Friday, December 26, 2008

wellness weekly

Treating Pain: The article I read for the blog is about rebound headaches and the like from over reliance or over use of pain medications in regards to treating migraines. It can be said of pain medications in general however. Many people rely on pills instead of ice, heat or physical therapy to treat pain and for some issues that can prolong the pain instead of ameliorating it. With regard to migraines there is not a lot of literature on prevention but of avoiding triggers. These can include certain foods and stress. There are medications that work to halt the migraine and though they have side effects, they are right for some people. The caution on rebound headaches, whether from over the counter or prescription meds is highest with narcotics and barbiturates. For muscle and joint pain, there is treatment outside of medications and that might be a wiser first action.
Drug Combo Dangers: Never one to overlook news on medications because I DO feel they are over used and misused, I read this week about a concern of poly pharmacotherapy with the 57-85 year old age group. (isn’t that an odd age range?) Anyway, it was found by the University of Chicago, that 50 % of that age group takes at least five medications on a daily basis. There are some medicines, especially noted in this research, that increase the risk of bleeding. Excess bleeding or thin blood can interfere with clotting. The problem is exacerbated by over the counter medications and supplements. Only 4 % of the study group did take drugs in combinations that were alarming, but if your one of them or love someone who is, the percent doesn’t matter. It is the doctors, pharmacists and patients responsibility to share information on ALL meds taken. Interestingly, one of the supplements that was taken by a large number of persons was Ginkgo biloba which we know was recently found ineffective in preventing memory loss. Taking an aspirin a day which is often recommended to persons over 50 becomes an issue when persons take supplements that also thin blood. Keep the lines of communication open, but also, try to get nutrients in your food where it is most generally considered safe. (ironically though, people on coumadin for example also have to watch what they eat).
Mega Nutrition: At the local farmer’s market last weekend I purchased a bunch of swiss chard. I also bought canned pumpkin last week and have made many dishes with both since then. I like to use the USDA nutrient website to see what is in my foods and WOW, both of these are jam packed with vitamins that can help our immune systems and our antioxidant activity. A tasty pumpkin spread I make includes plain canned pumpkin, fat free cream cheese, splenda, cinnamon and ground cloves. A delicious swiss chard side dish can be made by simply roasting the chard (stem first, leaves later) with garlic and parmesan cheese. (no cream, no oil needed). Calcium, iron, vitamin C, A, K and more can be found in abundance in the chard. (vitamin K can affect the INR of someone on coumadin). Pumpkin is great for potassium and beta carotene and vitamin A. Both of these are very low in calories, so if you remember the Volumetrics lessons, these are low density foods.
Lung Protection: I read this report of a research study with some ambivalence. The study found that a certain gene, when expressed, was protective for COPD. Chronic Obstructive Pulmonary Disease includes chronic bronchitis and emphysema. COPD is a killer and the majority who die from it are smokers. COPD can also be triggered by air pollution. The gene in question, which may also protect against lung cancer, is called Nrf2. It actually turns on other genes which do the work. The work is cleaning up the damage. This is where antioxidants can clear free radical residue and reduce inflammation and disease or as the makers of CDDO-lm hope, detoxify the harmful particulates. My concern is that people might think that this drug, once developed, could be something to take in order to keep smoking. Also, it could be used as a way to limit clear air measures by alleging to obviate them. Pollution and cigarette smoke do more than damage the lungs and I hope people do not consider this potential drug to be a panacea.
Diet Danger: Probably the things I speak out against the most are tobacco, pills and diets. An FDA alert gives me the opportunity to speak against two at once. The FDA recently reviewed some weight loss products that are for sale on the internet. These substances do not have to be approved by the FDA because they are not medications, but they have to answer to the FDA if they are caught doing inappropriate things, such as having medications in them and or causing adverse health events. The companies have restrictions on what they can advertise as well. Some products reviewed are contaminated, some have cancer causing agents in them and some have medications that have been found to cause adverse health outcomes. My thought though is that people want so badly to take a pill and lose weight that they will take these unproven and often dangerous concoctions at their own peril. These same desperate persons will not eat well and move more and I do not understand why this is so.
CHF: Chronic Heart Failure kills 300,000 persons a year according to an article I read this week. I am used to telling people that smoking kills 438,000 a year and I think that is a staggering number, so too, I was shocked by the CHF number. In that article the lifestyle factors associated with CHF were noted to include being overweight and not exercising enough. It is the end of the year and many people may start 2009 with a desire to improve their health and their active longevity. To do so, again I say, eat well, move more.

Happy Weekend.

Ps. My sister made an awesome Christmas meal for us and our dessert was fruit kabobs, with a yogurt based sauce. REALLY fresh fruit on a stick, strawberry, grapes and apples. Is that creative or what?!?

Saturday, December 20, 2008

Wellness Weekly

Time for another entry and I feel like I have not read as much about health and wellness this week or at least I have not read anything thoroughly. A few highlights or thoughts then.

Caffeine and Alcohol: Not a good idea really especially as drinks that combine them are often marketed to young adults who mistakenly think that they can consume more alcohol without having their wits affected because the caffeine makes them feel alert. And so this week MillersCoors has agreed to stop selling the drinks, called SPARKS though they deny any intent to encourage under age drinking. Or they may still sell SPARKS but change the ingredients.
Exercise and Energy: It has been said by experts and repeated by me, that exercising will actually increase your energy level. It is a hard concept to sell to people who feel tired most of the time, but lack of cardiovascular exercise could be the very cause of their lethargy. And this week we can add my anecdotal contribution to the research. I, when the gods are for me and the stars align perfectly, exercise nearly seven days a week and accumulate 40 miles of running along with a few other activities. Neither has been the case since October and besides feeling quite out of sorts (emotionally, mentally, physically and socially) I am TIRED! It especially hit me yesterday when I started out on a four mile run, my second run of the week. (the old me would have been on my third or fourth six mile run) and I felt sluggish, tired, weak. Geez I thought, you’d think I’d be refreshed but instead I was beat. I felt much better at the end of course and then got up early and rode my bike this morning as not exercising is clearly not the answer to my woes.
Smokeless Tobacco: My knowledge is growing in this area but no where near complete. Still, it helps to repeat what I read or hear so that it gets into my long term memory. And for that, I thank you faithful blog reader! So, recently it came to my attention that most oral cancer is NOT caused by smokeless tobacco products but by cigarettes. The carcinogens are in the smoke and of course the smoke does pass through the mouth on its way to the lungs where it does the most of its damage. That being said, though smoking causes oral cancer, smokeless tobacco does not cause lung cancer. There are carcinogens in chew, spit, snuff and snus but at varying levels by product. In fact, most of the tobacco available today is lower in carcinogens than the tobacco used in research which connected the product to oral cancer. Of course, there is still plenty of nicotine which may increase heart disease risk and either nicotine and or tobacco specific nitrosamines are correlated to pancreatic cancer as well. I learned at a workshop yesterday that smokeless tobacco products are not made the same way. A product called snus and originally from Sweden is a fine ground oral tobacco as is our Skoal and Copenhagen snuff . Both are called moist but made so differently. Snus are made through a pasteurization process but our products are fermented. The tobacco has to be processed this way to kill microbes. Any ways, the traditional American made product actually has more carcinogens to begin with and while the cans sit on shelves for sale more are created. I know a tobacco treatment expert who supports or at least doesn’t object to the sale and use of Snus as an alternative to smoking. He said that the absolutely worst thing a person can do is light anything and inhale it. However, smokeless tobacco products do contribute significantly to oral disease. And though tooth loss does not equate to lung cancer, it is still something that can be avoided. Also from smokeless tobacco comes gingival recession, bad breath, lesions that can become cancerous and poor oral treatment outcomes.
Sweetener Goes Mainstream: A sweetener that has been available for sale at Whole Foods for some years now and which is said to be calorie free and containing fiber, (it is made from an herb or plant), is now approved to be used as an additive. What does that mean for you? That soon sodas and perhaps foods will have this as the sugar free, calorie free sweetener instead of aspartame, saccharin or splenda. I wonder how long until someone sends an email about how Stevia will kill us. The only reason I kept using other sugar free products when I first heard about Stevia is because sold as a “sugar” it is very expensive. I wonder if this price difference will be reflected in our sodas and such. Be ready though, Pepsi and Coke have products ready and the first you may see is a new Sobe Lite.
Oatmeal: Just briefly, I see that some of our dining chains, like smoothie shops and maybe Starbucks are going to be offering oatmeal. The reason is because it is warm, filling, cheap and shouts, heart healthy. That being said, if nutrition info is available where ever you are inclined to buy this oatmeal do yourself a favor and check it out. It is very possible that your oatmeal could contain the same fat and calories as a donut by the time Starbucks gets through with it.

Okay I got a load of vegetables at the farmer’s market this morning and think I will go slice, dice and bake….

PS I asked Santa for a little camcorder and even if I happen to be the after Christmas Santa, I do think I will get one so that I can upload videos of some of my cooking techniques in the New Year.

PSS We do not gain so much wait on Thanksgiving and Christmas indulgence as we do by eating our way FROM Thanksgiving to Christmas… so slow down already.

Saturday, December 13, 2008

Wellness Weekly

Healthier Life Steps: Part of my job as a tobacco educator is to present information on treating tobacco dependence to health care providers. For many years, ten or more, there has been in place a clinical, best practice guideline for doing so. It is unfortunate that many providers are still unawares of what is referred to as the 5 As. I bring this up today because the AMA has come out with a similar strategy for identifying and addressing, let me repeat that, addressing, risk factors for disease in the patient. The four targeted behaviors are healthy eating, physical activity, reduced drinking and smoking cessation. The AMA has a survey that the patient would complete in the waiting room which the doctor and nurse could refer to during the visit. The clinical guidelines include handouts and a website. In case you are thinking that your weight or inactivity is not a problem because your doctor hasn’t mentioned it recently (or ever), this should disavow you of that notion. Instead, your health care provider may be uncomfortable addressing the issue.
Family yes, but genes or tradition? We tend to carry weights similar to that of our families, especially if we are isolated. People often assume that it is predestined, a matter of genes if you will. I wholeheartedly agree with Dr. Oz and his ilk. Genes are only about 25% of the issue. What you DO with those genes is really the determinate of weight and health in the long run. This week a research study supports that family lifestyle has at least the same impact on obesity as genes do. Individual behavior would of course have the greatest impact. In the Journal of Sociology, lead author Molly Martin stresses the importance of regular meals and physical activity as protective. A lot of times people, for fear of failure or fear of effort, accept an unhealthy weight as genetic or familial. This is a deadly acquiescence. When people point out my low weight and believe me THEY DO, I take the opportunity to promote the concept by saying, “It is NOT genetic.” It isn’t, there are some heavy people in my family.
Fish Mercury in Doubt? Long time readers are aware of my passion on this issue and my effort to stay on top of the good fish bad fish dilemma. Thus, I am perplexed about a recent headline, recent as in yesterday, regarding the FDAs stand on fish consumption. The official recommendations have not changed; the current issue is rather a political controversy with the EPA and FDA at odds with each other. Most of the mercury in fish is a consequence of coal fired power plant emissions so that makes me suspect the FDAs wavering as well. With the change in administrations approaching and clean coal and cap and trade back on the table, wouldn’t it be nice if methyl mercury didn’t hurt us after all? Fish is a good food for brain and hearts, but please do educate yourself on which fish have the highest levels of mercury and avoid them. (ps, the article I read didn’t mention coal at all, that is info I absorbed in graduate study)
Breast Cancer Test: Yesterday in Texas, a researcher reported that a gene test was more accurate in identifying women at high risk for breast cancer than the model that physicians have been using for some years. The problem is that it is one of five gene tests on the market that have not been approved by the FDA.(there is no current rule that the FDA has to vet them for efficacy) Most oncologists feel that genetic testing, especially direct to consumer, is more likely to cause fear than save lives. There is significant concern that tests like these will lead people into unnecessary surgeries and amputations. There is also concern that people will rely on tests and not take the advice that is offered for prevention of disease, including many cancers. That advice should be common knowledge to you now, but I will happily reiterate. To protect yourself, to control what you can, it is recommended by the ACS, the ALA, the AHA, the ADA, the AMA, and the DHHS, for starters, that people not use tobacco, refrain from excess alcohol use, move(their bodies) EVERY day, maintain a healthy weight and eat a low fat diet high in fiber, fruits and veggies.
Colonoscopy Alert: As I continue to dread turning fifty (ahem.. many years from now) and having to have one of these, more scary news is released. Apparently the two common bowel clearing medications prescribed to patients prior to the exam may damage the kidneys. There is a black box warning on the two sodium phosphate products and certain groups should use them with caution. One of which is people over 55, you know, the ones getting the colonoscopies. From an article regarding this, I want to point out that over the counter bowel cleansing products, (not regular laxatives) may also cause harm and may be under investigation. PLEASE do not consider bowel cleansing a safe activity. Eat more fiber and drink water. Anyways, colonoscopies can be life saving and colon cancer is a serious threat in this country. I do hope though, that this news might encourage insurance companies to promote the non invasive colon cancer screen that is available. Also note that there are other bowel cleansing products that can be prescribed or given for the colonoscopy that do not come with a black box warning.
MEDS: Ugh. I am already anti pill, and a WSJ article worth reading yourselves, only enforces my belief that we do NOT know nearly enough about the pills we take to trust them as we do. Unfortunately, those that prescribe the medications do not know the full story on whether they are effective and whether or not they are harmful either. That is not usually their fault, but the fault of drug companies who do not release ALL of their clinical data. New rules have been established and websites are in place to have all research reported but even then who is going to cull those reports and assuage our fears. I think it may be agencies like Public Citizen and Center for Science in the Public Interest. The article by Robert Lee Hotz is in yesterday’s journal. BTW, I was reading an article on a medication or treatment the other day at work and recall being really stymied by this research conclusion “it is more effective than placebo.” What does that mean, this worked better than not doing anything? Well, how MUCH better and at what cost? Saying something is better than nothing, oh and hey, could damage the kidneys, well that my friends, is a problem.
PRICES: Last note because it really pissed me off. At the store I noticed that regular highly processed snack cakes cost 1$ and the equally processed but 100 calorie kind, cost 2.50$ or 3$ for the same amount depending on brand. Food in boxes is generally not healthy, but sometimes we do want that processed sweet and right or wrong, many parents buy these snacks for their kids. Which one, especially in this economy, are they going to buy? The price difference is such bullshit.

Speaking of snacks……. I am due for one……… later…

Happy Weekend
Don’t smoke!
Eat Well
Move more

Saturday, December 6, 2008

Wellness Weekly

The Brain: I took note of a researcher’s recommendation while reading an article about the aging brain. The study was in regards to loss of attention, distraction and remembering. The science community is a bit concerned about the depth of this problem when baby boomers, as they are now, start turning 65 and older. It is expected that in the year 2050 the largest age group will be those over 65. Interesting. If they age well this could be good, though it is not expected that the majority will. My notes were that the brain can be protected if its host stimulates it with mental challenges, like learning new things or doing cross word puzzles and by exercising and eating food that is nutrient but not calorie dense. Sounds like a hell of a motivator to me.
Alcohol: Quick regurgitation here. Research states that women who have more than two drinks a day significantly increase their chance of having the type of irregular heart beat that can lead to stroke. It did not say that drinking was bad, it said that too many drinks is bad. Please recall serving sizes for alcohol. Wine is 4 ounces, beer is 12 and liquor is 1.5. Measure your drinks if you have to. Your life may depend on it. (by the way, saving your one to two drinks a day for one or two weekend days, NOT RECOMMENDED)
Tobacco and Pregnancy: I read a few things on this topic in the past week, some new, some older. First, it is a fact according to our US Surgeon General’s reports, that maternal smoking and exposure to second hand smoke can lead to low birth weight babies. It is also true by research, that low birth weight babies are 20 to 25% more likely to die in the first years of life than normal weight babies. In regards to poor birth outcomes it is also said that the mother’s weight is a factor. An overweight or obese mother has twice the chance of an adverse pregnancy outcome than an underweight mother. In regards to tobacco use again, very new research which should be tested through repetition, has shown that the adult children of mothers who smoked or who were exposed to significant amounts of second hand smoke, have artery changes indicative of heart disease. When you add that to the fact that many of those children were sedentary and overweight as well, the assertion that the generation will not live longer than the one before seems to gain credence.
Assistive Devices: The WSJ had a feature this week on devices that may make it easier for those baby boomers to age in place, in their homes, even though they may have some physical limitations as they get older. There were some interesting items and appliances in the works, however, the note I wrote regarded Moen’s special grab bars that will hold the weight of a 350 pound person. Now they would not be spending the money to make these special grab bars if they did not think there was a market for them. Pretty much I don’t know of many people who could be considered at a healthy weight if they were more than 200 pounds at any height, so that pretty much sums up a lot of our problems doesn’t it.
5210: This was explained to me in passing (ok, it wasn’t really in passing, it was while I was having my two beers and I wasn’t taking notes) so I may not get it just right. There is a right way as it is a campaign by one of our respected health and wellness agencies. The gist is that we should strive, on a daily basis, to have 5 fruits and vegetables, no more than 2 hours of screen time, at least 1 hour of physical activity and 0 sugary drinks. Pretty neat.

Happy Weekend
Don’t smoke!
Eat Well
Move more