L-Carnitine and Weight Loss…

April 28, 2009

Go to fullsize imageIve seen my friends drinking juice with L carnitine thinking that by doing so…they are enjoying the taste plus the calories from the juice while the Carnitine burns the fat that makes them lose weight.  This would be an ideal setting and definitely one that will earn the founder of this promise of weight loss while enjoying the food will win the Novel Prize Winner in Science….

All in the game of marketing and the problem is…these products are winning high in sales because people are easily fooled by marketing.  Just like our kids are fooled into eating fried chicken because they’re healthy!

Carnitine is an important nutrient.  It is one that helps the body turn fat into energy.  So marketing the product from this basis : enjoy the taste of juice while burning your fat and lose weight…is one marketing that is really stretching the facts too lame!  Unfortunately people buy the ads as if they are the truth!

Lastly beware of websites from companies selling the product…claiming facts regarding carnitine and products that they sell… because bias in reporting data is always evident.   Be vigilant when searching for them in the internet.  Always check the source and its realiability of the findings including the institution that claims the facts!!

The truth of L carnitine is that at present and quote from the University of Maryland website: NO PROOF!

 “Although L-carnitine has been marketed as a weight-loss supplement, there is no scientific evidence to date to show that it improves weight loss. A recent study of moderately overweight women found that L-carnitine did not significantly alter body weight, body fat, or lean body mass. Based on the results of this one small study, claims that L-carnitine helps reduce weight are not supported at this time.”

Dont Be Fooled… Enjoy Water instead!
 

 

 

Posted in General Health Tips, Medical News Bits | 10 Comments »

Licking Speeds Up Wound Healing….

April 15, 2009

Call it reflex but the moment something feels painful or see blood in our fingers or hands, we immediately bring that finger into our mouth to lick it!  We feel better and we think it stops the bleeding.

Now science tells us indeed we were right all along.  A recent study published online by FASEB showed that licking a wound can indeed speed up wound healing:

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Wounds in the oral cavity heal much faster than skin lesions. Among other factors, saliva is generally assumed to be of relevance to this feature. Rodent saliva contains large amounts of growth factors such as epidermal growth factor (EGF) and nerve growth factor (NGF).

In humans, however, the identity of the involved compounds has remained elusive, especially since EGF and NGF concentrations are 100,000 times lower than those in rodent saliva.

Using an in vitro model for wound closure, we examined the properties of human saliva and the fractions that were obtained from saliva by high-performance liquid chromotography (HPLC) separation.

  • We identified histatin 1 (Hst1) and histatin 2 (Hst2) as major wound-closing factors in human saliva.
  • In contrast, the D-enantiomer of Hst2 did not induce wound closure, indicating stereospecific activation. Furthermore, histatins were actively internalized by epithelial cells and specifically used the extracellular signal-regulated kinases 1/2 (ERK1/2) pathway, thereby enhancing epithelial migration.

This study demonstrates that members of the histatin family, which up to now were implicated in the antifungal weaponry of saliva, exert a novel function that likely is relevant for oral wound healing.

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Now we know why nature tells us to lick our wounds…why dogs and cats do it too!!!!  This study also explains why mouth sores heal easily even if we dont do anything to them.

Hopefully in the future, this will help scientists develop new and better ways to help heal the wounds especially among those with diabetes or poor circulation that require the most aggressive way of treating the wounds to avoid complications like amputation.

For now…if you can lick it… go for it!!!!

Posted in Medical News Bits, Personal Thoughts | 1 Comment »

Meat Is Not NEAT!

April 7, 2009

Go to fullsize imageIt is easier to convince a child to eat meat than to eat veggies.  This scenario is given.  We are exposed to too many ads on meat whether chicken meat or beef meat on TV and newspapers.  It is therefore a challenge to parents to introduce other varieties of food that we deem healthier to the next generation.  It may take us some time to be successful but a little step can indeed go a long way overtime!

Now comes another study to support the concept that meat is really not neat!  Published in the latest edition of  Archives of Internal Medicine:

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Background  High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.

Methods  The study population included the National Institutes of Health–AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.

Results  There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up.

  • Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality.
  • Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes.
  • Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes.
  • When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.

Conclusion  Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.

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This study further confirms the relationship between red meat and cancer, heart and overall risk of death.  Likewise, the study also showed that fish or intake of white meat was associated with a reduction in the risk of death.

Translating the data to common language…it means…

Over 10 years, those that eat meat equivalent to a quarter-pound hamburger can increase ones risk to die from cancer by 22 percent and the risk to die from heart disease by 27 percent. 

Bottom Line is:

Cut The Red Meat… Enjoy Fish in time for the Lenten Season….

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, Tips To Protect Your Heart | 5 Comments »

Take a Nap…Its Good for your Memory!!!

April 2, 2009

It is now known that being sleep deprived means…risking yourself to suffer from chronic illnesses including diabetes and heart disease.  Now comes an interesting observation published in Sleep Journal that links sleep to memory….

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Study Objectives:

In this study we examined the benefit of a daytime nap containing only NREM sleep on the performance of three declarative memory tasks: unrelated paired associates, maze learning, and the Rey-Osterrieth complex figure. Additionally, we explored the impact of factors related to task acquisition on sleep-related memory processing. To this end, we examined whether testing of paired associates during training leads to sleep-related enhancement of memory compared to simply learning the word pairs without test. We also examined whether strength of task acquisition modulates sleep-related processing for each of the three tasks.

Subjects and Procedure:

Subjects (11 male, 22 female) arrived at 11:30, were trained on each of the declarative memory tasks at 12:15, and at 13:00 either took a nap or remained awake in the sleep lab. After the nap period, all subjects remained in the lab until retest at 16:00.

Results:

Compared to subjects who stayed awake during the training retest interval, subjects who took a NREM nap demonstrated enhanced performance for word pairs that were tested during training, but not for untested word pairs. For each of the three declarative memory tasks, we observed a sleep-dependent performance benefit only for subjects that most strongly acquired the tasks during the training session.

Conclusions:

NREM sleep obtained during a daytime nap benefits declarative memory performance, with these benefits being intimately tied to how well subjects acquire the tasks and the way in which the information is acquired.

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In short…. 

For a sharper memory… taking a nap can definitely help!

“Not only do we need to remember to sleep, but most certainly we sleep to remember,” . The main message of the investigator and researcher Dr. William Fishbein, a cognitive neuroscientist at the recent meeting of the Society for Neuroscience.

So my friends… take a rest in between work…enjoy life… take it easy…

AND remember to take care of your brain because just like anything else in life…it needs to rest to function better!

Posted in General Health Tips, Lifestyle Measures, Medical News Bits | 4 Comments »

Can I Eat Eggs Everyday? Yes You Can!!!!

March 28, 2009

New studies have been made to refute the previous claims that eggs can increase ones cholesterol. 

A recent article published in the International Journal of Obesity showed that the previous notion of limiting eggs because they can increase cholesterol is no longer an acceptable fear.  In fact eggs can help one lose weight!

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Objective:

 To test the hypotheses that an egg breakfast, in contrast to a bagel breakfast matched for energy density and total energy, would enhance weight loss in overweight and obese participants while on a reduced-calorie weight loss diet.

Design:

Otherwise healthy overweight or obese participants were assigned to Egg (E), Egg Diet (ED), Bagel (B) or Bagel Diet (BD) groups, based on the prescription of either an egg breakfast containing two eggs (340 kcal) or a breakfast containing bagels matched for energy density and total energy, for at least 5 days per week, respectively. The ED and BD groups were suggested a 1000 kcal energy-deficit low-fat diet, whereas the B and E groups were asked not to change their energy intake.

Results:

After 8 weeks, in comparison to the BD group,

  • the ED group showed a 61% greater reduction in BMI,
  • a 65% greater weight loss ,
  • a 34% greater reduction in waist circumference (P<0.06) and
  • a 16% greater reduction in percent body fat (P=not significant).
  • No significant differences between the E and B groups on the aforementioned variables were obtained.
  • Further, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, did not differ between the groups.

Conclusions:

  The egg breakfast enhances weight loss, when combined with an energy-deficit diet, but does not induce weight loss in a free-living condition. The inclusion of eggs in a weight management program may offer a nutritious supplement to enhance weight loss.
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It is however to be emphasized that in this study, the egg diet was part of a calorie restircted diet suggesting that eating eggs as part of a low calorie diet can help one lose weight.  
  • But the added bonus of the study is the fact that eggs did not have any effect on the blood cholesterol level suggesting that it is really the intake of Saturated fat in the diet found in pastries, cakes and cookies that is harmful to the body!
  • The results of the study  were further confirmed in a similar finding from the University of Surrey research group which showed a similar no effect on cholesterol level with intake of 2 eggs per day for 6 to 8 weeks.
Hopefully…these two studies can now end the debate as to whether eggs are safe to eat or not.  Enjoy!!!!!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Truths on Obesity | 213 Comments »

How Safe Are Artificial Sweeteners….

March 25, 2009

One topic that has never died down during these years is the safety of artifical sweteeners.  The problem stems from internet messages and information being propagated by unknown sources regarding the dangers of these products.  As an endocrinologist, I have been recommending these sweeteners to my patients as they actually help stave off the craving for sugar without necessarily increasing the sugar load.

But how much is enough for these sweeteners?

Recently the Mayo Clinic organization published views on this controversy and recommendations.

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The Food and Drug Administration (FDA) has approved the following low-calorie sweeteners for use in a variety of foods. The FDA has established an “acceptable daily intake” (ADI) for each sweetener. This is the maximum amount considered safe to eat each day during your lifetime. ADIs are intended to be about 100 times less than the smallest amount that might cause health concerns.

Artificial sweetener ADI* Estimated ADI equivalent** OK for cooking?
Aspartame (NutraSweet, Equal) 50 milligrams (mg) per kilogram (kg) 18 to 19 cans of diet cola No
Saccharin (Sweet’N Low, SugarTwin) 5 mg per kg 9 to 12 packets of sweetener Yes
Acesulfame K (Sunett, Sweet One) 15 mg per kg 30 to 32 cans of diet lemon-lime soda*** Yes
Sucralose (Splenda) 5 mg per kg 6 cans of diet cola*** Yes

*FDA-established acceptable daily intake (ADI) limit per kilogram (2.2 pounds) of body weight.
**Product-consumption equivalent for a person weighing 150 pounds (68 kilograms).
***These products usually contain more than one type of sweetener.

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How about the safety of these products?

Although this is one product has been bombarded with bad publicity probably because of its popularity being present in almost any low calorie foods to diet sodas… the National Cancer Institute and other major health oragnizations including the American Diabetes Association and the US FDA continue to refute these claims… as so far,  there’s no scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer and that there are now numerous studies to confirm that artificial sweeteners are safe for the general population.

I for one contnue to use aspartame or splenda for my coffee eevry morning or in the afternoon. I am a user and a believer in these low calorie sweeteners that as long as used properly and not in excess of what is recommended…then it is safe!

Enjoy The Sweetness of Health!

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

The Nutritional Benefits of Pulses

March 22, 2009

Just gave a lecture to a group of food technologist, media personnel and nutritionist on the Nutritional Benefits of Pulses upon the invitation of the United States Department of Agriculture at the USDA Culinary Theater. Fortunately the Philippines now has access to the USDA products of pulses which have been neglected sources of healthy nutrients especially fiber.

I have been a proponent of healthy foods in my website. I am an advocate of healthy lifestyle for a healthy mind. And I am not hesitant to help promote products that are healthy and nutritious.

Pulses are actually edible seeds of legumes. Legumes include the peas, chickenpeas, beans and lentils. The good thing about them is that they are rich in fiber and have low glycemic index. As such, they therefore can be great partners to what we know as healthy diet.

A cup of cooked peas for example can be packed with fiber and yet very low in glycemic index meaning, the capacity to increase the blood sugar upon ingestion is very low. The combination of these properties provide one an ideal food that can be both filling and nutritious. As a result therefore, one gets to enjoy a food that can less likely contribute to weight gain which we know can lead to more serious chronic illnesses like diabetes, high blood pressure and stroke.

Several studies have now shown that obesity can lead to serious problems, and pulse based diet has been shown to help curb obesity in certain populations. Anything that can help us decrease the prevalence of obesity in this country and the world is really a welcome addition to our need to find more ways to combat this epidemic. Likewise, intake of pulses in certain regions of the world have been shown in epidemiological studies to result in long life span like the Japanese or the Swiss and reduce the risk of colon Cancer due to their pre-biotic properties. However long term studies need to be done to confirm this finding.

We don’t go to groceries and easily grab peas or beans in the aisle. We still need to be educated more about these foods and the USDA has led the way in this regard and I am pleased to be part of it. I myself am a fan of peas and beans.

I have started to educate my kids about the nutritious benefits of eating veggies and slowly and slowly, they’re learning to enjoy the greens more each day. So the next time you go grocery shopping… take a second look at Pulses. They are HEALTHY AND NUTRITIOUS!!!

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

Can Vitamin C Help Prevent GOUT?

March 19, 2009

Go to fullsize imageGood news for patients at risk of developing gout because a very common remedy and very affordable at that has been shown to help prevent gout.

A new study published in the latest edition of Archives of Internal Medicine showed a relationship linking higher intake of Vitamin C to lower risk of developing gout:

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Background  Several metabolic studies and a recent double-blind, placebo-controlled, randomized trial have shown that higher vitamin C intake significantly reduces serum uric acid levels. Yet the relation with risk of gout is unknown.

Methods  We prospectively examined, from1986 through 2006, the relation between vitamin C intake and risk of incident gout in 46 994 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout. Vitamin C intake was assessed every 4 years through validated questionnaires.

Results  During the 20 years of follow-up, we documented 1317 confirmed incident cases of gout. Compared with men with vitamin C intake less than 250 mg/d, the multivariate relative risk (RR) of gout was 0.83  for total vitamin C intake of 500 to 999 mg/d, 0.66  for 1000 to 1499 mg/d, and 0.55 (0.38-0.80) for 1500 mg/d or greater. The multivariate RR per 500-mg increase in total daily vitamin C intake was 0.83 . Compared with men who did not use supplemental vitamin C, the multivariate RR of gout was 0.66  for supplemental vitamin C intake of 1000 to 1499 mg/d and 0.55 (0.36-0.86) for 1500 mg/d or greater.

Conclusions  Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout.

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 What the study patients took were supplements of 1,500 mg daily.  What is interesting to note is that for every increase in Vitamin C intake of 500 mg per day, the risk of developing gout was decreased by 17%.

Likewise, those who took the 1500 mg supplemental form of Vitamin C had a 45% lower risk of developing gout than those who took lower doses of Vitamin C.  On the other hand those that took 1000 mg ov Vitamin had a 34% lower risk of developing gout!

It is known that Vitamin C can decrease the levels of uric acid oin the blood by increasing its excretion in the urine.

Does this mean,. we now go ahead and grab more Vitamin Cs in the market? I guess we need to wait for more studies to confirm this finding. 

But to those who continue to believe in Vitamin C and its role in preventing colds, this is one good news!

For me… getting the Vitmain Cs from fruits would be a better option.  Remember one orange can give you 70 mg of Vitamin C already.  Plus the ther benefits of fruit intake!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits | 4 Comments »

Reduce Your Risk for Diabetes Through Weight Loss: The Impact of Weight Loss Surgery

March 9, 2009

Go to fullsize imageWeight gain and Obesity play very important roles in the development of chronic diseases like Diabetes, High blood pressure and complications like Stroke and Heart Attack.  One therefore has to incorporate proper lifestyle and good behavior through daily physical acitvity to help avoid developing these conditions.  However there are certain inidividuas where weight loss through these behvioral methods no longer are enough to provide the weight loss one desires and therefore for ” medical” reasons, one resorts to drastic measures like Bariatric surgery.

But do they work in decreasing the risk? or do they help patients improve disease outcomes?

Now comes s study published in the American Journal of Medicine, March 2009  to show that weight loss indeed can work wonders to diabetes and that bariatric surgery can help:

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  • 621 studies from 1990 to April of 2006 were analyzed:  78.1% of diabetic patients had complete resolution and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery.
  •  Gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3% and BPD/DS 95.1%.
  •  After more than 2 year post-operative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%.
  • The Percent excess weight loss was 46.2%, 55.5%, 59.7% and 63.6%, for the type of surgery performed suggesting that BPD yielded the best result.

Concluding that:

  • 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and
  • 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group).

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The study for me tells us one thing: that weight loss indeed can work wonders.  However lets not all resort to surgery to achieve improvement in our risk for diseases as surgery also entails risks! 

While proper diet and physical activity are completely free and easy to do…all they need are the Two D’s to succeed: DETERMINATION and DISCIPLINE!

Posted in General Health Tips, Medical News Bits, The Diabetes Facts, The Truths on Obesity, What's New in Diabetes | 3 Comments »

Chewing Nuts and Weight Loss

March 3, 2009

I recommend munching on nuts like almonds or cashew for snacks among my patients becuase of their monounsaturated fat content.  The problem however with nuts is the tendency to overeat and the difficulty of stopping.

We are told that chewing ones food more often than swallowing right away after chewing 2x can have a dramatic effect on satiety and weight. More often than not, we chew our food only few times then swallow then grab some more food until we feel so bloated.  Thus it is often my principle to chew food properly and do it more times to allow my brain to inform my body that I am full!

Here’s one study that I found interesting published recently in the Journal of Clinical Nutrition.  This study looked at the number of times one chew the nuts and measure their level of satiety.

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Background: Epidemiologic and clinical data indicate that nuts can be incorporated into the diet without compromising body weight. This has been attributed to strong satiety properties, increased resting energy expenditure, and limited lipid bioaccessibility.

Objective: The role of mastication was explored because of evidence that the availability of nut lipids is largely dependent on the mechanical fracture of their cell walls.

Design: In a randomized, 3-arm, crossover study, 13 healthy adults (body mass index, in kg/m2: 23.1 ± 0.4) chewed 55 g almonds 10, 25, or 40 times. Blood was collected and appetite was monitored during the following 3 h. Over the next 4 d, all foods were provided, including 55 g almonds, which were consumed under the same chewing conditions. Complete fecal samples were collected.

Results: Hunger was acutely suppressed below baseline (P < 0.05), and fullness was elevated above baseline longer (P < 0.05) after 40 chews than after 25 chews. Two hours after consumption, fullness levels were significantly lower and hunger levels were significantly higher after 25 chews than after 10 and 40 chews (P < 0.05). Initial postingestive glucagon-like peptide-1 concentrations were significantly lower after 25 chews than after 40 chews (P < 0.05), and insulin concentrations declined more rapidly after 25 and 40 chews than after 10 chews (both P < 0.05). Fecal fat excretion was significantly higher after 10 chews than after 25 and 40 chews (both P < 0.05). All participants had higher fecal energy losses after 10 and 25 chews than after 40 chews (P < 0.005).

Conclusion: The results indicate important differences in appetitive and physiologic responses to masticating nuts and likely other foods and nutrients. 

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For me the significance of this study boils down to one: Chewing ones food more often is healthier for the body in terms of early satiety and therefore better for weight control.  This study really justifies the concept of chewing food slowly around 20 times or more before swallowing to allow your body to register that food has entered and that you’re full.  By practicing this behavior, one also is able to control the appetite and therfore results in better regulation of weight! 

So if you love nuts…chew them properly…chew them more than 40 x if you want… they’re not only healthy snack alternatives but better for weight loss too.

Posted in General Health Tips | 8 Comments »

Take Action on Your Weight!!! The Risks Associated with Being Overweight…

February 28, 2009

Go to fullsize imageBeing overweight needs immediate action!  Thats why when I registered a BMI of 25.6 with a fasting blood sugar of 96, I decided to take action and become healthier with my diet and physical activity.  Being overweight carries with it chronic diseases like diabetes, high blood pressure and cholesterol problem.  Not mentioning stroke and heart attack as endpoints!

For year 2009: Its NOW a Global Call to action as more and more children and adolescence are gaining weight.  There’s no time to sit back and relax on this matter as inaction means DISASTER in the long run for these children!

A recent study published in www.bmj.com showed that obese adolescents have the same risk of premature death in adulthood as people who smoke more than 10 cigarettes a day!!!!   This is indeed a scary thought.

Those who are overweight have the same risk as less heavy smokers.

BMI is a measure of your weight according to your height.  For Caucasians, a BMI of >25 if already overweight but for Asians, a lower BMI of 23 is considered abnormal already.

What if one is underweight?

Being underweight carries with it a better prognosis  as it carries with it no increased risk, irrespective of smoking status.  However, if you are also too thin with a a body mass index of less than 17; then it carried with it the same risk of premature death as being overweight.

The study suggests therefore that being OBESE and Overweight at the age of  18 carries the same risk of premature death as being too thin!  Both conditions stem from poor nutrition either too much or too little.

Its not late to start and do something for yourself or for our kids…. NOW!

Life is short..Take time to Take Care of your HEALTH!

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

High Blood Sugar Predicts Death in Heart Attack Patients

February 26, 2009

Just a note for all of the readers with family members who are diabetics.  This is just to make you aware that control of sugar is of paramount importance even at the time of hospitalization especially due to heart attack.

This new study published in Archives of Internal Medicine, Feb 2009 shows that the relationship between fasting blood sugar on admission and its ability to predict outcome of death within 6 months of the acute attack.

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Background  Elevated blood glucose level at admission is associated with worse outcome after a myocardial infarction. The impact of elevated glucose level, particularly fasting glucose, is less certain in non–ST-segment elevation acute coronary syndromes. We studied the relationship between elevated fasting blood glucose levels and outcome across the spectrum of ST-segment elevation and non–ST-segment elevation acute coronary syndromes in a large multicenter population broadly representative of clinical practice.

Methods  Fasting glucose levels were available for 13 526 patients in the Global Registry of Acute Coronary Events. A multivariate logistic regression analysis was used for assessing the association between admission or fasting glucose level and in-hospital or 6-month outcome, adjusted for the variables from the registry risk scores.

Results 

  • Higher fasting glucose levels were associated with a graded increase in the risk of in-hospital death (odds ratios [95% confidence intervals] vs <100 mg/dL: 1.51 [1.12-2.04] for 100-125 mg/dL, 2.20 [1.64-2.60] for 126-199 mg/dL, 5.11 [3.52-7.43] for 200-299 mg/dL, and 8.00 [4.76-13.5] for 300 mg/dL).
  • When taken as a continuous variable, higher fasting glucose level was related to a higher probability of in-hospital death, without detectable threshold and irrespective of whether patients had a history of diabetes mellitus.
  • Higher fasting glucose levels were found to be associated with a higher risk of postdischarge death up to 6 months.
  • The risk of postdischarge death at 6 months was significantly higher with fasting glucose levels between 126 and 199 mg/dL (1.71 [1.25-2.34]) and 300 mg/dL or greater (2.93 [1.33-6.43]), but not within the 200- to 299-mg/dL range (1.08 [0.60-1.95]).

Conclusions  Short-term and 6-month mortality was increased significantly with higher fasting glucose levels in patients across the spectrum of acute coronary syndromes, thus extending this relation to patients with non–ST-segment elevation myocardial infarction. The relation between fasting glucose level and risk of adverse short-term outcomes is graded across different glucose levels with no detectable threshold for diabetic or nondiabetic patients.

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Better still…. across the spectrum of diabetes management that good control should always be practiced.  

No ifs or buts…its the RULE!

Reduction in short term complications, the sense of well being…plus reduction of long term complications like stroke and heart attack…are more than enough for any diabetic in the family to make sure that good control should always be practiced.  

Ths study tells us that up to the time of the acute event, high sugar continues to present itself as a menace.  And that high sugar should not be relegated as a mere stress effect but for me should be aggressively treateed as metabolic effects can have lasting impact on ones health and are irreversible!

Be aggressive as high sugar may not manifest any symptoms until its late!

Posted in Medical News Bits, The Diabetes Facts, Tips To Protect Your Heart, What's New in Diabetes | 9 Comments »

Can Daily Intake of Eggs Be Healthy?

February 23, 2009

Go to fullsize imageControversies continue to surround whether eggs can cause harm if taken daily or not. Debate among the experts continue with assumptions that cholesterol in the diet actually has little effect on blood cholesterol.  No doubt that intake of saturated fat can increase the level of blood cholesterol and risk a patient to develop heart attack and stroke.  The relationship of Egg intake to disease continues to be debatable.

Now comes a new study publsished in the Diabetes Care , this February 2009  that for sure will add fuel to the ongoing controversy:

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OBJECTIVE—Whereas limited and inconsistent findings have been reported on the relation between dietary cholesterol or egg consumption and fasting glucose, no previous study has examined the association between egg consumption and type 2 diabetes. This project sought to examine the relation between egg intake and the risk of type 2 diabetes in two large prospective cohorts.

RESEARCH DESIGN AND METHODS—In this prospective study, we used data from two completed randomized trials: 20,703 men from the Physicians’ Health Study I (1982–2007) and 36,295 women from the Women’s Health Study (1992–2007). Egg consumption was ascertained using questionnaires, and we used the Cox proportional hazard model to estimate relative risks of type 2 diabetes.

RESULTS—During mean follow-up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes. Compared with no egg consumption, multivariable adjusted hazard ratios for type 2 diabetes were 1.09 (95% CI 0.87–1.37), 1.09 (0.88–1.34), 1.18 (0.95–1.45), 1.46 (1.14–1.86), and 1.58 (1.25–2.01) for consumption of <1, 1, 2–4, 5–6, and 7 eggs/week, respectively, in men (P for trend <0.0001). Corresponding multivariable hazard ratios for women were 1.06 (0.92–1.22), 0.97 (0.83–1.12), 1.19 (1.03–1.38), 1.18 (0.88–1.58), and 1.77 (1.28–2.43), respectively (P for trend <0.0001).

CONCLUSIONS—These data suggest that high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women. Confirmation of these findings in other populations is warranted.

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The question arises: whether it is the intake of egg that increased the risk to develop diabetes.  Or is it the relationship of the high fat diet associated with the egg intake that increased the risk.  It is known that high cholesterol and saturated fat intake can increase a patients risk to develop diabetes.

So when the study participants’ daily cholesterol intake was assessed, it showed a relationship related to diabetes risk!!!  When the researchers factored this relationship in, the association between egg intake and diabetes weakened suggesting that a cholesterol-rich diet might promote diabetes.  This also suggest that a person who may like eggs may also eat other fatty foods that will result in increasing the risk to deveolp the disease.

So a not so good news for egg lovers who have family history of diabetes.  This is one food that one may have to limit for now until more studies will show the relationship to be otherwise.

But for the others who have no risk of developing diabetes…I suggest that eggs should remain to be enjoyed as long as one should not exceed 3-5 eggs per week.  This recommnedation will stay for now. 

But do … Watch out in this site if new developments come in about eggs because for sure I will be the first to know and you will be the first to be informed !!!!

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

Is There Any Benefit in Taking A Multivitamin?

February 12, 2009

Go to fullsize imageI used to take one multivitamin pill per day.  I know of others who take tons of vitamins because they make them feel “better”. Or just a habit difficult to change. Or better still, relatives in the US send us with big bottles of these Vitamins as presents.  But are they USEFUL? 

Ever since, I already doubted the usefullness of these vitamins UNLESS one is not eating properly or is very choosy with food that predisposes one to deficiency of certain vitamins that we usually get from food.  But for people that have problems of the Opposite, that is… controlling the intake, I suggest you might as well spend your money on something else that’s healthy and has important benefit on ones health.

The latest issue of the Archives onf Internal Medicine published this recent study looking at the effectiveness of taking multivitamins.

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Background  Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease (CVD). Therefore, we decided to examine associations between multivitamin use and risk of cancer, CVD, and mortality in postmenopausal women.

Methods  The study included 161 808 participants from the Women’s Health Initiative clinical trials (N = 68 132 in 3 overlapping trials of hormone therapy, dietary modification, and calcium and vitamin D supplements) or an observational study (N = 93 676). Detailed data were collected on multivitamin use at baseline and follow-up time points. Study enrollment occurred between 1993 and 1998; the women were followed up for a median of 8.0 years in the clinical trials and 7.9 years in the observational study. Disease end points were collected through 2005.

We documented cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary, and lung; CVD (myocardial infarction, stroke, and venous thromboembolism); and total mortality.

Results  A total of 41.5% of the participants used multivitamins. After a median of 8.0 years of follow-up in the clinical trial cohort and 7.9 years in the observational study cohort, 9619 cases of breast, colorectal, endometrial, renal, bladder, stomach, lung, or ovarian cancer; 8751 CVD events; and 9865 deaths were reported. Multivariate-adjusted analyses revealed no association of multivitamin use with risk of cancer (hazard ratio [HR], 0.98, and 95% confidence interval [CI], 0.91-1.05 for breast cancer; HR, 0.99, and 95% CI, 0.88-1.11 for colorectal cancer; HR, 1.05, and 95% CI, 0.90-1.21 for endometrial cancer; HR, 1.0, and 95% CI, 0.88-1.13 for lung cancer; and HR, 1.07, and 95% CI, 0.88-1.29 for ovarian cancer); CVD (HR, 0.96, and 95% CI, 0.89-1.03 for myocardial infarction; HR, 0.99, and 95% CI, 0.91-1.07 for stroke; and HR, 1.05, and 95% CI, 0.85-1.29 for venous thromboembolism); or mortality (HR, 1.02, and 95% CI, 0.97-1.07).

Conclusion  After a median follow-up of 8.0 and 7.9 years in the clinical trial and observational study cohorts, respectively, the Women’s Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women.

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In short … wanna live long?  Live a healthy lifestyle.  There are other ways to better living not simple taking of pills as a shortcut or better still … lets take a walk and think again.

Pills or exercise?  I know your answers…keep it to yourselves.  You choose … it’s your life!

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

The New Way To Exercise and Get Results….

February 9, 2009

Go to fullsize imageGood news to those who just dont have the time to exercise.

A new study published online by the BMC, 2009 showed a new way to exercise that will have the same or better impact on our body’s metabolism than previously thought.

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Background

Classic, long duration aerobic exercise reduces cardiovascular and metabolic disease risk but this involves a substantial time commitment. Extremely low volume high-intensity interval training (HIT) has recently been shown to cause similar improvements to aerobic performance, but it has not been established whether HIT has the capacity to improve glycemic control.

Methods

Sixteen young men  performed 2 weeks of supervised HIT comprising of a total of 15 min of exercise (6 sessions; 4-6 x 30-s cycle sprints per session). Aerobic performance (250-kJ self-paced cycling time trial), and glucose, insulin and NEFA responses to a 75-g oral glucose load (oral glucose tolerance test; OGTT) were determined before and after training.

Results

Following 2 weeks of HIT, the area under the plasma glucose, insulin and NEFA concentration-time curves were all reduced (12%, 37%, 26% respectively, all P<0.001). Fasting plasma insulin and glucose concentrations remained unchanged, but there was a trend towards reduced fasting plasma NEFA concentrations post-training (pre: 350 +/- 36 v post: 290 +/- 39 mumol * l-1, P=0.058). Insulin sensitivity as measured by the Cederholm index was improved by 22.5% (P<0.01). Aerobic cycling performance was improved by ~6% (P<0.01).

Conclusions

The efficacy of a high intensity exercise protocol, involving only ~250 kcal work each week, to substantially improve insulin action in young sedentary subjects is remarkable. We feel this novel time-efficient training paradigm can be used as a strategy to reduce metabolic risk factors in young and middle aged sedentary populations who otherwise would not adhere to a classic high volume, time consuming exercise regimens

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In this study short burst of intense exercise activity lasting for like 30 seconds resulted in improvement of parameters that can have an impact in preventing chronic illnesses. 

The subjects used exercise bikes which we can easily buy in sports stores… performed a quick sprint insturcted to do it at their highest possible intensity for around 30 seconds.  The results showing significant improvements in exercise parameters biochemically suggest that any highly vigorous activity carried out in few minutes in a few days per week should achieve the same protective metabolic improvements. 

This is definitely good news to those who just cant find the right time and place to do their exercise workout.  This is one of the first studies to document that short bouts of exercise can be as effective in improving metabolic parameters as the usual recommendations of moderate exercise for 30 minutes most days of the week. 

Now my friends… no more excuses!!!

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

Are You Fit?

February 6, 2009

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 cardi who chaired the European Society of Cardiology program committee.

Check your heart rate… feel your pulse and count how many beats in one minute. 

What better way to help keep your heart fit is increasing physical activity.  Athletes for example can have a heart rate of less than 50/min.  Suggesting that their hearts dont need to work and pump more to give enough blood to the body… that’s what we call as FITNESS!

To be fit does not necessarily mean your slim and vice versa.  Fitness is a totally different ballgame in the field of health.  Fitness is a way of life… it requires the discipline to achieve it and the determination to make it part of daily living.  In the end… losing the FATNESS will follow.

Fitness Minus Fatness Equals Cardiovascular Health!

Posted in General Health Tips | Leave a Comment »

The Many Lessons I Learned in London

January 29, 2009

The experience I had travelling to London is a memorable one. I attended a postgraduate course in Endocrinology sponsored by the Royal College of Physicians and the trip was both culturally and educationally enriching.

After this trip, London is now among my top 5 must visits places in the world.  Not only is the place rich in culture ( watched Les Miserables in Queens Theatre in West End: marvelous experience), history (from Darwin to the Queen) and beautiful landmarks ( The Big Ben, The Palaces and the Eye) but also the warm hospitality that one can feel dealing with the British citizens.  One is warmly welcomed by the time one reaches the airport to the hotel staff to the cab drivers, waiters and store keepers.  You dont see homeless loitering around your path and was it safe to walk  around the Central London without fear of being mugged or robbed.

I was able to reunite with old  friends now staying in London and unfortunately some may have made it well but a lot of our OFWs are actually languishing in debt.  It makes one feel so vulnerable in a foreign land especially in times of economic crisis where London is the hardest hit among Europe’s developed countries.

The good news also is that our Filipino nurses occupy around 60% of the workforce in London’s major government hospital.  Interesting to note is that nurses are now handling endoscopy procedures as well as laparoscopic cholecystectomy procedures which is probably not going to happen in our country.  This is one thing unique in the British Health Care system.

Overall… this trip has been one welcome respite from the busy days in Cebu and what a great experience it has been.  I will definitely go back to London and this is one place that I will probably learn more things the more times I go back!

Posted in Lifestyle Measures, Memories and Trips | 4 Comments »

Saw Palmetto and Bleeding….

January 23, 2009

Go to fullsize imageI just came across a patient who is taking this herb without my knowledge.  He apparently was taking this supplement to treat his urinary urgency secondary to an enlarged prostate.  Thinking it as an approved herbal supplement and therefore safe, he thought of not telling anyone regarding this pill.  Not until he underwent dental extraction when he was referred because of bleeding.

I have always been against taking herbal supplements as a drug.  These meds may have “no apporved therapeutic claims”  BUT the advertisements that we see on TV and hear on radio claim otherwise and in fact a “cure for all” sort of ads.  Therefore we cant blame our laymen to be enticed to take them in hopes of feeling better, looking younger and curing their illness.

Mayo Clinic website  has this to say in the side effects of saw palmetto:

Few severe side effects of saw palmetto are noted in the published scientific literature. The most common complaints involve the stomach and intestines, and include stomach pain, nausea, vomiting, bad breath, constipation, and diarrhea. Stomach upset caused by saw palmetto may be reduced by taking it with food. Some reports suggest that there may be less abdominal discomfort with the preparation lipidosterolic extract of Serenoa repens (LSESR). A small number of reports describe ulcers or liver damage and yellowing of the skin (jaundice), but the role of saw palmetto is not clear in these cases. Similarly, reports of headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, and heart disease have been reported, but are not clearly caused by saw palmetto. People with health conditions involving the stomach, liver, heart, or lungs should use caution.

Caution is advised in people scheduled to undergo some surgeries or dental work, who have bleeding disorders, or who are taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

So BEWARE…again..Be Aware… that not all what you hear are TRUE.  Consult your doctors if you are taking any herbal supplements as they may interfere with the actions of the drugs we are giving to make you feel better!

A lesson to my patient? DEFINITELY!

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

Another Reason to Follow the Low Carb Diet… Your Blood Sugar!

January 19, 2009

Go to fullsize imageFinally a study that looked at the practice of using low carbohydarte diet for our diabetics in helping control their blood glucoses was recently published in Nutrition and Metabolism journal.  Everytime I give a lecture on Nutritional therapy the question of my practice in lowering the total carbohydrate content of the calorie intake is the central issue.  This study is one proof that the concept of limiting the carbs can do wonders to ones blood sugar!

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Objective

Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods: Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (<20 g of carbohydrate daily; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/day deficit from weight maintenance diet; LGID). Both groups received group meetings, nutritional supplementation, and an exercise recommendation. The main outcome was glycemic control, measured by hemoglobin A1c.

Results

Forty-nine (58.3%) participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p=0.03), body weight (-11.1 kg vs. -6.9 kg, p=0.008), and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p<0.001) compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2% of LCKD vs. 62% of LGID participants (p<0.01).

Conclusions

Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

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What is amazing of the results is that by following a low carb diet, diabetes medications were reduced or eliminated in 95 percent and likewise resulted in a greater weight loss.  We also know that by losing weight, patient becomes more insulin sensitive and therefore contributes further to improvements in metabolic profile. These are the two effects that we like whether we employ diet or medication to any patient we assessed to have a disease of the lifestyle. 

Is this nutritional therapy easy to do? 

Definitely not BUT its the determination to succeed and be treated without medication that can drive our patients to follow the regimen.  Just like any regimen involving FOOD… our vigilance to do what is healthy is more important than following our DESIRE to love food and EAT more!

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

A Quick Note on Exercise and Diabetes…

January 15, 2009

This past week has been extra busy for me and my staff in the clinical research unit because our site has been audited by the European Medicine Agency- the US counterpart of US FDA . My research site has been enrolling a significant number of patients and for that, this is to assure that the site is doing things according to international standards and making sure of patient safety.  This is I understand is the first of my sponsor, the first for my site and the first for Asia Pacific region.  But once we passed this inspection, I can then proudly say, we are EMEA “accreditied” 🙂

Just the same, no matter how busy one is, there should be no excuse why one cant exercise.  As Ive said in my previous post, I have lost weight and been trying to maintain my weight to prevent the onset of diabetes.  And the best way to prevent the onset of diabetes continues to be the PLAIN “E”. And I want to share this quick information regarding exercise and diabetes:

 DID YOU KNOW:
One hour of brisk walking a day cuts your Type II diabetes risk by 50% according to the Nurse’s Health Study. Many physicians recommend walking and exercise to help diabetics with weight and maintaining their blood sugar levels.

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips | 3 Comments »

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