Check The Music Your Kids Listen…and Be Warned!

April 7, 2008

Parents are sometime caught unaware that our kids Ipod is loaded with music that may not be healthy to their social and emotional well being.  We know classical music soothes our body and improves health and mood but other kinds of music like rap or rock have been shown to have disturbing impact.

An article recently published in Addiction Research and Theory, April 2008 issue showed how the rise in drug wars could be contributed by the kinds of music these kids are exposed to.

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This article explores the role of changing images of drug use in rap music from the 1970s to the 1990s. A sample of 341 rap music lyrics were coded for drug mentions, behaviours and contexts; drug attitudes and consequences; and music genres.
  • The results show that from 1979-1997, songs with references to drugs increased over 6-fold;
  • those exhibiting positive attitudes and consequences rose substantially
  • references to particular drug types changed significantly.
  • increased references to using drugs to signify glamour, wealth and sociability.

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There you go guys… be careful with what music our kids listen to.  If rap music before warns about the dangers of drug use, apparently recent rap music tend to glorify drug use… and this message may not be the kinds of inspiration our kids need.  The increase in drug reference was pretty alarming increasing form a mere 10% in the early 70’s to >60% in early 90’s!!!!

Check the music videos your kids watch and the contents of their iPods… It is better to intervene early than be sorry for the effects of these music on our kids in their social skills and adult behavior!

To Intervene Or Not To Intervene….

 

 

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

Acupuncture and Diabetes

April 5, 2008

Go to fullsize imageAlternative therapies continue to be in the mainstream of Diabetes Armamentarium.  You see patients bringing bottles of herb supplements apparently marketed as a treatment for Diabetes and related illnesses like high blood pressure and high cholesterol.  But one form of treatment that has gained wide acceptance both in the East where it originated and in the West where it is now widely practiced is Acupuncture.  And almost always in my practice do I come across a patient asking me about acupuncture and diabetes.

 

It is said that the effect of acupuncture is its ability to improve blood flow.  By balancing the energy levels, one’s circulation can be improved and therefore has the potential to prevent debilitating complications of diabetes related to poor circulation like foot amputation and the crippling nerve damage or diabetic neuropathy.  Anecdotal reports and few small scale studies have proven acupuncture to help ease pain and prevent diabetic foot ulcers but only if applied early in the disease process.   The problem is the absence of acceptable and properly done wide scale studies where proven results are duplicated. A research funding by the National Institutes of Health in the United States is being done in quest for an answer…

 

As medical practitioners, it is best to advise to patients that no studies at present can prove acupuncture to work beyond placebo effect. It is being tolerated by the US FDA considering its relative safety.  But it is always prudent for patients not to discontinue their medications or the proven therapies we provide them and to use acupuncture only conjunction with their medications.  Likewise it is best that patients should inform their physicians about their desire to have an acupuncture done and likewise should not accept any diagnosis of a disease from those performing the acupuncture..

 

Acupuncture…It’s a wait and see for now but so far results seem promising….

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

Your Weight and Your Risk To Develop Breast Cancer….

March 26, 2008

Go to fullsize imageObesity is one big epidemic that is becoming a huge economic burden due to the medical complications arising form the disease. 

In the recent issue of the the journal Clinical Cancer Research, the relationship between increased weight and the risk of developing breast cancer has been shown to be closely linked:

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Purpose: The purpose of this retrospective study was to determine the association and prognostic value of body mass index (BMI) at the time of initial diagnosis in patients with locally advanced breast cancer (LABC). 

Results: 

  • Obese patients tended to have a higher incidence of IBC compared with overweight and normal/underweight groups (P = 0.01). Median follow up was 6 years for all patients.
  • Patients with Locally Advanced Breast Cancer who were obese or overweight had a significantly worse Survival and Recurrence Free Survival (P = 0.001) and a higher incidence of visceral recurrence compared with normal/underweight patients.
  • In a multivariable model, BMI remained significantly associated with both Overall Survival and Recurrence Free Survival for the entire cohort. 

Conclusion: Patients with Locally Advanced Breast Cancer and high BMI have a worse prognosis.

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This study shows us that being obese is more than what we think it is… as mere cosmetics…rather it is a risk factor in itself that can result in a more aggressive type of a disease like breast cancer and can even lead to long term disability like stroke and early death as shown in several studies.

The excess adipose tissue or fat cell results in more circulating estrogen and more inflammatory substances that may be responsible for a more aggressive breast cancer and lesser cancer survival.  We now know that any excess fat cell results in a bigger machinery that produces a lot of substances we never knew about before… that can be harmful to our body!  In short… these fat cells are pretty active and definitely not the passive bystanders that we used to think they are… and therefore need to be dealt with more aggressively!

Another good reason for us to take care and get rid of the FAT….

Be Health and Weight Conscious!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, The Truths on Obesity | 4 Comments »

Lower Your Risk To Develop Diabetes By Eating Veggies….

March 24, 2008

www.calpoly.edu/~lcimarel/vegetables.jpgWe all know veggies are good.  But this recent finding that veggies can prevent diabetes is a welcome news to us trying to curb the epidemic of this disease due to unhealthly lifestyle and poor dietary habits.

I have trained my kids to eat veggies.  I found it amusing that one day my son said to me:  “Dad my classmates are teasing me that I am a Vegetarian!”  Suggesting that of all his classmates, he was the only one who had veggies on his lunch box.  Lucky me… my kids love veggies….and for a good reason!

This good news about veggies and diabetes was published in the March 2008 issue of the Journal of Nutrition:

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A population-based prospective study of 64,191 women with no history of T2D or other chronic diseases at study recruitment and with valid dietary information.

The relative risk for T2D for the upper quintile relative to the lower quintile of vegetable intake was 0.72 (95%CI: 0.61–0.85; P < 0.01) in multivariate analysis. Individual vegetable groups were all inversely and significantly associated with the risk of T2D.

Fruit intake was not associated with the incidence of diabetes in this population.

Our data suggest that vegetable consumption may protect against the development of T2D.

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This data is great suggesting that those who consumed the highest amount of vegiies in 4-5 years reduced the likelihood of developing diabetes by 28%.  That is… taking 428 grams of veggies per day reduced ones chances to develop this chronic disabling disease compared to if you only take 121 grams of veggies per day!

The advantages of veggies is that it contains high fiber as well as other substances like phytates and isoflavones that may help in reducing the risk for developing diabetes.

Although fruits did not show benefit…it likewise did not show harm.  Just the same fruits have been shown to reduce the risk of developing other diseases like cancer or heart disease.  Such that… its intake remains to be a cornerstone in promoting health!

Train Yourself and Your Kids To Eat Veggies for Health!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts, What's New in Diabetes | 1 Comment »

The Use of Aspirin and The Risk of Death and Cancer…

March 19, 2008

Diabetics are at risk for cardiovascular disease.  As such, an anticlotting agent like aspirin is always part of the drug regimen that we prescribe to our patients.  Studies have proven the use of aspirin to be beneficial in preventing heart disease and prolongoing survival to those at risk of cardiovascular disease in both men and women.

Now comes a new study that looked at the effect of taking aspirin on women without cardiovascular disease and to see if benefits are still present in terms of preventing heart disease or cancer.  This study involved 79,439 women who were enrolled in the Nurses’ Health Study since 1980 published in the Archives of Internal Medicine.

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  • In women who reported current aspirin use, there was a 25% reduction in death from all causes compared with women who never used aspirin regularly.
  • The risk reduction was more apparent for death from cardiovascular disease at 38%.
  • The risk reduction for death from cancer was only 12%.
  •  Use of aspirin for 1 to 5 years was associated with significant reductions in cardiovascular mortality 
  • In contrast, a significant reduction in risk of cancer deaths was not observed until after 10 years of aspirin use.
  • The benefit associated with aspirin was confined to low and moderate doses and was significantly greater in older participants and those with more cardiac risk factors.

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The above study points out that women who take low to moderate doses of aspirin meaning less than 6 tablets per week have lower risk for death from all causes as well as a lower risk for death from cardiovascular disease within 5 years of taking the drug.  However the lower risk for death from cancer was only noted after a longer exposure of 10 years. 

This study continues to propagate the magic of aspirin as a “health” drug.  It helps by preventing a complication that can result in long lasting disability like heart disease and softens the long term economic burden to an already “burdened” risk patient due to polypharmacy arising from diabetes or hypertension.

More studies of similar or better study design should give us more bullets to use to support the long term use of aspirin especially to women or men without risk of cardiovascular disease.

An Aspirin A Day Keeps Your Heart Beat Everyday!

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

Nutrition in Health and Disease….

March 17, 2008

This is called the Paradox of Food:  you need food to live and survive but the very reason for disease and illnesses stem from the abundance of food and poor nutrition!

I practice a field dealing with the metabolic diseases where poor nutrition plays a key role in its onset and progression to develop complications.  Control of blood glucose requires the right balance of nutrition, exercise and medications. The same formula apllies when treating obesity, hypertension and high cholesterol.

The problem with handling these diseases stem from the medical field lack of understanding of nutrition and the lack of importance given to medical nutrition therapy!   If you make rounds in the hospital … you see the diet prepared for a diabetic hypertensive is almost similar if not similar to the other patient in the other room who is not a  diabetic…  It may not be the dietician’s fault but the doctor prescribing the diet!  This is where I am very particular with my patients because I believe the long term success of successfully controlling their blood sugar or blood pressure or cholesterol stem from not what I give them as medications but what they take in as food!

The recent 2008 ADA recommendation for Nutrition  reasons out why Nutrition is important:

Clinical trials/outcome studies of Medical Nutrition Therapy have reported decreases in HbA1c (A1C) of 1% in type 1 diabetes and 1–2% in type 2 diabetes, depending on the duration of diabetes . Meta-analysis of studies in nondiabetic, free-living subjects and expert committees report that MNT reduces LDL cholesterol by 15–25 mg/dl . After initiation of MNT, improvements were apparent in 3–6 months. Meta-analysis and expert committees also support a role for lifestyle modification in treating hypertension .

The proportion of calories in the specific nutrition Rx will now be individualized and should be prescribed by your doctor.  I have my own personal dietician in my clinic now that I offer free couseling to my patients where personal preferences of food is taken into consideration.  I believe in individualized counseling so as to offer a  more successful diet regimen.  No prepared diets printed on a piece of paper!

I have been a proponent of using a 40% of total calories from carbohydrates for my diabetic patients as more and more data are coming out regarding the benefits of limited carbohydrate not only for losing weight but for better glycemic control.  It is but proper that for the first time the American Diabetes Association came up with their position paper recommending the same.

For me…it is plain and simple challenging one’s self discipline in not giving in to the “want” but following to the details of what is nutritious and healthy!!!

Live Life To The Fullest…By Eating Right!

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts, The Diabetes Facts, The Truths on Obesity, Tips on Hypertension, What's New in Diabetes | 4 Comments »

Wanna Lift Weights? Why Not?

March 15, 2008

When people talk about exercise… it is almost always synonymous to aerobic exercises like jogging, walking and dancing. Never does weight training come into the picture. Combining both should be better!

But why lift weights? Is it advantageous than just sweating it out by running?

A recent article from the Harvard HealthBeat beautifully illustrates the reasons  why:

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Muscle tissue, bone density, and strength all dwindle over the years. So, too, does muscle power. These changes open the door to accidents and injuries that can compromise your ability to lead an independent, active life. Strength training is the most effective way to slow and possibly reverse much of this decline.

Having smaller, weaker muscles doesn’t just change the way people look or move. Muscle loss affects the body in many ways. Strong muscles pluck oxygen and nutrients from the blood much more efficiently than weak ones. That means any activity requires less cardiac work and puts less strain on your heart.

Strong muscles are better at sopping up sugar in the blood and helping the body stay sensitive to insulin (which helps cells remove sugar from the blood). In these ways, strong muscles can help keep blood sugar levels in check, which in turn helps prevent or control type 2 diabetes and is good for the heart. Strong muscles also enhance weight control.

On the other hand, weak muscles hasten the loss of independence as everyday activities — such as walking, cleaning, shopping, and even dressing — become more difficult. They also make it harder to balance your body properly when moving or even standing still, or to catch yourself if you trip. The loss of power compounds this.

Perhaps it’s not so surprising that, by age 65, one in three people reports falls. Because bones also weaken over time, one out of every 20 of these falls ends in fracture, usually of the hip, wrist, or leg. The good news is that the risk of these problems can be reduced by an exercise and fitness routine that includes strength training.

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As we prevent complications from illnesses to happen…we also should have this obligation to live longer but healthier! And one sure thing to accomplish this goal is to exercise regularly and exercise the right way!

Incorporating weight training to your regimen not only strengthens muscles but likewise prevents obesity since the more muscle you have, the less fat you get and the more metabolically active the muscle mass is compared to fat! As a result you likewise help prevent the onset of chronic illnesses like diabetes and hypertension!

I do incorporate weights into my exercise regimen. I don’t go to the gym but after my sit-ups in the morning, I then do my routine abdominal twisting disc then do the weights using the arm band that you can buy in sports shops, or my barbell weights. You can likewise do the tiptoe setup by putting you two hands on the wall then tiptoe to raise yourself as high as you can then hold it for few seconds then repeat it 8 to 10 x daily!

Simple Rules and Simple Measures For a Healthier You!

Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Weight Loss Tips | 3 Comments »

The Pedometer: “Small But Terrific” Gadget for Losing Weight

March 12, 2008

Go to fullsize imageObesity continues to be a problem worldwide.  Measures to make people lose weight have made a lot of entrepreneurs out of doctors from selling miracle drugs to lose weight to marketing centers promising dramatic weight loss.  The bottom line however continues to be the need to incorporate lifestyle change to every measure that we implement in increasing chances to a successful weight loss.

The pedometer is one such gadget that is small and handy but a powerful tool to help patients lose weight.  A new meta-analysis published recently in the Annals of Family Medicine showed the effectiveness of this gadget in curbong obesity.

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RESULTS Nine studies met the study inclusion criteria. Cohort sample size ranged from 15 to 106, for a total of 307 participants, 73% of whom were women and 27% of whom were men. The duration of the intervention ranged from 4 weeks to 1 year, with a median duration of 16 weeks. The pooled estimate of mean weight change from baseline using a fixed-effects model and combining data from all 9 cohorts was –1.27 kg (95% confidence interval, –1.85 to –0.70 kg). Longer intervention duration was associated with greater weight change. On average, participants lost 0.05 kg per week during the interventions.

CONCLUSION Pedometer-based walking programs result in a modest amount of weight loss. Longer programs lead to more weight loss than shorter programs.

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What This Study Found as stated by the Editors of the AFM “In Brief”:

 Walking programs that use a pedometer as a motivational tool result in a moderate amount of weight loss in overweight or obese sedentary adults. The average participant in a pedometer-based walking program without dietary change can expect to lose about 1 pound every 10 weeks, or about 5 pounds per year. Longer programs are associated with greater weight loss.

Implications

  • The amount of weight loss from pedometer-based walking programs is small but significant from a clinical perspective.
  • Walking programs that use pedometers can have health benefits that are associated with both a modest weight loss and increased physical activity.

Small Steps Can Lead to Big Changes in Health!!!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, The Truths on Obesity, Weight Loss Tips | 8 Comments »

How To Increase Compliance To Lifestyle Change…

March 10, 2008

Nowadays, physicians just dont have the time to talk with their patients. Patients feel shortchanged when they have been waiting outside our clinics only to be seen for 5 minutes. 

The lesson I’ve learned from my training at the Mayo Clinic was the importance of patient – doctor relationship that should go beyond treating a disease.  But more so to provide comfort to an anxious patient not knowing what she or he has and the need to listen and care!  The words of advise from a doctor’s mouth is more than worth their time in seeing you and these patients see us because they trust us to help them lead a better healthy life.

Now comes a new study that confirms my practice in my clinic published in the Archives of Internal Medicine this 2/2008.

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Background  Our objective was to test the effect of physicians providing brief health lifestyle counseling to patients with type 2 diabetes mellitus during usual care visits.

Methods  We conducted a randomized controlled trial of a 12-month intervention at 2 large community health centers, enrolling 310 patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater. In the intervention group, self-management goals for nutrition and physical activity were set using a tailored computer program. Goals were then reviewed at each clinic visit by physicians. The control group received only printed health education materials. The main outcome measures included change in physical activity and body weight.

Results  In the intervention group, recommended levels of physical activity increased from 26% at baseline to 53% at 12 months (P < .001) compared with controls (30% to 37%; P = .27), and 32% of patients in the intervention group lost 6 or more pounds at 12 months compared with 18.9% of controls (odds ratio, 2.2; P = .006).

Conclusion  A brief intervention to increase the dialogue between patients and health care providers about behavioral goals can lead to increased physical activity and weight loss.

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This study confirms my belief and practice of spending more time with the patient in trying to help them understand how one can implement the standard of care in dealing with chronic diseases like obesity, high blood pressure, high cholesterol and diabetes.  If one understands the concept of why exercise and nutrition are important then the pressure is with the patient to comply otherwise he will suffer the consequences.

Compliance to medications and behavioral therapy is a must if one aims to reach the goal of preventing complications like stroke and heart attack!  I am always asked if I am successful with behavioral modification and in letting patient follow my dietary guidelines.  I guess I am because I spend time with them.

This has been my standing principle and guide in my practice and thus this website to help educate my patients and the public because I believe that….

“Understanding One’s Disease Is Key To Better Health”. 

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

Is Acupuncture Safe?

March 6, 2008

Before I left the Mayo Clinic after my fellowship, the center was already into research regarding the efficacy of this ancient chinese remedy called the Acupuncture.  It is one of the widely practiced alternative medicine in the US and therefore the National Institute of Health is also funding research into this area.  It is one alternative therapy that does not entail any intake of drugs and therefore I bend a little and allow the use of this form of therapy among my patients.

Here is an excerpt of what acupuncture is from the National Institutes of Health:

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Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine. In TCM, the body is seen as a delicate balance of two opposing and inseparable forces: yin and yang

Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. According to TCM, health is achieved by maintaining the body in a “balanced state”; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi (vital energy) along pathways known as meridians. Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Sources vary on the number of meridians, with numbers ranging from 14 to 20. One commonly cited source describes meridians as 14 main channels “connecting the body in a weblike interconnecting matrix” of at least 2,000 acupuncture points.

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The US FDA admits that this form of therpay is pretty safe with very few complications.  However it is advised that needles be sterile, nontoxic, and labeled for single use by qualified practitioners only.  Furthermore, the NIH site cautions that: “Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs.”

Whether the therapy really works for osteoarthritis to low back pain to diabetic foot ulcers remain to be seen.  The NIH is already funding research into these areas and their conclusions are worth waiting for!

For now… just like any alternative medicine…it is done at the patient’s will. It is not prescribed or advised but if asked then the doctor may tend to bend a little and allow this therapy to be done if other known modalities fail.

If Anything Else Fails..Try Acupuncture!

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

Want Your Kids To Lose Weight?

March 5, 2008

Go to fullsize imageA new study published in the Archives of Pediatric and Adolescent Medicine showed that cutting TV and Computer time can increase a child’s chances of controlling and losing weight. 

In a prepared statement from the authors…they theorized that:

  • “Television viewing is related to consumption of fast food and foods and beverages that are advertised on television,”
  • “Viewing cartoons with embedded food commercials can increase choice of the advertised item in preschoolers, and television commercials may prompt eating.”

The bottom line is: by restricitng TV time then the children can do other physical activites aside from benefiting from less exposure to food ads and therefore less chances for them to eat unhealthy junk.

My kids love cartoons and of course computer games.  But they’re off limits during school days.  Only when they finish their study period earlier that I allow them to play their PSP but restiricted to 30 minutes only.  The kid’s room has no cable so they cant watch cartoon network or other cable channels where junk food ads are in abundance.  They can however watch cartoon movies where I know nothing out of the box commercials promoting something I dont agree with will pop out in surprise!

I am a true follower of the above regulation in our house with regard to restricting TV and computer times and glad to say am pretty successful with my kids school and study habits PLUS improving their …

Health Through Better Nutrition and Discipline!

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

Can Multivitamins Prevent Cancer?

March 3, 2008

Do you take multivitamins daily?  Why? Out of habit? or because you believe they can prevent illneses especially cancer?

Well a new study refutes the claims that multivitamins can prevent cancer.  Recently published in the American Journal of Respiratory and Critical Care Medicine suggest that in fact the contrary maybe true and that is… it can be harmful!!!!__________________________________________________________

Rationale: Lung cancer is the leading cause of cancer-related mortality in the United States. Although supplements are used by half the population, limited information is available about their specific effect on lung cancer risk.

Objectives: To explore the association of supplemental multivitamins, vitamin C, vitamin E, and folate with incident lung cancer.

Methods: Prospective cohort of 77,721 men and women aged 50–76 years from Washington State in the VITAL (VITamins And Lifestyle) study. Cases were identified through the Seattle–Puget Sound SEER (Surveillance, Epidemiology, and End Results) cancer registry.

Measurements and Main Results:

  • Supplemental vitamin E was associated with a small increased risk of lung cancer (HR, 1.05 for every 100-mg/d increase in dose).
  • This risk of supplemental vitamin E was largely confined to current smokers (HR, 1.11 for every 100-mg/d increase) and was greatest for non–small cell lung cancer (HR, 1.07 for every 100-mg/d increase).

Conclusions: Supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk.

Patients should be counseled against using these supplements to prevent lung cancer.

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We have been disappointed with studies looking at whether multivitamins are beneficial or not.  Almost always they turn out to be negative and sometimes even do harm.  And yet we continue to take MVI as supplements to our diet for hope that they may replenish what have been lacking in our diets.  I even have patients who continue to show me their MVI preparations bought by their loved ones in the US whether they can take them or not.

What we know is that foods rich in vitmains have been proven to reduce the risk of cancer…BUT once these vitamins are packaged as pills…then the benefit is nowhere to be found!  And what is worst…in the above published study…Vitamin E was noted to increase the risk of lung Cancer especially among smokers!

The best option for us is not to rely on shortcuts to health packaged as pills…its in our lifestyle..the food we eat , the physical activities we do and the way we live our lives that matter most!

Health Shortcuts Packaged As Pills Are Of No Benefit!

Posted in General Health Tips, Medical News Bits, Nutrition Health Tips, Personal Thoughts | 4 Comments »

Low Carb Diet and Diabetes: A Better Partner?

February 29, 2008

Go to fullsize imageDieatry intervention remains the cornerstone of therapy for Diabetes.  It requires education and self discipline for it to work!  It may be frustrating for doctors but if only we find time to explain the benefits and allow this intervention to work…it is really worth the effort.  My center now not only caters to diabetes education but has already 2 dieticians on board to see the dietary needs of my patients with diabetes, high blood pressure and high cholesterol.

I have been a proponent of the 40% carb and 40% fat diet for my diabetic patients. The fat however should be mainly monounstaurated which will give us the source of the good fat with less than 7% to 10% of the Saturated fat or the Bad fat!  I always emphasize the low fat sources or the vegetable sources of protein! 

This February 2008 comes a new study from the Harvard Medical Group of the longstanding Nurses Health Study that came up with the finding that indeed a Low Carb Diet may be the way to go for Diabetic patients.

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Design:  prospectively examined the association between low-carbohydrate-diet score (based on percentage of energy as carbohydrate, fat, and protein) and risk of diabetes among 85 059 women in the Nurses’ Health Study.

Results: During 20 y of follow-up, we documented 4670 cases of type 2 diabetes. 

  •  A higher dietary glycemic load was strongly associated with an increased risk of diabetes in a comparison of extreme deciles (RR: 2.47; 95% CI: 1.75, 3.47; P for trend < 0.0001)).
  • A higher carbohydrate consumption was also associated with an increased risk of diabetes in a comparison of extreme deciles (RR: 1.26; 95% CI: 1.07, 1.49; P for trend = 0.003).

Conclusion: These data suggest that diets lower in carbohydrate and higher in fat and protein do not increase the risk of type 2 diabetes in women. In fact, diets rich in vegetable sources of fat and protein may modestly reduce the risk of diabetes.

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The term glycemic load refers to the capacity of a food to increase ones blood sugar upon ingestion.  As a result, I always emphasize to my patients to avoid some of the fruits with the highest glycemic index like pineapple, mangos, watermelon and banana and instead enjoy apple and pear.  The study proves that indeed the higher the glycemic load, the higher the risk to develop diabetes or for those with diabetes…the more difficult blood sugar control will be!

One more reason to go low Carb!  This recommendation looks similar to the Atkins Diet but with a better and healthier protein source with less saturated fat!

Finding a partner in life requires committment… similar to finding a partner in our quest for controlling blood sugar through proper lifestyle and the right diet AND should be made…. a way of life!

Indeed Low Carb Is The BETTER Partner for Health!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, The Diabetes Facts, What's New in Diabetes | 7 Comments »

Obesity Surgery for Diabetes: A Cure?

February 28, 2008

It is known that obesity links patients to chronic diseases like diabetes, high blood pressure and high cholesterol.  These conditions then increase one’s risk to suffer from stroke and heart attack.  Ideally therefore, if only we can make all patients lose weight, then the burden of these chronic conditions from developing can be dramatically reduced.  Unfortunately telling patients to be careful with what they eat and to be physically active can be a daunting task.

What about obesity surgery?  Is it an effective way to lose weight? 

Gastric Banding is indeed one shortcut way of losing weight.  Our center has been active in handling patients wanting to lose weight using this less invasive procedure BUT will it’s weight loss translate to better health?  IT DOES… concludes a recent study published in JAMA which is an Unblinded randomized controlled trial conducted from December 2002 through December 2006 at the University Obesity Research Center in Australia

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Of the 60 patients enrolled, 55 (92%) completed the 2-year follow-up.

  • Remission of type 2 diabetes was achieved by 22 (73%) in the surgical group and 4 (13%) in the conventional-therapy group.
  • Relative risk of remission for the surgical group was 5.5.
  • Surgical and conventional-therapy groups lost a mean (SD) of 20.7% (8.6%) and 1.7% (5.2%) of weight, respectively, at 2 years 
  • Remission of type 2 diabetes was related to weight loss and lower baseline HbA1c levels
  • There were no serious complications in either group.

Conclusions:

Participants randomized to surgical therapy were more likely to achieve remission of type 2 diabetes through greater weight loss. These results need to be confirmed in a larger, more diverse population and have long-term efficacy assessed.

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The procedure used in the study was the less invasive laparoscopic gastric band where a band is surgically placed on top of the stomach. An access port is then secured closer to the skin where a saline solution can be injected into to fill up the circular inflation membrane, making the band tighter.  As a result it constricts the stomach opening, and reduces the amount of space inside, giving the patient an earlier feeling of fullness, limiting food consumption.

Finally, this study confirms that indeed weight loss is the key to better control… either achieved by proper diet and physical activity or through surgery. 

Weight Loss For Cure and Health!

Posted in General Health Tips, Medical News Bits, The Truths on Obesity, Weight Loss Tips | 6 Comments »

The Obesity and Fatness Tax

February 27, 2008

Go to fullsize imageJust came from a convention in Agra India where I read in the papers that UK is starting to charge more in terms of insurance premium depending on the degree of obesity. 

Meaning the higher the BMI ( a measure of fatness) , the higher the premium!  It is the insurance way of probably getting back at the skyrocketing cost of Obesity in terms of medical costs.

Fatness therefore is now becoming a Liability! 

Whether this measure will translate into more people taking care of themeselves remain to be seen!  But it is one way to getting people to exercise and live a healthier lifestyle.  And in the long run benefit both the patient and of course the insurance compnay!

Insure Yourself To Better Health!

Posted in Medical News Bits, Personal Thoughts, The Truths on Obesity | 2 Comments »

Can Noise Increase Blood Pressure?

February 21, 2008

Go to fullsize imageA sudden noise or commotion can make your heart rate go up and can be felt as sudden chest beating or palpitation.  We all know that one reason for an increased BP is an increase in heart rate.

A new study published in the European Journal of Hypertension Februaury 12, 2008 looked at this relationship and examined the population living near the airport. The BP and heart rates were checked and evaluated during the noise caused by the airplanes and the results were interesting.

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Non-invasive ambulatory BP measurements at 15 min intervals were performed. Noise was measured during the night sleeping period and recorded digitally for the identification of the source of a noise event.

  • An increase in BP 6.2 mmHg for systolic and 7.4 mmHg for diastolic was observed over 15 min intervals in which an aircraft event occurred.
  • A non-significant increase in HR was also observed (by 5.4 b.p.m.).
  • When the actual maximum noise level of an event was assessed there were no systematic differences in the effects according to the noise source.

Conclusion: Effects of noise exposure on elevated subsequent BP measurements were clearly shown. The effect size of the noise level appears to be independent of the noise source.

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This study has clinical implications on the future risk of heart disease and stroke with elevated BP. It would be nice to know the future risk of these population compared to the general population in terms of heart disease in relation to their exposure to noice.

Environment plays an important role in how stress manifests in our body. Noise generated from any source will definitely have the same effect as the study population and in itself increases a patient’s risk for heart disease due to rises in BP.  What is important is that the study also found that any level of noise including traffic sounds and other bedtime noise like snoring can cause a BP to spike!

For me… relaxing in between stresses in life can make a difference.  Any noise generated while at work can be stressful in itself and taking time to relax and listen to music or the waves of the sea and enjoy can spell a huge Difference!

Take a Break From Noise…Why Not Enjoy a Spa?

Posted in General Health Tips, Lifestyle Measures, Medical News Bits, Personal Thoughts, Tips on Hypertension, Tips To Protect Your Heart | 3 Comments »

Can I Eat Dark Chocolate Everyday?

February 20, 2008

Go to fullsize imageIt’s in the headlines and magazines…that dark chocolate is healthy and in fact protective to the heart.  But does this mean, any dark chocolate can have that effect? And if so, can we then eat dark chocolate everyday?

The Harvard Heart Letter commented on this specific topic recently to dispell myths that all dark chocolates are the same.

The main ingredient that has a positive effect on the heart is the flavanol compound.  This is present in abundance in certain foods not only cacao but also fruits like apples, vegetables like beans and also present in onions.  These flavanoids in cacao give the chocolate a bitter taste and unfortunately this is almost always removed during the processing of chocolate to give it a yummy taste!  Chocolates that also contain alkali during the processing removes most of the flavanoids. 

Unfortunately one can’t tell the content of the flavanoids based on the color of the chocolate.  So here are some tips to get the best dark chocolate from Dr Thomas Lee, the Editor of the Harvard Heart Letter:

  • Look for the least-processed chocolate you can find.
  • Skip those that have been treated with alkali.
  • Keep in mind that you don’t need much.
  • Studies showing the benefits of cocoa have used an ounce — sometimes less — of flavanol-rich chocolate. The tough part of this dietary “therapy” is stopping with a small piece. But stop you should. An ounce of dark chocolate delivers about 150 calories. Eat that much every day without cutting back elsewhere and the girth you gain would far outweigh any benefit from chocolate.

In short… you may eat chocolate everyday but make sure it’s only a bite size.  If you cant handle the satisfaction of that… then hold it for more on special occasions.  Remember… dont fool yourself into believing that you are eating dark chocolate to help your heart… there are other ways to do that. It is the calories that count and chocolates give you more than what you need in a day if you over indulge in it!

Gaining weight is not worth the benefit that you’ll get from eating chocolates if you can get the same amount of flavanoid from eating apples!  They may not taste the same but the health benefits maybe more with fruits!

Enjoy Chocolates Wisely!

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

Stress and Heart Disease: A Close Circuit!

February 18, 2008

Stress from work?  Who isnt? But the way we handle stress can make a difference in how it affects our lives.  We always associate it as part of our day to day activity otherwise, it is not living if we dont have stress.  It gives us the challenge to move on and to pursue what we have in mind to achieve. But along the way comes the roadblocks called “Stress”

Recently an nice article examined how stress can affect out health.  I am a believer of stress as a big factor in increasing a patient’s risk to develop chronic illnesses like diabetes and high blood pressure.  Now published in the European Heart Journal is a detailed examination of how stress can affect the heart!

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A total of 10 308 London-based male and female civil servants aged 35–55 of the Whitehall II study were studied. Exposures included work stress and outcomes included behavioural risk factors, the metabolic syndrome, heart rate variability, morning rise in cortisol, and incident CHD on the basis of CHD death, non-fatal myocardial infarction, or definite angina.

  • Chronic work stress was associated with CHD and this association was stronger among participants aged under 50 by 68%.
  • There were similar associations between work stress and low physical activity, poor diet, the metabolic syndrome, its components, and lower heart rate variability.
  • Cross-sectionally, work stress was associated with a higher morning rise in cortisol.
  • Around 32% of the effect of work stress on CHD was attributable to its effect on health behaviours and the metabolic syndrome.

Conclusion: Work Stress may be an important determinant of CHD among workiing-age populations, which is mediated through indirect effects on health behaviours and direct effects on neuroendocrine stress pathways.

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The above results are clear: once you’re stressed out… you produce stress hormones through the nueroendocrine system resulting in an increase of serum cortisol which can be harmful to the body including the way it signals how the heart beats! End result: Heart disease….

Further examination revealed that work stress is associated with a poorer diet in terms of eating less fruit and vegetables, and less exercise which also then contribute to increasing one’s risk for heart disease further.  I am sure a lot of the readers are guilty of this!  Too little time…too much to do! In fact in this study around 32% of the effect of work stress on CHD could be explained by its effect on health behaviors and the metabolic syndrome.

In short….Enjoy your work…problems come but solutions are abundant.  It is a matter of finding them!

Mind Your Heart… Eat Healthy, Exercie Freely and Be Stress Free!

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

The Plenary Debate… Good Luck To Me!!!!

February 13, 2008

plearny-board.jpgplenary-debate-inside.jpg

This will be a fun learning debate and will be the highlight of the joint annual convention of the  Philippine Society of Hypertension and Philippine Lipid Society in Manila.

 As doctors… we continue to study and learn non stop!

And as a lecturer and speaker… that’s where I study more and as a result I learn more!

Again.. In Health…Learning is NonStop!

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

Exercise As An Investment In Life…. Offers Great Returns!

February 12, 2008

Go to fullsize imageExercise can reduce risk of death!!!

Exercise can make you live longer and make you enjoy your life better. We know this for centuries but lifestyle continues to be one big struggle for doctors to ask their patients to comply. 

That’s the conclusion reached in a study recently published in Circulation Feb 2008.

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Methods and Results— We assessed the association between exercise capacity and mortality in  male veterans with and without cardiovascular disease who successfully completed a treadmill exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. Fitness categories were based on peak metabolic equivalents (METs) achieved. Subjects were followed up for all-cause mortality for 7.5±5.3 years.

Among clinical and exercise test variables, exercise capacity was the strongest predictor of risk for mortality. The adjusted risk was reduced by 13% for every 1-MET increase in exercise capacity

  • Compared with those who achieved <5 METs, the mortality risk was 50% lower for those with an exercise capacity of 7.1 to 10 METs
  • 70% lower for those achieving >10 METs 
  •  The findings were similar for those with and without cardiovascular disease.

Conclusions— Exercise capacity is a strong predictor of all-cause mortality !

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So the study suggests…the more we exercise and the more calories we burn resulting in a better shape and better exercise capacity, the longer we live!  A 70% reduction in the risk of death is GREAT news for exercise lovers! There you go guys…. it’s about time that we sit down and think…how much do we love ourselves.  Are we doing things to satisfy our ambitions in life with great disregard to our well being?

We may be great thinkers, scholars or successful businessmen… we may be great in everything we do BUT our body also deserves to be treated right.  Success in life comes in different forms and all come from doing what you think is best!

If you therefore want to to enjoy that success and live longer…enjoy the fruits of your labor longer…enjoy life and have more fun times with your kids and family… then take the extra steps to health.  Just like what you do in taking the extra effort to be successful in your careers and goals in life.  So take time to Exercise…It is indeed an investment worthy of its great returns…..

Take The Extra Time To EXERCISE!!!

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

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