Resting To Burn Fat Faster….

November 24, 2007

exerc.jpgHere’s one good news to those who hate long hours of exercise to get a benefit! 

A study published in the Journal of Applied Physiology this June of 2007  showed that:

“repeated bouts of exercise cause enhanced fat metabolism compared with a single bout of prolonged exercise of equivalent total exercise duration.”

The exercise regimen that they tested?

… Exercise for 30 minutes…take a break for 20 minutes… then exercise again for 30 min…. 

The rest period resulted in more fats being burned than no rest period at all…

So just like any activity… the body needs to rest and rejuvenate!

Remember…

Overdoing Even A Good Thing May Do More Harm!!!

 

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Notes From Our Marketing Friends: 

One should apply healthy cleaning strategies at ones home. Use dust cleaners to avoid dust allergy. Many sort of allergies lead to serious diseases like eczema etc. Go for proper eczema treatment is you are suffering form eczema. Dirty carpets are the source of much kind of allergies. Use handy vacuum cleaner to ensure the complete cleanliness of the carpets.
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Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Weight Loss Tips | Leave a Comment »

What is An A1c?…. A New Guideline For The Diabetics….

November 23, 2007

http://martonhouse.wordpress.com/category/work-life-balance/I have to write about this new guideline in interpreting A1c for my Diabetic Patients who have been loyal followers of this website.  Or to those who are not used to doing home glucose monitoring and rely solely on A1c results in their blood test to check if their control is good or not.  Although I am not advocating to do away with monitoring…in fact I strongly advise all diabetics to do so!

Recently a new calculation was made to correlate A1c to average blood glucose levels.  Now there is a computation one can do and based on data from continuous home glucose monitoring, the correlation is now better than what it used to be.

This is a new information I gathered from the American Association of Diabetes Glucose Control Trials from the ADA News as reported in Diabetes in Control:

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Prior to this new information, the A1c was tied to the results of the DCCT, where a 6% was equal to 135mg/dL.  This came about when they checked the A1c and then looked at a couple of thousand finger sticks and averaged them out.  Now with the use of hundreds of thousands of readings, not just with the finger sticks but also with the use of continuous blood glucose monitors, we have more accurate results.  The equation yields a linear correlation over a wide range of A1c. This means that a 6% is no longer an average of 135mg/dL:  The new numbers:

o 6% = 126 mg/dl
o 7% = 155 mg/dl
o 8% = 182 mg/dl
o 9% = 211 mg/dl
o 10% = 239 mg/dl

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So for all patients who wonder what this A1c means…now this new information will help you decide what to do to your lifestyle especially if you go beyond the A1c of 6.5% that we recommend to help prevent the onset of complications. 

Remember a single blood sugar alone does not give you the whole picture…so if your physician keeps on checking just a Fasting blood sugar and tells you you’re doing fine…demand for an A1c level!

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More Sleep Time To Prevent Childhood Obesity

November 22, 2007

Go to fullsize imageChildhood Obesity is getting to be a huge problem not only in developed countries but worldwide!  The AACE Philippine Chapter in fact recently launched our Power of Prevention Program aimed at preventing Obesity among children where different school prinicpals and administrators were invited to the launching initially to involve Metro Manila school children. 

Now comes a remedy to wegiht gain among children that we can do at home!  A new interesting study was recenlty published in Pediatrics November 2007 issue , linking the lack of sleep or inadequate sleep among children and the risk of being overweight.

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Of 785 children, 50% were male, 81% were white, and 18% were overweight in 6th grade.

  • Shorter sleep duration in 6th grade was independently associated with a greater likelihood of overweight in 6th grade.
  • Shorter sleep duration in 3rd grade was also independently associated with overweight in 6th grade, independent of the child’s weight status in 3rd grade.
  • Sleep problems were not associated with overweight.

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So how many hours of sleep should our children have?  This study provided us some insights:

  • Sixth-graders with less than 8.5 hours of sleep a night had a 23 percent rate of obesity,
  • Well-rested peers with more than 9.25 hours of sleep had at 12 percent rate of obesity.

For me this study tells us one thing:

  • By putting your kids to sleep earlier… means less TV time…means less chances to munch on junk food…resulting in a lesser risk to gain weight!
  • Sleep is as important as healthy food and physical activity when it comes to Weight control.

Put Premium on Sleep Than Being Awake Especially For Our Children!

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Notes From Our Marketing Friends: 

There are many sensitive issues that a lactating mother must be keeping in mind. During lactation mother should follow healthy food recipes to avoid any kind of deficiency in her. As a lactating mother feeds her baby on her milk, so she should take complete care her breasts. There are many lactation equipments now available in the market that helps a mother to nourish her baby with her milk. These include medela breast pump, maternity bras and large cup nursing bras etc.
__________________________________________________________________________

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Weight Loss Tips | 2 Comments »

Tips On How To Be Healthy MINUS The Vitamins!

November 20, 2007

Supplements insluding Multivitamins continue to make market leaders in terms of income.  Many people inlcuding myself take multivitamins as part of the daily requirement to hopefully supply the vitamins not taken by our daily meals.  But do we have proofs that we really need them? Or are we better off without them?

I came across a new article from the Harvard News Letter which answered this specific questions published in November of 2007:

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Most experts agree that supplements add little, if anything, to a well-balanced diet. Exercise, however, is proven to achieve the benefits claimed for vitamins, even for people who eat properly, reports the November 2007 issue of Harvard Men’s Health Watch.

One leading reason people take vitamin supplements is to protect against cancer. But sadly, this strategy has been a flop. While studies continue on whether vitamin E and selenium can help reduce prostate cancer risk, data already show that beta carotene actually boosts the risk of lung cancer in smokers. And zinc, as well as high doses of folic acid, may also do more harm than good for men seeking to ward off prostate cancer.

The bottom line: Supplements do not reduce cancer risk.

In addition, vitamins are not recommended for heart disease prevention.

  • Trials of B vitamins have failed to demonstrate protection against heart disease. 
  • But people who eat fish twice a week enjoy a reduced risk of heart attack and sudden cardiac death.
  • Leafy, green vegetables and whole grains also help protect against heart disease.

If supplements can’t protect you against cancer or heart disease, what can? Current evidence suggests that exercise may be a crucial weapon in reducing the risk of some cancers.

  • Studies show that active people are less likely to develop colon cancer than sedentary individuals, and that
  • women who exercise can reduce their breast cancer risk. 
  •  Exercise’s effect on prostate cancer, however, is less clear; studies have produced varying results.
  • Evidence is also incomplete for lung and pancreatic cancers.

But when it comes to reducing the risk of heart disease, regular exercise is associated with a sharp reduction in heart attacks and cardiac deaths.

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We always look for shortcuts! I guess this is true to everybody in every walk of life.  Why make it more difficult if there’s a shorter way to achieve the same goal.  BUT…life is not that simple especially when it comes to better health!

There has been no single study to date to prove otherwise…that exercise can do harm than good… from prevention studies to community data. But we all know it’s good to do it…we just refuse to indulge ourselves to it and instead look for a pill that can do the same job…which up to now remains a fantasy than a reality! 

Dont be fooled in believing that Supplements can do the Health Job for you!  Remember….

In Health…There Are No ShortCuts!
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Notes From Our Marketing Friends: 

With the advancement in the technology everything is now in the access of the people while sitting at home. Many drug store are operating online. You can buy drugs and medicines from them. For example you can buy fioricet online as well as other medicines like aspirin etc. There are many online pharmacies which offer private medicines like generic cialis online as well.
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Does Avandia Cause Heart Attack? : The Ongoing Controversy

November 16, 2007

Recently, The US FDA made a new ruling regarding the controversy on whether the popular antidiabetic agent Avandia can really cause heart attack.  Below are important excerpts of the FDA ruling released as of November 14, 2007:

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People with type 2 diabetes who have underlying heart disease or who are at high risk of heart attack should talk with their health care provider about the revised warning as they evaluate treatment options. FDA advises health care providers to closely monitor patients who take Avandia for cardiovascular risks.

Avandia is approved to be used as a single therapy or used in combination with metformin and sulfonylureas, other oral anti-diabetes treatments.

During the past year, FDA has carefully weighed several complex sources of data, some which show conflicting results, related to the risk of chest pain, heart attacks and heart-related deaths, and deaths from any cause in patients treated with Avandia.

At this time, FDA has concluded that there isn’t enough evidence to indicate that the risks of heart attacks or death are different between Avandia and some other oral type 2 diabetes treatments. Therefore, FDA has requested that GSK conduct a new long-term study to evaluate the potential cardiovascular risk of Avandia, compared to an active control agent. GSK has agreed to conduct the study and FDA will ensure it is initiated promptly.

The revision of Avandia’s existing boxed warning – FDA’s strongest form of warning – includes the following statement:

A meta-analysis of 42 clinical studies (mean duration 6 months; 14,237 total patients), most of which compared Avandia to placebo, showed Avandia to be associated with an increased risk of myocardial ischemic events such as angina or myocardial infarction. Three other studies (mean duration 41 months; 14,067 patients), comparing Avandia to some other approved oral antidiabetic agents or placebo, have not confirmed or excluded this risk. In their entirety, the available data on the risk of myocardial ischemia are INCONCLUSIVE!

The previous upgraded warning, added to certain diabetes drugs (in class of drugs related to Avandia) on Aug. 14, 2007, emphasized that these types of drugs may worsen heart failure, a condition in which the heart does not adequately pump blood, in some patients. GSK is also developing a Medication Guide for patients to provide additional information about the benefits and risks and safe use of Avandia.

To date, no oral anti-diabetes drug has been conclusively shown to reduce cardiovascular risk. Consequently, the agency also will be requesting that labeling of all approved oral anti-diabetes drugs contain language describing the lack of data showing this benefit.

Today’s action follows recommendations made at the July 2007 joint meeting of FDA’s Endocrine and Metabolic Drugs and Drug Safety and Risk Management Advisory Committees. At the meeting, members voted 22-1 to recommend that Avandia stay on the market, pending a review of additional data. The committee also advised that information warning of the potential for increased risk of heart attacks should be added to the drug labeling. _______________________________________________

Ever since the data on avandia came into light after the Niessen article, further analysis of that article showed flaws in the statistical analysis.  It is therefore not surprising to me why this drug will not be pulled out in the market solely because of that article.  The medical community looks at actual facts rather than what is reported in newspapers or the media.

Based on my experience, the benefits of this drug continue to outweigh the potential risks…and just like any other drugs… all one needs to do is use the right drug for the right patient profile!

Meaning..never use this drug if the patient has heart failure or heart disease.  And this is true to all antidiabetic agents as reported by the US FDA as the risk of heart attack has not been shown to be different among the different oral agents. 

Plus…all patient with Diabetes…by the time of diagnosis… more than 5o% or probably ALL already have ongoing heart disease because by the time ones fasting blood sugar is abnormal…the disease process has been ongoing for 7 to 10 years already!

Therefore and Again… I always emphasize to all patients at risk: Lifestyle Change.  If one has the risk to develop Diabetes … do something NOW!  

Remember… All medications have risks!  But the benefits should always outweigh the risks before any drug is started on any patient!

Posted in Medical News Bits, Personal Thoughts, The Diabetes Facts, What's New in Diabetes | 3 Comments »

Tips on How To Get A Flat Tummy Without Tummy Tuck!

November 15, 2007

Go to fullsize imageI am ” no no” when it comes to cosmetic surgery.  It is definitely temporary measure of something that can be done with healthy lifestyle and discipline. Beauty as we said is deep within… and for me… only if you are using your face or body for business like being a movie star and marketing for extra mileage that one may elect to have them done.

Recently I came accross a short article on how we can flatten our tummy without necessarily resorting to surgery.  This comes from a reliable Health Source of the Mayo Clinic….

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Just can’t seem to maintain a flat tummy, even though you are not overweight? According to the August issue of the Mayo Clinic Women’s HealhSource, you could just have a genetic tendency to accumulate fat in that area. Or if you have lost some height over the years, bulges can become more prominent. Whatever the cause, you can help flatten your stomach.

  • Get regular, general exercise. Burning calories reduces overall body fat. (Just doing sit-ups won’t flatten the bulge.)
  • Target lower and deeper abdominal muscles. Exercises that target these muscle groups can help. An example is a pelvic tilt. Lie on your back on the floor with knees bent. Flatten your back against the floor by tightening your abdomen and bending your pelvis up. Hold for five to 10 seconds. Work up to 10 to 20 repetitions.
  • Stand tall. A slouched position makes your tummy more prominent.
  • Beware of bloating. Some foods — beans, cabbage and bran, for example — can cause bloating and accentuate your bulge.

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There you go my friends.  Simple and concise.  Do them daily…change your lifestyle that incorporates exercise or physical activity to your daily life.

Everyday before I take a bath…I lie on my bathroom floor and do the situps and tummy exercise.  Then I hop on to my waist twisting disc then I do the strength exercise using a rubberized belt ( I am not sure what you call it actually).  Once an activity is incorporated into your system…then its difficult to start the day without it!

Give Your Body The Look You Want It To Have….

Thru Exercise!

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Notes From Our Marketing Friends:

As people are becoming aware with the health and fitness issues they are spending most of their time in health and fitness centers. There are many 24 hour fitness centers which provide services round the clock. However you can make your own gym at your home as well. All the gym equipments are available online you can purchase weight scale, tread mills, racing cycles or anything you want. Accessories like yoga mats, water bottles are also available over the internet.

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Posted in Exercise and Activity Tips, General Health Tips, Healthy Practice Tips, Lifestyle Measures, Personal Thoughts | 3 Comments »

How Often Can Surgery Go Wrong?

November 14, 2007

Go to fullsize imageMore often than not… we will have one surgery in our lifetime.  And among my diabetics… almost always, eye surgeries are common because of chronic complications arising from uncontrolled blood sugar or high blood pressure.  Cataract formation is so common that surgery is often advised to improve vision.

You may have heard of horror stories of wrong surgeries done on the wrong patient or the wrong leg or the wrong eye!  How common can this be?

Recently in the November issue of the Archives of Ophthalmology comes a rather alarming data on the issue of wrong surgery on the wrong eye!

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Objective  To investigate the hypothesis that surgical confusions rarely occur but are unacceptable to the public; occur in predictable circumstances; involve a wrong lens implant more often than a wrong eye, procedure, or patient.

Methods  A retrospective series of 106 cases, including 42 from the Ophthalmic Mutual Insurance Company and 64 from the New York State Health Department.

Results  The most common confusion was wrong lens implants, accounting for 67 cases (63%). Wrong-eye operations occurred in 15 cases, wrong-eye block in 14, wrong patient or procedure in 8, and wrong corneal transplant in 2.

Conclusions  Surgical confusions occur infrequently. Although they usually cause little or no permanent injury, consequences for the patient, the physician, and the profession may be serious. Measures to prevent such confusions deserve the acceptance, support, and active participation of ophthalmologists.

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Doctors are humans and we make mistakes.  However wrong surgery on a wrong patient is almost always avoidable if universal precautions are adopted.  The team approach to confirming the patient’s identity on several occasions from different personnel can avoid this problem.

I always advise this to my patients who will undergo a procedure:

  1. Ask for a schedule early in the morning.
  2. Schedule the procedure on a Monday after a Sunday… when the surgeon has had plenty of rest!
  3. Look for the right surgeon and not just any surgeon.
  4. Be sure to ask around for the surgeons reputation and expertise.

Can Surgery go wrong? It can but can definitely be avoided if one is vigilant enough to avoid a disaster! It’s a matter of choosing the right guy to do the right procedure!!!

Precaution Is The Key!

Posted in Medical News Bits | 2 Comments »

Snoring and The Risk of Diabetes

November 13, 2007

Just came back from a successful preceptorship at the UCSF- Stanford University- Whittier Institute for Diabetes in San Francisco and San Diego.  There were only 10 MDs from the Asia Pacific region being taught by more that 12 professors.  It’s actually more than a 1:1 learning from the 4th Best institution in Endocrinology from the survey in The US News and World Report 2007.

One very interesting topic we discussed was snoring and the risk of developing diabetes.  Needless to say…snroing can be very common and yet often negelcted symptom.  We alwaus associatet snoring as… the person is either being too tried from work or just in a deep good night sleep.  But now studies have shown that snoring is indeed an unhealthy sign of future disease risk.

In a study published in the Journal of Epidimeology… it was noted that snoring actually increases a persons risk to develop Diabetes….

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Purpose: To examine the association between snoring and risk of developing type II diabetes mellitus, the authors analyzed data from the Nurses’ Health Study cohort.

Methods: This analysis included 69,852 US female nurses aged 40–65 years without diagnosed diabetes, cardiovascular disease, or cancer at baseline in 1986. Snoring patterns were ascertained by questionnaire.

Results: During 10 years of follow-up, 1,957 women were diagnosed with type II diabetes. In analyses adjusted for age and body mass index, snoring was associated with risk of diabetes

  1. for occasional snoring vs. nonsnoring, relative risk (RR) = 1.48 (95% confidence interval (CI): 1.29, 1.70);
  2. for regular snoring vs. nonsnoring, RR = 2.25 (95% CI: 1.91, 2.66); p for trend < 0.0001).
  3. Analyses stratified by body mass index, smoking history, or parental history of diabetes showed a consistent association between snoring and diabetes within the categories of these variables.

Conclusion: These results suggest that snoring is independently associated with elevated risk of type II diabetes.

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Snoring can be benign but can also be due to a more difficult disease called Obstructive Sleep Apnea where patients intermittently stop breathing with episodes of snoring suggesting obstruction.  Inability to breath causes them to cough and then resume sleeping.  Unfortunately these patients dont get into deep sleep and therefore feels tired when they wake up and tend to sleep or nap while awake in the chair or anywhere they feel sleepy.

We now know lack of sleep can be a stress factor that can contribute to increasing ones risk to develop diabetes.  It is therefore not surprising that snoring as a sign of sleep apnea is one way of being sleep debt!

Treating sleep apnea therefore in a person who is diabetic or at risk to develop diabetes can definitely have an impact on ones health…by improving his risk profile and improving blood sugar control.

My recommendation therefore for all  my diabetics who snore is to get a sleep study.  The sleep lab can determine what kind of sleep disorder one has and then implement measures to help one sleep including the administration of a CPAP machine.

Ask your partner if you snore… discuss it with your specialist and demand for a sleep study.  Treating sleep apnea can have a tremendous impact in controlling your blood sugar including ones risk to be overweight!  Plus.. you feel better when you wake up and a better sense of well being.

Snoring Can Be Bad For Your Health!

Posted in Medical News Bits, The Diabetes Facts, What's New in Diabetes | 4 Comments »

I Am Taking A Break….

November 4, 2007

I will be one of the 12 to 15 doctors worldwide invited to attend a 7 day preceptorial study at the University of San Francisco- Stanford University Program in Endocrinology courtesy of INNOVARA, USA starting today till November 10.

This is one opportunity that I will never miss as this is already my third invitation from them after the same study program done at Massachussetts General Hospital- Harvard Univiersity Program in 2004 and the Johns Hopkins University Program in 2005.

Having been trained at the Mayo Clinic for my endocrinology fellowship has been a big advantage in having the confidence to meet and discuss interesting cases with professors in these prestigious institutions.

Not only is the experience rewarding but likewise a memory to behold. Interacting with professors in your field of work and sharing knowledge with fellow endocrinologists from different parts of the world is all worth the time off form my practice and my family!

The camaraderie and the social bonding that develop with fellow doctors and professors is what counts most as we share our calling cards and ideas in the small classroom! You get to know each one of them as we share the same hotel, the same lunch and dinner area and the same classroom throughout the week.

I will still try to update my website if I can but my apologies for the coming week if I will be too tired learning and enjoying at the same time….

Posted in Memories and Trips, Personal Thoughts | 1 Comment »

The Benefit of Taking Siestas Or A Nap…

November 2, 2007

We’re know how to take naps and siestas in the past… BUT this habit is becoming a rarity rather than a need with the changing times.  However, new studies have come up that in regions where naps continue to be practiced, the incidence of cardiac problems seem to be on a decline… and now a new study may give us the reason why. 

Siesta apparently is associated with lowering of BP and as a result it reduces the strain to the heart in an article published in Journal of Applied Physiology  October of 2007 issue. 

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The siesta habit is associated with a 37% reduction in coronary mortality, possibly because of reduced cardiovascular stress associated with daytime sleep.  Whether the most important behavior is the daytime nap itself, a supine posture, or the expectancy of a nap is unknown.

We present the first detailed description on healthy individuals of the acute changes in cardiovascular function during defined phases of the daytime sleep-onset period. These responses were compared with lying awake and standing.

Following a night of restricted (4 h) sleep, nine healthy participants (aged 34 ± 5 yr) were allowed to sleep at 1400 for up to 1 h. Polysomnography was used to calculate three phases of daytime sleep onset: phase 1, a baseline period of relaxed wakefulness before lights out; phase 2, the period between lights out and onset of stage 1 sleep; and phase 3, the period between onsets of stages 1 and 2 sleep.

Differences (means ± SD) in blood pressure, heart rate, and forearm cutaneous vascular conductance (CVC) between phases were analyzed. During the 9.7 ± 13.8 min of phase 2, systolic and diastolic blood pressure was 4.7 ± 4.5 and 3.6 ± 2.8 mmHg lower than baseline, whereas CVC was 9.5 ± 4.3% higher than baseline (P < 0.05). Subsequent changes in cardiovascular function during the sleep itself were trivial (P > 0.05). The above changes were not observed when subjects stood or laid supine in relaxed wakefulness for 1 h (P > 0.05).

Our findings suggest that the period between lights out and sleep onset is associated with the largest acute reduction in blood pressure during one afternoon siesta.

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Now we know why siestas make us feel good and “healthier”.  In fact studies have shown that this blood pressure reduction may actually be the reason why there is lower coronary mortality rates in Mediterranean and Latin American populations where siestas are common… the effect of naps on the heart!

Simple take home message from this study: 

  1. Take time to rest and a nap…if you can have it in between breaks…go for it. 
  2. Sleep is likewise important… now it shows that sleep debt is unhealthy and dangerous!

Life is too short not to enjoy it BUT make sure you get enough rest and sleep to enjoy the beauty of life to live longer!

Siestas Equate To Better Health! 

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

Tips To Change Unhealthy Habits: Self Control vs WillPower

October 31, 2007

Go to fullsize imageHere’s one article I read from the Mayo Clinic Health Letter I want to share to everyone.  This is timely and concise at these times that everything that surrounds us is tempting us to do other than what our body requires us to do.  It’s The Will Power to do good things being overcome by destructive tempations leading to unhealthy lifestyle.

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But counting on willpower alone to make a change is inviting failure. A Special Report in the February issue of Mayo Clinic Health Letter discusses the essential steps to a healthier life, including how planning and self-control skills — not willpower alone — help make healthy behavior changes.

How Self Cotrol wins Over Will Power 

Dessert splurge

Willpower: I’ll make a cheesecake for others in the house, but I won’t eat it.

Self-control: I won’t make a cheesecake, but I can have a slice when I dine out.

Accessible alcohol

Willpower: I’ll keep a liquor cabinet for guests, but I won’t drink.

Self-control: For a time, and perhaps forever, I will not have alcohol in the house.

Smoking cessation

Willpower: I’ll stop cold turkey.

Self-control: Before I stop, I’ll talk to my doctor about ways to ease withdrawal.

Dining out

Willpower: We’ll go to the buffet, but I’ll just have salad.

Self-control: We’ll go to a restaurant that offers small portions and low-fat or vegetarian items.

Exercise

Willpower: Although I’m tired in the evening, I’m going to get out and walk for 30 minutes every day after dinner.

Self-control: I’m going to try to walk 15 to 30 minutes in the morning and at lunch. I’ll ask a friend to join me for encouragement.

Self-control is one step. But many factors impact why we do what we do — or don’t do. In fact, discarding an unhealthy behavior, or adopting a healthy one, is a tough challenge and often takes from three to 30 attempts.

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Simple easy steps to a healthy lifestyle.  Its a matter of combining self control and the will to do things in a manner that will satisfy your body, your self and your health!  It may take time to do things right but as long as one has the will and the foresight to do them with a purpose …then you will be successful! 

Remember…. Not trying is the worst thing you can do to yourself and your health!

Take Self Control and The Will To Be Healthy!

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Personal Thoughts | 2 Comments »

The Danger of Sleepless Nights!!!!

October 29, 2007

Go to fullsize imageFeeling Grumpy after waking up? Maybe lack of sound sleep? Or deprived of sleep? Or sleep debt?

No matter what you do, this lack of sleep has been shown to increase one’s emotional outburst.  Needless to say, one is not too keen in listening to problems in office or even offering solutions without having to raise ones voice.  It is therefore difficult or problematic to handle delicate situations in times of sleep debt.  The day to day interaction with friends or co workers and employees can result in negative outcome and productivity.

In the October 23 issue of Cell Biology comes a new study that looked at the reason why this happens as the lead author has said: “Sleep deprivation fractures the brain mechanisms that regulate key aspects of our mental health.”

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Sleep deprivation is known to impair a range of functions, including immune regulation and metabolic control, as well as neurocognitive processes, such as learning and memory. But evidence for the role of sleep in regulating our emotional brain-state is surprisingly scarce, and while the dysregulation of affective stability following sleep loss has received subjective documentation , any neural examination remains absent.

Clinical evidence suggests that sleep and emotion interact; nearly all psychiatric and neurological disorders expressing sleep disruption display corresponding symptoms of affective imbalance. Independent of sleep, knowledge of the basic neural and cognitive mechanisms regulating emotion is remarkably advanced.

The amygdala has a well-documented role in the processing of emotionally salient information, particularly aversive stimuli . The extent of amygdala engagement can also be influenced by a variety of connected systems, particularly the medial-prefrontal cortex (MPFC); the MPFC is proposed to exert an inhibitory, top-down control of amygdala function, resulting in contextually appropriate emotional responses.

We have focused on this network and using functional magnetic resonance image (fMRI) have obtained evidence, reported here, that a lack of sleep inappropriately modulates the human emotional brain response to negative aversive stimuli.

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My practice to to advocate a balance of stress and de-stress! Balance the time of work and play… this may not be easy for some but health dictates us to be vigilant and be more aggressive in finding ways our body can rest!!! The system works best if noxious stimuli can be avoided or be rid off!  Sleep is one way the body regenerates the energy it requires to handle the stresses of the next day!

Sleep Debt as we know of can lead to all the dangers of health stress: it has been shown to be a major risk factor for developing metabolic illnesses like Diabetes and High blood pressure.  With this new study comes data linking neuronal changes to sleep debt that can result in emotional unrest!  Remember…any emotional stress increases the production of stress hormones in the body that can have harmful effects on the heart!

Work is important but so is Sleep and Rest!  Just make sure…a balance is made between what you do and want to accomplish and what your health dictates you to do!

Health is Wealth My Friends!

Read My Other Related Posts:

Too Little Sleep Because Of Work?

Sleep And The Risk of Obesity and Diabetes
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 adtxtimg2.gif 2/18/08

Notes From Our Marketing Friends: 

There are many sensitive issues that a lactating mother must be keeping in mind. During lactation mother should follow healthy food recipes to avoid any kind of deficiency in her. As a lactating mother feeds her baby on her milk, so she should take complete care her breasts. There are many lactation equipments now available in the market that helps a mother to nourish her baby with her milk. These include medela breast pump, maternity bras and large cup nursing bras etc.
_________________________________________________________________________

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

Avandia and Heart Disease: Anything New?

October 27, 2007

Go to fullsize imageAvandia continues to be in the limelight.  As more physicians are aware of its benefits, controversy surrounding its use and possible side effects continue to be the main issue among patients.  Further analysis have been done by the European Medicine Agency, the counterpart of the US FDA, on whether the benefits outweigh the risk in the use of Avandia among our diabetic patients:

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Finalising a review of the benefits and risks of the thiazolidinediones rosiglitazone (Avandia) and pioglitazone (Actos), the European Medicines Agency has concluded that the benefits of these antidiabetic medicines continue to outweigh their risks in the approved indications. However, the Agency recommended changing the product information for rosiglitazone and agreed further initiatives to increase scientific knowledge on the safety of both medicines.The Agency’s Committee for Medicinal Products for Human Use (CHMP) carried out this review as part of its continuous monitoring of the safety of medicines, because of new information on these medicines’ side effects. This included information on the risk of bone fractures in women, and, in patients taking rosiglitazone, a possible risk of ischaemic heart disease (reduced blood supply to the heart muscle). This raised concerns over the benefit-risk balance of both rosiglitazone and pioglitazone.

Having assessed all available data, the CHMP concluded that the benefits of both rosiglitazone and pioglitazone in the treatment of type 2 diabetes continue to outweigh their risks.

However, the prescribing information should be updated to include a warning that, in patients with ischaemic heart disease, rosiglitazone should only be used after careful evaluation of each patient’s individual risk. In addition, the combination of rosiglitazone and insulin should only be used in exceptional cases and under close supervision.These changes will be introduced in forthcoming regulatory procedures for rosiglitazone-containing medicines. No changes to the prescribing information for medicines containing pioglitazone were considered necessary.

The Committee will review the results of currently ongoing studies. It also recommended that further studies be performed in order to increase the level of scientific knowledge on the two medicines.

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Whether the US FDA will follow the same guidelines remain to be seen.  What is important to this date is that further studies need to be done.  The risk of heart attack is always inherent in any diabetic…whether the use of Avanida increases the heart attack risk was found to be negative in the interim analysis of a well designed prospective study called RECORD…a study specifically designed to address this issue. 

The controversy on Avandia started after a metaanalysis of the previous small studies on Avandia was done and showed an increase risk in heart attack.. Unfortunately the medical community does not accept studies of this caliber to suggest a relationship because of the many loopholes associated with analyzing data in a Metaanalysis. 

Do check out my blogroll on AVANDIA update for previous posts.

To this date… the agency has said it well:

The Benefits Continue to Outweigh The Risks!

Posted in Medical News Bits, Personal Thoughts, The Diabetes Facts, What's New in Diabetes | 1 Comment »

That Health Rules Milestone…. Thanks To All…..

October 26, 2007

Go to fullsize imageThis website started as my way of enjoying the passion to educate and inform.  Glad to know from my Brother in Law, Wlison Ng, whose blog site, The Bizdrivenlife… is widely read among enterpreneurs…that such a thing as a blog exist in the online community!  I am glad that he showed me the way and am happy that I did heed his advise.

Now, I have been getting 400 hits per day …thanks to links from prestigoius online journals like the Wall Street Journal, CNN Health Online, Community Chat Forum like Optionz from Australia, other related blog sites like Sugar Stats.

My exposure to national media was made possible because of this website.  My article on Coffee was published in National Dailies like Manila Bullettin and Philippine Star including the Freeman in the local daily.  Opportunities like this come in handy and free.

The website has so far registered 85,400 visits in 1 year of existence.  I cant imagine writing health issues in that span of time.  I did not even realize it till now that the website celebrated its one year anniversary last August of 2007!!!  Happy Birthday to Me!!!!  I guess if one enjoys the things that one does…time really flies!

Again…thanks to all for visiting my website.  To my friends, my colleagues, my visitors and my patients….This website is for all of you!

Let’s All Enjoy Reading and Learning!

Posted in Personal Thoughts | 3 Comments »

What Happens To The Heart Of An Obese Child?

October 25, 2007

2069806394.jpgChildhood obesity is now becoming a major health problem not only in the US but also in the developing world. We know the consequences of our child becoming obese and how it will impact on out kids future in terms of their chances to become obese FOR LIFE.

What we dont know are the cardiac or heart consequences associated with increasing obesity in childhood.  This recent 2007 study published in the Journal of Cardiometabolic Syndrome looked at changes seen as markers that can lead to early heart problems among our obese children.

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Childhood obesity is a major health care issue in the United States. This epidemic has important cardiovascular implications. Newer imaging modalities in obese adults have demonstrated abnormal systolic and diastolic cardiac function. The authors proposed to determine whether these abnormalities are present in obese children.

A total of 168 children were identified from our echocardiographic database. Body mass index for age was calculated.

Echocardiographic clips were analyzed using imaging technology to determine myocardial motion, strain, and strain rate. Patients at risk for obesity and those meeting criteria for obesity had increased late diastolic myocardial motion compared with normal-weight children. Obese patients had decreased systolic strain compared with normal-weight children.

As with adults, obese children have significant differences in diastolic function and strain. These abnormalities may be subtle markers for the emergence of future cardiac disease. (JCMS. 2007;2:30–34)

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Children therefore are not immune to the structural and heart abnormalities associated with excess adipose tissue.  It is therefore not acceptable for parents to accept the old concept that since they are kids…lets allow them to gain weight because they are still in their growing years.  Now we know better…we are doing MORE harm than good to these children. 

It is likewise very important to educate our grandparents who tend to spoil our kids with the ancient concept of overfeeding and that overweight kids are healthier babies!

Times Have Changed..Begin the Year with Healthier kids!

Posted in Medical News Bits, Personal Thoughts, The Truths on Obesity | 1 Comment »

Cough Medicines and Stroke…. How To Avoid A Stroke!!!

October 23, 2007

1619007209.jpgThe risk of stroke with OTC cough medicines had been with us since 2003 after the publication of the study in STROKE  linking OTC cough and colds meds to stroke.  Apparently these decongestants contribute to around 200 to 400 cases of stroke annually. The study eventually led to FDA giving advisory against the use of Phenylpropanolamine ( PPA ) in any medications for sale as cold remedies. 

Now comes a new FDA advisory targetting the cold remedies we use for children.  Apparently the cold remedies have not been proven to be safe but instead cause harm including death.  This really comes timely considering the increase numbers of upper respiratory tract infections in this rainy season. 

But what is really important is for us to understand that there are reasons why one gets a Stroke. Here’s a list of risk factors compiled by WebMD which I want to share:

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Certain diseases or conditions increase your risk of stroke. These include:

Certain behaviors can increase your risk of stroke. These include:

  • Smoking, including secondhand smoke.
  • Physical inactivity.
  • Being overweight.
  • Diet with few fruits and vegetables. Research suggests that people who eat more fruits, vegetables, fish, and whole grains (for example, brown rice) may have a lower risk of stroke than people who eat lots of red meat, processed foods such as lunch meat, and refined grains (for example, white flour).
  • Diet with too much salt. A healthy diet includes less than 2,300 mg of sodium a day (about one teaspoon).
  • Use of some medicines, such as birth control pills-especially by women who smoke or have a history of blood-clotting problems-and anticoagulants or steroids. In postmenopausal women, hormone replacement therapy has been shown to slightly increase the risk of stroke.
  • Heavy use of alcohol. People who drink alcohol excessively, especially people who binge drink, are more likely to have a stroke. Binge drinking is defined as drinking more than 5 drinks in a short period of time.

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So if you have any of those risk factors…the more one should avoid decongestants based on what we now know in terms of the potential for PPA to cause a stroke.

Storke can be avoided and should be avoided because it is  disabling disease.  I always counsel my diabetic hypertensives that the main reason why I try to make sure they get an excellent control in terms of their sugar and blood pressure including cholesterol is mainly: TO REDUCE THEIR RISK in getting a Stroke and Heart disease.

Genes and Lifestyle Complement Each Other….

Posted in General Health Tips, Healthy Practice Tips, Medical News Bits, Personal Thoughts, The Diabetes Facts, Tips on Hypertension | Leave a Comment »

Byetta and Pancreatitis…

October 20, 2007

2520983995.jpgThis is just an information sheet to those who are on Byetta as part of the treatment regimen for Diabetes.  Any new drug in the market has post marketing survey done to determine any untoward events once a drug is marketed and used worldwide.  After its approval in 2005, it has just been available in the Philippines this year.

Byetta is known to cause nausea due to its effect in delaying gastric emptying.  This symptom usually goes away after weeks to months of use.  However if abdominal pain occurs and becomes persitsent… it is now advised to discontinue the drug and seek medical advise to rule out pancreatitis.

Acute Pancreatitis is inflammation of the pancreas and ussually is due to either alcohol intake or gallstone.  Once diagnosed and treated it is not life threatening.  Majority of the cases in the survey did well after trteatment of the disease.

The FDA has issued an alert to physicains to be aware of this effect:

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Posted 10/16/2007] FDA has reviewed 30 postmarketing reports of acute pancreatitis in patients taking Byetta (exenatide), a drug used to treat adults with type 2 diabetes.

An association between Byetta and acute pancreatitis is suspected in some of these cases. Amylin Pharmaceuticals, Inc. has agreed to include information about acute pancreatitis in the PRECAUTIONS section of the product label.

Healthcare professionals should be alert to the signs and symptoms of acute pancreatitis and instruct patients taking Byetta to seek prompt medical care if they experience unexplained, persistent, severe abdominal pain which may or may not be accompanied by vomiting. If pancreatitis is suspected, Byetta should be discontinued. If pancreatitis is confirmed, Byetta should not be restarted unless an alternative etiology is identified.
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Byetta is one new drug that will be very beneficial to our newly diagnosed diabetes especially those who are obese because of its capacity ot improve insulin sensitivty and increase beta cell mass.  Preventing the rapid decline of beta cell mass and function therefore theoritically should prevent progression of this disease and in turn prevent the onset of complications. 

The PLUS factor of thes agent: It can lead to significant weight loss and is the only agent so far that can really make a diabetic well controlled without necesarily increasing weight but rather lose weight!

For now with this new alert, I would have to make sure patients with history of pancreatitis, alcohol abuse or gallstone to refrain from using Byetta.   The data showed that those who developed Pancreatitis had at least 1 of the above risk factors.  Vigilance of these factors should lessen one’s risk to develop pancreatitis.

Just Like Any Drug… If It Has An Effect… It Should Have A Side Effect..Precaution Is The KEY!

Posted in Medical News Bits, Personal Thoughts, The Diabetes Facts, What's New in Diabetes | 1 Comment »

Going NUTS on NUTS….

October 18, 2007

imagesertyuyui.jpgIf you think of peanuts… you dont associate them with health food but rather… a kind of junk food? or an unhealthy snack alternative? and pretty salty!!!!

But the FDA has considered nuts as a healthy snack alternative based on the data that nuts have lots of protein and fiber and contain a lot of the good fat called monounsaturated fats as well as certain  antioxidants. 

BUT not all nuts are created equal:  the health claim recognized by the FDA only includes peanuts and certain tree nuts like:

  • walnuts because of its omega 3 fatty acids
  • almonds,
  • hazelnuts,
  • pecans,
  • some pine nuts,
  • pistachios, and
  • walnuts.  

These nuts carry with them several studies lowering LDL or bad cholesterol while improving HDL or good cholesterol and as aresult may actually have beneficial effects in protecting heart ailments.

Other nuts that did not get the qualty health claim from the FDA because they contain high saturated fat include: Brazil nuts, macadamia nuts, cashew nuts, and some varieties of pine nuts.

So for your next meal or snacks…dont feel guilty grabbing some nuts from the can and enjoy them.  Nuts are rich in protein and fiber and therefore can be very filling.  But again in moderation because even if they have health claim…they still contain calories and too much of which can also be harmful!

Let’s Go NUTS!

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

Life Is A Cycle….

October 17, 2007

2098012768.jpgI just saw a special patient this morning.  Routine checkup? or an emergency I asked after receiving a call from the secretary yesterday. 

Doctors…let it be known are the worst patients! We doctors also have this longstanding fear that someday, we will be hit by an illness that we specialize in.  As For me… I am extra careful because my mother is a diabetic and I am specializing in endocrinology dealing with diabetes and therefore I am concerend that I will have to deal with treating my diabetes in the future! Whew…scary…..

So going back to my patient this morning… it happened to be my mentor…our boss and our teacher when I was a first year student in Medical school.  Scary thought? …definitely.  Will I satisfy his questions?  If he can grade me again…will he pass me?

What made me write about him today is the thought that… In life… you just cant predict what will happen to you in the future.  We are blind as to what future holds for us in terms of fate or health!  We do what we can now to reduce the chances of getting ill or getting poor! 

But what I know is this simple fact: If you deal with people with kindness now… that favor will go back to you when you need it most.  If I can recall bad memories in my student years… these were not with this guy!  It is just a weird feeling and ironic that he who is in front of me seeking my medical advise … was the one in the past who helped mold me into what I am now!

Life is Short…Very unpredictable and really can come into a full cycle.  Let us treat everyone with kindness because one day you will not know who and where to seek for help in times of need!

Kindness Bears Fruits of Happy Memories!

Posted in Memories and Trips, Personal Thoughts | 1 Comment »

Can I Eat Eggs Everyday? … Part 2

October 15, 2007

3557864019.jpgOne of the top posts of this website is about eggs.  It has really been a puzzle to the medical community as to how this seemingly affordable and easy available food can be so intriguing in terms of its good and bad effect on health.  Its really an option for anyone to take which sides you are depending on what study you read.

A recent publication from the Harvard Health Publications regarding the myths and facts on eggs is worth mentioning here for my readers to know my answer when they ask…Can I eat eggs everyday doc?

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BOSTON, MA – Common misconceptions keep many people, especially those worried about heart disease, from eating eggs. The July issue of the Harvard Heart Letter unscrambles the dietary facts and myths about the egg.

Fact: Eggs are a good source of nutrients. One egg contains 6 grams of protein and some healthful unsaturated fats. Eggs are also a good source of choline, which has been linked with preserving memory, and lutein and zeaxanthin, which may protect against vision loss.

Fact: Eggs have a lot of cholesterol. The average large egg contains 212 milligrams of cholesterol. As foods go, that’s quite a bit, rivaled only by single servings of liver, shrimp, and duck meat.

Myth: All that cholesterol goes straight to your bloodstream and then into your arteries. Not so. For most people, only a small amount of the cholesterol in food passes into the blood. Saturated and trans fats have much bigger effects on blood cholesterol levels.

Myth: Eating eggs is bad for your heart. The only large study to look at the impact of egg consumption on heart disease—not on cholesterol levels or other intermediaries—found no connection between the two. In people with diabetes, though, egg-a-day eaters were a bit more likely to have developed heart disease than those who rarely ate eggs.

  • If you like eggs, eating one a day should be okay, especially if you cut back on saturated and trans fats.
  • Other ways to enjoy eggs without worrying about cholesterol include not eating the yolk, which contains all the cholesterol, or using pourable egg whites or yolk-free egg substitutes.

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One major reason why we advocate a low cholesterol diet is that any diet that is high in cholesterol may downregulate LDL-receptor (Bad cholesterol) synthesis which are the receptors that degrade or breakdown the bad cholesterol in our body. This bad effect apparently becomes more pronounced if the diet is also high in saturated fat because it can interfere with receptor binding and removal of the bad cholesterol and therefore accumulates in our system!

Likewise… if you eat a high cholesterol food…it is almost always associated with a high saturated fat meal! If you love egg yolk then it means the meal may also have steak or fried pork and other oily foods in it! This spells DISASTER!

Almost always… it’s already a cliche: eat everything in moderation.  I will continue to advocate 2 x or less eggs per week for my patients until more solid evidence tells me otherwise. 

It’s a matter of choosing the right food for a healthy body.

Posted in General Health Tips, Healthy Practice Tips, Lifestyle Measures, Medical News Bits, Nutrition Health Tips, Personal Thoughts | 27 Comments »

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