressure.

________________________________________________________________________________________

This double-blind, placebo-controlled, cross-over study evaluated the efficacy of daily consumption of a cocoa flavanol-containing dark chocolate bar with added PS on serum lipids, blood pressure, and other circulating cardiovascular health markers in a population with elevated serum cholesterol.

Regular consumption of the PS-containing chocolate bar resulted in reductions of 2.0 and 5.3% in serum total and LDL cholesterol (P < 0.05), respectively. Consumption of CF also reduced systolic blood pressure at 8 wk (-5.8 mm Hg; P < 0.05).

Results indicate that regular consumption of chocolate bars containing PS and CF as part of a low-fat diet may support cardiovascular health by lowering cholesterol and improving blood pressure.

________________________________________________________________________________________

In this study the participants utilized the AHA style diet, and were instructed to consume 2 cocoa flavanol-containing dark chocolate bars per day with (1.1 g sterol esters per bar) or without PS.  The participants really had fun because they were asked to consume 1 bar 2 times per day for 4 wk then switched to the other bar for an additional 4 wk. How I wished I can be part of a study like this!!!!

The research is again one of the many studies done so far on dark chocolate that provides intriguing information regarding the role of plant sterols (PS) and cocoa flavanols (CF) in maintaining cardiovascular health.

Remember though, these are dark chocolates supplemented with plant sterols in addition to cocoa flavanols. These are available in both CVS and Walgreens Pharmacy Stores in the US.  Meaning these dark chocolates are not the usual regular dark chocolates available anywhere. 

So Dark Chocolate…Anyone? 

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

The Link Between Sleep Apnea and Memory Loss

June 13, 2008
Obstructive Sleep Apnea from the word itself means there is an obstruction to sleep.  As a result majority of our obese diabetics who have OSA almost always have this obstruction corrected, diagnosed and managed because of the complications that can arise for this condition including stroke, heart disease and worsening diabetes.

Partners of patients with sleep apnea will complain that their partners snore a lot, usually stops breathing and awaken repeatedly during the night.  Due to the lack of deep sleep, these patients manifest chronic daytime fatigue with memory lapses and importantly has difficulty  concentrating or focusing.

A new review published in the Neuroscience Letters this June shows that there is a relationship between this condition and the dreaded memory loss. And that this memory loss is not only because of fatigue but structural abnormalities in the brain:
 _______________________________________________________________________________________
Obstructive sleep apnea (OSA) patients show compromised emotional and cognitive functions, including anterograde memory deficits. While some memory inadequacies in OSA may result from earlier-described structural deficits in the hippocampus, mammillary body injury also could contribute,
We evaluated mammillary body volumes in 43 OSA and 66 control subjects. Two high-resolution T1-weighted image volumes were collected on a 3.0 T magnetic resonance scanner, averaged to improve signal-to-noise, and reoriented (without warping) into a common space. Brain sections containing both mammillary bodies were oversampled, and the bodies were manually traced and volumes calculated.
  • OSA patients showed significantly reduced left, right, and combined mammillary body volumes compared with control subjects, after partitioning for age, gender, and head size (multivariate linear model, p < 0.05).
  • Left-side mammillary bodies showed greater volume reduction than the right side.
  • Diminished mammillary body volume in OSA patients may be associated with memory and spatial orientation deficits found in the syndrome.
  •  The mechanisms contributing to the volume loss are unclear, but may relate to hypoxic/ischemic processes, possibly assisted by nutritional deficiencies in the syndrome.

_______________________________________________________________________________________

There you go guys…. if you have the symptoms of OSA, have it checked right away.  It can be treated and managed so as to avoid brain injury.  It has been shown that repeated bouts of apnea or lack of oxygen flow to the brain can lead to brian cell death which eventually can lead to memory loss or forgetfullness!!!!

How to address OSA?  If you are obese then try to lose weight.  This is one of the major complications of being overweight and being obese.  We have sleep centers that can manage this disease medically or surgically.

Sleep Debt Equals Health Debt!

Posted in General Health Tips | 1 Comment »
Tags: , , ,

Tips For The Insomniacs….

June 11, 2008

One of the common complaints I get from my patients is the inability to sleep.  It may seem so simple but if you are an insomniac, trying to sleep can be a torture.  We all know sleep debt makes us feel weak and sluggish.  But what is not known is that sleep debt can lead to chronic illnesses like an increased risk to develop diabetes and heart disease.

So what should an insomniac do?

Here are some simple tips from the Harvard Health Letter…

______________________________________________________________________________________

 Changing your behavior, rather than medication, may be the first step to a better night’s sleep. And surprisingly, for chronic insomnia, the best treatment may be to cut back on the time you spend trying to sleep.

______________________________________________________________________________________

People with insomnia often find that spending less time in bed promotes more restful sleep and helps make the bedroom a welcome sight instead of a torture chamber. As you learn to fall asleep quickly and sleep soundly, the time in bed is slowly extended until you obtain a full night’s sleep.

Some sleep experts suggest starting with five or six hours at first, or whatever amount of time you typically sleep at night. Setting a rigid early morning waking time often works best. If the alarm is set for 7 a.m., a five-hour restriction means that no matter how sleepy you are, you must stay awake until 2 a.m. Once you are sleeping well during the allotted five hours, you can add another 15 or 30 minutes, then repeat the process until you’re getting a healthy amount of sleep.

_______________________________________________________________________________________

Hope this simple formula can work well for you.  If we can do this without any dependence to medications, the better. 

Lastly…Dont go to bed if you’re not sleepy! Dont watch TV! Read a book instead on a dim lighted area favorably with a yellow light! Asscociate your bed with sleep.  Enjoy every minute of your time with your bed.  Dont think of it as a torture chamber!  Just hug your pillow and think about how nice it is to sleep.  Dont think otherwise or you will really find yourself wondering… why you’re still awake and the more you think about it…. the more you will feel frustrated about not going to sleep.

Good Sleep Keeps You Fit!

Posted in General Health Tips, Lifestyle Measures, Personal Thoughts | Leave a Comment »
Tags: ,

Metformin for Pregnant Diabetics?

June 9, 2008

Go to fullsize imageYes we can!!!!

A recent published study: The MiG trail or the Metformin for Gestational Diabetes in the New England Journal of Medicine, May 2008 provide us more proofs that the use of metformin is not only preferred by pregnant dabetics BUT likewise is not associated with perinatal complications.

_______________________________________________________________________________________

Results

Of the 363 women assigned to metformin, 92.6% continued to receive metformin until delivery and 46.3% received supplemental insulin.

The rate of the primary composite outcome was 32.0% in the group assigned to metformin and 32.2% in the insulin group (relative risk, 1.00; 95% confidence interval, 0.90 to 1.10).

More women in the metformin group than in the insulin group stated that they would choose to receive their assigned treatment again (76.6% vs. 27.2%, P<0.001). The rates of other secondary outcomes did not differ significantly between the groups.

There were no serious adverse events associated with the use of metformin.

Conclusions

In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased perinatal complications as compared with insulin. The women preferred metformin to insulin treatment.

________________________________________________________________________________________

This is one randomized trial that we have been waiting for.  Now as an endocrinologist, I have more arms to support the use of this medication for my pregnant women diagnosed with gestational diabetes.  The more options a patient have , the better!  Controlling their blood glucoses while pregnant is important!  It is our aim to hopefully prevent them from becoming diabetics after the delivery by lessening the burden of the pancreas brought about by the hormonal changes of pregnancy.

It is therefore very important that for all women to know that if they have risk factors for diabetes including obesity and a strong family history of diabetes…that they make sure to ask their obstetricians that they be screened for gestational diabetes.  This is one case where the early diagnosis is paramount to early treatment… the better for the health of the pancreas.

This is indeed good news to our women who have fear for needles because now we have a safe and effective alternative to insulin.

Another Welcome Option To The Medical World!

 

Posted in Medical News Bits, The Diabetes Facts | 3 Comments »

Quick Steps To Achieve Healthy Weight…

June 6, 2008

Go to fullsize imageI came across a well written short article on how to achieve a healthy weight.  The advises sound so simple yet precise and direct to the point of concern.  We tend to disregard simple measures in life and then look for rigorous steps to achieve our goal.  That’s where failure can set in.  Make things simple and Let them work for you….

Here’s the quick 5 steps to a healthy weight from the Harvard Medical Group: The Harvard School of Public Health

__________________________________________________________________________________________________

1. Ban the strange diets. They may work in the short term, but almost any strange, extreme diet is doomed to fail. Your best friends when it comes to losing weight—and keeping it off? Choosing healthy foods and eating smaller portions, slowly.

2. Be more active. If there’s one best weight loss mantra it’s “exercise, exercise, exercise.” Choose activities you enjoy and do them every day. Exercising with a friend can help keep you on track. 

3. Turn off the television. Watching less TV can give you more time to be active—and less time to be enticed by junk food ads. Two easy ways to cut back on TV-watching: take the TV out of your bedroom, and make sure it’s off during meals.

4. Skip the sugary drinks. Drinking sugared soda, fruit drinks, or juice can give you several hundred calories a day without realizing it. Research suggests children and adults who drink soda or other sugary drinks are more likely to gain weight than those who don’t, and that switching from these to water or unsweetened drinks can reduce weight.

5. Think before you eat. Before you mindlessly reach for a snack, pause and ask yourself, Am I really hungry? Is there a healthier choice? It’s easy to lose sight of good food choices in today’s ad-crazy world. Simple questions like these can help keep us on track.

________________________________________________________________________________________________

Simple common sense tips for healthy living as well…

Live Life To The Fullest…By Living Healhty!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Weight Loss Tips | Leave a Comment »

The Many Benefits of Mediterranean Diet

June 4, 2008

What is Mediterranean Diet?

The common Mediterranean dietary pattern has these characteristics according to the American Heart Association :

  • high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
  • olive oil is an important monounsaturated fat source
  • dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
  • eggs are consumed zero to four times a week
  • wine is consumed in low to moderate amounts

The diet simply put focuses more on our consumption of olive oil, vegetables, fruits, nuts ( my post on Going nuts on Nuts) , cereals, legumes and fish ( my post on the Benefits of Eating fish)  and avoiding the well liked and “unhealthy meat and “saturated fat loaded” dairy products.

The many touted benefits of this diet has long been known in the medical field.  In fact major organizations have patterned their recommended healthy diets on the contents of the mediterranean diet.  Why?  Because… Many epidimeological studies have shown that the incidence of heart disease in Mediterranean countries is lower than in the United States where meat and saturated fat is a plenty!!!!.  In fact in those studies, where people practice the Mediterranean diet, mortality rates or the risk of death were also significantly lower!!!!

In a recent article published in the May 30 online of BMJ, Mediterranean diet has been shown to lower the risk of developing diabetes.  Another PLUS to this otherwise healthy alternative way of eating….

__________________________________________________________________________________________________

Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3). In the fully adjusted analyses the results were similar.

A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis.

Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

________________________________________________________________________________________________________________-

In this study, during an average of 4 years of follow-up, the researches found that found that people who adhered to a Mediterranean diet very closely had a lower risk of developing type 2 diabetes. and their risk were reduced by 83 percent.

It is however very important to emphasize that major health benefits may not be entirely due to the diet alone.  A healthy diet should always partner with healthy lifestyle including more physical activity.  All these require no shortcut but plain discipline!

A Healthy Diet For More Wealth!

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

The Wonders of Vitamin D…

May 28, 2008

Vitamin D has been a negelcted Vitamin for several centuries.  People are so mystified by Vitamin E and Vitamin C that almost always every patient that I encounter is either on E or C as vitamin supplements.  But recent data have shown that one Vitamin that stand out among the rest in terms of preventing illnesses is Vitamin D.

A new study that looked at how important Viatmin D in terms of it causing muscle pain was recently published. It looked at how deficiency of Vitamin D may play a big role in causing this chronic complaints among the elderly population. This study published in the American Journal of Geriatrics in May 2008 involved Nine hundred fifty-eight persons (aged ≥65) selected from city registries of Greve and Bagno a Ripoli.

_______________________________________________________________________________________ 

Lower concentrations of 25(OH)D are associated with significant back pain in older women but not men. Because vitamin D deficiency and chronic pain are fairly prevalent in older adults, these findings suggest it may be worthwhile to query older adults about their pain and screen older women with significant back pain for vitamin D deficiency.

_______________________________________________________________________________________

The main function of Vitamin D is in helping maintain a normal calcium level in the blood which is important for bone strength.  It aids in the absorption of calcium from the gut and can provide protection from osteoporosis as well as other chronic illnesses like hypertension (high blood pressure), cancer, and others.

Some health benefits of Vitamin D although will need more studies to fully prove its worth include for:

  •  Diabetes where Vitamin D has been shown to improve insulin sensitivity; 
  •  Colon cancer where a Metaanalysis showed VitaminD supplementation decreased the risk
  •  Multiple Sclerosis
  •  Prostate cancer where a reduction in risk was noted with higher Vitamin D Intake among others….

So how can we get enough Vitamin D?

Exposure to the morning sun for 10 to 15 minutes should provide you enough Vtamin D.  Other food sources include fish like salmon and tuna , egg yolk, cheese, fortified milk including yogurt, and cod liver oil.  It is best to check your Vitamin D level to determine if you are deficient or not.  There are many supplements of Vitamin D available in the market and it is best to discuss which is best for you with your doctor.

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

Soy Protein and The Heart….

May 26, 2008

Go to fullsize imageThere are many conflicting data on soy protein and the heart especially the claim that they lower cholesterol.  In fact in 1999 based on studies during that time, the US FDA allowed a health claim on food labels stating that a daily diet containing 25 grams of soy protein, also low in saturated fat and cholesterol, may reduce the risk of heart disease. 

However, the American Heart association in January of 2006 made a review of available data and made a conclusion that soy protein in itself did not significantly lower the bad cholestrol nor did it have any significant effect in increasing the good cholesterol.

But as an endocrinologist looking for alternative source of meat protein, the use of soy protein in place of meat which has high staurated fat will continue to play a major role in our attempt to reduce the risk of our patients from cardiovascular disease.

Recently a new article on the benefit of soy protein came out in Annals of Internal Medicine.  This study is so relevant to my practice especially among diabetic patients with kidney disease.  These are the patients we try to avoid taking meat protein because of the possibility of causing kidney function deterioration.  The study did not only show a good effect in sugar control but also markers of inflammation suggesting a potential effect in reducing cardiovascular disease plus improving markers of kidney function.

________________________________________________________________________________________

Soy protein consumption significantly affected cardiovascular risks such as fasting plasma glucose , total cholesterol , LDL cholesterol, and serum triglyceride concentrations.

Serum CRP levels were significantly decreased by soy protein intake compared with those in the control group .

Significant improvements were also seen in proteinuria  and urinary creatinine ( both measures od kidney function) by consumption of soy protein.

CONCLUSIONS—Longitudinal soy protein consumption significantly affected cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy.

______________________________________________________________________________________________________

Here is a list of the common sources of soy protein that we can enjoy includes: Tofu, soymilk, soyflour. Tempeh and Miso.  The soymilk and textured soy protein can be used as subsitute for meat or cows milk while the soyflour can be used in baking needs.

I believe in the benefits of soy protein.  I hope for more studies to come that will provide us with more data on its beneifts and potential to reduce disease risk especially the Heart!

Soy Protein: A Better Partner for the Heart!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Tips To Protect Your Heart | Leave a Comment »

Having High Sugar and High Blood Pressure Can be Deadly…

May 23, 2008

Go to fullsize imageAlmost always a patient that suffers from diabetes is obese, have high triglycerides and low HDL and develops high blood pressure and high cholesterol… the combination of which is called the Metabolic syndrome.  If any of these conditions are not addressed then ones risk to suffer from chronic complication like heart disease is increased.  Whether the sum of the components or the combination of two parts or only one component is present makes a patient more at risk to die is not well documented.

The new study published in Annals of Internal Medicine May 2008 now shows that having two parts increases the risk to die more than having the combination for the components of the syndrome itself….

_______________________________________________________________________________________

  1. After multivariable adjustment, compared with persons without MetS, those with MetS had a 22% higher mortality .
  2. Higher risk with MetS was confined to persons having elevated fasting glucose level  or treated diabetes mellitus or hypertension as one of the criteria;
  3. Persons having MetS without High Fasting Glucose or MetS without hypertension did not have higher risk.
  4. Evaluating MetS criteria individually, we found that only hypertension and EFG predicted higher mortality;
  5. Persons having both hypertension and Elevated Fasting Glucose had 82% higher mortality .
  6. Substantially higher proportions of deaths were attributable to EFG and hypertension (population attributable risk fraction [PAR%], 22.2%) than to MetS (PAR%, 6.3%).

________________________________________________________________________________________

There you go my friends…just having diabetes or hypertension makes one at higher risk to die from heart disease.  More so if high blood sugar is joined by high blood pressure then the risk to die is 82%!!!!

The above study therefore tells us that making a diagnosis of metabolic syndrome does not entail more risk to die than having just diabetes of hypertension alone.  Such that… it’s utility as a diagnosis and as a risk factor for cardiovascular mortality is put in question. 

So friends…please dont take these two conditions lightly!!! As an endocrinologist, I take these conditions seriously and that all patients with Diabetes are screened for blood pressure and cholesterol abnormalities and vice versa! 

To summarize the study:

Having High Sugar especially if with High Blood Pressure Can Be DEADLY! 

Posted in General Health Tips, Medical News Bits, Personal Thoughts, The Diabetes Facts, Tips To Protect Your Heart | 1 Comment »

Foods That Can Make Us Feel FULL….

May 12, 2008

Go to fullsize imageDifferent kinds of food give us different levels of satiety and the feeling of fullness.  You may not have realized it but in one meal, you get easily hungry in less than 2 hours and are wondering why this is so.

It is important for us to remember that the main role of food is solely to satisfy our craving, our hunger and definitely to provide us the needed calories for energy.  But the kind of food we eat will determine if we feel the feeling of satisfaction or not.  This satiety factor therefore will be a factor in making us eat more and therefore provide us with unecessary calories that make us gain weight!

What determines the feeling of fullness include the quantity of food we eat, the actual contents of the food and the texture including the smell.  Signals to the brain from the stomach make us feel satisfied or make us eat more.   

What foods can give us the highest satiety level? 

If your food contains a high level of protein, enough amounts of fiber and water, this food will give you the highest satisfaction rating.  In contrast foods high in fat will make you less satisfied and makes you want to eat more…this be the reason why a high fat diet makes you gain weight!  Intake of protein like a meal that includes fish meat or egg  gives a higher satiety level than carbohydrates.  But carbohydrate rich foods like pasta, rice or bread also provides a high satiety level. 

So to provide one with the highest satiety level of food for a meal… a whole grain bread with leans cuts of meat can provide a better satiety level and longer period of preventing hunger than if one eats a croissant!

The satiety factor of a food like glycemic index is just one of the many factors that affect the way we eat, the way we manage our lifestyle and the way we prevent weight gain. Complex factors come into play including social norms, culture and even mood in deciding whether we feel satisifed and enough food is enough for the meal!

The bottom line is: the higher the satiety factor the lesser we eat!  Likewise…my advise to all: once you feel full…then stop eating especially if you are indulging in a high carbohydrate meal!!!! Sometimes, its the great taste of food even if we are already full that makes us want to eat more. 

Dont be Fooled by Food…Be “Fulled” The Right Way!

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

Signs of Aging? Better Check Your Thyroid Gland…

May 8, 2008

Go to fullsize imageIf you complain of too much fatigability, or weakness and memory loss.. these may not be signs of aging but rather an abnormality in your thryoid gland. 

So where is the thyroid gland?  It is found in the neck just below the Adam’s apple.  Any malfunction of the thyroid gland results in a reduction body temperature ( you cant tolerate cold) , decrease in heart rate and muscle strength as well as increase in cholesterol.  Worst of all the symptoms are a decrease in memory and mood due to a sluggish feeling and weight gain.  When  these symptoms occur, you feel tired all the time and may blame aging as the culprit!

It si very easy to check thru blood tests called TSH ot Thyroid Stimulating Hormone and Free T4 or the thyroid hormone.  These tests are readily available but must be interpreted properly because any mistake in analysis can results in a wrong therapy.  Make sure you have the test confirmed for evaluation by a certified endocrinologist in your area.

A High TSH and Low FT4 is diagnostic.  Treatment is simple and requires thyroid hormone replacement. And boom…you will feel better, become more active and better sense of well being!  And feel young again!

So The next time….

You Feel unexpectedly Sluggish?…Check your Thyroid!

Posted in General Health Tips | 2 Comments »

Mixing Fun and Work Equals FUN…

May 6, 2008

Just came back from Manila this afternoon after I was invited to give a lecture in the annual convention of the Philippine College of Physoicians- the biggest organozation of all internists in the Philippines.  But before this date, I brought my family to take a vacation in Manila and visited some sights both for entertainment and cultural learnings.  I would have wanted to bring my family somewhere in Asia again during this summer but my being away to attend conventions for these past few months have made me decide to have fun with them in time for my work. And boy it was full of fun!

To those with kids and plan to explore Manila… these are the fun things you can do with your kids.  First we visited The Manila Ocean Park where the Oceanarium is located. It was full of fun for the kids and was the first time for my youngest to see such a huge collection of sea life. It can compete with the aqauriums in Hongkong and Singapore. 

 Then we proceeded to go to Star City which is a covered amusement park where the Snow World is located. Its bigger than the Snow City of Singapore and is more fun BUT… you need to bring your own jacket and boots if you like more time inside because they only provide you with a light jacket without boots which are not enough considering the freezing temperature.  Overall, Star City has lots of other fun rides for the kids and also clean and safe.  This early the kids are expressing their desire to go back!.

The next day we went to the Kiddie Fun ranch near Tiendesitas just around Ortigas also. The place has a huge adventure zone like playground and a huge inflatable slides with mini boat rides and games. Avilon mini zoo was a lso nearby and a walking distance which was also both fun and educational for the kids. But the most fun for them was when they rode on a donkey, held an eagle and fed the rabbits with a carrot stick on their hands.

The next day was more cultural as my son wanted to see the places he has learned in his Social Studies especailly Intramuros, Fort Santiago and Jose Rizal.  We toured Intramuros using a Kalesa ride and gave us a glimpse of the past.  We visited the place where Jose Rizal was imprisoned and traced his footsteps on the way to his death!  We visited the museum and glanced at his book the Noli mi Tangere and El Filibusterismo which my son knows about.  Then we visited the Discovery Science Center where the most amazing for my kids was the talking fish who interacted with them with questions and dances.  They now want to go back becuase of the FISH!  It has a Planetarium with an IMAX theater and Robotics.  Worth to visit.

The last day was a visit to Tom’s World and Toys R Us and a swim in our hotel…my favorite the Discovery Suite.

This Sunday I will be attending the American Association if Clinical Endocrinologist meeting in Orlando.  This one educational meeting that I always attend to update me of what’s new in my field. I will be away again for a week for work. But all these for the benefit to learning more so as a specialist I can update my knowledge of this ever changing field of Medicine.

But as all of us are busy, taking time to be with our kids and just be away from work is all much fun.  My way of mixing fun with work worked!  Grab all the time to be happy with them and bond with them.  They will be young only once! I feel better, healthier just laughing with them and younger as I rode the rides with them and as we all shouted together as if I was young again! 

Posted in General Health Tips | Leave a Comment »

Are Eggs Healthy To Eat?

May 1, 2008

One of the top posts in my website is my article on how much eggs can one eat.  The emphasis on eggs as being healthy but laden with cholesterol has made the public very confused.  Now comes a new study published in the American Journal of Nutrition done in Harvard University linking consumption of egg to increased mortality. 

_________________________________________________________________________________________________

Background: A reduction in dietary cholesterol is recommended to prevent cardiovascular disease (CVD). Although eggs are important sources of cholesterol and other nutrients, limited and inconsistent data are available on the effects of egg consumption on the risk of CVD and mortality.

Objective: We aimed to examine the association between egg consumption and the risk of CVD and mortality.

Design: In a prospective cohort study of 21 327 participants from Physicians’ Health Study I, egg consumption was assessed with an abbreviated food questionnaire. Cox regression was used to estimate relative risks.

Results: In an average follow-up of 20 y, 1550 new myocardial infarctions (MIs), 1342 incident strokes, and 5169 deaths occurred.

  • Egg consumption was not associated with incident MI or stroke in a multivariate Cox regression.
  • Adjusted hazard ratios (95% CI) for mortality were 1.0 (reference), 0.94 (0.87, 1.02), 1.03 (0.95, 1.11), 1.05 (0.93, 1.19), and 1.23 (1.11, 1.36) for the consumption of <1, 1, 2–4, 5–6, and 7 eggs/wk, respectively (P for trend < 0.0001).
  • This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold (hazard ratio: 2.01; 95% CI: 1.26, 3.20; P for interaction = 0.09).

Conclusions: Infrequent egg consumption does not seem to influence the risk of CVD in male physicians. In addition, egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population.

_________________________________________________________________________________________________________________

The data suggests that the higher the number of eggs consumed, the higher the mortality risk especially among diabetic patients.  This seems interesting because the risk to develop heart disease was not seen among those who are frequent egg eaters suggesting that the risk to die was not associated with heart disease but something else! Nevertheless, looking at prevoius relationships of cholesterol and death, the most likely explanation as assessed in the editorial by Dr Eckel of University of Colorado is still atherosclerotic disease.

The relationship between egg consumption and heart disease continues to be confusing.  This is understandable because now we know that the effect of cholesterol intake in the diet has less effect on the LDL or bad cholesterol in the blood than an intake of saturated fat or trans fat in the diet.  And as we all know, the egg yolk mainly contains cholesterol.

The editorial sums it all up:

So, if you are a male physician and are going to eat 1 egg/d, why not eat the whites only? Just think—with all of the trimmings, that 3-white egg omelet is almost indistinguishable by taste from an omelet enriched with 600 mg cholesterol, and the whites-only omelet also remains a very good source of protein, riboflavin, and selenium. If you cannot do without the yolks, go ahead and enjoy them, but why eat them >3–4 d/wk? If you are a man with diabetes, a more limited egg intake pattern seems prudent. But, remember: eggs are like all other foods—they are neither “good” nor “bad,” and they can be part of an overall heart-healthy diet.

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts | 7 Comments »

« Older posts
Newer posts »