Monday, October 31, 2011
FUN FACTS
* Having sex can make a woman look younger and more attractive due to the release of estrogen and collagen. *
* You heart will pump about 400 liters or about 800 quarts in your full lifetime. *
* The human brain uses approximately as much energy as a 10 watt light bulb. *
* Coughing can cause air to move through your windpipe faster than the speed of sound - over a thousand feet per second! *
* The human body contains over a billion miles of DNA. *
* Sex burns about 360 calories per hour. *
* The skin on your lips is 200 times more sensitive than your fingertips. *
* You heart will pump about 400 liters or about 800 quarts in your full lifetime. *
* The human brain uses approximately as much energy as a 10 watt light bulb. *
* Coughing can cause air to move through your windpipe faster than the speed of sound - over a thousand feet per second! *
* The human body contains over a billion miles of DNA. *
* Sex burns about 360 calories per hour. *
* The skin on your lips is 200 times more sensitive than your fingertips. *
Aspirin Cuts Bowel Cancer Risk
Taking two aspirin a day for two years reduces the long-term risk of bowel cancer in people with a family history of the disease by around 60 percent, according to a British study published Friday.
The finding could also have implications for the wider population, though more research is needed to determine an ideal dose for different groups of people.
In recent years there has been an intense debate about the merits of routinely taking aspirin, which increases the risk of stomach ulcers and internal bleeding, but also protects against heart problems.
John Burn of Newcastle University believes his study — the first randomized controlled trial into the effect of aspirin on cancer outcomes — is a key piece of evidence validating the case for aspirin.
Previous research into cancer and aspirin, a cheap drug originally developed by Bayer more than a century ago, has been based on less robust observational studies.
Burn's study looked at people with Lynch syndrome, a genetic condition predisposing them to a range of cancers. It affects at least one in 1,000 people and around half of them develop cancer, mainly in the bowel and womb.
His data suggests that for every 10,000 cancers prevented, there could be 1,000 extra ulcers due to aspirin.
"There's a trade-off. If we could get by on a smaller dose, then we could potentially avoid a lot of those ulcers," Burn told a news conference.
For the general population, taking low-dose aspirin might be a more sensible option, and a major new multi-dose trial should shed more light on this in the next few years, he added.
Delayed Effect
Burn and colleagues studied 861 people with Lynch syndrome, who began a two-year course of either 600 milligrams a day of aspirin or a placebo between 1999 and 2005.
An initial analysis in 2007 found no difference in cancer rates between the groups. But it turned out the effect was delayed and in 2010 there was a clear divergence, with 19 new bowel cancers among those on aspirin and 34 in the placebo arm.
What is more, among those patients who stuck to the full two-year regimen of pill-taking — some 60 percent of the total — the effects were more pronounced, and strongly statistically significant, with a 63 percent reduction in bowel cancer cases from 23 in the placebo group versus 10 in the aspirin group.
"What we have finally shown is that aspirin has a major preventative effect on cancer but this doesn't become apparent until years later," Burn said.
How exactly aspirin provides protection is unclear, but Burn said the delayed effect suggested aspirin may hit faulty stem cells before they mutate into pre-cancerous cells.
The study, which was published online by the Lancet medical journal and partially funded by Bayer, also found some evidence of a reduction in other solid cancers linked to Lynch syndrome.
"This is a really important study showing that aspirin can significantly reduce the risk of bowel and other cancers in patients genetically at high risk of developing cancer," said Chris Paraskeva of the University of Bristol, who was not involved in the research.
In a commentary in the Lancet, Andrew Chan of Harvard Medical School and Scott Lippman of the MD Anderson Cancer Center in Houston said the findings were "compelling" and arguably supported more general recommendations to consider aspirin for preventing bowel cancer, based on individual patients' risks.
The finding could also have implications for the wider population, though more research is needed to determine an ideal dose for different groups of people.
In recent years there has been an intense debate about the merits of routinely taking aspirin, which increases the risk of stomach ulcers and internal bleeding, but also protects against heart problems.
John Burn of Newcastle University believes his study — the first randomized controlled trial into the effect of aspirin on cancer outcomes — is a key piece of evidence validating the case for aspirin.
Previous research into cancer and aspirin, a cheap drug originally developed by Bayer more than a century ago, has been based on less robust observational studies.
Burn's study looked at people with Lynch syndrome, a genetic condition predisposing them to a range of cancers. It affects at least one in 1,000 people and around half of them develop cancer, mainly in the bowel and womb.
His data suggests that for every 10,000 cancers prevented, there could be 1,000 extra ulcers due to aspirin.
"There's a trade-off. If we could get by on a smaller dose, then we could potentially avoid a lot of those ulcers," Burn told a news conference.
For the general population, taking low-dose aspirin might be a more sensible option, and a major new multi-dose trial should shed more light on this in the next few years, he added.
Delayed Effect
Burn and colleagues studied 861 people with Lynch syndrome, who began a two-year course of either 600 milligrams a day of aspirin or a placebo between 1999 and 2005.
An initial analysis in 2007 found no difference in cancer rates between the groups. But it turned out the effect was delayed and in 2010 there was a clear divergence, with 19 new bowel cancers among those on aspirin and 34 in the placebo arm.
What is more, among those patients who stuck to the full two-year regimen of pill-taking — some 60 percent of the total — the effects were more pronounced, and strongly statistically significant, with a 63 percent reduction in bowel cancer cases from 23 in the placebo group versus 10 in the aspirin group.
"What we have finally shown is that aspirin has a major preventative effect on cancer but this doesn't become apparent until years later," Burn said.
How exactly aspirin provides protection is unclear, but Burn said the delayed effect suggested aspirin may hit faulty stem cells before they mutate into pre-cancerous cells.
The study, which was published online by the Lancet medical journal and partially funded by Bayer, also found some evidence of a reduction in other solid cancers linked to Lynch syndrome.
"This is a really important study showing that aspirin can significantly reduce the risk of bowel and other cancers in patients genetically at high risk of developing cancer," said Chris Paraskeva of the University of Bristol, who was not involved in the research.
In a commentary in the Lancet, Andrew Chan of Harvard Medical School and Scott Lippman of the MD Anderson Cancer Center in Houston said the findings were "compelling" and arguably supported more general recommendations to consider aspirin for preventing bowel cancer, based on individual patients' risks.
Drinking Boosts Heart Attack Survival
Women who drank anywhere from a few alcoholic drinks a month to more than three a week in the year leading up to a heart attack ended up living longer than women who never drank alcohol, according to a study.
The findings, which focused on more than 1,000 women and were published in the American Journal of Cardiology, add to mounting evidence that alcohol, regardless of the type of drink, can be good for the heart.
"One thing that was interesting was that we didn't see differences among different beverage types," said Joshua Rosenbloom, a student at Harvard Medical School who led the study.
"The most recent evidence suggests that it's the alcohol itself that's beneficial."
There was a similarly reduced risk of dying within the follow-up period whether the women drank wine, beer, or hard liquor, Rosenbloom and his colleagues found.
"One drink a day is a really good target, assuming that a person can be disciplined about that," said James O'Keefe, a cardiologist at St. Luke's Health System in Kansas City, Missouri, who was not involved in the study.
Researchers surveyed more than 1,200 women hospitalized for a heart attack. They asked questions about how many alcoholic drinks the women usually consumed, along with other health and lifestyle questions.
After at least 10 years of follow up, the team found that 44 out of every 100 women who had abstained from alcohol had died, while 25 out of every 100 light drinkers and 18 out of every 100 heavy drinkers had died.
This translated to about a 35 percent lower chance of dying during the follow-up period for women who drank, compared to those who didn't.
In an earlier study including men and women, O'Keefe found that people who continued to drink moderately after having a heart attack had better health than those who abstained.
"You don't need to assume that people need to stop drinking once they develop heart disease," he said.
"The problem is that alcohol is a slippery slope, and while we know that a little bit is good for us, a lot of it is really bad."
The findings, which focused on more than 1,000 women and were published in the American Journal of Cardiology, add to mounting evidence that alcohol, regardless of the type of drink, can be good for the heart.
"One thing that was interesting was that we didn't see differences among different beverage types," said Joshua Rosenbloom, a student at Harvard Medical School who led the study.
"The most recent evidence suggests that it's the alcohol itself that's beneficial."
There was a similarly reduced risk of dying within the follow-up period whether the women drank wine, beer, or hard liquor, Rosenbloom and his colleagues found.
"One drink a day is a really good target, assuming that a person can be disciplined about that," said James O'Keefe, a cardiologist at St. Luke's Health System in Kansas City, Missouri, who was not involved in the study.
Researchers surveyed more than 1,200 women hospitalized for a heart attack. They asked questions about how many alcoholic drinks the women usually consumed, along with other health and lifestyle questions.
After at least 10 years of follow up, the team found that 44 out of every 100 women who had abstained from alcohol had died, while 25 out of every 100 light drinkers and 18 out of every 100 heavy drinkers had died.
This translated to about a 35 percent lower chance of dying during the follow-up period for women who drank, compared to those who didn't.
In an earlier study including men and women, O'Keefe found that people who continued to drink moderately after having a heart attack had better health than those who abstained.
"You don't need to assume that people need to stop drinking once they develop heart disease," he said.
"The problem is that alcohol is a slippery slope, and while we know that a little bit is good for us, a lot of it is really bad."
Steroids Tied to Vitamin D Deficiency
People who use oral steroid medications may be at greater-than-average risk of a serious vitamin D deficiency, a new study suggests.
The findings, reported in the Journal of Clinical Endocrinology & Metabolism, do not prove that the drugs themselves are the cause.
But they do suggest that people on the medications should have their doctors check their blood levels of vitamin D, researchers say. And that may be especially important for children.
Steroid medications help control inflammation and are used for a number of medical conditions — including asthma, certain types of arthritis (such as rheumatoid arthritis), and autoimmune diseases like Crohn's disease, lupus, and multiple sclerosis.
In the new study, researchers found that among nearly 23,000 Americans in a government health survey, those using oral steroid medications were twice as likely as nonusers to have a severe vitamin D deficiency.
Overall, 11 percent of those on steroids had a vitamin D level below 10 ng/mL — which is considered too low to keep your bones, or the rest of you, healthy. That compared with 5 percent of study participants not on steroids.
Vitamin D levels that low can lead to a serious softening of the bones or muscle pain. Blood levels of about 20 ng/mL or above are considered sufficient for health.
"When doctors write that prescription for steroids and they're sending the patients for lab tests, they should also get the vitamin D level measured," lead researcher Dr. Amy L. Skversky, of Albert Einstein College of Medicine in New York, said in a news release from the university.
Skversky's team based their findings on a national health survey done between 2001 and 2006. It included 22,650 U.S. adults and children who had blood samples taken and reported on their medication use.
Just under one percent of the group said they'd used oral steroids in the past month — which would translate to 2.1 million Americans likely taking the drugs nationwide.
The steroid users in the study were twice as likely to have a vitamin D deficiency, even after researchers accounted for several other factors that affect D levels — including obesity, milk intake, and vitamin D supplement use.
The link was especially strong among children. Steroid users younger than 18 were 14 times more likely to have a vitamin D deficiency than kids not taking the medications.
It's not clear that the medications themselves were to blame, or fully to blame. It's likely, according to Skversky's team, that the conditions the drugs treat contribute to low vitamin D levels.
Some of those disorders can lead to poor nutrient absorption, for example, or limit people's physical activity — which may mean more time indoors, away from the sunlight that triggers the body's natural ability to make vitamin D.
On the other hand, there is evidence that steroid medications may lead to vitamin D deficiency, possibly by boosting an enzyme that curbs the vitamin's activity in the body.
The bottom line, according to Skversky, is that patients and doctors should be aware of the higher risk of vitamin D deficiency linked to oral steroids.
The latest recommendations from the Institute of Medicine, an advisory body to the U.S. government, are for most children and adults to get 600 IU of vitamin D per day. Adults older than 70 are advised to get 800 IU.
There are no special recommendations for people on steroid medication.
The sun is the major natural source of vitamin D. Food sources are relatively few and include fatty fish like salmon and mackerel, as well as dairy products and cereals that have added vitamin D. Multivitamins also contain vitamin D.
Not all steroids are taken orally. The study did not look at inhaled steroids, like those often used by people with asthma, so it's not clear if the findings would apply to those medications.
The findings, reported in the Journal of Clinical Endocrinology & Metabolism, do not prove that the drugs themselves are the cause.
But they do suggest that people on the medications should have their doctors check their blood levels of vitamin D, researchers say. And that may be especially important for children.
Steroid medications help control inflammation and are used for a number of medical conditions — including asthma, certain types of arthritis (such as rheumatoid arthritis), and autoimmune diseases like Crohn's disease, lupus, and multiple sclerosis.
In the new study, researchers found that among nearly 23,000 Americans in a government health survey, those using oral steroid medications were twice as likely as nonusers to have a severe vitamin D deficiency.
Overall, 11 percent of those on steroids had a vitamin D level below 10 ng/mL — which is considered too low to keep your bones, or the rest of you, healthy. That compared with 5 percent of study participants not on steroids.
Vitamin D levels that low can lead to a serious softening of the bones or muscle pain. Blood levels of about 20 ng/mL or above are considered sufficient for health.
"When doctors write that prescription for steroids and they're sending the patients for lab tests, they should also get the vitamin D level measured," lead researcher Dr. Amy L. Skversky, of Albert Einstein College of Medicine in New York, said in a news release from the university.
Skversky's team based their findings on a national health survey done between 2001 and 2006. It included 22,650 U.S. adults and children who had blood samples taken and reported on their medication use.
Just under one percent of the group said they'd used oral steroids in the past month — which would translate to 2.1 million Americans likely taking the drugs nationwide.
The steroid users in the study were twice as likely to have a vitamin D deficiency, even after researchers accounted for several other factors that affect D levels — including obesity, milk intake, and vitamin D supplement use.
The link was especially strong among children. Steroid users younger than 18 were 14 times more likely to have a vitamin D deficiency than kids not taking the medications.
It's not clear that the medications themselves were to blame, or fully to blame. It's likely, according to Skversky's team, that the conditions the drugs treat contribute to low vitamin D levels.
Some of those disorders can lead to poor nutrient absorption, for example, or limit people's physical activity — which may mean more time indoors, away from the sunlight that triggers the body's natural ability to make vitamin D.
On the other hand, there is evidence that steroid medications may lead to vitamin D deficiency, possibly by boosting an enzyme that curbs the vitamin's activity in the body.
The bottom line, according to Skversky, is that patients and doctors should be aware of the higher risk of vitamin D deficiency linked to oral steroids.
The latest recommendations from the Institute of Medicine, an advisory body to the U.S. government, are for most children and adults to get 600 IU of vitamin D per day. Adults older than 70 are advised to get 800 IU.
There are no special recommendations for people on steroid medication.
The sun is the major natural source of vitamin D. Food sources are relatively few and include fatty fish like salmon and mackerel, as well as dairy products and cereals that have added vitamin D. Multivitamins also contain vitamin D.
Not all steroids are taken orally. The study did not look at inhaled steroids, like those often used by people with asthma, so it's not clear if the findings would apply to those medications.
Top Docs Support PSA Screening
A survey of top doctors conducted by U.S. News & World Report found that almost all urologists and more than 60 percent of those who specialize in internal medicine support routine PSA testing. They rejected a proposal issued by the U.S. Preventive Services Task Force which advised doctor not to routinely screen men for PSA levels unless they have "highly suspicious" symptoms that point to prostate cancer.
The PSA test screens men for prostate cancer by measuring the blood level of a specific protein (prostate-specific antigen) that is connected with an increased risk of prostate cancer. Its purpose is to catch the disease early, when it's at its most curable stages. Of the 20 million men who undergo PSA screening each year, about 250, 000 are diagnosed with prostate cancer.
The government's proposal found there was little evidence that routinely screening men for PSA levels significantly reduced deaths from prostate cancer. The small benefit, they concluded, was overshadowed by the odds of an incorrect diagnosis.
But the doctors surveyed by U.S. News disagreed. "If you argue that you should not use PSA testing at all in [men without symptoms], you're essentially saying you don't want to find prostate cancer at a curable stage," Dr. Samir S. Taneja, director of urologic cancer at NYU Langone Medical Center and a responder to the survey, told U.S. News.
Of the urologist who responded to the survey, about 95 percent said doctors should continue to advise men to begin screening at age 50.
Survey of Top Doctors Finds Widespread Support for PSA Screening
Top Doctors strongly disagree with government task force proposal to drop use of prostate cancer test
In an exclusive new survey of Top Doctors conducted by U.S. News & World Report, virtually all responding urologists and more than 60 percent of internal-medicine specialists rejected the recent proposal by a high-level government advisory committee to end routine PSA testing, which is meant to catch prostate cancer early.
An estimated 20 million men a year undergo PSA screening, which determines the blood level of a protein called prostate-specific antigen; nearly 250,000 of them are diagnosed with prostate cancer. The proposal, issued by the U.S. Preventive Services Task Force, advises doctors not to screen patients with the PSA test unless they have symptoms that are "highly suspicious" for prostate cancer.
"If you argue that you should not use PSA testing at all in [men without symptoms], you're essentially saying you don't want to find prostate cancer at a curable stage," says Dr. Samir S. Taneja, director of urologic cancer at NYU Langone Medical Center and a responder to last week's U.S. News survey.
The government task force found little evidence that screening men with the PSA test significantly reduces deaths from prostate cancer. Whatever small benefit there might be, the task force concluded, is outweighed by the risk of an incorrect diagnosis or unnecessary procedure leading to death or complications. About a third of men treated for prostate cancer suffer urinary incontinence, impotence, or both, and about 1 in every 200 dies within 30 days from complications of surgery.
Doctors have debated the risks and benefits of the PSA test since 1994, when the Food and Drug Administration approved it for cancer screening. Even the test's supporters acknowledge that it is inherently imprecise. A high PSA level may indicate the presence of a tumor—or it may not. Nor is a low PSA level necessarily an all-clear. Moreover, the test cannot distinguish between a typical tumor, which grows so slowly that the threat is minimal, and one that is aggressive and potentially lethal.
To determine whether some of the nation's best doctors agree with the task force's proposed recommendation, U.S. News surveyed more than 600 urologists and internists who are recognized as Top Doctors by U.S. News and Castle Connolly Medical Ltd. More than a third of the physicians responded. (For a breakdown of the questions and responses, see Behind the U.S. News Top Doctors Survey on PSA Screening.)
About 95 percent of the responding urologists felt that doctors should continue to advise men starting at age 50, when testing typically begins, to have PSA screenings as part of a routine physical exam, contrary to the task force's recommendation. They included themselves in that group; 97 percent indicated they would be tested starting at 50. The internists were less unanimous—about 40 percent agreed with the proposed recommendation to end routine testing. But 72 percent of the responding male internists indicated that they themselves would have the test starting at age 50.
The vast majority of the survey respondents sent U.S. News comments as well. "Can you put a price on being saved from dying of cancer?" wrote Dr. Ernest H. Agatstein, a urologist with Paletz Agatstein Urology Medical Group in Downey, Calif.
PSA screening is "an awesome test," wrote Dr. Richard J. Macchia, a urologist at Cleveland Clinic Florida in Weston. "When I was young," he went on, "almost all the prostate cancer patients I saw had metastatic disease at diagnosis. Now, in patients who have their PSAs checked, I almost never see metastatic disease at the time of diagnosis. We can cure metastatic diseases only rarely."
The PSA test screens men for prostate cancer by measuring the blood level of a specific protein (prostate-specific antigen) that is connected with an increased risk of prostate cancer. Its purpose is to catch the disease early, when it's at its most curable stages. Of the 20 million men who undergo PSA screening each year, about 250, 000 are diagnosed with prostate cancer.
The government's proposal found there was little evidence that routinely screening men for PSA levels significantly reduced deaths from prostate cancer. The small benefit, they concluded, was overshadowed by the odds of an incorrect diagnosis.
But the doctors surveyed by U.S. News disagreed. "If you argue that you should not use PSA testing at all in [men without symptoms], you're essentially saying you don't want to find prostate cancer at a curable stage," Dr. Samir S. Taneja, director of urologic cancer at NYU Langone Medical Center and a responder to the survey, told U.S. News.
Of the urologist who responded to the survey, about 95 percent said doctors should continue to advise men to begin screening at age 50.
Survey of Top Doctors Finds Widespread Support for PSA Screening
Top Doctors strongly disagree with government task force proposal to drop use of prostate cancer test
In an exclusive new survey of Top Doctors conducted by U.S. News & World Report, virtually all responding urologists and more than 60 percent of internal-medicine specialists rejected the recent proposal by a high-level government advisory committee to end routine PSA testing, which is meant to catch prostate cancer early.
An estimated 20 million men a year undergo PSA screening, which determines the blood level of a protein called prostate-specific antigen; nearly 250,000 of them are diagnosed with prostate cancer. The proposal, issued by the U.S. Preventive Services Task Force, advises doctors not to screen patients with the PSA test unless they have symptoms that are "highly suspicious" for prostate cancer.
"If you argue that you should not use PSA testing at all in [men without symptoms], you're essentially saying you don't want to find prostate cancer at a curable stage," says Dr. Samir S. Taneja, director of urologic cancer at NYU Langone Medical Center and a responder to last week's U.S. News survey.
The government task force found little evidence that screening men with the PSA test significantly reduces deaths from prostate cancer. Whatever small benefit there might be, the task force concluded, is outweighed by the risk of an incorrect diagnosis or unnecessary procedure leading to death or complications. About a third of men treated for prostate cancer suffer urinary incontinence, impotence, or both, and about 1 in every 200 dies within 30 days from complications of surgery.
Doctors have debated the risks and benefits of the PSA test since 1994, when the Food and Drug Administration approved it for cancer screening. Even the test's supporters acknowledge that it is inherently imprecise. A high PSA level may indicate the presence of a tumor—or it may not. Nor is a low PSA level necessarily an all-clear. Moreover, the test cannot distinguish between a typical tumor, which grows so slowly that the threat is minimal, and one that is aggressive and potentially lethal.
To determine whether some of the nation's best doctors agree with the task force's proposed recommendation, U.S. News surveyed more than 600 urologists and internists who are recognized as Top Doctors by U.S. News and Castle Connolly Medical Ltd. More than a third of the physicians responded. (For a breakdown of the questions and responses, see Behind the U.S. News Top Doctors Survey on PSA Screening.)
About 95 percent of the responding urologists felt that doctors should continue to advise men starting at age 50, when testing typically begins, to have PSA screenings as part of a routine physical exam, contrary to the task force's recommendation. They included themselves in that group; 97 percent indicated they would be tested starting at 50. The internists were less unanimous—about 40 percent agreed with the proposed recommendation to end routine testing. But 72 percent of the responding male internists indicated that they themselves would have the test starting at age 50.
The vast majority of the survey respondents sent U.S. News comments as well. "Can you put a price on being saved from dying of cancer?" wrote Dr. Ernest H. Agatstein, a urologist with Paletz Agatstein Urology Medical Group in Downey, Calif.
PSA screening is "an awesome test," wrote Dr. Richard J. Macchia, a urologist at Cleveland Clinic Florida in Weston. "When I was young," he went on, "almost all the prostate cancer patients I saw had metastatic disease at diagnosis. Now, in patients who have their PSAs checked, I almost never see metastatic disease at the time of diagnosis. We can cure metastatic diseases only rarely."
How Diabetics Can Control Cholesterol - Lower Your Risk of Heart Disease and Stroke
Because people with diabetes are prone to cardiovascular problems, keeping blood vessels healthy is especially crucial. That can be difficult with hard-to-control blood sugar and the strain it takes on the heart, kidneys and eyes. Here are ways to protect your arteries – and prevent heart attack and stroke – through simple lifestyle changes…
Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes and kidneys.
Heart and blood vessel disease can lead to heart attacks and strokes, the leading causes of death for people with diabetes. You can do a lot to prevent or slow down diabetes problems each day and year to stay healthy and prevent diabetes-related problems.
What should I do each day to stay healthy with diabetes?
Follow the healthy eating plan that you and your doctor or dietitian have worked out.
Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
Take your medicines as directed.
What can I do to prevent heart disease and stroke?
People with diabetes can do a lot to prevent heart disease and stroke. For example:
Keep glucose in the blood under control. See if your blood glucose is under control by having an A1C test at least twice a year. The A1C test tells you your average blood glucose for the past 2-3 months. The target for most people with diabetes is below 7. In some people with heart disease or other circumstances, their doctor may recommend slightly higher levels of A1C.
Keep your blood pressure under control. Have it checked at every doctor visit. The target for most people with diabetes is below 130/80.
Keep your blood cholesterol level under control. Have it checked at least once a year. The targets for most people with diabetes are
LDL (low-density lipoproteins or bad cholesterol): below 100
HDL (high-density lipoproteins or good cholesterol): above 40 in men and above 50 in women
Triglycerides, another type of fat in the blood: below 150
Make physical activity a part of your daily routine. Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you. Take a half-hour walk every day or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the lot. Choose an activity you like and stay active.
Eat "heart-healthy" foods: Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods.
Lose weight. If you are overweight, try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.
If you smoke, quit. Your doctor can tell you about ways to help quit smoking.
Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
How do my blood vessels get clogged?
Several things, including having diabetes, can make your blood cholesterol level too high. Cholesterol, a substance made by the body, is used for many important functions, including to produce hormones. It's also found in some food derived from animals.
When cholesterol is too high, the insides of large blood vessels become narrowed or clogged, a problem called atherosclerosis. Narrowed and clogged blood vessels make it harder for enough blood to get to all parts of your body. This condition can cause problems.
What happens when blood vessels are clogged?
You can have serious health problems, for example:
Chest pain, also called angina. With angina, you feel pain in your chest, arms, shoulders or back. You may feel the pain more when your heart beats faster, such as when you exercise. It may go away when you rest. You also may sweat a lot and feel very weak. If you don't get treatment, chest pain may happen more often. If diabetes has damaged your heart nerves, you may not feel the chest pain. If you have chest pain with activity, contact your doctor.
Heart attack. A heart attack happens when a blood vessel in or near your heart becomes blocked. Then your heart muscle can't get enough blood. When an area of your heart stops working, it becomes weaker. During a heart attack, you may have chest pain along with nausea, indigestion, extreme weakness and sweating. Or you may have no symptoms at all. If you have chest pain that persists, call 911. Delay in getting treatment may make a heart attack worse.
Stroke. A stroke can happen when the blood supply to your brain is blocked. Then your brain can be damaged.
What are the warning signs of a heart attack?
You may have one or more of the following warning signs:
chest pain or discomfort
pain or discomfort in your arms, back, jaw, or neck
indigestion or stomach pain
shortness of breath
sweating
nausea
light-headedness
Or, you may have no symptoms at all. They may come and go. If you have any of these warning signs, call 911 right away. Getting prompt treatment can reduce damage to the heart.
How do narrowed blood vessels cause high blood pressure?
Narrowed blood vessels leave a smaller opening for blood to flow through. Having narrowed blood vessels is like turning on a garden hose and holding your thumb over the opening. The smaller opening makes the water shoot out with more pressure.
In the same way, narrowed blood vessels lead to high blood pressure. Other factors, such as kidney problems and being overweight, also can lead to high blood pressure.
Many people with diabetes also have high blood pressure. If you have heart, eye or kidney problems from diabetes, high blood pressure can make them worse.
You will see your blood pressure written with two numbers separated by a slash. For example, your reading might be 120/70, said as "120 over 70." For people with diabetes, the target is to keep the first number below 130 and the second number below 80.
If you have high blood pressure, ask your doctor how to lower it. Your doctor may ask you to take blood pressure medicine daily. Some blood pressure medicines can also help keep your kidneys healthy.
You may also be able to control your blood pressure by:
Eating more fruits and vegetables
Eating less salt and high-sodium foods
Losing weight if you need to
Being physically active
Not smoking
Limiting alcoholic drinks
Getting to a healthy weight
What are the warning signs of a stroke?
A stroke happens when part of your brain is not getting enough blood and stops working. Depending on the part of the brain that's damaged, a stroke can cause:
Sudden weakness or numbness of your face, arm, or leg on one side of your body
Sudden confusion, trouble talking or trouble understanding
Sudden dizziness, loss of balance or trouble walking
Sudden trouble seeing in one or both eyes or double vision
Sudden severe headache
Sometimes, one or more of these warning signs may happen and then disappear. You might be having a "mini-stroke," also called a TIA or a transient ischemic attack.
If you have any of these warning signs, call 911 right away. Getting care for a TIA may reduce or prevent a stroke. Getting prompt treatment for a stroke can reduce the damage to the brain and improve chances for recovery.
How can clogged blood vessels hurt my legs and feet?
Peripheral arterial disease, also called PAD, can happen when the openings in your blood vessels become narrow and your legs and feet don't get enough blood. You may feel pain in your legs when you walk or exercise. Some people also have numbness or tingling in their feet or legs or have sores that heal slowly.
What can I do to prevent or control PAD?
Don't smoke.
Keep glucose in the blood and blood pressure under control.
Keep blood fats close to normal.
Be physically active.
Ask your doctor if you should take aspirin every day.
You also may need surgery to treat PAD.
For more information, visit our Type 2 Diabetes Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes and kidneys.
Heart and blood vessel disease can lead to heart attacks and strokes, the leading causes of death for people with diabetes. You can do a lot to prevent or slow down diabetes problems each day and year to stay healthy and prevent diabetes-related problems.
What should I do each day to stay healthy with diabetes?
Follow the healthy eating plan that you and your doctor or dietitian have worked out.
Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
Take your medicines as directed.
What can I do to prevent heart disease and stroke?
People with diabetes can do a lot to prevent heart disease and stroke. For example:
Keep glucose in the blood under control. See if your blood glucose is under control by having an A1C test at least twice a year. The A1C test tells you your average blood glucose for the past 2-3 months. The target for most people with diabetes is below 7. In some people with heart disease or other circumstances, their doctor may recommend slightly higher levels of A1C.
Keep your blood pressure under control. Have it checked at every doctor visit. The target for most people with diabetes is below 130/80.
Keep your blood cholesterol level under control. Have it checked at least once a year. The targets for most people with diabetes are
LDL (low-density lipoproteins or bad cholesterol): below 100
HDL (high-density lipoproteins or good cholesterol): above 40 in men and above 50 in women
Triglycerides, another type of fat in the blood: below 150
Make physical activity a part of your daily routine. Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you. Take a half-hour walk every day or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the lot. Choose an activity you like and stay active.
Eat "heart-healthy" foods: Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods.
Lose weight. If you are overweight, try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.
If you smoke, quit. Your doctor can tell you about ways to help quit smoking.
Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.
How do my blood vessels get clogged?
Several things, including having diabetes, can make your blood cholesterol level too high. Cholesterol, a substance made by the body, is used for many important functions, including to produce hormones. It's also found in some food derived from animals.
When cholesterol is too high, the insides of large blood vessels become narrowed or clogged, a problem called atherosclerosis. Narrowed and clogged blood vessels make it harder for enough blood to get to all parts of your body. This condition can cause problems.
What happens when blood vessels are clogged?
You can have serious health problems, for example:
Chest pain, also called angina. With angina, you feel pain in your chest, arms, shoulders or back. You may feel the pain more when your heart beats faster, such as when you exercise. It may go away when you rest. You also may sweat a lot and feel very weak. If you don't get treatment, chest pain may happen more often. If diabetes has damaged your heart nerves, you may not feel the chest pain. If you have chest pain with activity, contact your doctor.
Heart attack. A heart attack happens when a blood vessel in or near your heart becomes blocked. Then your heart muscle can't get enough blood. When an area of your heart stops working, it becomes weaker. During a heart attack, you may have chest pain along with nausea, indigestion, extreme weakness and sweating. Or you may have no symptoms at all. If you have chest pain that persists, call 911. Delay in getting treatment may make a heart attack worse.
Stroke. A stroke can happen when the blood supply to your brain is blocked. Then your brain can be damaged.
What are the warning signs of a heart attack?
You may have one or more of the following warning signs:
chest pain or discomfort
pain or discomfort in your arms, back, jaw, or neck
indigestion or stomach pain
shortness of breath
sweating
nausea
light-headedness
Or, you may have no symptoms at all. They may come and go. If you have any of these warning signs, call 911 right away. Getting prompt treatment can reduce damage to the heart.
How do narrowed blood vessels cause high blood pressure?
Narrowed blood vessels leave a smaller opening for blood to flow through. Having narrowed blood vessels is like turning on a garden hose and holding your thumb over the opening. The smaller opening makes the water shoot out with more pressure.
In the same way, narrowed blood vessels lead to high blood pressure. Other factors, such as kidney problems and being overweight, also can lead to high blood pressure.
Many people with diabetes also have high blood pressure. If you have heart, eye or kidney problems from diabetes, high blood pressure can make them worse.
You will see your blood pressure written with two numbers separated by a slash. For example, your reading might be 120/70, said as "120 over 70." For people with diabetes, the target is to keep the first number below 130 and the second number below 80.
If you have high blood pressure, ask your doctor how to lower it. Your doctor may ask you to take blood pressure medicine daily. Some blood pressure medicines can also help keep your kidneys healthy.
You may also be able to control your blood pressure by:
Eating more fruits and vegetables
Eating less salt and high-sodium foods
Losing weight if you need to
Being physically active
Not smoking
Limiting alcoholic drinks
Getting to a healthy weight
What are the warning signs of a stroke?
A stroke happens when part of your brain is not getting enough blood and stops working. Depending on the part of the brain that's damaged, a stroke can cause:
Sudden weakness or numbness of your face, arm, or leg on one side of your body
Sudden confusion, trouble talking or trouble understanding
Sudden dizziness, loss of balance or trouble walking
Sudden trouble seeing in one or both eyes or double vision
Sudden severe headache
Sometimes, one or more of these warning signs may happen and then disappear. You might be having a "mini-stroke," also called a TIA or a transient ischemic attack.
If you have any of these warning signs, call 911 right away. Getting care for a TIA may reduce or prevent a stroke. Getting prompt treatment for a stroke can reduce the damage to the brain and improve chances for recovery.
How can clogged blood vessels hurt my legs and feet?
Peripheral arterial disease, also called PAD, can happen when the openings in your blood vessels become narrow and your legs and feet don't get enough blood. You may feel pain in your legs when you walk or exercise. Some people also have numbness or tingling in their feet or legs or have sores that heal slowly.
What can I do to prevent or control PAD?
Don't smoke.
Keep glucose in the blood and blood pressure under control.
Keep blood fats close to normal.
Be physically active.
Ask your doctor if you should take aspirin every day.
You also may need surgery to treat PAD.
For more information, visit our Type 2 Diabetes Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
Sunday, October 30, 2011
THOUGHT FOR THE DAY...
Whenever you are asked if you can do a job, tell 'em, 'Certainly I can!' Then get busy and find out how to do it. - Theodore Roosevelt, 1858-1919
FUN FACTS
* Curvy hips indicate smart women who will deliver intelligent children. *
* On average, someone in the US suffers a stroke every 40 seconds; someone dies every 3 minutes from stroke. *
* Brain scans show that people who view photos of a beloved experience an activation of the caudate - the part of the brain involving cravings. *
* After age 30, the brain shrinks a quarter of a percent (0.25%) in mass each year. *
* 10 seconds is the amount of time until unconsciousness after the loss of blood supply to the brain. *
* The brain can stay alive for 4 to 6 minutes without oxygen. After that cells begin die. *
* A man's beard grows fastest when he anticipates sex. *
* On average, someone in the US suffers a stroke every 40 seconds; someone dies every 3 minutes from stroke. *
* Brain scans show that people who view photos of a beloved experience an activation of the caudate - the part of the brain involving cravings. *
* After age 30, the brain shrinks a quarter of a percent (0.25%) in mass each year. *
* 10 seconds is the amount of time until unconsciousness after the loss of blood supply to the brain. *
* The brain can stay alive for 4 to 6 minutes without oxygen. After that cells begin die. *
* A man's beard grows fastest when he anticipates sex. *
Why you should never trust 'doctor's orders' - AND - Bacteria love your cellphone
Why you should never trust 'doctor's orders'
Sometimes, it might seem like your doctor is relying on years of education and experience.
Other times, you might be convinced he's making it up as he goes.
In reality, most doctors follow the guidelines issued by the major medical associations -- and that means some of the biggest decisions he makes about you and your health are based on badly biased information.
Treatment guidelines are routinely written by "experts" with a direct financial stake in the outcome -- and now, a new study finds a massive chain of conflicts in the guidelines written for diabetes treatments and cholesterol control.
Since these just so happen to be two of the most medicated (not to mention over-medicated) conditions in the country, is anyone really surprised?
There have been 288 "experts" on the 14 cholesterol and diabetes panels that have met in the United States and Canada over the past decade, and researchers say 52 percent of them had conflicts of interest such as financial ties to the drug industry.
Even worse, they found those conflicts among 11 percent of the panelists who claimed they were free and clear.
Whoops. Busted!
And of course, you can't really stack a deck without putting some of your best cards on top -- so half of all chairs of the guideline-writing committees had conflicts.
The panels were convened by organizations including private ones like the American Diabetes Association and American Heart Association as well as government groups such as the U.S. Preventive Services Task Force.
But when you break it down, only 16 percent of the members of government-sponsored panels had conflicts, versus 69 percent of those convened by nongovernmental groups.
What's more, five of the groups in the study didn't even require conflict disclosures -- and the U.S. Preventive Services Task Force won't reveal its own without a Freedom of Information Act request.
That's one of those things that make it look like you're hiding something... even if you're not.
This isn't limited to cholesterol and diabetes panels -- not by a longshot.
Earlier this year, researchers examined 17 critical guidelines from the American Heart Association and American College of Cardiology that were issued between 2003 and 2008, and found that 56 percent of the 498 people who helped write them had conflicts of interest... including 81 percent of those who led the groups.
Put it all together, and it's pretty clear why you can't leave your doctor's office without yet another prescription: The deck was stacked against you long before you even walked through the door.
__________________________________________________________________________
Bacteria love your cellphone
I'm always a little grossed out when I see someone walk out of the bathroom with a cellphone in hand -- either checking messages or already mid-conversation.
Don't ask when -- or where -- that conversation started... you probably don't want to know.
The thought alone is enough to make you sick, but the latest research shows how it could make you literally ill: Cellphones are crawling with germs, including the nasty bacteria that live in poop.
I don't know about you, but that's enough to make me think twice about borrowing someone else's cellphone.
British researchers collected 390 samples from cellphones and hands in 12 U.K. cities and found bacteria on 92 percent of phones and 82 percent of hands.
Now, you know there are different types of bacteria out there. Some of them are bound to be crawling on you at any given time, and most of them are pretty harmless.
But 16 percent of hands and cellphones had the E. coli bacteria found in feces -- even though 95 percent claimed to have washed their hands.
Yeah, right.
The researchers say they didn't ask if people used their phones on the toilet -- but point out that since people use their phones pretty much everywhere else, it's not out of the question that people are conducting business while doing their business.
And that means you could transfer germs to the phone while on the toilet, wash your hands and then get germy all over again when you pick up the phone -- because phones don't get washed.
Not if you want to be able to use the phone, anyway.
You're not supposed to use liquids of any kind on the newest phones, and the alcohol that can kill bugs is a definite no-no on those shiny smartphone screens.
That means the best defense is prevention: Don't touch your phone when you're in the bathroom. Write on the walls instead.
Then, wash you hands before you even think of checking to see who texted you you while you were doing your business.
Finally, don't borrow anyone else's cellphone. And, just to be safe, don't let anyone borrow yours.
On a mission for your health,
Ed Martin
Editor, House Calls
Sometimes, it might seem like your doctor is relying on years of education and experience.
Other times, you might be convinced he's making it up as he goes.
In reality, most doctors follow the guidelines issued by the major medical associations -- and that means some of the biggest decisions he makes about you and your health are based on badly biased information.
Treatment guidelines are routinely written by "experts" with a direct financial stake in the outcome -- and now, a new study finds a massive chain of conflicts in the guidelines written for diabetes treatments and cholesterol control.
Since these just so happen to be two of the most medicated (not to mention over-medicated) conditions in the country, is anyone really surprised?
There have been 288 "experts" on the 14 cholesterol and diabetes panels that have met in the United States and Canada over the past decade, and researchers say 52 percent of them had conflicts of interest such as financial ties to the drug industry.
Even worse, they found those conflicts among 11 percent of the panelists who claimed they were free and clear.
Whoops. Busted!
And of course, you can't really stack a deck without putting some of your best cards on top -- so half of all chairs of the guideline-writing committees had conflicts.
The panels were convened by organizations including private ones like the American Diabetes Association and American Heart Association as well as government groups such as the U.S. Preventive Services Task Force.
But when you break it down, only 16 percent of the members of government-sponsored panels had conflicts, versus 69 percent of those convened by nongovernmental groups.
What's more, five of the groups in the study didn't even require conflict disclosures -- and the U.S. Preventive Services Task Force won't reveal its own without a Freedom of Information Act request.
That's one of those things that make it look like you're hiding something... even if you're not.
This isn't limited to cholesterol and diabetes panels -- not by a longshot.
Earlier this year, researchers examined 17 critical guidelines from the American Heart Association and American College of Cardiology that were issued between 2003 and 2008, and found that 56 percent of the 498 people who helped write them had conflicts of interest... including 81 percent of those who led the groups.
Put it all together, and it's pretty clear why you can't leave your doctor's office without yet another prescription: The deck was stacked against you long before you even walked through the door.
__________________________________________________________________________
Bacteria love your cellphone
I'm always a little grossed out when I see someone walk out of the bathroom with a cellphone in hand -- either checking messages or already mid-conversation.
Don't ask when -- or where -- that conversation started... you probably don't want to know.
The thought alone is enough to make you sick, but the latest research shows how it could make you literally ill: Cellphones are crawling with germs, including the nasty bacteria that live in poop.
I don't know about you, but that's enough to make me think twice about borrowing someone else's cellphone.
British researchers collected 390 samples from cellphones and hands in 12 U.K. cities and found bacteria on 92 percent of phones and 82 percent of hands.
Now, you know there are different types of bacteria out there. Some of them are bound to be crawling on you at any given time, and most of them are pretty harmless.
But 16 percent of hands and cellphones had the E. coli bacteria found in feces -- even though 95 percent claimed to have washed their hands.
Yeah, right.
The researchers say they didn't ask if people used their phones on the toilet -- but point out that since people use their phones pretty much everywhere else, it's not out of the question that people are conducting business while doing their business.
And that means you could transfer germs to the phone while on the toilet, wash your hands and then get germy all over again when you pick up the phone -- because phones don't get washed.
Not if you want to be able to use the phone, anyway.
You're not supposed to use liquids of any kind on the newest phones, and the alcohol that can kill bugs is a definite no-no on those shiny smartphone screens.
That means the best defense is prevention: Don't touch your phone when you're in the bathroom. Write on the walls instead.
Then, wash you hands before you even think of checking to see who texted you you while you were doing your business.
Finally, don't borrow anyone else's cellphone. And, just to be safe, don't let anyone borrow yours.
On a mission for your health,
Ed Martin
Editor, House Calls
Stay Healthy This Winter - FLU VACCINE DANGEROUS, COMPLICATIONS??
Old Man Winter is on his way, bringing with him viruses and colds. In addition to being a sign that Halloween is near, jack-o'-lanterns also indicate that flu season is imminent, along with the usual frantic warnings from the health community to get a flu shot.
Regular readers of my newsletter know I am opposed to the flu vaccine. Much of the hype concerning the flu is nothing but scare tactics by those who benefit from selling flu vaccines and those receiving money from vaccine manufacturers.
I believe the vaccine itself is dangerous. Many people suffer complications from it, and some are left permanently paralyzed and neurologically damaged. One recent study found that people over the age of 55 who receive the flu vaccine every year for five years in a row increase their risk of developing Alzheimer’s disease 10-fold, in part due to two powerful brain toxins in the vaccine. My report "Vaccines and Brain Injuries — Are You At Risk?"will give you more information on the dangers of vaccines.
Fortunately, there are ways to fight colds and viruses, including the flu, that get results. These include simple precautions, such as avoiding crowds and washing your hands. Viruses are commonly spread by touching contaminated objects — like doorknobs, phones, and shared computer keyboards — as well as from shaking hands. The key is to have all members of the family wash their hands frequently.
Children are primary carriers of viruses. In addition to making sure they wash their hands as they emerge from the bathroom and before handling food, wipe their toys often with a safe cleaner. Studies have shown that children’s toys, especially child walkers, are a source of some of the nastiest germs. Since babies often put toys in their mouths, they can be a frequent cause of middle-ear infections.
In addition, a good way to prevent viruses or reduce their impact is to supplement your diet with a well-balanced multivitamin/mineral capsule. Studies have shown that a deficiency of even a single vitamin, such as vitamin C, or a single mineral, such as selenium, can dramatically impair the immune system. And recent studies have indicated that many Americans aren’t getting enough vitamin D in their diets, especially in winter. To learn more about vitamin D-3, read my special report "Vitamin D's Hidden Role in Your Health."
Additional nutrients can boost the immune system and help it fight off winter germs. For a complete list, read my special report "Winter Health Worries."
Dr. Blaylock’s
Regular readers of my newsletter know I am opposed to the flu vaccine. Much of the hype concerning the flu is nothing but scare tactics by those who benefit from selling flu vaccines and those receiving money from vaccine manufacturers.
I believe the vaccine itself is dangerous. Many people suffer complications from it, and some are left permanently paralyzed and neurologically damaged. One recent study found that people over the age of 55 who receive the flu vaccine every year for five years in a row increase their risk of developing Alzheimer’s disease 10-fold, in part due to two powerful brain toxins in the vaccine. My report "Vaccines and Brain Injuries — Are You At Risk?"will give you more information on the dangers of vaccines.
Fortunately, there are ways to fight colds and viruses, including the flu, that get results. These include simple precautions, such as avoiding crowds and washing your hands. Viruses are commonly spread by touching contaminated objects — like doorknobs, phones, and shared computer keyboards — as well as from shaking hands. The key is to have all members of the family wash their hands frequently.
Children are primary carriers of viruses. In addition to making sure they wash their hands as they emerge from the bathroom and before handling food, wipe their toys often with a safe cleaner. Studies have shown that children’s toys, especially child walkers, are a source of some of the nastiest germs. Since babies often put toys in their mouths, they can be a frequent cause of middle-ear infections.
In addition, a good way to prevent viruses or reduce their impact is to supplement your diet with a well-balanced multivitamin/mineral capsule. Studies have shown that a deficiency of even a single vitamin, such as vitamin C, or a single mineral, such as selenium, can dramatically impair the immune system. And recent studies have indicated that many Americans aren’t getting enough vitamin D in their diets, especially in winter. To learn more about vitamin D-3, read my special report "Vitamin D's Hidden Role in Your Health."
Additional nutrients can boost the immune system and help it fight off winter germs. For a complete list, read my special report "Winter Health Worries."
Dr. Blaylock’s
11 Joint Supplements You Haven’t Tried - Lesser-Known Natural Remedies for Osteoarthritis Pain
If you suffer from osteoarthritis pain, you’ll probably try anything to ease stiffness and discomfort. Glucosamine is the most well-known, but many other natural arthritis remedies work just as well. From plant bark to spices to shellfish, these joint supplements could become an important part of your arthritis regimen. Read on to learn about their effectiveness and how to take them safely...
A lot of controversy has arisen over common joint supplements like glucosamine and chondroitin, spurred by large studies that questioned their effectiveness at easing osteoarthritis pain.
But those aren’t the only natural arthritis remedies out there. An array of natural supplements reduce pain, stiffness and joint inflammation.
Some are traditional herbs and spices that have been used for centuries; others were recently proven effective by modern science. Most can be taken with or without medications.
“Whether or not you’re taking prescription or non-prescription osteoarthritis pain relievers, it may be worthwhile to turn to [these] supplements,” says David Pisetsky, M.D., Ph.D., chief of rheumatology, allergy and clinical immunology at Duke University Medical Center in Durham, N.C.
But just because a supplement is labeled “natural” doesn’t mean it’s safe, Pisetsky warns. Talk to your doctor about proper dosage, potential allergies and drug interactions first.
“It’s possible to take too much, and many supplements can have side effects,” Pisetsky says. “Hiding [them] from your doctor can affect the success of your treatment.”
With that in mind, here are 11 joint supplements worth considering.
Joint Supplement #1: Digestive enzymes
Proteolytic enzymes help you digest protein. Some come from animal sources (trypsin and chymotrypsin are also made by your pancreas), while others are derived from foods (papain from papaya and bromelain from pineapple).
These enzymes may reduce pain and inflammation and remove cellular waste products associated with osteoarthritis pain, according to a 2008 study by Cardiff University in Wales.
Don’t take these enzymes if you’re also on prescription blood thinners or having surgery in less than two weeks, Mangrum says. Be careful if you have gastroesophageal reflux disease (GERD) because enzymes can irritate the gastrointestinal tract.
And steer clear if you're allergic to pineapples or papayas because you may have a reaction to their enzymes too.
Recommended dosage: “Most [of these] products are made of a combination of enzymes, and there’s no standardized dose,” Mangrum says. “It’s generally best to find a product from a high-quality supplier and use the amount recommended on the bottle.”
Look for the United States Pharmacopeia (USP) Verified seal. The nonprofit organization tests supplements for quality, purity and consistency.
Enzymes are best when taken with water, between meals and 60 minutes apart from non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which are enzyme inhibitors.
Joint Supplement #2: Pycnogenol
That is the brand name for an antioxidant-rich water extract of bark from the French maritime pine – a tree grown in coastal southwest France. Pycnogenol supplements may have short-term benefits in relieving osteoarthritis pain, some studies have shown.
The compound reduced symptoms of knee OA by 55%, and stiffness levels dropped by 53%, in a 2009 study by Chieti-Pescara University in Italy. As a result, participants trimmed their use of NSAIDs by 58%, the study found.
The capsule generally has few side effects, but it may reduce blood sugar levels. So if you have diabetes or hypoglycemia, or are taking diabetes medications or blood thinners, talk to your doctor before using it, Mangrum advises.
Recommended dosage: In the Italian study, 100 milligrams (mg) per day provided the best results. Although it’s a trademarked product, it’s available from a wide variety of supplement manufacturers.
Joint Supplement #3: Boswellia serrata
Extracts from the boswellia plant – also known as frankincense – have been used as a joint remedy for centuries as part of India’s Ayurvedic medical tradition.
“Studies have also shown that a specific boswellia extract, known as 5-Loxin, may improve joint health by reducing the age-related wear and tear of cartilage,” adds Steven V. Joyal, M.D., vice president of scientific and medical affairs for the nonprofit Life Extension Foundation in Fort Lauderdale, Fla.
When 70 patients took 5-Loxin as joint supplements for 90 days, they “significantly” reduced osteoarthritis pain and improved physical function, according to a 2009 study published in Arthritis Research & Therapy.
Recommended dosage: “Seventy-five milligrams of boswellia extract daily is well-tolerated and safe, without known drug interactions,” Joyal says.
Joint Supplement #4: Propolis
Made by bees to seal their hives, this gummy mixture of plant resins, oils and waxes contains amino acids, minerals, vitamins, pollen and anti-inflammatory compounds known as bioflavonoids.
Although no human trials have been conducted, propolis extract has improved arthritis symptoms and decreased physical weakness in rats.
"The flavonoids in propolis can be anti-inflammatory and may help with mild pain relief,” says internist Jacob Teitelbaum, M.D., author of Pain Free 1-2-3 (McGraw-Hill).
Propolis may interact with a variety of medications, including anticoagulants, antibiotics, anti-cancer drugs, anti-inflammatories, immunosuppressants and osteoporosis drugs. Severe allergic reactions are also possible, especially in people allergic to bee stings.
Recommended dosage: Propolis is available at different potencies in many forms, including tablet, capsule, ointment, powder and extract. Recommended amounts can vary, depending on any allergies or medications you’re taking.
“Follow the package [recommendation] and talk to your physician for a specific dose,” Teitelbaum says.
Joint Supplement #5: Green-lipped mussel extract
Extract from this New Zealand shellfish shows promise in easing osteoarthritis pain in several studies, including a 2008 research review by the University of Southampton in England.
Although scientists are still exploring why mussels might help OA, some speculate they slow cartilage damage while reducing inflammation.
However, side effects - stomach upset, skin rashes and even gout, a form of arthritis - have been reported by some people.
Recommended dosage: Follow package instructions. About 210 mg per day of an oil extract or 1,150 mg per day of freeze-dried powder may reduce joint tenderness and morning stiffness, according to one study reviewed by the University of Southampton researchers.
Joint Supplement #6: Devil’s claw
A traditional South African plant in the sesame family, this herbal remedy relieves pain similar to NSAIDs and prescription anti-inflammatory drugs, according to Mangrum.
The active ingredients are “flavonoids and plant phenols that inhibit inflammation and pain in the joints affected by osteoarthritis,” he says. They also have antioxidant properties, he adds.
“Side effects are generally rare and can include headache or tinnitus [ringing in the ears],” Mangrum says.
Recommended dosage: Take a daily extract with 50-60 mg of the main active ingredient, harpagoside, Mangrum suggests.
Joint Supplement #7: White Willow Bark
Salicin, a chemical like aspirin, gives this remedy its anti-inflammatory and pain-relieving effects.
“Research has shown willow bark to be safe and effective for treating osteoarthritis of the hip and knee,” and may also help with back pain, Teitelbaum says.
Side effects tend to be mild, but stomach upset or bleeding and ulcers are possible. Taking more than the recommended dose could lead to skin rash, stomach inflammation, nausea, vomiting, kidney inflammation and tinnitus (ringing in ears).
Check with your doctor if you’re taking beta blockers, diuretics or blood thinners, Mangrum says. Don’t take willow bark if you’re allergic to aspirin.
Recommended dosage: 60-240 mg per day, Mangrum says.
Joint Supplement #8: Ginger
This flavorful root is also a time-honored remedy for osteoarthritis pain. It inhibits the production of key inflammatory chemicals in the body, helping reduce joint pain, Teitelbaum says.
It’s considered safe and isn’t known to interact with any prescription medicines, he adds. Large amounts can cause heartburn or stomach upset.
Recommended dosage: Take powdered ginger capsules or drink ginger tea according to package instructions. Or else chew 2-3 cubes of candied ginger cubes or eat 3-6 slices of pickled ginger (like you’d find in a sushi restaurant) as joint supplements daily, Teitelbaum says.
Joint Supplement #9: Curcumin
This active ingredient in the Indian spice turmeric, a bright-yellow member of the ginger family, is a powerful anti-inflammatory and pain reliever, Teitelbaum says.
Several animal studies have suggested it may help prevent damage to cartilage, he adds.
There’s a chance of mild side effects like nausea and diarrhea – but that’s very rare, Teitelbaum says.
Recommended dosage: Look for turmeric capsules with standardized curcumin content, and take it according to package instructions – usually 400-600 mg up to three times per day. Or add 1/4 to 1/2 teaspoon ground turmeric to a serving of food.
Joint Supplement #10: Vitamin D
A deficiency in this important nutrient could play a role in osteoarthritis, says Stella Metsovas, a clinical nutritionist in Southern California.
“Vitamin D helps the body conquer pro-inflammatory reactions, so getting this critical nutrient in your daily regimen is key to preventing osteoarthritis,” Metsovas says.
Research conducted over the past decade suggests that low levels of vitamin D can worsen knee osteoarthritis. When the knees of 880 randomly selected people were viewed with an MRI, those with higher blood levels of vitamin D had healthier cartilage, according to a 2009 study published in Arthritis Rheumatology.
Recommended dosage: You can get some vitamin D from food (such as fatty fish) and sunlight (which produces the vitamin when it hits your skin), but many people still need a supplement. “At least 800 International Units (IU) per day is required for those wanting osteoarthritic prevention,” Metsovas says.
Joint Supplement #11: Vitamin K
This vitamin regulates cartilage growth, Metsovas says.
It may repair joints or prevent further damage, easing osteoarthritis pain. Women with higher blood levels of vitamin K had fewer osteoarthritis markers in their knee and hand joints, a 2006 Boston University study found.
“The best way to get vitamin K is through food,” Metsovas says. “It’s found in dark leafy green veggies like kale, Swiss chard, Brussels sprouts, parsley and romaine lettuce.”
Doctors often advise avoiding vitamin K if you’re taking the anticoagulant warfarin (Coumadin), because it can interfere with the drug’s effects.
Recommended dosage: There’s no recommended dietary allowance for vitamin K, but adult women should get 90 micrograms (mcg) per day, according to the National Institutes of Health. That’s easy enough if you eat your veggies: A half cup of cooked broccoli has about 315 mcg, and a half cup of boiled Swiss chard has about 350 mcg.
For more expert advice and information, visit our Osteoarthritis Health Center.
How Much Do You Know About the Types of Arthritis?
About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030.
A lot of controversy has arisen over common joint supplements like glucosamine and chondroitin, spurred by large studies that questioned their effectiveness at easing osteoarthritis pain.
But those aren’t the only natural arthritis remedies out there. An array of natural supplements reduce pain, stiffness and joint inflammation.
Some are traditional herbs and spices that have been used for centuries; others were recently proven effective by modern science. Most can be taken with or without medications.
“Whether or not you’re taking prescription or non-prescription osteoarthritis pain relievers, it may be worthwhile to turn to [these] supplements,” says David Pisetsky, M.D., Ph.D., chief of rheumatology, allergy and clinical immunology at Duke University Medical Center in Durham, N.C.
But just because a supplement is labeled “natural” doesn’t mean it’s safe, Pisetsky warns. Talk to your doctor about proper dosage, potential allergies and drug interactions first.
“It’s possible to take too much, and many supplements can have side effects,” Pisetsky says. “Hiding [them] from your doctor can affect the success of your treatment.”
With that in mind, here are 11 joint supplements worth considering.
Joint Supplement #1: Digestive enzymes
Proteolytic enzymes help you digest protein. Some come from animal sources (trypsin and chymotrypsin are also made by your pancreas), while others are derived from foods (papain from papaya and bromelain from pineapple).
These enzymes may reduce pain and inflammation and remove cellular waste products associated with osteoarthritis pain, according to a 2008 study by Cardiff University in Wales.
Don’t take these enzymes if you’re also on prescription blood thinners or having surgery in less than two weeks, Mangrum says. Be careful if you have gastroesophageal reflux disease (GERD) because enzymes can irritate the gastrointestinal tract.
And steer clear if you're allergic to pineapples or papayas because you may have a reaction to their enzymes too.
Recommended dosage: “Most [of these] products are made of a combination of enzymes, and there’s no standardized dose,” Mangrum says. “It’s generally best to find a product from a high-quality supplier and use the amount recommended on the bottle.”
Look for the United States Pharmacopeia (USP) Verified seal. The nonprofit organization tests supplements for quality, purity and consistency.
Enzymes are best when taken with water, between meals and 60 minutes apart from non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which are enzyme inhibitors.
Joint Supplement #2: Pycnogenol
That is the brand name for an antioxidant-rich water extract of bark from the French maritime pine – a tree grown in coastal southwest France. Pycnogenol supplements may have short-term benefits in relieving osteoarthritis pain, some studies have shown.
The compound reduced symptoms of knee OA by 55%, and stiffness levels dropped by 53%, in a 2009 study by Chieti-Pescara University in Italy. As a result, participants trimmed their use of NSAIDs by 58%, the study found.
The capsule generally has few side effects, but it may reduce blood sugar levels. So if you have diabetes or hypoglycemia, or are taking diabetes medications or blood thinners, talk to your doctor before using it, Mangrum advises.
Recommended dosage: In the Italian study, 100 milligrams (mg) per day provided the best results. Although it’s a trademarked product, it’s available from a wide variety of supplement manufacturers.
Joint Supplement #3: Boswellia serrata
Extracts from the boswellia plant – also known as frankincense – have been used as a joint remedy for centuries as part of India’s Ayurvedic medical tradition.
“Studies have also shown that a specific boswellia extract, known as 5-Loxin, may improve joint health by reducing the age-related wear and tear of cartilage,” adds Steven V. Joyal, M.D., vice president of scientific and medical affairs for the nonprofit Life Extension Foundation in Fort Lauderdale, Fla.
When 70 patients took 5-Loxin as joint supplements for 90 days, they “significantly” reduced osteoarthritis pain and improved physical function, according to a 2009 study published in Arthritis Research & Therapy.
Recommended dosage: “Seventy-five milligrams of boswellia extract daily is well-tolerated and safe, without known drug interactions,” Joyal says.
Joint Supplement #4: Propolis
Made by bees to seal their hives, this gummy mixture of plant resins, oils and waxes contains amino acids, minerals, vitamins, pollen and anti-inflammatory compounds known as bioflavonoids.
Although no human trials have been conducted, propolis extract has improved arthritis symptoms and decreased physical weakness in rats.
"The flavonoids in propolis can be anti-inflammatory and may help with mild pain relief,” says internist Jacob Teitelbaum, M.D., author of Pain Free 1-2-3 (McGraw-Hill).
Propolis may interact with a variety of medications, including anticoagulants, antibiotics, anti-cancer drugs, anti-inflammatories, immunosuppressants and osteoporosis drugs. Severe allergic reactions are also possible, especially in people allergic to bee stings.
Recommended dosage: Propolis is available at different potencies in many forms, including tablet, capsule, ointment, powder and extract. Recommended amounts can vary, depending on any allergies or medications you’re taking.
“Follow the package [recommendation] and talk to your physician for a specific dose,” Teitelbaum says.
Joint Supplement #5: Green-lipped mussel extract
Extract from this New Zealand shellfish shows promise in easing osteoarthritis pain in several studies, including a 2008 research review by the University of Southampton in England.
Although scientists are still exploring why mussels might help OA, some speculate they slow cartilage damage while reducing inflammation.
However, side effects - stomach upset, skin rashes and even gout, a form of arthritis - have been reported by some people.
Recommended dosage: Follow package instructions. About 210 mg per day of an oil extract or 1,150 mg per day of freeze-dried powder may reduce joint tenderness and morning stiffness, according to one study reviewed by the University of Southampton researchers.
Joint Supplement #6: Devil’s claw
A traditional South African plant in the sesame family, this herbal remedy relieves pain similar to NSAIDs and prescription anti-inflammatory drugs, according to Mangrum.
The active ingredients are “flavonoids and plant phenols that inhibit inflammation and pain in the joints affected by osteoarthritis,” he says. They also have antioxidant properties, he adds.
“Side effects are generally rare and can include headache or tinnitus [ringing in the ears],” Mangrum says.
Recommended dosage: Take a daily extract with 50-60 mg of the main active ingredient, harpagoside, Mangrum suggests.
Joint Supplement #7: White Willow Bark
Salicin, a chemical like aspirin, gives this remedy its anti-inflammatory and pain-relieving effects.
“Research has shown willow bark to be safe and effective for treating osteoarthritis of the hip and knee,” and may also help with back pain, Teitelbaum says.
Side effects tend to be mild, but stomach upset or bleeding and ulcers are possible. Taking more than the recommended dose could lead to skin rash, stomach inflammation, nausea, vomiting, kidney inflammation and tinnitus (ringing in ears).
Check with your doctor if you’re taking beta blockers, diuretics or blood thinners, Mangrum says. Don’t take willow bark if you’re allergic to aspirin.
Recommended dosage: 60-240 mg per day, Mangrum says.
Joint Supplement #8: Ginger
This flavorful root is also a time-honored remedy for osteoarthritis pain. It inhibits the production of key inflammatory chemicals in the body, helping reduce joint pain, Teitelbaum says.
It’s considered safe and isn’t known to interact with any prescription medicines, he adds. Large amounts can cause heartburn or stomach upset.
Recommended dosage: Take powdered ginger capsules or drink ginger tea according to package instructions. Or else chew 2-3 cubes of candied ginger cubes or eat 3-6 slices of pickled ginger (like you’d find in a sushi restaurant) as joint supplements daily, Teitelbaum says.
Joint Supplement #9: Curcumin
This active ingredient in the Indian spice turmeric, a bright-yellow member of the ginger family, is a powerful anti-inflammatory and pain reliever, Teitelbaum says.
Several animal studies have suggested it may help prevent damage to cartilage, he adds.
There’s a chance of mild side effects like nausea and diarrhea – but that’s very rare, Teitelbaum says.
Recommended dosage: Look for turmeric capsules with standardized curcumin content, and take it according to package instructions – usually 400-600 mg up to three times per day. Or add 1/4 to 1/2 teaspoon ground turmeric to a serving of food.
Joint Supplement #10: Vitamin D
A deficiency in this important nutrient could play a role in osteoarthritis, says Stella Metsovas, a clinical nutritionist in Southern California.
“Vitamin D helps the body conquer pro-inflammatory reactions, so getting this critical nutrient in your daily regimen is key to preventing osteoarthritis,” Metsovas says.
Research conducted over the past decade suggests that low levels of vitamin D can worsen knee osteoarthritis. When the knees of 880 randomly selected people were viewed with an MRI, those with higher blood levels of vitamin D had healthier cartilage, according to a 2009 study published in Arthritis Rheumatology.
Recommended dosage: You can get some vitamin D from food (such as fatty fish) and sunlight (which produces the vitamin when it hits your skin), but many people still need a supplement. “At least 800 International Units (IU) per day is required for those wanting osteoarthritic prevention,” Metsovas says.
Joint Supplement #11: Vitamin K
This vitamin regulates cartilage growth, Metsovas says.
It may repair joints or prevent further damage, easing osteoarthritis pain. Women with higher blood levels of vitamin K had fewer osteoarthritis markers in their knee and hand joints, a 2006 Boston University study found.
“The best way to get vitamin K is through food,” Metsovas says. “It’s found in dark leafy green veggies like kale, Swiss chard, Brussels sprouts, parsley and romaine lettuce.”
Doctors often advise avoiding vitamin K if you’re taking the anticoagulant warfarin (Coumadin), because it can interfere with the drug’s effects.
Recommended dosage: There’s no recommended dietary allowance for vitamin K, but adult women should get 90 micrograms (mcg) per day, according to the National Institutes of Health. That’s easy enough if you eat your veggies: A half cup of cooked broccoli has about 315 mcg, and a half cup of boiled Swiss chard has about 350 mcg.
For more expert advice and information, visit our Osteoarthritis Health Center.
How Much Do You Know About the Types of Arthritis?
About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030.
Seniors and Cosmetic Surgery — How Old Is Too Old?
Many seniors are opting to regain a more youthful look with a few nips and tucks, but can you be too old for cosmetic surgery? "No," Dr. Kenneth Beer, one of the nation's top dermatologists who teaches dermatology at the University of Miami, tells Newsmax Health. "Most seniors today are healthier than two generations ago. They are remaining vital well into their late 70s and early 80s. They feel good and feel young, so they want to look young.
"In addition to increased life expectancies and wanting to look younger, many are remaining in the job market and they want to look their best and to look competitive," Beer says.
"Seniors do very well with cosmetic procedures," he says. "Sometimes they have better outcomes than younger people because they tend to be more reliable in their follow-up." For those seniors who are healthy and choose to have cosmetic surgery," says Dr. Beer, owner of www.scientificskin.com, "all options are on the table." That includes facelifts, tummy tucks — the works.
Beer says three factors should guide seniors when deciding to have cosmetic surgery: their budget, their tolerance for procedures, and their overall health.
Noninvasive procedures are popular, and in his practice, Beer combines lasers, Botox, and fillers to melt years from aging faces. "We look at people and see what they need: fillers to plump up volume, Botox to relax wrinkles, and lasers to resurface the skin."
"Some of the laser procedures actually work better in seniors," he said. "You see a more dramatic difference."
The changes aren't permanent, however, and patients will need "enhancement" procedures as time marches on. "It's like everything else," he says. "We can turn the hands of the clock back, but they'll start running again."
If he could recommend one product for all seniors to use, it would be Retin-A. "It has a ton of science behind it," he says. "It's a topical product that's been used for 20 years to improve wrinkles, minimize dark or liver spots, and make the skin look younger. If I had my choice, every senior would be on it."
Dr. Beer: Cosmetic Procedures Work 'Really Well' on Seniors
"In addition to increased life expectancies and wanting to look younger, many are remaining in the job market and they want to look their best and to look competitive," Beer says.
"Seniors do very well with cosmetic procedures," he says. "Sometimes they have better outcomes than younger people because they tend to be more reliable in their follow-up." For those seniors who are healthy and choose to have cosmetic surgery," says Dr. Beer, owner of www.scientificskin.com, "all options are on the table." That includes facelifts, tummy tucks — the works.
Beer says three factors should guide seniors when deciding to have cosmetic surgery: their budget, their tolerance for procedures, and their overall health.
Noninvasive procedures are popular, and in his practice, Beer combines lasers, Botox, and fillers to melt years from aging faces. "We look at people and see what they need: fillers to plump up volume, Botox to relax wrinkles, and lasers to resurface the skin."
"Some of the laser procedures actually work better in seniors," he said. "You see a more dramatic difference."
The changes aren't permanent, however, and patients will need "enhancement" procedures as time marches on. "It's like everything else," he says. "We can turn the hands of the clock back, but they'll start running again."
If he could recommend one product for all seniors to use, it would be Retin-A. "It has a ton of science behind it," he says. "It's a topical product that's been used for 20 years to improve wrinkles, minimize dark or liver spots, and make the skin look younger. If I had my choice, every senior would be on it."
Dr. Beer: Cosmetic Procedures Work 'Really Well' on Seniors
Hormones Cause Dieters to Regain Weight
Any dieter knows that it's hard to keep off weight you've lost. Now a study finds that even a year after dieters shed a good chunk of weight quickly, their hormones were still insisting, "Eat! Eat! Eat!"
The findings suggest that dieters who have regained weight are not just slipping back into old habits, but are struggling against a persistent biological urge.
"People who regain weight should not be harsh on themselves, as eating is our most basic instinct," Joseph Proietto of the University of Melbourne in Australia, an author of the study, said in an email. The research appears in Thursday's issue of the New England Journal of Medicine.
Weight regain is a common problem for dieters. To study what drives it, Proietto and his colleagues enrolled 50 overweight or obese patients in a 10-week diet program in Australia. They wanted to see what would happen in people who lost at least 10 percent of their body weight. Ultimately, only 34 people lost that much and stuck with the study long enough for analysis.
The program was intense. On average, the participants lost almost 30 pounds during the 10 weeks, faster than the standard advice of losing one or two pounds a week. They took in 500 to 550 calories a day, using a meal replacement called Optifast plus vegetables for eight weeks. Then for two weeks they were gradually reintroduced to ordinary foods.
Despite counseling and written advice about how to maintain their new weights, they gained an average of 12 pounds back over the next year. So they were still at lower weights than when they started.
The scientists checked the blood levels of nine hormones that influence appetite. The key finding came from comparing the hormone levels from before the weight-loss program to one year after it was over. Six hormones were still out of whack in a direction that would boost hunger.
The dieters also rated themselves as feeling hungrier after meals at the one-year mark, compared to what they reported before the diet program began.
Experts not connected to the study said the persistent effect on hormone levels was not surprising, and that it probably had nothing to do with the speed of the weight loss.
People who lose less than 10 percent of body weight would probably show the same thing, though to a lesser degree, said Dr. George Bray of the Pennington Biomedical Research Center in Baton Rouge, La.
A key message of the study is that "it's better not to gain weight than to try to lose it," Bray said.
Why would a dieter's body rebel against weight loss? It's an evolutionary holdover from earlier times, when weight loss could threaten survival and reproduction, says Dr. Rudolph Leibel, an obesity expert at Columbia University in New York. So "it's not surprising at all" that our bodies would fight back for at least a year, he said. "This is probably a more or less permanent response."
People who lose significant weight not only gain bigger appetite but also burn fewer calories than normal, creating "a perfect storm for weight regain," Leibel said.
He said avoiding weight regain appears to be a fundamentally different problem from losing weight in the first place, and that researchers should pay more attention to it.
The study was supported by the Australian government, medical professional groups and a private foundation. Proietto served on a medical advisory board of Nestle, maker of Optifast, until last year.
The findings suggest that dieters who have regained weight are not just slipping back into old habits, but are struggling against a persistent biological urge.
"People who regain weight should not be harsh on themselves, as eating is our most basic instinct," Joseph Proietto of the University of Melbourne in Australia, an author of the study, said in an email. The research appears in Thursday's issue of the New England Journal of Medicine.
Weight regain is a common problem for dieters. To study what drives it, Proietto and his colleagues enrolled 50 overweight or obese patients in a 10-week diet program in Australia. They wanted to see what would happen in people who lost at least 10 percent of their body weight. Ultimately, only 34 people lost that much and stuck with the study long enough for analysis.
The program was intense. On average, the participants lost almost 30 pounds during the 10 weeks, faster than the standard advice of losing one or two pounds a week. They took in 500 to 550 calories a day, using a meal replacement called Optifast plus vegetables for eight weeks. Then for two weeks they were gradually reintroduced to ordinary foods.
Despite counseling and written advice about how to maintain their new weights, they gained an average of 12 pounds back over the next year. So they were still at lower weights than when they started.
The scientists checked the blood levels of nine hormones that influence appetite. The key finding came from comparing the hormone levels from before the weight-loss program to one year after it was over. Six hormones were still out of whack in a direction that would boost hunger.
The dieters also rated themselves as feeling hungrier after meals at the one-year mark, compared to what they reported before the diet program began.
Experts not connected to the study said the persistent effect on hormone levels was not surprising, and that it probably had nothing to do with the speed of the weight loss.
People who lose less than 10 percent of body weight would probably show the same thing, though to a lesser degree, said Dr. George Bray of the Pennington Biomedical Research Center in Baton Rouge, La.
A key message of the study is that "it's better not to gain weight than to try to lose it," Bray said.
Why would a dieter's body rebel against weight loss? It's an evolutionary holdover from earlier times, when weight loss could threaten survival and reproduction, says Dr. Rudolph Leibel, an obesity expert at Columbia University in New York. So "it's not surprising at all" that our bodies would fight back for at least a year, he said. "This is probably a more or less permanent response."
People who lose significant weight not only gain bigger appetite but also burn fewer calories than normal, creating "a perfect storm for weight regain," Leibel said.
He said avoiding weight regain appears to be a fundamentally different problem from losing weight in the first place, and that researchers should pay more attention to it.
The study was supported by the Australian government, medical professional groups and a private foundation. Proietto served on a medical advisory board of Nestle, maker of Optifast, until last year.
Saturday, October 29, 2011
THOUGHT FOR THE DAY...
Remember brick walls let us show our dedication. They are there to separate us from the people who don’t really want to achieve their childhood dreams.
FUN FACTS
One or two alcohol drinks a day can be anti-inflammatory.
Gin is a mild diuretic which helps the body get rid of excessive fluid. Thus, it can reduce problems such as menstrual bloating.
It has been shown that caffeine causes headaches when stopped suddenly and can cause morning headaches that are relieved by a dose of caffeine.
It has been shown that caffeine causes headaches when stopped suddenly and can cause morning headaches that are relieved by a dose of caffeine.
The levels of two stress hormones, cortisol and epinephrine which suppress the body's immune system, will actually drop after a dose of laughter.
Scientists estimate that laughing 100 times is equivalent to a 10-minute workout on a rowing machine.
Gin is a mild diuretic which helps the body get rid of excessive fluid. Thus, it can reduce problems such as menstrual bloating.
It has been shown that caffeine causes headaches when stopped suddenly and can cause morning headaches that are relieved by a dose of caffeine.
It has been shown that caffeine causes headaches when stopped suddenly and can cause morning headaches that are relieved by a dose of caffeine.
The levels of two stress hormones, cortisol and epinephrine which suppress the body's immune system, will actually drop after a dose of laughter.
Scientists estimate that laughing 100 times is equivalent to a 10-minute workout on a rowing machine.
How to Lower High Cholesterol When You Have Diabetes
Did your last doctor’s office visit reveal high cholesterol? What’s next? Is it time to start taking pills or can you lower your LDL levels the old-fashioned way – diet and exercise? Learn more about the stages of your condition, including the diagnosis, treatments and medication available. Plus, how well do you understand cholesterol? Take our quiz to find out...
Cholesterol often gets a bad rap, but did you know it’s essential for many bodily functions?
It repairs cell membranes, produces vitamin D on the skin, makes hormones such as estrogen and testosterone, and helps with cells related to memory and learning, says Tracy Stevens, M.D., a cardiologist and spokeswoman for the American Heart Association (AHA).
But too much cholesterol can have deadly consequences, especially if you have diabetes type II. This waxy substance in the blood contributes to 20% of all strokes, 50% of all heart attacks and affects 36 million U.S. adults, according to the AHA.
You could have high cholesterol levels for years and never know it until something goes wrong, says Lisa Reis, M.D., a cardiologist and assistant professor at Saint Louis University Hospital in Missouri.
Fortunately, high cholesterol is easy to tame, says Binoy Singh, M.D., an internist and cardiologist with ColumbiaDoctors of Somers, N.Y.
“Many women can dramatically lower their cholesterol by eating a healthier diet and starting an exercise program and will not need to take medication,” he says.
Some cholesterol is healthy (“good” cholesterol), but high levels of “bad cholesterol” can sabotage your health. People with diabetes have a harder time controlling cholesterol levels because the disease tends to lower "good" cholesterol levels and increase "bad" cholesterol readings. It puts them at a higher risk of heart disease, according to the AHA.
Good cholesterol, or high-density lipoprotein cholesterol (HDL), can protect against heart disease and stroke.
Bad cholesterol, or low-density lipoprotein cholesterol (LDL), accumulates in arteries that feed the heart (coronary arteries) and brain (carotid artery in the neck). Together with other substances, bad cholesterol forms plaque, a thick, hard deposit that narrows arteries and makes them less flexible – a condition called atherosclerosis.
If a blood clot forms and blocks an artery that’s already narrowed by plaque, you could have a heart attack or stroke, depending on which artery is clogged.
Two other substances that affect arteries and contribute to cholesterol are triglycerides and Lp(a) cholesterol, Stevens says.
Triglycerides are a type of fat that’s made by the body. In low levels, they’re not harmful. But lifestyle factors – such as being overweight or obese, being a couch potato, eating a high-carb diet, smoking and drinking too much alcohol – can cause triglycerides to proliferate to dangerous levels, she says.
If you have high triglyceride levels, you’re more likely to have high total cholesterol, too little good (HDL) cholesterol and too much bad (LDL) cholesterol, and an increased risk of cardiovascular disease, Stevens says. High triglyceride levels also increase your risk for metabolic syndrome, which is a combination of obesity, abdominal fat, unhealthy cholesterol levels, high blood pressure and insulin resistance that increases your risk for diabetes, heart disease and even death.
Lp(a) is a variation of bad (LDL) cholesterol. Scientists don’t fully understand Lp(a) but believe it may accelerate the accumulation of fatty deposits, increasing an already high risk of heart disease and stroke, according to the AHA.
About 25% of cholesterol in the body comes from foods that contain cholesterol, namely animal products such as meat, eggs, full-fat dairy treats like milk, cheese, butter and ice cream, and some seafood, including shrimp, says Darlene Zimmerman, M.S., R.D., Heart Smart dietitian at Henry Ford Hospital Heart and Vascular Institute in Detroit.
“Plant foods don’t have cholesterol,” she says.
The liver manufactures the remaining 75% of cholesterol in the body, says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore.
Testing
A simple blood test can determine whether you have high cholesterol levels.
If you have a family history of high cholesterol, get tested at age 20 and then every five years, advises Cindy Haines, M.D., a family physician and author of The New Prescription, How to Get the Best Health-Care in a Broken System (Health Communications Inc.).
If you’re not at high risk, get your first test by your early 30s, she adds.
How to Read the Numbers
A cholesterol test delivers measurements in milligrams per deciliter of blood (mg/dL). Your total cholesterol level should be less than 200 mg/dL. If it’s 200-239, it’s considered borderline high. If it’s more than 240 mg/dl, your risk is twice as high as a woman with healthy cholesterol, Stevens says.
Your good (HDL) cholesterol should be at least 50 mg/dL. The higher your good (HDL) cholesterol, the lower your risk for heart disease.
Being overweight or obese, smoking, and being inactive can lower your HDL. Estrogen may raise HDL cholesterol levels, which may explain why high cholesterol is more common among postmenopausal women than younger women, says Peter Alagona Jr., a cardiologist and researcher with Penn State Hershey Heart and Vascular Institute.
Your bad (LDL) cholesterol should be less than 100 mg/dL. Unhealthy lifestyle habits raise bad cholesterol levels. But a 2011 study conducted at Texas A&M University found that women who exercised rigorously and gained the most muscle mass also had the highest levels of LDL – an unexpected result that scientists are still trying to figure out.
Your triglyceride levels should be less than 150 mg/dL.
If you have risk factors for high cholesterol but normal test results, your doctor can order a special blood test called NMR LipoProfile that measures regular cholesterol and the number of LDL cholesterol-carrying particles in your bloodstream for a more complete picture of your cardiovascular risk, says James Underberg, M.D., a lipidologist with New York University Center for the Prevention of Cardiovascular Disease.
Treatment
So how is high cholesterol treated?
“Diet and exercise form the cornerstone of high cholesterol treatment,” says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore. “You may be able to lower your levels in a few months with healthier lifestyle habits.”
Some steps you can take:
“Eat a heart-healthy Mediterranean diet that revolves around fresh fruits and vegetables, whole grain foods, foods that are high in fiber, lean meats and poultry. Try to eat fish at least once or twice a week,” Zimmerman says.
Cut the fat: Eat a low-fat diet that contains no more than 25%-30% calories from fat, says Julie Bolick, M.S., R.D., a clinical nutritionist and lipid specialist for University of Utah’s Cardiovascular Genetics division. “Limit saturated fat to 7% of your daily fat intake by eating lean meats, margarine instead of butter and switching to low-fat and fat-free dairy products. The rest should come from monounsaturated fats and polyunsaturated fats.” Monounsaturated fats are found in olive, peanut and canola oils, nuts and fatty fish like salmon, mackerel and herring. Polyunsaturated fats are found in soybean, corn and safflower oils, fatty fish, walnuts and sunflower seeds, oils and butters.
Focus on omega-3 fatty acids: A 2002 study conducted at Penn State Hershey Heart and Vascular Institute found that the omega-3 fatty acids in fish oil lowered triglycerides by as much as 30% and raised HDL cholesterol by as much as 3%. Best sources of the fatty acids include Pacific herring, farm-raised Atlantic salmon, mackerel, sardines and fresh tuna, as well as canola, flaxseed, walnut, soybean and fish oils.
Lower dietary cholesterol: Limit cholesterol to 300 milligrams (mg) daily, or 200 mg if you have heart disease, Bolick says. Avoid concentrated sources of cholesterol such as organ meats, egg yolks and whole milk products and switch to lean meats, egg substitute or egg whites and skim milk.
Avoid trans fats: “These are the black sheep of fats because they raise bad cholesterol and lower good cholesterol,” says Dominique Fradin-Read, M.D., a physician, and assistant clinical professor at Loma Linda University School of Medicine in Los Angeles. Trans fats also raise triglycerides and Lp(a). “Products can claim to be free of trans fats if they contain less than 0.5 grams of trans fat per serving, but small amounts can really add up,” he says. Check the food label. If it lists partially hydrogenated fat, the product contains trans fats.
Stop smoking: Smoking increases inflammation of arteries and destabilizes plaque, which can rupture and lead to heart attacks or even death, says Stevens.
Drink in moderation: “One drink a day, such as a glass of red wine or a beer, can help increase good cholesterol,” Zimmerman says.
Lower sodium: High cholesterol levels contribute to high blood pressure and a high sodium diet increases the risk. Reduce your intake to 2,300 mg or less and slash sodium by eating fresh, rather than canned or preserved, foods and avoiding salty items such as bacon, soups and stews. For more information, check out the DASH diet (Dietary Approaches to Stop Hypertension).
Medications
If diet and exercise aren’t enough to lower your cholesterol or if you have very high cholesterol, your doctor may prescribe one of these medications, which can lower cholesterol in 4-6 weeks, Kahn says:
Statins (Lipitor, Lescol, Crestor): These medications inhibit an enzyme in the liver from producing cholesterol. Side effects are rare but include muscle aches and pains.
Bile-acid-binding resins (Welchol, Prevalite, Questran): The liver converts cholesterol to bile to aid in digestion. Resins bind to this bile in the digestive tract and it’s then eliminated from the body. In response, the liver uses excess cholesterol to make more bile acids, which in turn are also cleared from the body.
Cholesterol absorption inhibitors (Zetia, Vytorin): These drugs inhibit absorption of dietary cholesterol and reduce blood cholesterol.
Fibrates (Lofibra, Tricor, Lopid): Fibrates decrease triglycerides by reducing the liver's production of very-low-density lipoprotein (VLDL) cholesterol and increasing the removal of triglycerides from your blood.
Niacin (Niaspan): Prescription-strength niacin inhibits the liver from producing bad (LDL and VLDL) cholesterol.
Omega-3 fatty acids (Lovaza, a prescription-strength omega-3 fatty acid): will help lower your triglycerides.
For more information, visit our Cholesterol Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
Cholesterol often gets a bad rap, but did you know it’s essential for many bodily functions?
It repairs cell membranes, produces vitamin D on the skin, makes hormones such as estrogen and testosterone, and helps with cells related to memory and learning, says Tracy Stevens, M.D., a cardiologist and spokeswoman for the American Heart Association (AHA).
But too much cholesterol can have deadly consequences, especially if you have diabetes type II. This waxy substance in the blood contributes to 20% of all strokes, 50% of all heart attacks and affects 36 million U.S. adults, according to the AHA.
You could have high cholesterol levels for years and never know it until something goes wrong, says Lisa Reis, M.D., a cardiologist and assistant professor at Saint Louis University Hospital in Missouri.
Fortunately, high cholesterol is easy to tame, says Binoy Singh, M.D., an internist and cardiologist with ColumbiaDoctors of Somers, N.Y.
“Many women can dramatically lower their cholesterol by eating a healthier diet and starting an exercise program and will not need to take medication,” he says.
Some cholesterol is healthy (“good” cholesterol), but high levels of “bad cholesterol” can sabotage your health. People with diabetes have a harder time controlling cholesterol levels because the disease tends to lower "good" cholesterol levels and increase "bad" cholesterol readings. It puts them at a higher risk of heart disease, according to the AHA.
Good cholesterol, or high-density lipoprotein cholesterol (HDL), can protect against heart disease and stroke.
Bad cholesterol, or low-density lipoprotein cholesterol (LDL), accumulates in arteries that feed the heart (coronary arteries) and brain (carotid artery in the neck). Together with other substances, bad cholesterol forms plaque, a thick, hard deposit that narrows arteries and makes them less flexible – a condition called atherosclerosis.
If a blood clot forms and blocks an artery that’s already narrowed by plaque, you could have a heart attack or stroke, depending on which artery is clogged.
Two other substances that affect arteries and contribute to cholesterol are triglycerides and Lp(a) cholesterol, Stevens says.
Triglycerides are a type of fat that’s made by the body. In low levels, they’re not harmful. But lifestyle factors – such as being overweight or obese, being a couch potato, eating a high-carb diet, smoking and drinking too much alcohol – can cause triglycerides to proliferate to dangerous levels, she says.
If you have high triglyceride levels, you’re more likely to have high total cholesterol, too little good (HDL) cholesterol and too much bad (LDL) cholesterol, and an increased risk of cardiovascular disease, Stevens says. High triglyceride levels also increase your risk for metabolic syndrome, which is a combination of obesity, abdominal fat, unhealthy cholesterol levels, high blood pressure and insulin resistance that increases your risk for diabetes, heart disease and even death.
Lp(a) is a variation of bad (LDL) cholesterol. Scientists don’t fully understand Lp(a) but believe it may accelerate the accumulation of fatty deposits, increasing an already high risk of heart disease and stroke, according to the AHA.
About 25% of cholesterol in the body comes from foods that contain cholesterol, namely animal products such as meat, eggs, full-fat dairy treats like milk, cheese, butter and ice cream, and some seafood, including shrimp, says Darlene Zimmerman, M.S., R.D., Heart Smart dietitian at Henry Ford Hospital Heart and Vascular Institute in Detroit.
“Plant foods don’t have cholesterol,” she says.
The liver manufactures the remaining 75% of cholesterol in the body, says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore.
Testing
A simple blood test can determine whether you have high cholesterol levels.
If you have a family history of high cholesterol, get tested at age 20 and then every five years, advises Cindy Haines, M.D., a family physician and author of The New Prescription, How to Get the Best Health-Care in a Broken System (Health Communications Inc.).
If you’re not at high risk, get your first test by your early 30s, she adds.
How to Read the Numbers
A cholesterol test delivers measurements in milligrams per deciliter of blood (mg/dL). Your total cholesterol level should be less than 200 mg/dL. If it’s 200-239, it’s considered borderline high. If it’s more than 240 mg/dl, your risk is twice as high as a woman with healthy cholesterol, Stevens says.
Your good (HDL) cholesterol should be at least 50 mg/dL. The higher your good (HDL) cholesterol, the lower your risk for heart disease.
Being overweight or obese, smoking, and being inactive can lower your HDL. Estrogen may raise HDL cholesterol levels, which may explain why high cholesterol is more common among postmenopausal women than younger women, says Peter Alagona Jr., a cardiologist and researcher with Penn State Hershey Heart and Vascular Institute.
Your bad (LDL) cholesterol should be less than 100 mg/dL. Unhealthy lifestyle habits raise bad cholesterol levels. But a 2011 study conducted at Texas A&M University found that women who exercised rigorously and gained the most muscle mass also had the highest levels of LDL – an unexpected result that scientists are still trying to figure out.
Your triglyceride levels should be less than 150 mg/dL.
If you have risk factors for high cholesterol but normal test results, your doctor can order a special blood test called NMR LipoProfile that measures regular cholesterol and the number of LDL cholesterol-carrying particles in your bloodstream for a more complete picture of your cardiovascular risk, says James Underberg, M.D., a lipidologist with New York University Center for the Prevention of Cardiovascular Disease.
Treatment
So how is high cholesterol treated?
“Diet and exercise form the cornerstone of high cholesterol treatment,” says Brian Kahn, M.D., a cardiologist with the Heart Center at Overlea in Baltimore. “You may be able to lower your levels in a few months with healthier lifestyle habits.”
Some steps you can take:
“Eat a heart-healthy Mediterranean diet that revolves around fresh fruits and vegetables, whole grain foods, foods that are high in fiber, lean meats and poultry. Try to eat fish at least once or twice a week,” Zimmerman says.
Cut the fat: Eat a low-fat diet that contains no more than 25%-30% calories from fat, says Julie Bolick, M.S., R.D., a clinical nutritionist and lipid specialist for University of Utah’s Cardiovascular Genetics division. “Limit saturated fat to 7% of your daily fat intake by eating lean meats, margarine instead of butter and switching to low-fat and fat-free dairy products. The rest should come from monounsaturated fats and polyunsaturated fats.” Monounsaturated fats are found in olive, peanut and canola oils, nuts and fatty fish like salmon, mackerel and herring. Polyunsaturated fats are found in soybean, corn and safflower oils, fatty fish, walnuts and sunflower seeds, oils and butters.
Focus on omega-3 fatty acids: A 2002 study conducted at Penn State Hershey Heart and Vascular Institute found that the omega-3 fatty acids in fish oil lowered triglycerides by as much as 30% and raised HDL cholesterol by as much as 3%. Best sources of the fatty acids include Pacific herring, farm-raised Atlantic salmon, mackerel, sardines and fresh tuna, as well as canola, flaxseed, walnut, soybean and fish oils.
Lower dietary cholesterol: Limit cholesterol to 300 milligrams (mg) daily, or 200 mg if you have heart disease, Bolick says. Avoid concentrated sources of cholesterol such as organ meats, egg yolks and whole milk products and switch to lean meats, egg substitute or egg whites and skim milk.
Avoid trans fats: “These are the black sheep of fats because they raise bad cholesterol and lower good cholesterol,” says Dominique Fradin-Read, M.D., a physician, and assistant clinical professor at Loma Linda University School of Medicine in Los Angeles. Trans fats also raise triglycerides and Lp(a). “Products can claim to be free of trans fats if they contain less than 0.5 grams of trans fat per serving, but small amounts can really add up,” he says. Check the food label. If it lists partially hydrogenated fat, the product contains trans fats.
Stop smoking: Smoking increases inflammation of arteries and destabilizes plaque, which can rupture and lead to heart attacks or even death, says Stevens.
Drink in moderation: “One drink a day, such as a glass of red wine or a beer, can help increase good cholesterol,” Zimmerman says.
Lower sodium: High cholesterol levels contribute to high blood pressure and a high sodium diet increases the risk. Reduce your intake to 2,300 mg or less and slash sodium by eating fresh, rather than canned or preserved, foods and avoiding salty items such as bacon, soups and stews. For more information, check out the DASH diet (Dietary Approaches to Stop Hypertension).
Medications
If diet and exercise aren’t enough to lower your cholesterol or if you have very high cholesterol, your doctor may prescribe one of these medications, which can lower cholesterol in 4-6 weeks, Kahn says:
Statins (Lipitor, Lescol, Crestor): These medications inhibit an enzyme in the liver from producing cholesterol. Side effects are rare but include muscle aches and pains.
Bile-acid-binding resins (Welchol, Prevalite, Questran): The liver converts cholesterol to bile to aid in digestion. Resins bind to this bile in the digestive tract and it’s then eliminated from the body. In response, the liver uses excess cholesterol to make more bile acids, which in turn are also cleared from the body.
Cholesterol absorption inhibitors (Zetia, Vytorin): These drugs inhibit absorption of dietary cholesterol and reduce blood cholesterol.
Fibrates (Lofibra, Tricor, Lopid): Fibrates decrease triglycerides by reducing the liver's production of very-low-density lipoprotein (VLDL) cholesterol and increasing the removal of triglycerides from your blood.
Niacin (Niaspan): Prescription-strength niacin inhibits the liver from producing bad (LDL and VLDL) cholesterol.
Omega-3 fatty acids (Lovaza, a prescription-strength omega-3 fatty acid): will help lower your triglycerides.
For more information, visit our Cholesterol Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
Testosterone Protects Muscle Mass in Aging Men
Older men who have higher levels of testosterone tend to lose less lean mass muscle. The loss is especially pronounced in older men who lose weight, says a study conducted by Oregon's Kaiser Permanente Northwest. The men with higher testosterone levels also retained more lower body strength.
The loss of muscle mass and strength contribute to frailty in senior citizen. Reduced muscle mass is connected with falls, fractures, and limited mobility. Men lose more muscle mass than women as they age, which suggests that sex steroids, including testosterone, may contribute to body composition and changes in physical function. The study attempted to understand the relationship between testosterone levels and healthy aging. It found that higher testosterone levels may help maintain muscle mass in older men and delay frailty.
"Our study finds that men, aged 65 years and older, with higher testosterone levels lost less muscle mass, especially in their arms and legs, than men this age who had lower testosterone levels," said Erin LeBlanc, M.D., of Kaiser Permanente Northwest in Portland, Ore. and lead author of the study. "Men who had higher testosterone levels before they lost weight also lost less leg function and could stand up more easily from a chair than men who had lower testosterone levels before they lost weight."
In this study, researchers used data from 1,183 men aged 65 years or older with an average follow-up of 4.5 years. Body composition was measured using dual energy X-ray absorptiometry (DXA) scans. Physical performance was measured through a series of exercises that evaluated grip strength, lower extremity power, walking speed, and the ability to rise from a chair without the use of arms.
"Our study adds evidence to the growing body of literature that suggest higher levels of endogenous testosterone may be favorably associated with some key components of healthy aging in men," said LeBlanc.
The loss of muscle mass and strength contribute to frailty in senior citizen. Reduced muscle mass is connected with falls, fractures, and limited mobility. Men lose more muscle mass than women as they age, which suggests that sex steroids, including testosterone, may contribute to body composition and changes in physical function. The study attempted to understand the relationship between testosterone levels and healthy aging. It found that higher testosterone levels may help maintain muscle mass in older men and delay frailty.
"Our study finds that men, aged 65 years and older, with higher testosterone levels lost less muscle mass, especially in their arms and legs, than men this age who had lower testosterone levels," said Erin LeBlanc, M.D., of Kaiser Permanente Northwest in Portland, Ore. and lead author of the study. "Men who had higher testosterone levels before they lost weight also lost less leg function and could stand up more easily from a chair than men who had lower testosterone levels before they lost weight."
In this study, researchers used data from 1,183 men aged 65 years or older with an average follow-up of 4.5 years. Body composition was measured using dual energy X-ray absorptiometry (DXA) scans. Physical performance was measured through a series of exercises that evaluated grip strength, lower extremity power, walking speed, and the ability to rise from a chair without the use of arms.
"Our study adds evidence to the growing body of literature that suggest higher levels of endogenous testosterone may be favorably associated with some key components of healthy aging in men," said LeBlanc.
Q&A - Can Sugar Treat Diabetic Ulcers?
Q: A few months ago, I read about using sugar dressings on wounds. I tried it on one of our diabetic clients who had an ulcerated wound, and it healed in three days! The day after the first application the rawness of the wound was gone! Do you recommend sugar dressings for wounds?
-Lily S.
A: Hi Lily,
I first wrote about this inexpensive and effective solution in 1991. Since then, I’ve seen and heard countless stories of sweet success.
Sugar or honey dressing may be used to treat any kind of open wound or burn. (We use sugar at the Whitaker Wellness Institute because it’s less messy.) It will not work on abscesses or pustules that are covered with skin. Do not use on a bleeding wound as sugar promotes bleeding.
Follow these steps:
Unravel a 4" x 4" piece of gauze into a long strip and coat it with Vaseline.
Place it around the outside edges of the wound, like a donut.
Cover the wound with 1/4-inch of sugar. (The Vaseline “donut” will keep it in place.)
Place a 4" x 4" sponge on top of the wound. Bandage it firmly but not too snugly with a cling dressing.
Change the dressing every one or two days. Remove, irrigate with water, saline, or hydrogen peroxide, pat dry, and repeat steps 1–4.
Yours in good health,
Dr. Whitaker
Want to learn more about diabetes control? Visit DrWhitaker.com.
-Lily S.
A: Hi Lily,
I first wrote about this inexpensive and effective solution in 1991. Since then, I’ve seen and heard countless stories of sweet success.
Sugar or honey dressing may be used to treat any kind of open wound or burn. (We use sugar at the Whitaker Wellness Institute because it’s less messy.) It will not work on abscesses or pustules that are covered with skin. Do not use on a bleeding wound as sugar promotes bleeding.
Follow these steps:
Unravel a 4" x 4" piece of gauze into a long strip and coat it with Vaseline.
Place it around the outside edges of the wound, like a donut.
Cover the wound with 1/4-inch of sugar. (The Vaseline “donut” will keep it in place.)
Place a 4" x 4" sponge on top of the wound. Bandage it firmly but not too snugly with a cling dressing.
Change the dressing every one or two days. Remove, irrigate with water, saline, or hydrogen peroxide, pat dry, and repeat steps 1–4.
Yours in good health,
Dr. Whitaker
Want to learn more about diabetes control? Visit DrWhitaker.com.
X-rays Don't Cut Lung Cancer Deaths
Annual lung-cancer screening with a chest X-ray doesn’t reduce deaths from the disease as it offers no benefit for early detection, a study found.
The study of 154,901 participants — smokers, former smokers and people who never smoked — found similar rates of death from lung cancer between those who received annual chest X-rays for up to four years and those who got their usual medical care. The research, which followed the patients for 13 years, was released today by the Journal of the American Medical Association.
The findings provide definitive evidence that chest X-rays aren’t a useful tool for finding lung cancer early enough, researchers said. A U.S study last year showed that current and former smokers who received computerized tomography, or CT, scans were 20 percent less likely to die of lung cancer than those who got chest X-rays.
“This study shows us we can’t really expect much at all with lung cancer screening with chest X-ray,” said Robert Smith, senior director for cancer control with the American Cancer Society in Atlanta, who wasn’t an author of today’s paper, in an Oct. 25 telephone interview. “We have already put to rest whether or not lung cancer screening with chest X-ray offers similar benefits to CT screening. It doesn’t. We need to have a better understanding of how to screen for lung cancer.”
Today’s study, called the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, began nine years before theNational Lung Screening Trial, which compared CT scans to chest X-rays in current and former smokers. At the start of the trial, chest X-rays were the standard technology used to screen for lung cancer. The results were presented at the meeting of the American College of Chest Physicians in Honolulu.
CT Scan Sensitivity
CT scans provide a more detailed picture of the lungs than chest X-rays so they are better able to identify small tumors, said study author Christine Berg, chief of the Early Detection Research Group at the National Cancer Institute’s Division of Cancer Prevention in Rockville, Maryland. Researchers didn’t expect to see a benefit from X-rays, though they waited for the data because the study was the definitive trial on the use of chest X-rays as a lung cancer screening tool.
“The problem was it wasn’t finding lung cancer at a small enough size,” she said. “Lung cancer is a very aggressive disease so you have to find it very small in order to cut it out and cure it.”
Future X-Ray Role
In the future, X-rays may play a role in lung cancer screening if the technology improves enough to detect smaller tumors. CT scans can be problematic because they can identify many suspicious nodules that aren’t positive, Berg said. They’re also more costly. Medicare, pays about $350 to $370 for a CT scan Institutions generally $750 to $1,000 for the scan while most insurers pay $50 to $100 for an X-ray, she said.
This year more than 220,000 people will be diagnosed with lung cancer and almost 157,000 will die from the disease, which kills more people than any other cancers, according to the National Cancer Institute.
Neither the U.S. Preventive Services Task Force, an independent panel of experts in medicine, nor the American Cancer Society recommends screening for lung cancer. Berg said recommendations for the U.S. task force may be available by the end of 2012.
Lung Association Recommendations
The American Lung Association will have recommendations on lung cancer screening in about three months, said Norman Edelman, the Washington-based group’s chief medical officer, in an Oct. 25 telephone interview.
“Lung cancer kills more people than any other cancer. It’s a devastating disease. The cure rates are small,” he said. “We certainly need better tools to deal with lung cancer. There is a hope that catching lung cancer early will increase survivability. We need a lot more research.”
Researchers in today’s study included more than 154,000 people ages 55 to 74 who were current or former smokers or who never smoked. About half were assigned to annual lung cancer screenings for four years using X-rays and the other half were assigned to receive standard medical care, which included advice on quitting smoking, from 1993 to 2001. They were followed for either 13 years or through December 2009.
During the study period, 1,696 people in the screening group and 1,620 in the standard medical care group were diagnosed with cancer. Chest X-rays picked up 307 cancers, while the rest were found between X-rays or after the screenings ended, Berg said.
Lung-cancer death rates between the groups were similar with 1,213 lung cancer deaths in the X-ray group and 1,230 in the standard medical care group, the research showed.
“Chest X-ray screening would not be recommended for a lung cancer screening program,” said Berg. “I do believe this study doesn’t show any benefit.”
The study of 154,901 participants — smokers, former smokers and people who never smoked — found similar rates of death from lung cancer between those who received annual chest X-rays for up to four years and those who got their usual medical care. The research, which followed the patients for 13 years, was released today by the Journal of the American Medical Association.
The findings provide definitive evidence that chest X-rays aren’t a useful tool for finding lung cancer early enough, researchers said. A U.S study last year showed that current and former smokers who received computerized tomography, or CT, scans were 20 percent less likely to die of lung cancer than those who got chest X-rays.
“This study shows us we can’t really expect much at all with lung cancer screening with chest X-ray,” said Robert Smith, senior director for cancer control with the American Cancer Society in Atlanta, who wasn’t an author of today’s paper, in an Oct. 25 telephone interview. “We have already put to rest whether or not lung cancer screening with chest X-ray offers similar benefits to CT screening. It doesn’t. We need to have a better understanding of how to screen for lung cancer.”
Today’s study, called the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, began nine years before theNational Lung Screening Trial, which compared CT scans to chest X-rays in current and former smokers. At the start of the trial, chest X-rays were the standard technology used to screen for lung cancer. The results were presented at the meeting of the American College of Chest Physicians in Honolulu.
CT Scan Sensitivity
CT scans provide a more detailed picture of the lungs than chest X-rays so they are better able to identify small tumors, said study author Christine Berg, chief of the Early Detection Research Group at the National Cancer Institute’s Division of Cancer Prevention in Rockville, Maryland. Researchers didn’t expect to see a benefit from X-rays, though they waited for the data because the study was the definitive trial on the use of chest X-rays as a lung cancer screening tool.
“The problem was it wasn’t finding lung cancer at a small enough size,” she said. “Lung cancer is a very aggressive disease so you have to find it very small in order to cut it out and cure it.”
Future X-Ray Role
In the future, X-rays may play a role in lung cancer screening if the technology improves enough to detect smaller tumors. CT scans can be problematic because they can identify many suspicious nodules that aren’t positive, Berg said. They’re also more costly. Medicare, pays about $350 to $370 for a CT scan Institutions generally $750 to $1,000 for the scan while most insurers pay $50 to $100 for an X-ray, she said.
This year more than 220,000 people will be diagnosed with lung cancer and almost 157,000 will die from the disease, which kills more people than any other cancers, according to the National Cancer Institute.
Neither the U.S. Preventive Services Task Force, an independent panel of experts in medicine, nor the American Cancer Society recommends screening for lung cancer. Berg said recommendations for the U.S. task force may be available by the end of 2012.
Lung Association Recommendations
The American Lung Association will have recommendations on lung cancer screening in about three months, said Norman Edelman, the Washington-based group’s chief medical officer, in an Oct. 25 telephone interview.
“Lung cancer kills more people than any other cancer. It’s a devastating disease. The cure rates are small,” he said. “We certainly need better tools to deal with lung cancer. There is a hope that catching lung cancer early will increase survivability. We need a lot more research.”
Researchers in today’s study included more than 154,000 people ages 55 to 74 who were current or former smokers or who never smoked. About half were assigned to annual lung cancer screenings for four years using X-rays and the other half were assigned to receive standard medical care, which included advice on quitting smoking, from 1993 to 2001. They were followed for either 13 years or through December 2009.
During the study period, 1,696 people in the screening group and 1,620 in the standard medical care group were diagnosed with cancer. Chest X-rays picked up 307 cancers, while the rest were found between X-rays or after the screenings ended, Berg said.
Lung-cancer death rates between the groups were similar with 1,213 lung cancer deaths in the X-ray group and 1,230 in the standard medical care group, the research showed.
“Chest X-ray screening would not be recommended for a lung cancer screening program,” said Berg. “I do believe this study doesn’t show any benefit.”
10 Ways to Stay Depression-Free
You finally beat depression. But even after the sadness lifts, your symptoms may return. So how can healthy habits like ditching the booze, getting more vitamin D or practicing yoga help? We talked to experts about the top 10 natural ways to manage moods. Plus, how much do you know about depression? Take our quiz to find out...
After months of battling depression, you’re feeling normal again. Your doctor or therapist has given you tools for staying positive, and you know the warning signs of a depressive episode so you can get help as soon as you sense them.
Now’s the time to enjoy life – and to take better care of your physical and mental well-being. Depression is a lifelong, chronic condition, and it needs to be maintained like any other disease.
“You have to approach depression the same way you would diabetes. There’s a vigilance you have to maintain for a balanced life,” says Alan Manevitz, M.D., associate professor of clinical psychiatry at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City.
Besides medication or therapy, that means practicing healthy habits associated with better moods.
Healthy living is an important part of self-care, Manevitz says. For example, when you eat right, brain cells get appropriate nutrition so “the brain works at its maximum,” he explains. And exercise releases endorphins, brain chemicals that act as natural antidepressants.
Here are 10 lifestyle changes that can keep you feeling your best.
1. Lose the booze.
People with chronic depression sometimes use alcohol to self-medicate.
Drinking releases neurotransmitters that may make you feel better, but only temporarily. And as you develop a tolerance, you need larger amounts, and then it becomes even more of a depressant on your central nervous system, Manevitz says.
If you’re taking antidepressants, alcohol can also increase their side effects, making you drowsy, more intoxicated than usual, or in some cases, causing a blood pressure spike that could lead to a stroke, according to the Mayo Clinic.
2. Work up a sweat.
Exercise is great for mental well-being, says Jasper Smits, Ph.D., director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas.
It can head off a recurrence of mild to moderate depression, or help you overcome an episode, according to his team’s research.
With severe depression, exercise can augment traditional treatments, including psychotherapy or antidepressant medication, adds Smits, co-author of Exercise for Mood and Anxiety: Proven Strategies for Overcoming Depression and Enhancing Well-Being (Oxford University Press).
Researchers are still determining how physical activity helps, but evidence suggests it may act as a form of behavioral activation, a depression treatment strategy that encourages people to be productive rather than inactive.
“If you’ve been productive, your mood improves,” Smits says.
Smits recommends aiming for the government’s physical-activity recommendations: 150 minutes per week of moderately intense movement (brisk walking, water aerobics, gardening); 75 minutes of vigorous activity (jumping rope, running, hiking); or a combination of the two.
Multiple studies have found benefits from doing 20-60 minutes of exercise per session, so aim for at least 20 minutes. But if you’re new to exercise or short on time, that doesn’t mean you should skip it.
“Even a 10-minute walk has short-term positive effects on mood,” Smits says.
3. Eat like a Spaniard.
Closely following a Mediterranean diet is strongly associated with lower depression risk, according to a 2009 Spanish study published in the Archives of General Psychiatry.
Researchers speculate that the diet’s heart-healthy benefits – reducing inflammation, improving blood vessel function and decreasing the risk of metabolic syndrome – may play a role in keeping the brain fit.
Mediterranean-style eating is simple: When you’re grocery shopping, fill your cart with fresh fruits and vegetables, whole grains, olive oil, beans, fish, poultry, nuts and low-fat dairy. Meanwhile, cut back on refined carbs, fatty meats and highly processed foods.
4. Get your zzz’s.
It’s no surprise that too little rest can worsen your mood, but depression itself can keep you from sleeping through the night, according to the National Sleep Foundation.
The connection between the conditions is significant: People with regular insomnia are nearly 10 times more likely to have significant depression, and 17 times more likely to develop anxiety, according to a 2005 University of North Texas study.
If you’re having trouble sleeping – whether or not you’re currently depressed – talk to your doctor or a sleep expert so you can get the 7-9 hours you need.
5. Get more vitamin D.
Low levels of vitamin D have long been linked to depression. And research is ongoing about whether the fat-soluble vitamin can improve rates of seasonal affective disorder (SAD), or winter depression.
SAD hits when days get shorter and there’s less sunlight, our prime natural source of vitamin D. But we don’t always get enough of the vitamin in summer, either, because the sunscreen we slather on to protect against skin cancer blocks D-producing rays.
It’s also hard to get the amount of D we need from food. Only certain fish (salmon, sardines, tuna, mackerel and cod), D-fortified milk and a few other foods contain much of this important nutrient.
How much do you need? Expert opinions vary. Government recommendations suggest 200 international units (IU) per day until age 50, 400 IU between 51 and 70, and 600 IU after that.
But some researchers recommend considerably more. Vitamin D expert Michael F. Holick, M.D., Ph.D., professor of medicine, molecular medicine physiology and biophysics at Boston University Medical Center, thinks adults actually need closer to 1,500-2,000 IU of vitamin D per day.
Since one 8-ounce glass of milk only has about 100 IU, your best bet is taking a multivitamin or vitamin D supplement.
Read more about this and other supplements in 4 Natural Mood-Boosters: Do They Work?
6. Embrace your inner yogi.
Yoga relaxes you, but does it fight depression? Researchers at Boston University School of Medicine think it could. And the more you practice, the better off you may be.
In their study, published in the Journal of Alternative and Complementary Medicine in 2007, participants spent three hours a week either walking or practicing Iyengar yoga, a form of hatha yoga that uses blocks, belts and other props to ensure correct body alignment during postures.
Their moods and anxiety levels were measured at the start of the study and at weeks 4, 8 and 12. MRI brain scans were also done to measure levels of a neurotransmitter called gamma aminobutyric acid (GABA), low levels of which are associated with mood and anxiety disorders.
At the end of the study, the scans showed higher GABA levels in the participants who practiced yoga. (Those new to the discipline saw a 13% increase, while experienced yoga practitioners had a 27% rise.) By contrast, those who only walked had no bump in GABA levels.
According to researcher Chris Streeter, M.D., associate professor of psychiatry and neurology, yoga boosts the activity of the parasympathetic nervous system, which is associated with rest and rejuvenation.
So why didn’t walking offer the same benefits? In this study, participants were limited to ambling around the periphery of a gymnasium. Walking outside or walking faster could make it a more effective mood booster, Streeter says.
The key to getting the most out of any workout is to choose a physical activity you like and do it in a setting you’ll enjoy, she adds.
7. Just say om.
People who practiced transcendental meditation (TM), a form of “mantra meditation” in which you mentally repeat a sound, had fewer depression symptoms than those who didn’t, according to researchers who presented two studies at a 2010 meeting of the Society of Behavioral Medicine.
In fact, participants with clinically significant depression who meditated twice a day for a year had an average 48% reduction in symptoms.
Not only does TM decrease psychological stress, it may also reduce a person’s reactions to environmental stress and reduce the amount of brooding about problems, says lead study author Sanford Nidich, Ed.D., senior researcher at the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa.
It may also have a positive effect on serotonin, the brain’s feel-good chemical, Nidich adds.
You don’t need to join a particular group to learn healthy meditation techniques – just read How to Meditate to get started.
8. Keep your cool.
Too much mental stress can harm your ability to maintain a steady mood. But stress overload varies by person – some can't function outside a calm environment, while others may do fine in stressful situations.
For example, “some people thrive as a fireman or ER doctor,” Manevitz says. “Others get so stressed out they’re vulnerable to depression.”
His solution? Balance your life based on the amount and kinds of stress you can handle. “You need to know what your abilities and trigger points are.”
9. Kick the habit.
Here’s another reason to put away that pack: Women who smoke have a greater risk of developing major depression than non-smokers, according to a 10-year Australian study published in 2008 in the British Journal of Psychiatry.
Among heavy smokers – those who smoked more than 20 cigarettes per day – the depression risk was more than double that of non-smokers: 15% of the smokers studied went on to develop major depression, while only 6.5% of the non-smokers did.
Smoking can be another way of self-medicating for a depressed mood, so ask your doctor or therapist to help you quit. Click here for tips to quit smoking.
10. Build a support system.
People who care about you can help you through tough times, and that includes mental illnesses.
In fact, a 2005 study published in the American Journal of Psychiatry reported that women who feel more loved and have more support from friends and family members face lower risk for major depression.
If you have a tendency to isolate yourself, make an extra effort to spend time with friends and family. Support groups, social clubs and interest-based organizations can also help bring you out of your shell.
Learn more about managing your moods in our Depression Health Center.
How Much Do You Know About Depression?
Depression is an extremely disabling disorder. Despite all the progress in diagnosing and treating this disease, many people still are in the dark when it comes to understanding depression.
After months of battling depression, you’re feeling normal again. Your doctor or therapist has given you tools for staying positive, and you know the warning signs of a depressive episode so you can get help as soon as you sense them.
Now’s the time to enjoy life – and to take better care of your physical and mental well-being. Depression is a lifelong, chronic condition, and it needs to be maintained like any other disease.
“You have to approach depression the same way you would diabetes. There’s a vigilance you have to maintain for a balanced life,” says Alan Manevitz, M.D., associate professor of clinical psychiatry at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City.
Besides medication or therapy, that means practicing healthy habits associated with better moods.
Healthy living is an important part of self-care, Manevitz says. For example, when you eat right, brain cells get appropriate nutrition so “the brain works at its maximum,” he explains. And exercise releases endorphins, brain chemicals that act as natural antidepressants.
Here are 10 lifestyle changes that can keep you feeling your best.
1. Lose the booze.
People with chronic depression sometimes use alcohol to self-medicate.
Drinking releases neurotransmitters that may make you feel better, but only temporarily. And as you develop a tolerance, you need larger amounts, and then it becomes even more of a depressant on your central nervous system, Manevitz says.
If you’re taking antidepressants, alcohol can also increase their side effects, making you drowsy, more intoxicated than usual, or in some cases, causing a blood pressure spike that could lead to a stroke, according to the Mayo Clinic.
2. Work up a sweat.
Exercise is great for mental well-being, says Jasper Smits, Ph.D., director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas.
It can head off a recurrence of mild to moderate depression, or help you overcome an episode, according to his team’s research.
With severe depression, exercise can augment traditional treatments, including psychotherapy or antidepressant medication, adds Smits, co-author of Exercise for Mood and Anxiety: Proven Strategies for Overcoming Depression and Enhancing Well-Being (Oxford University Press).
Researchers are still determining how physical activity helps, but evidence suggests it may act as a form of behavioral activation, a depression treatment strategy that encourages people to be productive rather than inactive.
“If you’ve been productive, your mood improves,” Smits says.
Smits recommends aiming for the government’s physical-activity recommendations: 150 minutes per week of moderately intense movement (brisk walking, water aerobics, gardening); 75 minutes of vigorous activity (jumping rope, running, hiking); or a combination of the two.
Multiple studies have found benefits from doing 20-60 minutes of exercise per session, so aim for at least 20 minutes. But if you’re new to exercise or short on time, that doesn’t mean you should skip it.
“Even a 10-minute walk has short-term positive effects on mood,” Smits says.
3. Eat like a Spaniard.
Closely following a Mediterranean diet is strongly associated with lower depression risk, according to a 2009 Spanish study published in the Archives of General Psychiatry.
Researchers speculate that the diet’s heart-healthy benefits – reducing inflammation, improving blood vessel function and decreasing the risk of metabolic syndrome – may play a role in keeping the brain fit.
Mediterranean-style eating is simple: When you’re grocery shopping, fill your cart with fresh fruits and vegetables, whole grains, olive oil, beans, fish, poultry, nuts and low-fat dairy. Meanwhile, cut back on refined carbs, fatty meats and highly processed foods.
4. Get your zzz’s.
It’s no surprise that too little rest can worsen your mood, but depression itself can keep you from sleeping through the night, according to the National Sleep Foundation.
The connection between the conditions is significant: People with regular insomnia are nearly 10 times more likely to have significant depression, and 17 times more likely to develop anxiety, according to a 2005 University of North Texas study.
If you’re having trouble sleeping – whether or not you’re currently depressed – talk to your doctor or a sleep expert so you can get the 7-9 hours you need.
5. Get more vitamin D.
Low levels of vitamin D have long been linked to depression. And research is ongoing about whether the fat-soluble vitamin can improve rates of seasonal affective disorder (SAD), or winter depression.
SAD hits when days get shorter and there’s less sunlight, our prime natural source of vitamin D. But we don’t always get enough of the vitamin in summer, either, because the sunscreen we slather on to protect against skin cancer blocks D-producing rays.
It’s also hard to get the amount of D we need from food. Only certain fish (salmon, sardines, tuna, mackerel and cod), D-fortified milk and a few other foods contain much of this important nutrient.
How much do you need? Expert opinions vary. Government recommendations suggest 200 international units (IU) per day until age 50, 400 IU between 51 and 70, and 600 IU after that.
But some researchers recommend considerably more. Vitamin D expert Michael F. Holick, M.D., Ph.D., professor of medicine, molecular medicine physiology and biophysics at Boston University Medical Center, thinks adults actually need closer to 1,500-2,000 IU of vitamin D per day.
Since one 8-ounce glass of milk only has about 100 IU, your best bet is taking a multivitamin or vitamin D supplement.
Read more about this and other supplements in 4 Natural Mood-Boosters: Do They Work?
6. Embrace your inner yogi.
Yoga relaxes you, but does it fight depression? Researchers at Boston University School of Medicine think it could. And the more you practice, the better off you may be.
In their study, published in the Journal of Alternative and Complementary Medicine in 2007, participants spent three hours a week either walking or practicing Iyengar yoga, a form of hatha yoga that uses blocks, belts and other props to ensure correct body alignment during postures.
Their moods and anxiety levels were measured at the start of the study and at weeks 4, 8 and 12. MRI brain scans were also done to measure levels of a neurotransmitter called gamma aminobutyric acid (GABA), low levels of which are associated with mood and anxiety disorders.
At the end of the study, the scans showed higher GABA levels in the participants who practiced yoga. (Those new to the discipline saw a 13% increase, while experienced yoga practitioners had a 27% rise.) By contrast, those who only walked had no bump in GABA levels.
According to researcher Chris Streeter, M.D., associate professor of psychiatry and neurology, yoga boosts the activity of the parasympathetic nervous system, which is associated with rest and rejuvenation.
So why didn’t walking offer the same benefits? In this study, participants were limited to ambling around the periphery of a gymnasium. Walking outside or walking faster could make it a more effective mood booster, Streeter says.
The key to getting the most out of any workout is to choose a physical activity you like and do it in a setting you’ll enjoy, she adds.
7. Just say om.
People who practiced transcendental meditation (TM), a form of “mantra meditation” in which you mentally repeat a sound, had fewer depression symptoms than those who didn’t, according to researchers who presented two studies at a 2010 meeting of the Society of Behavioral Medicine.
In fact, participants with clinically significant depression who meditated twice a day for a year had an average 48% reduction in symptoms.
Not only does TM decrease psychological stress, it may also reduce a person’s reactions to environmental stress and reduce the amount of brooding about problems, says lead study author Sanford Nidich, Ed.D., senior researcher at the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa.
It may also have a positive effect on serotonin, the brain’s feel-good chemical, Nidich adds.
You don’t need to join a particular group to learn healthy meditation techniques – just read How to Meditate to get started.
8. Keep your cool.
Too much mental stress can harm your ability to maintain a steady mood. But stress overload varies by person – some can't function outside a calm environment, while others may do fine in stressful situations.
For example, “some people thrive as a fireman or ER doctor,” Manevitz says. “Others get so stressed out they’re vulnerable to depression.”
His solution? Balance your life based on the amount and kinds of stress you can handle. “You need to know what your abilities and trigger points are.”
9. Kick the habit.
Here’s another reason to put away that pack: Women who smoke have a greater risk of developing major depression than non-smokers, according to a 10-year Australian study published in 2008 in the British Journal of Psychiatry.
Among heavy smokers – those who smoked more than 20 cigarettes per day – the depression risk was more than double that of non-smokers: 15% of the smokers studied went on to develop major depression, while only 6.5% of the non-smokers did.
Smoking can be another way of self-medicating for a depressed mood, so ask your doctor or therapist to help you quit. Click here for tips to quit smoking.
10. Build a support system.
People who care about you can help you through tough times, and that includes mental illnesses.
In fact, a 2005 study published in the American Journal of Psychiatry reported that women who feel more loved and have more support from friends and family members face lower risk for major depression.
If you have a tendency to isolate yourself, make an extra effort to spend time with friends and family. Support groups, social clubs and interest-based organizations can also help bring you out of your shell.
Learn more about managing your moods in our Depression Health Center.
How Much Do You Know About Depression?
Depression is an extremely disabling disorder. Despite all the progress in diagnosing and treating this disease, many people still are in the dark when it comes to understanding depression.
Dosing for Vitamin B12
Question: What is the lowest dosage of vitamin B12 you recommend? If shots are not available, do you recommend B12 tablets?
Dr. Brownstein's Answer:
Injectable B12 works much better than oral doses. However, if you can’t get a doctor to prescribe the natural, injectable form of B12, then oral dosing is a reasonable alternative.
I recommend using either hydroxyl- or methyl-cobalamin for oral dosing, and I suggest using it sublingually (under the tongue). The usual dosing is 1,000 to 2,000 mcg per day (1 to 2 mg per day).
Vitamin B12 deficiency, which is common among people older than 50 and those with chronic illnesses, can cause or mimic many health woes including almost any neurological problem, such as depression, fatigue, brain fog, confusion, neuropathy, Alzheimer’s disease, multiple sclerosis, fibromyalgia, chronic fatigue syndrome, and Parkinson’s disease. More information about vitamin B12 can be found in the March 2009 issue of my newsletter "Natural Way to Health."
Dr. Brownstein's Answer:
Injectable B12 works much better than oral doses. However, if you can’t get a doctor to prescribe the natural, injectable form of B12, then oral dosing is a reasonable alternative.
I recommend using either hydroxyl- or methyl-cobalamin for oral dosing, and I suggest using it sublingually (under the tongue). The usual dosing is 1,000 to 2,000 mcg per day (1 to 2 mg per day).
Vitamin B12 deficiency, which is common among people older than 50 and those with chronic illnesses, can cause or mimic many health woes including almost any neurological problem, such as depression, fatigue, brain fog, confusion, neuropathy, Alzheimer’s disease, multiple sclerosis, fibromyalgia, chronic fatigue syndrome, and Parkinson’s disease. More information about vitamin B12 can be found in the March 2009 issue of my newsletter "Natural Way to Health."
Friday, October 28, 2011
FUN FACTS
* 20 minutes after smoking a cigarette, blood pressure drops to normal. *
* Smoking while pregnant increases the chances of spontaneous abortions (miscarriages) stillbirths and premature labor. *
* Smokers get ten times more wrinkles than non-smokers. *
* Cigarette smoke contains 4,800 chemicals, 69 of which cause cancer. *
* A human being loses an average of 40 to 100 strands of hair a day. *
* A person can live without food for about a month, but only about a week without water. *
* Smoking while pregnant increases the chances of spontaneous abortions (miscarriages) stillbirths and premature labor. *
* Smokers get ten times more wrinkles than non-smokers. *
* Cigarette smoke contains 4,800 chemicals, 69 of which cause cancer. *
* A human being loses an average of 40 to 100 strands of hair a day. *
* A person can live without food for about a month, but only about a week without water. *
'Muffin Test' Helps Diagnose Diabetes
Giving a "muffin test" to people at risk for diabetes might help doctors diagnose the disease and its warning signs, according to a new study.
Tests for diabetes and its precursor, impaired glucose tolerance, check how well the body uses glucose, a type of sugar.
In one common test, called an oral glucose tolerance test, a person fasts overnight and then drinks a sugary solution while doctors monitor how the body reacts and how much sugar sticks around in the blood.
Researchers behind the new report wondered if people might prefer munching on a muffin to downing the glucose drink — and if a muffin test would give doctors a better idea of how the body deals with real food.
"Women really hate to get tested" with the oral glucose tolerance test, said Dr. Michael Traub of the Albert Einstein College of Medicine in Bronx, New York, who worked on the study.
"It's really not such a pleasant test," he told Reuters Health, adding that many people often feel ill from the drink.
"A muffin more closely resembles what someone really eats — it may just provide a more adequate test."
The findings suggest the muffin test was able to diagnose women with impaired glucose tolerance, and was cheaper than the standard sugar drink. But a diabetes researcher not involved in the study wondered if doctors really need a baked-good test — and how convenient it would be in the first place.
Muffins are different everywhere, said Dr. William Herman, director of the Michigan Diabetes Research and Training Center in Ann Arbor — whereas doctors know exactly what's in the glucose drink and can judge how each person responds equally.
"Getting a standardized muffin across the United States and across the world I think would be challenging," Herman told Reuters Health.
Using a glucose drink, he said, is "probably more convenient. Glucose solutions have a longer shelf-life. We know exactly what's in them."
The current study involved 73 women in their 40s and 50s. After an overnight fast, the women were given a muffin from a local bakery — one of a variety of flavors, including chocolate chip, corn, and blueberry. Two hours later, Traub and his colleagues measured the amount of glucose in their blood to determine how well the body had used sugar in the baked goods.
A smaller group of 12 women also had a standard oral glucose tolerance test involving the sugary solution.
According to the muffin test, eight of the 73 women had impaired glucose tolerance — and more than half of those would have been missed by a regular blood test done after fasting, researchers reported in Menopause.
The muffin test diagnosed two women in the 12-person group with the early signs of diabetes. One of those was also spotted by the oral glucose tolerance test.
Traub and his colleagues said a muffin, which costs about $1, is cheaper than a $5 bottle of glucose solution, and it also didn't seem to give any women stomach problems, like the solution sometimes does.
And he said that even with reasonable variations in muffin type from place to place, the test would likely give consistent results — but that larger studies are needed to show that's the case.
Still, Herman had his doubts as to the usefulness of a muffin test.
"I just think that we have more standardized testing techniques now, and I think debating how to test and whether we should use muffins or cookies or jelly beans is sort of diverting attention from the fact that people should be tested and treated if they have this," he said.
"There still is a lot of undiagnosed diabetes and glucose intolerance out there. It is important to identify people with glucose intolerance."
Treating people with early blood sugar problems with drugs or advising weight loss and physical activity can help delay or prevent full-on diabetes, he added.
Tests for diabetes and its precursor, impaired glucose tolerance, check how well the body uses glucose, a type of sugar.
In one common test, called an oral glucose tolerance test, a person fasts overnight and then drinks a sugary solution while doctors monitor how the body reacts and how much sugar sticks around in the blood.
Researchers behind the new report wondered if people might prefer munching on a muffin to downing the glucose drink — and if a muffin test would give doctors a better idea of how the body deals with real food.
"Women really hate to get tested" with the oral glucose tolerance test, said Dr. Michael Traub of the Albert Einstein College of Medicine in Bronx, New York, who worked on the study.
"It's really not such a pleasant test," he told Reuters Health, adding that many people often feel ill from the drink.
"A muffin more closely resembles what someone really eats — it may just provide a more adequate test."
The findings suggest the muffin test was able to diagnose women with impaired glucose tolerance, and was cheaper than the standard sugar drink. But a diabetes researcher not involved in the study wondered if doctors really need a baked-good test — and how convenient it would be in the first place.
Muffins are different everywhere, said Dr. William Herman, director of the Michigan Diabetes Research and Training Center in Ann Arbor — whereas doctors know exactly what's in the glucose drink and can judge how each person responds equally.
"Getting a standardized muffin across the United States and across the world I think would be challenging," Herman told Reuters Health.
Using a glucose drink, he said, is "probably more convenient. Glucose solutions have a longer shelf-life. We know exactly what's in them."
The current study involved 73 women in their 40s and 50s. After an overnight fast, the women were given a muffin from a local bakery — one of a variety of flavors, including chocolate chip, corn, and blueberry. Two hours later, Traub and his colleagues measured the amount of glucose in their blood to determine how well the body had used sugar in the baked goods.
A smaller group of 12 women also had a standard oral glucose tolerance test involving the sugary solution.
According to the muffin test, eight of the 73 women had impaired glucose tolerance — and more than half of those would have been missed by a regular blood test done after fasting, researchers reported in Menopause.
The muffin test diagnosed two women in the 12-person group with the early signs of diabetes. One of those was also spotted by the oral glucose tolerance test.
Traub and his colleagues said a muffin, which costs about $1, is cheaper than a $5 bottle of glucose solution, and it also didn't seem to give any women stomach problems, like the solution sometimes does.
And he said that even with reasonable variations in muffin type from place to place, the test would likely give consistent results — but that larger studies are needed to show that's the case.
Still, Herman had his doubts as to the usefulness of a muffin test.
"I just think that we have more standardized testing techniques now, and I think debating how to test and whether we should use muffins or cookies or jelly beans is sort of diverting attention from the fact that people should be tested and treated if they have this," he said.
"There still is a lot of undiagnosed diabetes and glucose intolerance out there. It is important to identify people with glucose intolerance."
Treating people with early blood sugar problems with drugs or advising weight loss and physical activity can help delay or prevent full-on diabetes, he added.
Insomnia Linked to Higher Heart Risk
As if you didn't have enough to worry about during those sleepless nights, a Norwegian study suggests that people with insomnia face a 27 to 45 percent higher risk of heart attack.
About one-third of people report having trouble sleeping and should see a doctor for help, urged the authors of the study published in Circulation, a journal of the American Heart Association.
"Sleep problems are common and fairly easy to treat," said Lars Erik Laugsand, lead researcher from the Norwegian University of Science and Technology Department of Public Health in Trondheim.
"So it's important that people are aware of this connection between insomnia and heart attack and talk to their doctor if they're having symptoms."
The data came from 52,610 Norwegian adults who answered a national survey about their insomnia symptoms in 1995-97.
Over the next 11 years, researchers identified 2,368 people who had their first heart attacks, via hospital records and Norway's National Cause of Death Registry.
After adjusting for factors such as age, sex, marital status, education level, blood pressure, cholesterol, diabetes, weight, exercise, shift work, depression, and anxiety, researchers found the highest boost in risk among the most troubled sleepers.
When they compared data from people who said they usually slept fine to people who said they had trouble falling asleep almost daily over the course of the last month, they saw a 45 percent higher risk in the sleepless group.
Those who said they could fall asleep but not stay asleep all night showed a 30 percent higher risk of heart attack than the group that slept well.
And those who said they did not wake up feeling refreshed showed a 27 percent higher risk.
The researchers did not adjust their data for obstructive sleep apnea, a condition that arises when air flow is interrupted during sleep, and cautioned that particular sleep patterns among the Norwegian sample may not make the data immediately applicable to other populations.
However, similar links between insomnia and cardiovascular disease have been suggested in previous studies on U.S. populations.
"It is becoming increasingly evident that insomnia is a significant modifiable risk factor for cardiovascular disease," said Girardin Jean-Louis, an associate professor in the Department of Medicine at SUNY Downstate Medical Center, who was not involved in the study.
Jean-Louis said more research was needed, but noted that some sleep conditions like short sleep and obstructive sleep apnea bear two of the same biomarkers as cardiovascular disease — C-reactive protein and interleukin-6 — which are proteins linked to inflammation.
The body's regulatory cycle for sleeping and wakefulness, known as circadian rhythms, could also play a role, according to Edward Fisher, professor of cardiovascular medicine at New York University.
"It is known that animals with disrupted circadian rhythms develop metabolic changes that, if they occurred in people, would increase heart disease risk," said Fisher, who also was not a part of the study.
"Overall, independent of the exact mechanism, the association shown seems plausible, and is yet another reason to do as the authors advise — seek professional help for better sleep," he added.
"Besides improving the general quality of life, it might even provide cardiovascular benefits."
About one-third of people report having trouble sleeping and should see a doctor for help, urged the authors of the study published in Circulation, a journal of the American Heart Association.
"Sleep problems are common and fairly easy to treat," said Lars Erik Laugsand, lead researcher from the Norwegian University of Science and Technology Department of Public Health in Trondheim.
"So it's important that people are aware of this connection between insomnia and heart attack and talk to their doctor if they're having symptoms."
The data came from 52,610 Norwegian adults who answered a national survey about their insomnia symptoms in 1995-97.
Over the next 11 years, researchers identified 2,368 people who had their first heart attacks, via hospital records and Norway's National Cause of Death Registry.
After adjusting for factors such as age, sex, marital status, education level, blood pressure, cholesterol, diabetes, weight, exercise, shift work, depression, and anxiety, researchers found the highest boost in risk among the most troubled sleepers.
When they compared data from people who said they usually slept fine to people who said they had trouble falling asleep almost daily over the course of the last month, they saw a 45 percent higher risk in the sleepless group.
Those who said they could fall asleep but not stay asleep all night showed a 30 percent higher risk of heart attack than the group that slept well.
And those who said they did not wake up feeling refreshed showed a 27 percent higher risk.
The researchers did not adjust their data for obstructive sleep apnea, a condition that arises when air flow is interrupted during sleep, and cautioned that particular sleep patterns among the Norwegian sample may not make the data immediately applicable to other populations.
However, similar links between insomnia and cardiovascular disease have been suggested in previous studies on U.S. populations.
"It is becoming increasingly evident that insomnia is a significant modifiable risk factor for cardiovascular disease," said Girardin Jean-Louis, an associate professor in the Department of Medicine at SUNY Downstate Medical Center, who was not involved in the study.
Jean-Louis said more research was needed, but noted that some sleep conditions like short sleep and obstructive sleep apnea bear two of the same biomarkers as cardiovascular disease — C-reactive protein and interleukin-6 — which are proteins linked to inflammation.
The body's regulatory cycle for sleeping and wakefulness, known as circadian rhythms, could also play a role, according to Edward Fisher, professor of cardiovascular medicine at New York University.
"It is known that animals with disrupted circadian rhythms develop metabolic changes that, if they occurred in people, would increase heart disease risk," said Fisher, who also was not a part of the study.
"Overall, independent of the exact mechanism, the association shown seems plausible, and is yet another reason to do as the authors advise — seek professional help for better sleep," he added.
"Besides improving the general quality of life, it might even provide cardiovascular benefits."
Cholesterol Expert Q&A - TOP CARDIOLOGIST ANSWERS YOUR CHOLESTEROL QUESTIONS
Does high cholesterol alone mean you’ll develop heart disease? Is there an ideal cholesterol reading? A top cardiologist answers some common questions about cholesterol levels and shares details about some exciting new treatments on the horizon. Plus, find out how well you understand cholesterol with our quiz...
Is cholesterol as bad as many of us think?
It’s linked to heart disease: People with high total cholesterol– one of every six adults in the U.S. –run twice the risk of heart disease as those with optimal levels, according to the U.S. Centers for Disease Control and Prevention. But is cholesterol solely to blame?
And does a high cholesterol level automatically equal heart disease?
We spoke to cardiologist Prediman K. Shah, M.D., director of the cardiology division at Cedars-Sinai Heart Institute and Medical Center in Los Angeles, to get answers– as well as learn about promising research that may give high cholesterol levels the boot for good.
Some people claim cholesterol isn’t linked to heart disease. Can you shed some light on this?
There’s absolutely no question that cholesterol is linked to heart disease. Research clearly shows that cholesterol leads to formation of plaque, the substance the blocks the arteries. Without cholesterol, you can’t get arterial blockage. But cholesterol alone is not the cause of heart disease.
Something else besides a high cholesterol level creates heart disease?
Yes. Some people have high cholesterol and never have plaque. Some people with average cholesterol will have extreme plaque.
Besides cholesterol, inflammation also produces the plaque that builds up in arteries and contributes to heart disease. Without inflammation, cholesterol doesn’t convert into plaque.
People differ in terms of susceptibility to inflammation, which affects their likelihood of developing plaque and heart disease. So cholesterol causes arterial blockage, but not by itself.
What do we know about the inflammation process then?
A certain type of cholesterol – LDL, the so-called bad cholesterol– is implicated in inflammation. When LDL cholesterol gets trapped in an artery, it oxidizes – that is, converts to an irritant. This irritant causes inflammation, which contributes to thickening of the arterial wall and more cholesterol deposits and plaque formation.
Compelling research shows that if we eliminate certain inflammation genes in a mouse with high cholesterol levels between 1,000 and 2,000 [mg/dL], very little plaque develops in the arterial walls. So inflammation is necessary to transform high cholesterol into plaque. We can’t do those same studies in humans, but we believe it’s a similar process.
Are the same genes that prompt other types of inflammation – arthritic inflammation, for example – also responsible for inflammation in arteries?
Some genes involved in inflammation in the heart are common to other diseases, and some are very specific to the arterial wall.
People generally think bad LDL cholesterol should be below 100 and the good HDL should be 60 and above. What is an ideal cholesterol reading?
It’s actually a little complicated. Those are good guidelines, but what is ideal for you may be bad for me. No two people with the same cholesterol levels will have the same degree of plaque.
My body might respond with an inflammatory response to lower cholesterol levels . If you have a less responsive inflammatory system, you might escape heart disease, despite having higher cholesterol. So there’s a lot of individual variability.
How can you find out how responsive (or not) your inflammatory system is? Is there a test?
Unfortunately, there is not a test to find out if you are a plaque-former or not. But a CT scan of the heart and an ultrasound of carotid arteries are very useful tools.
If you’re over 60 years old with elevated cholesterol, yet a CT scan of the heart and an ultrasound of the carotid arteries show you’re free of plaque, we know something is protecting you.
If your grandparents or parents didn’t suffer from heart disease, are you free and clear?
No, not at all. Children don’t automatically inherit the blunting effect.
If someone is 60-plus and you find through imaging they don’t have high cholesterol levels, what then?
I tell them there’s no need to take medication, but they should still follow a heart-healthy lifestyle.
Should everyone have a CT scan of the heart and ultrasound of the carotid arteries to determine if they should take medication?
No, that’s not necessary. You have to consider the risk profile. If a patient is ultra-low risk, I wouldn’t do imaging or give medication. And if the patient is ultra-high [risk], I’d just prescribe medication regardless. It’s really the in-between people with whom we use imaging.
I helped develop the SHAPE [Screening for Heart Attack Prevention and Eradication] guidelines that clarify this. These were guidelines recommended to the public in 2006. At that time, they were not widely accepted. But now, the American Heart Association and others are also recommending imaging for intermediate-risk patients.
Why wouldn’t everyone want these tests to check for high cholesterol levels, though? Are they risky or expensive?
The test is not expensive anymore. At Cedars-Sinai, it’s less than $200.There is some degree of radiation involved, though.
You don’t want to do anything with radiation willy-nilly. You want to use it only in people who are most likely to benefit. That said, the level of radiation is actually coming down, because technology is always getting better.
Can you explain the risk categories for cardiac disease?
Ultra low is someone with no family history of cardiac disease, LDL below 100, normal HDL, no diabetes, no high blood pressure, doesn’t smoke, is physically active and isn’t obese. If, under these circumstances, you have cholesterol clog an artery, it’s like lightning striking – extremely rare.
High risk would be somebody who is a smoker, diabetic, has high cholesterol levels, is obese and has high blood pressure. The vast majority of these people will automatically be prescribed medication [to lower their cholesterol].
But in between is a very large group. That’s where we can use imaging to decide whom to treat aggressively with medication and who doesn’t need it.
When you’re considering cholesterol-lowering medication, cost is not the only factor. You’re also considering a lifelong treatment of drugs that do carry some side effects.
What kind of side effects?
The most common side effects of statins include muscle aches and muscle weakness. One of 10 people who take statins will have muscle soreness or stiffness. This side effect usually goes away if you change medication or dose. But there are some reports of neuro-muscular side effects persisting years after drug cessation.
People always worry about liver damage, but fewer than one of 1,000 will experience any negative side effects that have to do with the liver.
Still, statins are the most effective treatment to lower LDL cholesterol. Research backs up the claim that lowering cholesterol reduces cardiac risk, but statins haven’t eliminated heart attacks and strokes. And not everyone can take them.
People on immuno-suppressants and antiretroviral medications, for example, have to be careful because there could be a drug-to-drug interaction. People with liver disease also can’t take them.
Recently, the National Institutes of Health halted a study that was testing statins to lower LDL, along with niacin to raise HDL. Apparently the treatment for high cholesterol levels wasn’t working and even perhaps may slightly increase stroke risk. Are you concerned about this common practice of doctors combining niacin with a statin?
We shouldn’t jump on the bandwagon of demonizing this treatment quite yet. I’ve been a big prescriber of niacin [with a statin] because all prior data was supportive. So I was a bit puzzled and surprised when the study was stopped. I would like to see the data. It will probably take a few months before we understand what happened.
You have some exciting research going on right now. Can you tell us about it?
We’re working on a number of issues related to atherosclerosis and cholesterol. One involves the concept of vaccinations against LDL cholesterol buildup. We’ve developed this vaccine over the last 15 years in collaboration with Dr. Jan Nilsson, a Swedish scientist.
LDL contains a protein called ApoB-100. There’s evidence that ApoB-100 contains the antigen to LDL cholesterol. That is, it triggers an immune response that can reduce [bad] cholesterol and plaque in arteries.
We’ve been taking antigens from ApoB-100, making synthetic copies in the lab and using them in vaccinations to reduce inflammation and plaque in animal models. We’re hoping to complete these studies by the end of year.
How important might a cholesterol vaccine be?
It could be a game-changer. Imagine if you could vaccinate children against heart disease. It’s a possibility.
And your other cholesterol research?
The other idea is based on a mutant gene that occurs in about 40 families in Limone Sul Garda in Italy. The gene has a protein– ApoA-1 Milano– that was discovered to have a protective effect on the heart. When injected, it stops plaque formation in rabbits and mice. So it can halt and reverse plaque buildup.
A 2003 study showed the reversal of plaque in coronary arteries within five weeks of an ApoA-1 Milano protein injection. It’s a very difficult protein to produce, though. We’ve been trying three different ways, and at least one may go to human trials in the next couple of years.
Are you optimistic that vaccinations to fight high cholesterol levels may someday be widely used?
I’m cautiously optimistic.
In the meantime, what’s your advice to people regarding cholesterol?
Choose your parents wisely! There’s a genetic propensity to high cholesterol. Other than that, eat healthy and exercise. Don’t smoke. See your doctor to get your cholesterol checked. And, for now, take your statin medication if you need it.
For more information and expert advice, visit our Cholesterol Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
Is cholesterol as bad as many of us think?
It’s linked to heart disease: People with high total cholesterol– one of every six adults in the U.S. –run twice the risk of heart disease as those with optimal levels, according to the U.S. Centers for Disease Control and Prevention. But is cholesterol solely to blame?
And does a high cholesterol level automatically equal heart disease?
We spoke to cardiologist Prediman K. Shah, M.D., director of the cardiology division at Cedars-Sinai Heart Institute and Medical Center in Los Angeles, to get answers– as well as learn about promising research that may give high cholesterol levels the boot for good.
Some people claim cholesterol isn’t linked to heart disease. Can you shed some light on this?
There’s absolutely no question that cholesterol is linked to heart disease. Research clearly shows that cholesterol leads to formation of plaque, the substance the blocks the arteries. Without cholesterol, you can’t get arterial blockage. But cholesterol alone is not the cause of heart disease.
Something else besides a high cholesterol level creates heart disease?
Yes. Some people have high cholesterol and never have plaque. Some people with average cholesterol will have extreme plaque.
Besides cholesterol, inflammation also produces the plaque that builds up in arteries and contributes to heart disease. Without inflammation, cholesterol doesn’t convert into plaque.
People differ in terms of susceptibility to inflammation, which affects their likelihood of developing plaque and heart disease. So cholesterol causes arterial blockage, but not by itself.
What do we know about the inflammation process then?
A certain type of cholesterol – LDL, the so-called bad cholesterol– is implicated in inflammation. When LDL cholesterol gets trapped in an artery, it oxidizes – that is, converts to an irritant. This irritant causes inflammation, which contributes to thickening of the arterial wall and more cholesterol deposits and plaque formation.
Compelling research shows that if we eliminate certain inflammation genes in a mouse with high cholesterol levels between 1,000 and 2,000 [mg/dL], very little plaque develops in the arterial walls. So inflammation is necessary to transform high cholesterol into plaque. We can’t do those same studies in humans, but we believe it’s a similar process.
Are the same genes that prompt other types of inflammation – arthritic inflammation, for example – also responsible for inflammation in arteries?
Some genes involved in inflammation in the heart are common to other diseases, and some are very specific to the arterial wall.
People generally think bad LDL cholesterol should be below 100 and the good HDL should be 60 and above. What is an ideal cholesterol reading?
It’s actually a little complicated. Those are good guidelines, but what is ideal for you may be bad for me. No two people with the same cholesterol levels will have the same degree of plaque.
My body might respond with an inflammatory response to lower cholesterol levels . If you have a less responsive inflammatory system, you might escape heart disease, despite having higher cholesterol. So there’s a lot of individual variability.
How can you find out how responsive (or not) your inflammatory system is? Is there a test?
Unfortunately, there is not a test to find out if you are a plaque-former or not. But a CT scan of the heart and an ultrasound of carotid arteries are very useful tools.
If you’re over 60 years old with elevated cholesterol, yet a CT scan of the heart and an ultrasound of the carotid arteries show you’re free of plaque, we know something is protecting you.
If your grandparents or parents didn’t suffer from heart disease, are you free and clear?
No, not at all. Children don’t automatically inherit the blunting effect.
If someone is 60-plus and you find through imaging they don’t have high cholesterol levels, what then?
I tell them there’s no need to take medication, but they should still follow a heart-healthy lifestyle.
Should everyone have a CT scan of the heart and ultrasound of the carotid arteries to determine if they should take medication?
No, that’s not necessary. You have to consider the risk profile. If a patient is ultra-low risk, I wouldn’t do imaging or give medication. And if the patient is ultra-high [risk], I’d just prescribe medication regardless. It’s really the in-between people with whom we use imaging.
I helped develop the SHAPE [Screening for Heart Attack Prevention and Eradication] guidelines that clarify this. These were guidelines recommended to the public in 2006. At that time, they were not widely accepted. But now, the American Heart Association and others are also recommending imaging for intermediate-risk patients.
Why wouldn’t everyone want these tests to check for high cholesterol levels, though? Are they risky or expensive?
The test is not expensive anymore. At Cedars-Sinai, it’s less than $200.There is some degree of radiation involved, though.
You don’t want to do anything with radiation willy-nilly. You want to use it only in people who are most likely to benefit. That said, the level of radiation is actually coming down, because technology is always getting better.
Can you explain the risk categories for cardiac disease?
Ultra low is someone with no family history of cardiac disease, LDL below 100, normal HDL, no diabetes, no high blood pressure, doesn’t smoke, is physically active and isn’t obese. If, under these circumstances, you have cholesterol clog an artery, it’s like lightning striking – extremely rare.
High risk would be somebody who is a smoker, diabetic, has high cholesterol levels, is obese and has high blood pressure. The vast majority of these people will automatically be prescribed medication [to lower their cholesterol].
But in between is a very large group. That’s where we can use imaging to decide whom to treat aggressively with medication and who doesn’t need it.
When you’re considering cholesterol-lowering medication, cost is not the only factor. You’re also considering a lifelong treatment of drugs that do carry some side effects.
What kind of side effects?
The most common side effects of statins include muscle aches and muscle weakness. One of 10 people who take statins will have muscle soreness or stiffness. This side effect usually goes away if you change medication or dose. But there are some reports of neuro-muscular side effects persisting years after drug cessation.
People always worry about liver damage, but fewer than one of 1,000 will experience any negative side effects that have to do with the liver.
Still, statins are the most effective treatment to lower LDL cholesterol. Research backs up the claim that lowering cholesterol reduces cardiac risk, but statins haven’t eliminated heart attacks and strokes. And not everyone can take them.
People on immuno-suppressants and antiretroviral medications, for example, have to be careful because there could be a drug-to-drug interaction. People with liver disease also can’t take them.
Recently, the National Institutes of Health halted a study that was testing statins to lower LDL, along with niacin to raise HDL. Apparently the treatment for high cholesterol levels wasn’t working and even perhaps may slightly increase stroke risk. Are you concerned about this common practice of doctors combining niacin with a statin?
We shouldn’t jump on the bandwagon of demonizing this treatment quite yet. I’ve been a big prescriber of niacin [with a statin] because all prior data was supportive. So I was a bit puzzled and surprised when the study was stopped. I would like to see the data. It will probably take a few months before we understand what happened.
You have some exciting research going on right now. Can you tell us about it?
We’re working on a number of issues related to atherosclerosis and cholesterol. One involves the concept of vaccinations against LDL cholesterol buildup. We’ve developed this vaccine over the last 15 years in collaboration with Dr. Jan Nilsson, a Swedish scientist.
LDL contains a protein called ApoB-100. There’s evidence that ApoB-100 contains the antigen to LDL cholesterol. That is, it triggers an immune response that can reduce [bad] cholesterol and plaque in arteries.
We’ve been taking antigens from ApoB-100, making synthetic copies in the lab and using them in vaccinations to reduce inflammation and plaque in animal models. We’re hoping to complete these studies by the end of year.
How important might a cholesterol vaccine be?
It could be a game-changer. Imagine if you could vaccinate children against heart disease. It’s a possibility.
And your other cholesterol research?
The other idea is based on a mutant gene that occurs in about 40 families in Limone Sul Garda in Italy. The gene has a protein– ApoA-1 Milano– that was discovered to have a protective effect on the heart. When injected, it stops plaque formation in rabbits and mice. So it can halt and reverse plaque buildup.
A 2003 study showed the reversal of plaque in coronary arteries within five weeks of an ApoA-1 Milano protein injection. It’s a very difficult protein to produce, though. We’ve been trying three different ways, and at least one may go to human trials in the next couple of years.
Are you optimistic that vaccinations to fight high cholesterol levels may someday be widely used?
I’m cautiously optimistic.
In the meantime, what’s your advice to people regarding cholesterol?
Choose your parents wisely! There’s a genetic propensity to high cholesterol. Other than that, eat healthy and exercise. Don’t smoke. See your doctor to get your cholesterol checked. And, for now, take your statin medication if you need it.
For more information and expert advice, visit our Cholesterol Health Center.
How Well Do You Understand Cholesterol?
Cholesterol is much maligned, yet many people don’t understand this essential substance and how it works in our bodies. Do you know your HDL from your LDL? How about which lifestyle choices influence cholesterol levels?
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